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    1047 results match your criteria Academic Pediatrics[Journal]

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    From Design to Dissemination: Conducting Quantitative Medical Education Research.
    Acad Pediatr 2017 Nov 5. Epub 2017 Nov 5.
    University of California, Davis, Department of Pediatrics,. Electronic address:
    Rigorous medical education research is critical to effectively develop and evaluate the training we provide our learners. Yet, many clinical medical educators lack the training and skills needed to conduct high quality medical education research. This paper offers guidance on conducting sound quantitative medical education research. Read More

    Hospital and Community Characteristics Associated with Pediatric Direct Admission to Hospital.
    Acad Pediatr 2017 Oct 27. Epub 2017 Oct 27.
    Instititute for Healthcare Delivery and Population Science and Department of Medicine, University of Massachusetts Medical School - Baystate 3601 Main Street, Springfield, MA, 01199; Department of Quantitative Health Sciences, University of Massachusetts Medical School Worcester, MA.
    Objectives: One-quarter of pediatric hospitalizations begin as direct admissions, defined as hospitalization without receiving care in the hospital's emergency department (ED). Direct admission rates are highly variable across hospitals, yet previous studies have not examined reasons for this variation. We aimed to determine the relationships between hospital and community factors and pediatric direct admission rates, and evaluate the degree to which these characteristics explain variation in risk-adjusted direct admission rates. Read More

    Visits to Primary Care and Emergency Department Reliance for Foster Youth: Impact of Medicaid Managed Care.
    Acad Pediatr 2017 Oct 25. Epub 2017 Oct 25.
    Institute for Child Health Policy, Department of Health Outcomes and Policy, University of Florida.
    Objective: To examine the rate of access to primary and preventive care and ED reliance for foster youth as well as the impact of a transition from Fee-for-service (FFS) Medicaid to managed care on this access.

    Method: Secondary administrative data were obtained from Medicaid programs in one state which transitioned foster youth from a FFS to a managed care (TX) and another state, comparable in population size and racial/ethnic diversity, which continuously enrolled foster youth in a FFS system (FL). Eligible participants were foster youth (0-18 years) enrolled in these states between 2006 and 2010 (n= 126,714). Read More

    Characteristics Associated with Parent-Teacher Concordance on Child Behavior Problem Ratings in Low-Income Preschoolers.
    Acad Pediatr 2017 Oct 25. Epub 2017 Oct 25.
    Department of Pediatrics, University of Michigan Medical School, 1540 E Hospital Dr, Ann Arbor, MI 48109, United States.; Center for Human Growth and Development, University of Michigan, 300 N Ingalls St, Ann Arbor, MI 48104, United States.; Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address:
    Background: Assessment of pediatric behavior problems often requires rating scales from multiple reporters in different settings (e.g., home and school); however, concordance between reporters may be low. Read More

    Receipt of Medication and Behavioral Therapy among a National Sample of School-Aged Children Diagnosed with ADHD.
    Acad Pediatr 2017 Oct 20. Epub 2017 Oct 20.
    Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, 88 East Newton Street, Vose 3, Boston, MA 02118. Electronic address:
    Objective In 2011, the American Academy of Pediatrics published practice guidelines for ADHD, recommending both medication and behavioral therapy for school-aged children. The current study examines associations between child/family characteristics and ADHD medication, behavioral, and combined therapy. Methods This study used data from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, a nationally-representative follow-up survey to the 2011-2012 National Survey of Children's Health. Read More

    Walk-in Model for Ill Care in an Urban Academic Pediatric Clinic.
    Acad Pediatr 2017 Oct 20. Epub 2017 Oct 20.
    James M. Anderson Center for Health Systems Excellence and Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229, USA. Electronic address:
    Objectives: Since the Institute of Medicine's 2001 charge to reform healthcare, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to healthcare reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. Read More

    Do Fathers' Home Reading Practices at Age 2 Predict Child Language and Literacy at Age 4?
    Acad Pediatr 2017 Oct 19. Epub 2017 Oct 19.
    Murdoch Children's Research Institute, Parkville, Victoria, Australia; The University of Melbourne, Carlton, Victoria, Australia; The Royal Children's Hospital, Parkville, Victoria, Australia.
    Background: Maternal shared reading practices predict emergent literacy, but fathers' contributions are less certain. We examined whether fathers' shared home reading activities at 2 years (1) predict language and emergent literacy at age 4 years, when controlling for maternal contributions; and (2) differentially benefit these outcomes in disadvantaged children.

