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Active surveillance: an essential tool in safeguarding the health and well-being of children and youth.

https://arctichealth.org/en/permalink/ahliterature162751
Source
CMAJ. 2007 Jul 17;177(2):169-71
Publication Type
Article
Date
Jul-17-2007
Author
Danielle Grenier
Author Affiliation
Department of Pediatrics, University of Ottawa, Ottawa, Ont. danielleg@cps.ca
Source
CMAJ. 2007 Jul 17;177(2):169-71
Date
Jul-17-2007
Language
English
Publication Type
Article
Keywords
Age Distribution
Canada - epidemiology
Child
Child Welfare
Child, Preschool
Female
Health Surveys
Humans
Incidence
Infant
Male
Pediatrics - standards - trends
Prognosis
Rickets - epidemiology - etiology - prevention & control
Risk factors
Severity of Illness Index
Sex Distribution
Vitamin D - administration & dosage
Vitamin D Deficiency - complications - diagnosis
Notes
Cites: Arch Dis Child. 2007 Jun;92(6):527-3317158859
Cites: CMAJ. 2006 Sep 12;175(6):587-9016966660
Cites: MMWR Recomm Rep. 2001 Jul 27;50(RR-13):1-35; quiz CE1-718634202
Cites: J Pediatr. 2007 Jul;151(1):79-84, 84.e117586195
Cites: CMAJ. 2007 Jul 17;177(2):161-617600035
Comment On: CMAJ. 2007 Jul 17;177(2):161-617600035
PubMed ID
17600036 View in PubMed
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A consensus-established set of important indicators of pediatric emergency department performance.

https://arctichealth.org/en/permalink/ahliterature159518
Source
Pediatr Emerg Care. 2008 Jan;24(1):9-15
Publication Type
Article
Date
Jan-2008
Author
Geoffrey R Hung
Dominic Chalut
Author Affiliation
Division of Emergency Medicine, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. ghung@cw.bc.ca
Source
Pediatr Emerg Care. 2008 Jan;24(1):9-15
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Adult
Benchmarking
Emergency Service, Hospital - standards
Employee Performance Appraisal - standards
Female
Guideline Adherence
Health Care Surveys
Hospitals, Pediatric
Humans
Male
Middle Aged
Ontario
Pediatrics - standards - trends
Physician's Practice Patterns - standards
Practice Guidelines as Topic
Quality Assurance, Health Care
Quality Indicators, Health Care - standards
Questionnaires
Sensitivity and specificity
Abstract
Quality assurance is a new and important area of research in pediatric emergency medicine (PEM). There are few studies that describe which performance indicators best represent the PEM practice. The primary study objective is to construct a set of performance indicators that have been selected by current and former pediatric emergency department (PED) medical directors as most useful in assessing PED performance. The secondary objective is to assess which indicators are currently measured to assess performance in PEDs.
Current and former directors of accredited Canadian PEM programs were considered as eligible participants. A list of indicators was generated by a survey (item pool generation); this list was refined by clarifying unclear terms or eliminating redundant and unquantifiable performance indicators (item scaling); PED directors were asked to rate each item of this refined list to indicate which indicators were more useful in assessing PED performance (item prioritization). A novel ranking formula was used to prioritize those items considered most useful by a larger proportion of respondents, using the provided rating scores.
Fourteen current and former medical directors were considered eligible participants. Indicators related to patient morbidity and mortality, adverse outcomes, return visits, patient length of stay (LOS), and waiting times were considered to be more useful. Less useful indicators included the number of deaths, daily census, number of incident reports, and individual physicians' admission rates. The most commonly measured PED performance indicators included the rate of patients who left without being seen, patient LOS, and the waiting time until being seen by a physician by triage category.
The top quartile of performance indicators considered most useful by participants included indicators that reflected clinical outcomes, LOS, and waiting times. A dichotomy may exist between those performance indicators that PED directors considered more useful and those indicators that are currently measured.
PubMed ID
18165798 View in PubMed
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Current treatment by United States and Canadian pediatric rheumatologists.

