Relationship between quality of CME instruction and changes in physicians' patient-management plans.
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Biomedical subjects
Publications and source records attributed to E F Lenoski.
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By retrospective review of 1,061 charts and prospective analysis of all accidental injuries seen in a Pediatric Emergency Room over a 5-year period, criteria were developed to identify the source of an injury as either specific or nonspecific, i.e., whether a unique causative mechanism was clear or not from the clinical or radiologic signs. These criteria were then used to diagnose 712 cases of child abuse, of which 43 were burns. There were four specific burn patterns. Readily evident were contacts with hot objects; the other were caused by various applications of hot liquids. In these latter cases, the position of the body at the time of burning could be precisely detected by analysis of the depth, configuration, distribution of the burns, and the reciprocal relation to flexion creases and joints of the spared areas. This information is a powerful tool for assessing the veracity of the history presented by the child's caretaker when considering a diagnosis of child battery.
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A communication gap in transmission of information from health professionals to indigent parents is demonstrated by the incomplete immunization of children attending pediatric health facilities. To bridge this gap, young women of similar ethnic and social backgrounds were recruited and trained briefly in counseling parents concerning adequate immunization. The effectiveness of these Health Aides in motivating parents to complete an immunization series was less than that of Public Health Nurses. Even so, the Aides were able to motivate two-thirds of the families that they counseled. Conclusions were that a significant number of children appearing in a large public emergency room facility are unimmunized. Many of these children are not seriously ill and an immunization series can be initiated "on the spot." Motivation to complete the series can be done almost as satisfactorily by young rapidly trained indigenous Health Aides as by professionals.
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