Child Maltreatment Prevention – Finding Common Ground with Unintentional Injury Prevention

Child Maltreatment Prevention – Finding Common Ground with Unintentional Injury Preventio

Interactive Spaced Online Education in Pediatric Trauma

Pediatric resident trauma education is suboptimal due to lack of a curriculum and limited trauma experience and education resources. The objective of the study was to test knowledge retention and acceptability of interactive spaced education (ISE) in pediatric trauma. Prospective, randomized trial involving 40 physicians in a pediatric emergency department was used. Instrument was comprised of 48 multiple-choice questions (evaluative component) and answer critiques (educational component) on pediatric trauma divided into two modules. The instrument was assessed for test–retest reliability, item difficulty, and construct validity. Intervention consisted of online administration of each module as eight spaced emails (3 questions each) over a course of 4 weeks and was repeated after 2 and 4 months. Participants received an answer critique on committing to an answer. Primary outcome was difference in mean percentage of correct answers at 2 and 4 months versus baseline. Paired t test and effect size (d) were performed. Secondary outcome was exit-survey of ISE acceptability. There was significant improvement at 2 months (8.0, 95% confidence intervel [CI] = [3.6, 12.5], d = 0.75), but improvement at 4 months (1.6, 95% CI = [−4.5, 7.7], d = 0.18) was not significant. Sixty percent would retake and recommend ISE to others. Interactive, spaced education improves knowledge in pediatric trauma and is well accepted. Studies are required to determine the optimal spacing interval for this form of education

Basin-wide sea level coherency in the tropical Indian Ocean driven by Madden–Julian Oscillation

Changes in sea level may be attributed either to barotropic (involving the entire water column) or baroclinic processes (governed by stratification). It has been widely accepted that barotropic sea level changes in the tropics are insignificant at intraseasonal time scales (periods of 30–80 days). Based on bottom pressure records, we present evidence for significant basin-wide barotropic sea level variability in the tropical Indian Ocean during December–April with standard deviations amounting to ∼30–60% of the standard deviation in total intraseasonal sea level variability. The origin of this variability is linked to a small patch of wind over the Eastern Indian Ocean, associated with boreal winter Madden–Julian Oscillations (MJO). These large fluctuations are likely to play a prominent role in the intraseasonal sea level and mass budgets. Because of their much faster propagation than baroclinic processes, they allow the basin to adjust to climatic perturbations much more rapidly than was previously thought

A study of complexity of oral mucosa using fractal geometry

Background: The oral mucosa lining the oral cavity is composed of epithelium supported by connective tissue. The shape of the epithelial-connective tissue interface has traditionally been used to describe physiological and pathological changes in the oral mucosa. Aim: The aim is to evaluate the morphometric complexity in normal, dysplastic, well-differentiated, and moderately differentiated squamous cell carcinoma (SCC) of the oral mucosa using fractal geometry. Materials and Methods: A total of 80 periodic acid–Schiff stained histological images of four groups: normal mucosa, dysplasia, well-differentiated SCC, and moderately differentiated SCC were verified by the gold standard. These images were then subjected to fractal analysis. Statistical Analysis: ANOVA and post hoc test: Bonferroni was applied. Results: Fractal dimension (FD) increases as the complexity increases from normal to dysplasia and then to SCC. Normal buccal mucosa was found to be significantly different from dysplasia and the two grades of SCC (P < 0.05). ANOVA of fractal scores of four morphometrically different groups of buccal mucosa was significantly different with F (3,76) = 23.720 and P< 0.01. However, FD of dysplasia was not significantly different from well-differentiated and moderately differentiated SCC (P = 1.000 and P = 0.382, respectively). Conclusion: This study establishes FD as a newer tool in differentiating normal tissue from dysplastic and neoplastic tissue. Fractal geometry is useful in the study of both physiological and pathological changes in the oral mucosa. A new grading system based on FD may emerge as an adjuvant aid in cancer diagnosis

An Emergency Department Intervention to Improve Knowledge of Child Passenger Safety

