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Publisher: Elsevier   (Total: 3048 journals)

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Showing 1 - 200 of 3048 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 7)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 25, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 86, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 361, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 226, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 24, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Acute Pain     Full-text available via subscription   (Followers: 13)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 6)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 26, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 44, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 26, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 42, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 50, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 12)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 8, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 62)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 2, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 361, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 16)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 44, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 327, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 413, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 40, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 55, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access   (Followers: 1)
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 46, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 40, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 9, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 46, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 200, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 59, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 24, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 35, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 58, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 12)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 167, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 12)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 172, SJR: 1.907, h-index: 126)

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover Academic Pediatrics
  [SJR: 1.402]   [H-I: 51]   [25 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1876-2859
   Published by Elsevier Homepage  [3048 journals]
  • Academic Pediatric Association Research Award Acceptance Speech May 2017,
           San Francisco, California
    • Authors: Rita Mangione-Smith
      Pages: 805 - 806
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Rita Mangione-Smith


      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.07.001
       
  • Facilitating Tough Conversations: Using an Innovative Simulation-Primed
           Qualitative Inquiry in Pediatric Research
    • Authors: Ambrose H. Wong; Gunjan K. Tiyyagura; James M. Dodington; Bonnie Hawkins; Denise Hersey; Marc A. Auerbach
      Pages: 807 - 813
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Ambrose H. Wong, Gunjan K. Tiyyagura, James M. Dodington, Bonnie Hawkins, Denise Hersey, Marc A. Auerbach
      Deep exploration of a complex health care issue in pediatrics might be hindered by the sensitive or infrequent nature of a particular topic in pediatrics. Health care simulation builds on constructivist theories to guide individuals through an experiential cycle of action, self-reflection, and open discussion, but has traditionally been applied to the educational domain in health sciences. Leveraging the emotional activation of a simulated experience, investigators can prime participants to engage in open dialogue for the purposes of qualitative research. The framework of simulation-primed qualitative inquiry consists of 3 main iterative steps. First, researchers determine applicability by consideration of the need for an exploratory approach and potential to enrich data through simulation priming of participants. Next, careful attention is needed to design the simulation, with consideration of medium, technology, theoretical frameworks, and quality to create simulated reality relevant to the research question. Finally, data collection planning consists of a qualitative approach and method selection, with particular attention paid to psychological safety of subjects participating in the simulation. A literature review revealed 37 articles that used this newly described method across a variety of clinical and educational research topics and used a spectrum of simulation modalities and qualitative methods. Although some potential limitations and pitfalls might exist with regard to resources, fidelity, and psychological safety under the auspices of educational research, simulation-primed qualitative inquiry can be a powerful technique to explore difficult topics when subjects might experience vulnerability or hesitation.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.06.007
       
  • Road to the Future: Priorities for Child Health Services Research
    • Authors: Gerry Fairbrother; Denise Dougherty; Rosina Pradhananga; Lisa A. Simpson
      Pages: 814 - 824
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Gerry Fairbrother, Denise Dougherty, Rosina Pradhananga, Lisa A. Simpson
      Background Prior health services research (HSR) agendas for children have been published, but major ones are now over 15 years old and do not reflect augmented understanding of the drivers and determinants of children's health; recent changes in the organization, financing, and delivery of health care; a growing emphasis on population health; and major demographic shifts in the population. A policy-relevant research agenda that integrates knowledge gained over the past 2 decades is essential to guide future child HSR (CHSR). We sought to develop and disseminate a robust, domestically focused, policy-oriented CHSR agenda. Methods The new CHSR agenda was developed through a series of consultations with leaders in CHSR and related fields. After each round of consultation, the authors synthesized the previous experts' guidance to help inform subsequent discussions. The multistep process in generation of the agenda included identification of major policy-relevant research domains and specification of high-value research questions for each domain. Stakeholders represented in the discussions included those with expertise in child and family advocacy, adult health, population health, community development, racial and ethnic disparities, women's health, health economics, and government research funders and programs. Results In total, 180 individuals were consulted in developing the research agenda. Six priority domains were identified for future research, including both enduring and emerging emphases: 1) framing children's health issues so that they are compelling to policy-makers; 2) addressing poverty and other social determinants of child health and wellbeing; 3) promoting equity in population health and health care; 4) preventing, diagnosing, and treating high priority health conditions in children; 5) strengthening performance of the health care system; and 6) enhancing the CHSR enterprise. Within these 6 domains, 40 specific topics were identified as the most pertinent for future research. Three overarching and crosscutting themes that affect research across the domains were also noted: the need for syntheses to build on the current, and sometimes extensive, evidence base to avoid duplication; the interrelated nature of the domains, which could lead to synergies in research; and the need for multidisciplinary collaborations in conducting research because research studies will look beyond the health sector. Conclusions The priorities presented in the agenda are policy-oriented and include a greater emphasis on how findings are framed and communicated to support action. We expect that the agenda will be useful for immediate uptake by investigators and research funders.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.04.015
       
  • Commercial Sexual Exploitation and Sex Trafficking of Children and
           Adolescents: A Narrative Review
    • Authors: Elizabeth Barnert; Zarah Iqbal; Janine Bruce; Arash Anoshiravani; Gauri Kolhatkar; Jordan Greenbaum
      Pages: 825 - 829
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Elizabeth Barnert, Zarah Iqbal, Janine Bruce, Arash Anoshiravani, Gauri Kolhatkar, Jordan Greenbaum
      Commercial sexual exploitation and sex trafficking of children and adolescents represent a severe form of child abuse and an important pediatric health concern. Youth who are commercially sexually exploited have a constellation of clinical risk factors and high rates of unmet physical and mental health needs, including conditions that directly result from their victimization. Common physical health needs among commercially sexually exploited children and adolescents include violence-related injuries, pregnancy, sexually transmitted infections, and other acute infections. Common mental health conditions include substance use disorders, post-traumatic stress disorder, depression and suicidality, and anxiety. The existing literature indicates that trauma-informed approaches to the care of commercially sexually exploited youth are recommended in all aspects of their health care delivery. Additionally, medical education that attunes providers to identify and appropriately respond to the unique needs of this highly vulnerable group of children and adolescents is needed. The available research on commercial sexual exploitation and sex trafficking of children and adolescents remains fairly limited, yet is expanding rapidly. Especially relevant to the field of pediatrics, future research to guide health professionals in how best to identify and care for commercially sexually exploited children and adolescents in the clinical setting signifies a key gap in the extant literature and an important opportunity for future study.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.07.009
       
  • Peer Victimization and Academic Performance in Primary School Children
    • Authors: Lisa K. Mundy; Louise Canterford; Silja Kosola; Louisa Degenhardt; Nicholas B. Allen; George C. Patton
      Pages: 830 - 836
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Lisa K. Mundy, Louise Canterford, Silja Kosola, Louisa Degenhardt, Nicholas B. Allen, George C. Patton
      Objective Peer victimization is a common antecedent of poor social and emotional adjustment. Its relationship with objectively measured academic performance is unclear. In this study we aimed to quantify the cross-sectional associations between peer victimization and academic performance in a large population sample of children. Methods Eight- to 9-year-old children were recruited from a stratified random sample of primary schools in Australia. Academic performance was measured on a national achievement test (1 year of learning equals 40 points). Physical and verbal victimization were measured according to child self-report. Results Multilevel mixed-effects linear regression analyses were conducted. For female children, verbal victimization was associated with poorer academic performance on writing (β = 17.2; 95% confidence interval [CI], −28.2 to −6.2) and grammar/punctuation (β = −20.8; 95% CI, −40.1 to −1.6). Physical victimization was associated with poorer performance on numeracy (male children: β = −29.0; 95% CI, −53.8 to −4.1; female children: β = −30.1; 95% CI, −56.6 to −3.5), and writing (female children: β = −21.5; 95% CI, −40.4 to −2.7). Verbal and physical victimization were associated with poorer performance on reading (male children: β = −31.5; 95% CI, −59.9 to −3.1; female children: β = −30.2; 95% CI, −58.6 to −1.8), writing (female children: β = −25.5; 95% CI, −42.8 to −8.2), spelling (female children: β = −32.3; 95% CI, −59.6 to −4.9), and grammar/punctuation (female children: β = −32.2; 95% CI, −62.4 to −2.0). Conclusions Children who were physically victimized were 6 to 9 months behind their non-victimized peers on measures of academic performance. There are growing reasons for education systems to invest in the prevention of bullying and promotion of positive peer relationships from the earliest years of school.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.06.012
       
