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Biomedical subjects

A B Bergman

Publications and source records attributed to A B Bergman.

At least 37 records · Page 2Linked to original sources
PubMed1994

Advocacy training during pediatric residency.

Despite broad concerns about the welfare of children, most pediatric residents are not able to engage in child advocacy during their busy training years. Yet residency can provide an opportunity for young pediatricians to learn valuable advocacy skills by undertaking an independent project with an experienced mentor. We describe the University of Washington Pediatrics Residency Program's experience in training interested residents in child advocacy. Basic requirements are that advocacy projects must not interfere with clinical training, resident participation must be voluntary, and faculty with advocacy skills must be available to help guide the residents. Four resident projects are outlined and guidelines for instituting such programs are presented.

Child↗
PubMed1994

The Seattle children's bicycle helmet campaign: changes in helmet use and head injury admissions.

OBJECTIVE: To describe the impact of a community bicycle helmet campaign on helmet use and the incidence of bicycle-related head injuries. SETTING: Metropolitan community and a large health maintenance organization. INTERVENTIONS: Communitywide bicycle helmet campaign. OUTCOMES: Rate of observed bicycle helmet use in the community and incidence of bicycle-related injuries in an health maintenance organization population. RESULTS: Helmet use among school-aged children increased from 5.5% in 1987 to 40.2% in 1992. Bicycle-related head injuries decreased by 66.6% in 5- to 9-year-old and 67.6% in 10- to 14-year-old members of an health maintenance organization. CONCLUSIONS: Educational campaigns can increase helmet use and decrease the incidence of bicycle-related head injury.

Adolescent↗
PubMed1993

Relationship between epidemiologic risk factors and clinicopathologic findings in the sudden infant death syndrome.

The risk of sudden infant death syndrome (SIDS) is said to be enhanced by factors such as prematurity, low birth weight, and perinatal distress. The significance of risk factors for SIDS research was questioned because the majority of SIDS victims seem to lack them. Therefore, postmortem records of 1144 infants who died suddenly and unexpectedly in King County, Washington, over a 25-year period were studied. Deaths were classified as "explained" if a cause was apparent, "classic" SIDS if the history and autopsy were unrevealing or, where the diagnosis of SIDS was doubtful, as "probable" or "possible" SIDS. The infants' birth certificates were compared with those of 3647 infants born during a similar period. Seventy-nine deaths (7%) were explained. The 1065 previously certified as SIDS were reclassified classic SIDS (82%), probable SIDS (13%), and possible SIDS (5%). Low birth weight, small size for gestational age, prematurity, and low 5-minute Apgar scores each form a "continuum"; the possible-SIDS group had the highest proportion of such infants, followed by the probable- and classic-SIDS groups, which exhibit extensive overlap with the control population. A 5-minute Apgar score of less than 7 and delayed postnatal growth rate are not risk factors for classic SIDS. Risk factors are more prevalent in SIDS infants where the diagnosis may be doubtful. The great majority of SIDS victims possess fewer risk factors. To avoid the bias of confounding variables, SIDS research should focus on as "pure" a SIDS population as is possible.

Adult↗
PubMed1991

Prevention of pedestrian injuries to children: effectiveness of a school training program.

Pedestrian injuries are a complex problem for which no single intervention will be completely effective. One component of a community-wide program, training of schoolchildren in street-crossing skills, is evaluated. The program targeted public school students in grades K through 4 with an eight-session training program by a single teacher, cross-age teaching, videotape feedback, and in 1990 parent-child activity workbooks. Children's street crossing was observed pretraining and posttraining and graded on four behaviors: WALKING on sidewalk/shoulder vs in the street; STOPPING at the curb; LOOKING L-R-L before crossing; KEEP LOOKING while crossing. Analysis was conducted on matched pairs in which observations pretraining were compared with those posttraining on same child. Observations were completed on 137 children in 1989 and 92 in 1990. Nearly all children walked on the side of the road; however, fewer than 50% of children STOPPED, 25% LOOKED, and fewer than 20% KEPT LOOKING before training. Training did not improve the performance on the first two behaviors in either year, significantly increased LOOKING in 1990, and increased KEEP LOOKING by twofold in 1989 and threefold in 1990. It is concluded that pedestrian skills of children can be improved but that such a program must be part of a broader effort if pedestrian injuries are to decrease.

Accidents, Traffic↗
PubMed1991

Sweden's experience in reducing childhood injuries.

Why does Sweden have the lowest childhood injury rate of any country in the world? The answer lies in a combination of factors including the special characteristics of Swedish society and an energetic 35-year campaign. Contributing societal characteristics are a small, relatively homogeneous, health conscious, law-abiding population that values children. Key factors in the campaign have been support of trauma surveillance systems and injury prevention research, ensuring safer environments and products through legislation and regulation, and a broad-based safety education campaign using coalitions of existing groups. Emulating the strategies used in the Swedish campaign would markedly reduce the number of US children killed, injured, and disabled from trauma.

Accidents, Home↗
PubMed1990

The Seattle children's bicycle helmet campaign.

