1,253 results match your criteria Academic Pediatrics[Journal]


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

Acad Pediatr 2019 Feb 14. Epub 2019 Feb 14.

Department of Pediatric and Adolescent Medicine, Einstein Medical Center Philadelphia.

Objective: Pacifier use decreases the risk of Sudden Infant Death Syndrome (SIDS) but its impact on breastfeeding remains controversial. We evaluated the impact of a Baby Friendly-aligned pacifier policy on subsequent pacifier use and breastfeeding at one month of age.

Methods: We conducted a prospective two stage (pre- and post-) 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 Feb 13. Epub 2019 Feb 13.

Senior Advisor for Educational Affairs, Professor of Medical Education and Pediatrics, University of Virginia School of Medicine, 200 Jeanette Lancaster Way, PO Box 800005, Charlottesville, VA 22908. Electronic address:

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http://dx.doi.org/10.1016/j.acap.2019.02.003DOI Listing
February 2019

Teachable Moments from the Maasai.

Authors:
Jennifer Bass

Acad Pediatr 2019 Feb 5. Epub 2019 Feb 5.

Department of Pediatrics, Kaiser Permanente Northwest, Oregon Health Sciences University, 3500 N Interstate Ave, Portland OR 97227. Electronic address:

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http://dx.doi.org/10.1016/j.acap.2019.02.001DOI Listing
February 2019

The Most Memorable One.

Authors:
Elizabeth Toll

Acad Pediatr 2019 Jan 30. Epub 2019 Jan 30.

Clinical Associate Professor, Pediatrics and Medicine, The Warren Alpert Medical School of Brown University. 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
4 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.

Yale University School of Medicine, Department of Pediatrics, New Haven, CT, USA. Electronic address:

Objectives: 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 multi-disciplinary case review. The aims of this study were to understand the Program's strengths and challenges 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.

Medical College of Wisconsin, Pediatric Emergency Medicine, Milwaukee, Wisconsin.

Background: PEM and PCP providers are the most likely physicians to initially label a child as penicillin allergic. Differences in knowledge and management of reported penicillin allergy between these two groups has not been well characterized.

Methods: A cross-sectional 20-question survey was administered to PEM and PCP's 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
7 Reads

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

Acad Pediatr 2019 Jan 23. Epub 2019 Jan 23.

Division of Critical Care Medicine, Seattle Children's Hospital, Seattle, Washington, USA.

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 ICU. 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 1,000 Days: A Qualitative Study.

Acad Pediatr 2019 Jan 21. Epub 2019 Jan 21.

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, 622 W. 168th Street, New York, NY, USA. Electronic address:

Background: Novel approaches to reduce sugar-sweetened beverage (SSB) consumption during the first 1,000 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 1,000 days.

Methods: In this qualitative research, we performed semi-structured in-depth interviews of 25 women and 7 nutrition/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 2008-2015.

Acad Pediatr 2019 Jan 18. Epub 2019 Jan 18.

Division of Health Services Management and Policy, The Ohio State University - College of Public Health, 200-5 Cunz Hall, Columbus, OH 43210 USA. Electronic address:

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 U. Read More

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http://dx.doi.org/10.1016/j.acap.2019.01.003DOI Listing
January 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, MA.

Objectives: As both fever and pneumonia can be are 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 were 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 10. Epub 2019 Jan 10.

Professer of Pediatrics and Pediatric Emergency Medicine, The Children's Hospital of Philadelphia, 3501 Civic Center Blvd, 9(th) Floor, Philadelphia, PA 19104. Electronic address:

Background/objective: Although there is 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 ED at an urban, freestanding children's hospital to complete a validated, two-question screen for FI. 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
7 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
2 Reads

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

Acad Pediatr 2019 Jan 2. 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
January 2019
2 Reads

Quality Improvement Driven Reduction in County-wide, Medicaid Acute Asthma Healthcare Utilization.

Acad Pediatr 2018 Dec 28. Epub 2018 Dec 28.

