1,284 results match your criteria Academic Pediatrics[Journal]


A Learning Loop Model of Collaborative Decision Making in Chronic Illness.

Acad Pediatr 2019 Apr 19. Epub 2019 Apr 19.

Center for Community Health Integration, Department of Family Medicine & Community Health, Department of Population & Quantitative Health Sciences, Department of Sociology, Case Western Reserve University, Cleveland, Ohio 44106. Electronic address:

Shared decision-making is a core attribute of quality healthcare that has proved challenging to implement and assess in pediatric practice. Current models of shared decision-making are limited, including their capacity: to incorporate multiple stakeholders; to integrate downstream effects of subacute or minor decisions; and to account for the context(s) in which such decisions are being made and enacted. Based on a review of literature from organizational psychology, cognitive sciences, business, and medicine, we propose an iterative decision-making model of care planning, and identify targets at several levels of influence warranting measurement in future studies. Read More

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http://dx.doi.org/10.1016/j.acap.2019.04.006DOI Listing

Characteristics of High Performing Primary Care Pediatric Practices: A Qualitative Study.

Acad Pediatr 2019 Apr 17. Epub 2019 Apr 17.

Department of Medicine, University of Massachusetts Medical School-Baystate, 759 Chestnut St., Springfield, MA 01199; Institute for Health Care Delivery and Population Science, University of Massachusetts Medical School-Baystate, 3601 Main St., Springfield, MA 01199; Department of Quantitative Health Sciences, University of Massachusetts Medical School-Worcester, 55 Lake Avenue N., Worcester, MA, 01655. Electronic address:

Objective: Performance on pediatric quality measures varies across primary care practices. Healthcare quality is associated with organizational factors, but their effect is understudied in pediatric care. This study aimed to develop hypotheses regarding the relationship between organizational factors and composite scores on pediatric quality measures. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183071
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http://dx.doi.org/10.1016/j.acap.2019.04.005DOI Listing
April 2019
1 Read

The relationship between housing instability and poor diet quality among urban families.

Acad Pediatr 2019 Apr 12. Epub 2019 Apr 12.

Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.

Objective: To examine associations between housing instability and poor diet quality in a sample of urban parents and children.

Methods: Cross-sectional study of 340 parent/guardian-child dyads visiting a pediatric primary care center in Boston, Massachusetts. The parent/guardian (hereafter, parent) completed two Harvard Service Food Frequency Questionnaires, one regarding their own dietary intake and one regarding their child's intake, and an assessment of health-related social needs. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183059
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http://dx.doi.org/10.1016/j.acap.2019.04.004DOI Listing
April 2019
5 Reads

Parental Dual use of E-cigarettes and Traditional Cigarettes.

Acad Pediatr 2019 Apr 10. Epub 2019 Apr 10.

Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States; Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States; Harvard Medical School, Boston, MA; American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL.. Electronic address:

Background: E-cigarettes are growing in popularity. Dual use of e-cigarettes and cigarettes is an increasingly common practice, but little is known about patterns of dual use in parents.

Objectives: To describe smoking-related behaviors among dual-users. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859193011
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http://dx.doi.org/10.1016/j.acap.2019.04.001DOI Listing
April 2019
1 Read
2.007 Impact Factor

Refusal of Vitamin K by Parents of Newborns: A Qualitative Study.

Acad Pediatr 2019 Apr 10. Epub 2019 Apr 10.

Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.

Background And Objective: Despite American Academy of Pediatrics recommendations, some parents refuse IM vitamin K as prophylaxis against vitamin K deficiency bleeding (VKDB) for their newborn. The purpose of our study was to describe attitudes and perceptions of parents who choose to defer IM vitamin K for their newborn.

Methods: Using qualitative methodology, we conducted in-depth semi-structured interviews with parents of newborns in 3 hospitals in Connecticut and California. Read More

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http://dx.doi.org/10.1016/j.acap.2019.04.003DOI Listing
April 2019
2.007 Impact Factor

Concordance of Child and Parent Reports of Children's Screen Media Use.

Acad Pediatr 2019 Apr 10. Epub 2019 Apr 10.

Division of Primary Care Pediatrics and Duke Center for Childhood Obesity Research, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Objective: Little is known about the concordance of parent and child reports of children's media consumption, even though parents are often asked to report for their children in clinical care settings. We aimed to understand how parent and child reports of children's media consumption differ in an era of changing screen media consumption via personal devices.

Methods: As part of a larger study about the reception of health-related cues from children's media, children ages 9 to 11 (N=114) and their parents independently completed identical questionnaires about specific media use and health behaviors. Read More

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http://dx.doi.org/10.1016/j.acap.2019.04.002DOI Listing
April 2019
1 Read

Secondhand smoke exposure and sleep-related breathing problems in toddlers.

