Pediatrics最新文献_第8页

Preparing Physician-Scientists for the Future of Academic Medicine. 为未来的学术医学培养医生科学家。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067045

Audrea M Burns, Daniel J Moore, Caroline E Rassbach, Debra Boyer, Candace Gildner, Bobbi Byrne, Kelly W Harris, Audra Iness, Weston T Powell, Danielle Callaway, Jacquelyn Lajiness, Catherine S Forster, Jordan S Orange, Kate G Ackerman, Satid Thammasitboon

{"title":"Preparing Physician-Scientists for the Future of Academic Medicine.","authors":"Audrea M Burns, Daniel J Moore, Caroline E Rassbach, Debra Boyer, Candace Gildner, Bobbi Byrne, Kelly W Harris, Audra Iness, Weston T Powell, Danielle Callaway, Jacquelyn Lajiness, Catherine S Forster, Jordan S Orange, Kate G Ackerman, Satid Thammasitboon","doi":"10.1542/peds.2024-067045","DOIUrl":"10.1542/peds.2024-067045","url":null,"abstract":"The changing field of academic medicine presents unique challenges for physician-scientists, who intricately weave the complexities of research and patient care. These challenges have significantly lengthened the time needed for scientific discoveries to be applied in clinical practice. In response to these escalating demands, the training trajectory for physician-scientists has notably expanded over recent decades. In anticipation of and preparation for future training requirements, the National Pediatrician-Scientist Collaborative Workgroup facilitated a series of convenings with a diverse array of stakeholders vested in physician-scientist training. The framework Strategic Foresight was used to explore possible future scenarios and develop strategic plans. Seven pivotal themes, termed \"performance zones,\" emerged from this endeavor: (1) revolution in education through technology-enhanced learning, (2) educational outcomes beyond content mastery, (3) artificial intelligence-empowered research portfolios and expansive networks, (4) evolution of high-performance inclusive, equitable, distributed, and agile teams, (5) evolution of antifragile systems, (6) a multiparadigmatic program of research, and (7) interdependence and commitments to a common agenda for collective impact. These identified zones underscore the imperative for physician-scientists to acquire novel skill sets essential for navigating the impending shifts in the health care landscape. These findings are poised to steer policy initiatives and educational advancements, fortifying the foundation for future physician-scientist training needs.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Circumstances Surrounding Fatal Pediatric Opioid Poisonings, 2004-2020. 2004-2020 年致命儿科阿片类药物中毒的情况。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043N

Julie R Gaither, Sarah McCollum, Kirsten Bechtel, John M Leventhal, Sasha Mintz

{"title":"The Circumstances Surrounding Fatal Pediatric Opioid Poisonings, 2004-2020.","authors":"Julie R Gaither, Sarah McCollum, Kirsten Bechtel, John M Leventhal, Sasha Mintz","doi":"10.1542/peds.2024-067043N","DOIUrl":"10.1542/peds.2024-067043N","url":null,"abstract":"Objectives: There is little understanding of the circumstances behind fatal pediatric opioid poisonings. Our objective was to characterize opioid fatalities according to child, family, and household factors.Methods: We used data from the National Fatality Review-Case Reporting System to describe the circumstances behind the deaths of children 0 to 17 years of age who died of an opioid poisoning (ie, prescription opioid, heroin, illicit fentanyl) between 2004 and 2020. Decedents were stratified into age groups: 0-4, 5-9, 10-14, and 15-17 years.Results: The majority (65.3%) of the 1696 fatal opioid poisonings occurred in the child's own home. Prescription opioids contributed to 91.8% of deaths, heroin contributed to 5.4%, and illicit fentanyl to 7.7%. Co-poisonings with nonopioid substances occurred in 43.2% of deaths. Among 0- to 4-year-olds, 33.9% died of homicide and 45.0% had a primary caregiver with a history of substance use/abuse. Among 10- to 14-year-olds and 15- to 17-year-olds, respectively, 42.0% and 72.8% of decedents had a history of substance use/abuse. In each age group, at least 25.0% of children were victims of previous child maltreatment.Conclusions: A history of maltreatment and substance use-whether on the part of the caregiver or the child-are common factors surrounding fatal pediatric opioid poisonings, the majority of which occur in the child's own home. Families with children of all ages would benefit from interventions focused on opioid prescribing, storage, disposal, and misuse. These findings also underscore the urgency of ensuring that access to naloxone becomes universal for families with a history of maltreatment and/or substance use.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 3","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using Sudden Unexpected Infant Death-Case Registry Data to Drive Prevention. 利用婴儿意外猝死--病例登记数据推动预防工作。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043J