Nationwide Children's Hospital, Columbus, Ohio, 700 Children's Dr., Columbus, OH, 43205 USA; The Ohio State University College of Medicine, Columbus, Ohio, 370 W. 9(th) Ave., Columbus, OH 43210 USA. Electronic address:

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

Methods: Multiple evidence-based interventions targeting general pediatric asthma care as well as high healthcare utilizers were implemented using standardized quality improvement (QI) methodologies. Annual asthma ED and IP utilization rates by 2-18 year-old ACO members living in the surrounding county (>140,000 eligible members in 2016) adjusted per 1000 children over 2008-2016 were determined using Poisson regression. Read More

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http://dx.doi.org/10.1016/j.acap.2018.12.005DOI Listing
December 2018
3 Reads

Depressive Symptoms Among Urban Adolescents with Asthma: A Focus for Providers.

Acad Pediatr 2018 Dec 20. Epub 2018 Dec 20.

Department of Pediatrics, Division of General Pediatrics (M Shankar, M Fagnano, SW Blaakman, and JS Halterman).

Objectives: Asthma is the most common chronic disease of childhood in the United States, disproportionately affecting urban, poor, and minority children. Adolescents are at high risk for poor asthma outcomes and for depressive symptoms. The purpose of this study is to investigate associations between depressive symptoms and asthma-related clinical and functional outcomes among urban teens. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183080
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http://dx.doi.org/10.1016/j.acap.2018.12.004DOI Listing
December 2018
8 Reads

The Challenges of Multisource Feedback: Feasibility and Acceptability of Gathering Patient Feedback for Pediatric Residents.

Acad Pediatr 2018 Dec 18. Epub 2018 Dec 18.

Department of Pediatrics (D Mahoney, A Bogetz, E Phillips, R Blankenburg, and CE Rassbach), Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine (D Mahoney), Palo Alto, Calif.

Objective: The Accreditation Council for Graduate Medical Education calls for residency programs to incorporate multisource feedback, which may include patient feedback, into resident competency assessments. Program directors face numerous challenges in gathering this feedback. This study assesses the feasibility and acceptability of patient feedback collection in the inpatient and outpatient setting at 3 institutions. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183079
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http://dx.doi.org/10.1016/j.acap.2018.12.002DOI Listing
December 2018
2 Reads

Justifications for Discrepancies Between Competency Committee and Program Director Recommended Resident Supervisory Roles.

Acad Pediatr 2018 Dec 17. Epub 2018 Dec 17.

Department of Pediatrics (M Barnes and A Schwartz), University of Illinois at Chicago; Department of Medical Education (A Schwartz), University of Illinois at Chicago; Association of Pediatric Program Directors (APPD) Longitudinal Educational Assessment Research Network (LEARN) (B King and A Schwartz), McLean, Va.

Objective: To explore justifications for differences between summative entrustment decisions made about pediatric residents by individuals who are charged with the review of residents (clinical competency committee, or CCC, members) and those who ultimately make final summative decisions about resident performance (program directors, or PDs).

Methods: Individual CCC member and PD supervisory role categorizations were made in the 2015 to 2016 academic year at 14 pediatric residency programs, placing residents into 1 of 5 progressive supervisory roles. When PD recommendations differed from CCC members, a free-text justification was requested. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183079
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http://dx.doi.org/10.1016/j.acap.2018.12.003DOI Listing
December 2018
2 Reads

Association Between Outdoor Air Pollution Levels and Inpatient Outcomes in Pediatric Pneumonia Hospitalizations, 2007 to 2008.

Acad Pediatr 2018 Dec 11. Epub 2018 Dec 11.

Department of Pediatrics, New York University (NYU) Langone Health/Bellevue Hospital Center (AF Glick, S Tomopoulos, AH Fierman, and L Trasande); Departments of Environmental Medicine and Population Health, NYU School of Medicine (L Trasande); NYU Wagner School of Public Service (L Trasande); NYU College of Global Public Health (L Trasande).

Objective: Pneumonia is a leading cause of pediatric admissions. Although air pollutants are associated with poor outcomes, few national studies have examined associations between pollutant levels and inpatient pediatric pneumonia outcomes. We examined the relationship between ozone (O) and fine particulate matter with a diameter ≤2. Read More

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http://dx.doi.org/10.1016/j.acap.2018.12.001DOI Listing
December 2018
1 Read

Mothers' Mental Health Care Use After Screening for Postpartum Depression at Well-Child Visits.

Acad Pediatr 2018 Nov 26. Epub 2018 Nov 26.

