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Behavioral Pediatrics

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https://www.readbyqxmd.com/read/28929269/behavioral-health-integration-in-health-care-settings-lessons-learned-from-a-pediatric-hospital-primary-care-system
#1
Leandra Godoy, Melissa Long, Donna Marschall, Stacy Hodgkinson, Brooke Bokor, Hope Rhodes, Howard Crumpton, Mark Weissman, Lee Beers
Behavioral health integration within primary care has been evolving, but literature traditionally focuses on smaller scale efforts. We detail how behavioral health has been integrated across a large, urban pediatric hospital system's six primary care clinics (serving over 35,000 children annually and insured predominately through Medicaid) and discuss strategies for success in sustaining and expanding efforts to achieve effective integration of behavioral health into primary care. In a time span of 3 years, the clinics have implemented routine, universal behavioral health screening at well child visits, participated in a 15-month behavioral health screening quality improvement learning collaborative, and integrated the work of psychologists and psychiatrists...
September 19, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/28928043/treating-postpartum-mood-and-anxiety-disorders-in-primary-care-pediatrics
#2
Polina Umylny, Miguelina German, Alexa Lantiere
Postpartum psychiatric disorders represent a significant public health problem that has not been readily addressed, particularly in the primary care setting. As maternal mood and anxiety difficulties are associated with a number of adverse outcomes for the mother, her offspring and the family system, addressing these concerns during the perinatal period is of critical importance. Although researchers and clinicians have become increasingly aware of the problem, postpartum mood and anxiety disorders (PMADs) remain widely unrecognized and poorly understood by both patients and providers...
September 16, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28922267/the-1-year-follow-up-clinic-for-neonates-and-children-after-respiratory-extracorporeal-membrane-oxygenation-support-a-10-year-single-institution-experience
#3
Suzan Kakat, Maura O'Callaghan, Liz Smith, Raymond Hreiche, Deborah A Ridout, Jo Wray, Timothy Thiruchelvam, Katherine L Brown, Aparna U Hoskote
OBJECTIVES: To establish the effectiveness of a "1-year extracorporeal membrane oxygenation follow-up clinic" and to characterize any neurodevelopmental concerns identified. DESIGN: Single-center retrospective cohort of respiratory extracorporeal membrane oxygenation survivors over 10 years. SETTING: Nationally commissioned center for neonatal and pediatric (> 28 d of life) respiratory extracorporeal membrane oxygenation. PATIENTS: Children attending the follow-up clinic 1 year after receiving respiratory extracorporeal membrane oxygenation between 2003 and 2013...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28921528/practitioner-review-treatment-of-chronic-insomnia-in-children-and-adolescents-with-neurodevelopmental-disabilities
#4
REVIEW
Oliviero Bruni, Marco Angriman, Fabrizio Calisti, Alessandro Comandini, Giovanna Esposito, Samuele Cortese, Raffaele Ferri
BACKGROUND: Sleep disturbances, in particular insomnia, represent a common problem in children with neurodevelopmental disabilities (NDDs). Currently, there are no approved medications for insomnia in children by the US Food and Drug Administration or European Medicines Agency and therefore they are prescribed off-label. We critically reviewed pediatric literature on drugs as well as nonpharmacological (behavioral) interventions used for sleep disturbances in children with NDDs. METHODS: PubMed, Ovid (including PsycINFO, Ovid MEDLINE(®) , and Embase), and Web of Knowledge databases were searched through February 12, 2017, with no language restrictions...
