human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The fever is one of the commonest symptoms of disease in childhood . A mother 's knowledge and conception of fever may determine the degree of her anxiety and fear , and reflect on the way the fever is managed at home . Our underst and ing of mothers ' attitudes may help to improve the home management of fever by correcting unrealistic beliefs . Mothers of 100 children were r and omly selected and interviewed to answer a question naire about fever . Sixty mothers thought that fever could lead to death , others thought that it might lead to paralysis , mental retardation or brain damage . This may explain their undue anxiety and fear when having a child with fever . Cold exposure , teething , exposure to sunlight and having a warm drink were considered as causes . A minority reduced the child 's clothes during fever . Tap water sprinkling and occasionally alcohol were used . Ninety-four mothers used  antipyretics  , all used  paracetamol  and 23 per cent used  aspirin .  Sixty two used  antibiotics indiscriminately . Improved health education is required to allay mothers fear and anxiety and promote a more appropriate fever management at home AIMS AND OBJECTIVES This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management . BACKGROUND Paediatric nurses ' inconsistent , ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests . Determinants of antipyretic administration , identified by the theory of planned behaviour , were belief-based attitudes and subjective norms . DESIGN A quasi-experiment explored group effects of a peer education programme , based on the theory of planned behaviour , on factors influencing paediatric nurses ' antipyretic administration . Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months postpeer education programme .  METHODS All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited . The peer education programme consisted of four one-hour sessions targeting evidence -based knowledge , myths and misconceptions , normative , attitudinal and control influences over and rehearsal of evidence -based fever management .  All nurses in experimental hospital targeted wards were eligible to attend .  Peer education and support facilitated session information reaching those unable to attend sessions . RESULTS Two-way univariate anovas explored between subject , experimental and control group and within subject factors , pre , post and latency data . Significant interactions in normative influence ( p = 0.01 ) and intentions ( p = 0.01 ) , a significant main group effect in control influence ( p = 0.01 ) and a significant main effect between audit data across time points ( p = 0.03 ) highlight peer education programme effectiveness in behaviour change . Normative , control and intention changes postpeer education programme were maintained in latency data ; mean temperature was not . CONCLUSION The peer education programme , based on a behaviour change theory , initiated and maintained evidence -based intentions for antipyretics use in fever management . RELEVANCE TO CLINICAL PRACTICE The promotion of evidence -based change in organizational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes In comparison with other diseases , febrile convulsion , despite its excellent prognosis , is a cause of high anxiety among mothers . The objective of our study was to evaluate the knowledge , concerns , attitudes and practice s of the mothers of children with first febrile convulsion . A prospect i ve question naire-based study was carried out at the Mofid Children ’s Hospital . One hundred and twenty-six mothers of consecutive children presenting with febrile convulsion were enrolled . Only 58 ( 46 % ) mothers recognised the convulsion . Forty-nine ( 39 % ) of them interpreted the seizure as death . Others interpreted it as other causes . Eighty-five ( 68 % ) parents did not carry out any intervention prior to getting the child to the hospital . The most common cause of concern among parents was the state of their child ’s health in the future ( n = 120 , 95 % ) , followed by the fear of recurrence ( n = 83 , 66 % ) , mental retardation ( n = 60 , 48 % ) , paralysis ( n = 39 , 31 % ) , physical disability ( n = 37 , 30 % ) and learning dysfunction ( n = 28 , 22 % ) . In 41 ( 33 % ) mothers , there were other causes of concerns , including fear of visual defect , hearing loss , memory loss , brain defect , delay in walking , drug adverse effects , coma and death . Sixty-eight percent of mothers had acceptable information about the measures that should be taken to prevent recurrence . Awareness of preventive measures was higher in mothers with high educational level ( P < 0.01 ) . Seventy-six percent of mothers did not know anything about the necessary measures in case of recurrence . From this study , we conclude that parental fear of febrile convulsion is a major problem , with serious negative consequences affecting daily familial life We evaluated the ability of an office health education program to ( 1 ) increase  parental knowledge about fever in children , ( 2 ) improve parental satisfaction with services , and ( 3 ) affect the number of fever-associated clinic visits .  