PolicyLab, Children's Hospital of Philadelphia (S Kallem, M Matone, RC Boyd, and JP Guevara); Leonard Davis Institute of Health Economics, University of Pennsylvania (S Kallem, JP Guevara), Philadelphia; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania (S Kallem, M Matone, JP Guevara), Philadelphia; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania (JP Guevara), Philadelphia, Pa.

Objective: The American Academy of Pediatrics recommends postpartum depression (PPD) screening. It is unknown whether pediatricians are effective in linking mothers to mental health services. The objectives of the current study are to determine 1) mental health care use among women with Medicaid insurance after a positive PPD screen and 2) maternal and infant factors that predict the likelihood of mental health care use. Read More

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http://dx.doi.org/10.1016/j.acap.2018.11.013DOI Listing
November 2018
1 Read

Neighborhood Risk Factors for Pediatric Fall-Related Injuries: A Retrospective Analysis of a Statewide Hospital Network.

Acad Pediatr 2018 Nov 26. Epub 2018 Nov 26.

Hassenfeld Child Health Innovation Institute (Y Veras, ML Rogers, PM Vivier); The Warren Alpert Medical School of Brown University (Y Veras, MR Zonfrillo, MJ Mello); The Injury Prevention Center at Rhode Island Hospital and Hasbro Children's Hospital (MR Zonfrillo, MJ Mello, PM Vivier); Department of Health Services Policy and Practice, Brown University (MJ Mello, PM Vivier), Providence, RI.

Background: Falls represent the leading cause of nonfatal unintentional injuries among children in the United States. Although unintentional injury risks have been studied, neighborhood impact on falls remains underexplored. This study examined the association of neighborhood attributes with rates of fall-related injuries. Read More

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http://dx.doi.org/10.1016/j.acap.2018.11.012DOI Listing
November 2018
4 Reads

Are Incoming Pediatric Interns Ready to Obtain the Essential Components of an Informed Consent for Lumbar Puncture?

Acad Pediatr 2018 Nov 23. Epub 2018 Nov 23.

Department of Pediatrics (EA Omoruyi, A Guardiola, and MS Barratt), McGovern Medical School, The University of Texas Health Science Center, Houston, Tex.

Objective: In 2013, the Association of American Medical Colleges created the "Core Entrustable Professional Activities (EPAs) for Entering Residency" to more clearly define the set of activities that entering residents should be able to perform on day 1 of residency without direct supervision. EPA #11 is obtaining informed consent for tests and/or procedures. This EPA acknowledges that an entrustable learner should be able to document a complete consent among other components. Read More

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http://dx.doi.org/10.1016/j.acap.2018.11.011DOI Listing
November 2018
4 Reads

Pediatric Chief Residents' Experiences as Inpatient Attending Physicians.

Acad Pediatr 2018 Nov 22. Epub 2018 Nov 22.

Department of Pediatrics (RR Osborn), University of Michigan School of Medicine, Ann Arbor, Mich.

Background: Some pediatric chief residents perform supervisory clinical duties during chief residency, but these activities are highly variable and descriptions are limited. Our goals were to characterize inpatient service performed by pediatric chief residents and to explore factors that influence their experiences as inpatient attending physicians.

Methods: Pediatric chief residents at Accreditation Council for Graduate Medical Education-accredited programs in 2016 were invited to complete a 40-item electronic questionnaire about their inpatient service obligation as well as attitudes regarding this experience. Read More

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http://dx.doi.org/10.1016/j.acap.2018.11.010DOI Listing
November 2018
10 Reads

Community Resource Needs Assessment Among Families Presenting to a Pediatric Emergency Department.

Acad Pediatr 2018 Nov 22. Epub 2018 Nov 22.

Division of Emergency and Transport Medicine (JE Semple-Hess, PK Pham, and DB Liberman), Children's Hospital Los Angeles; Department of Pediatrics (JE Semple-Hess and DB Liberman), Keck School of Medicine, University of Southern California, Los Angeles.

Objective: To identify community resource needs among families presenting to a pediatric emergency department (PED).