September 18, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28919764/levetiracetam-is-associated-with-decrease-in-subclinical-epileptiform-discharges-and-improved-cognitive-functions-in-pediatric-patients-with-autism-spectrum-disorder
#5
Minjian Wang, Li Jiang, Xiaoju Tang
OBJECTIVE: Subclinical epileptiform discharges (SEDs) are common in pediatric patients with autism spectrum disorder (ASD), but the effect of antiepileptic drugs on SEDs in ASD remains inconclusive. This physician-blinded, prospective, randomized controlled trial investigated an association between the anticonvulsant drug levetiracetam and SEDs in children with ASD. METHODS: A total of 70 children with ASD (4-6 years) and SEDs identified by electroencephalogram were randomly divided into two equal groups to receive either levetiracetam and educational training (treatment group) or educational training only (control)...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28917203/cognitive-behavioral-correlates-of-proxy-reports-on-cognitive-capabilities-in-pediatric-patients-with-epilepsy
#6
Christoph Helmstaedter, Renata Vaz Pandolfo, Christian Hoppe, Juri-Alexander Witt
PURPOSE: To validate the Cognitive Problems in Children and Adolescents Questionnaire (KOPKIJ, German: Kognitive Probleme bei Kindern und Jugendlichen), a proxy report measure for recognizing cognitive problems in pediatric patients with epilepsy. METHODS: Anonymized data sets from 279 pediatric epilepsy patients were standardized in regard to the KOPKIJ results of 352 healthy children and adolescents. The KOPKIJ was related to objective routine neuropsychological assessment (NPY), and to two subjective measures, the Child Behavior Checklist questionnaire (CBCL), a proxy rating by the parents, and a questionnaire for self-perceived health-related quality of life in children and adolescents (KINDL)...
September 6, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28916019/the-basic-science-of-behavior-change-and-its-application-to-pediatric-providers
#7
REVIEW
Allison R Love, Peter S Jensen, Lisa Khan, Tiffany West Brandt, James Jaccard
Pediatric primary care providers (PPCPs) are increasingly expected to know how to assess, diagnose, and treat a wide range of mental health problems in children and adolescents. For many PPCPs, this means learning and performing new practice behaviors that were not taught in their residency training. Typical continuing education approaches to engage PPCPs in new practices have not yielded the desired changes in provider behavior. This article summarizes behavior change principles identified through basic behavior science, adult education, and communication research, and discusses their application to a patient-centered pediatric primary care mental health curriculum...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916016/comparing-two-models-of-integrated-behavioral-health-programs-in-pediatric-primary-care
#8
REVIEW
Miguelina Germán, Michael L Rinke, Brittany A Gurney, Rachel S Gross, Diane E Bloomfield, Lauren A Haliczer, Silvie Colman, Andrew D Racine, Rahil D Briggs
This study examined how to design, staff, and evaluate the feasibility of 2 different models of integrated behavioral health programs in pediatric primary care across primary care sites in the Bronx, NY. Results suggest that the Behavioral Health Integration Program model of pediatric integrated care is feasible and that hiring behavioral health staff with specific training in pediatric, evidence-informed behavioral health treatments may be a critical variable in increasing outcomes such as referral rates, self-reported competency, and satisfaction...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916014/integrated-behavioral-health-care-in-pediatric-subspecialty-clinics
#9
REVIEW
Chase Samsel, Monique Ribeiro, Patricia Ibeziako, David R DeMaso
Comorbid behavioral and physical health conditions are accompanied by troubling symptom burden, functional impairment, and treatment complexity. Pediatric subspecialty care clinics offer an opportunity for the implementation of integrated behavioral health (BH) care models that promote resiliency. This article reviews integrated BH care in oncology, palliative care, pain, neuropsychiatry, cystic fibrosis, and transplantation. Examples include integrated care mandates, standards of care, research, and quality improvement by child and adolescent psychiatrists (CAPs) and allied BH clinicians...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916010/competencies-and-training-guidelines-for-behavioral-health-providers-in-pediatric-primary-care
#10
REVIEW
Wanjiku F M Njoroge, Ariel A Williamson, Jennifer A Mautone, Paul M Robins, Tami D Benton
This article focuses on the cross-discipline training competencies needed for preparing behavioral health providers to implement integrated primary care services. After a review of current competencies in the disciplines of child and adolescent psychiatry, psychology, and social work, cross-cutting competencies for integrated training purposes are identified. These competencies are comprehensive and broad and can be modified for use in varied settings and training programs. An existing and successful integrated care training model, currently implemented at Children's Hospital of Philadelphia, is described...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916009/incorporating-trainees-development-into-a-multidisciplinary-training-model-for-integrated-behavioral-health-within-a-pediatric-continuity-clinic
#11
REVIEW
Kimberly Kelsay, Maya Bunik, Melissa Buchholz, Bridget Burnett, Ayelet Talmi
Integrated behavioral and mental health systems of care for children require multidisciplinary team members to have specific competencies and knowledge of the other disciplines' strengths and practice needs. Training models for multidisciplinary professionals should consider the developmental level of trainees. The authors describe a model of flexible scaffolding, increasing intensity, and depth of experience as trainees gain skills and knowledge.
