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This article provides the results of a study utilizing baseline data from the School-Based Asthma Therapy Trial, an ongoing comprehensive school-based intervention for urban children. We examined the effect of family routines as measured by the Asthma Routines Questionnaire on asthma care measures of trigger control and medication adherence, as well as on parental quality of life. We found that families with more asthma routines had better adherence with preventive medications ( r = .36) and less exposure to environmental triggers ( r = −.22). These findings suggest that assisting families in developing routines around asthma care might improve preventive care for urban youth.

Tooth decay and poor oral health are the most common chronic health conditions in children in the United States today. This article discusses the significance of dental caries in children, the importance of oral health promotion, barriers to providing and obtaining oral health care, and current recommendations for practice. This article also recommends strategies for the promotion of optimal oral health in children and adolescents through screening, triaging, education, and tracking.

Vascular diseases can be quite grave in children. Common diseases in children that cause a generalized vasculitis include Kawasaki disease, Henoch-Schonlein purpura, and Rocky Mountain spotted fever. Rheumatic fever, though preventable, is increasing in incidence and may cause arteritis, and therefore is discussed as a vascular disease. Developmental considerations should be considered when providing adequate care. Play therapy is a crucial part of every day in a child's life, even when ill with a vascular illness. Play helps a child gain control over the stress of a serious illness and hospitalization.

Obesity in children and adolescents has become an epidemic in the United States. The ramifications of obesity at a young age are longstanding and affect physical health, emotional health, and the economics of the health care industry. The Strong Pediatric Practice at Golisano Children's Hospital is a large inner-city practice serving more than 14,000 urban children and adolescents, the majority living below the poverty level. The Obesity Task Force, which comprises four nurse practitioners, two nurses, a nutritionist, and one physician, developed and implemented the “Passport to Health” tool in an attempt to encourage providers to assess and work with families around the issues of weight and activity, a need that was identified through chart audits. The Passport to Health supports the policy statements on prevention of overweight and obesity by the Centers for Disease Control and Prevention, National Association of Pediatric Nurse Practitioners, and American Academy of Pediatrics. Quality assurance standards for managed care that mandate body mass index (BMI) assessment and nutrition counseling in all children and adolescents also is supported by this tool. The Passport to Health also provides the same message as a current community initiative in the Rochester area that has received widespread media coverage. This tool includes a visual color-coded indicator of the child's BMI status and a synopsis of specific healthy eating and activity goals, and it permits an individualized goal to be established. The Passport to Health translates information that the provider knows about the BMI status into information that the family and child can embrace and understand. Chart audits as well as exit interviews have demonstrated that use of the Passport to Health has increased the assessment, identification, and counseling by providers in relation to healthy eating and activity. Chart audits found that nurse practitioners embraced this practice change more readily than did other providers. We also found that the use of the Passport to Health has increased the involvement of the child and adolescent in discussions about weight and activity status. Recommendations to encourage future practice changes have been established and will be implemented. The changes include intensive education with providers who were less likely to utilize the Passport to Health tool. The Passport to Health could be implemented easily in any pediatric practice setting.

PURPOSE. The major purpose of this study was to explore the effect of routines on asthma management and morbidity outcomes for children with asthma and their parents. DESIGN AND METHODS. This study is a secondary data analysis in a sample of 150 children, which was originally used for an intervention study. RESULTS. Parents who had fewer routines in their homes had lower quality-of-life scores and higher burden of asthma scores when compared to parents in households with more routines. More routines were associated with improved asthma morbidity outcomes as measured by nurse rankings of routines. PRACTICE IMPLICATIONS. Assisting families to establish routines may result in improved asthma morbidity outcomes.

The burden of asthma has increased dramatically despite increased understanding of asthma and new medication regimens. Data reported here are part of a larger study investigating factors that influence parental asthma illness representation and the impact of this representation on treatment outcomes, including the parent/health care provider relationship. We investigated the influence of asthma related education provided by health care providers on these outcomes. After interviewing 228 parents of children with asthma, we found that asthma education received from the child's health care providers positively influenced parental belief systems, especially attitudes towards anti-inflammatory medications and facts about asthma. Parents who reported receiving more education also reported stronger partnerships with their child's health care provider.

Through this past decade, health care research has focused on clinical trials and establishing intervention versus control group research to improve the health of children and adolescents. Many of these clinical intervention trials have not demonstrated significantly improved health for these persons. One possible reason for the failure to demonstrate improved health is that the young persons' perspective is lacking. Focus group method of data collection is an excellent vehicle to help gain the young person's perspective on a variety of issues related to health and wellness. Including the young person's perspective when designing a program may encourage this person to participate in the new initiative, which would ultimately improve the health of children and adolescents to a greater degree than when their perspective is not taken into account. This article discusses the use of focus groups as an important part of the research process in pediatric and adolescent populations.

Introduction: Adequate treatment for asthma depends on accurate assessment and intervention by the parent and child and timely communication with the provider. These actions by the parent may be affected by their understanding of asthma management and their concerns about medications being prescribed. This research reports parental experiences with their children with asthma, specifically their beliefs, knowledge, and attitudes about asthma management, including medication use. Methods: Data reported are from a study investigating parental attitudes and beliefs affecting antiinflammatory medication use in childhood asthma. These qualitative findings emerged from one-on-one semistructured qualitative interviews with 18 parents of children 2 to 18 years of age who were from diverse racial and socioeconomic backgrounds and who represented the spectrum of illness severity. Results: Eight main themes within the domain of asthma management and medication use were identified: “I know my child,” “trial and error,” “partnership,” “need for education,” “negotiating responsibility,” “hassles with medication administration,” “preferences,” and “the benefits outweigh the risks of side effects.” Discussion: These themes emphasize parents' need to partner with providers in their child's asthma management, as well as their need for ongoing asthma education. Parents also expressed concern about adverse effects of antiinflammatory medication but acknowledged the importance of controlling asthma symptoms. Based on these findings, systematic practice changes are recommended that provide regular opportunities for parent and child asthma education in a structured asthma wellness or “tune-up” visit. J Pediatr Health Care. (2003). 17, 118-125.

Imperforate hymen is a rare occurrence in younger women resulting in hydrocolpos and hydrometrocolpos. Though imperforate hymen may be diagnosed in infancy, females ages 9-15 years most often present with the problem. Imperforate hymen usually is a congenital anomaly, but has been reported as a result of sexual abuse. This case report reviews the presentation and treatment of a 13-year-old female with imperforate hymen.

As competition within the health care field increases, marketing strategies are becoming more important for all members of the health care team, including nurse practitioners. The purpose of this research was to identify marketing strategies being used by nurse practitioners in New York state. A total of 285 practitioners responded to a survey containing questions related to marketing techniques traditionally used in the business world: service differentiation, market segmentation and practice promotion. A majority of respondents did not report using many of the marketing strategies contained in the survey, although most nurse practitioners did report identifying themselves as primary care providers in one-on-one interactions with clients. Significantly higher marketing scores were found for nurse practitioners who attended a workshop or seminar on marketing strategies, had three or more years of experience, or who practiced in private outpatient settings.