Methods: A convenience sample of English- and Spanish-speaking caregivers residing in Los Angeles County who presented to the PED of a large urban children's hospital were surveyed. The needs assessment survey assessed demographics, food insecurity, and previous and anticipated need for 12 common community resources. Read More

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http://dx.doi.org/10.1016/j.acap.2018.11.009DOI Listing
November 2018
11 Reads

Potential Impact of Initial Clinical Data on Adjustment of Pediatric Readmission Rates.

Acad Pediatr 2018 Nov 20. Epub 2018 Nov 20.

Division of General Pediatrics (MM Nakamura, SL Toomey, MC Bryant, S Ashrafzadeh, and MA Schuster); Informatics Program (C Lin and GK Savova), Boston Children's Hospital; Kaiser Permanente School of Medicine (MA Schuster), Pasadena, Calif.

Objective: Comparison of readmission rates requires adjustment for case-mix (ie, differences in patient populations), but previously only claims data were available for this purpose. We examined whether incorporation of relatively readily available clinical data improves prediction of pediatric readmissions and thus might enhance case-mix adjustment.

Methods: We examined 30-day readmissions using claims and electronic health record data for patients ≤18 years and 29 days of age who were admitted to 3 children's hospitals from February 2011 to February 2014. Read More

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http://dx.doi.org/10.1016/j.acap.2018.09.006DOI Listing
November 2018
7 Reads

Development of a Brief Screening Tool for Early Literacy Skills in Preschool Children.

Acad Pediatr 2018 Nov 16. Epub 2018 Nov 16.

Department of Pediatrics, MetroHealth Medical Center, CaseWestern Reserve University (R Needlman), Cleveland, Ohio.

Background: Preschool children develop early literacy skills (ELS) needed for reading acquisition. Screening for delayed ELS could trigger interventions to prevent reading problems.

Objective: To develop a brief screening test for ELS delays, the Early Literacy Skills Assessment Tool (ELSAT). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183075
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http://dx.doi.org/10.1016/j.acap.2018.11.008DOI Listing
November 2018
12 Reads

Admit v. Discharge-A Cost Analysis of Infants 29-60 Days Old with Febrile Urinary Tract Infection at Low Risk for Bacteremia.

Acad Pediatr 2018 Nov 8. Epub 2018 Nov 8.

Department of Emergency Medicine, Children's National Health System, George Washington University School of Medicine and Health Sciences, 111 Michigan Ave NW, Washington, DC 20010. Electronic address:

Background And Objectives: Ninety percent of infants 29-60 days old presenting to the emergency department (ED) with fever and urinary tract infection are admitted due to fear of concomitant bacteremia. Many of these infants are at low risk for bacteremia and can be safely discharged with no heightened risk of adverse events. This study sought to estimate the potential savings from outpatient management of low-risk infants. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183074
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http://dx.doi.org/10.1016/j.acap.2018.11.002DOI Listing
November 2018
10 Reads

Development and Pilot Testing of a Coping Kit for Parents of Hospitalized Children.

Acad Pediatr 2018 Nov 8. Epub 2018 Nov 8.

Pediatric Advanced Care Team (DL Hill, KW Carroll, KJG Snyder, C Feudtner), Division of Gastroenterology (M Mascarenhas, J Erlichman), Division of Neonatology (CA Patterson), and Division of Oncology (LP Barakat), The Children's Hospital of Philadelphia, Philadelphia, Pa.

Objective: Serious pediatric illness places great stress on families. Parents who learn coping skills may better manage these stressors. This study sought to develop and refine a stress coping intervention for parents of hospitalized children, assess the intervention acceptability among these parents, and gather preliminary data on stress, negative and positive affect, anxiety, depression, and self-efficacy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183074
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http://dx.doi.org/10.1016/j.acap.2018.11.001DOI Listing
November 2018
12 Reads

Presence of Small Screens in Bedrooms Is Associated With Shorter Sleep Duration and Later Bedtimes in Children With Obesity.

Acad Pediatr 2018 Nov 8. Epub 2018 Nov 8.

Division of General Academic Pediatrics (MP Duggan, EM Taveras, MW Gerber, CM Horan, NM Oreskovic), Massachusetts General Hospital for Children; Department of Pediatrics (EM Taveras, NM Oreskovic), Harvard Medical School. Electronic address:

Background: The presence of small screens in the sleep environment has been associated with shorter sleep duration and later bedtimes in children of normal weight, but the role these devices play in the sleep environment of overweight children is unclear. We sought to examine the association of small screen presence in the sleep environment with sleep behaviors among school-age children with obesity.