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916007/from-theory-to-action-children-s-community-pediatrics-behavioral-health-system
#12
REVIEW
Abigail Schlesinger, Jacquelyn M Collura, Emily Harris, Joanna Quigley
Integrated health care models attempt to cross the barrier between behavioral and medical worlds in order to improve access to quality care that meets the needs of the whole patient. Unfortunately, the integration of behavioral health and physical health providers in one space is not enough to actually promote integration. There are many models for promoting integration and collaboration within the primary care context. This article uses the experience of the Children's Community Pediatrics Behavioral Health Services system to highlight components of collaboration that should be considered in order to successfully integrate behavioral health within a medical home...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28915907/effect-of-a-mother-s-recorded-voice-on-emergence-from-general-anesthesia-in-pediatric-patients-study-protocol-for-a-randomized-controlled-trial
#13
Seok Young Song, Sang Gyu Kwak, Eugene Kim
BACKGROUND: Emergence delirium is a behavioral disturbance after general anesthesia in children and may distress both the patients and the primary caregivers, such as parents and medical staff, looking after the patients. Various medical and emotional interventions have been investigated to reduce emergence delirium; however, none are completely effective. This trial intends to assess whether the mother's recorded voice can reduce this adverse post-anesthesia event and facilitate arousal from general anesthesia...
September 15, 2017: Trials
https://www.readbyqxmd.com/read/28914731/academic-developmental-behavioral-pediatric-faculty-at-developmental-behavioral-pediatric-research-network-sites-changing-composition-and-interests
#14
Nancy Roizen, Ruth E K Stein, Ellen J Silver, Pamela High, Marilyn C Augustyn, Nathan J Blum
OBJECTIVE: To obtain and review workforce data, given the critical demand for developmental pediatricians (DPs). METHODS: Survey of demographics and professional activities of DP physician faculty at Developmental-Behavioral Pediatric (DBP) Research Network fellowship training sites. RESULTS: Of the eligible providers at 12 centers, 76% (n = 50) completed surveys. They were on average 50 years old and mostly female (86%), white (82%), and working full time (74%)...
September 7, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28914364/unhealthy-lifestyle-habits-and-diabetes-specific-health-related-quality-of-life-in-youths-with-type-1-diabetes
#15
Enza Mozzillo, Eugenio Zito, Claudio Maffeis, Elena De Nitto, Giulio Maltoni, Marco Marigliano, Stefano Zucchini, Adriana Franzese, Giuliana Valerio
AIMS: Management of type 1 diabetes mellitus (T1DM) influences several aspects of life, such as adherence to healthy lifestyle habits and health-related quality of life (HRQoL). Our aim was to evaluate the association between unhealthy lifestyle habits and HRQoL in adolescents and young adults with T1DM. METHODS: Two hundred and forty-two Caucasian patients (13-19 years) consecutively enrolled over a 12-month period in three Regional Pediatric Diabetes Centers in Italy...
