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Pediatric community health center

Francesc Torres-Andres, Ericka L Fink, Michael J Bell, Mahesh S Sharma, Eric J Yablonsky, Joan Sanchez-de-Toledo
OBJECTIVES: To identify patient- and disease-related factors related to survival and favorable outcomes for children who underwent extracorporeal cardiopulmonary resuscitation after a refractory cardiac arrest. DESIGN: Retrospective observational study with prospective assessment of long-term functional outcome. PATIENTS: Fifty-six consecutive children undergoing extracorporeal cardiopulmonary resuscitation at our institution from 2007 to 2015...
March 9, 2018: Pediatric Critical Care Medicine
Adrienne W Henize, Andrew F Beck, Melissa D Klein, John Morehous, Robert S Kahn
Introduction Children and families living in poverty frequently encounter social risks that significantly affect their health and well-being. Physicians' near universal access to at-risk children and their parents presents opportunities to address social risks, but time constraints frequently interfere. We sought to redesign our waiting room to create a clinic-to-community bridge and evaluate the impact of that redesign on family-centered outcomes. Methods We conducted a pre-post study of a waiting room redesign at a large, academic pediatric primary care center...
March 10, 2018: Maternal and Child Health Journal
Andrea Postier, Kris Catrine, Stacy Remke
Little is known about the role of pediatric palliative care (PPC) programs in providing support for home compassionate extubation (HCE) when families choose to spend their child's end of life at home. Two cases are presented that highlight the ways in which the involvement of PPC teams can help to make the option available, help ensure continuity of family-centered care between hospital and home, and promote the availability of psychosocial support for the child and their entire family, health care team members, and community...
March 7, 2018: Children
Megumi J Okumura, Heather A Knauer, Kris E Calvin, John I Takayama
Background and Objectives Pediatricians face numerous challenges in providing care for children with special health care needs (CSHCN). Few studies have described health care resources available to support pediatricians to care for CSHCN. This study investigated available resources to care for CSHCN and factors associated with having a greater proportion of CSHCN in practice. Methods We conducted a statewide survey of active members of the American Academy of Pediatrics in California to study pediatric subspecialty care access, community and office resources and practice barriers...
March 1, 2018: Maternal and Child Health Journal
Brett R Anderson, Evan S Fieldston, Jane W Newburger, Emile A Bacha, Sherry A Glied
BACKGROUND: Significant disparities exist between patients of different races and with different family incomes; less is understood regarding community-level factors on outcomes. METHODS: In this study, we used linked data from the Pediatric Health Information System database and the US Census Bureau to examine associations between median annual household income by zip code and mortality, length of stay, inpatient standardized costs, and costs per day, over and above the effects of race and payer, first for children undergoing cardiac surgery (2005-2015) and then for all pediatric discharges (2012-2015)...
February 22, 2018: Pediatrics
Kimberly Burkhart, Michele Knox, Kimberly Hunter, Deanna Pennewitt, Karyssa Schrouder
The Play Nicely program is a multimedia training program designed to teach caregivers and health care professionals how to manage early childhood aggression and to use positive parenting practices. The aim of this article is to help the practicing clinician determine whether the Play Nicely program should be incorporated into his/her practice and to evaluate whether the program is effective at decreasing positive attitudes toward spanking in a socioeconomically disadvantaged population in both a resident pediatric clinic and a community center...
February 19, 2018: Journal of Pediatric Health Care
Sultan Alghadeer, Manal Alrohaimi, Abeer Althiban, Nora A Kalagi, Bander Balkhi, Anas A Khan
Introduction: Although the majority of poisoning-related cases can be managed in home settings, reduction of hospital visits and admissions are still important challenge. Thousands of interventions are involved and the appropriate management of poisoning is therefore a major task and burden to any institution. Therefore, the present study was aimed to identify the most common classes of toxic substances and route of poisoning in children and to investigate the pattern of drug and chemical poisoning in suspected case fatalities, the subsequent need for hospital admission and arrival time to hospital...
