Academic Pediatrics最新文献_第3页

Interpersonal Factors in the Emergency Care of Injured Children and Youth with Special Healthcare Needs.

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-11 DOI: 10.1016/j.acap.2025.102796

Denise F Lillvis, Brooks Harmon, Hector Osei, Bonnie M Vest, Brian M Clemency, Kunal Chadha, Carroll M Harmon, Jihnhee Yu, Gregory G Homish, Tamara D Simon, E Brooke Lerner

{"title":"Interpersonal Factors in the Emergency Care of Injured Children and Youth with Special Healthcare Needs.","authors":"Denise F Lillvis, Brooks Harmon, Hector Osei, Bonnie M Vest, Brian M Clemency, Kunal Chadha, Carroll M Harmon, Jihnhee Yu, Gregory G Homish, Tamara D Simon, E Brooke Lerner","doi":"10.1016/j.acap.2025.102796","DOIUrl":"10.1016/j.acap.2025.102796","url":null,"abstract":"<p><strong>Objective: </strong>Children and youth with special healthcare needs (CYSHCN) are those who have one or more chronic conditions necessitating medical, educational, and/or social services use. Of the 15 million CYSHCN, a quarter report accessing emergency care annually, some of whom have physical injuries. This study examines the perspectives, challenges, and opportunities identified by prehospital and hospital clinicians delivering injury care to CYSHCN.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with 23 hospital and 13 prehospital clinicians in one geographic region. All interviews were recorded and transcribed; interviews were analyzed using multiple coders and rapid analysis procedures to identify themes.</p><p><strong>Results: </strong>One intrapersonal theme pertaining to clinicians' prior experiences and six interpersonal themes capture the factors characterized by the participating EMS- and hospital-level clinicians. Identified interpersonal themes include: 1) how prior experiences of injured CYSHCN shape future encounters with emergency care, 2) communication challenges specific to CYSHCN, 3) parental expertise and guidance during care, 4) emotional support, 5) trust-building, and 6) the need to balance accommodations pertaining to the child's special healthcare need in the emergent care context.</p><p><strong>Conclusions: </strong>In prehospital and hospital settings, injured CYSHCN may need care for both their physical injury and their special healthcare need. Prehospital and hospital clinicians, who likely have not previously provided care for the child, are mindful of the opportunities and challenges this situation presents. These results inform an understanding of how clinicians approach care of injured CYSHCN in the emergency setting and indicate opportunities for future exploration, such as how to effectively leverage family strengths in this context.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102796"},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Director of Fellowships: A New Level of Educational Leadership in Academic Pediatric Departments

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-10 DOI: 10.1016/j.acap.2025.102797

Lindsay C. Johnston MD, MEd , Hayley A. Gans MD , Jerri A. Rose MD , Mackenzie S. Frost MD MEd , Meredith F. Bone MD, MS , Shelley Kumar MSc, MS , Jennifer A. Rama MD, MEd

{"title":"Director of Fellowships: A New Level of Educational Leadership in Academic Pediatric Departments","authors":"Lindsay C. Johnston MD, MEd , Hayley A. Gans MD , Jerri A. Rose MD , Mackenzie S. Frost MD MEd , Meredith F. Bone MD, MS , Shelley Kumar MSc, MS , Jennifer A. Rama MD, MEd","doi":"10.1016/j.acap.2025.102797","DOIUrl":"10.1016/j.acap.2025.102797","url":null,"abstract":"<div><h3>Objective</h3><div>A departmental educational leadership role, Director of Fellowships (DF), has emerged in academic pediatric departments to aid in subspecialty programmatic support. Demographics, job responsibilities, and challenges are not fully described and thus may be underappreciated.</div></div><div><h3>Methods</h3><div>An electronic survey was distributed to DFs through the Association of Pediatric Program Directors listserv. Descriptive statistics and thematic analysis of free text were performed.</div></div><div><h3>Results</h3><div>Response rate was 36/54 (67%). Most DFs were female (75%) and were in clinical practice for a median of 15 (interquartile range 12.5–20) years with 10 (interquartile range 7–13) years in fellowship program leadership and 39% with advanced training in education. The main responsibilities included oversight of fellowship core curriculum, faculty development of fellowship program directors, assistance with performance issues, and coordination of common fellowship events. Challenges were limited community understanding of DF role; insufficient time/resources; and disparate fellowship needs. Perceived outcomes included centralization of and advocacy for resources, educational innovation, and greater visibility/enhanced community among fellowship program directors, fellows, and coordinators.</div></div><div><h3>Conclusions</h3><div>DFs are increasingly widespread, filling important gaps in graduate medical education. Individuals in this role provide necessary expertise and management of central resources, which can break down fellowship silos. However, support is variable and institutional impact is understudied.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102797"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Suicide-Risk Identification Across Developmental and Behavioral Pediatric Practices: A DBPNet Study

