Biomedical subjects

S T Melman

Publications and source records attributed to S T Melman.

3 recordsLinked to original sources

PubMed1994

Multiple immunizations. Ouch!

The purpose of this study was to determine the stated willingness of parents/caretakers to allow the administration of multiple, injected immunizations to their children at a single visit. Two hundred eighty-one parents/caretakers accompanying their children to an inner-city pediatric clinic were presented with hypothetical situations in which their children would be due for two, three, or four injections to complete their series of age-appropriate immunizations. Given a scenario of two needed injections, 24 (8.5%) of the 281 parents/caretakers preferred to divide the injections between two visits; for three injections, 119 (42.3%) preferred two visits; and for four injections, 164 (58.4%) preferred two visits. The commonly stated preference of our predominantly minority parent/caretaker population to divide more than two injections between two visits seriously conflicts with the US Public Health Service's National Vaccine Advisory Committee's recommendations and potentially exacerbates immunization delays. Therefore, physicians must be prepared to strongly urge simultaneous administration of all needed vaccine doses at any opportunity.

Adult↗

PubMed1994

Readability of the childhood immunization information forms.

OBJECTIVE: To compare the reading level required to understand childhood immunization information forms with the reading grade level of an inner-city parent/caretaker population. DESIGN: Descriptive study (parents/caretakers). SETTING: Inner-city pediatric clinic. PARTICIPANTS: One hundred fifty English-speaking, low-income parent/caretakers. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: The reading level of our parent population ranged from grades 2.9 to 13.3, with a median grade level of 6.90. The reading levels required for the three vaccine information pamphlets issued in 1992 by the Centers for Disease Control and Prevention (Atlanta, Ga) averaged 11.1 (approximately at the level of a high school junior). Eighty-six percent of our parents/caretakers did not have a reading level sufficient to cope with the easiest of the forms. CONCLUSIONS: The vaccine information pamphlets require a reading level beyond the capability of the vast majority of our parent population. Therefore, the goal of informed consent clearly is not being met.

Adolescent↗

PubMed1988

Cost effectiveness in the choice of antibiotics for the initial treatment of otitis media in children: a decision analysis approach.

If the initial use of amoxicillin fails to cure otitis media, a family will be burdened with medical costs for a second medication, additional office visit fees and time lost from employment. For some families the initial choice of a more expensive but more effective antibiotic may be more cost effective. Using a decision analysis approach we compared the cost effectiveness of amoxicillin and cefaclor. As the amoxicillin efficacy rate decreases or as parental salaries are increased, the cost-effective advantage moves towards cefaclor. With the decision analysis method described, a practitioner can use costs and efficacy rates relevant to his or her practice to determine the most cost-effective initial antibiotic for a child with otitis media.

Amoxicillin↗