  • A Qualitative Study of What US Parents Say and Do When Their Young
           Children See Pornography
    • Authors: Emily F. Rothman; Jennifer Paruk; Ashlee Espensen; Jeff R. Temple; Kelley Adams
      Pages: 844 - 849
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Emily F. Rothman, Jennifer Paruk, Ashlee Espensen, Jeff R. Temple, Kelley Adams
      Objective There is no empirical information about how parents react when they discover that their young children have seen pornography. To address this gap in the literature, the current study sought to improve our understanding of parental reactions to discovering that their children ages <12 years old have seen pornography using a mixed-methods approach. Methods A convenience sample of participants (N = 279) was recruited from the online survey service Mechanical Turk. Eligible participants completed an online survey comprising close-ended and open-ended questions about their reactions when their young children saw pornography. Qualitative data were analyzed using a content analysis approach. Results Parents had 5 main reactions when realizing that their children had viewed pornography: 1) angry, shaming, or punitive; 2) calm and factual; 3) ignoring, minimizing, or denying that it happened; 4) panic or fear; and 5) lying to the child about what the child viewed. Most parents reacted calmly, while a small percentage reported that they hit, scolded, or shamed their young children for seeing the pornography. Many reported not knowing what to say or do. Conclusions Development and evaluation of parental scripts for developmentally appropriate parent–child (or pediatrician–child) communication about pornography could benefit the field.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.04.014
       
  • Impaired Patient-Reported Outcomes Predict Poor School Functioning and
           Daytime Sleepiness: The PROMIS Pediatric Asthma Study
    • Authors: Conor M. Jones; Darren A. DeWalt; I-Chan Huang
      Pages: 850 - 854
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Conor M. Jones, Darren A. DeWalt, I-Chan Huang
      Objective Poor asthma control in children is related to impaired patient-reported outcomes (PROs; eg, fatigue, depressive symptoms, anxiety), but less well studied is the effect of PROs on children's school performance and sleep outcomes. In this study we investigated whether the consistency status of PROs over time affected school functioning and daytime sleepiness in children with asthma. Methods Of the 238 children with asthma enrolled in the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Study, 169 children who provided survey data for all 4 time points were used in the analysis. The child's PROs, school functioning, and daytime sleepiness were measured 4 times within a 15-month period. PRO domains included asthma impact, pain interference, fatigue, depressive symptoms, anxiety, and mobility. Each child was classified as having poor/fair versus good PROs per meaningful cut points. The consistency status of each domain was classified as consistently poor/fair if poor/fair status was present for at least 3 time points; otherwise, the status was classified as consistently good. Seemingly unrelated regression was performed to test if consistently poor/fair PROs predicted impaired school functioning and daytime sleepiness at the fourth time point. Results Consistently poor/fair in all PRO domains was significantly associated with impaired school functioning and excessive daytime sleepiness (Ps < .01) after controlling for the influence of the child's age, sex, and race/ethnicity. Conclusions Children with asthma with consistently poor/fair PROs are at risk of poor school functioning and daytime sleepiness. Developing child-friendly PRO assessment systems to track PROs can inform potential problems in the school setting.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.07.010
       
  • Effectiveness of the Spirometry 360 Quality Improvement Program for
           Improving Asthma Care: A Cluster Randomized Trial
    • Authors: Rita Mangione-Smith; Chuan Zhou; Michael J. Corwin; James A. Taylor; Fiona Rice; James W. Stout
      Pages: 855 - 862
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Rita Mangione-Smith, Chuan Zhou, Michael J. Corwin, James A. Taylor, Fiona Rice, James W. Stout
      Objective To determine the effectiveness of the Spirometry 360 distance learning quality improvement (QI) program for enhancing the processes and outcomes of care for children with asthma. Methods Cluster randomized controlled trial involving 25 matched pairs of pediatric primary care practices. Practices were recruited from 2 practice-based research networks: the Slone Center Office-based Research Network at Boston University, Boston, Mass, and the Puget Sound Pediatric Research Network, Seattle, Wash. Study participants included providers from one of the 50 enrolled pediatric practices and 626 of their patients with asthma. Process measures assessed included spirometry test quality and appropriate prescription of asthma controller medications. Outcome measures included asthma-specific health-related quality of life, and outpatient, emergency department, and inpatient utilization for asthma. Results At baseline, 25.4% of spirometry tests performed in control practices and 50.4% of tests performed in intervention practices were of high quality. During the 6-month postintervention period, 28.7% of spirometry tests performed in control practices and 49.9% of tests performed in intervention practices were of high quality. The adjusted difference-of-differences analysis revealed no intervention effect on spirometry test quality. Adjusted differences-of-differences analysis also revealed no intervention effect on appropriate use of controller medications or any of the parent- or patient-reported outcomes examined. Conclusions In this study, the Spirometry 360 distance learning QI program was ineffective in improving spirometry test quality or parent- or patient-reported outcomes. QI programs like the one assessed here may need to focus on practices with lower baseline performance levels or may need to be tailored for those with higher baseline performance.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.06.015
       
  • Development and Implementation of the Family Experiences With Coordination
           of Care Survey Quality Measures
    • Authors: Courtney Gidengil; Layla Parast; Q. Burkhart; Julie Brown; Marc N. Elliott; K. Casey Lion; Elizabeth A. McGlynn; Eric C. Schneider; Rita Mangione-Smith
      Pages: 863 - 870
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Courtney Gidengil, Layla Parast, Q. Burkhart, Julie Brown, Marc N. Elliott, K. Casey Lion, Elizabeth A. McGlynn, Eric C. Schneider, Rita Mangione-Smith
      Objective Ensuring high-quality care coordination for children with medical complexity (CMC) could yield significant health and economic benefits because they account for one-third of pediatric health care expenditures. The objective of this study was to develop and field test the Family Experiences with Coordination of Care (FECC) survey, which facilitates assessment of 20 new caregiver-reported quality measures for CMC. Methods We identified caregivers of Medicaid-insured CMC aged 0 to 17 years in Minnesota and Washington state, categorized by the Pediatric Medical Complexity Algorithm as having complex chronic disease. Eligible caregivers had CMC with at least 4 visits to health care providers participating in Medicaid in 2012. Caregivers were randomized to telephone or mixed mode (mail with telephone follow-up). Survey administration and data were collected in 2013. Results Twelve hundred nine caregivers responded to the FECC survey (response rate, 41%; 36% via telephone only, 46% via mixed mode; P < .001). Among CMC with a hospitalization, caregivers were invited to join hospital rounds in 51% of cases. Seventy-two percent of caregivers reported their child had a care coordinator; among these, 96% reported knowing how to access the care coordinator. Few children had written shared care plans (44%) or emergency care plans (20%). Only 10% of adolescents had a written transition care plan. Scores were lower from mixed mode respondents than from telephone-only respondents for some measures. Conclusions The FECC survey enables the evaluation of care coordination quality for CMC. Both survey modes were feasible to implement, but mixed mode administration produced a higher response rate.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.03.012
       