September 15, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28906318/nutritional-state-and-feeding-behaviors-of-children-with-eosinophilic-esophagitis-and-gastroesophageal-reflux-disease
#16
Pooja Mehta, Glenn T Furuta, Taryn Brennan, Michelle L Henry, Nancy Creskoff Maune, Shikha S Sundaram, Calies Menard-Katcher, Dan Atkins, Faith Takurukura, Sandra Giffen, Zhaoxing Pan, Angela M Haas
OBJECTIVE: Because both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) are associated with malnutrition and feeding dysfunction, this study compares growth, nutrition and feeding behaviors in children with GERD and EoE. METHODS: Subjects aged 1-7 with GERD or EoE were enrolled in a prospective study. Assessments included length/height, weight, 3-day food diary, serum biomarkers of nutrition, and the Behavioral Pediatric Feeding Assessment Scale (BPFAS)...
September 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28906316/secondary-loss-of-response-to-infliximab-in-pediatric-crohn-s-disease-does-it-matter-how-and-when-we-start
#17
Rishi Bolia, Jeremy Rosenbaum, Vered Schildkraut, Winita Hardikar, Mark Oliver, Donald Cameron, George Alex
OBJECTIVES: A significant proportion of children with Crohn's disease develop a secondary loss of response (LOR) to infliximab. Our aim was to study the impact of initial treatment strategies on secondary LOR. METHODS: We reviewed the medical records of children with Crohn's disease who received scheduled maintenance infliximab therapy for at least 12 months. We compared children who developed LOR with those who did not; with regards to their clinical and laboratory parameters, disease phenotype and treatment strategy before developing LOR...
September 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28906315/development-of-the-aim-to-decrease-anxiety-and-pain-treatment-adapt-for-pediatric-functional-abdominal-pain-disorders
#18
Natoshia Raishevich Cunningham, Sarah Nelson, Anjana Jagpal, Erin Moorman, Michael Farrell, Scott Pentiuk, Susmita Kashikar-Zuck
OBJECTIVES: To evaluate the feasibility and acceptability of the Aim to Decrease Anxiety and Pain Treatment (ADAPT), a brief, on-line and in-person behavioral intervention targeting pain and anxiety in youth with functional abdominal pain disorders (FAPD). METHODS: Patients were recruited from several outpatient pediatric gastroenterology clinics. Nine participants (ages 9-13) completed the full protocol. Thematic analysis of detailed qualitative feedback was obtained via semi-structured patient and caregiver interviews after treatment was conducted...
September 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28905651/interdisciplinary-management-of-pediatric-obesity-lessons-learned-in-the-midsouth
#19
E Thomaseo Burton, Webb A Smith, Idia B Thurston, Emily Gray, Virginia Perry, Sachin Jogal, Joan C Han
The Healthy Lifestyle Clinic (HLC) is an interdisciplinary weight management clinic conceived to address alarming rates of pediatric obesity and related comorbidities in the midsouth region of the United States. The clinical cohort presented is a subset of the 609 patients evaluated during the first 2 years of the HLC and comprises 380 patients with a minimum of 6 months of follow-up. The primarily non-Hispanic black (67.1%) cohort presented with severe obesity ( MzBMI = 2.52 ± 0.41) and particularly high rates of insulin resistance, among other comorbidities...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28904966/the-effect-of-oral-dexmedetomidine-premedication-on-preoperative-cooperation-and-emergence-delirium-in-children-undergoing-dental-procedures
#20
Sultan Keles, Ozlem Kocaturk
INTRODUCTION: The aim of this study was to detect the effect of 1 μg/kg of oral dexmedetomidine (DEX) as premedication among children undergoing dental procedures. MATERIALS AND METHODS: The study involved 100 children between 2 and 6 years of age, ASA I, who underwent full-mouth dental rehabilitation. The DEX group (n = 50) received 1 μg/kg DEX in apple juice, and the control group (n = 50) received only apple juice. The patients' scores on the Ramsay Sedation Scale (RSS), parental separation anxiety scale, mask acceptance scale, and pediatric anesthesia emergence delirium scale (PAEDS) and hemodynamic parameters were recorded...
2017: BioMed Research International
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