https://arctichealth.org/en/permalink/ahliterature200794
Source
J Rheumatol. 1999 Sep;26(9):2036-8
Publication Type
Article
Date
Sep-1999
Author
R Q Cron
S. Sharma
D D Sherry
Author Affiliation
Department of Pediatrics, University of Washington, Seattle, USA.
Source
J Rheumatol. 1999 Sep;26(9):2036-8
Date
Sep-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adrenal Cortex Hormones - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Arthritis, Juvenile - drug therapy
Canada
Child
Child, Preschool
Clinical Competence
Female
Health Surveys
Humans
Male
Methotrexate - therapeutic use
Pediatrics - standards - trends
Physician's Practice Patterns - statistics & numerical data
Questionnaires
Sulfasalazine - therapeutic use
United States
Abstract
To determine current treatment practices for 11 selected pediatric rheumatic diseases.
A questionnaire was mailed to 224 US and Canadian physicians who were listed in membership directories that included pediatric rheumatologists.
One hundred seventy-four questionnaires (78%) were returned. Board certified pediatricians accounted for 86% of respondents. Nonsteroidal antiinflammatory drugs were the most commonly used medicines for all forms of juvenile rheumatoid arthritis (JRA), seronegative enthesopathy and arthropathy syndrome (SEA), and Henoch-Schönlein purpura, whereas oral corticosteroids were most frequently used for systemic lupus erythematosus (SLE), juvenile dermatomyositis, polyarteritis nodosa, and sarcoidosis. Intraarticular corticosteroid injection was the second most common therapy for pauciarticular JRA, but methotrexate (MTX) was second for polyarticular and systemic onset forms of JRA, and sulfasalazine was second for SEA. For all diseases, MTX was administered orally roughly twice as often as subcutaneously. In treating SLE, cyclophosphamide was used more frequently than azathioprine, cyclosporin A, or intravenous immunoglobulin.
The results from this survey should allow individual practitioners to compare their treatment patterns to pediatric rheumatologists in the US and Canada as a whole.
PubMed ID
10493688 View in PubMed
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Performance of a career development and compensation program at an academic health science center.

https://arctichealth.org/en/permalink/ahliterature164820
Source
Pediatrics. 2007 Apr;119(4):e791-7
Publication Type
Article
Date
Apr-2007
Author
Hugh O'Brodovich
Joseph Beyene
Susan Tallett
Daune MacGregor
Norman D Rosenblum
Author Affiliation
Department of Pediatrics, University of Toronto, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G-1X8. hugh.obrodovich@sickkids.ca
Source
Pediatrics. 2007 Apr;119(4):e791-7
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Academic Medical Centers - organization & administration
Attitude of Health Personnel
Career Mobility
Education, Medical, Continuing - organization & administration
Employee Performance Appraisal - organization & administration
Faculty, Medical - organization & administration
Health Care Surveys
Humans
Job Satisfaction
Ontario
Pediatrics - standards - trends
Peer Review
Probability
Program Development
Program Evaluation
Quality of Health Care
Staff Development
Abstract
The academic physicians of our department developed a novel Career Development and Compensation Program to outline job expectations, enhance career development, and provide a peer-review process to assess performance. The Career Development and Compensation Program was founded on the principle that sustained achievement in education, clinical care, or research should be valued, supported, and rewarded in an equivalent manner and that reward for clinical work should not be limited by the focus of the university on research and education. The objective of this study was to determine whether the principles of the Career Development and Compensation Program were sustained during the initial 7 years of its implementation.
The outcome of the 7 triennial reviews that occurred from 1999 to 2005 was evaluated. For the purposes of some analyses, physicians were classified as predominately clinical (clinician-specialists and clinician-teachers), predominately education (clinician-educators), or predominately research (clinician-investigators and clinician-scientists).
Each of the job profiles had a similar probability to increase a level within the Career Development and Compensation Program at the time of triennial review. Similarly, all 5 job profiles had a similar rate of increase in their level in relation to the total number of years of experience at an academic health science center. Neither the university academic rank nor gender of the physician affected the probability of increasing a level at the time of the triennial review.
The peer-reviewed Career Development and Compensation Program recognizes sustained achievement in each area of education, clinical care, and research in an equivalent manner with no detectable effect of academic rank or gender.
PubMed ID
17339386 View in PubMed
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[Significance of child health services for children's health. Possibilities and limitations in a future perspective]

https://arctichealth.org/en/permalink/ahliterature32660
Source
Lakartidningen. 2000 Jun 21;97(25):3064-6
Publication Type
Article
Date
Jun-21-2000
Author
A. HÃ¥kansson
C. Sundelin
Author Affiliation
Samhällsmedicinska institutionen, Universitetssjukhuset MAS, Malmö.
Source
Lakartidningen. 2000 Jun 21;97(25):3064-6
Date
Jun-21-2000
Language
Swedish
Publication Type
Article
Keywords
Child
Child Health Services - standards - trends
Child Welfare
Child, Preschool
Documentation
Humans
Infant
Infant Welfare
Pediatrics - standards - trends
Practice Guidelines
Regional Medical Programs
Research
Sweden
PubMed ID
10911699 View in PubMed
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Update on trauma care in Canada. 2. Update on pediatric trauma.

