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Ambulatory pediatric medicine

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https://www.readbyqxmd.com/read/30262361/epistaxis-health-disparities-in-the-united-states-pediatric-population
#1
Lindsay Yang, Kevin Hur, Jeffrey Koempel, Elisabeth H Ference
OBJECTIVE: Despite epistaxis occurring in up to 60% of the population, few studies have investigated health status disparities in the pediatric epistaxis population. The aim of this study was to evaluate sociodemographic risk factors associated with epistaxis visits for pediatric patients. METHODS: Data were extracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey Outpatient Department from 2001 to 2010. Outpatient visits of children less than 18 years who received a primary, secondary, or tertiary diagnosis of epistaxis (ICD-9CM code 784...
November 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29760022/burnout-and-scope-of-practice-in-new-family-physicians
#2
Amanda K H Weidner, Robert L Phillips, Bo Fang, Lars E Peterson
PURPOSE: Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may provide. We examined the associations between family physician scope of practice and self-reported burnout. METHODS: Secondary analysis of the 2016 National Family Medicine Graduate Survey respondents who provided outpatient continuity care (N = 1,617). We used bivariate analyses and logistic regression to compare self-report of burnout and measures of scope of practice including: inpatient medicine, obstetrics, pediatric ambulatory care, number of procedures and/or clinical content areas, and providing care outside the principal practice site...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29524594/pediatric-and-gynecologic-rates-of-documentation-of-last-menstrual-period-in-female-adolescents
#3
Kristl Tomlin, Lucia Mirea, Amy Williamson
STUDY OBJECTIVE: The American Academy of Pediatrics and American College of Obstetricians and Gynecologists have identified the menstrual cycle as essential in assessing overall health of adolescent girls. Menses should be considered a "vital sign" and documentation of last menstrual period (LMP) is recommended at every patient encounter. The aim of this study was to estimate and compare LMP documentation among adolescent and pediatric health care providers. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study identified a random sample of 50 female patients seen in the general pediatrics (PEDS), adolescent medicine (AM), and pediatric and adolescent gynecology (PAG) ambulatory clinics at Phoenix Children's Hospital between January 1, 2016 and March 31, 2016...
August 2018: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29378672/patient-provider-and-practice-characteristics-associated-with-inappropriate-antimicrobial-prescribing-in-ambulatory-practices
#4
Monica L Schmidt, Melanie D Spencer, Lisa E Davidson
OBJECTIVE To reduce inappropriate antimicrobial prescribing across ambulatory care, understanding the patient-, provider-, and practice-level characteristics associated with antibiotic prescribing is essential. In this study, we aimed to elucidate factors associated with inappropriate antimicrobial prescribing across urgent care, family medicine, and pediatric and internal medicine ambulatory practices. DESIGN, SETTING, AND PARTICIPANTS Data for this retrospective cohort study were collected from outpatient visits for common upper respiratory conditions that should not require antibiotics...
March 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29183146/improving-rates-of-screening-for-anemia-in-infancy
#5
Barbara Ha, Deirdre L O'Sullivan, Carol A Diamond, Amy J Plumb, Jeffrey S Sleeth, Frank R Greer, Pamela J Kling
In 2010, the American Academy of Pediatrics recommended universal screening for anemia at approximately 1 year of age. This quality improvement study sought to improve anemia screening in an ambulatory setting. In a large university-based setting, a best practice alert (BPA) was placed within the electronic health record. The primary outcome was overall screening rate in ambulatory family medicine (DFM) and pediatrics (PEDS) clinics. From 2545 pre-BPA clinic visits over a 12-month period, the screening rate was 48...
August 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/28834845/primary-care-residents-in-teaching-health-centers-their-intentions-to-practice-in-underserved-settings-after-residency-training
#6
Zohray Talib, Mariellen Malloy Jewers, Julia H Strasser, David K Popiel, Debora Goetz Goldberg, Candice Chen, Hayden Kepley, Fitzhugh Mullan, Marsha Regenstein
PURPOSE: To describe the residents who chose to train in teaching health centers (THCs), which are community-based ambulatory patient care sites that sponsor primary care residencies, and their intentions to practice in underserved settings. METHOD: The authors surveyed all THC residents training in academic years 2013-2014, 2014-2015, and 2015-2016, comparing their demographic characteristics with data for residents nationally, and examined THC residents' intentions to practice in underserved settings using logistic regression analysis...
January 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28827380/age-limit-of-pediatrics
#7
Amy Peykoff Hardin, Jesse M Hackell
Pediatrics is a multifaceted specialty that encompasses children's physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged...
