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Clinical Pediatrics

Delma-Jean Watts, Maurice Hajjar, Nizar Dowla, Priya Hirway, Shuba Kamath
Language barriers and access to telephone advice have been shown to affect patient care. Less is known about access to telephone advice for families whose usual language is not English. The objective was to characterize the use of pediatric primary care telephone advice by families based on usual language spoken at home. A total of 277 surveys were completed by families presenting for sick visits at an academic pediatric primary care practice. No meaningful differences in the use of telephone advice when a child was sick were found by language category...
December 5, 2018: Clinical Pediatrics
Katherine Lepere, Nicole Etsekson, Douglas J Opel
No abstract text is available yet for this article.
December 5, 2018: Clinical Pediatrics
Carolina Jaramillo, Christina Nyquist, Kirsten A Riggan, Jason Egginton, Sean Phelan, Megan Allyse
Increased prenatal diagnoses of sex chromosome aneuploidies (SCAs) amid limited knowledge of their prognoses heighten the need to understand how families contend with the implications of an SCA. To explore the experiences of parents and individuals who received a genetic diagnosis of an SCA (excluding Turner syndrome), we conducted semistructured qualitative telephone interviews with 43 participants affected by these conditions. Parents (n = 35) and individuals (n = 8) expressed almost unanimous interest in more optimistic portrayals of their condition from their providers, even when the prognosis is uncertain...
December 5, 2018: Clinical Pediatrics
Sarah M Baker, Luke Z Li, Russell W Steele
No abstract text is available yet for this article.
December 5, 2018: Clinical Pediatrics
Logan Key, Diego R Hijano, Sandra R Arnold
No abstract text is available yet for this article.
December 3, 2018: Clinical Pediatrics
Jessica Levi, Krystyne Basa, Kevin Wong, Thierry Morlet, Robert O'Reilly
Retrospective chart review of 248 children (1-19 years old) with tinnitus who presented to a tertiary pediatric hospital between 2006 and 2011, looking at which cofactors are predictors of pediatric tinnitus. In our review, we extracted demographics, symptoms, historical data, imaging, and laboratory results; we compared with the general population. Eighty-seven percent had normal hearing. Age distribution, noise exposure, and frequency of psychiatric diagnoses in our cohort were consistent with previous reports...
December 3, 2018: Clinical Pediatrics
Andrew M Margileth
BACKGROUND: Prior reports on large congenital melanocytic nevi (LCMN) do not provide a clear management approach to physicians to advise parents or patients. Whether the presence of a halo around the nevus can guide management has not been fully explored. DESIGN: Children born with an LCMN were observed without active intervention. OBJECTIVES: (1) To guide physicians, health providers, and parents in the management of CMN. (2) To ascertain the value of the absence or presence of a halo component of the nevi...
December 3, 2018: Clinical Pediatrics
Thomas Brown, Mark Moran
At any time there are millions of athletes ages 6 to 18 years participating in sports-related activities and the number is increasing. Unfortunately, the number of overuse injuries is also on the rise. This increase is most likely associated with single-sport specialization before the onset of puberty. As physicians and health care providers, we must educate these young athletes, their parents, and coaches to ensure safety. Short breaks are recommended and everyone involved should understand the athlete should not train more than 5 days per week and must take off 2 to 4 months per year consecutively depending on the specific sport and position on the team...
November 27, 2018: Clinical Pediatrics
K Ning Chan, Anna Silverstein, Leah N Bryan, Courtney E McCracken, Wendalyn K Little, Andi L Shane
Acute otitis media (AOM) is a leading cause of health encounters and antimicrobial prescriptions in children worldwide. We assessed (1) the rates of antimicrobial prescribing by pediatric emergency department clinicians using a smartphone otoscope device as compared with a conventional otoscope and (2) clinician acceptability of the smartphone device. We conducted a randomized control study in children's hospital emergency departments over 6 months. More than 1500 encounters were analyzed. The odds of prescribing antibiotics after being given a diagnosis of AOM by clinicians assigned to the smartphone group was 11% higher than the conventional group (18...
November 21, 2018: Clinical Pediatrics
ChangWon C Lee, Faye F Holder-Niles, Linda Haynes, Jenny Chan Yuen, Corinna J Rea, Kathleen Conroy, Joanne E Cox, Clement J Bottino
There is growing emphasis on using patient-reported outcome measures to enhance clinical practice. This study was a retrospective review of scores on the Childhood Asthma Control Test (C-ACT) and the Pediatric Symptom Checklist-17 (PSC-17) at a pediatric primary care center in Boston, Massachusetts. A total of 218 patients were selected at random using billing codes for well-child (WC) care and asthma, excluding complex medical conditions. Cutoff scores were used to identify uncontrolled asthma (C-ACT ⩽19) and clinically significant psychosocial symptoms (+PSC-17)...
