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A 2-year-old girl sustained severe injury to 2 fingers from a home paper shredder. This case illustrates the risk of injury from paper shredders, which are increasingly common household items. Toddlers are at risk of finger injury and amputation. The US Consumer Product Safety Commission performed an investigation of reported injuries and the characteristics of paper shredders that might have contributed to the injuries, and we summarize their findings. [ABSTRACT FROM AUTHOR]

BACKGROUND. Implementation of electronic medical record systems promises significant advances in patient care, because such systems enhance readability, availability, and data quality. Structured data entry (SDE) applications can prompt for completeness, provide greater accuracy and better ordering for searching and retrieval, and permit validity checks for data quality monitoring, research, and especially decision support. A generic SDE application (OpenSDE) to support documentation of patient history and physical examination findings was developed and tailored for the domain of general pediatrics. OBJECTIVE. TO evaluate OpenSDE for its completeness, uniformity of reporting, and usability in general pediatrics. METHODS. Four (trainee) pediatricians documented data for 8 first-visit patients in the traditional, paper-based, medical record and immediately thereafter in OpenSDE (electronic record). The 32 paper records obtained served as the common data source for data entry in OpenSDE by the other 3 physicians (transcribed record). Data entered by 2 experienced users, with all patient information present in the paper record, served as the control record. Data entry times were recorded, and a questionnaire was used to assess users' experiences with OpenSDE. RESULTS. Clinicians documented 44% of all available patient information identically in the paper and electronic records. Twenty-five percent of all patient information was documented only in the paper record, and 31% was present only in the electronic record. Differences were found in patient history and physical examination documentation in the electronic record; more information was missing for patient history (38%) than for physical examination (15%). Furthermore, physical examination contained more additional information (39%) than did patient history (21%). The interobserver agreement of documentation of patient information from the same data source was fair to moderate, with [kappa] values of 0.39 for patient history and 0.40 for physical examination. Data entry times in OpenSDE decreased from 25 minutes to CONCLUSION. OpenSDE seems to be a promising application for the support of physician data entry in general pediatrics. www.pediatrics.org/cgi/doi/10.1542/ peds.2004-2741 doi:10.1542/peds.2004-2741 Key Words electronic medical record, structured data entry, pediatrics, evaluation Abbreviations EMR--electronic medical record SDE--structured data entry CI--confidence interval, SEVERAL WEAKNESSES OF paper-based medical records have been identified, such as illegible handwriting, ambiguous and incomplete data, data fragmentation, and poor availability. (1) In addition, paper records often become bulky [...]

"Computer technology was supposed to replace paper. But that hasn't happened. Every country in the Western world uses more paper today, on a per-capita basis, than it did ten years [...]

Background: Filter paper (FP) blood lead testing services have been available commercially for years. Proficiency testing services, however, and the associated regulatory standards associated with it, have not. This fact figured heavily into the Center for Disease Control & Prevention's (CDC) and some State agencies historical positions of not supporting the use of filter paper based methods in childhood lead poisoning prevention programs. In 1996, the WSLH developed a Filter Paper Proficiency Testing Pilot Program (FP PT) to address this need. Methods: Laboratories with a research and/or commercial interest in blood lead FP techniques were recruited through a variety of methods. Six such labs were identified, five in the USA and one in Canada. In the first year of the Pilot study, three of the six labs were offering the FP test commercially. A draft plan was developed, based upon the existing National Blood Lead Proficiency Testing Program administered at WSLH, published papers on the subject, and input from the participating parties. A consensus plan was adopted and in Oct 1997, the first specimens were distributed. Results: Results from the first year of the Pilot study are presented. Laboratory data were collected from the participating labs from Oct 1997 to June 1998. Three distinct assessment tools were used to measure lab performance. All measures yielded similar conclusions regarding individual lab performance. The initial two events were considered preliminary and results were poor. Later events were evaluated according to CLIA laboratory regulatory guidelines. Over the 7-month period, 35 specimens were tested by the six participants, yielding 210 individual results. Three of the six labs performed acceptably throughout the testing period. Of the individual lab results falling outside of the CLIA criteria, 85% fell below the minimum acceptable range. Performance was largely method dependent. Conclusion: An FP PT Program was developed that can assist and monitor the performance of FP blood lead laboratories. The existence of the FPPT will serve as a necessary quality assurance tool for FP labs, requiring them to conform to federal lab regulations. Performance data from the Program can also serve as an independent assessment tool for pediatricians considering utilizing FP labs in their practices. All procedures were approved by the University of Wisconsin-Madison Center for Health Sciences Human Subjects Committee and the CDC Internal Review Board, and are in accordance with the Helsinki Declarations., Jane M. Maney, MT (ASCP). University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene (WSLH), Madison, [...]