Acad Pediatr 2019 Apr 5. Epub 2019 Apr 5.

AAP Julius B. Richmond Center of Excellence, Elk Grove Village, IL, USA; Kentucky Children's Hospital, Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA.

Background: Adequate sleep during childhood is an important component of overall health and wellbeing for children. Secondhand smoke (SHS) exposure has been linked to a higher risk of sleep-disordered breathing.

Objective: Our objective was to investigate relationships between secondhand smoke exposure and sleep-related breathing problems in healthy toddlers ages 2-5. Read More

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http://dx.doi.org/10.1016/j.acap.2019.03.008DOI Listing
April 2019
1 Read
2.007 Impact Factor

Implementation of Recommendations for Long-Acting Contraception among Women Aged 13-18 in Primary Care.

Acad Pediatr 2019 Apr 5. Epub 2019 Apr 5.

Department of Medical Education, Colorado Permanente Medical Group, Kaiser Permanente Colorado; Institute for Health Research, Kaiser Permanente Colorado; Department of Medicine, University of Colorado Anschutz Medical Campus. Electronic address:

Objectives: Clinical specialty societies recommend long-acting reversible contraceptives (LARC) as first-line contraception for adolescent women. We evaluated whether a combined educational and process improvement intervention enhanced LARC placement in primary care within an integrated health care system.

Methods: The intervention included journal clubs, live continuing education, point-of-care guidelines and new patient materials. Read More

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http://dx.doi.org/10.1016/j.acap.2019.03.009DOI Listing
April 2019
2 Reads

Current Practices and Perspectives on Peer Observation and Feedback: A National Survey.

Acad Pediatr 2019 Mar 22. Epub 2019 Mar 22.

Associate Professor, Department of Pediatrics, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC 20010. Electronic address:

Objective: Peer observation and feedback (POF) is the direct observation of an activity performed by a colleague followed by feedback with the goal of improved performance and professional development. Although well described in the education literature, the use of POF as a tool for development beyond teaching skills has not been explored. We aimed to characterize the practice of POF among pediatric hospitalists, to explore the perceived benefits and barriers, and to identify preferences regarding POF. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183063
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http://dx.doi.org/10.1016/j.acap.2019.03.005DOI Listing
March 2019
2 Reads

Seeking Care for Pediatric Illness: Health System Perspective.

Acad Pediatr 2019 Mar 20. Epub 2019 Mar 20.

Department of Pediatrics, Section of Emergency Medicine, 999 N 92(nd) St. CCC Suite 550, Medical College of Wisconsin, Milwaukee, WI, 53226. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S18762859193008
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http://dx.doi.org/10.1016/j.acap.2019.03.007DOI Listing
March 2019
4 Reads

Disparities in Caregivers' Experiences at the Dentist with their Young Child.

Acad Pediatr 2019 Mar 20. Epub 2019 Mar 20.

Post-doctoral fellow, UCI School of Education, Irvine, CA. Electronic address:

Objective: To understand the experiences that diverse families have when taking their young child to the dentist and document their prevalence.

Study Design: An exploratory sequential design was used. First, four focus groups (n=33) with low-income female caregivers of children under 6 years were done in English and Spanish. Read More

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http://dx.doi.org/10.1016/j.acap.2019.03.006DOI Listing
March 2019
6 Reads

Impact of child abuse clinical pathways on skeletal survey performance in high risk infants.

Acad Pediatr 2019 Mar 14. Epub 2019 Mar 14.

Division of General Pediatrics, The Children's Hospital of Philadelphia, 34(th) Street and Civic Center Boulevard, Philadelphia, PA 19104, USA; Center for Pediatric Clinical Effectiveness and PolicyLab, The Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA 19146, USA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, 34(th) Street and Civic Center Boulevard, Philadelphia, PA 19104.

Objectives: 1) To examine the association between the presence of a child abuse pathway and the odds of skeletal survey performance in infants with injuries associated with high risk of abuse, 2) to determine if pathway presence decreased disparities in skeletal survey performance.

Methods: In this retrospective study of children <1 year diagnosed with injuries associated with high risk of abuse at hospitals in the Pediatric Hospital Information System, information regarding the presence of a child abuse pathway was collected via survey. We examined whether the presence of a child abuse pathway was associated with the odds of obtaining a skeletal survey adjusting for patient level factors. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183069
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http://dx.doi.org/10.1016/j.acap.2019.02.012DOI Listing
March 2019
8 Reads

Prevalence of childhood hearing loss and secular trends: A systematic review and meta-analysis.

Acad Pediatr 2019 Mar 11. Epub 2019 Mar 11.

Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia; Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia; Department of Paediatrics & The Liggins Institute, The University of Auckland, Grafton, Auckland, New Zealand. Electronic address:

Background: Better epidemiologic information on childhood hearing loss would inform research priorities and efforts to prevent its progression.

Objectives: To estimate prevalence and secular trends in children's hearing loss.

Data Sources: MEDLINE and EMBASE (January 1996 to August 2017). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183052
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http://dx.doi.org/10.1016/j.acap.2019.01.010DOI Listing
March 2019
11 Reads
2.007 Impact Factor

Interactive Effects of Infant Gestational Age and Infant Fussiness on the Risk of Maternal Depressive Symptoms in a Nationally Representative Sample.

Acad Pediatr 2019 Mar 10. Epub 2019 Mar 10.

Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan School of Medicine (M Quist and PE Shah); Center for Human Growth and Development (N Kaciroti and PE Shah). Electronic address:

Objective: To examine the interactive effects of gestational age and infant fussiness on the risk of maternal depressive symptoms in a nationally representative sample.

Methods: Our sample included 8200 children from the Early Childhood Longitudinal Study, Birth Cohort. Gestational age categories were very preterm (VPT, 24-31 weeks), moderate/late preterm (MLPT, 32-36 weeks) and full term (FT, 37-41 weeks). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183054
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http://dx.doi.org/10.1016/j.acap.2019.02.015DOI Listing
March 2019
3 Reads

Talking About Childhood Obesity: A Survey of What Parents Want.

Acad Pediatr 2019 Mar 10. Epub 2019 Mar 10.

Division of Endocrinology, Department of Pediatrics, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD, 20889, USA. Electronic address:

Objectives: To determine parent preferences when discussing their child's weight regarding weight-based terms, most motivating terms, preferred setting, and if the awareness of their child's weight status impacted these preferences.

Study Design: Parents of children aged 3-17 years (N=349) presenting for health supervision visits completed a survey to assess the degree of offensiveness and motivation for change of commonly used weight-based terminology, and preferred setting for discussion of weight. Parents were asked to assess their child's weight status using recommended terminology (obese, overweight, healthy weight, underweight) and their response was compared to the child's objective BMI percentile. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183068
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http://dx.doi.org/10.1016/j.acap.2019.03.003DOI Listing
March 2019
12 Reads

Screening for Social Determinants of Health in Pediatric Resident Continuity Clinic.

Acad Pediatr 2019 Mar 9. Epub 2019 Mar 9.

Department of Pediatrics, University of North Carolina at Chapel Hill. Electronic address:

Objective: Describe current practices in systematic screening for social determinants of health (SDH) in pediatric resident clinics enrolled in the Continuity Research Network (CORNET).

Methods: CORNET clinic directors were surveyed on demographics, barriers to screening, and screening practices for 15 SDH including the screen source, the timing of screening, the process of administering the screen, and the personnel involved in screening. Incidence rate ratios were tabulated to investigate relationships among screening practices and clinic staff composition. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859193005
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http://dx.doi.org/10.1016/j.acap.2019.02.008DOI Listing
March 2019
3 Reads

Parents' Use of Technologies for Health Management: A Health Literacy Perspective.

Acad Pediatr 2019 Mar 9. Epub 2019 Mar 9.

Pediatrics, New York University School of Medicine - Bellevue Hospital (N Meyers, AF Glick, AL Mendelsohn, BP Dreyer, JJ Velazquez, and HS Yin); Population Health, New York University School of Medicine (AL Mendelsohn, HS Yin). Electronic address:

Objective: Parent use of technology to manage child health issues has the potential to improve access and health outcomes. Few studies have examined how parent health literacy affects usage of Internet and cell phone technologies for health management.

Methods: Cross-sectional analysis of data collected as part of a randomized controlled experiment in 3 urban pediatric clinics. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.008DOI Listing
March 2019
6 Reads

Geographic disparities in treatment for children with autism spectrum disorder.

Acad Pediatr 2019 Mar 8. Epub 2019 Mar 8.

National Center on Birth Defects and Developmental Disabilities, 1600 Clifton Road, Atlanta, GA, 30329.

Objective: Geographic differences may provide insight into what factors influence the likelihood that a child is diagnosed with ASD in the US, yet there have been few nationally representative surveys that have explored this topic. The current study expands the limited literature by analyzing regional differences in ASD prevalence, service utilization, and the presence of unmet needs within a nationally representative sample of children.

Methods: Data were drawn from the 2014-2016 National Health Interview Survey (NHIS), a nationally representative household survey of the noninstitutionalized US population. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183070
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http://dx.doi.org/10.1016/j.acap.2019.02.013DOI Listing
March 2019
3 Reads

Procedural Sedation Outside the Operating Room and Potential Neurotoxicity: Analysis of an At-Risk Pediatric Population.