R and omly selected experimental and control groups differed only in that the former group viewed a slide-tape presentation . Testing of population sample s before and after the presentation disclosed a highly significant improvement in knowledge about fever in the experimental population that persisted for almost 6 months . Monitoring of subsequent clinic visits revealed a 30 % to 35 % decrease in visits for fever and a 20 % to 25 % decrease in all visits for acute problems . These findings suggest that an audiovisual health education intervention can significantly improve patient confidence in managing fever as reflected by decreased clinic visits . This program is potentially useful in both the office and clinic in a health maintenance organization setting BACKGROUND Fever is one of the most common symptoms in childhood . Mothers ' insufficient knowledge about its evaluation and treatment frequently leads to excessive fear and anxiety . OBJECTIVES To explore mothers ' knowledge concerning management of  fever in their children , at home . DESIGN Descriptive , correlational . SETTING S An emergency department of a pediatric hospital . PARTICIPANTS A total of 327 mothers with febrile children r and omly selected in the waiting room . METHODS Data collection was based on interviews by using a question naire which was specifically developed for this study . RESULTS Almost one out of three mothers ( 32.4 % ) evaluated fever as a temperature between 37 - 38 degrees C and the 38.1 % of them considered that side effects could be a result of these temperatures . The majority of the mothers ( 73.7 % ) administered antipyretics at body temperatures of 37 - 38.5 degrees C , usually without a medical instruction ( 49.2 % ) . Younger mothers with lower education levels and those who admitted to hospital for the first time with children less than 12 months of age showed the poorest level of Knowledge about fever evaluation and treatment . CONCLUSIONS Educational interventions by health care professionals aim ing at educating young mothers with a low educational level and those with a child younger than 12 months old who seek medical attention at hospital , for the first time , are needed to dispel misconceptions about fever and to promote the appropriate management of the febrile child Objective The aims of the study were to determine the following : 1 ) if a fever education program ( interactive or written ) reduces parent fever anxiety ; 2 ) if an interactive fever program was more effective as a teaching style than st and ard written material alone ; and 3 ) if a fever program increases parent fever home management and reduces return emergency department ( ED ) visits . Method A quasiexperimental , pretest and post-test pilot study examining parental fever anxiety was conducted at The Children ’s Hospital of Philadelphia . Eligible participants consisted of 87 parents and their children , aged 3 months to 5 years presenting with fever > 38.4 ° C , and without coexisting serious illness . Results Both the interactive fever education program and the st and ard written fever pamphlet were equally effective as teaching methods . Data revealed a 30 % reduction in fever anxiety rated as moderate-severe on arrival to none-low post-fever education , increased parent fever home management skills with correct use of thermometer and antipyretics , and reduced unnecessary return ED visits . Conclusion Parents in the acute and nonacute care setting may benefit from an interactive fever education program that includes the definition and benefit of fever , the correct use of a thermometer , fever home management skills , and appropriate fever telephone follow-up INTRODUCTION The purpose of this study was to examine the effectiveness of fever management education in increasing knowledge , confidence , comfort , and satisfaction of the parent/gr and parent . METHOD A r and omized repeated measures design was used to evaluate the effectiveness of an educational brochure and video . After baseline data were collected on parent/gr and parents of children receiving st and ard care , each site was r and omized into two groups : Group 1 parents were given a video and brochure about fever management as they left the clinic/office ; Group 2 were shown the video and given the brochure before seeing their health care provider . The parent/gr and parents of 216 children , mean age 21.8 months , completed the Fever Management Question naire ( FMQ ) at 48 - 72 hours , 1 , 3 , and 6 months post-education . RESULTS Knowledge scores of parents/gr and parents in both CALM