January 2018: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Lauren Fiechtner, Meghan Perkins, Vincent Biggs, Nancy Langhans, Mona Sharifi, Giselle O'Connor, Sarah Price, Joseph Locascio, Karen Kuhlthau, Jo-Ann Kwass, Candace Nelson, Thomas Land, Matt Longjohn, Valerie Lawson, Katherine Hohman, Elsie M Taveras
BACKGROUND: Recent studies have demonstrated the effectiveness of family-centered, pediatric weight management programs in reducing childhood obesity. Yet, programs to optimize the care of low-income children with obesity are needed. We sought to examine the comparative effectiveness of two, potentially scalable pediatric weight management programs delivered to low-income children in a clinical or community setting. MATERIALS AND METHODS: The Clinic and Community Approaches to Healthy Weight trial is a randomized trial in two communities in Massachusetts that serve a large population of low-income children and families...
January 9, 2018: Contemporary Clinical Trials
C-O Bagayoko, M Niang, A Anne, D Traoré, H Sangho, A-K Traoré, A Geissbuhler
The PACT-Denbaya project (Program for community access to telemedicine for families) aimed to help improve the health of mothers and child in rural communities through the delegation of obstetric-gynecologic and pediatric tasks, supported by teleconsultations. This operational research took place in 6 community health centers in the Dioïla health district in Mali. Our method was based of the delegation of tasks, supported by teleconsultations. Experts in pediatrics and obstetrics/gynecology provided a week-long training program to general practitioners and midwives, in the management of the most common problems in the field and in the use of the "Bogou" teleconsultation and "Dudal" tele-education platforms to ensure exchanges and follow-up...
November 1, 2017: Médecine et Santé Tropicales
Klaus B von Pressentin, Robert J Mash, Laurel Baldwin-Ragaven, Roelf Petrus Gerhardus Botha, Indiran Govender, Wilhelm Johannes Steinberg, Tonya M Esterhuizen
PURPOSE: Evidence of the influence of family physicians on health care is required to assist managers and policy makers with human resource planning in Africa. The international argument for family physicians derives mainly from research in high-income countries, so this study aimed to evaluate the influence of family physicians on the South African district health system. METHODS: We conducted a cross-sectional observational study in 7 South African provinces, comparing 15 district hospitals and 15 community health centers (primary care facilities) with family physicians and the same numbers without family physicians...
January 2018: Annals of Family Medicine
Benjamin J Oldfield, Bennett W Clark, Monica C Mix, Katherine C Shaw, Janet R Serwint, Sanjay V Desai, Rachel M Kruzan, Rosalyn W Stewart, Sebastian Ruhs, Leonard S Feldman
BACKGROUND: Although residency programs are well situated for developing a physician workforce with knowledge, skills, and attitudes that incorporate the strengths and reflect the priorities of community organizations, few curricula explicitly do so. AIM: To develop urban health primary care tracks for internal medicine and combined internal medicine-pediatrics residents. SETTING: Academic hospital, community health center, and community-based organizations...
January 3, 2018: Journal of General Internal Medicine
Tiffany Blake-Lamb, Alexy Arauz Boudreau, Sarah Matathia, Etna Tiburcio, Meghan E Perkins, Brianna Roche, Milton Kotelchuck, Derri Shtasel, Sarah N Price, Elsie M Taveras
INTRODUCTION: Obesity interventions may be most effective if they begin in the earliest stages of life, support changes across family, clinical, and public health systems, and address socio-contextual factors. METHODS: The First 1000Days is a systematic program starting in early pregnancy lasting through the first 24months of infancy to prevent obesity among low-income mother-infant pairs in three community health centers in Massachusetts. The program uses a Collective Impact approach to create the infrastructure for sustained, system-wide changes for obesity prevention across early life clinical and public health services, including Obstetrics, Pediatrics, Adult Medicine, Behavioral Health, Nutrition, Community Health, the Women, Infants and Children (WIC) program, and the Maternal, Infant and Childhood Home Visiting program...
February 2018: Contemporary Clinical Trials
Barbie Drews, Michelle Macaluso, Hannah Piper, Nandini Channabasappa
Pediatric patients with intestinal failure often require central venous catheters for extended periods of time for parenteral nutrition, blood sampling, and medication administration, increasing morbidity, mortality, and costs. In 2007, we reported a central line-associated bloodstream infection rate of 7.0 per 1,000 catheter line-days in our pediatric patients with intestinal failure. On the basis of this high rate of catheter-associated infections, we developed and implemented a central line care curriculum for patients/family caregivers and home health nurses...