Gina S Lowell, Felicia Clark, Rojin Ahadi, Kyran P Quinlan

{"title":"Using Sudden Unexpected Infant Death-Case Registry Data to Drive Prevention.","authors":"Gina S Lowell, Felicia Clark, Rojin Ahadi, Kyran P Quinlan","doi":"10.1542/peds.2024-067043J","DOIUrl":"https://doi.org/10.1542/peds.2024-067043J","url":null,"abstract":"Sudden unexpected infant death (SUID) is a major contributor to infant death and a persistent public health issue. After an initial decline after the 1994 \"Back to Sleep\" campaign, SUID numbers plateaued. Currently, ∼10 infants die suddenly and unexpectedly each day in the United States. In 2019, we established a surveillance system for SUID in Cook County, Illinois, partnering our academic medical center, the Cook County Medical Examiner's Office, and child death review to create the Cook County SUID Case Registry. Our data show that, in Cook County, including the city of Chicago, ∼1 infant dies unexpectedly during sleep every week. Of these SUID, ∼25% were because of suffocation/possible suffocation. SUID peaks at 30 to 60 days old. SUID rates are 15 times higher in non-Hispanic Black infants and 3 times higher in Hispanic infants, compared with white infants. Nearly all involved 1 or more unsafe sleep factors. SUID are concentrated in community areas experiencing high hardship. Through our Community Partnership Approaches for Safe Sleep-Chicago team, we have developed collaborative prevention approaches in affected communities, allowing for conversations with families and those who support them to better understand barriers to safe sleep that they experience. These partnerships and our data allow for tailoring of informed prevention approaches to address upstream factors driving disproportionate infant mortality in historically disinvested communities, as well as optimizing the immediate risks posed by the infant sleep environment. Data from our system show the number of SUID declining modestly since our prevention work began.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 3","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fetal, Infant, and Child Fatality Data Lead to Better Clinical Practice, Policy, and Advocacy. 胎儿、婴儿和儿童死亡数据有助于改进临床实践、政策和宣传。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043R

Rachel Y Moon, Kyran P Quinlan, Abigael Collier

引用次数: 0

Massachusetts Pediatric Injury Equity Review (MassPIER): A Process to Address Injury Inequities. 马萨诸塞州儿科伤害公平审查（MassPIER）：解决伤害不公平问题的程序。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043D

Fatemeh Naghiloo, Wendy Shields, Shannon Frattaroli, Max Rasbold-Gabbard, Rebekah Thomas, Sadiqa Kendi

{"title":"Massachusetts Pediatric Injury Equity Review (MassPIER): A Process to Address Injury Inequities.","authors":"Fatemeh Naghiloo, Wendy Shields, Shannon Frattaroli, Max Rasbold-Gabbard, Rebekah Thomas, Sadiqa Kendi","doi":"10.1542/peds.2024-067043D","DOIUrl":"https://doi.org/10.1542/peds.2024-067043D","url":null,"abstract":"Objectives: Significant inequities in pediatric injury outcomes exist. We aim to develop a process to assist child death review (CDR) teams in identifying upstream factors that lead to inequitable outcomes in pediatric injuries.Methods: We spent 6 months (November 2021-April 2022) working with 3 CDR teams in Massachusetts to understand their tools and processes for CDR. During that time, we began to iteratively develop a pediatric injury equity review process and tools. Between May and October 2022, acceptability and adaptability of the resulting Massachusetts Pediatric Injury Equity Review (MassPIER) process and tools were evaluated through focus groups and a Research Electronic Data Capture survey of participants. We compared the prevention recommendations of the CDR teams before the implementation of MassPIER with those generated using MassPIER. A χ2 and Fisher's exact test assessed whether the 2 sets of recommendations differed with regard to equity.Results: A 7-step process was developed, along with 2 tools for use during the MassPIER process. From an acceptability and adaptability standpoint, 100% of participants strongly agreed or agreed that the MassPIER process was simple to follow and adaptable to any type of injury. Ninety-five percent of participants agreed or strongly agreed that the approach could be replicated by other teams. Furthermore, the MassPIER process increased the likelihood of generating equity-focused recommendations in general (P < .05), and particularly recommendations focusing on economic inequities (P < .05).Conclusions: MassPIER is effective in facilitating equity-focused discussion and recommendation development. It is acceptable to team members, and adaptable to other types of injury.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 3","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Childhood Firearm Deaths During Intimate Partner Violence Incidents: 2004-2020. 儿童在亲密伴侣暴力事件中死于枪支：2004-2020.