THE MASS MEDIA have the power to shape the public's perceptions of health care issues, including medical errors, and influence public policy related to such issues. Social knowledge of medications [...]

For some time now, Pediatrics has been grappling with one of the problems that every journal loves to have: a steadily increasing volume of manuscript submissions. Since 1995 computer software [...]

Presents information on a study which screened hemoglobin with alkaline electrophoresis on cellulose acetate followed by acid electrophoresis on citrate agar in New York City. Critical application of specimens to the citrate agar plates of the screening procedure; Accurate monitoring of the hemoglobin screening method; Results and discussion.

Cites the benefits of neonatal screening for cystic fibrosis. Effectiveness of presymptomatic treatment; Usefulness of neonatal screening in reproductive decision making; Characteristics of the screening tests.

"Paper enables a certain kind of thinking. Picture, for instance, the top of your desk. Chances are that you have a keyboard and a computer screen off to one side, [...]

"Why do we pile documents instead of filing them? Because piles represent the process of active, ongoing thinking. The psychologist Alison Kidd argues that 'knowledge workers' use the physical space [...]

The article discusses the author's views on the emergence of the technology for cost-efficient paperless receipts at retail stores, which he thinks would also lead to exploitation of email addresses for marketing purposes.

Argues whether or not mercury thermometers should be banned. European countries which banned the import or sale of mercury thermometers; Risk of mercury in pregnant women.

Objectives: To compare laboratory and programmatic issues in neonatal hemoglobin screening in two systems using either liquid cord blood or heel puncture blood dried on filter paper (DB) to determine the accuracy of hemoglobin phenotype; the collection rate of cord blood versus DB; and the types of and reasons for errors., Methods: Cord blood samples for 6904 newborns were analyzed by electrophoresis in a large hospital laboratory. DB samples on the same cohort were analyzed by isoelectric focusing in a state public health laboratory., Results: Interlaboratory concordance was 99.4% for 6904 matched specimen pairs, which included 27 disease and 596 carrier phenotypes. In 42 pairs, discordances for potential disease phenotypes occurred with cord blood samples. Errors involving carrier phenotypes occurred in 15 cord blood samples and 14 DB samples. Inconclusive results requiring repeat testing occurred more often in the cord blood testing system (92) than in the DB system (23). Clerical transcriptions and limitations of the techniques accounted for most laboratory errors. Noncompliance in sample collection occurred more frequently with cord blood (181) than DB (86)., Conclusions: Both systems are subject to errors, but are equally reliable for neonatal hemoglobinopathy screening.

Presents an excerpt from the article `Streetfighting scientists,' which focuses on the practice of science journalism, published in the October 1982 issue of the periodical `Working Papers for a New Society.'

This is a prepublication version of an article that has undergone peer review and been accepted for publication but is not the final version of record. This paper may be cited using the DOI and date of access. This paper may contain information that has errors in facts, figures, and statements, and will be corrected in the final published version. The journal is providing an early version of this article to expedite access to this information. The American Academy of Pediatrics, the editors, and authors are not responsible for inaccurate information and data described in this version. [ABSTRACT FROM AUTHOR]

