No abstract

Caregivers are more likely to report family burden problems when child functioning is poorer and health care needs are unmet. Improved identification and provision of services is a potentially modifiable factor that may decrease family burden after pediatric traumatic brain injury.

Although pediatric hospitalization rates for mild traumatic brain injuries have decreased over the past 15 years, rates for moderate and severe traumatic brain injuries are relatively unchanged. Our study provides national estimates of pediatric traumatic brain injury hospitalizations that can be used as benchmarks to increase injury prevention effectiveness through targeting of effective strategies.

To determine the proportion of young children seen in primary care pediatric practices who meet clinical criteria for the diagnosis of sinusitis, and variations in the management of these patients' conditions.

ATV riders who do not wear helmets are more likely to receive significant injuries to the head, face, and neck. Prevention strategies and enforceable policy interventions to increase helmet use among ATV riders appear warranted.

FCR are associated with higher parent satisfaction, consistent medical information, and care plan discussion, with no additional burden to health service use. Additional studies should assess FCR under different settings of care.

OBJECTIVE. Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event.METHODS. A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the 2 test was used to compare urban versus rural preparedness.RESULTS. The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey.CONCLUSIONS. There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/masscasualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.www.pediatrics.org/cgi

Results: ATV riders frankly discussed current use and safety behaviors and were aware of some ATV risks. Youths felt that age specific regulation was unlikely to be a helpful strategy. Participants endorsed messages demonstrating graphic consequences as likely to get the attention of young riders regarding risks. Educational settings were suggested, including hunter and driver safety classes. Conclusions: Efforts to improve ATV safety awareness should clearly show pediatric ATV injury risk and safety practices. Campaigns must also show realistic understanding of current use practices to be credible for users. Messages emphasizing the consequences of ATV use were endorsed as most likely to have impact. Approaches based on age based restrictions were considered unrealistic and alternative strategies were suggested.A ll-terrain vehicle (ATV) injury in children is a serious and increasing problem in the United States. In 1997, there were an estimated 54 700 ATV related injuries treated in US emergency rooms, including an estimated 21 132 in children under age 16 years. By 2001, the number of people treated in US emergency rooms for ATV related injury had increased to 111 700; including an estimated 33 071 children under age 16 years.1 In the 1990s, there were an estimated 273 deaths each year in the US resulting from ATV related injury, more than a third of whom were children. 2With the introduction and rapid rise in popularity of ATVs in the 1980s, a dramatic increase in ATV related injury was seen, including a large proportion of pediatric injuries.3 The US Consumer Product Safety Commission (CPSC) responded and entered into a consent decree with ATV manufacturers that banned production of three wheeled ATVs and prescribed a number of safety related measures, including warning labels and ATV safety programs. In spite of these efforts, there are numerous recent reports of striking increases in pediatric injuries. [4][5][6][7] The CPSC reported that between 1997 and 2001, overall exposure to ATVs in terms of numbers in use, number of drivers, and driving hours has increased by 36% (number of drivers) to 50% (number of driving hours). During the same period, however, a disproportionate increase of 104% in injuries occurred.1 Pediatric exposure also increased by 9.1% in the number of riders and 34.2% in riding hours for children under age 16.1 Although children under 16 make up only 14% of riders, they comprise 35% of all deaths caused by ATVs, and demonstrate a risk of death 4.5-12 times greater than adult comparison groups. [3][4][5][6][7][8] In addition to age, other risk factors including male sex, use of three wheeled rather than four wheeled vehicles, on-road use, and lack of helmet use are associated with increased risk of injury and death. Helmets have been shown to reduce nonfatal head injury by up to 64% and mortality risk by 42%, 9 but studies suggest that even among previously injured patients, helmet use is low and risk taking behavior persists.10 Rural states tend to have higher rates of ATV use and inju...