  • Comparison of Text Messages Versus E-mail When Communicating and Querying
           With Mothers About Safe Infant Sleep
    • Authors: Rachel Y. Moon; Fern R. Hauck; Ann L. Kellams; Eve R. Colson; Nicole L. Geller; Timothy C. Heeren; Stephen M. Kerr; Michael J. Corwin
      Pages: 871 - 878
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Rachel Y. Moon, Fern R. Hauck, Ann L. Kellams, Eve R. Colson, Nicole L. Geller, Timothy C. Heeren, Stephen M. Kerr, Michael J. Corwin
      Objective To assess how mothers' choice of e-mail or text messages (SMS) to receive safe sleep communications is associated with educational video viewing and responses to care practice queries. Methods Seven hundred ninety-two new mothers received safe sleep-related communications for 60 days after newborn hospital discharge as part of a trial of health education interventions on infant care practices. Mothers chose e-mail or SMS for study communications and were sent 22 short safe sleep videos and 41 queries regarding infant care practices. Results Study communications via e-mail were elected by 55.7% of participants. The SMS group had a modestly higher overall view rate of videos (59.1% vs 54.4%; adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.07–1.81) and a substantially higher response rate to queries (70.0% vs 45.2%; aOR, 3.48; 95% CI, 2.74–4.43). Conclusions Participants more commonly opted to receive infant care practice videos and queries via e-mail. SMS was associated with higher viewing and response rates, especially for query responses. These results highlight the importance of understanding how specific modalities of communication might vary in reach.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.06.004
       
  • Randomized Trial of a Children's Book Versus Brochures for Safe Sleep
           Knowledge and Adherence in a High-Risk Population
    • Authors: John S. Hutton; Resmi Gupta; Rachel Gruber; Jennifer Berndsen; Thomas DeWitt; Nicholas J. Ollberding; Judith B. Van Ginkel; Robert T. Ammerman
      Pages: 879 - 886
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): John S. Hutton, Resmi Gupta, Rachel Gruber, Jennifer Berndsen, Thomas DeWitt, Nicholas J. Ollberding, Judith B. Van Ginkel, Robert T. Ammerman
      Objective Sleep-related infant deaths have plateaued in the past decade, disproportionately affecting low socioeconomic status (SES) families. Printed materials are widely used for anticipatory guidance, yet none for safe sleep has been studied. We tested the efficacy of a specially designed children's book compared to brochures for safe sleep knowledge and adherence, which we hypothesized would be greater due to superior readability and engagement. Methods This randomized controlled trial involved low-SES mothers (n = 282) enrolled in a home visiting program. Home visitors (n = 56) were randomly assigned to perform safe sleep teaching and assessments during 3 visits: third trimester, 1 week old, and 2 months old, exclusively utilizing a specially designed children's book or brochures, and surveys incorporating the American Academy of Pediatrics' safe sleep recommendations. Outcomes were safe sleep knowledge, adherence, and usefulness of materials, controlling for maternal health literacy. Results Safe sleep knowledge increased across all time points with no overall group difference, though gains for sleep-evocative and general health items varied. Odds of bed sharing were higher and exclusive crib use lower for the brochure group (P < .05). Mothers and home visitors reported similar usefulness, though home visitors reported greater dialogue via the book and mothers in the book group reported more book sharing with their baby. Conclusions While a specially designed children's book and brochures were equally effective conveying aggregate safe sleep knowledge in low-SES mothers, adherence to exclusive crib use and avoiding bed sharing were greater in the book group, attributable to enhanced dialogue, readability and emotional engagement. Children's books are a promising mode of anticipatory guidance, warranting further investigation.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.04.018
       
  • Variation in Safe Sleep and Breastfeeding Practices Among Non-Hispanic
           Black Mothers in the United States According to Birth Country
    • Authors: Margaret G.K. Parker; Eve R. Colson; Lauren Provini; Denis V. Rybin; Stephen M. Kerr; Timothy Heeren; Michael J. Corwin
      Pages: 887 - 892
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Margaret G.K. Parker, Eve R. Colson, Lauren Provini, Denis V. Rybin, Stephen M. Kerr, Timothy Heeren, Michael J. Corwin
      Objective To examine variation in safe sleep and breastfeeding practices among US non-Hispanic black (NHB) mothers according to birth country. Methods We analyzed NHB mothers who were surveyed regarding safe sleep and breastfeeding practices when their infants were 2 to 6 months of age in 2011 to 2014, as part of a larger national study. We examined prevalences of safe sleep and breastfeeding practices according to birth country and examined odds of adherence to American Academy of Pediatrics recommended safe sleep and breastfeeding practices in foreign-born NHB mothers, compared with US-born NHB mothers. Our multivariate models included adjustment for maternal age, education, income, and US geographic region, and infant age at the time of the survey. Results Among 828 NHB mothers, 690 (83%) were US-born, 42 (5%) were African-born, 47 (6%) were Haitian-born, 24 (3%) were Jamaican-born, and 25 (3%) were born elsewhere. In the analysis of 803 US, African-, Haitian-, and Jamaican-born mothers, we found that Jamaican-born mothers had a lower rate of supine sleep compared with US-born mothers (40% vs 66%; adjusted odds ratio, 0.34; 95% confidence interval, 0.18–0.63). African-born mothers had lower rates of bedsharing compared with US-born mothers (11% vs 25% adjusted odds ratio, 0.22; 95% confidence interval, 0.11–0.46). Foreign-born mothers had higher rates of any and exclusive breastfeeding, compared with US-born mothers (85% and 40% vs 23% and 13%, respectively). Conclusions Safe sleep and breastfeeding practices vary among US NHB mothers according to birth country. These data illustrate the importance of recognizing heterogeneity of safe sleep and breastfeeding practices within racial/ethnic groups.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.07.003
       
  • Types of Objects in the Sleep Environment Associated With Infant
           Suffocation and Strangulation
    • Authors: Christopher E. Gaw; Thitphalak Chounthirath; Jonathan Midgett; Kyran Quinlan; Gary A. Smith
      Pages: 893 - 901
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Christopher E. Gaw, Thitphalak Chounthirath, Jonathan Midgett, Kyran Quinlan, Gary A. Smith
      Objective To investigate the circumstances of death and types and roles of objects present in the sleep environment at the time of death for infants who died from suffocation or strangulation during sleep. Methods This study analyzed 1736 reported incidents of accidental suffocation and strangulation in bed (ASSB) of infants younger than 1 year of age. These fatalities occurred from 2000 through 2012 and were reported to the United States Consumer Product Safety Commission. Results The mean age of ASSB death was 3.76 months (SD, 2.51). Infants younger than 5 months accounted for 67.3% (1168 of 1736) of all reported fatalities and 58.3% (1009 of 1731) were male. Deceased infants were often found in a crib or bassinet (30.6%; 383 of 1253) or in the prone orientation (84.9%; 595 of 701). The most common objects associated with infant ASSB were pillows (24.5%; 425 of 1736), mattresses (21.0%; 364 of 1736), blankets (13.1%; 228 of 1736), and walls (11.5%; 199 of 1736). Wedged (43.3%; 616 of 1424) or positioned on top of an object (25.9%; 369 of 1424) were the most common positions associated with death. Infants were often found wedged between a mattress and wall (30.2%; 181 of 599) or oriented face-down or prone on top of a pillow (52.2%; 187 of 358). Sleep surface sharing was associated with 6.5% (112 of 1736) of ASSB deaths. Conclusions Pillows and blankets are objects in sleep environments frequently associated with unintentional suffocation and strangulation of infants. Increased efforts should be made to remove these and other objects from sleep environments of infants.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.07.002
       