groups were significantly higher than those in the control group at 48 hours and 1-month post-visit . By 6 months , the knowledge level of the parent/gr and parents in CALM2 , those who viewed the video in the office , was significantly different from the other two groups . Satisfaction , comfort , and confidence of all three groups were high at all three points . Parents/gr and parents in both CALM groups were highly satisfied with the education they received . DISCUSSION Educating parent/gr and parents about fever management using written and video material s is effective in increasing knowledge about fever management van Stuijvenberg M , de Vos S , Tjiang GCH , Steyerberg EW , Derksen‐Lubsen G , Moll HA . Parents'fear regarding fever and febrile seizures . Acta Pædiatr 1999 ; 88 : 618‐22 . Stockholm . ISSN AIM OF THE STUDY To investigate the effect of febrile seizures on the behaviour and emotional situation of parents in order to improve our attitude towards these children and parents in future . METHODS We analysed 135 question naires on  parents ' behaviour and emotional situation during and after a  febrile seizure in their children . RESULTS Febrile seizures were unknown to 44 % of the parents . 121 parents ( 91 % ) reported severe anxiety  on witnessing the first febrile seizure . In 69 % the anxiety was so strong , that the parents believed their child would die . Severe anxiety was significantly associated with lack of knowledge about febrile seizures : 79 % ( no knowledge of febrile seizures ) versus 59 % ( with knowledge ) . The level of anxiety appeared to be associated with low educational level , but not with ethnic background or income . CONCLUSIONS Our study shows that knowledge of febrile seizures among concerned parents in our region remains insufficient . The results are ambiguous . On the one h and we found an association between severe anxiety and lack of knowledge on febrile seizures , suggesting that information prior to the first febrile seizure might reduce the anxiety level and thus lead to appropriate reactions in case of recurrence . On the other h and although parents knew about febrile seizures , they still had very high anxiety levels and would react inappropriately in case of recurrence . Therefore if information is provided to parents , it must be specific , especially about which measures are to be taken or avoided respectively . A prospect i ve study to observe positive and negative effects of preventive information is needed AIMS AND OBJECTIVES To identify whether providing a new information leaflet for parents regarding the management of a febrile convulsion  was more effective in comparison with st and ard leaflets . BACKGROUND Although information leaflets are frequently recommended within healthcare , their quality is often poor . Furthermore , the evidence regarding the effectiveness of leaflets is inconsistent . Few studies have evaluated the effects of providing leaflets that have been developed to improve their quality . Within the specialty of paediatrics , parents are often unprepared regarding the management of febrile convulsion at home and the provision of supplementary leaflets is recommended , despite limited evidence regarding the effectiveness of this approach . There is also limited evidence regarding whether improving the quality of these leaflets leads to better outcomes , e.g. increasing parents ' behavioural knowledge . DESIGN Double-blind r and omized controlled trial . METHOD One hundred and twenty-six parents of children hospitalized due to benign febrile convulsion were recruited ( May 2000-February 2002 ) . Seventy-one parents were r and omized to receive the st and ard care ( control leaflet ) and 55 parents received the intervention ( new leaflet ) .  Data were collected from parents on discharge immediately prior to receiving the intervention and 7 - 14 days following the intervention via telephone interview . RESULTS Parents who received the new leaflet found this to be more reassuring and easier to underst and than parents who received the control leaflet . No differences between groups were identified regarding the primary outcome , i.e. behavioural knowledge and most of the secondary outcomes , e.g. perceived confidence , state anxiety and satisfaction with the leaflet . CONCLUSION Although this study provides modest support for the effectiveness of providing high- quality leaflets , further research is required to determine the best methods for optimizing the effectiveness of leaflets provided at hospital discharge . RELEVANCE TO CLINICAL PRACTICE The quality of leaflets may influence some outcomes , e.g. underst and ing and reassurance with the written information provided ; however , additional strategies to inform parents may be necessary INTRODUCTION The patient overload in pediatric healthcare facilities is caused in part by parents bringing their children in 