September 2017: Pediatrics
https://www.readbyqxmd.com/read/28557775/nonemergency-acute-care-when-it-s-not-the-medical-home
#8
Gregory P Conners, Susan J Kressly, James M Perrin, Julia E Richerson, Usha M Sankrithi
The American Academy of Pediatrics (AAP) affirms that the optimal location for children to receive care for acute, nonemergency health concerns is the medical home. The medical home is characterized by the AAP as a care model that "must be accessible, family centered, continuous, comprehensive, coordinated, compassionate, and culturally effective." However, some children and families use acute care services outside the medical home because there is a perceived or real benefit related to accessibility, convenience, or cost of care...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28516798/complementary-and-alternative-medicine-use-in-uninsured-children-in-texas
#9
Sanghamitra M Misra, Danielle Guffey, Isabel Roth, Angelo P Giardino
Use of complementary and alternative medicine (CAM) among US children is 12% according to the 2012 National Health Interview Study. Certain pediatric populations have higher CAM use. We studied an uninsured population because limited access to care likely results in higher CAM use. We surveyed 250 uninsured patients in a free pediatric mobile clinic program. In the largely Hispanic population, rate of CAM use in the preceding 12 months was 45% among children and 59% among parents. Ninety-one percent of children who used CAM had parents who used CAM while only 32% of parents used CAM for themselves but did not use CAM for their children ( P < ...
August 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28498154/pediatric-to-adult-transition-and-medication-adherence-in-patients-with-inflammatory-bowel-disease
#10
Jayson Jeganathan, Cheng Hiang Lee, Antony Rahme, Darren K Tiao, Celine Weston, Shoma Dutt, Annabel Magoffin, Vu Kwan, Aladdin Alswaifi, Peter H Katelaris, Kevin J Gaskin, Edward V OʼLoughlin, Rupert W Leong
BACKGROUND: Medication nonadherence is common in inflammatory bowel disease and is associated with poor outcomes. There has been no study on pediatric-to-adult transition as a risk factor for nonadherence in inflammatory bowel disease, which has been demonstrated in other diseases. We aimed to assess whether transitioned (TR) patients have higher nonadherence rates than young adults (YAs) diagnosed in adulthood. METHODS: Consecutive ambulatory subjects were prospectively recruited and completed the validated Medication Adherence Reporting Scale (MARS), with the primary outcome being adherence differences between group age-matched TR and YA groups...
July 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28489227/using-quality-improvement-in-resident-education-to-improve-transition-care
#11
Sofija D Volertas, Rita Rossi-Foulkes
The importance of a specific transition process is recognized by many health organizations. Got Transition, a cooperative endeavor aimed at improving the transition from pediatric to adult health care, developed Six Core Elements defining the basic components of health care transition support. In this article, we review the Six Core Elements by presenting a model that combines resident quality improvement and transition care training. In this Internal Medicine-Pediatrics residency program, ambulatory training for residents takes place in a combined adult and pediatric clinic...
May 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28464172/initial-experience-of-a-primary-urgent-care-clinic-curriculum-and-subspecialty-lectureship-series-implementation-in-a-los-angeles-county-hospital
#12
Harsh Agrawal, Anna Martinez, Elizabeth R Volkmann, Oleg Melamed, Soma Wali
OBJECTIVES: Urgent care clinics are extremely busy in the University of California-Los Angeles (UCLA) County hospital system. We determined that residents and medical students in the internal medicine residency program who are rotating through these clinics did not receive enough teaching during their rotation. We decided to create and implement an urgent care curriculum and lectures to help achieve structure for the rotation. The goal of this series was to educate and assist residents in the primary care setting to comfortably manage subspecialty conditions, help reduce the already-overwhelmed county subspecialty referral system, and promote learning...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28439357/resident-dyads-providing-transition-care-to-adolescents-and-young-adults-with-chronic-illnesses-and-neurodevelopmental-disabilities
#13
Richard J Chung, Joan Jasien, Gary R Maslow
BACKGROUND: Youth with special health care needs often experience difficulty transitioning from pediatric to adult care. These difficulties may derive in part from lack of physician training in transition care and the challenges health care providers experience establishing interdisciplinary partnerships to support these patients. OBJECTIVE: This educational innovation sought to improve pediatrics and adult medicine residents' interdisciplinary communication and collaboration...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28431439/-quality-of-and-attendance-at-healthy-child-clinics-in%C3%A2-germany
#14
Alexandra Weithase, Mandy Vogel, Henriette Kiep, Sarah Schwarz, Laura Meißner, Janine Herrmann, Kristin Rieger, Christiane Koch, Volker Schuster, Wieland Kiess
Background For several years the German healthy child clinics program has been a highly appreciated preventive measure and is subject to constant development. However, attendance depends on the families' sociodemographic situation. Findings are documented in a medical checkup booklet (the so-called Gelbes Heft). Currently, there is no procedure to use the data collected for epidemiological purposes nor to evaluate the pediatric prevention measures in Germany. Methods Between 2011 and 2016, we recruited 3480 study participants for our population-based cohort study LIFE Child in Leipzig...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28301621/treatment-of-atopic-dermatitis-in-the-united-states-analysis-of-data-from-the-national-ambulatory-medical-care-survey
#15
COMPARATIVE STUDY
Sean P McGregor, Michael E Farhangian, Karen E Huang, Steven R Feldman
<p>Introduction: Atopic dermatitis (AD) affects both adult and pediatric patients, and multiple practitioners encounter and manage AD. However, differences with regard to the treatment of AD between specialties are not well characterized. OBJECTIVE: The primary objective of this study was to determine if there is a difference between dermatologists and non-dermatology specialties with regard to treatment strategies for AD and to describe those differences. METHODS: Data from the 1993-2010 National Ambulatory Medical Care (NAMCS) and National Hospital Ambulatory Care (NHAMCS) Surveys were used to characterize outpatient visits made for AD...