    Methods: Design: Two-parent families recruited from 5 relatively disadvantaged communities for the universal Let's Read literacy promotion population-based trial (ISRCTN 04602902) in Melbourne, Australia. Read More

    Outpatient Visits before Ambulatory Care Sensitive Hospitalization of Children Using Medicaid.
    Acad Pediatr 2017 Sep 27. Epub 2017 Sep 27.
    Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115.
    Objectives: Hospitalizations for ambulatory care sensitive conditions (ACSC) are measured to indicate healthcare system quality, with the premise that fewer hospitalizations would occur with better preceding outpatient care. Our objective was to identify outpatient care received in the 7 days preceding acute pediatric hospitalizations, and to compare receipt of outpatient care by hospitalization type (ACSC vs. non-ACSC). Read More

    Responsible Milestone-Based Educational Handover with Individualized Learning Plan from Undergraduate to Graduate Pediatric Medical Education.
    Acad Pediatr 2017 Sep 19. Epub 2017 Sep 19.
    Department of Emergency Medicine, University of Michigan Medical School, 6121 Taubman Health Sciences Library, 1135 Catherine Street Ann Arbor, MI 48109-5726. Electronic address:

    Gaming the System: Creation of a Random Case-Generating Game for Use in Morning Report.
    Acad Pediatr 2017 Sep 16. Epub 2017 Sep 16.
    University of Minnesota School of Medicine & Masonic Children's Hospital, Department of Pediatrics, 6th Floor East Building, M6532450 Riverside Avenue, Minneapolis, MN 55454 USA. Electronic address:
    Background: Case-based morning reports are a staple of residency education. Little is known about the role of game-based learning in facilitating case-based discussions.

    Objectives: Compare an educational game that can be used for creating impromptu case-based sessions to traditional morning report. Read More

    Chronic School Absenteeism and the Role of Adverse Childhood Experiences.
    Acad Pediatr 2017 Nov - Dec;17(8):837-843. Epub 2017 Sep 18.
    University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo; Department of Pediatrics, Children's Hospital Colorado, Aurora, Colo.
    Objective: To examine the association between chronic school absenteeism and adverse childhood experiences (ACEs) among school-age children.

    Methods: We conducted a secondary analysis of data from the 2011-2012 National Survey of Children's Health including children 6 to 17 years old. The primary outcome variable was chronic school absenteeism (≥15 days absent in the past year). Read More

    Variation in Generational Perceptions of Child Health and Well-being.
    Acad Pediatr 2017 Sep 12. Epub 2017 Sep 12.
    Children's Hospital Association, Washington, DC.
    Objective: To assess adults' perceptions regarding the health and well-being of children today relative to their own health and well-being as youth and the potential for intergenerational differences in those perceptions.

    Methods: A cross-sectional, Internet-based survey of a nationally representative household sample was conducted using GfK Custom Research's Web-enabled KnowledgePanel, a probability-based panel representative of the US population. We assessed perceptions of children's health and well-being today compared to when respondents were growing up, including physical and mental health; and children's education, exercise, diet, health care, safety of communities, and emotional support from families, groups, and organizations. Read More

    Latino Parents' Perceptions of Pediatric Weight Counseling Terms.
    Acad Pediatr 2017 Sep 12. Epub 2017 Sep 12.
    Ambulatory Care Services, Denver Health, Denver, CO; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Institute for Health Research, Kaiser Permanente Colorado, Denver, CO. Electronic address:
    Objective: Little is known about Latino parents' perceptions of weight-related language in English or Spanish, particularly for counseling obese youth. We sought to identify English and Spanish weight counseling terms perceived as desirable for providers to use, motivating, and inoffensive by Latino parents across demographic groups.