  • Increasing Trainee Reporting of Adverse Events With Monthly
           Trainee-Directed Review of Adverse Events
    • Authors: Alla Smith; Jonathan Hatoun; James Moses
      Pages: 902 - 906
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Alla Smith, Jonathan Hatoun, James Moses
      Objective Underreporting of adverse events by physicians is a barrier to improving patient safety. In an effort to increase resident and medical student (hereafter “trainee”) reporting of adverse events, trainees developed and led a monthly conference during which they reviewed adverse event reports (AERs), identified system vulnerabilities, and designed solutions to those vulnerabilities. Methods Monthly conferences over the 22-month study period were led by pediatric trainees and attended by fellow trainees, departmental leadership, and members of the hospital's quality improvement team. Trainees selected which AERs to review, with a focus on common near misses. Discussions were directed toward the development of potential solutions to issues identified in the reports. Trainee submissions of AERs were tracked monthly. Results The mean number of AERs submitted by trainees increased from 6.7 per month during the baseline period to 14.1 during the study period (P < .001). The average percent of reports submitted by trainees increased from a baseline of 27.6% to 46.1% during the study period (P = .0059). There was no significant increase in reporting by any other group (attending, nursing, or pharmacy). Multiple meaningful solutions to identified system vulnerabilities were developed with trainee input. Conclusions Trainee-led monthly adverse event review conferences sustainably increased trainee reporting of adverse events. These conferences had the additional benefit of having trainees use their unique perspective as frontline providers to identify important system vulnerabilities and develop innovative solutions.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.01.004
       
  • Integrating Education and Service in Pediatric Residency Training: Results
           of a National Survey
    • Authors: Jennifer C. Kesselheim; Alan Schwartz; Debra Boyer; Stephen Barone; Kimberly Boland; Alston Dunbar; John Frohna; Abdulla Ghori; Lisa Gilmer; Jason Homme; Janara Huff; Matthew Kapklein; Richard Mazzaccaro; Alisa McQueen; Nicole Paradise-Black
      Pages: 907 - 914
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Jennifer C. Kesselheim, Alan Schwartz, Debra Boyer
      Objective The definition and proper role of service, as it relates to education, in the residency training experience has been long debated. In this study we aimed to develop definitions for service and education, delineate how each is perceived to contribute value to training, and to measure respondents' ratings of service and education using case vignettes. Methods We conducted a multisite cohort survey study of pediatric residents (n = 797) and program directors (PDs; n = 37) using a region-stratified sample of 2 to 3 participating pediatric residency programs per region. Results Surveys were completed by 34 PDs (92%) and 359 trainees (45%). PDs and residents agree that service can, in the absence of formal teaching, be considered educational. When asked how often rotations provide an appropriate balance between education and service, 94% of PDs responded ‘extremely/very often’ whereas only 68% of residents agreed (P = .005). Residents were significantly more likely than PDs to endorse definitions for service that included volunteer work (82% vs 59%; P = .002), going above and beyond for a patient (91% vs 78%; P = .017), and routine patient care activities (91% vs 72%; P < .001). For 6 of 12 case vignettes, trainees gave median service ratings that were significantly higher than PDs (P = .03). Conclusions Medical educators and pediatric residents hold mismatched impressions of their training programs' balance of service obligations with clinical education. Specifically, residents more frequently report an overabundance of service. Both groups acknowledge that service activities can be educationally valuable although the groups' definitions of service are not fully aligned.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.06.013
       
  • Rotational Learning Plans: Introducing Programmatic Tools and Practices
           Toward Meaningful and Continuous Goal Setting Within Residency Training
    • Authors: Raquel G. Hernandez; Akshata Hopkins; Kimberly R. Collins
      Pages: 915 - 917
      Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8
      Author(s): Raquel G. Hernandez, Akshata Hopkins, Kimberly R. Collins


      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.05.003
       
  • Child Well-being and Adverse Childhood Experiences in the United States
    • Authors: Christina D. Bethell; Lisa A. Simpson; Michele R. Solloway
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Christina D. Bethell, Lisa A. Simpson, Michele R. Solloway


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.06.011
       
  • Promoting Lifelong Health and Well-being: Staying the Course to Promote
           Health and Prevent the Effects of Adverse Childhood and Community
           Experiences
    • Authors: Martha Davis; Tracy Costigan; Kristin Schubert
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Martha Davis, Tracy Costigan, Kristin Schubert


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.12.002
       
  • Promoting Early Brain and Child Development: Perceived Barriers and the
           Utilization of Resources to Address Them
    • Authors: Andrew S. Garner; Amy Storfer-Isser; Moira Szilagyi; Ruth E.K. Stein; Cori M. Green; Bonnie D. Kerker; Karen G. O'Connor; Kimberly E. Hoagwood; Sarah McCue Horwitz
      Pages: 697 - 705
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Andrew S. Garner, Amy Storfer-Isser, Moira Szilagyi, Ruth E.K. Stein, Cori M. Green, Bonnie D. Kerker, Karen G. O'Connor, Kimberly E. Hoagwood, Sarah McCue Horwitz
      Objective Efforts to promote early brain and child development (EBCD) include initiatives to support healthy parent–child relationships, tools to identify family social-emotional risk factors, and referrals to community programs to address family risk factors. We sought to examine if pediatricians perceive barriers to implementing these activities, and if they utilize resources to address those barriers. Methods Data were analyzed from 304 nontrainee pediatricians who practice general pediatrics and completed a 2013 American Academy of Pediatrics Periodic Survey. Sample weights were used to decrease nonresponse bias. Bivariate comparisons and multivariable regression analyses were conducted. Results At least half of the pediatricians agreed that barriers to promoting EBCD include: a lack of tools to promote healthy parent–child relationships, a lack of tools to assess the family environment for social-emotional risk factors, and a lack of local resources to address family risks. Endorsing a lack of tools to assess the family environment as a barrier was associated with using fewer screening tools and community resources. Endorsing a lack of local resources as a barrier was associated with using fewer community resources and fewer initiatives to promote parent–child relationships. Interest in pediatric mental health was associated with using more initiatives to promote healthy parent–child relationships, screening tools, and community resources. Conclusions Although the majority of pediatricians perceive barriers to promoting EBCD, few are routinely using available resources to address these barriers. Addressing pediatricians' perceived barriers and encouraging interest in pediatric mental health may increase resource utilization and enhance efforts to promote EBCD.