Methods: We surveyed 526 parents of children ages 6 to 12 years old with a body mass index ≥95th percentile who were participating in a randomized trial to treat childhood obesity. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183075
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http://dx.doi.org/10.1016/j.acap.2018.11.004DOI Listing
November 2018
8 Reads

Longitudinal Analyses of Pediatrician Burnout.

Acad Pediatr 2018 Nov 7. Epub 2018 Nov 7.

Tufts University School of Medicine (LK Leslie), Boston, Mass; American Board of Pediatrics (LK Leslie), Chapel Hill, NC.

Objective: Utilize the unique capabilities of a longitudinal design to 1) examine whether burnout is increasing over time among 2 cohorts of pediatricians, and 2) identify factors associated with decreased burnout.

Methods: Data from a national longitudinal study, the American Academy of Pediatrics Pediatrician Life and Career Experience Study, were used to examine self-reported burnout over a 5-year period (2012 to 2016) among 2002 to 2004 and 2009 to 2011 residency graduates (N = 1804). Study participation rates ranged from 94% in 2012 to 85% in 2016. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183075
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http://dx.doi.org/10.1016/j.acap.2018.11.006DOI Listing
November 2018
10 Reads

Foster Caregiver Experience of Pediatric Hospital-to-Home Transitions: A Qualitative Analysis.

Acad Pediatr 2018 Nov - Dec;18(8):928-934. Epub 2018 Jul 7.

Department of Pediatrics, The Barbara Bush Children's Hospital at Maine Medical Center (LA Mallory), Portland, Me. Electronic address:

Objective: Children entering foster care after discharge from the hospital are at risk for adverse events associated with the hospital-to-home transition. Education of foster caregivers regarding transitional care needs is key. However, little is known about the unique needs of foster caregivers as they transition from hospital to home with a new foster child or how hospital-based health care teams can better support foster caregivers. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183040
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http://dx.doi.org/10.1016/j.acap.2018.06.007DOI Listing
July 2018
17 Reads

National Quality Improvement Initiative in Home Visiting Services Improves Breastfeeding Initiation and Duration.

Acad Pediatr 2018 Nov 3. Epub 2018 Nov 3.

Division of Global Health Equity (MC Arbour and S Atwood), Brigham and Women's Hospital, Boston, Mass.

Objective: To improve breastfeeding through home visiting.

Methods: From 2013 to 2016, the Home Visiting Collaborative Improvement and Innovation Network (HV CoIIN) enrolled 15 home visiting agencies serving 1000 families in 7 states. Using the Breakthrough Series Collaborative model, HV CoIIN faculty taught a theory of change and continuous quality improvement (CQI) skills, as well as facilitating opportunities for networked learning. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183075
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http://dx.doi.org/10.1016/j.acap.2018.11.005DOI Listing
November 2018
10 Reads

Burnout in Pediatric Residents: Comparing Brief Screening Questions to the Maslach Burnout Inventory.

Acad Pediatr 2018 Nov 3. Epub 2018 Nov 3.

Department of Pediatrics (JR Serwint), The Johns Hopkins University, Baltimore, Md.

Background: Measuring burnout symptoms is important, but the Maslach Burnout Inventory (MBI) has 22 items. This project compared 3 single-item measures with the MBI and other factors related to burnout.

Methods: Data were analyzed from the 2016 and 2017 Pediatric Resident Burnout-Resilience Study Consortium surveys, which included standard measures of perceived stress, mindfulness, resilience, and self-compassion; the MBI; and the 1- and 2-item screening questions. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183074
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http://dx.doi.org/10.1016/j.acap.2018.11.003DOI Listing
November 2018
6 Reads

De-escalating Angry Caregivers: A Randomized Controlled Trial of a Novel Communication Curriculum for Pediatric Residents.

Acad Pediatr 2018 Oct 25. Epub 2018 Oct 25.

Department of Pediatrics (SL Hilgenberg, AL Bogetz, and RL Blankenburg), Lucile Packard Children's Hospital, Stanford School of Medicine, Palo Alto, Calif.

