0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
This Month in Archives of Pediatrics and Adolescent Medicine |

This Month in Archives of Pediatrics & Adolescent Medicine FREE

Arch Pediatr Adolesc Med. 2009;163(6):503. doi:10.1001/archpediatrics.2009.89.
Text Size: A A A
Published online

EFFECT OF TELEPHONE CALLS FROM PRIMARY CARE PRACTICES AFTER PEDIATRIC EMERGENCY DEPARTMENT VISITS

One of the ways to control health care costs is to decrease inappropriate use of the emergency department (ED) and to increase use of the medical home. This randomized trial was designed to test whether a telephone call from a primary care provider to families after an ED visit would decrease subsequent ED use. The intervention unfortunately resulted in only a small, nonsignificant reduction in the number of subsequent ED visits overall, though there was a 24% reduction in the number of subsequent ED visits in adolescents. However, among subjects who had a follow-up visit, there was a 12% reduction in the number of subjects going to the ED. Brief follow-up telephone calls from practices should be further explored as a method of improving patient care and decreasing overall health care costs.

See Article

SPORTS PRACTICE AMONG ADOLESCENTS WITH CHRONIC HEALTH CONDITIONS

Physical activity is increasingly recognized as an important component of health, with effects on physical, mental, and emotional health. There are a number of factors that affect sports participation among adolescents, but one that has not been well explored is chronic health conditions. In this large study of 16- to 20-year-olds from Switzerland, males with chronic conditions were less likely to participate in sports than males without, though among females, there was no effect from having a chronic health condition. Adolescents with chronic health conditions did view this as a barrier, though not the main barrier, to sports participation; lack of time for sports was cited as a barrier for sports participation by many. Encouraging sports participation among all adolescents, including those with chronic conditions, is appropriate.

See Article

QUALITY IMPROVEMENT STRATEGIES FOR CHILDREN WITH ASTHMA: A SYSTEMATIC REVIEW

Despite clear evidence-based guidelines for the management of pediatric asthma, a significant gap remains between accepted best practices for pediatric asthma care and actual care delivered to patients in the United States. Quality improvement strategies have the potential to improve outpatient pediatric asthma care. This systematic review examined the effect of 79 different studies on asthma care and outcome. Most of the 26 self-monitoring or self-management studies found at least 1 significant improvement in outcomes in the intervention group, including reduction in the number of days with symptoms and school absenteeism. Educational interventions that were focused on parents were most likely to be associated with significant improvement in clinical outcomes. Changes in how health care is organized and delivered to children with asthma were successful in decreasing school absenteeism. The greater the number of quality improvement strategies used, the better the clinical outcomes were. The key will now be to ensure that these effective strategies are implemented.

Place holder to copy figure label and caption

Mean hospitalizations per year are decreased in the caregiver education studies. The upper panel presents the difference in the postintervention rate of hospital days per year in the intervention and control groups from the studies that used quality improvement strategies other than caregiver education. The studies to the left of 0 indicate fewer hospital days per year in the intervention group than in the control group.

Graphic Jump Location

See Article

ACCESS TO PEDIATRIC TRAUMA CARE IN THE UNITED STATES

Injury is the most common cause of death of children in the United States, and trauma center care has been shown to reduce the risk of death for severely injured patients. Timeliness of access to trauma centers is key to reducing mortality and improving outcomes. In this study, Nance and colleagues inventoried pediatric trauma centers and examined access to pediatric-specific trauma care. Overall, 71.5% of children younger than 15 years lived within 60 minutes of a pediatric trauma center by ground or air transport. However, less than 25% of children in 12 states lived within 60 minutes of a pediatric trauma center. Access was most limited in children living in the least densely populated areas of the country. More than 17 million children were found to not have timely access to pediatric trauma care.

Place holder to copy figure label and caption

Geographic representation of access within 60 minutes of a verified pediatric trauma center (PTC).

Graphic Jump Location

See Article

Figures

Place holder to copy figure label and caption

Mean hospitalizations per year are decreased in the caregiver education studies. The upper panel presents the difference in the postintervention rate of hospital days per year in the intervention and control groups from the studies that used quality improvement strategies other than caregiver education. The studies to the left of 0 indicate fewer hospital days per year in the intervention group than in the control group.

Graphic Jump Location
Place holder to copy figure label and caption

Geographic representation of access within 60 minutes of a verified pediatric trauma center (PTC).

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

134 Views
0 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs