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Academic Pediatrics

Sai Iyer, Diana Do, Natacha Akshoomoff, Vanessa L Malcarne, Kate Hattrup, Susan P Berger, Sheila Gahagan, Robert Needlman
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). METHODS: This study included 4-year-old typically-developing, English language predominant children attending preschool. The ELSAT comprised 63 items relating to three main ELS domains and was piloted with 21 children...
November 16, 2018: Academic Pediatrics
Astrid B Sarvis, Robert C Sarvis, David Schnadower, James M Chamberlain, David J Mathison
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. METHODS: A comparative cost analysis was performed using bacteremia probability estimates from a previously published prediction model...
November 8, 2018: Academic Pediatrics
Douglas L Hill, Karen W Carroll, Kjg Snyder, Maria Mascarenhas, Jessi Erlichman, Chavis A Patterson, Lamia P Barakat, Chris Feudtner
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. METHODS: We conducted an observational study in 2 phases, enrolling parents of children who were inpatients with serious illness, 10 in Phase 1 and 40 in Phase 2...
November 8, 2018: Academic Pediatrics
Michael P Duggan, Elsie M Taveras, Monica W Gerber, Christine M Horan, Nicolas M Oreskovic
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. OBJECTIVE: 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 6-12 years old with a body mass index (BMI) ≥ 95th percentile who were participating in a randomized trial to treat childhood obesity...
November 8, 2018: Academic Pediatrics
William L Cull, Mary Pat Frintner, Amy Jost Starmer, Laurel K Leslie
OBJECTIVE: Utilize the unique capabilities of a longitudinal design to 1.) examine whether burnout is increasing over time among two 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 (PLACES), were used to examine self-reported burnout over a five-year period, 2012 to 2016, among 2002-2004 and 2009-2011 residency graduates (N = 1804)...
November 6, 2018: Academic Pediatrics
MaryCatherine Arbour, Mary Mackrain, Elaine Fitzgerald, Sidney Atwood
OBJECTIVE: To improve breastfeeding through home visiting. METHODS: From 2013-2016, the Home Visiting Collaborative Improvement and Innovation Network (HV-CoIIN) enrolled 15 home visiting agencies serving 1,000 families in seven states. Using the Breakthrough Series Collaborative model (BTS), HV-CoIIN faculty taught a theory of change and continuous quality improvement (CQI) skills and facilitated opportunities for networked learning. RESULTS: HV CoIIN improved home visitors' breastfeeding competencies and use of data to inform practice...
November 3, 2018: Academic Pediatrics
Kathi J Kemper, Paria Wilson, Alan Schwartz, John D Mahan, Maneesh Batra, Betty Staples, Hilary McClafferty, Charles J Schubert, Janet R Serwint
BACKGROUND: Measuring burnout symptoms is important, but the Maslach Burnout Inventory (MBI) has 22 items. This project compared three single items 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, self-compassion, and resilience, the MBI, and the 1- and 2-item screening questions. RESULTS: In 2016 and 2017, data were collected from 1785/2723 (65%) and 2148/3273 (66%) eligible pediatric residents respectively...
November 2, 2018: Academic Pediatrics
Sarah L Hilgenberg, Alyssa L Bogetz, Collin Leibold, David Gaba, Rebecca L Blankenburg
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. We developed, implemented, and evaluated the impact of a novel de-escalation curriculum on pediatric resident communication skills...
October 24, 2018: Academic Pediatrics
Daniel J Schumacher, Laurel K Leslie, K Derek Van, Gary L Freed
PURPOSE: 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. QI question responses were compared to demographic characteristics of the respondents and chi-square statistics were calculated...
October 24, 2018: Academic Pediatrics
Caroline E Rassbach, Alyssa L Bogetz, Nicola Orlov, Alisa McQueen, Vasudha Bhavaraju, David Mahoney, Collin Leibold, Rebecca L Blankenburg
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 IRB-approved, randomized-controlled trial with pediatric residents at three institutions in 2015-2016...
October 24, 2018: Academic Pediatrics
Ye Zhu, Kelly Close, Leslie Zeldin, Rocio B Quinonez, B Alexander White, R Gary Rozier
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...
October 22, 2018: Academic Pediatrics
Amanda D Osta, Marta A King, Janet R Serwint, Susan B Bostwick
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. Although there are many models of emotional debriefing, these are not commonly performed in clinical practice. We provide a guide for implementing emotional debriefing training, utilizing the AAP Resilience Curriculum, into clinical training programs with a focus on preparing senior residents and fellows to act as debriefing facilitators...
October 18, 2018: Academic Pediatrics
James M Perrin, Joan Rosenbaum Asarnow, Terry Stancin, Stephen P Melek, Gregory K Fritz
OBJECTIVE: To estimate additional payments associated with co-existing mental health or substance use disorders (MH/SUD) among commercially-insured children and youth with chronic medical conditions (CMC). To determine whether children's MH/SUD have similar associations with parental health care payments. METHOD: Cross-sectional analysis of a national database of paid commercial insurance claims for 2012-13. Participants were children/youth ages 0-26 years covered as dependents on parents' health insurance and categorized by presence or absence of any of 11 chronic medical conditions and MH/SUD...
October 10, 2018: Academic Pediatrics
Marsha Gerdes, J Felipe Garcia-Espana, David Webb, Karen Friedman, Sherry Winston, Jennifer Culhane
OBJECTIVE: To assess the validity of Spanish versions of the Survey of Well-being of Young Children (SWYC) Milestones and the Ages and Stages Questionnaire (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...
October 10, 2018: Academic Pediatrics
Kelsey A Miller, Debra Hillier, Christiana Russ, Marcella Luercio, Ariel S Winn
No abstract text is available yet for this article.
October 9, 2018: Academic Pediatrics
Adam Pallant, Sharon M Hudson, Eyal Ben-Isaac
OBJECTIVES: 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 (APPD). Surveys assessed PD demographics, characteristics of the residency program and the PDs' positions (including salary), and measures of satisfaction...
October 2, 2018: Academic Pediatrics
Rebecca N Dudovitz, Mitchell D Wong, Giselle Perez-Aguilar, Grace Kim, Paul J Chung
No abstract text is available yet for this article.
October 1, 2018: Academic Pediatrics
Sara K Kane, Diane E Lorant
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. In a national survey, we found a large variability in faculty assessment of the amount of supervision trainees need for various resuscitation scenarios. Objective documentation of trainee performance would permit competency-based decisions on the level of supervision required and facilitate feedback on trainee performance...
September 28, 2018: Academic Pediatrics
Esther K Chung, Ruth S Gubernick, Marianna LaNoue, Diane J Abatemarco
OBJECTIVES: Practicing Safety™ (PS) is an AAP 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 (QI) initiative to standardize CAN risk assessment, using materials adapted from PS (aPS) was conducted through the use of "SmartTools" in an electronic health record (EHR)...
September 28, 2018: Academic Pediatrics
Daniel J Schumacher, Abigail Martini, Eric Holmboe, Kartik Varadarajan, Jamiu Busari, Cees van der Vleuten, Carol Carraccio
OBJECTIVE: Despite the need for quality measures relevant to the work residents complete, few attempts have been made to address this gap. Resident-sensitive quality measures (RSQMs) can help fill this void. This study engaged resident and supervisor stakeholders to develop and inform next steps in creating such measures. METHODS: Two separate nominal group techniques (NGTs), one with residents and one with faculty and fellow supervisors, were used to generate RSQMs for 3 specific illnesses (asthma, bronchiolitis, and closed head injury) as well as general care for the pediatric emergency department...
September 27, 2018: Academic Pediatrics
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