Pediatrics最新文献_第9页

Differences in Pediatricians' Income by Sex Over Time. 儿科医生收入在不同时期的性别差异。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-066240

Mary Pat Frintner, Gary L Freed, Bobbi J Byrne, Laurel K Leslie, Amy J Starmer, Elizabeth A Gottschlich, Lynn M Olson

{"title":"Differences in Pediatricians' Income by Sex Over Time.","authors":"Mary Pat Frintner, Gary L Freed, Bobbi J Byrne, Laurel K Leslie, Amy J Starmer, Elizabeth A Gottschlich, Lynn M Olson","doi":"10.1542/peds.2024-066240","DOIUrl":"10.1542/peds.2024-066240","url":null,"abstract":"Objective: Previous Pediatrician Life and Career Experience Study (PLACES) 2016 data revealed that female pediatricians reported earning ∼94% of what male pediatricians reported, after adjusting for factors that might impact income. Has this disparity persisted?Methods: Data from PLACES, a national longitudinal study, was used to examine pediatrician-reported income from 2017 to 2022. A regression analysis estimated the adjusted differences in female and male pediatricians' annual income for each survey year. Models included sex and other key personal and practice characteristics for which female and male pediatricians' careers might differ. A mixed effects regression for longitudinal analysis examined income across years for female and male pediatricians and if time-variant characteristics are associated with increased or decreased income.Results: PLACES participation ranged from 83.6% in 2017% to 75.5% in 2022 (analytic n = 1251 in 2017 and 1077 in 2022). The unadjusted mean annual income in 2022 was $237 168, $220 374 for female pediatricians and $284 286 for male pediatricians. Adjusting for key characteristics, female pediatrician income was ∼93% of male pediatrician income, a gap of ∼$ 11 000 annually. Income increased across years (coefficient = 0.03, P < .001). The year-sex interaction was not significant, indicating that the female-male disparity did not change over time. Three time-variant characteristics associated with increased income over time included increased portion of continuous full-time work, work hours, and time in administrative work.Conclusions: A national longitudinal study revealed that female pediatricians reported earning ∼93% of what their male colleagues reported, with a consistent gap from 2017 to 2022.","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":"142522594","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

Characteristics and Circumstances of Suicide Among Children Aged 6 to 9 Years: 2006-2021. 2006-2021 年 6-9 岁儿童自杀的特征和情况。

IF 6.2 2区医学

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

Sasha Mintz, Heather Dykstra, Michelle Cornette, Rebecca F Wilson, Janet M Blair, Diane Pilkey, Abigael Collier

{"title":"Characteristics and Circumstances of Suicide Among Children Aged 6 to 9 Years: 2006-2021.","authors":"Sasha Mintz, Heather Dykstra, Michelle Cornette, Rebecca F Wilson, Janet M Blair, Diane Pilkey, Abigael Collier","doi":"10.1542/peds.2024-067043L","DOIUrl":"https://doi.org/10.1542/peds.2024-067043L","url":null,"abstract":"Background: Limited research exists on suicide among children aged 5 to 9 years. The objective of this study was to examine characteristics of suicide in children younger than 10 years.Methods: Data are from the National Fatality Review-Case Reporting System (NFR-CRS) for years 2006 through 2021 for children aged 6 to 9 years who died by suicide. No suicide deaths were reported in NFR-CRS for children aged ≤ 5 years. Descriptive analyses by demographics and circumstances were conducted. A thematic analysis of prevention recommendations made by child death review teams was performed.Results: From 2006 to 2021, NFR-CRS identified 78 suicide decedents aged 6 to 9 years. The largest share were aged 9 years (72%), male (74%), non-Hispanic Black (42%), and died by hanging (86%) at home (91%). School-related problems (39%), history of child maltreatment (36%), history of mental health services (30%), argument with parents (23%), and familial discord (19%) were common circumstances. Key suicide prevention themes included education for caregivers and school staff, improved behavioral health services, and implementation of school policies and programs.Conclusions: Results provide a more complete picture of suicide among younger children, improving understanding of their unique characteristics. It is recommended that program planners consider both age-appropriateness and the impacts of social (eg, racism) and structural inequities in their approaches to prevention, encompassing both community and school-based strategies. For pediatricians, results emphasize the importance of lethal means counseling, safety planning, and educating parents and caregivers on the distinct warning signs of suicide for younger children.","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":"142558472","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

E-Cigarette Use by Female vs Male High School Students. 女高中生与男高中生使用电子烟的情况。

IF 8 2区医学

Pediatrics Pub Date : 2024-10-25 DOI: 10.1542/peds.2024-067767

Andrew B Seidenberg,Emily M Donovan,Michael Liu,Jennifer M Kreslake

引用次数: 0

Diagnosis and Treatment of Tethered Spinal Cord: A Systematic Review. 脊髓拴系的诊断与治疗：系统回顾

IF 8 2区医学

Pediatrics Pub Date : 2024-10-25 DOI: 10.1542/peds.2024-068270

Patrick Hsieh,Eric Apaydin,Robert G Briggs,Dalal Al-Amodi,Andrea Aleman,Kellie Dubel,Ariana Sardano,Judy Saint-Val,Kim Sysawang,Diana Zhang,Sachi Yagyu,Aneesa Motala,Danica Tolentino,Susanne Hempel