March 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28269952/adoption-of-secure-messaging-in-a-patient-portal-across-pediatric-specialties
#16
Mary Masterman, Robert M Cronin, Sharon E Davis, Jared A Shenson, Gretchen P Jackson
Few studies have explored adoption of patient portals for pediatric patients outside primary care or disease-specific applications. We examined use of patient-provider messaging in a patient portal across pediatric specialties during the three years after implementation of pediatric portal accounts at Vanderbilt University Medical Center. We determined the number of patient-initiated message threads and clinic visits for pediatric specialties and percentage of these outpatient interactions (i.e., message threads + clinic visits) done through messaging...
2016: AMIA ... Annual Symposium Proceedings
https://www.readbyqxmd.com/read/28213605/2017-recommendations-for-preventive-pediatric-health-care
#17
(no author information available yet)
The 2017 Recommendations for Preventive Pediatric Health Care (Periodicity Schedule) have been approved by the American Academy of Pediatrics (AAP) and represents a consensus of AAP and the Bright Futures Periodicity Schedule Workgroup. Each child and family is unique; therefore, these recommendations are designed for the care of children who are receiving competent parenting, have no manifestations of any important health problems, and are growing and developing in a satisfactory fashion. Developmental, psychosocial, and chronic disease issues for children and adolescents may require frequent counseling and treatment visits separate from preventive care visits...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28126353/auditing-access-to-outpatient-rehabilitation-services-for-children-with-traumatic-brain-injury-and-public-insurance-in-washington-state
#18
Molly M Fuentes, Leah Thompson, D Alex Quistberg, Wren L Haaland, Karin Rhodes, Deborah Kartin, Cheryl Kerfeld, Susan Apkon, Ali Rowhani-Rahbar, Frederick P Rivara
OBJECTIVE: To identify insurance-based disparities in access to outpatient pediatric neurorehabilitation services. DESIGN: Audit study with paired calls, where callers posed as a mother seeking services for a simulated child with history of severe traumatic brain injury and public or private insurance. SETTING: Outpatient rehabilitation clinics. PARTICIPANTS: Sample of rehabilitation clinics (N=287): 195 physical therapy (PT) clinics, 109 occupational therapy (OT) clinics, 102 speech therapy (ST) clinics, and 11 rehabilitation medicine clinics...
September 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28025242/a-new-era-in-quality-measurement-the-development-and-application-of-quality-measures
#19
Terry Adirim, Kelley Meade, Kamila Mistry
Quality measures are used for a variety of purposes in health care, including clinical care improvement, regulation, accreditation, public reporting, surveillance, and maintenance of certification. Most quality measures are 1 of 3 types: structure, process, or outcome. Health care quality measures should address the domains of quality across the continuum of care and reflect patient and family experience. Measure development for pediatric health care has a number of important challenges, including gaps in the evidence base; the fact that measures for most conditions must be age-specific; the long, resource-intensive development process; and the national focus on measure development for adult conditions...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/28025241/clinical-tools-to-assess-asthma-control-in-children
#20
REVIEW
Chitra Dinakar, Bradley E Chipps
Asthma affects an estimated 7 million children and causes significant health care and disease burden. The most recent iteration of the National Heart, Lung and Blood Institute asthma guidelines, the Expert Panel Report 3, emphasizes the assessment and monitoring of asthma control in the management of asthma. Asthma control refers to the degree to which the manifestations of asthma are minimized by therapeutic interventions and the goals of therapy are met. Although assessment of asthma severity is used to guide initiation of therapy, monitoring of asthma control helps determine whether therapy should be maintained or adjusted...
January 2017: Pediatrics
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