Biomedical subjects
Terry Kind
Publications and source records attributed to Terry Kind.
Do the leading children's hospitals have quality web sites? A description of children's hospital web sites.
BACKGROUND: Although leading children's hospitals are recognized as preeminent in the provision of health care to children, the quality of their Web sites has not been described. OBJECTIVE: To describe technical characteristics of the Web sites of leading children's hospitals. METHODS: This is a cross-sectional descriptive infodemiology study. Two reviewers independently reviewed and analyzed the Web sites of 26 nationally prominent children's hospitals in June 2003, using objective criteria based on accessibility (based on age and language), attribution, completeness, credibility, currency, disclosure, readability, and other technical elements. RESULTS: One-third of Web sites included content for children and adolescents. Twenty-four (92%) of the Web sites had health and disease-specific information. One-third contained only English, while two-thirds included other languages. All 26 Web sites included a disclaimer, although none had a requirement to read the disclaimer before accessing health and disease specific information. Twenty-four (92%) had search options. Although most (85%) listed a copyright date, only 10% listed the date last updated. CONCLUSIONS: This is the first study to examine the Web sites of leading children's hospitals. Although the Web sites were designed for children's hospitals, only a few sites included content for children and adolescents. Primary care physicians who refer patients to these sites should be aware that many have limited content for children, and should assess them for other limitations, such as inconsistent documentation of disclaimers or failure to show the date of the last Web site update. These Web sites are a potentially useful source of patient information. However, as the public increasingly looks to the Internet for health information, children's hospitals need to keep up with increasingly high standards and demands of health-care consumers.
Can an information prescription change parental attitudes and behaviors related to using the Internet for health information resources?
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Ethical issues in pediatric e-health.
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Use of the Internet for health information and communication.
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Cobalamin C disease presenting as hemolytic-uremic syndrome in the neonatal period.
Anew case of cobalamin C disease associated with hemolytic-uremic syndrome (HUS) in the neonatal period is described. A 28-day-old boy presented with failure to thrive, hypotonia, pancytopenia, and features of HUS (microangiopathic hemolytic anemia, thrombocytopenia, and renal failure). The possibility of the diagnosis of an underlying vitamin B12 disorder was prompted by evidence of megaloblastic changes on the peripheral smear and by finding in the literature a suggested association of neonatal HUS with this cobalamin-related metabolic disorder. Amino acid analysis showed elevated homocysteine levels in the plasma and increased levels of both homocysteine and methyl malonic acid in the urine. Diagnosis of cobalamin C disease was confirmed by complementation studies using skin fibroblasts. Therapy included parenteral hydroxocobalamin, carnitine, and leucovorin calcium (folinic acid). Cobalamin C disease should be considered in the diagnosis of patients presenting with HUS in infancy who have unexplained megaloblastosis, pancytopenia, neurologic impairment, and failure to thrive. Early diagnosis and institution of therapy may be effective in improving survival and quality of life.
Internet and computer access and use for health information in an underserved community.
BACKGROUND: The "digital divide" is the gap between those with access to information tools such as the Internet and those without access. The gap has been described by income, education, age, and race. Little information exists on computer and Internet access and use for health information by parents, particularly among populations of low income and low education level. OBJECTIVE: To describe computer and Internet access and use, including health information retrieval, among low-income, urban, African American caregivers (parents). DESIGN: Cross-sectional survey administered in pediatric waiting rooms of urban community-based health centers in a low-income area. PARTICIPANTS: Caregivers of pediatric outpatients. MAIN OUTCOME MEASURES: Access to computers, Internet access, and use of Internet for health information. RESULTS: In 2003, among 260 African Americans who completed surveys, 58% had a computer and 41% had home Internet access. Fifty-two percent had used the Internet for finding health information. Ninety-three percent agreed or strongly agreed that there is useful health information on the Internet. Ninety-two percent agreed or strongly agreed that they would want to talk with a medical professional about health information on the Internet. Sixty-five percent of respondents had no additional schooling after high school. Annual household income was <US 24,999 dollars for 57%. Computer use and Internet access were significantly higher in caregivers with higher education and income. CONCLUSIONS: Most pediatric patients' families have home computers and believe there is useful health information on the Internet, even among low-income and traditionally underserved populations. Most would like to discuss Internet-based health information with their providers.