Pediatric hematology-oncology (PHO) is 1 of the oldest recognized pediatric subspecialities. PHO physicians care for infants, children, adolescents, and young adults with all types of cancer and nonmalignant blood conditions, in many cases temporarily assuming the role of a primary care physician because of the complexity and intensity of treatment. However, the number of clinically active PHO subspecialists needed to care for children in the United States remains unknown. Recent papers suggest a potential oversaturation of PHO physicians in some geographic areas. This article is part of a Pediatrics supplement focused on projecting the future supply of the pediatric subspecialty workforce. It draws on information available in the literature, data from the American Board of Pediatrics, and findings from a new microsimulation model estimating the future supply of pediatric subspecialists through 2040. The model predicts a workforce growth in PHO subspecialists of 66% by 2040. Alternative scenarios, including changes in clinical time and fellowship size, resulted in a difference in growth of ±18% from baseline. The model also forecasts significant geographic maldistribution. For example, the current workforce is concentrated in the Northeast Census region and the model predicts the New England Census division will have a 2.9-fold higher clinical workforce equivalent per 100 000 children aged 0 to 18 years than the Mountain Census division by 2040. These findings suggest potential opportunities to improve the PHO subspecialty workforce and the outcomes and experiences of its patient population through educational changes, practice initiatives, policy interventions, and dedicated research. [ABSTRACT FROM AUTHOR]

In response to a number of emerging issues, in 2017 the federal Maternal and Child Health Bureau funded its first collaborative quality improvement network aimed at improving the quality of life for children with medical complexity, the well-being of their families and the cost-effectiveness of their care. This paper is intended as a brief introduction to the Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity or CMC CoIIN project. In it, you will learn about the origins of the project, the guiding principles used to cocreate and promote measurable, meaningful family engagement in systems-level change efforts, its goals and objectives, the impact of the coronavirus disease 2019 pandemic on the project and some high-level learnings from our experiences, which have implications for future care delivery improvements for this growing and vulnerable population of children. [ABSTRACT FROM AUTHOR]

The Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity (CMC CoIIN) was designed with a foundational commitment to partnership with family leaders to codesign and improve systems of care and supports for CMC and their families -- this fundamental commitment was essential to the CMC CoIIN's measurement strategy. In this paper, we examine key learnings from partnering with family leaders from interdisciplinary state teams in the CMC CoIIN to identify and define quantitative quality improvement measures to improve care and support for CMC and their families, including quality of life, well-being, and flourishing; unmet health needs; and support systems such as medical home, patient and family engagement, and shared plans of care. Codesigning the CMC CoIIN measurement strategy with family leaders greatly enhanced our measurement approach and provided numerous unique learning opportunities for the CMC CoIIN's project team and state teams. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Parental depression affects as many as 1 in 5 US families. Pediatric professionals can play an important role in detecting parental depression, yet most studies on parental depression screening focus only on the postpartum period. The authors performed this scoping review to understand the existing literature on parental depression screening outside the postpartum period (child >12 months old) and to identify knowledge gaps. METHODS: Sources for this research include PubMed, CINAHL, SCOPUS, Web of Science, and APA Psych Info. We included English language papers concerning screening for maternal and/or paternal depression or mood disorders outside of the postpartum period by pediatric clinicians or in a pediatric health care setting. Extracted variables included publication year, title, author(s), country, geographic setting, clinical setting, child age range (in years), parental focus, sample size, study type, approach, screening instrument(s), and findings. RESULTS: Forty-one papers were included. The proportion of positive parental depression screens was consistently high across the included studies. Relatively few structured screening programs outside of the postpartum period were identified, especially for fathers. The included studies suggest that screening can be accomplished in pediatric settings, but appropriate referral and follow-up of positive screens poses a major challenge. This review was limited to English language papers concerning parental depression outside of the postpartum period. CONCLUSIONS: These findings suggest that screening for parental depressive symptoms outside the postpartum period could identify families in need of support. Research is required to identify best practices for referral and follow-up of parents who screen positive. [ABSTRACT FROM AUTHOR]

