Social distancing (SD) during the coronavirus disease 2019 (COVID-19) pandemic has largely removed children from school, day care, and other contact with peers. In addition to reducing transmission of severe acute respiratory syndrome 2, these changes would be expected reduce infectious diseases among children. We sought determine effect SD on 12 commonly diagnosed in pediatric primary care that are contagious various extents: otitis media (AOM), bronchiolitis, common cold, croup,...

Thirty-five children <2 years of age mechanically ventilated for respiratory syncytial virus (RSV) infection were randomized to receive an intravenous infusion 15 mg/kg MEDI-493 or placebo. RSV concentration was measured in tracheal secretions by plaque assay before and at 24-h intervals after treatment. The reduction from day 0 1 (-1.7+/-0.28 vs. -0. 6+/-0.21 log10 pfu/mL; P=.004) 2 (-2.5+/-0.26 -1.0+/-0.41 P=.012) significantly greater the group than placebo group. nasal aspirates did not...

Using data from the Slone Survey, we sought to define prevalence of over-the-counter and prescription medication use among US children <12 years age determine patterns most commonly used medications.The Survey was a random-digit-dial telephone survey in previous 7 days for representative sample population. Between February 1998 April 2007, enrolled 2857 0 11 48 contiguous states.The response rate 61%. Overall, 56% had >or=1 product preceding interview, with 15%, 7.1%, 3.1%, 1.9% taking 2, 3,...

Observation without initial antibiotic therapy was accepted as an option for acute otitis media (AOM) management in the 2004 American Academy of Pediatrics and Family Physicians clinical practice guideline. The guideline also recommended amoxicillin first-line treatment most children, analgesic to reduce pain if it present. Our objective compare AOM after publication guideline.We analyzed National Ambulatory Medical Care Survey, 2002-2006 (N = 1114), which occurred US physicians' offices....

Objective: The characteristics and microbiology of the full spectrum pediatric diarrhea occurring in U.S. community setting are not well-understood. Methods: Six-month prospective cohort study 604 healthy 6- to 36-month-old children recruited by Slone Center Office-based Research Network. Results: incidence parent-defined was 2.2 episodes per person-year. median duration 2 days with a 6 stools episode. Outpatient visits hospitalization were prompted 9.7 0.3% episodes, respectively. most...

Pediatric cough and cold medications are widely marketed in the United States, but precise patterns of use among children not known. Such information is especially important given recent reports suggesting that these responsible for previously underappreciated serious adverse events deaths children. We sought to describe prevalence pediatric medications, with particular attention young children.We analyzed data on defined as any oral medication contains >or=1 antitussive, decongestant,...

In the context of protracted shortages pediatric behavioral health (BH) specialists, BH integration in primary care can increase access to services. The objectives this study were assess structure and process outcomes patient experience (access quality), cost, provider satisfaction.In 2013, we launched a multicomponent, transdiagnostic integrated model (Behavioral Health Integration Program [BHIP]) large network Massachusetts. Study participants comprised first 13 practices enroll BHIP...

OBJECTIVES. In 2004, the American Academy of Pediatrics and Family Physicians released a clinical practice guideline on management acute otitis media that included endorsement an observation option for selected cases recommendations specific antibiotics. We sought to describe primary care physicians' current compare it with guideline's trends since 2004. DESIGN. used mail survey from March through June 2006 within Slone Center Office-Based Research Network, national practice-based pediatric...

This retrospective cohort study across 77 pediatric practices in Massachusetts assessed the frequency of CXR utilization among children with pneumonia diagnosed primary care setting and determined whether was associated differences antibiotic treatment outcomes. Multivariable logistic regression used to evaluate association between performance future clinic revisit, performance, change, a composite failure outcome, adjusting for markers illness severity. Among 29 528 treated pneumonia, 2462...