November 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
Susan L Ryerson Espino, Erin H Kelly, Anne Rivelli, Kathy Zebracki, Lawrence C Vogel
STUDY DESIGN: Focus group study. OBJECTIVES: Explore unmet needs and support preferences of caregivers of youth with spinal cord injury (SCI). SETTING: One pediatric specialty rehabilitation hospital system in the United States. METHODS: Four focus groups were conducted with a convenience sample of 26 caregivers who were primarily mothers (96%) and married (65%), and had at least some college education (85%). Children living with SCI were on average 12...
November 30, 2017: Spinal Cord
Nicholas Chadi, Miriam Kaufman, Elli Weisbaum, Catherine Malboeuf-Hurtubise, Sara Ahola Kohut, Christine Viner, Jake Locke, Dzung X Vo
BACKGROUND: Eight-week mindfulness-based interventions (MBIs) have a beneficial impact on mental health and well-being in adolescents with chronic health conditions. Usually delivered in person in a group setting, these programs are difficult to access for teens with disabilities or who do not have in-person MBIs available in their communities. OBJECTIVE: This paper outlines the rationale, development, and design of a randomized controlled trial comparing the effects of an MBI delivered in person or via eHealth in adolescents with a chronic illness...
November 27, 2017: JMIR Research Protocols
Claire Leonie Ward, David Shaw, Evelyn Anane-Sarpong, Osman Sankoh, Marcel Tanner, Bernice Elger
This study explores ethical issues raised in providing medical care to participants and communities of low-resource settings involved in a Phase II/III pediatric malaria vaccine trial (PMVT). We conducted 52 key informant interviews with major stakeholders of an international multi-center PMVT (GSK/PATH-MVI RTS,S) (NCT00866619) in Ghana and Tanzania. Based on their stakeholder experiences, the responses fell into three main themes: (a) undue inducement, (b) community disparities, and (c) broad therapeutic misconceptions...
February 2018: Journal of Empirical Research on Human Research Ethics: JERHRE
Katherine Hobbs Knutson, Mark J Meyer, Nisha Thakrar, Bradley D Stein
Many children are treated for mental health disorders in primary care settings. The system of care (SOC) provides a framework for collaboration among pediatric mental health providers, but it is unclear if youth treated for mental health disorders in primary care receive such coordination. At the South Boston Community Health Center from September /2012 to August 2013 for 74 individuals ≤18 years, the odds of contact with SOC agencies (mental health, education, child protective services, juvenile justice and developmental disabilities) were compared for mental health treatment in primary versus specialty care...
January 2018: Clinical Pediatrics
Heather J Walter, Gina Kackloudis, Emily K Trudell, Louis Vernacchio, Jonas Bromberg, David R DeMaso, Glenn Focht
The objective of this study was to assess feasibility, utilization, perceived value, and targeted behavioral health (BH) treatment self-efficacy associated with a collaborative child and adolescent psychiatry (CAP) consultation and BH education program for pediatric primary care practitioners (PCPs). Eighty-one PCPs from 41 member practices of a statewide pediatric practice association affiliated with an academic medical center participated in a program comprising on-demand telephonic CAP consultation supported by an extensive BH learning community...
October 1, 2017: Clinical Pediatrics
Joan C Lo, Thomas E Baudendistel, Abhay Dandekar, Phuoc V Le, Stanton Siu, Bruce Blumberg
Collaborative partnerships between community-based academic residency training programs and schools of public health, represent an innovative approach to training future physician leaders in population management and public health. In Kaiser Permanente Northern California, development of residency-Masters in Public Health (MPH) tracks in the Internal Medicine Residency and the Pediatrics Residency programs, with MPH graduate studies completed at the University of California Berkeley School of Public Health, enables physicians to integrate clinical training with formal education in epidemiology, biostatistics, health policy, and disease prevention...
2017: Advances in Medical Education and Practice
Ariel A Williamson, Sonia L Rubens, Kristina E Patrick, Melisa Moore, Jodi A Mindell
STUDY OBJECTIVES: Community-based research indicates that Black preschoolers tend to have more bedtime difficulties and are at higher risk for obstructive sleep apnea (OSA) compared to White preschoolers. This study examined differences in sleep patterns and problems by race among a clinical sample of Black and White preschoolers at an outpatient sleep clinic. METHODS: Data were collected from electronic medical records for 125 children ages 2-5 years (mean = 3...
November 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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