Racemic epinephrine compared to salbutamol in hospitalized young children with bronchiolitis; a randomized controlled clinical trial [ISRCTN46561076]

BACKGROUND: Bronchiolitis is the most common cause of lower respiratory tract illness in infancy, and hospital admission rates appear to be increasing in Canada and the United States. Inhaled beta agonists offer only modest short-term improvement. Trials of racemic epinephrine have shown conflicting results. We sought to determine if administration of racemic epinephrine during hospital stay for bronchiolitis improved respiratory distress, was safe, and shortened length of stay. METHODS: The study was a randomized, double-blind controlled trial of aerosolized racemic epinephrine compared to salbutamol every one to 4 hours in previously well children aged 6 weeks to ≤ 2 years of age hospitalized with bronchiolitis. The primary outcome was symptom improvement as measured by the Respiratory Distress Assessment Instrument (RDAI); secondary outcomes were length of stay in hospital, adverse events, and report of symptoms by structured parental telephone interview one week after discharge. RESULTS: 62 children with a mean age of 6.4 months were enrolled; 80% of children had Respiratory Syncytial Virus (RSV). Racemic epinephrine resulted in significant improvement in wheezing and the total RDAI score on day 2 and over the entire stay (p < 0.05). The mean LOS in the epinephrine arm was 2.6 days (95% CI 2, 3.2) v. 3.4 days in those in the salbutamol group (95% CI 2.6, 4.2) (p > 0.05). Adverse events were not significantly different in the two arms. At one week post-discharge, over half of parents reported that their child still had a respiratory symptom and 40% had less than normal feeding. CONCLUSION: Racemic epinephrine relieves respiratory distress in hospitalized infants with bronchiolitis and is safe but does not abbreviate hospital stay. Morbidity associated with bronchiolitis as identified by parents persists for at least one week after hospital discharge in most infants

Resources for teaching technical services in a rapidly changing global environment

The global information context is changing rapidly, and resources to support instruction relating to the evolving standards and practices in technical services are in high demand. What do we need and how robust are the resources that are available? What can and should Technical Services educators do to best prepare information professionals in the face of this evolving context, world-wide? This panel will address these and other questions related to materials used for teaching technical services courses, while also considering the audience for the materials, from three complementary perspectives. Drawing from an analysis of existing courses offered by Master’s programs in LIS, competencies developed by professional organizations, job descriptions, relevant literature, and feedback from students and instructors, the first panel presentation will take a look at the current state of information organization education, including resources used, topics covered, and training gaps. The second panel presentation will reflect on technical services instruction for school and public librarians in particular, exploring the relationship between theory and practice for cataloging instruction. The third panel presentation will address the topic of providing Open Educational Resources (OERs), highlighting the panelist’s experiences on a university’s OER task force and as a grant recipient. The results shared will consist of a perspective of graduate LIS faculty on institutional OER initiatives, which are usually focused on undergraduate education, particularly in the sciences, as well as a view of creating OERs for a graduate level LIS course on a technical services topic The session will be co-moderated by the SIG sponsors. The moderators will introduce the topic, providing initial background and insight on the problem of the rapidly-changing field of technical services and the educational needs. Time at the end will be reserved for interaction with the audience

Resources for teaching technical services in a rapidly changing global environment

The global information context is changing rapidly, and resources to support instruction relating to the evolving standards and practices in technical services are in high demand. What do we need and how robust are the resources that are available? What can and should Technical Services educators do to best prepare information professionals in the face of this evolving context, world-wide? This panel will address these and other questions related to materials used for teaching technical services courses, while also considering the audience for the materials, from three complementary perspectives. Drawing from an analysis of existing courses offered by Master’s programs in LIS, competencies developed by professional organizations, job descriptions, relevant literature, and feedback from students and instructors, the first panel presentation will take a look at the current state of information organization education, including resources used, topics covered, and training gaps. The second panel presentation will reflect on technical services instruction for school and public librarians in particular, exploring the relationship between theory and practice for cataloging instruction. The third panel presentation will address the topic of providing Open Educational Resources (OERs), highlighting the panelist’s experiences on a university’s OER task force and as a grant recipient. The results shared will consist of a perspective of graduate LIS faculty on institutional OER initiatives, which are usually focused on undergraduate education, particularly in the sciences, as well as a view of creating OERs for a graduate level LIS course on a technical services topic The session will be co-moderated by the SIG sponsors. The moderators will introduce the topic, providing initial background and insight on the problem of the rapidly-changing field of technical services and the educational needs. Time at the end will be reserved for interaction with the audience

Empyema associated with community-acquired pneumonia: A Pediatric Investigator's Collaborative Network on Infections in Canada (PICNIC) study

Abstract Background Although the incidence of serious morbidity with childhood pneumonia has decreased over time, empyema as a complication of community-acquired pneumonia continues to be an important clinical problem. We reviewed the epidemiology and clinical management of empyema at 8 pediatric hospitals in a period before the widespread implementation of universal infant heptavalent pneumococcal vaccine programs in Canada. Methods Health records for children < 18 years admitted from 1/1/00–31/12/03 were searched for ICD-9 code 510 or ICD-10 code J869 (Empyema). Empyema was defined as at least one of: thoracentesis with microbial growth from pleural fluid, or no pleural fluid growth but compatible chemistry or cell count, or radiologist diagnosis, or diagnosis at surgery. Patients with empyemas secondary to chest trauma, thoracic surgery or esophageal rupture were excluded. Data was retrieved using a standard form with a data dictionary. Results 251 children met inclusion criteria; 51.4% were male. Most children were previously healthy and those ≤ 5 years of age comprised 57% of the cases. The median length of hospitalization was 9 days. Admissions occurred in all months but peaked in winter. Oxygen supplementation was required in 77% of children, 75% had chest tube placement and 33% were admitted to an intensive care unit. While similarity in use of pain medication, antipyretics and antimicrobial use was observed, a wide variation in number of chest radiographs and invasive procedures (thoracentesis, placement of chest tubes) was observed between centers. The most common organism found in normally sterile samples (blood, pleural fluid, lung biopsy) was Streptococcus pneumoniae. Conclusion Empyema occurs most commonly in children under five years and is associated with considerable morbidity. Variation in management by center was observed. Enhanced surveillance using molecular methods could improve diagnosis and public health planning, particularly with regard to the relationship between immunization programs and the epidemiology of empyema associated with community-acquired pneumonia in children