Acad Pediatr 2019 Mar 8. Epub 2019 Mar 8.

Children's Healthcare of Atlanta at Egleston, Ga (PP Kamat, C Sulton, CE McCracken, and HK Simon); Pediatrics and Emergency Medicine (C Sulton and HK Simon).

Objectives: To determine the characteristics of children who met the risk criteria for potential neurotoxicity defined by the US Food and Drug Administration (FDA; 2016 warning) in a procedural sedation (PS) service.

Study Design: A single-center retrospective review of all infants and children aged <3 years receiving PS outside the operating room from 2014 to 2016. Demographics, duration of, and the reason for PS were analyzed. Read More

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http://dx.doi.org/10.1016/j.acap.2019.02.011DOI Listing
March 2019
6 Reads

Improving Adolescent Depression Screening in Pediatric Primary Care.

Acad Pediatr 2019 Mar 9. Epub 2019 Mar 9.

Departments of Pediatrics (VS Harder, SE Barry, S French, AB Consigli, and BL Frankowski).

Objective: Depression among adolescents is a leading public health problem. Although screening for adolescent depression in primary care is strongly recommended, screening rates remain low. Effective quality improvement (QI) initiatives can facilitate change. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183052
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http://dx.doi.org/10.1016/j.acap.2019.02.014DOI Listing
March 2019
7 Reads

Objective Assessment of Resident Teaching Competency Through a Longitudinal, Clinically Integrated, Resident-as-Teacher Curriculum.

Acad Pediatr 2019 Mar 8. Epub 2019 Mar 8.

Division of General and Community Pediatrics (FJ Real, D DeBlasio, JR Spaulding, and M Klein); Division of Hospital Medicine (N Unaka, K Jerardi, and M Klein); Department of Pediatrics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine (MW Zackoff, FJ Real, D DeBlasio, B Sobolewski, N Unaka, K Jerardi, and M Klein), Ohio.

Objective: Competency-based training should be paired with objective assessments. To date, there has been limited objective assessment of resident-as-teacher curricula (RATC). We sought to assess the impact of a longitudinal RATC on postgraduate year-1 (PGY1) resident teaching competency using Observed Structured Teaching Encounters (OSTEs) for the skills of 1) brief didactic teaching [DT], 2) feedback [FB], and 3) precepting [PR]. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.011DOI Listing
March 2019
2 Reads

Longitudinal associations of electronic application use and media program viewing with cognitive and psychosocial development in preschoolers.

Acad Pediatr 2019 Mar 7. Epub 2019 Mar 7.

Early Start, School of Education, Faculty of Social Sciences, University of Wollongong, Australia, 2500; Illawarra Health and Medical Research Institute, University of Wollongong, Australia, 2500.

Objective: To investigate associations of traditional (program viewing) and contemporary electronic media use (electronic applications; 'apps') with preschoolers' executive function and psychosocial development 12 months later.

Methods: An analysis of longitudinal data from 185 children (mean age: 4.2 ± 0. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183071
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http://dx.doi.org/10.1016/j.acap.2019.02.010DOI Listing
March 2019
3 Reads

Material Hardships and Health Care Utilization Among Low-Income Children with Special Health Care Needs.

Acad Pediatr 2019 Mar 8. Epub 2019 Mar 8.

AE Fuller is now with the Division of Paediatric Medicine, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada.

Objective: Material hardships, defined as difficulty meeting basic needs, are associated with adverse child health outcomes, including suboptimal health care utilization. Children with special health care needs (CSHCN) may be more vulnerable to the effects of hardships. Our objective was to determine associations between material hardships and health care utilization among CSHCN. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.009DOI Listing
March 2019
2 Reads

The Care of Adult Patients in Pediatric Emergency Departments.

Acad Pediatr 2019 Mar 7. Epub 2019 Mar 7.

Division of Emergency Medicine, Department of Pediatrics (ER Alpern), Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Ill.

Objective: Adult patients are increasingly receiving care in pediatric emergency departments (PEDs), but little is known about the epidemiology of these visits. The goals of this study were to examine the characteristics of adult patients (≥21 years) treated in PEDs and to describe the variation in resource utilization across centers.

Methods: We conducted a cross-sectional study examining visits to 30 PEDs (2012-2016) using the Pediatric Health Information System. Read More

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http://dx.doi.org/10.1016/j.acap.2019.03.004DOI Listing
March 2019
1 Read

Impact of Mobile Device-Based Clinical Decision Support Tool on Guideline Adherence and Mental Workload.

Acad Pediatr 2019 Mar 7. Epub 2019 Mar 7.

Departments of Pediatrics (KM Richardson, E Kerns, and RJ McCulloh).