Though bicycle head trauma is a significant cause of mortality and morbidity, much of which can be mitigated by wearing protective helmets, in 1986, few schoolchildren in the area of Seattle, Wash, were observed to wear helmets. We describe the mechanics of a multifaceted campaign undertaken to alter this situation, involving a coalition of health, bicycle, and helmet industry organizations. These were the major objectives: (1) to convince parents that riding bicycles without helmets is hazardous, (2) to lower the price of helmets to more affordable levels, and (3) to overcome the reluctance of children to wear helmets. The campaign was successful; the sales of one brand of a youth helmet in the Seattle area rose from 1500 to 22,000 over a 3-year period, and the observed helmet usage rate among school-age children increased from 5% to 16% compared with a rise of only 1% to 3% in a control community, Portland, Ore.

Accident Prevention↗
PubMed1989

Iron-fortified formulas. Pediatricians' prescribing practices.

Primary care pediatricians in Washington State were surveyed regarding their attitudes about iron-fortified formula. Of the 210 responding physicians who stated an opinion 70 (33%) feel that there are definite indications for non-fortified formula, and 33 (16%) routinely recommend formula without added iron. Despite evidence that adding iron to formula has helped reduce the prevalence of anemia in children and does not cause gastrointestinal symptoms, iron-fortified formula is not universally recommended by pediatricians.

Attitude of Health Personnel↗
PubMed1989

Toxic epidermal necrolysis. A comprehensive approach. Multidisciplinary management in a burn center.

Toxic Epidermal Necrolysis (TEN) is a life-threatening disorder with reported mortality rates of 25-60 percent in pediatric patients. The authors report on their experience in managing six children using a standardized treatment protocol in the intensive care unit of a regional burn center. Areas of sloughed skin were covered with porcine xenograft (pig skin) until reepithelialization was complete. There was one death in the series, and one child had ophthalmologic complications. Treatment in a multidisciplinary burn center is recommended for children with TEN.

Burn Units↗
PubMed1989

Parental attitudes and practices toward children as pedestrians.

Community programs to reduce the toll from pedestrian injuries in childhood must include parents as a key element. This study, consisting of a survey questionnaire, was undertaken to provide information concerning current parent attitudes and practices that could be used to guide prevention programs. The survey consisted of 2464 questionnaires from parents of children in grades kindergarten to four in a suburban school district. Although 94% of parents did not believe that 5- to 6-year-old children can reliably cross streets alone, one third of parents allowed kindergarten-aged children to cross residential streets alone and first-grade children to walk alone to school. The presence of speeding traffic or the lack of safe places to walk did not influence parents in limiting their children's crossings. Few (17%) parents believed that children should be taught not to cross alone; one half of parents, including 41% of parents of kindergarten-aged children believed that children should be taught to cross busy streets without traffic lights. According to results of the study, parent expectations for their children's pedestrian skills may be inappropriate and may be a fruitful target for injury-prevention programs.

Accidents, Traffic↗
PubMed1988

The public cost of motorcycle trauma.

Despite the effectiveness of motorcycle helmet legislation, many states have repealed these laws during the last decade. Aspects often neglected by policymakers are who pays for the care of these victims and how much of this cost is subsidized by public funds. To determine the extent of this subsidy, we studied the cost of care of 105 motorcyclists hospitalized at a major trauma center during a 12-month period. Total direct costs for these 105 patients, followed up for a mean of 20 months, were more than $2.7 million, with an average of $25,764 per patient. Only 60% of the direct costs were accounted for by the initial hospital care; 23% of costs were for rehabilitation care or readmission for treatment of acute problems. The majority (63.4%) of care was paid for by public funds, with Medicaid accounting for more than half of all charges.

Adult↗
PubMed1988

Urban-rural location and the risk of dying in a pedestrian-vehicle collision.

Statewide data from two sources were used to compare the pedestrian-vehicle collision injury and fatality rates for urban and rural areas of Washington State from 1981 through 1983. Although the rates of pedestrian injuries are higher in urban areas, the pedestrian fatality rate in rural areas is higher for nearly all age groups, and at all posted speeds. Multiple logistic regression was carried out to measure the risk of dying once involved in a pedestrian-vehicle collision in rural areas compared to the risk for urban areas. This relative risk was seen to be elevated (RR = 2.3; 95% CI = 2.0-2.6) even after controlling for the effects of age and sex of the pedestrian, and posted speed of the vehicle. When explored further it was seen that a larger proportion of fatalities died out of the hospital and within the first hour after injury in rural areas than in urban areas. It is possible that Emergency Medical Services care is less rapidly available and that accessibility to trauma centers is more limited in rural areas.

Accidents, Traffic↗
PubMed1988

Resident stress.

Explore the source record for details and available documents.

Humans↗
PubMed1987

Factors associated with pedestrian-vehicle collision injuries and fatalities.

Data from Washington State police records of pedestrian-vehicle collisions were used to tabulate injury and fatality rates for 1981 to 1983 and to investigate event characteristics associated with the occurrence of fatalities. Case-fatality rates are seen to be relatively higher when there is decreased visibility due to fog, lack of lighting or dark color of pedestrian clothing. Fatality rates from death certificate data for the same time period were compared with the police-reported rates. For children younger than 5 years, fewer cases of pedestrian death are reported by police than by death certificate, because a large proportion of fatal injuries (27%) is not traffic related or occurs at home (46%) in the garage or driveway.

Accidents, Traffic↗