      PubDate: 2017-10-28T22:10:16Z
      DOI: 10.1016/j.acap.2016.11.013
       
  • The Cumulative Effect of Health Adversities on Children's Later Academic
           Achievement
    • Authors: Jon Quach; Cattram Nguyen; Meredith O'Connor; Melissa Wake
      Pages: 706 - 714
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Jon Quach, Cattram Nguyen, Meredith O'Connor, Melissa Wake
      Objective We aimed to determine whether the accumulation of physical, psychosocial, and combined health adversities measured at age 8 to 9 years predicts worsening of academic scores cross-sectionally at 8 to 9 and longitudinally at 10 to 11 years. Methods Design: Longitudinal data from Waves 3 and 4 in the Longitudinal Study of Australian Children (83% of 4983 retained). Exposures (8–9 years): Physical health adversities (yes/no; summed range, 0–5): overweight, special health care needs, chronic illness, PedsQL Physical, and global health. Psychosocial health adversities (yes/no; summed range, 0–4): parent- and teacher-reported behavior, PedsQL Psychosocial, sleep problems. Combined health adversities (range 0-9). Outcomes (8–9, and 10–11 years): National academic standardized test scores. Analysis: Generalized estimating equations, accounting for multiple academic domains in each year and socioeconomic position and cognition. Results At 8 to 9 years, 23.9%, 9.9%, and 5.3% had 1, 2, or ≥3 physical health adversities, respectively, while 27.2%, 9.5%, and 4.9% had 1, 2, or ≥3 psychosocial health adversities. For each additional health adversity at 8 to 9 years, academic scores fell incrementally in year 3 and year 5 (both P < .001), with reductions of at least 0.4 SDs for ≥3 health adversities. Number was more important than type (physical, psychosocial) of adversity. Conclusions The accumulation of health adversities predicts poorer academic achievement up to 2 years later. Interventions might need to address multiple domains to improve child academic outcomes and be delivered across the health-education interface.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.03.002
       
  • From Design to Dissemination: Conducting Quantitative Medical Education
           Research
    • Authors: Erika L. Abramson; Caroline R. Paul; Jean Petershack; Janet Serwint; Janet E. Fischel; Mary Rocha; Meghan Treitz; Heather McPhillips; Tai Lockspeiser; Patricia Hicks; Linda Tewksbury; Margarita Vasquez; Daniel J. Tancredi; Su-Ting T. Li
      Abstract: Publication date: Available online 5 November 2017
      Source:Academic Pediatrics
      Author(s): Erika L. Abramson, Caroline R. Paul, Jean Petershack, Janet Serwint, Janet E. Fischel, Mary Rocha, Meghan Treitz, Heather McPhillips, Tai Lockspeiser, Patricia Hicks, Linda Tewksbury, Margarita Vasquez, Daniel J. Tancredi, Su-Ting T. Li
      Rigorous medical education research is critical to effectively develop and evaluate the training we provide our learners. Yet, many clinical medical educators lack the training and skills needed to conduct high quality medical education research. This paper offers guidance on conducting sound quantitative medical education research. Our aim is to equip readers with the key skills and strategies necessary to conduct successful research projects, highlighting new concepts and controversies in the field. We utilize Glassick's criteria for scholarship as a framework to discuss strategies to ensure that the research question of interest is worthy of further study and how to use existing literature and conceptual frameworks to strengthen a research study. Through discussions of the strengths and limitations of commonly used study designs, we expose the reader to particular nuances of these decisions in medical education research and discuss outcomes generally focused upon, as well as strategies for determining the significance of consequent findings. We conclude with information on critiquing research findings and preparing results for dissemination to a broad audience. Practical planning worksheets and comprehensive tables illustrating key concepts are provided in order to guide researchers through each step of the process. Medical education research provides wonderful opportunities to improve how we teach our learners, to satisfy our own intellectual curiosity and ultimately, to enhance the care provided to patients.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.10.008
       
  • Erratum
    • Abstract: Publication date: November–December 2017
      Source:Academic Pediatrics, Volume 17, Issue 8


      PubDate: 2017-11-11T10:58:56Z
       
  • Development of New Quality Measures for Hospital-Based Care of Suicidal
           Youth
    • Authors: Layla Parast; Naomi S. Bardach; Q. Burkhart; Laura P. Richardson; J. Michael Murphy; Courtney A. Gidengil; Maria T. Britto; Marc N. Elliott; Rita Mangione-Smith
      Abstract: Publication date: Available online 31 October 2017
      Source:Academic Pediatrics
      Author(s): Layla Parast, Naomi S. Bardach, Q. Burkhart, Laura P. Richardson, J. Michael Murphy, Courtney A. Gidengil, Maria T. Britto, Marc N. Elliott, Rita Mangione-Smith
      Objectives To develop, validate, and test the feasibility of implementation of four new quality measures assessing ED and inpatient care for suicidal youth. Methods Four quality measures were developed to assess hospital-based care for suicidal youth. These measures, focused on counseling caregivers about a) restricting access to lethal means of self-harm and b) benefits and risks of anti-depressant medications, were operationalized into 2 caregiver surveys, assessing ED and inpatient quality, respectively. Survey field tests included caregivers of youth who received inpatient and/or ED care for suicidality at one of two children's hospitals between 7/2013-6/2014. We examined the feasibility of obtaining measure scores and variation in scores. Multivariate models examined associations between quality measure scores and four validation metrics: modified Child Hospital Consumer Assessments of Health Care Providers and Systems© communication composites, hospital readmissions, and ED return visits. Results Response rates were 35% (ED) and 31% (inpatient). Most caregivers reported receiving counseling to restrict their child's access to lethal means of self-harm (90% in the ED and 96% in the inpatient setting). In the inpatient setting, caregivers reported higher rates of counseling on benefits (95%) of newly prescribed anti-depressants than risks (physical side effects 85%, increased suicidality 72%). Higher scores on the latter measure were associated with higher nurse (p<0.001) and doctor (p<0.01) communication composite scores. Measure scores were not associated with readmissions or ED return visits. Conclusions These new quality measures evaluate key aspects of care for suicidal youth, and may facilitate assessing quality of care for this vulnerable population.

      PubDate: 2017-11-11T10:58:56Z
      DOI: 10.1016/j.acap.2017.09.017
       
  • Hospital and Community Characteristics Associated with Pediatric Direct
           Admission to Hospital
    • Authors: JoAnna K. Leyenaar; Meng-Shiou Shieh; Tara Lagu; Penelope S. Pekow; Peter K. Lindenauer
      Abstract: Publication date: Available online 27 October 2017
      Source:Academic Pediatrics
      Author(s): JoAnna K. Leyenaar, Meng-Shiou Shieh, Tara Lagu, Penelope S. Pekow, Peter K. Lindenauer
      Objectives One-quarter of pediatric hospitalizations begin as direct admissions, defined as hospitalization without receiving care in the hospital's emergency department (ED). Direct admission rates are highly variable across hospitals, yet previous studies have not examined reasons for this variation. We aimed to determine the relationships between hospital and community factors and pediatric direct admission rates, and evaluate the degree to which these characteristics explain variation in risk-adjusted direct admission rates. Methods We conducted a cross-sectional study of the Healthcare Cost and Utilization Project's Kids Inpatient Database, American Hospital Association Database, and Area Health Resource File, including children <18 years of age who were admitted for a medical hospitalization in states contributing data to all datasets. Using hierarchical generalized linear modeling we generated risk-adjusted direct admission rates and used generalized linear models to assess the association of hospital and community characteristics with these risk-adjusted rates. Results We included 211,458 children discharged from 933 hospitals and 26 states; 20.2% were admitted directly. One-fifth of the variance in risk-adjusted direct admission rates was attributed to observed hospital and community factors. The greatest proportion of this explained variance was related to ED volume (37%), volume of pediatric hospitalizations (27%), and size of the pediatrician workforce (12%). Conclusions Direct admission rates were associated with several hospital and community characteristics, but the majority of variation in hospitals' direct admission rates was not explained by these factors. These findings suggest opportunities for diverse hospital types to develop the infrastructure and communication systems necessary to support pediatric direct admissions.