November 21, 2018: Clinical Pediatrics
Maria D Brown, Joseph Rausch, Elise D Berlan
A dearth of research exists examining provider adherence to preventative health care guidelines at adolescent well-care visits. We examined adherence in 3 domains: documentation of sexual activity, documentation of menstrual characteristics, and administration of the human papillomavirus vaccine. We identified electronic health records of a random sample of 124 adolescent girls seen within the hospital-affiliated pediatric primary care clinics from July 1, 2014, to June 30, 2015. Approximately one quarter of the records examined had no documentation of sexual activity...
November 19, 2018: Clinical Pediatrics
Sasha A Fleary
Given the medical home model of care's (MHMOC) potential to reduce disparities in health care, this study determined the relationship between MHMOC, MHMOC indicators, and (1) demographic characteristics and (2) health outcomes in US children. Caregivers (n = 50 212) of children 0 to 17 years completed the 2016 National Survey of Children's Health. The MHMOC measure comprised 5 indicators (e.g., having a personal doctor/nurse and receiving family-centered care). Bivariate and multiple logistic regressions assessed the relationships between MHMOC, MHMOC indicators, and (1) demographic characteristics and (2) health outcomes...
November 18, 2018: Clinical Pediatrics
Sharmeen Samuel, Robin Fountain, David Start, Peter P Karpawich
No abstract text is available yet for this article.
November 17, 2018: Clinical Pediatrics
David J Kolko, Eunice Torres, Kevin Rumbarger, Everette James, Renee Turchi, Cheryl Bumgardner, Connell O'Brien
This study reports on a statewide survey of medical and behavioral health professionals to advance the knowledge base on the benefits and obstacles to delivering integrated pediatric health care. Surveys distributed in 3 statewide provider networks were completed by 110 behavioral health specialists (BHSs) and 111 primary care physicians (PCPs). Survey content documented their perceptions about key services, benefits, barriers, and needed opportunities related to integrated care. Factor analyses identified 8 factors, and other items were examined individually...
November 17, 2018: Clinical Pediatrics
John McAteer, Sarah Elizabeth Smith, Rabbia Waris
No abstract text is available yet for this article.
November 15, 2018: Clinical Pediatrics
Marc James Abrigo Uy, Mark A Pereira, Jerica M Berge, Katie A Loth
The primary objective of this study was to describe parents' preference for how physicians should approach diet and weight-related advice for their child. Semi-structured interviews were conducted with parents (n = 40) of preschoolers, transcribed verbatim, and double-coded using an inductive thematic analysis approach. Parents identified recommendations for how physicians should approach conversations about weight. Themes included (1) Tone and Approach are Important, (2) Avoid Judgment, (3) Have Regard for Parental Expertise, (4) Consider the Timing of the Discussion with Parents, and (5) Equip Parents with Concrete and Individualized Recommendations...
November 15, 2018: Clinical Pediatrics
Rhea Daniel, John Lieb, Judy Pascasio, Harpreet Pall
No abstract text is available yet for this article.
November 15, 2018: Clinical Pediatrics
Prithwijit Das, Anna Kuznetsova, Meng'ou Zhu, Ruth Milanaik
No abstract text is available yet for this article.
November 5, 2018: Clinical Pediatrics
Jenna Fine, Amelia Bray-Aschenbrenner, Howard Williams, Paula Buchanan, Jason Werner
We reviewed the resource utilization of patients with human rhinovirus/enterovirus (HRV/ENT), influenza A/B (FLU), or respiratory syncytial virus (RSV). A total of 2013 patients with nasopharyngeal swabs positive for HRV/ENT, RSV, or FLU were included. Records were reviewed for respiratory support, vascular access procedures, emergency department care only versus admission versus pediatric intensive care unit (PICU) care, antibiotics, length of stay, and billing data. Of the 2013 subjects, 1251 tested positive for HRV/ENT, 558 for RSV, and 204 for FLU...
November 2, 2018: Clinical Pediatrics
Angela S Volk, Stephanie A Marton, Brittany S Richardson, Luis Rauda, Heidi L Schwarzwald, Neel M Naik
Asthma, a chronic childhood disease, has resulted in increased emergency department (ED) visits with high costs. Many asthma ED visits are nonemergent and could be treated in outpatient clinics. Literature has concluded that a 2-day course of oral dexamethasone has comparable outcomes to a 5-day course of prednisone in the ED and hospital setting. A retrospective chart review was performed on children requiring in-house treatment with a corticosteroid (dexamethasone n = 23, prednisone n = 40) for acute asthma exacerbations at an ambulatory medical home...
October 31, 2018: Clinical Pediatrics
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