Objective: Medical providers struggle when communicating with angry patients and their caregivers. Pediatric residents perceive communication competencies as an important priority for learning, yet they lack confidence and desire more training in communicating with angry families. Few curricula exist to support trainees with de-escalation skill development. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183074
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http://dx.doi.org/10.1016/j.acap.2018.10.005DOI Listing
October 2018
3 Reads

Pediatric Residents' Reports of Quality Improvement Training and Experiences: Time for an Improvement Cycle?

Acad Pediatr 2018 Oct 25. Epub 2018 Oct 25.

Child Health Evaluation and Research Center (KD Van and GL Freed), University of Michigan, Ann Arbor.

Objective: Explore pediatric residents' experiences and confidence with quality improvement (QI).

Methods: Pediatric residents were surveyed nationally in July 2017 about their demographic characteristics, experiences with QI projects over the previous year, and confidence with QI skills. Descriptive statistics and distributions of each individual demographic and QI variable, as well as training program size, were calculated for each variable. Read More

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http://dx.doi.org/10.1016/j.acap.2018.10.006DOI Listing
October 2018
8 Reads

The Effect of Faculty Coaching on Resident Attitudes, Confidence, and Patient-Rated Communication: A Multi-Institutional Randomized Controlled Trial.

Acad Pediatr 2018 Oct 24. Epub 2018 Oct 24.

Department of Pediatrics (AL Bogetz, C Leibold, and RL Blankenburg), Stanford School of Medicine, Palo Alto, Calif.

Objective: Despite a national focus on physician-patient communication, there is a paucity of literature on how patient and family feedback (PFF) can be used as a tool to help residents learn communication skills. The purpose of this study was to assess the effect of coaching on residents' attitudes towards PFF, self-confidence in communication, and patient-rated communication skills.

Methods: This was an institutional review board-approved, randomized-controlled trial with pediatric residents at 3 institutions from 2015 to 2016. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183073
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http://dx.doi.org/10.1016/j.acap.2018.10.004DOI Listing
October 2018
9 Reads

A Clinical Vignette-Based Study of Physicians' Adherence to Guidelines for Dental Referrals of Young Children.

Acad Pediatr 2018 Oct 22. Epub 2018 Oct 22.

Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Electronic address:

Objectives: The American Academy of Pediatrics (AAP) recommends an oral health risk assessment and referral to a dental home by a child's first birthday. We evaluated the adherence of primary care providers (PCPs) to AAP dental referral guidelines for children age <4 years and barriers to implementation of these guidelines.

Methods: A cross-sectional survey of PCPs randomly selected from the 435 practices in North Carolina identified as providing well-child visits for Medicaid children age <4 years was completed in 2013. Read More

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http://dx.doi.org/10.1016/j.acap.2018.05.013DOI Listing
October 2018
11 Reads

Implementing Emotional Debriefing in Pediatric Clinical Education.

Acad Pediatr 2018 Oct 18. Epub 2018 Oct 18.

Department of Pediatrics (AD Osta), University of Illinois at Chicago, Chicago, Ill; Department of Pediatrics (MA King), Saint Louis University School of Medicine, St. Louis, Mo; Department of Pediatrics (JR Serwint), Johns Hopkins University School of Medicine, Baltimore, Md; and Department of Pediatrics (SB Bostwick), Weill Cornell Medical College, New York, NY.

Challenging situations and intense emotions are inherent to clinical practice. Failure to address these emotions has been associated with health care provider burnout. One way to combat this burnout and increase resilience is participation in emotional debriefing. Read More

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http://dx.doi.org/10.1016/j.acap.2018.10.003DOI Listing
October 2018
2 Reads

Mental Health Conditions and Health Care Payments for Children with Chronic Medical Conditions.

Acad Pediatr 2019 Jan - Feb;19(1):44-50. Epub 2018 Oct 10.

Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, and Bradley Hasbro Children's Research Center (GK Fritz), Providence, RI.

Objective: To estimate additional payments associated with co-existing mental health or substance use disorders (MH/SUDs) among commercially insured children and youth with chronic medical conditions (CMCs) and to determine whether children's MH/SUDs have similar associations with parental health care payments.

Methods: Cross-sectional analysis of a national database of paid commercial insurance claims for 2012-2013. Participants were children and youth ages 0 to 26 years covered as dependents on parents' health insurance and categorized by the presence or absence of any of 11 chronic medical conditions and MH/SUDs. 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.2018.10.001DOI Listing
October 2018
10 Reads

Psychometric Properties of Two Developmental Screening Instruments for Hispanic Children in the Philadelphia Region.