OBJECTIVES Describe the impact of coronavirus disease 2019 (COVID-19) pandemic on pediatric primary care visits for 7 mental health categories before and during COVID-19 pandemic. METHODS This interrupted time series analysis compared rate to providers in Massachusetts Three periods were defined: prepandemic period (January 2019–February 2020), emergency (March 2020–May (June 2020–September 2021). The visit diagnoses included alcohol substance use disorders, anxiety attention-deficit...

Background. The commercially-available C6 Lyme enzyme immunoassay (EIA) has been approved to replace the standard whole-cell sonicate EIA as a first-tier test for diagnosis of disease and suggested stand-alone diagnostic. However, not extensively studied in pediatric patients undergoing evaluation disease. Methods. We collected discarded serum samples from children adolescents (aged ≤21 years) conventional 2-tiered testing at single hospital-based clinical laboratory located an area endemic...

Children with sickle cell disease were immunized either 2 doses of 7-valent pneumococcal conjugate vaccine followed by 1 dose 23-valent polysaccharide or a single vaccine. Functional antibodies to 7 serotypes measured flow cytometric opsonophagocytic assay (OPA) and compared IgG anticap-sular antibody concentrations ELISA. Moderate correlations found between OPA ELISA titers for all (r values, 0.41–0.70; P < .001 serotypes). After immunization vaccine, geometric mean significantly higher in...

Objectives. To describe sleep positions among low birth weight infants, variations in position according to weight, and changes over time. analyze risk factors influences associated with prone sleep. Design. Prospective cohort study. Setting. Massachusetts Ohio, 1995–1998. Study Participants. Mothers of 907 infants. Results. At 1, 3, 6 months after hospital discharge, the prevalence sleeping was 15.5%, 26.8%, 28.3%, respectively. The corresponding rates for supine were 23.8%, 37.9%, 50.2%...

<i>Background:</i> The validity of parental reporting children's health outcomes is an important methodological issue in community-based pediatric research. We assessed the parents' reports their acute otitis media (AOM) history over previous month a pilot study xylitol for AOM prevention. <i>Methods:</i> Parents children participating conducted Slone Center Office-Based Research (SCOR) Network were interviewed monthly 3 months and asked whether child had been diagnosed with month. A blinded...

Pediatricians are required to perform quality improvement for board recertification. We developed an asthma project within the Pediatric Physicians' Organization at Children's, independent practice association affiliated with Boston Children's Hospital, designed meet recertification requirements and improve care.The program was based on learning collaborative model. practice-based registries of children 5 17 years age persistent helped physicians processes care through education, data...

Acute otitis media (AOM) is a common childhood illness and the leading indication for antibiotic prescriptions US children. Xylitol, naturally occurring sugar alcohol, can reduce AOM when given 5 times per day as gum or syrup, but more convenient dosing regimen needed widespread adoption.We designed pragmatic practice-based randomized controlled trial to determine if viscous xylitol solution at dose of g 3 could occurrence clinically diagnosed among otitis-prone children 6 months through...

<h3>Importance</h3> Annual preventive health visits provide an opportunity to screen youths for unhealthy substance use and intervene before serious harm results. <h3>Objectives</h3> To assess the feasibility acceptability estimate efficacy of a primary care computer-facilitated screening practitioner-delivered brief intervention (CSBI) system compared with usual (UC) youth associated risk riding impaired driver. <h3>Design, Setting, Participants</h3> An intent-to-treat pilot randomized...

To identify primary care physicians' familiarity with the 2004 acute otitis media (AOM) clinical practice guideline and to compare their practices its recommendations.Mail survey October through December all active physician members of Slone Center Office-based Research Network, a national, practice-based, pediatric research network.The response rate was 276 469 (58.8%). Overall, 90.5% had read or summaries it. Pneumatic otoscopy always used by 16.2%, half time more 23.1%, less than 34.6%...

Because of severe and protracted shortages pediatric behavioral health (BH) specialists, collaboration between primary care practitioners (PCPs) BH specialists has the potential to increase access services by expanding workforce. In a previous study, we demonstrated that phase 1 integration program (BHIP) enrolling 13 independently owned, community-based practices was associated with increased while averting substantial cost increases achieving high provider self-efficacy professional...