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-10 DOI: 10.1016/j.acap.2025.102793

Kate E. Wallis MD, MPH , Sarah N. Wozniak-Kelly BA , Jaclyn Cacia MS, CCRC , Katherine K. Wu MPH , Cy Nadler PhD

{"title":"Suicide-Risk Identification Across Developmental and Behavioral Pediatric Practices: A DBPNet Study","authors":"Kate E. Wallis MD, MPH , Sarah N. Wozniak-Kelly BA , Jaclyn Cacia MS, CCRC , Katherine K. Wu MPH , Cy Nadler PhD","doi":"10.1016/j.acap.2025.102793","DOIUrl":"10.1016/j.acap.2025.102793","url":null,"abstract":"<div><h3>Objective</h3><div>To identify variations in practices, facilitators of and barriers to universal suicide screening of children and adolescents with IDDs in pediatric developmental and behavioral health settings.</div></div><div><h3>Methods</h3><div>Centers from the Developmental Behavioral Pediatrics Research Network (DBPNet) were invited to describe suicide-screening practices in their developmental-behavioral pediatrics, psychology, and/or psychiatry clinics. A representative per site/specialty was asked to complete surveys (summarized with descriptive statistics) and semi-structured interviews (summarized using thematic analysis) to explore sites’ current practices, and barriers/facilitators to screening.</div></div><div><h3>Results</h3><div>Participants included 34 survey respondents and 21 interviewees<em>.</em> Surveys revealed variation in suicide screening practices across sites; 44.1% of respondents reported that their practice conducts universal screening, but the screening processes varied widely. Interviews identified some facilitators to screening youth with IDD, such as standardizing procedures, training, and having staff available to respond to positive screens. Barriers to universal screening include factors at the patient, family, provider, and system levels. Insufficient mental health care systems, as well as a lack of IDD-specific supports, are significant challenges.</div></div><div><h3>Conclusions</h3><div>Despite Joint Commission requirements and specific expertise in behavioral health, sites serving patients with IDD vary widely in how suicide screening is implemented and how positive screens are addressed. Findings offer opportunities to standardize procedures to increase suicide risk identification and response.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102793"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Diversity, Equity and Inclusion Considerations in the 2024 National Residency Matching Program Results

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-10 DOI: 10.1016/j.acap.2025.102799

Alexandra M.S. Corley MD MPH , Colin Orr MD, MPH , Michelle A. Lopez MD, MPH , Chineze Ebo MD , Xavier Williams MD, MPH , Jean L. Raphael MD MPH , Aisha N. Barber MD MEd

引用次数: 0

Childhood Disability and Serious School Discipline Among Urban Youth

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-10 DOI: 10.1016/j.acap.2025.102798

Christine James PhD, Lenna Nepomnyaschy PhD

{"title":"Childhood Disability and Serious School Discipline Among Urban Youth","authors":"Christine James PhD, Lenna Nepomnyaschy PhD","doi":"10.1016/j.acap.2025.102798","DOIUrl":"10.1016/j.acap.2025.102798","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations between childhood disability, its various types (physical, cognitive, emotional), and serious school discipline (suspensions/expulsions) in adolescence.</div></div><div><h3>Methods</h3><div>We conducted analyses of secondary data from the Future of Families & Child Wellbeing Study, a population-based urban birth cohort followed across 6 waves in 20 large US cities, to investigate associations between childhood disability and serious school discipline in adolescence. Disability status included disabling physical, cognitive, and emotional conditions reported by the child’s mother between ages 1 and 9. Serious school discipline was measured at youth aged 15 as suspensions or expulsions in the past 2 years based on reports by the mother and the youth. Associations were examined using logistic regression models adjusting for confounding factors, presented as average marginal effects.</div></div><div><h3>Results</h3><div>Of the 2504 adolescents in the analysis sample, one third (33%) were identified as having a measurable disability and these youth were more likely to have experienced receiving serious school discipline, based on mother and youth reports. Adolescents with cognitive or emotional conditions had a significantly higher likelihood of receiving serious school discipline compared to those who did not have those conditions, while those with physical disability did not.</div></div><div><h3>Conclusion</h3><div>In this study of US urban youth, teens with cognitive or emotional conditions had a higher likelihood of experiencing serious school discipline, while youth with physical disability did not, suggesting that youth with less visible disability conditions are more likely to be penalized at school. These findings point to the urgent need for improved interventions for these youth.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102798"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