Objective: To evaluate the individual-level impact of an electronic clinical decision support (ECDS) tool, PedsGuide, on febrile infant clinical decision making and cognitive load.

Methods: A counterbalanced, prospective, crossover simulation study was performed among attending and trainee physicians. Participants performed simulated febrile infant cases with use of PedsGuide and with standard reference text. Read More

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http://dx.doi.org/10.1016/j.acap.2019.03.001DOI Listing
March 2019
2 Reads

Total Breastfeeding Duration and Household Food Insecurity in Healthy Urban Children.

Acad Pediatr 2019 Mar 1. Epub 2019 Mar 1.

Institute of Health Policy, Management and Evaluation (PC Parkin, JL Maguire, CS Birken, and CM Borkhoff), University of Toronto; Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PD Wong, PC Parkin, JL Maguire, CS Birken, and CM Borkhoff); Sick Kids Research Institute (PD Wong, PC Parkin, CS Birken, and CM Borkhoff), Hospital for Sick Children.

Objective: Health care policy positions breastfeeding as an important part of the solution to household food insecurity; however, there are critical gaps in our knowledge of the relationship between breastfeeding duration (exposure variable) and household food insecurity (outcome variable). Our objective was to examine this relationship.

Methods: A cross-sectional study was conducted from 2008 to 2016 of healthy urban children (N = 3838) who were 0 to 3years old and recruited from The Applied Research Group for Kids (TARGet Kids!), a practice-based research network in Toronto, Canada. Read More

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http://dx.doi.org/10.1016/j.acap.2019.02.009DOI Listing
March 2019
3 Reads

Mothers' Perceptions of the Cardboard Box as a Potential Sleep Space.

Acad Pediatr 2019 Feb 23. Epub 2019 Feb 23.

Department of Pediatrics, Yale University School of Medicine, (N Dalvie and J Loyal) New Haven, Conn. Electronic address:

Objective: Due to increasing popularity, our hospital began considering distributing cardboard boxes combined with safe sleep education to new mothers. As a first step in studying the impact of this intervention on bedsharing in our community, we sought to understand mothers' perceptions of the cardboard box.

Methods: We recruited primarily low-income, English- or Spanish-speaking mothers of infants aged 2 to 16 weeks during routine primary care visits. Read More

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http://dx.doi.org/10.1016/j.acap.2019.02.007DOI Listing
February 2019

Social and Functional Characteristics of Receipt and Service Use Intensity of Core Early Intervention Services.

Acad Pediatr 2019 Feb 21. Epub 2019 Feb 21.

Department of Health Systems, Management and Policy (ZS Richardson and BM McManus). Electronic address:

Objective: Describe children's diagnostic, social, and functional characteristics associated with the use of core early intervention (EI) services.

Methods: The sample included infants and toddlers (N = 2045) discharged from an urban EI program (2014-2016). Adjusted logit models estimated the marginal effects and 95% confidence intervals (CIs) of receipt of any of the 4 core EI services, controlling for the child's developmental condition type, race and ethnicity, primary language, sex, insurance type, age at referral, and functional performance at EI entry. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859193004
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http://dx.doi.org/10.1016/j.acap.2019.02.004DOI Listing
February 2019
5 Reads

Trends in Visits and Costs for Mental Health Emergencies in a Pediatric Emergency Department, 2010-2016.

Acad Pediatr 2019 Feb 21. Epub 2019 Feb 21.

Division of Emergency Medicine (JA Hoffmann, AM Stack, MC Monuteaux, and LK Lee).

Objective: Analyze trends in visit numbers, length of stay (LOS), and costs of pediatric mental health emergency department (ED) visits over time.

Methods: We conducted a cross-sectional, time-series analysis from 2010 to 2016 of mental health visits, identified by billing diagnosis codes, among children 5 to 18years old in a tertiary pediatric ED. We used Poisson regression to analyze trends in rates of mental health visits, patient-hours, and visits with LOS ≥ 24hours. Read More

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http://dx.doi.org/10.1016/j.acap.2019.02.006DOI Listing
February 2019

Weight Bias in Pediatric Inpatient Care.

Acad Pediatr 2019 Feb 20. Epub 2019 Feb 20.

Department of Pediatrics, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA; Brenner FIT (Families in Training), Brenner Children's Hospital, Medical Center Blvd, Winston-Salem, NC 27157, USA. Electronic address:

Objective: Weight bias can influence medical care but has not been studied in the pediatric inpatient setting. We will quantify implicit and explicit weight bias of pediatric inpatient providers and qualitatively explore providers' attitudes toward children with obesity and patient/family perceptions of weight bias in the hospital.