      PubDate: 2017-10-28T22:10:16Z
      DOI: 10.1016/j.acap.2017.10.002
       
  • Walk-in Model for Ill Care in an Urban Academic Pediatric Clinic
    • Authors: Stephen Warrick; John Morehous; Zeina M. Samaan; Mona Mansour; Tracy Huentelman; Pamela J. Schoettker; Srikant Iyer
      Abstract: Publication date: Available online 20 October 2017
      Source:Academic Pediatrics
      Author(s): Stephen Warrick, John Morehous, Zeina M. Samaan, Mona Mansour, Tracy Huentelman, Pamela J. Schoettker, Srikant Iyer
      Objectives Since the Institute of Medicine's 2001 charge to reform healthcare, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to healthcare reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. Methods We used quality improvement methods to create a separate non-emergency care stream in a large academic primary care clinic serving 19,000 patients (> 90% Medicaid). The PPC walk-in clinic opened in July 2013 with service 4 hours per day and expanded to an all-day clinic in October 2013. Statistical process control methods were used to measure the change over time in the volume of ill patients and visits seen in the PPC walk-in clinic. Results Average weekly walk-in non-emergent ill visits increased from 61 to 158 following opening of the PPC walk-in clinic. The percent of non-emergent ill visits in the medical home increased from 41% to 45%. Visits during regular clinic hours increased from 55% to 60%. Clinic cycle time remained unchanged. Conclusions Implementation of a walk-in care stream for acute illness within the medical home has allowed us to provide ill care to a higher proportion of patients, although we have not yet achieved our predicted volume. Matching access to demand is key to successfully meeting patient needs.

      PubDate: 2017-10-28T22:10:16Z
      DOI: 10.1016/j.acap.2017.10.004
       
  • Receipt of Medication and Behavioral Therapy among a National Sample of
           School-Aged Children Diagnosed with ADHD
    • Authors: Morgan Walls; Caitlin Allen; Howard Cabral; Lewis E. Kazis; Megan Bair-Merritt
      Abstract: Publication date: Available online 20 October 2017
      Source:Academic Pediatrics
      Author(s): Morgan Walls, Caitlin Allen, Howard Cabral, Lewis E. Kazis, Megan Bair-Merritt
      Objective In 2011, the American Academy of Pediatrics published practice guidelines for ADHD, recommending both medication and behavioral therapy for school-aged children. The current study examines associations between child/family characteristics and ADHD medication, behavioral, and combined therapy. Methods This study used data from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, a nationally-representative follow-up survey to the 2011-2012 National Survey of Children's Health. Descriptive statistics were used to estimate frequencies of ADHD treatments and multivariable logistic regression to examine child/family characteristics associated with parent-reported medication use, classroom management, and parent training for children ages 8 to 17 diagnosed with ADHD (n=2,401). Results Black and Hispanic children were less likely than white children to have ever taken ADHD medication. Hispanic children were less likely than white children to be currently taking medications (aOR: 0.49, 95% CI: 0.30-0.80). No differences were found in current medication use for black children when compared to white children. Thirty-percent of parents reported that their child was currently receiving classroom management and 31% reported having ever received parent training for ADHD. Children whose ADHD medication was managed by a primary care physician were less likely to receive combined medication and behavioral therapy when compared to children managed by specialty physicians (aOR: 2.58, 95% CI: 1.75-3.79). Conclusion Most school-aged children reported taking medication for ADHD, however, medication disparities persist. Parent-reported use of behavioral therapies are low. Future research should examine reasons for observed variation in treatment and interventions to optimize ADHD care.

      PubDate: 2017-10-28T22:10:16Z
      DOI: 10.1016/j.acap.2017.10.003
       
  • Do Fathers' Home Reading Practices at Age 2 Predict Child Language and
           Literacy at Age 4'
    • Authors: Jon Quach; Anna Sarkadi; Natasha Napiza; Melissa Wake; Amy Loughman; Sharon Goldfeld
      Abstract: Publication date: Available online 19 October 2017
      Source:Academic Pediatrics
      Author(s): Jon Quach, Anna Sarkadi, Natasha Napiza, Melissa Wake, Amy Loughman, Sharon Goldfeld
      Background Maternal shared reading practices predict emergent literacy, but fathers' contributions are less certain. We examined whether fathers' shared home reading activities at 2 years (1) predict language and emergent literacy at age 4 years, when controlling for maternal contributions; and (2) differentially benefit these outcomes in disadvantaged children. Methods Design: Two-parent families recruited from 5 relatively disadvantaged communities for the universal Let's Read literacy promotion population-based trial (ISRCTN 04602902) in Melbourne, Australia. Exposure, 2 years: Home reading practices via self-reported maternal and paternal StimQ-Toddler questionnaires, dichotomised at study median (high vs. low). Outcomes, 4 years: Receptive and expressive language (Clinical Evaluation of Language Fundamentals-4), emergent literacy (Sunderland Phonological Awareness Test–Revised). Analyses: Aim 1: Linear regression, adjusted for mothers' home reading, 2-year-old vocabulary and communication skills and family disadvantage. Aim 2: Interaction of disadvantage [yes vs. no] with high home reading by (a) fathers and (b) at least one parent. Results Data were available for 405 (62.3%) families. High father reading at 2 years (reference: low) predicted better expressive (mean difference 8.0, 95%CI 4.5 to 11.5) and receptive (mean difference 7.3, 95%CI 4.1 to 10.5) language at 4 years (both p<0.001) but not emergent literacy skills. Similar patterns were observed in families with at least one parent with high home reading. Father reading did not differentially benefit outcomes in disadvantaged children. Conclusion Fathers' involvement in reading at 2 years predicted better language but not emergent literacy at 4 years, and did not protect against adverse effects of socioeconomic disadvantage.

      PubDate: 2017-10-21T12:20:46Z
      DOI: 10.1016/j.acap.2017.10.001
       
  • Outpatient Visits before Ambulatory Care Sensitive Hospitalization of
           Children Using Medicaid
    • Authors: Neal A. deJong; Troy Richardson; Nicole Chandler; Michael J. Steiner; Matt Hall; Jay Berry
      Abstract: Publication date: Available online 28 September 2017
      Source:Academic Pediatrics
      Author(s): Neal A. deJong, Troy Richardson, Nicole Chandler, Michael J. Steiner, Matt Hall, Jay Berry
      Objectives Hospitalizations for ambulatory care sensitive conditions (ACSC) are measured to indicate healthcare system quality, with the premise that fewer hospitalizations would occur with better preceding outpatient care. Our objective was to identify outpatient care received in the 7 days preceding acute pediatric hospitalizations, and to compare receipt of outpatient care by hospitalization type (ACSC vs. non-ACSC). Methods This was a retrospective, observational study using a 10-state database of Medicaid claims to identify outpatient visits within 7 days before acute, unplanned hospitalization for children ages 0-17 years. We used logistic regression to assess the relationship between hospitalization type and occurrence of a preceding outpatient clinic visit, controlling for patient age, race/ethnicity, type of Medicaid, and complex chronic conditions. Results Of 254,902 hospitalizations, 28.6% had a preceding outpatient visit. Thirty-five percent of hospitalizations were for ACSC. A greater percentage of ACSC vs. non-ACSC hospitalizations had a preceding outpatient visit (31.1% vs. 27.3%, p<0.001). In multivariable analysis, characteristics associated with a preceding outpatient visit were age <1 vs. 13-17 years [aOR 2.4 (95% CI 2.3-2.5)], ≥2 vs. 0 complex chronic conditions [aOR 1.9 (95% CI 1.8, 2.0)], Medicaid managed care vs. fee-for-service [aOR 1.2 (95% CI 1.2-1.3)], and ACSC vs. non-ACSC hospitalization [aOR 1.2 (95% CI 1.1-1.2)]. Conclusions Although receipt of outpatient care was modestly higher in children hospitalized with an ACSC, most hospitalized children did not receive preceding outpatient care. Further investigation is needed to assess why such a large proportion of children do not receive outpatient care before acute, unplanned hospitalization, especially for ACSC.