https://arctichealth.org/en/permalink/ahliterature227900
Source
Can J Surg. 1990 Dec;33(6):443-6
Publication Type
Article
Date
Dec-1990
Author
G K Blair
Author Affiliation
Department of Surgery, British Columbia's Children's Hospital, Vancouver.
Source
Can J Surg. 1990 Dec;33(6):443-6
Date
Dec-1990
Language
English
Publication Type
Article
Keywords
Abdominal Injuries - diagnosis - epidemiology - therapy
Canada - epidemiology
Child
Clinical Protocols - standards
Databases, Factual
Decision Trees
Humans
Pediatrics - standards - trends
Traumatology - standards - trends
Abstract
Selective conservatism is the key to the rational management of pediatric trauma, realizing that children may harbour severe occult injuries. The modern treatment of childhood abdominal trauma best exemplifies this approach: nonoperative management of splenic trauma is now standard for children, and a selective conservative approach is advised in the handling of childhood liver and pancreatic injuries. Prevention of childhood injuries should be the goal. The development of a national database of childhood trauma should provide the basis for action to educate and legislate for prevention. When prevention fails, however, up-to-date quality pediatric trauma care is the key.
PubMed ID
2253119 View in PubMed
Less detail

Vitamin D-deficiency rickets among children in Canada.

https://arctichealth.org/en/permalink/ahliterature77310
Source
CMAJ. 2007 Jul 17;177(2):161-6
Publication Type
Article
Date
Jul-17-2007
Author
Ward Leanne M
Gaboury Isabelle
Ladhani Moyez
Zlotkin Stanley
Author Affiliation
Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont. Lward@cheo.on.ca
Source
CMAJ. 2007 Jul 17;177(2):161-6
Date
Jul-17-2007
Language
English
Publication Type
Article
Keywords
Age Distribution
Breast Feeding
Canada - epidemiology
Child
Child, Preschool
Confidence Intervals
Female
Health education
Health Surveys
Humans
Incidence
Infant
Male
Pediatrics - standards - trends
Poisson Distribution
Primary prevention - methods
Questionnaires
Rickets - drug therapy - epidemiology - etiology
Risk factors
Severity of Illness Index
Sex Distribution
Vitamin D - administration & dosage
Vitamin D Deficiency - complications - diagnosis
Abstract
BACKGROUND: Based on regional and anecdotal reports, there is concern that vitamin D-deficiency rickets is persistent in Canada despite guidelines for its prevention. We sought to determine the incidence and clinical characteristics of vitamin D-deficiency rickets among children living in Canada. METHODS: A total of 2325 Canadian pediatricians were surveyed monthly from July 1, 2002, to June 30, 2004, through the Canadian Paediatric Surveillance Program to determine the incidence, geographic distribution and clinical profiles of confirmed cases of vitamin D-deficiency rickets. We calculated incidence rates based on the number of confirmed cases over the product of the length of the study period (2 years) and the estimates of the population by age group. RESULTS: There were 104 confirmed cases of vitamin D- deficiency rickets during the study period. The overall annual incidence rate was 2.9 cases per 100,000. The incidence rates were highest among children residing in the the north (Yukon Territory, Northwest Territories and Nunavut). The mean age at diagnosis was 1.4 years (standard deviation [SD] 0.9, min-max 2 weeks-6.3 years). Sixty-eight children (65%) had lived in urban areas most of their lives, and 57 (55%) of the cases were identified in Ontario. Ninety-two (89%) of the children had intermediate or darker skin. Ninety-eight (94%) had been breast-fed, and 3 children (2.9%) had been fed standard infant formula. None of the breast-fed infants had received vitamin D supplementation according to current guidelines (400 IU/d). Maternal risk factors included limited sun exposure and a lack of vitamin D from diet or supplements during pregnancy and lactation. The majority of children showed clinically important morbidity at diagnosis, including hypocalcemic seizures (20 cases, 19%). INTERPRETATION: Vitamin D-deficiency rickets is persistent in Canada, particularly among children who reside in the north and among infants with darker skin who are breast-fed without appropriate vitamin D supplementation. Since there were no reported cases of breast-fed children having received regular vitamin D (400 IU/d) from birth who developed rickets, the current guidelines for rickets prevention can be effective but are not being consistently implemented. The exception appears to be infants, including those fed standard infant formula, born to mothers with a profound vitamin D deficiency, in which case the current guidelines may not be adequate to rescue infants from the vitamin D-deficient state.
Notes
Comment In: CMAJ. 2007 Jul 17;177(2):169-7117600036
PubMed ID
17600035 View in PubMed
Less detail

7 records – page 1 of 1.