Methods: We performed a mixed-methods study including semi-structured key informant interviews and validated tests for implicit (Implicit Association Test, IAT) and explicit (Crandall's Anti-Fat Attitudes Questionnaire, AFAQ) bias with pediatric hospitalists, residents, and acute care nurses. Read More

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http://dx.doi.org/10.1016/j.acap.2019.02.005DOI Listing
February 2019

Impact of a Baby-Friendly-Aligned Pacifier Policy on Pacifier Use at 1 Month of Age.

Acad Pediatr 2019 Feb 14. Epub 2019 Feb 14.

Department of Pediatric and Adolescent Medicine, Einstein Medical Center Philadelphia, Philadelphia, Penn Dr. Ekambaram is now with Baylor Scott & White Medical Center, Round Rock, Tex.

Objective: Pacifier use decreases the risk of sudden infant death syndrome, but its impact on breastfeeding remains controversial. We evaluated the impact of a pacifier policy aligned with the World Health Organization and United Nations Children's Fund Baby-Friendly Hospital Initiative on subsequent pacifier use and breastfeeding at 1 month of age.

Methods: We conducted a prospective 2-stage (pre- and post-implementation) cohort study of newborns at a birth hospital before and after implementation of a Baby-Friendly-aligned pacifier policy. Read More

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http://dx.doi.org/10.1016/j.acap.2019.02.002DOI Listing
February 2019

Reducing Burnout and Reinforcing Resilience: Answering the Call for Rigorous Research.

Acad Pediatr 2019 Apr 14;19(3):245-247. Epub 2019 Feb 14.

Office of Medical Education, University of Virginia School of Medicine, Charlottesville. Electronic address:

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http://dx.doi.org/10.1016/j.acap.2019.02.003DOI Listing
April 2019
1 Read

Teachable Moments From the Maasai.

Authors:
Jennifer Bass

Acad Pediatr 2019 Apr 5;19(3):248-250. Epub 2019 Feb 5.

Department of Pediatrics, Northwest Permanente, Oregon Health Sciences University, Portland, Ore. Electronic address:

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http://dx.doi.org/10.1016/j.acap.2019.02.001DOI Listing

The Most Memorable One.

Authors:
Elizabeth Toll

Acad Pediatr 2019 Jan 30. Epub 2019 Jan 30.

Departments of Pediatrics and Medicine, The Warren Alpert Medical School of Brown University, Providence, RI. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S18762859193003
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http://dx.doi.org/10.1016/j.acap.2019.01.007DOI Listing
January 2019
7 Reads

A Qualitative Study Examining Stakeholder Perspectives of a Local Child Abuse Program in Community Emergency Departments.

Acad Pediatr 2019 Jan 29. Epub 2019 Jan 29.

Department of Pediatrics, Yale University School of Medicine, New Haven, Conn.

Objective: Emergency department (ED) providers may fail to recognize or report child abuse and/or neglect (CAN). To improve recognition and reporting, we designed the Community ED CAN Program, in which teams of local clinicians (nurses, physicians, physician assistants) received training in CAN and 1) disseminated evidence-based education; 2) provided consultation, case follow-up, and access to specialists; and 3) facilitated multidisciplinary case review. The aims of this study were to understand the Program's strengths andchallenges and to explore factors that influenced implementation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859193001
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http://dx.doi.org/10.1016/j.acap.2019.01.006DOI Listing
January 2019
3 Reads

Reported Knowledge and Management of Potential Penicillin Allergy in Children.

Acad Pediatr 2019 Jan 28. Epub 2019 Jan 28.

Pediatric Emergency Medicine (D Vyles, V Heffner, P Drayna, and DC Brousseau).

Background: Pediatric emergency medicine (PEM) and primary care provider (PCP) providers are the most likely physicians to initially label a child as allergic to penicillin. Differences in knowledge and management of reported penicillin allergy between these 2 groups have not been well characterized.

Methods: A cross-sectional, 20-question survey was administered to PEM and PCPs to ascertain differential knowledge and management of penicillin allergy. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.002DOI Listing
January 2019
20 Reads

Impacts of a Pediatric Extracorporeal Cardiopulmonary Resuscitation (ECPR) Simulation Training Program.

Acad Pediatr 2019 Jan 24. Epub 2019 Jan 24.

Division of Critical Care Medicine (T Chan, H Valdivia, L Yalon, and J Roberts), Seattle Children's Hospital, Wash.

Objective: To examine the impacts of a large-scale simulation-based extracorporeal cardiopulmonary resuscitation (ECPR) training program in an academic children's hospital.

Methods: The study followed a quasi-experimental, mixed-method, time series design. Two-hour high-fidelity ECPR simulations were held monthly in the pediatric, cardiac, and neonatal intensive care units. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.005DOI Listing
January 2019
7 Reads

Parental and Provider Perceptions of Sugar-Sweetened Beverage Interventions in the First 1000Days: A Qualitative Study.