    Methods: Latino parents of children treated at urban safety-net clinics completed surveys in English or Spanish. Read More

    Reasons Why Children and Adolescents With Attention-Deficit/Hyperactivity Disorder Stop and Restart Taking Medicine.
    Acad Pediatr 2017 Sep 12. Epub 2017 Sep 12.
    Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
    Objective: To describe the prevalence of reasons why children and adolescents stop and restart attention-deficit/hyperactivity disorder (ADHD) medicine and whether functional impairment is present after stopping medicine.

    Methods: We used the prospective longitudinal cohort from the Multimodal Treatment of Study of Children With ADHD. At the 12-year follow-up, when participants were a mean of 21. Read More

    Blood and Hair Aluminum Levels, Vaccine History, and Early Infant Development: A Cross-Sectional Study.
    Acad Pediatr 2017 Sep 14. Epub 2017 Sep 14.
    Pediatric Environmental Health Center, Boston, Mass; Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, Mass; Harvard Medical School, Boston, Mass. Electronic address:
    Objective: To evaluate relationships between whole blood (B-Al) and hair aluminum (H-Al) levels in healthy infants and their immunization history and development.

    Methods: We conducted a cross-sectional study of 9- to 13-month-old children recruited from an urban primary care center, excluding those with a history of renal disease or receipt of either aluminum-containing pharmaceuticals or parenteral nutrition. Aluminum levels were measured using inductively coupled plasma-mass spectrometry. Read More

    Feasibility of Implementing Group Well Baby/Well Woman Dyad Care at Federally Qualified Health Centers.
    Acad Pediatr 2017 Sep 14. Epub 2017 Sep 14.
    Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md; Department of Populations, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md.
    Objective: Group care has been shown to be effective for delivery of infant well child care. Centering Parenting (CP) is a model of group dyad care for mothers and infants. CP might improve quality and efficiency of preventive care, particularly for low-income families. Read More

    Identifying Which Urban Children With Asthma Benefit Most From Clinician Prompting: Subgroup Analyses From the Prompting Asthma Intervention in Rochester-Uniting Parents and Providers (PAIR-UP) Trial.
    Acad Pediatr 2017 Sep 9. Epub 2017 Sep 9.
    Division of General Pediatrics, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY.
    Objective: Clinician prompts increase the likelihood of guideline-recommended corrective actions (preventive medication prescription, dose change, and/or adherence promotion) for symptomatic children with poorly controlled or persistent asthma in the primary care setting, but it is unclear if all children equally benefit. The objectives of this study were to identify whether asthma severity, visit type, and current preventive medication use were predictive of corrective actions during visits for children with symptomatic asthma, and determine whether these factors modified the effect of a prompting intervention.

    Methods: We conducted prespecified subgroup analyses of a cluster randomized controlled trial of physician prompting that promoted guideline-based asthma management for urban children with symptomatic asthma. Read More

    Association of Picky Eating With Weight Status and Dietary Quality Among Low-Income Preschoolers.
    Acad Pediatr 2017 Sep 5. Epub 2017 Sep 5.
    Center for Human Growth and Development, University of Michigan; Department of Nutritional Sciences, University of Michigan School of Public Health; Department of Pediatrics, University of Michigan Medical School, Ann Arbor.
    Background: Picky eating is common in children. Few studies have examined predictors of picky eating, and the association of picky eating with weight status and dietary quality is inconsistent in the literature. We aimed to identify predictors of picky eating and to test the association of picky eating with child body mass index z-score (BMIz), dietary quality, and micronutrient intake. Read More

    Adolescent Health Risk Behaviors: Parental Concern and Concordance Between Parent and Adolescent Reports.
    Acad Pediatr 2017 Sep 1. Epub 2017 Sep 1.
    Center for Child Health, Behavior and Development, Seattle Children's Research Institute; Department of Pediatrics, University of Washington, Seattle, Wash. Electronic address:
    Objective: We investigated which adolescent health risk behaviors are of concern to parents generally, according to adolescent age, gender, and in the context of perceived risk. We compared adolescent and parent reports of the presence of health-risk behaviors and factors predicting agreement.

