Directional speakers as a tool for animal vocal communication studies.

Audio playbacks are a common experimental tool in vocal communication research. However, low directionality of sound makes it hard to control the audience exposed to the stimuli. Parametric speakers offer a solution for transmitting directional audible signals by using ultrasonic carrier waves.

Life-Threatening Bleeding in Children: A Prospective Observational Study.

Objectives: The purpose of our study was to describe children with life-threatening bleeding.

Design: We conducted a prospective observational study of children with life-threatening bleeding events.

Setting: Twenty-four childrens hospitals in the United States, Canada, and Italy participated.

Accelerated Idioventricular Rhythm: A Rare Case of Wide-Complex Dysrhythmia in a Teenager.

Background: Accelerated idioventricular rhythm (AIVR) is an uncommon and typically benign dysrhythmia with similarities to more malignant forms of ventricular tachycardia (VT). It is often seen in adults after myocardial infarctions, although it also arises in the newborn period, as well as in children with and without congenital heart disease.

Case Report: We describe a presentation of AIVR in an otherwise healthy 13-year-old girl, discovered on arrival to the pediatric emergency department in the setting of post-tonsillectomy bleeding.

The Evolution of State-Based Dental Sealant Programs in Oregon Within the Context of the State Health Care Transformation Process.

Context: The 2007 Oregon Smile Survey of first, second, and third graders found that, since the first (2002) Smile Survey, all major measures of Oregon children's oral health had worsened. The Centers for Disease Control and Prevention recommends 2 interventions proven effective in preventing dental caries (cavities) in a population: community water fluoridation and school dental sealant programs. Repeated attempts at the state level to mandate water fluoridation had failed.

Increasing Community Resilience Through Improved Lifeline Infrastructure Performance.

The concept of community resilience is complex and multidimensional, relying on engineering and other disciplines to help communities break the cycle of destruction and recovery and reduce the impacts of earthquakes and other hazards. This article presents proposed prioritized actions to improve lifeline infrastructure resilience based on an assessment of lifeline infrastructure performance commissioned and funded by the National Institute of Standards and Technology (NIST).

The Medical Resuscitation Committee: Interprofessional Program Development to Optimize Care for Critically Ill Medical Patients in an Academic Pediatric Emergency Department.

Provision of optimal care to critically ill patients in a pediatric emergency department is challenging. Specific challenges include the following: (a) patient presentations are highly variable, representing the full breadth of human disease and injury, and are often unannounced; (b) care team members have highly variable experience and skills and often few meaningful opportunities to practice care delivery as a team; (c) valid data collection, for quality assurance/improvement and clinical research, is limited when relying on traditional approaches such as medical record review or self-report; (d) specific patient presentations are relatively uncommon for individual providers, providing few opportunities to establish and refine the requisite knowledge and skill; and (e) unscientific or random variation in care delivery. In the current report, we describe our efforts for the last decade to address these challenges and optimize care delivery to critically ill patients in a pediatric emergency department.

Characteristics of Pediatric Emergency Revisits After an Asthma-Related Hospitalization.

Study Objective: We identify and characterize factors related to subsequent emergency revisits among children hospitalized for asthma.

Methods: This population-based, prospective, observational cohort included children aged 2 to 16 years, hospitalized for asthma at an urban pediatric facility and followed for greater than or equal to 12 months. The primary outcome was asthma-related emergency revisit within 12 months of discharge.

Sudden Collapse of a Preschool-Aged Child on the Playground.

Purpose: Primary cardiac events are rare in children. There is little information in the literature regarding the most appropriate emergency department (ED) management of this type of pediatric patient, especially with regard to medication use.

Summary: This case highlights the pediatric ED evaluation and treatment of sudden collapse in a child with an ultimate diagnosis of hypertrophic cardiomyopathy.

Sudden Cardiac Arrest in Pediatrics.

Sudden cardiac arrest (SCA) in the pediatric population is a rare and potentially devastating occurrence. An understanding of the differential diagnosis for the etiology of the cardiac arrest allows for the most effective emergency care and provides the patient with the best possible outcome. Pediatric SCA can occur with or without prodromal symptoms and may occur during exercise or rest.

Asthma-related emergency department use: current perspectives.

Asthma is one of the most common chronic pediatric diseases. Patients with asthma often present to the emergency department for treatment for acute exacerbations. These patients may not have a primary care physician or primary care home, and thus are seeking care in the emergency department.

Pediatric spontaneous pneumothorax.

Spontaneous pneumothorax (SP) occurs when air enters the pleural space in the absence of a traumatic or iatrogenic etiology and is an uncommon phenomenon in the pediatric population. Although the typical presentation has been well described in the literature, much debate still surrounds the epidemiology, pathophysiology, diagnosis, and management of this condition in the pediatric population. To date, much of the emphasis in the pediatric literature has been on surgical options.

Moyamoya disease in an 8-year-old boy presenting with weakness.

Moyamoya disease is a progressive, unilateral, or bilateral carotid artery stenosis of unknown etiology. It often presents in children as a transient ischemic attack, with a focal neurological deficit. This case describes an 8-year-old boy who presented with left-sided weakness secondary to moyamoya vasculopathy.

The clinical impact of the presence or absence of the fifth finger flexor digitorum superficialis on grip strength.

Previous studies have determined abnormalities in the fifth small finger flexor digitorum superficialis (FDS) tendons as interconnected (common) to the fourth finger (FDS) or absent. This study examined the effect of FDS-absent and FDS-common presentations of the fifth finger on grip strength in a mixed-gender group of rehabilitation science students and faculty members from the Medical University of South Carolina. This study evaluated 171 subjects.

Functional testing: Approaches and injury management integration.

Functional Capacity Evaluations (FCEs) have become the standard for identifying an individual's physical abilities and/or limitations following injury or illness. While philosophies and approaches differ, the focus of most FCE systems is to identify the individual's maximum capabilities. This article will discuss the usefulness of the FCE information and how FCEs are impacted by multiple factors including APTA guidelines, machine based testing, therapist expertise, medical legal credibility and court testimony, IMEs and FCE, and return to work/return to function.

Process improvement plan for the reduction of sternal surgical site infections among patients undergoing coronary artery bypass graft surgery.

In an attempt to reduce sternal infections caused by Staphylococcus aureus, a protocol was introduced that included the administration of intranasal mupirocin calcium 2% before surgery to patients undergoing cardiothoracic surgery. Surveillance data indicated a 55% reduction in the rate of deep sternal wound infections caused by S aureus and superficial sternal wound infections have declined from 25 to 6 since the adoption of the protocol. At the study institution, this protocol is now an ongoing process to reduce the incidence of sternal infections caused by S aureus among cardiothoracic patients.