Acad Pediatr 2019 Jan 21. Epub 2019 Jan 21.

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics (K Morel, K Nichols, Y Nong, and JA Woo Baidal). Electronic address:

Background: Novel approaches to reduce sugar-sweetened beverage (SSB) consumption during the first 1000 days-pregnancy through age 2 years-are urgently needed.

Objective: To examine perceptions of SSB consumption and acceptability of potential intervention strategies to promote SSB avoidance in low-income families in the first 1000days.

Methods: In this qualitative research, we performed semistructured, in-depth interviews of 25 women and 7nutrition/health care providers. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.004DOI Listing
January 2019

Disappearing Medicaid Enrollment Disparities for US Citizen Children in Immigrant Families: State-Level Trends from 2008 to 2015.

Acad Pediatr 2019 Apr 19;19(3):333-341. Epub 2019 Jan 19.

Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio.

Objective: Medicaid and the Children's Health Insurance Program (CHIP) provide health insurance to 38% of all children in the United States. Uninsured rates continued to fall over the past decade, and citizen children in immigrant families experienced the most dramatic gains. Our objective is to test whether states have managed to close Medicaid enrollment gaps between US citizen children in native and immigrant families. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.003DOI Listing
April 2019
1 Read

Temperature-Adjusted Respiratory Rate for the Prediction of Childhood Pneumonia.

Acad Pediatr 2019 Jan 16. Epub 2019 Jan 16.

Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Mass.

Objectives: As both fever and pneumonia can be associated with tachypnea, we investigated the relationship between body temperature and respiratory rate (RR) in young children and whether temperature-adjusted RR enhances the prediction of pneumonia.

Methods: In this retrospective cross-sectional analysis of 91,429 children < 5 years of age presenting to an urban pediatric emergency department, the relationship between triage RR and temperature was analyzed using regression analysis. We assessed the predictive value of temperature-adjusted RR for the diagnosis of pneumonia; diagnostic performance was evaluated for continuous RR as well as World Health Organization (WHO) age-based RR thresholds. Read More

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http://dx.doi.org/10.1016/j.acap.2018.11.015DOI Listing
January 2019
2 Reads

Food for Thought: A Randomized Trial of Food Insecurity Screening in the Emergency Department.

Acad Pediatr 2019 Jan 11. Epub 2019 Jan 11.

Division of Emergency Medicine (D Cullen and J Fein), The Children's Hospital of Philadelphia.

Background: Despite the growing interest in screening for food insecurity in the clinical setting, little evidence exists regarding screening formats that maximize disclosure and caregiver comfort.

Methods: In this randomized trial, we asked English-speaking adult caregivers of pediatric patients in the emergency department at an urban, freestanding children's hospital to complete a validated, 2-question screen for food insecurity. Respondents were assigned via block randomization to complete the survey by either verbal interview or electronic tablet. Read More

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http://dx.doi.org/10.1016/j.acap.2018.11.014DOI Listing
January 2019
1 Read

Impact of a Resident Research Grant on Scholarly Output During Pediatric Residency.

Acad Pediatr 2019 Jan 11. Epub 2019 Jan 11.

Division of Infectious Diseases (TJ Sandora); Department of Pediatrics (AS Winn, LE Nigrovic, FH Lovejoy, and TJ Sandora), Harvard Medical School, Boston, Mass.

Lack of research funding is a known barrier to performing research during residency. Receipt of an institution-based resident research grant was associated with increased scholarly output. Programs should consider creating funding mechanisms to promote scholarship during residency. Read More

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http://dx.doi.org/10.1016/j.acap.2018.12.009DOI Listing
January 2019
1 Read

Medical Student Participation in Patient- and Family-Centered Rounding: A National Survey of Pediatric Clerkships.

Acad Pediatr 2019 Jan 11. Epub 2019 Jan 11.

Department of Pediatrics, Johns Hopkins All Children's Hospital (PD Quigley), St. Petersburg, Fla.

Objective: Pediatrics rotations may be medical students' only experience with patient- and family-centered rounding (PFCR). It is unclear how students participate in or are prepared for PFCR. We surveyed national pediatrics clerkships to determine the prevalence of PFCR and the proportion providing orientation in order to inform a needs assessment for PFCR orientation. Read More

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http://dx.doi.org/10.1016/j.acap.2018.12.010DOI Listing
January 2019
2 Reads

The Strengths and Difficulties Questionnaire Self-Report: A Valid Instrument for the Identification of Emotional and Behavioral Problems.

Acad Pediatr 2019 Jan 10. Epub 2019 Jan 10.