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The fever is one of the commonest symptoms of disease in childhood . A mother 's knowledge and conception of fever may determine the degree of her anxiety and fear , and reflect on the way the fever is managed at home . Our underst and ing of mothers ' attitudes may help to improve the home management of fever by correcting unrealistic beliefs . Mothers of 100 children were r and omly selected and interviewed to answer a question naire about fever . Sixty mothers thought that fever could lead to death , others thought that it might lead to paralysis , mental retardation or brain damage . This may explain their undue anxiety and fear when having a child with fever . Cold exposure , teething , exposure to sunlight and having a warm drink were considered as causes . A minority reduced the child 's clothes during fever . Tap water sprinkling and occasionally alcohol were used . Ninety-four mothers used  antipyretics  , all used  paracetamol  and 23 per cent used  aspirin .  Sixty two used  antibiotics indiscriminately . Improved health education is required to allay mothers fear and anxiety and promote a more appropriate fever management at home AIMS AND OBJECTIVES This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management . BACKGROUND Paediatric nurses ' inconsistent , ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests . Determinants of antipyretic administration , identified by the theory of planned behaviour , were belief-based attitudes and subjective norms . DESIGN A quasi-experiment explored group effects of a peer education programme , based on the theory of planned behaviour , on factors influencing paediatric nurses ' antipyretic administration . Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months postpeer education programme .  METHODS All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited . The peer education programme consisted of four one-hour sessions targeting evidence -based knowledge , myths and misconceptions , normative , attitudinal and control influences over and rehearsal of evidence -based fever management .  All nurses in experimental hospital targeted wards were eligible to attend .  Peer education and support facilitated session information reaching those unable to attend sessions . RESULTS Two-way univariate anovas explored between subject , experimental and control group and within subject factors , pre , post and latency data . Significant interactions in normative influence ( p = 0.01 ) and intentions ( p = 0.01 ) , a significant main group effect in control influence ( p = 0.01 ) and a significant main effect between audit data across time points ( p = 0.03 ) highlight peer education programme effectiveness in behaviour change . Normative , control and intention changes postpeer education programme were maintained in latency data ; mean temperature was not . CONCLUSION The peer education programme , based on a behaviour change theory , initiated and maintained evidence -based intentions for antipyretics use in fever management . RELEVANCE TO CLINICAL PRACTICE The promotion of evidence -based change in organizational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes In comparison with other diseases , febrile convulsion , despite its excellent prognosis , is a cause of high anxiety among mothers . The objective of our study was to evaluate the knowledge , concerns , attitudes and practice s of the mothers of children with first febrile convulsion . A prospect i ve question naire-based study was carried out at the Mofid Children ’s Hospital . One hundred and twenty-six mothers of consecutive children presenting with febrile convulsion were enrolled . Only 58 ( 46 % ) mothers recognised the convulsion . Forty-nine ( 39 % ) of them interpreted the seizure as death . Others interpreted it as other causes . Eighty-five ( 68 % ) parents did not carry out any intervention prior to getting the child to the hospital . The most common cause of concern among parents was the state of their child ’s health in the future ( n = 120 , 95 % ) , followed by the fear of recurrence ( n = 83 , 66 % ) , mental retardation ( n = 60 , 48 % ) , paralysis ( n = 39 , 31 % ) , physical disability ( n = 37 , 30 % ) and learning dysfunction ( n = 28 , 22 % ) . In 41 ( 33 % ) mothers , there were other causes of concerns , including fear of visual defect , hearing loss , memory loss , brain defect , delay in walking , drug adverse effects , coma and death . Sixty-eight percent of mothers had acceptable information about the measures that should be taken to prevent recurrence . Awareness of preventive measures was higher in mothers with high educational level ( P < 0.01 ) . Seventy-six percent of mothers did not know anything about the necessary measures in case of recurrence . From this study , we conclude that parental fear of febrile convulsion is a major problem , with serious negative consequences affecting daily familial life We evaluated the ability of an office health education program to ( 1 ) increase  parental knowledge about fever in children , ( 2 ) improve parental satisfaction with services , and ( 3 ) affect the number of fever-associated clinic visits .  