      PubDate: 2017-10-01T16:03:37Z
      DOI: 10.1016/j.acap.2017.09.015
       
  • Commentary on Mundy, Canterford, Kosola et al. Peer victimisation and
           academic performance in primary school children
    • Authors: Rashmi Shetgiri
      Abstract: Publication date: Available online 21 September 2017
      Source:Academic Pediatrics
      Author(s): Rashmi Shetgiri


      PubDate: 2017-09-25T05:38:16Z
      DOI: 10.1016/j.acap.2017.08.011
       
  • Responsible Milestone-Based Educational Handover with Individualized
           Learning Plan from Undergraduate to Graduate Pediatric Medical Education
    • Authors: Jocelyn Huang Schiller; Heather L. Burrows; Amy E. Fleming; Meg G. Keeley; Lauren Wozniak; Sally A. Santen
      Abstract: Publication date: Available online 20 September 2017
      Source:Academic Pediatrics
      Author(s): Jocelyn Huang Schiller, Heather L. Burrows, Amy E. Fleming, Meg G. Keeley, Lauren Wozniak, Sally A. Santen


      PubDate: 2017-09-25T05:38:16Z
      DOI: 10.1016/j.acap.2017.09.010
       
  • Gaming the System: Creation of a Random Case-Generating Game for Use in
           Morning Report
    • Authors: Pallavi Kamra; Emily C. Borman-Shoap; Lei Zhang; Michael B. Pitt
      Abstract: Publication date: Available online 18 September 2017
      Source:Academic Pediatrics
      Author(s): Pallavi Kamra, Emily C. Borman-Shoap, Lei Zhang, Michael B. Pitt
      Background Case-based morning reports are a staple of residency education. Little is known about the role of game-based learning in facilitating case-based discussions. Objectives Compare an educational game that can be used for creating impromptu case-based sessions to traditional morning report. Methods We created a game called Differential Diagnosis Slot Machine, which allows participants to quickly generate theoretical cases for discussion.Five traditional morning report (TMR) and game-based morning report (GBMR) sessions were conducted. Participants completed an anonymous survey after each session rating their learning, enjoyment, participation, and desire for similar future sessions. Learners also described who they learned from during the session. Two-group comparison was done using logistic regression with generalized estimating equations. Statistical significance was determined at p < 0.05. Results All participants (61 in each type of session) completed the survey. Learners were more likely to respond with ‘5’ or ‘strongly agree’, for the GBMR, with statistically significant difference in all but self-rated learning category. While nearly all of the learners in the TMR sessions (93.4%) indicated that they learned most from the facilitator, responses from the GBMR session had a wider variation with 72.1% indicating residents, and 11.5% choosing medical students (p<0.01). Conclusion The game-based morning report was rated as equivalent or better than traditional morning report in all self-rated categories. It also allowed for more peer-directed learning and as it encourages creative problem solving may be a useful adjunct for case-based teaching.

      PubDate: 2017-09-25T05:38:16Z
      DOI: 10.1016/j.acap.2017.09.009
       
  • Chronic School Absenteeism and the Role of Adverse Childhood Experiences
    • Authors: Hilary Stempel; Matthew Cox-Martin; Michael Bronsert; L. Miriam Dickinson; Mandy A. Allison
      Abstract: Publication date: Available online 18 September 2017
      Source:Academic Pediatrics
      Author(s): Hilary Stempel, Matthew Cox-Martin, Michael Bronsert, L. Miriam Dickinson, Mandy A. Allison
      Objective To examine the association between chronic school absenteeism and adverse childhood experiences (ACEs) among school-aged children. Methods We conducted a secondary analysis of data from the 2011-2012 National Survey of Children’s Health including children 6-17 years old. The primary outcome variable was chronic school absenteeism (> 15 days absent in past year). We examined the association between chronic school absenteeism and ACEs using logistic regression with weighting for individual ACEs, summed ACE score, and latent class analysis of ACEs. Results Among the 58,765 school-aged children in the study sample, 2,416 (4.1%) experienced chronic school absenteeism. Witnessing or experiencing neighborhood violence was the only individual ACE significantly associated with chronic absenteeism (aOR 1.55 95% confidence interval [CI] 1.20-2.01). Having one or more ACE was significantly associated with chronic absenteeism: 1 ACE (aOR 1.35 95% CI 1.02-1.79), 2-3 ACEs (aOR 1.81 95% CI 1.39-2.36) and ≥ 4 ACEs (aOR 1.79 95% CI 1.32-2.43). Three of the latent classes were also associated with chronic absenteeism and children in these classes had a high probability of endorsing neighborhood violence, family substance use, or having multiple ACEs. Conclusions ACEs exposure was associated with chronic school absenteeism in school-aged children. To improve school attendance, along with future graduation rates and long-term health, these findings highlight the need for an interdisciplinary approach to address child adversity that involves pediatricians, mental health providers, schools, and public health partners.

      PubDate: 2017-09-25T05:38:16Z
      DOI: 10.1016/j.acap.2017.09.013
       
  • Blood and Hair Aluminum Levels, Vaccine History, and Early Infant
           Development: A Cross-Sectional Study
    • Authors: Mateusz P. Karwowski; Catherine Stamoulis; Larissa M. Wenren; G. Mayowa Faboyede; Nicolle Quinn; Kathleen M. Gura; David C. Bellinger; Alan D. Woolf
      Abstract: Publication date: Available online 14 September 2017
      Source:Academic Pediatrics
      Author(s): Mateusz P. Karwowski, Catherine Stamoulis, Larissa M. Wenren, G. Mayowa Faboyede, Nicolle Quinn, Kathleen M. Gura, David C. Bellinger, Alan D. Woolf


      PubDate: 2017-09-19T02:36:30Z
      DOI: 10.1016/j.acap.2017.09.003
       
  • National Landscape of Interventions to Improve Pediatric Resident Wellness
           and Reduce Burnout
    • Authors: Paria M. Wilson; Kathi J. Kemper; Charles J. Schubert; Maneesh Batra; Betty B. Staples; Janet R. Serwint; Hilary McClafferty; John D. Mahan
      Abstract: Publication date: Available online 14 September 2017
      Source:Academic Pediatrics
      Author(s): Paria M. Wilson, Kathi J. Kemper, Charles J. Schubert, Maneesh Batra, Betty B. Staples, Janet R. Serwint, Hilary McClafferty, John D. Mahan


      PubDate: 2017-09-19T02:36:30Z
      DOI: 10.1016/j.acap.2017.09.012
       
  • Feasibility of Implementing Group Well Baby/Well Woman Dyad Care at
           Federally Qualified Health Centers
    • Authors: Gabriela Duran; Mariam Faiz-Nassar; Kristin Mmari; Cynthia S. Minkovitz; Katherine A. Connor
      Abstract: Publication date: Available online 14 September 2017
      Source:Academic Pediatrics
      Author(s): Gabriela Duran, Mariam Faiz-Nassar, Kristin Mmari, Cynthia S. Minkovitz, Katherine A. Connor
      Objective Group care has been shown to be effective for delivery of infant well child care. Centering Parenting™ (CP) is a model of group dyad care for mothers and infants. CP may improve quality and efficiency of preventive care, particularly for low income families. Federally Qualified Health Centers (FQHC) may be optimal sites for implementation, however facilitators and barriers may be unique. The aim of this qualitative study was to assess stakeholder perspectives on the feasibility of implementing Centering ParentingTM in FQHCs in Baltimore. Methods Semi-structured interviews were conducted with mothers, clinicians, staff, and administrators recruited from two FQHCs using purposive sampling. Interviews were recorded, transcribed verbatim, and uploaded to Atlas.ti for analysis. Using an inductive thematic analysis approach, two investigators coded the transcripts. Matrices of key codes were developed to identify themes and patterns across stakeholder groups. Results Interviews were completed with 26 mothers and 16 clinicians, staff, and administrators. Most participants considered CP desirable. Facilitators included: peer support and education, emphasis on maternal wellness, and increased patient and clinician satisfaction. Barriers included: exposure to “others”, scheduling and coordination of care, productivity, training requirements, and cost. Parenting experience did not appear to impact perspectives on CP. Conclusions Perceptions regarding facilitators and barriers to CP implementation in FQHCs are similar to existing group well child care literature . The benefit of emphasis on maternal wellness is a unique finding. Maternal wellness integration may make CP a particularly desirable model for implementation at FQHCs, but potential systems barriers must be addressed.