Children with inherited and/or acquired respiratory disorders often arrive in adolescence and adulthood with diminished lung function that might have been detected and prevented had better mechanisms been available to identify and to assess progression of disease. Fortunately, advances in genetic assessments, low-cost diagnostics, and minimally- invasive novel biomarkers are being developed to detect and to treat respiratory diseases before they give rise to loss of life or lung function. This paper summarizes the Developing Biomarkers for Pulmonary Health sessions of the National Heart, Lung, and Blood Institute- sponsored 2021 Defining and Promoting Pediatric Pulmonary Health workshop. These sessions discussed genetic testing, pulse oximetry, exhaled nitric oxide, and novel biomarkers related to childhood lung diseases. [ABSTRACT FROM AUTHOR]

Healthy sleep and optimal ventilatory control begin in early development and are crucial for positive child outcomes. This paper summarizes information presented at the Sleep and Ventilatory Control sessions of the National Heart, Lung, and Blood-sponsored 2021 Defining and Promoting Pediatric Pulmonary Health workshop. These sessions focused on pediatric sleep health, screening for sleep health and sleep disorders in primary care using the electronic health record, infant sleep and ventilatory control, and home sleep testing. Throughout this summary, we discuss key gaps in and barriers to promoting sleep and ventilatory health that were identified during the workshop sessions. We conclude with strategies to address these gaps and barriers and directions for future multidisciplinary research, patient care, and training. [ABSTRACT FROM AUTHOR]

Screening neonates for methylmalonic aciduria is part of routine screening for metabolic disorders in Massachusetts. The process of urine collection by the parent and transmitted to the central screening laboratory was described in a previous publication (Pediatrics 49: 825, 1972). The primary objective of screening for methylmalonic aciduria is to detect methylmalonic acidemia, an inherited organic acid disorder. During the most recent 5 1/2-year period when the sensitive fast blue B stain was used in the analysis, four infants with methylmalonic acidemia were detected among 293,535 screened. Additional infants and children who came to attention because of clinical illness or family study also could be readily detected. Prior to this period, 325,634 neonates had been screened with the aniline-xylose method, which proved to be not sensitive enough for the identification of methylmalonic aciduria. Some affected infants have responded well to therapy and are clinically normal while two have shown poor biochemical response and are developmentally delayed. Four children in two families appear to have a benign variant of methylmalonic acidemia. Based on these studies the observed incidence of methylmalonic acidemia in Massachusetts is 1:48,000. Screening for methylmalonic aciduria may be an appropriate addition to newborn screening programs.

Presents an abstract of the study `Patient Satisfaction with Paper-Based Versus Personal Digital Assistant-Based Survey Completion,' by Kevin B. Johnson, Michele D. Wilson et al, presented at the American Academy of Pediatrics 1996 Annual Meeting on October 25-30, 1996 in Boston, Massachusetts.

OBJECTIVES: Delayed child skill development is a common phenomenon in low- and middle-income countries. Effective and low-cost strategies suitable for application to less-developed countries are needed. We summarize empirical findings from recent papers that study a replication of the Jamaica Reach Up and Learn home visiting program in China, China REACH, and compare child skill growth profiles in the China Reach Up and Jamaica interventions. METHODS: Different interventions often use different measures for assessing early childhood skill development. To estimate the growth of underlying skills across programs, we address the challenge that different programs use different assessments. We use a modified version of the Rasch model to anchor scores on common items to estimate skill development. RESULTS: Language skill growth curves are comparable for both interventions. This pattern is consistent for the treatment and control groups across the interventions. Skill growth curves are not statistically significantly different between China REACH and Jamaican interventions. We find evidence of the importance of early investment. CONCLUSIONS: The China REACH intervention significantly improves the development of multiple skills. At the same ages, treatment effect sizes and skill growth curves are comparable across the Jamaica and China REACH interventions, despite differences in scale and cultural settings. The scale of the program is much greater in China than in Jamaica, showing that the Jamaican curriculum can be effectively expanded to larger populations. Annual costs per child are roughly $500 (2015 US dollars). [ABSTRACT FROM AUTHOR]

Presents miscellaneous facts, which appeared in the December 2, 1990 issue of `The Burlington Press.' Group of engineers who have developed the intelligent toilet to monitor vital signs; Year when the first toilet paper in the United States appear; When Thomas Crapper's Valveless Waste Preventer with aromatic cedar seats was marketed.