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043Q

Laura A Seewald, Heather A Hartman, Philip Stallworth, Eugenio Weigend Vargas, Peter F Ehrlich, Heather Dykstra, Cynthia Ewell Foster, Rebeccah Sokol, Douglas Wiebe, Patrick M Carter

引用次数: 0

Factors Associated With Sudden Unexpected Postnatal Collapse. 与产后猝死有关的因素

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043F

Jeffrey D Colvin, Esther Shaw, Matt Hall, Rachel Y Moon

{"title":"Factors Associated With Sudden Unexpected Postnatal Collapse.","authors":"Jeffrey D Colvin, Esther Shaw, Matt Hall, Rachel Y Moon","doi":"10.1542/peds.2024-067043F","DOIUrl":"https://doi.org/10.1542/peds.2024-067043F","url":null,"abstract":"Background: Sudden unexpected postnatal collapse (SUPC) is a category of sudden unexpected infant death (SUID), limited to previously well infants born at ≥34 weeks' gestation who die suddenly and unexpectedly at ≤6 days of age. We compared SUPC risk factors to SUID at older ages.Methods: We conducted a retrospective cross-sectional study of 2010-2020 SUID deaths in the National Fatality Review Case Reporting System, excluding SUPC occurring in the birth hospital. Our main outcome was age at death: ≤6 days (SUPC) versus occurring from 7 days old but not having reached their first birthday. We performed multivariable logistic regression using stepwise selection.Results: Of 6051 SUID deaths, 98 (1.6%) were SUPC. The median SUPC age was 4 days. A higher percentage of SUPC deaths occurred with surface sharing (73.5% versus 59.6%; odds ratio, 2.74 [1.59-4.73]). Infants who died of SUPC had higher odds of a mother ≥40 years (adjusted odds ratio [aOR], 13.1 [95% confidence interval [CI], 3.3-51.4]), being the first live birth (aOR, 4.0 [95% CI, 2.4-6.9]), being swaddled (aOR, 2.7 [95% CI, 1.7-4.1]), and of dying after their caregiver fell asleep while feeding (aOR, 2.6 [95% CI, 1.6-4.4]).Conclusions: Common SUID risk factors, including surface sharing and prone position, were present in SUPC deaths. However, compared with SUID at older ages, SUPC was associated with older and primiparous mothers, swaddling, and the caregiver falling asleep while feeding the infant. Clinicians should reinforce all American Academy of Pediatrics' safe sleep recommendations and provide guidance regarding situations when parents may fall asleep during a feeding.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 3","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leveraging the Fetal and Infant Mortality Review (FIMR) Process to Advance Health Equity. 利用胎儿和婴儿死亡率审查 (FIMR) 程序促进健康公平。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043E

Jack E Turman, Susanna Joy, Rosemary Fournier

{"title":"Leveraging the Fetal and Infant Mortality Review (FIMR) Process to Advance Health Equity.","authors":"Jack E Turman, Susanna Joy, Rosemary Fournier","doi":"10.1542/peds.2024-067043E","DOIUrl":"https://doi.org/10.1542/peds.2024-067043E","url":null,"abstract":"The fetal and infant mortality review (FIMR) process is a community-oriented strategy focused on improving the health services systems for pregnant persons, infants, and their families. FIMR helps communities to understand and change systems that contribute to racial disparities in birth outcomes. FIMR equally values the medical and social services delivery records and the personal narratives of families who have suffered a fetal or infant loss when creating the de-identified case summaries to be reviewed by teams. A two-tiered process, FIMR uses a multidisciplinary Case Review Team (CRT) as the information processor and the Community Action Team (CAT) as the action arm of the process. Pediatricians are vital to both teams, helping to bring about systems change to improve maternal and child health. This paper examines how the well-established FIMR team serving Indianapolis (Marion County, IN) worked to build the capacity of its CAT to address racial disparities in birth outcomes through 5 distinct steps: focus on the primary causes of local fetal or infant mortality, focus on neighborhoods with the highest stable fetal or infant mortality rates, designation of a CAT leader, creation of a culture of regular CAT meetings inclusive of a health-equity skill building curriculum, and inclusion of Grassroots Maternal and Child Health Leaders on the CAT. This paper demonstrates how the synergy between local organizations and community members can effectively address racial disparities in birth outcomes.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"154 Suppl 3","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Barriers to Swimming Lessons for Children. 儿童上游泳课的障碍。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-068122

Michelle L Macy, Sadiqa Kendi, Angela Beale-Tawfeeq, Anne C Bendelow, Tyler Lennon, Marie E Heffernan

引用次数: 0

Examining Permanent Contraception for Children, Adolescents, and Young Adults With Intellectual Developmental Disorder: Ethical, Legal, and Medical Considerations: Clinical Report. 研究智力发育障碍儿童、青少年和青年的永久性避孕：伦理、法律和医学考虑因素：临床报告。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-068955

Gina M Geis, Barbara S Saunders, Paula Hillard

引用次数: 0