Acad Pediatr 2018 Oct 10. Epub 2018 Oct 10.

Maternal-Fetal Medicine (J Culhane), Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, Conn.

Objective: To assess the validity of Spanish versions of the Survey of Well-being of Young Children (SWYC) Milestones and the Ages & Stages Questionnaire, Third Edition (ASQ-3), and to document the rates of developmental delays in an urban cohort of children with Hispanic parents.

Methods: Spanish-speaking families with a child 9 to 60 months of age (N = 991) were initially screened using Spanish translations of the SWYC Milestones and the ASQ-3. A stratified random sample of 494 of these children subsequently received standardized clinical assessment to confirm the presence of developmental delays. 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.2018.10.002DOI Listing
October 2018
6 Reads

Applying Self-Determination Theory to Redesign an Inpatient Care Team.

Acad Pediatr 2018 Oct 9. Epub 2018 Oct 9.

Department of Medicine, Boston Children's Hospital, Boston, Mass.

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http://dx.doi.org/10.1016/j.acap.2018.09.010DOI Listing
October 2018
2 Reads

Update on How School Environments, Social Networks, and Self-Concept Impact Risky Health Behaviors.

Acad Pediatr 2018 Oct 2. Epub 2018 Oct 2.

Department of Pediatrics, UCLA Children's Discovery and Innovation Institute (RN Dudovitz and PJ Chung); Department of Pediatrics, UCLA David Geffen School of Medicine (RN Dudovitz, MD Wong, G Kim, and PJ Chung); Department of Health Policy and Management, Fielding School of Public Health (PJ Chung), University of California, Los Angeles; RAND Corporation (PJ Chung), Santa Monica, Calif.

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183068
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http://dx.doi.org/10.1016/j.acap.2018.09.014DOI Listing
October 2018
12 Reads

Satisfaction, Salaries, and Sustainability: Results of a National Survey of Pediatric Program Directors.

Acad Pediatr 2019 Jan - Feb;19(1):11-17. Epub 2018 Oct 2.

Department of Pediatrics (SM Hudson and E Ben-Isaac), Keck School of Medicine of the University of Southern California and Children's Hospital Los Angeles. Electronic address:

Objective: Describe the career and work environment of pediatric program directors (PDs) and associated factors, including salary disparities and long-term career plans.

Methods: A national, anonymous, electronic survey was sent to all categorical residency PD members of the Association of Pediatric Program Directors. Surveys assessed PD demographics, characteristics of the residency program and PD positions (including salary), and measures of satisfaction. 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.2018.09.015DOI Listing
October 2018
8 Reads

Creation and Validation of Tool to Assess Resident Competence in Neonatal Resuscitation.

Acad Pediatr 2018 Sep 28. Epub 2018 Sep 28.

Department of Pediatrics/Neonatology, Indiana University School of Medicine, Indianapolis, Ind.

Background: The American Board of Pediatrics requires that pediatricians be able to initiate stabilization of a newborn. After residency, 45% of general pediatricians routinely attend deliveries. However, there is no standard approach or tool to measure resident proficiency in newborn resuscitation across training programs. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183060
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http://dx.doi.org/10.1016/j.acap.2018.09.004DOI Listing
September 2018
3 Reads

Child Abuse and Neglect Risk Assessment: Quality Improvement in a Primary Care Setting.

Acad Pediatr 2018 Sep 29. Epub 2018 Sep 29.

Department of Obstetrics and Gynecology (D Abatemarco), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Penn.

Objectives: Practicing Safety is an American Academy of Pediatrics toolkit to help practices address child abuse and neglect (CAN) risk by increasing screening and providing resources. The objectives in an urban practice serving low-income children were to 1) standardize CAN risk assessment and developmental screening, and 2) improve resource provision.

Methods: A quality improvement initiative to standardize CAN risk assessment, using materials adapted from Practicing Safety, was conducted through the use of SmartTools in an electronic health record. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18762859183064
Publisher Site
http://dx.doi.org/10.1016/j.acap.2018.09.011DOI Listing
September 2018
3 Reads