    Methods: Three hundred adolescents aged 13 to 18 years (mean, 14. Read More

    Adolescent Self-Screening for Mental Health Problems; Demonstration of an Internet-Based Approach.
    Acad Pediatr 2017 Sep 1. Epub 2017 Sep 1.
    Harvard Medical School, Boston, Mass.
    Objective: To examine the prevalence of positive screening scores, construct validity, and opportunities for follow-up in a large sample of adolescents who chose to fill out the Pediatric Symptom Checklist-Youth Form (PSC-Y) through the Mental Health America (MHA) Web site.

    Methods: MHA sent researchers a deidentified data set of all PSC-Y data submitted to MHA from May 15, 2015 to May 14, 2016. The analytic data set contained 29,886 PSC-Y forms from youth aged 11 to 17 years who sought out the Web site and chose to fill out the PSC-Y anonymously and independently online. Read More

    A New Framework for Addressing Adverse Childhood and Community Experiences: The Building Community Resilience Model.
    Acad Pediatr 2017 Sep - Oct;17(7S):S86-S93
    Sumner Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, DC.
    Objective: We propose a transformative approach to foster collaboration across child health, public health, and community-based agencies to address the root causes of toxic stress and childhood adversity and to build community resilience.

    Methods: Physicians, members of social service agencies, and experts in toxic stress and adverse childhood experiences (ACEs) were interviewed to inform development of the Building Community Resilience (BCR) model. Through a series of key informant interviews and focus groups, we sought to understand the role of BCR for child health systems and their partners to reduce toxic stress and build community resilience to improve child health outcomes. Read More

    Responding to ACEs With HOPE: Health Outcomes From Positive Experiences.
    Acad Pediatr 2017 Sep - Oct;17(7S):S79-S85
    Center for the Study of Social Policy, Washington, DC.
    This article introduces a framework called "HOPE: Health Outcomes From Positive Experiences." The HOPE framework focuses on the need to actively promote positive childhood experiences that contribute to healthy development and well-being, as well as prevent or mitigate the effect of adverse childhood experiences and other negative environmental influences. Key positive childhood experiences fall within 4 broad categories: being in nurturing, supportive relationships; living, developing, playing, and learning in safe, stable, protective, and equitable environments; having opportunities for constructive social engagement and connectedness; and learning social and emotional competencies. Read More

    Income Inequality and the Differential Effect of Adverse Childhood Experiences in US Children.
    Acad Pediatr 2017 Sep - Oct;17(7S):S70-S78
    Child and Adolescent Health Measurement Initiative, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
    Objective: Adverse childhood experiences (ACEs) can affect health and development across the life course. Despite a general understanding that adversity is associated with lower income, we know less about how ACEs manifest at different income levels and how these income-related patterns affect children's health and development.

    Methods: Data from the 2011 to 2012 National Survey of Children's Health were used to examine the prevalence of 9 ACEs in US children, across 4 levels of household income, and in relationship to 5 parent-reported measures of child health. Read More

    Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice.
    Acad Pediatr 2017 Sep - Oct;17(7S):S51-S69
    University of California, San Francisco, School of Medicine, Department of Family and Community Medicine, Center on Social Disparities in Health.
    Background: Advances in human development sciences point to tremendous possibilities to promote healthy child development and well-being across life by proactively supporting safe, stable and nurturing family relationships (SSNRs), teaching resilience, and intervening early to promote healing the trauma and stress associated with disruptions in SSNRs. Assessing potential disruptions in SSNRs, such as adverse childhood experiences (ACEs), can contribute to assessing risk for trauma and chronic and toxic stress. Asking about ACEs can help with efforts to prevent and attenuate negative impacts on child development and both child and family well-being. Read More

    Prioritizing Possibilities for Child and Family Health: An Agenda to Address Adverse Childhood Experiences and Foster the Social and Emotional Roots of Well-being in Pediatrics.
    Acad Pediatr 2017 Sep - Oct;17(7S):S36-S50
    Academy Health, Washington, DC.
    Objective: A convergence of theoretical and empirical evidence across many scientific disciplines reveals unprecedented possibilities to advance much needed improvements in child and family well-being by addressing adverse childhood experiences (ACEs), promoting resilience, and fostering nurturance and the social and emotional roots of healthy child development and lifelong health. In this article we synthesize recommendations from a structured, multiyear field-building and research, policy, and practice agenda setting process to address these issues in children's health services.

