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author:("Samson, linda")
2.  The Children’s Hospital of Eastern Ontario Housing Checkup: A survey of the housing needs of children and youth 
Paediatrics & Child Health  2008;13(4):293-297.
Housing is a key determinant of child and youth health. A significant number of Canadian children and youth are living in housing need, but information regarding the housing status of children and youth in the Ottawa, Ontario, community is lacking.
To examine the housing status of children and youth accessing emergency health services at the Children’s Hospital of Eastern Ontario (Ottawa, Ontario), and the factors associated with housing status.
Youth and families of children registered at the Children’s Hospital of Eastern Ontario’s emergency department were offered a questionnaire. Affordability, adequacy, suitability and stability of housing were evaluated through self-reporting. Housing need was defined as an inability to meet one or more of these criteria. Associations among housing and household composition, demographics and weight-for-age percentiles were examined.
One thousand three hundred sixty surveys were completed. Fifty-four per cent of respondents (663 of 1224) were living in housing need, including 33% of respondents (381 of 1166) who were living in unaffordable housing. Single-parent families (OR 2.82), families with six or more members (OR 2.51) and families who rented (OR 5.27) were more likely to be living in housing need. Children and youth with a primary care physician were more likely to be living in stable housing (OR 0.41). Unsuitable housing was associated with extreme weight-forage percentiles (OR 1.90).
More than one-half of the children and youth in the present study were living in housing need. Health care providers have a responsibility to identify and understand the determinants of health of their patients, including housing, and to work for the improved health of their patients and their communities.
PMCID: PMC2529444  PMID: 19337595
Community medicine; Determinants of health; Housing; Public health
7.  Necrotizing fasciitis in children in eastern Ontario: a case-control study 
Early recognition and treatment are important factors that can help improve survival following necrotizing fasciitis. However, early recognition is complicated by the difficulty in distinguishing the infection from other, less serious soft-tissue infections such as cellulitis. We reviewed the charts of children presenting with necrotizing fasciitis at a tertiary care pediatric hospital in Ontario to document potential increases in the frequency of cases and to identify clinical and laboratory features that could help distinguish between necrotizing fasciitis and cellulitis.
Necrotizing fasciitis was defined as a soft-tissue infection characterized by necrosis of subcutaneous tissue and confirmed at surgery or on pathological examination. A retrospective chart review was conducted to identify cases of necrotizing fasciitis that occurred between June 1, 1983, and May 31, 1999. The characteristics of the identified cases, their clinical manifestations and the laboratory features at presentation were compared with those of matched controls admitted to the hospital with cellulitis.
In total, 8 cases of necrotizing fasciitis were identified during the study period. There were no cases from 1983 to 1987, 1 from 1988 to 1991, 1 from 1992 to 1995, and 6 cases from 1996 to 1999. Compared with the children who had cellulitis, those who had necrotizing fasciitis were more likely to present with a generalized erythematous rash (odds ratio [OR] 11.0; 95% confidence interval [CI] 1.5-81.6) and a toxic appearance (OR 23.0; 95% CI 2.0- 262.5). They were also more likely than the children with cellulitis to have a history of fever (8/8 v. 10/24, p = 0.004), a higher temperature (mean 38.7∘C v. 37.8∘C, p = 0.006), a higher respiratory rate (mean 31.5 v. 25.4 breaths/min, p = 0.02) and a lower platelet count on presentation (mean 194.0 v. 299.3 &khcy% 109/L, p = 0.03).
On presentation, factors that may help distinguish necrotizing fasciitis from cellulitis include a generalized erythematous rash, toxic appearance, fever and low platelet count.
PMCID: PMC80371  PMID: 10976253

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