TNO Child Health (MHC Theunissen, MS de Wolff, and SA Reijneveld), Leiden; Department of Health Sciences (SA Reijneveld), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Objective: Validated questionnaires help community pediatric services to identify emotional and behavioral problems (EBPs). This study assesses the psychometric properties of the self-report version of the Strengths and Difficulties Questionnaire (SDQ) for the identification of EBPs in adolescents (13 to 14 years old) and the added value of the SDQ parent-form version.

Methods: We obtained data on 500 adolescents (mean age 13. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183054
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http://dx.doi.org/10.1016/j.acap.2018.12.008DOI Listing
January 2019
12 Reads

Use of Commercial Direct-to-Consumer Telemedicine by Children.

Acad Pediatr 2019 Jan 10. Epub 2019 Jan 10.

Department of Health Care Policy (Z Shi and A Mehrotra), Harvard Medical School, Boston, Mass; RAND Corporation (A Mehrotra), Boston, Mass.

Objective: In commercial direct-to-consumer (DTC) telemedicine, physicians outside of the medical home treat common, acute complaints through real-time, audio-visual conferencing using telephones and personal computers. There has been little examination of the use of DTC telemedicine by children. We describe trends in DTC telemedicine use and DTC telemedicine visit characteristics. Read More

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http://dx.doi.org/10.1016/j.acap.2018.11.016DOI Listing
January 2019
1 Read

Building Capacity in Pediatric Environmental Health: A Fifteen-Year Report on the Academic Pediatric Association's Professional Development Program.

Acad Pediatr 2019 Jan 9. Epub 2019 Jan 9.

Icahn School of Medicine at Mount Sinai, New York, NY 10029.

Background: Environmental exposures contribute to multiple diseases in children. Yet few pediatricians have training in Pediatric Environmental Health (PEH) and few academic health centers have PEH expertise. To build national capacity in PEH, the Academic Pediatric Association (APA) launched a professional development program that since 2002 has encouraged the establishment of post-residency/post-doctoral training programs, supported a Special Interest Group, and convened an annual mentored retreat for PEH trainees. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.001DOI Listing
January 2019
1 Read

Key Studies in Medical Education from 2017: A Narrative Review.

Acad Pediatr 2019 Jan 4. Epub 2019 Jan 4.

Department of Pediatrics (HB Fromme), University of Chicago Pritzker School of Medicine, Chicago, Ill.

Education, like clinical medicine, should be based on the most current evidence in the field. Despite the overwhelming breadth of literature in medical education, pediatric educators desire and need to incorporate best practices into their educational approaches. This article provides an overview of 18 articles from the literature in 2017 that the authors consider to be key articles in the field of pediatric medical education. Read More

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http://dx.doi.org/10.1016/j.acap.2018.12.007DOI Listing
January 2019
3 Reads

Pre-Registration of Educational Trials: Should Educational Trials Be Expected to Be Conducted With the Same Rigor as Clinical Trials?

Acad Pediatr 2019 Mar 2;19(2):131-132. Epub 2019 Jan 2.

Department of Pediatric and Adolescent Medicine (RM Jacobson), Mayo Clinic, Rochester, Minn.

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http://dx.doi.org/10.1016/j.acap.2018.12.006DOI Listing
March 2019
3 Reads

Quality Improvement-Driven Reduction in Countywide Medicaid Acute Asthma Health Care Utilization.

Acad Pediatr 2019 03 29;19(2):216-226. Epub 2018 Dec 29.

Pediatric Pulmonology (ED Allen), Respiratory Therapy (G Ayres), The Center for Surgical Outcomes Research (J Cooper), Ambulatory Pediatrics (J Groner, S Hersey, and D Snyder), Hospital Pediatrics (G McGwire), Pediatric Allergy/Immunology (D Stukus), Pediatric Emergency Medicine (KS Stukus), Neonatology (C Timan), Data Resource Center (N Wegener), Chief Medical Officer (RJ Brilli), Nationwide Children's Hospital; Quality Improvement Services (T Montgomery), The Ohio State University Wexner Medical Center; Operations (J Gillispie), President (SP Gleeson), Children's Community Practices (C Rowe), Partners for Kids, Columbus, Ohio.

Objective: This study evaluates the impact of a coordinated effort by an urban pediatric hospital and its associated accountable care organization to reduce asthma-related emergency department (ED) and inpatient utilization by a large, countywide Medicaid patient population.

Methods: Multiple evidence-based interventions targeting general pediatric asthma care and high health care utilizers were implemented using standardized quality improvement methodologies. Annual asthma ED and inpatient utilization rates by 2- to 18-year-old members of an accountable care organization living in the surrounding county (>140,000 eligible members in 2016), adjusted per 1000 children from 2008 through 2016, were analyzed using Poisson regression. Read More

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http://dx.doi.org/10.1016/j.acap.2018.12.005DOI Listing
March 2019
7 Reads