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Pediatric community health center

Deborah Q Shelef, Cynthia Rand, Randi Streisand, Ivor B Horn, Kabir Yadav, Lisa Stewart, Naja Foushee, Damian Waters, Stephen J Teach
BACKGROUND: Stakeholder engagement has the potential to develop research interventions which are responsive to patient and provider preferences. This approach contrasts with traditional models of clinical research, in which researchers determine the study's design. OBJECTIVE: This article describes the impact of stakeholder engagement on the design of a randomized trial of an intervention designed to improve child asthma outcomes by reducing parental stress. METHODS: The study team developed and implemented a stakeholder engagement process that provided iterative feedback regarding the study design, patient-centered outcomes, and intervention...
October 12, 2016: Journal of Allergy and Clinical Immunology
Sarah E Velasquez, Enrique Chaves-Carballo, Eve-Lynn Nelson
BACKGROUND: Approximately 2.7 million individuals in the United States are affected by epilepsy. It is the fourth most common neurological disorder and affects people of all ages, races, and economic backgrounds. In many rural states, the few pediatric neurologists commonly practice in the metropolitan areas. The inadequate resources present challenges for families residing in rural areas or with limited transportation resources. One remedy for this situation is to deliver pediatric neurology services to rural areas through videoconferencing...
August 10, 2016: Pediatric Neurology
Julia B Nath, Shaughnessy Costigan, Feng Lin, Eric Vittinghoff, Renee Y Hsia
OBJECTIVE: To determine whether increasing access to federally qualified health centers (FQHCs) in California was associated with decreased rates of emergency department (ED) use by children without insurance or insured by Medicaid. METHODS: We combined several data sets to longitudinally analyze 58 California counties between 2005 and 2013. We defined access to FQHCs by county using 2 measures: FQHC sites per 100 square miles between 2005 and 2012 and percentage of Medicaid-insured and uninsured children served by FQHCs from 2008 to 2013...
September 22, 2016: Pediatrics
Geetha Raghuveer, David A White, Laura L Hayman, Jessica G Woo, Juan Villafane, David Celermajer, Kenneth D Ward, Sarah D de Ferranti, Justin Zachariah
BACKGROUND: Although public health programs have led to a substantial decrease in the prevalence of tobacco smoking, the adverse health effects of tobacco smoke exposure are by no means a thing of the past. In the United States, 4 of 10 school-aged children and 1 of 3 adolescents are involuntarily exposed to secondhand tobacco smoke (SHS), with children of minority ethnic backgrounds and those living in low-socioeconomic-status households being disproportionately affected (68% and 43%, respectively)...
October 18, 2016: Circulation
Paramala J Santosh, Laura Bell, Federico Fiori, Jatinder Singh
Antipsychotic (ATP) prescription rates have increased in children and adolescents despite concern regarding the safety and effectiveness of ATP usage in community populations. Rising safety concerns and uncertainty regarding ATP effectiveness in children stress the need for improvement in routine clinical outcome monitoring and research. Due to the growing number of children exposed to atypical ATPs, studies assessing the risk/benefit ratio of administering ATPs in this age group-especially in off-label conditions-become of high importance...
September 8, 2016: Journal of Child and Adolescent Psychopharmacology
Deirdre A Quinn, Stephanie J Mitchell, Amy Lewin
STUDY OBJECTIVE: To explore interpersonal factors associated with maintaining contraceptive use over time among urban, African American teen mothers. DESIGN: Longitudinal study, 2011-2015. SETTING: Six pediatric primary care sites in the same city, all of which primarily serve urban, low-income, African American families. PARTICIPANTS: Teen mothers accessing health services for their child at one of the six study sites...
August 23, 2016: Journal of Pediatric and Adolescent Gynecology
Elise W Sarvas, Scott A Schwantes, Jeffrey M Karp
Pediatric dentists are the primary providers of dental homes for children with life-threatening and complex chronic conditions. These children are increasingly living at home and seeking health care in community-based settings, including dental offices. Pediatric dentists may feel ill prepared to assume the roles and responsibilities of a pediatric palliative care provider due to limited education and training during dental school and residency; however, they should be sensitive to the palliative care needs of children and families...