WOS: 000284943800002PubMed ID: 21088639Objectives: The objective of the study was to test the impact of an educational video in improving child passenger safety knowledge. Methods: This was a prospective randomized study performed in the emergency department of an urban children's hospital involving parents of non-critically ill children younger than 9 years. Parents were randomized to observe a video on child passenger safety or comparison group. All completed a survey, 8-question pretest at enrollment, and posttest after 1 month and received written safety materials at discharge. The outcome measure to test knowledge was the difference in mean pretest-posttest scores on a questionnaire. Results: We enrolled 274 parents (137 intervention, 137 comparison). Thirty subjects were found ineligible for analysis after enrollment because their children were outside the age range for inclusion. Analysis was restricted to 131 parents in the intervention group and 113 in the comparison group. No significant differences existed between groups when comparing demographics and child passenger safety characteristics except for the number of children in the household. After excluding those lost to follow-up (91 parents) and who dropped out (14 parents), analysis was restricted to 74 subjects in the intervention group and 65 in the comparison group. Mean pretest scores were as follows: intervention, 4.95 (SD, 1.49); comparison, 5.12 (SD, 1.32). Mean posttest scores were as follows: intervention, 5.24 (SD, 1.60); comparison, 4.77 (SD, 1.39). Difference in mean pretest-posttest scores showed a significant improvement in the intervention group compared with the comparison group: 0.65 (95% confidence interval, 0.14-1.16) on independent-samples t test (P = 0.012). Conclusions: Child passenger safety education can be effectively imparted to parents in the emergency department.Texas Pediatric Society; State FarmThis study received grant support from the Texas Pediatric Society and State Farm

Drugs Used to Treat Pediatric Emergencies.

This clinical report is a revision of "Preparing for Pediatric Emergencies: Drugs to Consider." It updates the list, indications, and dosages of medications used to treat pediatric emergencies in the prehospital, pediatric clinic, and emergency department settings. Although it is not an all-inclusive list of medications that may be used in all emergencies, this resource will be helpful when treating a vast majority of pediatric medical emergencies. Dosage recommendations are consistent with current emergency references such as the Advanced Pediatric Life Support and Pediatric Advanced Life Support textbooks and American Heart Association resuscitation guidelines

Dynamic light-matter coupling across multiple spatial dimensions in a quantum dots-in-a-well heterostructure

Semiconductor heterostructures incorporating multiple degrees of spatial confinement have recently attracted substantial interest for photonic applications. One example is the quantum dots-in-a-well (DWELL) heterostructure, consisting of zero-dimensional quantum dots embedded in a two-dimensional quantum well and surrounded by three-dimensional bulk material. This structure offers several advantages over conventional photonic devices while providing a model system for the study of light-matter interactions across multiple spatial dimensions. Here, we use ultrafast differential transmission spectroscopy2 to temporally and spectrally resolve density-dependent carrier dynamics in a DWELL heterostructure. We observe excitation-dependent shifts of the quantum dot energy levels at low densities, while at high densities we observe an anomalous induced absorption at the quantum dot excited state that is correlated to quantum well population dynamics. These studies of density-dependent light-matter interactions across multiple coupled spatial dimensions provide clues to the underlying physics governing quantum dot properties, with important implications for DWELL-based photonic devices

Prevention of Drowning

Drowning is a leading cause of injury-related death in children. In 2017, drowning claimed the lives of almost 1000 US children younger than 20 years. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in the prevention of drowning

Interactive Spaced Online Education in Pediatric Trauma

Pediatric resident trauma education is suboptimal due to lack of a curriculum and limited trauma experience and education resources. The objective of the study was to test knowledge retention and acceptability of interactive spaced education (ISE) in pediatric trauma. Prospective, randomized trial involving 40 physicians in a pediatric emergency department was used. Instrument was comprised of 48 multiple-choice questions (evaluative component) and answer critiques (educational component) on pediatric trauma divided into two modules. The instrument was assessed for test–retest reliability, item difficulty, and construct validity. Intervention consisted of online administration of each module as eight spaced emails (3 questions each) over a course of 4 weeks and was repeated after 2 and 4 months. Participants received an answer critique on committing to an answer. Primary outcome was difference in mean percentage of correct answers at 2 and 4 months versus baseline. Paired t test and effect size (d) were performed. Secondary outcome was exit-survey of ISE acceptability. There was significant improvement at 2 months (8.0, 95% confidence intervel [CI] = [3.6, 12.5], d = 0.75), but improvement at 4 months (1.6, 95% CI = [−4.5, 7.7], d = 0.18) was not significant. Sixty percent would retake and recommend ISE to others. Interactive, spaced education improves knowledge in pediatric trauma and is well accepted. Studies are required to determine the optimal spacing interval for this form of education