Academic Pediatrics最新文献_第8页

Cost of Intentional Drug Overdose and Other Self-Harm Among Youth in the United States, 2021 2021 年美国青少年故意吸毒过量和其他自残行为的成本。

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-12 DOI: 10.1016/j.acap.2025.102800

Laura M. Prichett PhD, MHS , Nancy S. Weinfield PhD , Michael J. Miller RPh, DrPH, FAPhA , Brian R.E. Schultz MD , Barry S. Solomon MD, MPH , Eileen M. McDonald MS , Leticia M. Ryan MD, MPH

{"title":"Cost of Intentional Drug Overdose and Other Self-Harm Among Youth in the United States, 2021","authors":"Laura M. Prichett PhD, MHS , Nancy S. Weinfield PhD , Michael J. Miller RPh, DrPH, FAPhA , Brian R.E. Schultz MD , Barry S. Solomon MD, MPH , Eileen M. McDonald MS , Leticia M. Ryan MD, MPH","doi":"10.1016/j.acap.2025.102800","DOIUrl":"10.1016/j.acap.2025.102800","url":null,"abstract":"<div><h3>Objective</h3><div>To quantify the annual direct health care cost of intentional overdose and other types of self-harm resulting in emergency department and/or inpatient encounters among youth in the United States.</div></div><div><h3>Methods</h3><div>Using the 2021 Nationwide Emergency Department Sample and National Inpatient Sample datasets, produced by the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, we determined nationally representative cross-sectional frequencies and costs for specific types of self-harm encounters among 8- to 21-year-old pediatric and young adult patients.</div></div><div><h3>Results</h3><div>The total combined 1-year cost of all self-harm encounters was $869 million (95% confidence interval [CI] $841M–$897M). The majority of this cost was due to intentional overdose–related encounters, which totaled $530 million (95% CI $512M–$547M). Of this total, $232 million (95% CI $223M–$241M) was paid by public insurers and $296 million (95% CI $281M–$312M) was paid by private insurers. Encounters by females accounted for 79% of the intentional overdose costs ($420 million, 95% CI $404M–$435M).</div></div><div><h3>Conclusions</h3><div>Based on 2021 data, preventing youth intentional overdose could save the US health system up to $530 million, annually. As we collectively work to prevent suicide deaths among young people, it is important to recognize the needs of the larger group of youth who are engaging in serious self-harm and nonfatal suicidal acts, the majority of whom are young females. Prevention of intentional overdose in this population should be a priority, both in terms of upstream public health efforts and promotion of evidence-based methods of safer storage.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102800"},"PeriodicalIF":3.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426639","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 Evolving Landscape of Using Telehealth to Address Pediatric Mental Health in a Postpandemic Era 在大流行后时代，利用远程保健解决儿科心理健康问题的不断变化的情况。

IF 3 3区医学

Academic Pediatrics Pub Date : 2025-02-11 DOI: 10.1016/j.acap.2025.102791

Natoshia R. Cunningham PhD , Samantha L. Ely BA , Brittany N. Barber Garcia PhD

引用次数: 0

Interpersonal Factors in the Emergency Care of Injured Children and Youth with Special Healthcare Needs. 人际关系因素在受伤儿童及有特殊保健需要青少年的紧急护理中的作用。

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 主任奖学金：在学术儿科教育领导的新水平。

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 跨发育和行为儿科实践的自杀风险识别：一项DBPNet研究。

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 2024年全国住院医师匹配计划结果的多样性、公平性和包容性考虑。

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 城市青少年的儿童残疾和严重的学校纪律。

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 匹配，劳动力，未来：医学教育者的关键角色。

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 报告自杀意念和企图的差异：对儿科初级保健自杀风险筛查的意义。

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] 《美国青少年/年轻人中烟草制品使用和重要呼吸道症状》的勘误表[儿科学术杂志，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