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Clinical Pediatrics

Eli Sprecher, Kathleen Conroy, Jenny Chan, Paul R Lakin, Joanne Cox
Navigating health care systems can be a challenge for families. A retrospective descriptive cohort analysis was conducted assessing referrals to patient navigators (PNs) in one urban academic pediatric primary care practice. PNs tracked referral processes and a subset of PN referrals was assessed for markers of successful referrals. The most common reasons for referral were assistance overcoming barriers to care (46%), developmental concerns (38%), and adherence/care coordination concerns (14%). Significant predictors of referral were younger age, medical complexity, public insurance, male sex, and higher rates of no-show to visits in primary or subspecialist care...
February 1, 2018: Clinical Pediatrics
Lindsay R Lavin, Cody H Penrod, Cristina M Estrada, Donald H Arnold, Benjamin R Saville, Meng Xu, Deborah E Lowen
Approximately one fourths of infant fractures are due to abuse. Recognition of abuse is important to avoid further morbidity/mortality. There is limited knowledge regarding how frequently pediatric emergency department clinicians consider abuse in infants with fractures. Our primary objective was to estimate the percentage of infants with fractures for whom abuse was considered, and to examine characteristics associated with abuse consideration. We performed a retrospective review of infants <1 year of age presenting to a pediatric emergency department...
February 1, 2018: Clinical Pediatrics
Victoria M Wurster Ovalle, Wendy J Pomerantz, Michael A Gittelman
This was a retrospective study examining severe injuries to Ohio children in order to provide pediatricians with targeted injury talking points at well visits. We included children ≤14 years old from the Ohio Trauma Acute Care Registry with severe unintentional injuries from January 1, 2003, to December 31, 2012. There were 45 347 patients; 611 died, and the mean age was 6.8 years. Fractures/dislocations were common (46.6%), and many injuries occurred at home (49.1%). In children ≤2 years old, the leading causes of injury were falls and burns/fire; falls and motor vehicle collisions (MVCs) predominated above this age...
February 1, 2018: Clinical Pediatrics
Max Rubinstein, Stephanie Ruest, Siraj Amanullah, Annie Gjelsvik
We examined the association between having a regular primary care physician (PCP) and measures of flourishing and academic success in children with attention-deficit hyperactivity disorder (ADHD). We performed a cross-sectional study using data from the 2011-2012 National Survey of Children's Health. Children aged 6 to 17 years with a diagnosis of ADHD were included in the study (n = 8173). The exposure was whether the guardian identified a regular PCP for their child. The outcomes were parental-reported measures of child well-being and academic performance...
January 1, 2018: Clinical Pediatrics
Jessica L Coleman, Barley R Halton, Russell W Steele
No abstract text is available yet for this article.
January 1, 2018: Clinical Pediatrics
Jessica B Beavers, Shasha Bai, Jennifer Perry, Jordan Simpson, Sara Peeples
There is growing interest in the Kaiser early-onset sepsis (EOS) risk calculator though institutions are hesitant to deviate from the Centers for Disease Control and Prevention guidelines and implement this in their hospitals. We describe the process of implementing routine use of the risk calculator in term and late preterm newborns delivered to mothers with chorioamnionitis in a level III neonatal intensive care unit (NICU). A retrospective chart review of infants delivered to mothers with chorioamnionitis from 2011 to 2014 was performed...
December 1, 2017: Clinical Pediatrics
Ihuoma U Eneli, Candace Howell, Megan E Rose, Keeley Pratt, Ericca L Lovegrove, Erica L Domrose, Phyllis J Polas
Childhood obesity remains a serious public health threat. There is an urgent need for innovative, effective, and sustainable interventions for childhood obesity that are multisector, integrated, and pragmatic. Using the 2007 Expert Committee on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity as a guide, a tertiary care obesity program at a children's hospital established the Primary Care Obesity Network (PCON). This article describes the structure, implementation, resources, and outcome measures of the PCON, a network of primary care practices and a tertiary care obesity center established to prevent and treat childhood obesity in Central Ohio...
December 1, 2017: Clinical Pediatrics
Hannah L H Lange, Steven C Matson, Andrea E Bonny
No abstract text is available yet for this article.
December 1, 2017: Clinical Pediatrics
Lesley N Desmond, Russell W Steele
No abstract text is available yet for this article.
December 1, 2017: Clinical Pediatrics
Ioni M Kokodis, Russell W Steele
No abstract text is available yet for this article.