    Methods: Between Spring of 2013 and Winter of 2017, the field-building and agenda-setting process directly engaged more than 500 individuals and comprised 79 distinct agenda-setting and field-building activities and processes, including: 4 in-person meetings; 4 online crowdsourcing rounds across 10 stakeholder groups; literature and environmental scans, publications documenting ACEs, resilience, and protective factors among US children, and commissioning of this special issue of Academic Pediatrics; 8 in-person listening forums and 31 educational sessions with stakeholders; and a range of action research efforts with emerging community efforts. Read More

    Mitigating Adverse Childhood Experiences Through Investments in Early Childhood Programs.
    Acad Pediatr 2017 Sep - Oct;17(7S):S28-S29
    Office of the Deputy Assistant Secretary for Early Childhood, Administration for Children and Families, US Department of Health and Human Services, Washington, DC; and the Children, Families, and Communities program, the David and Lucile Packard Foundation, Los Altos, Calif. Electronic address:

    Evolving a More Nurturing Society to Prevent Adverse Childhood Experiences.
    Acad Pediatr 2017 Sep - Oct;17(7S):S150-S157
    Social Development Research Group, School of Social Work, University of Washington, Seattle, Wash.
    This article presents a framework for evolving a society that nurtures the health and well-being of its population. We review evidence that adverse social conditions, including poverty, conflict, discrimination, and other forms of social rejection, contribute immensely to our most ubiquitous psychological, behavioral, and health problems. We then enumerate the ways that effective family and school prevention programs could ameliorate much of the social adversity leading to these problems. Read More

    Financing Mechanisms for Reducing Adversity and Enhancing Resilience Through Implementation of Primary Prevention.
    Acad Pediatr 2017 Sep - Oct;17(7S):S144-S149
    Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md; Mental Health America, Temple Terrace, Fla. Electronic address:
    The experience of adversity and toxic stress in childhood is associated with the development of chronic health and behavioral health problems. These problems contribute substantially to health care expenditures and the overall burden of disease. Although a strong scientific literature documents the effectiveness of primary prevention in reducing childhood adversity, promoting well-being and lessening the incidence of negative outcomes, funding for these interventions is highly fragmented across multiple government agencies as well as private and philanthropic sectors. Read More

    Addressing Adverse Childhood Experiences Through the Affordable Care Act: Promising Advances and Missed Opportunities.
    Acad Pediatr 2017 Sep - Oct;17(7S):S136-S143
    AcademyHealth, Washington, DC.
    Adverse childhood experiences (ACEs) occur when children are exposed to trauma and/or toxic stress and may have a lifelong effect. Studies have shown that ACEs are linked with poor adult health outcomes and could eventually raise already high health care costs. National policy interest in ACEs has recently increased, as many key players are engaged in community-, state-, and hospital-based efforts to reduce factors that contribute to childhood trauma and/or toxic stress in children. Read More

    Developing a Community-Wide Initiative to Address Childhood Adversity and Toxic Stress: A Case Study of The Philadelphia ACE Task Force.
    Acad Pediatr 2017 Sep - Oct;17(7S):S130-S135
    Section of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pa.
    The Philadelphia ACE Task Force is a community based collaborative of health care providers, researchers, community-based organizations, funders, and public sector representatives. The mission of the task force is to provide a venue to address childhood adversity and its consequences in the Philadelphia metropolitan region. In this article we describe the origins and metamorphosis of the Philadelphia ACE Task Force, which initially was narrowly focused on screening for adverse childhood experiences (ACEs) in health care settings but expanded its focus to better represent a true community-based approach to sharing experiences with addressing childhood adversity in multiple sectors of the city and region. Read More

    ACE, Place, Race, and Poverty: Building Hope for Children.
    Acad Pediatr 2017 Sep - Oct;17(7S):S123-S129
    Child and Family Policy Center, Des Moines, Iowa, and the Center for the Study of Social Policy, Washington, DC. Electronic address:
    Adverse childhood experiences research has focused attention on the importance of family safety, stability, and nurturing in ensuring healthy development. This safety, stability, and nurturing can be compromised by family poverty, discrimination and marginalization, and geographic location. Drawing upon census data, this report shows that place, race, and poverty are intertwined concepts with particular implications for young children. Read More

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