R and omly selected experimental and control groups differed only in that the former group viewed a slide-tape presentation . Testing of population sample s before and after the presentation disclosed a highly significant improvement in knowledge about fever in the experimental population that persisted for almost 6 months . Monitoring of subsequent clinic visits revealed a 30 % to 35 % decrease in visits for fever and a 20 % to 25 % decrease in all visits for acute problems . These findings suggest that an audiovisual health education intervention can significantly improve patient confidence in managing fever as reflected by decreased clinic visits . This program is potentially useful in both the office and clinic in a health maintenance organization setting BACKGROUND Fever is one of the most common symptoms in childhood . Mothers ' insufficient knowledge about its evaluation and treatment frequently leads to excessive fear and anxiety . OBJECTIVES To explore mothers ' knowledge concerning management of  fever in their children , at home . DESIGN Descriptive , correlational . SETTING S An emergency department of a pediatric hospital . PARTICIPANTS A total of 327 mothers with febrile children r and omly selected in the waiting room . METHODS Data collection was based on interviews by using a question naire which was specifically developed for this study . RESULTS Almost one out of three mothers ( 32.4 % ) evaluated fever as a temperature between 37 - 38 degrees C and the 38.1 % of them considered that side effects could be a result of these temperatures . The majority of the mothers ( 73.7 % ) administered antipyretics at body temperatures of 37 - 38.5 degrees C , usually without a medical instruction ( 49.2 % ) . Younger mothers with lower education levels and those who admitted to hospital for the first time with children less than 12 months of age showed the poorest level of Knowledge about fever evaluation and treatment . CONCLUSIONS Educational interventions by health care professionals aim ing at educating young mothers with a low educational level and those with a child younger than 12 months old who seek medical attention at hospital , for the first time , are needed to dispel misconceptions about fever and to promote the appropriate management of the febrile child Objective The aims of the study were to determine the following : 1 ) if a fever education program ( interactive or written ) reduces parent fever anxiety ; 2 ) if an interactive fever program was more effective as a teaching style than st and ard written material alone ; and 3 ) if a fever program increases parent fever home management and reduces return emergency department ( ED ) visits . Method A quasiexperimental , pretest and post-test pilot study examining parental fever anxiety was conducted at The Children ’s Hospital of Philadelphia . Eligible participants consisted of 87 parents and their children , aged 3 months to 5 years presenting with fever > 38.4 ° C , and without coexisting serious illness . Results Both the interactive fever education program and the st and ard written fever pamphlet were equally effective as teaching methods . Data revealed a 30 % reduction in fever anxiety rated as moderate-severe on arrival to none-low post-fever education , increased parent fever home management skills with correct use of thermometer and antipyretics , and reduced unnecessary return ED visits . Conclusion Parents in the acute and nonacute care setting may benefit from an interactive fever education program that includes the definition and benefit of fever , the correct use of a thermometer , fever home management skills , and appropriate fever telephone follow-up INTRODUCTION The purpose of this study was to examine the effectiveness of fever management education in increasing knowledge , confidence , comfort , and satisfaction of the parent/gr and parent . METHOD A r and omized repeated measures design was used to evaluate the effectiveness of an educational brochure and video . After baseline data were collected on parent/gr and parents of children receiving st and ard care , each site was r and omized into two groups : Group 1 parents were given a video and brochure about fever management as they left the clinic/office ; Group 2 were shown the video and given the brochure before seeing their health care provider . The parent/gr and parents of 216 children , mean age 21.8 months , completed the Fever Management Question naire ( FMQ ) at 48 - 72 hours , 1 , 3 , and 6 months post-education . RESULTS Knowledge scores of parents/gr and parents in both CALM groups were