2016: Pediatric Dentistry
Jeffrey Goldhagen, Mark Fafard, Kelly Komatz, Terry Eason, William C Livingood
BACKGROUND: Children with chronic complex-medical conditions comprise a small minority of children who require substantial healthcare with major implications for hospital utilization and costs in pediatrics. Community-Based Pediatric Palliative Care (CBPPC) provides a holistic approach to patient care that can improve their quality of life and lead to reduced costs of hospital care. This study's purpose was to analyze and report unpublished evaluation study results from 2007 that demonstrate the potential for CBPPC on Health Related Quality of Life (HRQoL) and hospital utilization and costs in light of the increasing national focus on the care of children with complex-medical conditions, including the Affordable Care Act's emphasis on patient-centered outcomes...
2016: BMC Palliative Care
Amy Lewin, Stephanie Mitchell, Lee Beers, Kristine Schmitz, Michel Boudreaux
PURPOSE: The Generations program, a patient-centered medical home, providing primary medical care, social work, and mental health services to teen mothers and their children, offers a promising approach to pregnancy prevention for teen mothers. This study tested whether the Generations intervention was associated with improved rates of contraceptive and condom use among participants 12 months after program entry. METHODS: This study compared teen mothers enrolled in Generations to those receiving standard community-based pediatric primary care over 12 months...
August 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Omolara T Uwemedimo, Gitanjli Arora, Christiana M Russ
PURPOSE OF REVIEW: This paper provides a brief overview of the current landscape of global child health and the impact of social determinants on the world's children. In the United States (US), global child health (GCH) has increasingly been highlighted as a priority area by national organizations, such as the National Academy of Medicine and American Academy of Pediatrics, as well as individual pediatricians committed to ensuring the health of all children regardless of geographic location...
October 2016: Current Opinion in Pediatrics
Kendra Hatfield-Timajchy, Jennifer L Brown, Lisa B Haddad, Rana Chakraborty, Athena P Kourtis
Given the realistic expectations of HIV-infected adolescents and young adults (AYA) to have children and start families, steps must be taken to ensure that youth are prepared to deal with the challenges associated with their HIV and parenting. Literature reviews were conducted to identify published research and practice guidelines addressing parenting or becoming parents among HIV-infected AYA in the United States. Research articles or practice guidelines on this topic were not identified. Given the paucity of information available on this topic, this article provides a framework for the development of appropriate interventions and guidelines for use in clinical and community-based settings...
July 2016: AIDS Patient Care and STDs
Koen Luyckx, Jessica Rassart, Eva Goossens, Silke Apers, Leen Oris, Philip Moons
Patients with CHD are vulnerable to psychiatric disorders. The present study compared baseline depressive symptoms between adolescents with CHD and community adolescents, and also assessed the development and persistence of depressive symptoms in patients. We examined the implications of persistent depressive symptoms towards quality of life and patient-reported health. In total, 296 adolescents with CHD participated in a four-wave longitudinal study, with 9-month intervals, and completed measures of depressive symptoms - Center for Epidemiologic Studies Depression Scale (CES-D) - at time points one to four and of quality of life - linear analogue scale (LAS) - and patient-reported health - LAS and Pediatric Quality of Life Inventory - at T (time) 4...
August 2016: Cardiology in the Young
Sally Lindsay, Melissa Fellin, Heather Cruickshank, Amy McPherson, Joanne Maxwell
BACKGROUND: Young adults with spina bifida are underserved in health care and are at risk as they transition to adult health care. A pediatric rehabilitation hospital and an adult community health center partnered to help address this gap. Although some research has explored general transition experiences of youth with disabilities, little is known about their experiences in a transition model that involves an inter-agency partnership, continuous, age-appropriate, and client-centered care...
October 2016: Disability and Health Journal
(no author information available yet)
The National Association of Pediatric Nurse Practitioners (NAPNAP) affirms that the delivery of children's health care should be family-centered, accessible, comprehensive, coordinated, culturally appropriate, compassionate, and focused on the overall well-being of children and families. All qualified pediatric health care providers should collaborate in providing health care services for children in pediatric health care/medical homes. Interventions must address the concepts of family-centered partnerships, community-based systems, and transitional care from pediatric to adult services...