The Match, The Workforce, The Future: The Key Role for Medical Educators

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-10 DOI: 10.1016/j.acap.2025.102794

Robert J. Vinci MD , Laura Degnon CAE , Melissa Gillooly MPP , Joseph Gigante MD , April Buchanan MD , Rebecca Blankenburg MD, MPH

引用次数: 0

Differences in Reporting Suicide Ideation and Attempt: Implications for Suicide Risk Screening in Pediatric Primary Care

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-07 DOI: 10.1016/j.acap.2025.102795

Alexandra Huttle MD, MS , Christina Rombola MA , Ana Ortin-Peralta PhD , Erika L. Abramson MD, MSc , Muhammad Waseem MD , Regina Miranda PhD

{"title":"Differences in Reporting Suicide Ideation and Attempt: Implications for Suicide Risk Screening in Pediatric Primary Care","authors":"Alexandra Huttle MD, MS , Christina Rombola MA , Ana Ortin-Peralta PhD , Erika L. Abramson MD, MSc , Muhammad Waseem MD , Regina Miranda PhD","doi":"10.1016/j.acap.2025.102795","DOIUrl":"10.1016/j.acap.2025.102795","url":null,"abstract":"<div><h3>Objective</h3><div>Pediatricians are uniquely positioned to identify suicide-related risk, yet clinical practices as to when, how, and who gets screened may vary due to differences in policy statements on youth suicide risk screening in primary care. To address these differences, we examined agreement between reports of past suicide ideation (SI) and suicide attempt (SA) across multiple assessment methods and over time. We further explored associations across sociodemographic factors and severity of mental health symptoms on reporting patterns on these methods for adolescents at elevated risk.</div></div><div><h3>Methods</h3><div>Adolescents (N = 162) with SI and/or SA were recruited from multiple clinical sites in and around New York City. Adolescents completed interviews and self-report measures validated to assess suicide-related risk, depressive symptoms, and anxiety symptoms.</div></div><div><h3>Results</h3><div>Agreement between questions on verbal interviews over time was fair (κ = 0.38), with adolescents under-reporting lifetime SI as time from a crisis went by. Agreement between questions on self-report measures was moderate (κ = 0.51), with adolescents under-reporting past-month SI on a depression screen compared to a suicide-specific screen. Participants with less severe mental health-related symptoms were significantly less likely to report past-month SI consistently.</div></div><div><h3>Conclusions</h3><div>This study highlights important trends in suicide-related reporting patterns among adolescents at elevated risk for suicide and may have important implications for clinical practice guidelines. To capture more adolescents at risk for suicide, results not only support a universal screening approach using suicide-specific tools but may suggest the need to increase screening frequency in pediatric primary care.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102795"},"PeriodicalIF":3.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Corrigendum to “Tobacco Product Use and Functionally Important Respiratory Symptoms Among US Adolescents/Young Adults” [Acad Pediatr. 2022; 22(6):1006–1016]

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-07 DOI: 10.1016/j.acap.2024.08.006

Susanne Tanski MD, MPH , Michael J. Halenar MPH , Kathryn C. Edwards PhD , Jennifer Emond PhD , Steven Woloshin MD , Mary Brunette MD , Lisa Schwartz MD , Kristie A. Taylor PhD , Maciej L. Goniewicz PhD, PharmD , Ray Niaura PhD , Gabriella Anic PhD , Yanling Chen PhD , Priscilla Callahan-Lyon MD , Lisa D. Gardner PhD , Theresa Thekkudan PhD , Nicolette Borek PhD , Heather L. Kimmel PhD , Kenneth Michael Cummings PhD, MPH , Andrew Hyland PhD , James Sargent MD

引用次数: 0

Positive Childhood Experiences Support Cognition and Counteract Behavior and Emotion Problems During Early Adolescence

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-07 DOI: 10.1016/j.acap.2025.102792