significantly higher than those in the control group at 48 hours and 1-month post-visit . By 6 months , the knowledge level of the parent/gr and parents in CALM2 , those who viewed the video in the office , was significantly different from the other two groups . Satisfaction , comfort , and confidence of all three groups were high at all three points . Parents/gr and parents in both CALM groups were highly satisfied with the education they received . DISCUSSION Educating parent/gr and parents about fever management using written and video material s is effective in increasing knowledge about fever management van Stuijvenberg M , de Vos S , Tjiang GCH , Steyerberg EW , Derksen‐Lubsen G , Moll HA . Parents'fear regarding fever and febrile seizures . Acta Pædiatr 1999 ; 88 : 618‐22 . Stockholm . ISSN AIM OF THE STUDY To investigate the effect of febrile seizures on the behaviour and emotional situation of parents in order to improve our attitude towards these children and parents in future . METHODS We analysed 135 question naires on  parents ' behaviour and emotional situation during and after a  febrile seizure in their children . RESULTS Febrile seizures were unknown to 44 % of the parents . 121 parents ( 91 % ) reported severe anxiety  on witnessing the first febrile seizure . In 69 % the anxiety was so strong , that the parents believed their child would die . Severe anxiety was significantly associated with lack of knowledge about febrile seizures : 79 % ( no knowledge of febrile seizures ) versus 59 % ( with knowledge ) . The level of anxiety appeared to be associated with low educational level , but not with ethnic background or income . CONCLUSIONS Our study shows that knowledge of febrile seizures among concerned parents in our region remains insufficient . The results are ambiguous . On the one h and we found an association between severe anxiety and lack of knowledge on febrile seizures , suggesting that information prior to the first febrile seizure might reduce the anxiety level and thus lead to appropriate reactions in case of recurrence . On the other h and although parents knew about febrile seizures , they still had very high anxiety levels and would react inappropriately in case of recurrence . Therefore if information is provided to parents , it must be specific , especially about which measures are to be taken or avoided respectively . A prospect i ve study to observe positive and negative effects of preventive information is needed AIMS AND OBJECTIVES To identify whether providing a new information leaflet for parents regarding the management of a febrile convulsion  was more effective in comparison with st and ard leaflets . BACKGROUND Although information leaflets are frequently recommended within healthcare , their quality is often poor . Furthermore , the evidence regarding the effectiveness of leaflets is inconsistent . Few studies have evaluated the effects of providing leaflets that have been developed to improve their quality . Within the specialty of paediatrics , parents are often unprepared regarding the management of febrile convulsion at home and the provision of supplementary leaflets is recommended , despite limited evidence regarding the effectiveness of this approach . There is also limited evidence regarding whether improving the quality of these leaflets leads to better outcomes , e.g. increasing parents ' behavioural knowledge . DESIGN Double-blind r and omized controlled trial . METHOD One hundred and twenty-six parents of children hospitalized due to benign febrile convulsion were recruited ( May 2000-February 2002 ) . Seventy-one parents were r and omized to receive the st and ard care ( control leaflet ) and 55 parents received the intervention ( new leaflet ) .  Data were collected from parents on discharge immediately prior to receiving the intervention and 7 - 14 days following the intervention via telephone interview . RESULTS Parents who received the new leaflet found this to be more reassuring and easier to underst and than parents who received the control leaflet . No differences between groups were identified regarding the primary outcome , i.e. behavioural knowledge and most of the secondary outcomes , e.g. perceived confidence , state anxiety and satisfaction with the leaflet . CONCLUSION Although this study provides modest support for the effectiveness of providing high- quality leaflets , further research is required to determine the best methods for optimizing the effectiveness of leaflets provided at hospital discharge . RELEVANCE TO CLINICAL PRACTICE The quality of leaflets may influence some outcomes , e.g. underst and ing and reassurance with the written information provided ; however , additional strategies to inform parents may be necessary INTRODUCTION The patient overload in pediatric healthcare facilities is caused in part by parents bringing their children in 
    Output:
    