March 2016: Journal of Pediatric Health Care
Brandi L McClain, Zalaya K Ivy, Valencia Bryant, Mark Rodeghier, Michael R DeBaun
INTRODUCTION: In children with sickle cell disease (SCD), concomitant asthma is associated with increased morbidity and mortality when compared with children with SCD without asthma. Despite the well-established burden of asthma in children with SCD, no paradigm of care exists for the co-management of these two diseases. METHODS: To address this gap, an integrated SCD and asthma clinic was created in a community health center that included (1) a dual respiratory therapist/asthma case manager; (2) an SCD nurse practitioner with asthma educator certification; (3) an onsite pulmonary function test laboratory; (4) a pediatric hematologist with expertise in managing SCD and asthma; and (5) application of the National Asthma Education and Prevention Program guidelines...
July 2016: American Journal of Preventive Medicine
Diane Armao, Terry Hartman, Christopher M Shea, Cassandra Sams, Marija Ivanovic, Lynn Ansley Fordham, J Keith Smith
Pediatric CT radiation dose optimization is a challenging process for pediatric-focused facilities and community hospitals alike. Ongoing experience and trial-and-error approaches to dose reduction in the large academic hospital setting may position these centers to help community hospitals that strive for CT quality improvement. We describe our hands-on approach in a pilot project to create a partnership between an academic medical center and a community hospital to develop a toolkit for implementing CT dose reduction...
June 9, 2016: Journal of the American College of Radiology: JACR
Courtney L Bradley, Heidi R Luder, Andrew F Beck, Rachel Bowen, Pamela C Heaton, Robert S Kahn, Mona Mansour, Stephen Obszarski, Stacey M Frede
OBJECTIVES: To design and implement a collaborative medication therapy management (MTM) program targeting pediatric patients with high-risk asthma in a community pharmacy. SETTING: Underserved inner city of Cincinnati, OH. PRACTICE DESCRIPTION: A large national grocery store chain pharmacy and an academic hospital developed a partnership aimed at improving asthma care for shared patients. An interdisciplinary project team was formed, including 2 clinical pharmacists, 1 pharmacy district clinical coordinator, 1 pharmacy division clinical coordinator, 1 associate professor at a college of pharmacy, 1 pharmacy resident, and 3 pediatric physicians...
July 2016: Journal of the American Pharmacists Association: JAPhA
Matthew E Oster, Susan W Aucott, Jill Glidewell, Jesse Hackell, Lazaros Kochilas, Gerard R Martin, Julia Phillippi, Nelangi M Pinto, Annamarie Saarinen, Marci Sontag, Alex R Kemper
Newborn screening for critical congenital heart defects (CCHD) was added to the US Recommended Uniform Screening Panel in 2011. Within 4 years, 46 states and the District of Columbia had adopted it into their newborn screening program, leading to CCHD screening being nearly universal in the United States. This rapid adoption occurred while there were still questions about the effectiveness of the recommended screening protocol and barriers to follow-up for infants with a positive screen. In response, the Centers for Disease Control and Prevention partnered with the American Academy of Pediatrics to convene an expert panel between January and September 2015 representing a broad array of primary care, neonatology, pediatric cardiology, nursing, midwifery, public health, and advocacy communities...
May 2016: Pediatrics
Zackary D Brown, Amita K Bey, Christopher M Bonfield, Ashly C Westrick, Katherine Kelly, Kevin Kelly, John C Wellons
OBJECTIVE Disparities in surgical access and timing to care result from a combination of complex patient, social, and institutional factors. Due to the perception of delayed presentation for overall health care services and treatment in African American patients on the part of the senior author, this study was designed to identify and quantify these differences in access and care between African American and Caucasian children with craniosynostosis. In addition, hypotheses regarding reasons for this difference are discussed...
September 2016: Journal of Neurosurgery. Pediatrics
Daniel B Horton, Brian L Strom, Mary E Putt, Carlos D Rose, David D Sherry, Julia S Sammons
IMPORTANCE: The incidence of Clostridium difficile infection has increased among children. The epidemiology of pediatric C difficile infection-associated reactive arthritis is poorly understood. OBJECTIVE: To characterize the incidence, recognition, and distinguishing clinical features of pediatric C difficile infection-associated reactive arthritis among children with C difficile infection. DESIGN, SETTING, AND PARTICIPANTS: In this cohort and nested case-control study using electronic health records from January 1, 2004, to December 31, 2013, across 3 geographically diverse pediatric health care networks, we screened for reactive arthritis among 148 children between ages 2 and 21 years with diagnostic or procedural codes suggesting musculoskeletal disease associated with C difficile diagnosis or positive testing...
July 5, 2016: JAMA Pediatrics
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