Nicole E. Logan PhD , William W. Lewis-de los Angeles MD

{"title":"Positive Childhood Experiences Support Cognition and Counteract Behavior and Emotion Problems During Early Adolescence","authors":"Nicole E. Logan PhD , William W. Lewis-de los Angeles MD","doi":"10.1016/j.acap.2025.102792","DOIUrl":"10.1016/j.acap.2025.102792","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to identify the independent associations of positive childhood experiences (PCEs) on brain health (cognitive function, behavioral and emotional problems) among early adolescents.</div></div><div><h3>Methods</h3><div>Data from the 2-year follow-up visit from the Adolescent Brain and Cognitive Development (ABCD) study were analyzed (N = 5449, mean age: 12.0 ± 0.7, age range = 10.6–13.4 years). Adverse childhood experiences (ACEs) were measured by parent report at baseline, and PCEs were measured by parent report at year two. Dependent variables included cognitive function domains (National Institutes of Health [NIH] Toolbox) and the child behavior checklist (CBCL) subscales at year two. Multivariate linear regression analyses were performed for each dependent variable, with the number of PCEs and ACEs as independent variables, adjusting for age, sex, race and ethnicity, puberty stage, and family income.</div></div><div><h3>Results</h3><div>PCEs were associated with better cognitive function on tasks of picture vocabulary (b = 0.29, 95% CI 0.15–0.43), flanker (b = 0.14, 0.00–0.28), reading recognition (b = 0.19, CI 0.08–0.31), and picture sequence memory (b = 0.44, CI 0.21–0.67). The PCEs:ACEs interaction showed that greater PCEs predicted a weaker association of ACEs on the CBCL subscales: anxious-depressed (b = −0.06, −0.10 to −0.01), withdrawn (b = −0.06, −0.09 to −0.04), aggressive behavior (b = −0.11, −0.17 to −0.06), rule-breaking behaviors (b = −0.06, −0.09 to −0.04), social problems (b = −0.04, −0.07 to −0.01), somatic complaints (b = −0.03, −0.06 to 0.00), and total CBCL problems (b = −0.46, −0.69 to −0.23).</div></div><div><h3>Conclusions</h3><div>Exposure to PCEs supports cognition and is protective against psychopathology, even among children exposed to ACEs.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102792"},"PeriodicalIF":3.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Suicide Prevention Training in Pediatric Primary Care: A Scoping Review

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-06 DOI: 10.1016/j.acap.2025.102790

John T. Parkhurst PhD , Amanda Burnside PhD , Anna Ros PhD , Julia Ellis BA , Andrea Fawcett MLIS , Susan Sirota MD , Sarah Helseth PhD , Rachel Ballard MD

{"title":"Suicide Prevention Training in Pediatric Primary Care: A Scoping Review","authors":"John T. Parkhurst PhD , Amanda Burnside PhD , Anna Ros PhD , Julia Ellis BA , Andrea Fawcett MLIS , Susan Sirota MD , Sarah Helseth PhD , Rachel Ballard MD","doi":"10.1016/j.acap.2025.102790","DOIUrl":"10.1016/j.acap.2025.102790","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric primary care providers are expected to deliver suicide prevention strategies that may include screening, assessment, intervention, and specialist referral. Training is often provided to increase knowledge and confidence, and to shape clinician behavior with suicide prevention activities. The effectiveness of suicide prevention training, specifically for pediatric primary care, has been minimally explored.</div></div><div><h3>Objectives</h3><div>The aim of this scoping review is to describe the current state of the literature on the acceptability and effectiveness of suicide prevention training in pediatric primary care settings.</div></div><div><h3>Data Sources</h3><div>Medical librarian search included PubMed, Ovid Medline, APA PsycINFO (EBSCO), CINAHL (EBSCO), Embase (Elsevier), Google Scholar, and the Cochrane Library using MESH terms: adolescent, child, pediatrics, suicide prevention, depression, outpatient, primary care, and general practice.</div></div><div><h3>Results</h3><div>Four thousand two hundred and seventy four peer-reviewed studies were identified from databases and screened for inclusion. Sixty two studies were retrieved for full-text review. Sixteen articles met inclusion criteria. Results identified one randomized control trial of suicide prevention training.</div></div><div><h3>Conclusions</h3><div>Suicide prevention training appears to enhance the knowledge and confidence of pediatric primary care providers in the short term. However, further research is necessary to assess the impact of this training on provider behavior change and patient outcomes. This review provides an overview of the current landscape of research on suicide prevention training in pediatrics and offers recommendations for future investigators.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102790"},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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