December 1, 2017: Clinical Pediatrics
Harry Bramley, Alyssa Henson, Mechelle M Lewis, Lan Kong, Christy Stetter, Matthew Silvis
Sleep disturbance is a common problem following concussion. A retrospective chart review was conducted at a regional concussion clinic on patients 13 to 18 years of age between 2005 and 2011. Statistical analysis evaluated sleep disturbance and duration of concussion, as well as the use and effectiveness of melatonin. A total of 417 patients met inclusion criteria. One hundred twenty-three (34%) reported disturbance in sleep. There was no difference in sleep disturbance based on age, gender, or past number of concussions...
December 2017: Clinical Pediatrics
Rachel Schwemberger, Russell W Steele
No abstract text is available yet for this article.
December 2017: Clinical Pediatrics
Ariane Boutin, Ana Carceller, Marie Pier Desjardins, Marisol Sanchez, Jocelyn Gravel
BACKGROUND: Trying to differentiate serious bacterial infection (SBI) from a self-limiting illness in febrile infants seen in the pediatric emergency department (PED) is a significant challenge. The aim of the study was to determine the prevalence of dehydration and its relationship to SBI in febrile full-term newborns under 1 week of age seen in a PED. METHODS: A retrospective observational study was carried out on all children younger than 8 days of age with fever who presented to a single, tertiary care, PED from January 2009 to April 2014...
December 2017: Clinical Pediatrics
Anisha Gundewar, Rebecca David, Sean M Frey, Maria Fagnano, Jill S Halterman
National guidelines recommend that children with persistent asthma have at least 2 preventive asthma visits (PAVs) per year. We sought to determine the percent of urban children with persistent asthma who had a PAV in the past year, and to identify differences in demographics, health-related variables, and management associated with PAVs. Using data from 530 children (3-10 years) participating in a school-based asthma trial, we found that only 25% of children had at least 1 PAV, with only 5% receiving ≥2 visits...
December 2017: Clinical Pediatrics
Laura Leaman, William Hennrikus, Adam Y Nasreddine
The aim of this study was to identify seasonal variation in nonaccidental injury (NAI) in children <1 year of age. Fifty consecutive patients age ≤12 months with a fracture were identified between January 2010 and June 2012. Patients' records were reviewed for demographic, clinical, and radiographic data. Zip code was used to collect socioeconomic data. Out of 50 patients included in the study, fractures in 16 (32%) patients were reported for abuse. NAI was reported in 2/13 (15%) fracture cases presenting in the spring, 5/6 (83%) in summer, 6/15 (40%) in autumn, and 3/14 (21%) in winter...
December 2017: Clinical Pediatrics
Katie Williams, David Wargowski, Jens Eickhoff, Ellen Wald
Increasing evidence suggests children with Down syndrome do not receive recommended health care services. We retrospectively assessed adherence to the 2001 American Academy of Pediatrics health supervision guidelines for 124 children with Down syndrome. Cervical spine radiographs were completed for 94% of children, often preoperatively. Adherence to complete blood count recommendations was 55% (95% CI 44% to 66%); lower for males ( P = .01) and children with private medical insurance ( P = .04). Adherence to thyroid function recommendations was 61% (95% CI 54% to 67%); higher for children seen by a pediatrician ( P = ...
December 2017: Clinical Pediatrics
Ryan Eid, Scott Bickel, Nemr Eid
No abstract text is available yet for this article.
December 2017: Clinical Pediatrics
Jennifer L Heithaus, Kimberly A Twyman, Barbara A Braddock
To better understand adolescents experiencing peer victimization, ostracism, and emotional health problems, this study aimed to describe a cohort of middle school students identified as having school peer-related social difficulties as 2 groups: those with mental health diagnoses (MHDs; n = 17) and those without diagnoses (n = 8). Participants were administered a test battery to examine communication ability, social responsiveness, social activity, ostracism, victimization, and emotional health. Results showed that adolescents with MHDs, relative to those without, scored significantly lower on measures of communication ability, social responsiveness, and social activity but similarly on measures of victimization, ostracism, and internalizing/externalizing factors...
December 2017: Clinical Pediatrics
Maria T Britto, Jennifer M Rohan, Cassandra M Dodds, Terri L Byczkowski
We enrolled 64 patients age 12 to 22 years with a diagnosis of poorly controlled persistent asthma in a 6-month longitudinal crossover study. During the 3 intervention months, participants created personalized text messages to be sent to their phones. Adherence was objectively monitored in 22 of the participants. The adolescent participants gave high ratings on the acceptability of the text messaging system. Asthma control improved from baseline to month 1 regardless of whether teens were in the texting or control group...
December 2017: Clinical Pediatrics
Joshua Daniel Arthur, Andrew James Rand, Kelly L West, Diana Borton McShane
No abstract text is available yet for this article.
December 2017: Clinical Pediatrics
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