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Current Problems in Pediatric and Adolescent Health Care

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https://www.readbyqxmd.com/read/30389361/judicious-antibiotic-prescribing-in-ambulatory-pediatrics-communication-is-key
#1
Nicole M Poole
Children in outpatient clinics are prescribed over 15 million courses of unnecessary antibiotics annually. Clinicians have identified parent pressure for antibiotics, parent satisfaction, and time constraints as the primary drivers of unnecessary antibiotic prescribing. Over the past decade, parents have become more aware that antibiotics only treat bacterial infections, yet continue to report an expectation for antibiotics in 50-65% of acute care visits. Parental expectations for antibiotics stem from parental concerns about symptom severity and a desire to alleviate symptoms...
October 30, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30337150/the-burden-and-impact-of-antibiotic-prescribing-in-ambulatory-pediatrics
#2
Alexandra B Yonts, Matthew P Kronman, Rana F Hamdy
Antibiotics are one of the most commonly prescribed classes of medication for children and adolescents. While they are arguably the most powerful tool we possess against bacterial infections, they are frequently given to children whose illnesses are due to viruses or other non-infectious etiologies. When antibiotics are not used judiciously, the consequences can be serious and accumulate over time. This review article quantifies the burden of antimicrobial use in the pediatric outpatient setting in the United States, reviews recommended first line antibiotic regimens for common outpatient pediatric and adolescent conditions, investigates the reasons for inappropriate prescribing of antibiotics in outpatient healthcare settings, and explores the range of consequences of overuse and inappropriate use of antibiotics, from adverse drug reactions to impact on the microbiome to rising rates of antimicrobial resistance in common ambulatory conditions...
October 15, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30337149/evidenced-based-interventions-for-children-with-autism-spectrum-disorder
#3
Meredith N Will, Kristn Currans, Jennifer Smith, Stephanie Weber, Amie Duncan, Jenny Burton, Kimberly Kroeger-Geoppinger, Valerie Miller, Megan Stone, Lindsay Mays, Ashley Luebrecht, Anna Heeman, Craig Erickson, Julia Anixt
This paper reviews evidenced-based interventions for children with autism spectrum disorders (ASD) across the disciplines of psychology, speech-language pathology, occupational therapy, and developmental pediatrics. BACKGROUND: rates of ASD diagnoses have been steadily rising over the past 2 decades. There are a wide range of therapies and interventions, of varying levels of evidence, across disciplines that are now available to treat children with ASD. The field has moved toward a greater emphasis on the identification and utilization of evidenced-based treatments...
October 15, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30322711/from-paper-to-practice-strategies-for-improving-antibiotic-stewardship-in-the-pediatric-ambulatory-setting
#4
Michael J Bozzella, Nada Harik, Jason G Newland, Rana F Hamdy
Antibiotic stewardship aims to better patient outcomes, reduce antibiotic resistance, and decrease unnecessary health care costs by improving appropriate antibiotic use. More than half of annual antibiotic expenditures for antibiotics in the United States are prescribed in the ambulatory setting. This review provides a summary of evidence based strategies shown to improve antibiotic prescribing in ambulatory care settings including: providing education to patients and their families, providing education to clinicians regarding best practices for specific conditions, providing communications training to clinicians, implementing disease-specific treatment algorithms, implementing delayed prescribing for acute otitis media, supplying prescribing feedback to providers with peer comparisons, using commitment letters, and prompting providers to justify antibiotic prescribing for diagnoses for which antibiotics are not typically recommended...
October 13, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30316803/foreward-outpatient-antimicrobial-stewardship
#5
Mary C Ottolini
No abstract text is available yet for this article.
October 10, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30293897/commentary-evidence-based-interventions-for-children-and-adolescents-with-autism-spectrum-disorders
#6
Richard Solomon
No abstract text is available yet for this article.
October 4, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30270135/running-pdsa-cycles
#7
Patricia Christoff
The need to change the delivery of healthcare in the United States has been the focus of several recent publications. Quality improvement concepts initially utilized in industry have been applied to healthcare to reduce error and variation in outcomes. The Plan-Do-Study-Act (PDSA) Methodology is one of the most commonly used tools in quality improvement. The PDSA cycle is an iterative, four step model for improving a process. The first step is the development of a plan in which predictions of outcomes are clearly stated and tasks are assigned...
September 27, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30270134/commentary-evidence-based-interventions-for-children-and-adolescents-with-autism-spectrum-disorders
#8
Daniel L Coury
No abstract text is available yet for this article.
September 27, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30270133/leadership-in-quality-improvement
#9
Kelly C Sandberg
This article presents thoughts from a quality improvement team leader in a small institution application of methodology from the Institute for Healthcare Improvement. Successful leadership in quality improvement depends on structural supports in building learning systems as well as a supportive culture. Many resources can be used in quality improvement efforts. Serious students of quality improvement and leadership will seek out opportunities to learn and improve as they tailor their efforts to local needs and resources...