{"title":"Diagnosis and Treatment of Tethered Spinal Cord: A Systematic Review.","authors":"Patrick Hsieh,Eric Apaydin,Robert G Briggs,Dalal Al-Amodi,Andrea Aleman,Kellie Dubel,Ariana Sardano,Judy Saint-Val,Kim Sysawang,Diana Zhang,Sachi Yagyu,Aneesa Motala,Danica Tolentino,Susanne Hempel","doi":"10.1542/peds.2024-068270","DOIUrl":"https://doi.org/10.1542/peds.2024-068270","url":null,"abstract":"CONTEXTTethered cord syndrome is associated with motor and sensory deficits.OBJECTIVEOur objective was to summarize evidence regarding the diagnosis, prophylactic surgery, symptomatic treatment, and repeat surgery of tethered spinal cord in a systematic review (CRD42023461296).DATA SOURCES AND STUDY SELECTIONWe searched 13 databases, reference-mined reviews, and contacted authors to identify diagnostic accuracy studies and treatment studies published until March 2024.DATA EXTRACTIONOne reviewer abstracted data, and a content expert checked the data for accuracy. We assessed the risk of bias, strength of evidence (SoE), and applicability.RESULTSThe evidence base includes 103 controlled studies, many with risk of bias and applicability concerns, and 355 case series providing additional clinical information. We found moderate SoE for MRI diagnosing tethered spinal cord, with medium to high diagnostic sensitivity and specificity. A small number of prophylactic surgery studies suggested motor function benefits and stability of neurologic status over time, but also complications such as surgical site infection (low SoE). A larger body of evidence documents treatments for symptomatic patients; studies revealed improvement in neurologic status after surgical detethering (low SoE), but also postoperative complications such as cerebrospinal fluid leakage (moderate SoE). A small body of evidence exists for retethering treatment (low or insufficient SoE for all outcomes).LIMITATIONSThere was insufficient evidence for key outcomes (eg, over- or undertreatment, clinical impact of diagnostic modalities, ambulation, quality of life).CONCLUSIONSThis comprehensive overview informs difficult clinical decisions that parents and their children with tethered spinal cords, as well as their health care providers, face.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"67 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490605","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

Increasing Follow-up for Adolescents With Depressive Symptoms. 增加对有抑郁症状的青少年的随访。

IF 8 2区医学

Pediatrics Pub Date : 2024-10-24 DOI: 10.1542/peds.2024-066495

Mary Carol Burkhardt,Landon Krantz,Rachel B Herbst,Jennifer Hardie,Samuel Eggers,Tracy Huentelman,Allison Reyner,Cynthia White,William B Brinkman

{"title":"Increasing Follow-up for Adolescents With Depressive Symptoms.","authors":"Mary Carol Burkhardt,Landon Krantz,Rachel B Herbst,Jennifer Hardie,Samuel Eggers,Tracy Huentelman,Allison Reyner,Cynthia White,William B Brinkman","doi":"10.1542/peds.2024-066495","DOIUrl":"https://doi.org/10.1542/peds.2024-066495","url":null,"abstract":"BACKGROUNDPrompt follow-up for positive depression screen results is important in providing high-quality care for adolescents. We sought to improve follow-up within 30 days for adolescents (≥12 years) with Patient Health Questionnaire-9 scores ≥10, or those with a positive question 9, from 25% to 40%.METHODSWe conducted a quality improvement project at 6 primary care locations serving ∼33,300 patients (70% Black, 7.3% Hispanic, 80% Medicaid-enrolled). Our team identified key drivers and iteratively tested interventions, including contacting patients after antidepressant medication initiation, scheduling patients for follow-up during index visits, collaborating with integrated psychologists to expedite therapy for higher-risk patients, and reaching out to patients without scheduled follow-ups.RESULTSPre-intervention, 13.3% (589 of 4427) of adolescent encounters met the criteria for follow-up within 30 days, and 25.8% had a documented follow-up within 30 days. During the intervention period, 12.3% (764 of 6224) of adolescent encounters met the criteria for follow-up within 30 days, and the mean follow-up rate increased to 43.1%. By monitoring process measures, we scheduled follow-up visits for 18.9% of patients during the index encounter. Outreach to the remainder led to 32.6% of these patients completing follow-up. Our balancing measure of monitoring integrated psychology visit volumes remained stable.CONCLUSIONSThe application of quality improvement methods in primary care practices increased the frequency of follow-up care for high-risk adolescents after a positive depression screen.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"44 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489791","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

A 6-Week-Old Boy With Irritability and Abdominal Distension. 一名 6 周大的男孩，患有易激惹和腹胀。

IF 8 2区医学

Pediatrics Pub Date : 2024-10-24 DOI: 10.1542/peds.2023-065290

Celeste Hall,Alison M Friedmann,Anna Handorf,Patrick J Lenehan,Pallavi Sagar,Hannah Bank,Clement D Lee

