Breastfeeding rates in US Baby-Friendly hospitals: results of a national survey.

Objectives: The objectives of this study were to analyze all available breastfeeding data from US Baby-Friendly hospitals in 2001 to determine whether breastfeeding rates at Baby-Friendly designated hospitals differed from average US national, regional, and state rates in the same year and to determine prime barriers to implementation of the Baby-Friendly Hospital Initiative.

Methods: In 2001, 32 US hospitals had Baby-Friendly designation. Using a cross-sectional design with focused interviews, this study surveyed all 29 hospitals that retained that designation in 2003.

Parental acceptance of the human papillomavirus vaccine.

We conducted focus groups and individual interviews to explore parental views on the human papillomavirus (HPV) vaccine. Parents were generally positive about the HPV vaccine. Some participants perceived their children were not at risk for acquiring HPV and questioned vaccinating young adolescents against HPV.

A content analysis of e-mail communication between primary care providers and parents.

Background: E-mail exchange between parents of patients and providers has been cited by the Institute of Medicine as an important aspect of contemporary medicine; however, we are unaware of any data describing actual exchanges.

Objective: The purpose of this study was to evaluate the content of e-mails between providers and parents of patients in pediatric primary care, as well as parent attitudes about e-mail.

Design/methods: Over a 6-week period, all e-mail exchanges between 2 primary care pediatricians and their patients' parents were evaluated and coded.

Changes in reporting of race/ethnicity, socioeconomic status, gender, and age over 10 years.

Background: The recognition of health disparities as an important aspect of US health care has led to renewed interest in the reporting of race/ethnicity and socioeconomic status (SES) in original research reports.

Purpose: To describe reporting of race/ethnicity and SES, in comparison with age and gender, and to report changes with time.

Methods: All original research articles that focused on children and asthma that were published in The Journal of the American Medical Association, The New England Journal of Medicine, Pediatrics, The Journal of Pediatrics, and Archives of Pediatrics and Adolescent Medicine were reviewed for 2 time periods, 1991-1993 and 2000-2002.

School nursing services: use in an urban public school system.

Objective: To describe the quantity and type of school health services provided by nurses in Boston Public Schools.

Setting: In 2001, the 63 024 students enrolled predominantly belonged to minority groups (48% black, 28% Hispanic, and 9% Asian) and were eligible for a free or reduced-price lunch (71%).

Main Outcome Measure: Analysis of the 2001-2002 Boston Public Schools Health Services database.

Pediatric resident education about medical errors.

Background: National organizations have called for patient safety curricula to help reduce the incidence of errors. Little is known about what trainees are taught about medical errors.

Objective: 1) To determine the amount and type of training that pediatric residents have about medical errors and 2) to assess pediatric chief resident knowledge about medical errors.

The views of U.S. medical school deans toward academic primary care.

Purpose: To understand the views of U.S. medical school deans about their primary care faculties.

A call for outcomes research in medical education.

The primary goal of medical education is to produce physicians who deliver high-quality health care. Recent calls for greater accountability in medical education and the development of outcomes research methodologies should encourage a new research effort to examine the effects of medical training upon clinical outcomes. The authors offer a research agenda that links medical education and quality of health care and give specific examples of potential research projects that would begin to examine that relationship.

Daily multivitamins with iron to prevent anemia in high-risk infants: a randomized clinical trial.

Objective: The goal of this study was to assess the effectiveness of multivitamins with iron as prophylaxis against iron deficiency and anemia in infancy.

Methods: The study was a double-blinded, randomized, pragmatic, clinical trial conducted at 3 urban primary care clinics. Subjects included healthy, full-term infants who were enrolled at their 6-month well-child visit.

Breastfeeding information in pediatric textbooks needs improvement.

The objective of this study is to determine if breastfeeding information in general pediatric textbooks used in the United States is accurate and up-to-date. Seven pediatric textbooks published between 1999 and 2002 were reviewed. Three reviewers examined breastfeeding content in each text independently.

Use of an electronic medical record improves the quality of urban pediatric primary care.

Objective: To evaluate the quality of pediatric primary care, including preventive services, before and after the introduction of an electronic medical record (EMR) developed for use in an urban pediatric primary care center.

Methods: A pre-postintervention analysis was used in the study. The intervention was a pediatric EMR.

What is the system of care for abused and neglected children in children's institutions?

Objectives: The objectives of this study were to describe the number of children with suspected abuse or neglect (CAN) cared for in selected children's hospitals, to determine how they are tracked and followed, and to better describe the composition, function, and financial support of child protection teams (CPTs).

Methods: A self-administered survey was mailed to child abuse contact leaders at institutions that were members of the National Association of Children's Hospitals and Related Institutions in 2001. Responses from rehabilitation hospitals and those that did not indicate whether a CPT was present were excluded.

Women's health after pregnancy and child outcomes at age 3 years: a prospective cohort study.

Objectives: This study examined the persistence and comorbidity of women's physical and mental health conditions after pregnancy and the association of these conditions with child outcomes.

Methods: A national cohort of women who recently gave birth were surveyed in 1988 and again in 1991. We examined longitudinal data on maternal poor physical health, depressive symptoms, and smoking, and maternal report of child outcomes (at age approximately 3 years).

Maternal cigarette smoking, metabolic gene polymorphism, and infant birth weight.

Context: Little is known about genetic susceptibility to cigarette smoke in relation to adverse pregnancy outcomes.

Objective: To investigate whether the association between maternal cigarette smoking and infant birth weight differs by polymorphisms of 2 maternal metabolic genes: CYP1A1 and GSTT1.

Design, Setting, And Participants: Case-control study conducted in 1998-2000 among 741 mothers (174 ever smokers and 567 never smokers) who delivered singleton live births at Boston Medical Center.

Impact of site of care, race, and Hispanic ethnicity on medication use for childhood asthma.

Objective: To understand the importance of source of care and other factors that influence differences in asthma medication use by race and Hispanic ethnicity.

Methods: The Childhood Asthma Severity Study provided 12-month, retrospective, parent-reported questionnaire data on a monthly basis for children ages View Article and Find Full Text PDF

Metered-dose inhaler: the emergency department orphan.

Objective: Physicians providing emergency department care to children primarily use nebulizers for the delivery of bronchodilators and these physicians have misconceptions regarding the advantages and disadvantages of using metered-dose inhalers (MDIs) with a spacer (MDI + S) for acute asthma exacerbations.

Design: Self-administered mail survey.

Setting: Emergency department.

Daily multivitamins with iron to prevent anemia in infancy: a randomized clinical trial.

This study assessed the effectiveness of multivitamins (MV) with iron as prophylaxis against iron deficiency (ID) and anemia in infancy. The study was a double-blind, randomized trial at 2 urban primary care clinics. Subjects included healthy, full-term infants enrolled at their 6-month well-child visit.

Improving parent knowledge about antibiotics: a video intervention.

Objective: To determine whether an educational video could improve parent knowledge, beliefs, and behaviors about the appropriate use of oral antibiotics.

Study Design: A randomized, controlled trial was conducted in an urban primary care clinic and a suburban pediatric practice. Parents were randomly assigned to the intervention or control groups.