Pediatricians may receive three credit hours in Category I for the Physician's Recognition Award of the American Medical Association by reading the material in this issue and successfully answering the questions in the quiz below. To obtain credits, follow these instructions.
1 . Read each of the articles carefully. Do not neglect the tables and other illustrative materials, as they have been selected to enhance your knowledge and understanding.
2. The following questions have been designed to provide a useful link between the articles in the issue and your everyday practice. Read each question, choose the correct answer, and record your answer on the CME Registration Form at the end of the quiz. Retain a copy of your answers so that they can be compared with the correct answers that will be sent to you later.
3. Type or print your full name and address and your Social Security number in the spaces provided on the CME Registration Form.
4. Send the completed form, with your check or money order for S 1 8 made out to PEDIATRIC ANNALS CME CENTER, 6900 Grove Road, Thorofare, NJ 08086.
5. Your answers will be graded, and you will be advised that you have passed (or failed). An answer sheet containing all correct answers will be mailed to you. Review the parts of the articles dealing with any questions you have missed, and read the supplemental material on this aspect of the subject listed in the references in this issue.
6. Be sure to mail the form on or before the deadline listed on the CME Registration Form so that credit can be awarded. (After that date, the quiz will close, and correct answers will appear in the magazine.) Unanswered questions will be considered incorrect and so scored. A minimum score of 70 must be obtained in order for credits to be awarded.
As an organization accredited for continuing medical education, the Lenox Hill Hospital of New York designates this continuing medical education activity as meeting the criteria for three credit hours in Category I for Educational Materials for the Physician's Recognition Award of the American Medical Association, provided it has been completed according to instructions.
1 . The unique feature of community pediatrics Is its concern:
A. Primarily for children who are well but who need preventive sen/ice.
B. Primarily for children who have symptoms of illness but who do not receive accessible or effective care.
C. Primarily for children who seek medical care in physicians' offices or at a hospital.
D. For all children of the population, well or sick.
2. The American Academy of Pediatrics' Pediatrie Research In Office Settings network follows a model that was initially well established in:
3. The term "new morbidity" refers to problems associated with:
A. Accidents and injuries.
B. Prematurity and its complications.
C. School learning, behavior, and social problems.
D. Malignancies and their earlier diagnoses.
4. If a university pediatrie department is to practice true community pediatrics, the university must provide for the care of all children in that community.
5. Over the last two decades, the proportion of primary care provided to children (particularly for those under 1 0 years of agej by pediatricians in the United States is:
B. Staying about the same.
6. The current percentage of pediatricians who have completed their training and who are involved in officebased primary care pediatrics approximates:
D. More than 85%.
7. Since the days of William Osier, the centerpiece of medical education has been:
A. The medical school laboratories.
B. The hospital emergency rooms.
C. The hospital in-patient wards.
D. The primary care office settings.
8. All of the following values are of significant importance to community-based education except:
A. It helps students and residents formulate and clarify their earner decisions.
B. It strengthens the bonds between community practice and the medical center ("town-gown" relationships).
C. It allows students and residents to see that office primary care medicine is at an easier, slower, and less stressful pace than academic medicine.
D. It has the potential to improve the quality of practice and ultimately benefit the nation's children.
9. Ail of the following have important roles in community pediatrie research studies except:
C. Population demographics.
10. In research terminology, clinicians are interested primarily, and often exclusively. In patients or numerators, while epidemiologists are concerned in general with denominators.
11. Ail of the following statements regarding research in the United States are true except:
A. As a percentage of total health-care dollars, funding for health-care research in children has reached an all-time high in this decade.
B. Laboratory or bench research has always been judged to be more scientific and therefore more highly regarded than ambulatory or community-based research.
C. Survey research or dry lab research involving people, groups, and the community is and always has been considered less worthy than research done in the wet lab - on animals, cells, or subcellular tissues.
D. In health-care research, children often are viewed as less important than adults, and funding for health-care research in children often is decreased from that of health-care research in adults.
12. Despite the fact that relatively few children are hospitalized in any given year, those costs of hospitalization account for what proportion of the total child health expenditure in any given year?
D. More than 67%.
13. From studies done in the early 1980s comparing pediatrie hospital!· zation rates, the most striking findings were that for most of the medical conditions examined, children residing in Boston, when compared with children residing in Rochester, were hospitalized:
B. About at the same rate.
C. About twice as often.
D. From two and one half to six times more often.
14. All of the following factors can be used as explanations for the significant, observed differences in rates of childhood hospltalizatlons in different communities except;
A. Access Io services.
B. Ages of the childhood population.
C. Epidemiology of illness.
D. Physician behavior.
15. Through the 1950s and the 1960s, approximately what percentage of children referred to as mentally retarded were subsequently found not to be mentally retarded but rather diagnosed as developmentally disabled?
16. The neighborhood health center movement that was Initiated in the 1960s has continued to expand and currently exists in more than 2000 sites and reaches approximately:
A. 500 000 patients.
B. 2 million patients.
C. 4 to 5 million patients.
O. Nearly 7 million patients.
17. All of the following statements about the juvenile justice system are true except:
A. In 1990 alone, about 2 million children and adolescents were arrested in the United States and entered the juvenile justice system.
B. Incarcerated pregnant young women are the only group in the juvenile justice system to receive appropriate and adequate medical care.
C. Children and adolescents in our juvenile justice system do not get the health services they need.
D. There are nearly three quarters of a million children and adolescents incarcerated in adult prisons each year.
18. The anchoring points of primary care, as defined by Alpert and Chamey in a 1973 article, included all of the following except:
A. Provision of episodic, fragmented and urgent care while recognizing many patients will not accept ongoing longitudinal medical care.
B. Acceptance of the coordinated and longitudinal responsibility for patients whether sick or well.
C. Integration of all physical, psychological, and social aspects of patient care and the management thereof.
D. Delivery of family focused care, with full recognition of the family as the fundamental unit of living in our society.
19. In the Industrialized countries of the world, there exists a direct association between the percentage of physicians in that country who are generalists rather than specialists and the percentage of gross national product (GNP) that is spent on health care.
20. Currently in the United States:
A. About 50% of physicians are generalists and 9% of the GNP is spent on health care.
B. About 35% of physicians ate generalists and 12% of the GNP is spent on health care.
C. About 25% of physicians are generalists and 17% of the GNP is spent on health care.
D. About 15% of physicians are generalists and 20% of the GNP is spent on health care.
Answers to the September Quiz Renal Diseases