September 27, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30268745/understanding-variation-part-2-the-control-chart
#10
Elizabeth Williams
Both run and control charts can be used to answer the question "How will we know that a change is an improvement?". Run charts are advantageous at the start of an improvement effort, when little is known about the system and how it performs. Over time, transitioning to a control chart may provide more specific information and insight into the data being measured. The type of numeric data being collected helps guide the most appropriate choice ofcontrol chart. Control chart rules exist and should be used to determine if a change in the data represents common cause or special cause variation...
September 26, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30266381/building-of-profound-knowledge
#11
Stacy Roehrs
Health systems are complex. Understanding the interrelationship among the four components of W. Edwards Deming's System of Profound Knowledge (theories of systems, theory of knowledge, understanding variation, and psychology of change) allows us to begin the work of quality improvement. Each system is perfectly designed to deliver the results it produces. One must gain knowledge of the system through small tests of change (Plan-Do-Study-Act Cycles). We also need to understand and prevent undesirable variation and encourage desirable variation...
September 25, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30262163/pharmacological-management-of-behavioral-disturbances-in-children-and-adolescents-with-autism-spectrum-disorders
#12
Martine Lamy, Craig A Erickson
Autism spectrum disorder (ASD) is a heterogeneous neuropsychiatric condition that, based on recent CDC estimates affects an estimated 1 in 59 American children. Behavioral treatments remain the mainstay of treatment for the core symptoms of ASD including communication deficits, social interaction deficits and repetitive behavior. However, youth with ASD may also have severe behavioral challenges including irritability, aggression, and hyperactivity. Currently there are only two medications (risperidone and aripiprazole) approved by the FDA for the treatment of irritability associated with ASD in children...
September 24, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30224198/child-welfare-system-interventions-on-behalf-of-children-and-families-highlighting-the-role-of-court-appointed-special-advocates
#13
Martha Gershun, Claire Terrebonne
Nearly three-quarters of a million children are victims of abuse and neglect in the United States every year. This article describes the scope of the problem and explains how the child welfare system intervenes, including how cases are reported, how Child Protective Services (CPS) assesses the risk, how CPS determines when in-home services are appropriate or if a child should be removed from the home, how ongoing cases are managed, and the options for permanency for children in the system. The article also explains how the Family Court system operates as the decision-maker in child abuse and neglect cases and discusses the various models of legal representation provided to child victims, depending on the jurisdiction in which they live...
September 14, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30213526/foreword-quality-improvement-part-ii
#14
EDITORIAL
John M Pascoe
No abstract text is available yet for this article.
September 10, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30174181/pediatricians-and-court-appointed-special-advocates-casa
#15
John D Lantos
No abstract text is available yet for this article.
August 30, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30049477/cardiovascular-clearance-for-sports-participation
#16
Sona Dave, Ronald Feinstein
Sudden cardiac death (SCD) in a young athlete is a rare but tragic occurrence. The goal of this article is to provide information about the risks of sudden cardiac death in athletes by reviewing the epidemiology and describing the current screening recommendations of the American Heart Association/American College of Cardiology. 1 The specifics of and reasons for differences between screening guidelines in the United States and the screening guidelines in Europe are highlighted. Electrocardiogram (ECG) changes that can be expected in the setting of conditioning vs pathology are described...
July 24, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30017603/evaluation-and-management-of-concussion-in-young-athletes
#17
Jennifer Kosoy, Ronald Feinstein
Learning about concussion diagnosis and management is important for all individuals who will be taking care of young athletes. There are about 1.7million reported concussions per year, and, of these, about 20% are sports related. There are risks in all sports, but the highest rates of concussions are from football, rugby, and hockey, with soccer being the highest cause for girls. An on-field assessment includes evaluating airway, breathing, and circulation, followed by cervical spine assessment. Then, concussion evaluation tools can be used to aid in making the diagnosis...
July 14, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30017602/foreword-clearance-for-sports-participation-concussions-cardiovascular-and-other-medical-concerns
#18
Ronald Feinstein, Martin Fisher
No abstract text is available yet for this article.
July 14, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30213528/foreword-quality-improvement-part-i
#19
John M Pascoe
No abstract text is available yet for this article.
July 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/30213527/modeling-causal-relationships-in-quality-improvement
#20
Merrilee Cox, Kelly Sandberg
Taking the time to plan a quality improvement project before starting the project improves the likelihood of success. Understanding the tools that can be utilized for identification of a problem, the causes behind it, and the development of the theoretical framework of the planned improvement are crucial. Fishbone diagrams or cause and effect diagrams are often utilized to identify the root causes leading to an identified problem. Keydriver diagrams can provide the structure for a quality improvement project, establishing the aim and identifying the drivers and interventions that lead to change...
July 2018: Current Problems in Pediatric and Adolescent Health Care
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