引用次数: 0

Neurally Adjusted Ventilatory Assist to Monitor Diaphragmatic Activity in Infantile Botulism. 神经调节通气辅助系统监控婴幼儿肉毒中毒患者的膈肌活动。

IF 8 2区医学

Pediatrics Pub Date : 2024-10-23 DOI: 10.1542/peds.2024-066729

Nada Darwish,Jaimie E Wardinger,Tammy Corr

{"title":"Neurally Adjusted Ventilatory Assist to Monitor Diaphragmatic Activity in Infantile Botulism.","authors":"Nada Darwish,Jaimie E Wardinger,Tammy Corr","doi":"10.1542/peds.2024-066729","DOIUrl":"https://doi.org/10.1542/peds.2024-066729","url":null,"abstract":"Infantile botulism is a potentially life-threatening neuromuscular disorder. It presents with descending paralysis that can involve the diaphragm and cause respiratory failure. Neurally adjusted ventilatory assist (NAVA) provides synchronized bilevel positive pressure by using electrical diaphragmatic (Edi) signals. Diaphragmatic paresis is thought to be a contraindication for using NAVA. However, the use of a NAVA catheter allows continuous assessment of diaphragm activity in infantile botulism. We discuss a case of infantile botulism in an infant from central Pennsylvania who presented with poor oral feeding, hypothermia, and lethargy and progressed to develop apnea and acute respiratory failure. The infant was intubated and mechanically ventilated. A diagnosis of infantile botulism was confirmed through the detection of botulinum toxin in the infant's stool, and the infant was treated with botulism immune globulin neutralizing antibodies. During his recovery phase, a NAVA catheter was placed, which allowed monitoring of Edi signals to gauge the return of diaphragm activity and to assist with the assessment of extubation readiness. We describe the trends in this infant's Edi signals following administration of globulin neutralizing antibodies and the successful transition to invasive, and subsequently, noninvasive NAVA. Our report demonstrates the clinical utility of monitoring diaphragmatic activity using a NAVA catheter and that NAVA provided adequate respiratory support to an infant during the recovery phase of infantile botulism.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488193","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 2024 Joseph W. St. Geme, Jr Leadership Award Address: To Create a Better World for Children and Families. 2024 年小约瑟夫-W-圣吉梅领袖奖颁奖词：为儿童和家庭创造更美好的世界。

IF 8 2区医学

Pediatrics Pub Date : 2024-10-23 DOI: 10.1542/peds.2024-068085

Benard P Dreyer

引用次数: 0

Neighborhood Disadvantage and Birth Outcomes Among Refugees. 难民的邻里劣势与出生结果。

IF 8 2区医学

Pediatrics Pub Date : 2024-10-21 DOI: 10.1542/peds.2024-065750

Else Foverskov,Justin S White,Trine Frøslev,Lars Pedersen,Henrik T Sørensen,Rita Hamad

{"title":"Neighborhood Disadvantage and Birth Outcomes Among Refugees.","authors":"Else Foverskov,Justin S White,Trine Frøslev,Lars Pedersen,Henrik T Sørensen,Rita Hamad","doi":"10.1542/peds.2024-065750","DOIUrl":"https://doi.org/10.1542/peds.2024-065750","url":null,"abstract":"OBJECTIVETo examine the association between neighborhood socioeconomic disadvantage and birth outcomes among refugee women in Denmark, leveraging a natural experiment.METHODSThis register-based study included 15 118 infants born to women who arrived in Denmark as refugees during 1986 to 1998, when a dispersal policy was in place that quasirandomly assigned newcomers to neighborhoods with varying degrees of socioeconomic disadvantage. Neighborhood disadvantage was measured using a composite index representing neighborhood-level income, education, unemployment, and welfare assistance. These data were linked to individual-level birth register data. Outcomes included low birth weight, preterm birth, and small-for-gestational-age infants. Associations between neighborhood disadvantage at resettlement and birth outcomes up to 20 years after resettlement were examined using multivariable regressions adjusting for characteristics of the women at resettlement.RESULTSEach SD of increase in neighborhood disadvantage was associated with an 18% increase in low birth weight risk (0.61 percentage points [pp], 95% confidence interval [CI]: 0.19-1.02), 15% increase in preterm birth risk (0.64 pp, 95% CI: 0.22-1.07), and 7% increase in small-for-gestational-age risk (0.78 pp, 95% CI: 0.01-1.54) 5 years after resettlement. Results did not differ after adjusting for urbanicity and conational density, but associations were attenuated after adjusting for municipality-level fixed effects, suggesting that local government characteristics may partially explain the associations.CONCLUSIONSResettling in a disadvantaged neighborhood is associated with higher risk of adverse birth outcomes among refugee women. This highlights how policy decisions affecting settlement of refugees can have long-term consequences, including on the health of the next generation.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486364","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

Lessons Learned About Safety Nets for Refugee Arrivals and Health Outcomes. 关于难民抵达安全网和健康结果的经验教训。

IF 8 2区医学

Pediatrics Pub Date : 2024-10-21 DOI: 10.1542/peds.2024-067543

Joshua Rothman,Cara Texler,Janine Young

引用次数: 0