      PubDate: 2017-09-19T02:36:30Z
      DOI: 10.1016/j.acap.2017.09.011
       
  • In Search of an Answer
    • Authors: Richard Mario Lurshay
      Abstract: Publication date: Available online 14 September 2017
      Source:Academic Pediatrics
      Author(s): Richard Mario Lurshay


      PubDate: 2017-09-19T02:36:30Z
      DOI: 10.1016/j.acap.2017.09.008
       
  • Reasons Why Children and Adolescents with ADHD Stop and Restart Taking
           Medicine
    • Authors: William B. Brinkman; John O. Simon; Jeffery N. Epstein
      Abstract: Publication date: Available online 12 September 2017
      Source:Academic Pediatrics
      Author(s): William B. Brinkman, John O. Simon, Jeffery N. Epstein
      Objective To describe the prevalence of reasons why children and adolescents stop and restart attention-deficit/hyperactivity disorder (ADHD) medicine and whether functional impairment is present after stopping medicine. Methods We used the prospective longitudinal cohort from the Multimodal Treatment of Study of Children with ADHD. At the 12 year follow-up when participants were a mean of 21.1 years old, 372 participants (76% male, 64% Caucasian) reported ever taking ADHD medicine. Participants reported the age when they last stopped and/or restarted ADHD medicine and also endorsed reasons for stopping and restarting. Results Seventy-seven percent (286/372) reported stopping medicine for a month or longer at some time during childhood or adolescence. Participants were a mean of 13.3 years old when they last stopped medicine. The most commonly endorsed reasons for stopping medication related to 1) medicine not needed/helping, 2) side effects, 3) logistical barriers of getting/taking medication, and 4) social concerns/stigma. Seventeen percent (64/372) reported restarting medicine after stopping for a month or longer. Commonly endorsed reasons for restarting related to 1) medicine needed/helped, 2) resolution of logistical barriers to getting/taking. For both stopping and restarting, the proportion endorsing some reasons differed by age range, with the overall pattern suggesting that parental involvement in decisions decreased with age. Nearly all participants had impairment at the assessment after stopping regardless of whether medication was resumed. Conclusions Different reasons for stopping and/or restarting medicine are relevant at different times for different teens. Tailored strategies may help engage adolescents as full partners in their treatment plan.

      PubDate: 2017-09-19T02:36:30Z
      DOI: 10.1016/j.acap.2017.09.005
       
  • The Significance of Unknown Significance
    • Authors: Julia Aquino
      Abstract: Publication date: Available online 12 September 2017
      Source:Academic Pediatrics
      Author(s): Julia Aquino


      PubDate: 2017-09-19T02:36:30Z
      DOI: 10.1016/j.acap.2017.09.007
       
  • Latino Parents' Perceptions of Pediatric Weight Counseling Terms
    • Authors: Shanna Doucette Knierim; Sophia Newcomer; Alyssa Castillo; Alanna Kulchak Rahm; Silvia Raghunath; Christina Clarke; Leslie Wright; Matthew Haemer; Simon J. Hambidge
      Abstract: Publication date: Available online 12 September 2017
      Source:Academic Pediatrics
      Author(s): Shanna Doucette Knierim, Sophia Newcomer, Alyssa Castillo, Alanna Kulchak Rahm, Silvia Raghunath, Christina Clarke, Leslie Wright, Matthew Haemer, Simon J. Hambidge
      Objective Little is known about Latino parents’ perceptions of weight-related language in English or Spanish, particularly for counseling obese youth. We sought to identify English and Spanish weight counseling terms perceived as desirable for providers to use, motivating, and inoffensive by Latino parents across demographic groups. Methods Latino parents of children treated at urban safety-net clinics completed surveys in English or Spanish. Parents rated the desirable, motivating, or offensive properties of terms for excess weight using a 5-point scale. We compared parental ratings of terms and investigated the association of parent and child characteristics with parent perceptions of terms. Results 525 surveys met inclusion criteria (255 English, 270 Spanish). English survey respondents rated “unhealthy weight” and “too much weight for his/her health” the most motivating and among the most desirable and least offensive terms. Spanish survey respondents found “demasiado peso para su salud” highly desirable, highly motivating, inoffensive and valued its connection to the child’s health. “Overweight”/”sobrepeso” and “high BMI”/“índice de masa corporal alta” were not as desirable or as motivating. “Chubby”, “fat”, “gordo”, and “muy gordo” were the least motivating and most offensive terms. Parents’ ratings of commonly used clinical terms varied widely across demographic groups, but more desirable terms had less variability. Conclusions “Unhealthy weight”, “too much weight for his/her health” and the Spanish equivalent “demasiado peso para su salud” were the most desirable, motivating, and minimally offensive terms. Latino parents’ positive perceptions of these terms occurred across parent and child characteristics, supporting their use in weight counseling.

      PubDate: 2017-09-19T02:36:30Z
      DOI: 10.1016/j.acap.2017.09.006
       
  • Variation in Generational Perceptions of Child Health and Well-being
    • Authors: Gary L. Freed; Matthew M. Davis; Dianne C. Singer; Acham Gebremariam; Sara L. Schultz; Amilcar Matos-Moreno; Mark Wietecha
      Abstract: Publication date: Available online 12 September 2017
      Source:Academic Pediatrics
      Author(s): Gary L. Freed, Matthew M. Davis, Dianne C. Singer, Acham Gebremariam, Sara L. Schultz, Amilcar Matos-Moreno, Mark Wietecha
      Objective To assess adults’ perceptions regarding the health and well-being of children today relative to their own health and well-being as youth and the potential for intergenerational differences in those perceptions. Methods A cross-sectional, internet-based survey of a nationally representative household sample. The study was conducted using GfK Custom Research’s web-enabled KnowledgePanel®, a probability-based panel representative of the U.S. population. We assessed perceptions of children’s health and well-being today compared to when respondents were growing up including (1) physical and mental health and (2) children’s education, exercise, diet, health care, safety of communities and emotional support from families, groups and organizations. Results Overall, 1330 (65%; 1330/2047) adult respondents completed the survey. Only 26% of respondents believe that the current physical health of children, and 14% that the current mental health of children, is better today than when they were growing up. There was a significant trend among generations with a greater proportion of older generations perceiving the physical health of children to be better today. Only 15% of respondents report the chances for a child to grow up with good mental health in the future are “better” now than when they were growing up. Conclusions Adults across all generations in the U.S. today view children’s health as unlikely to meet the goals of the American Dream of continuous improvement. Although demographic changes require continued focus on our aging population, we must equally recognize the importance of advancing a healthy future for our nation’s children, who will assume the mantle of our future.

      PubDate: 2017-09-19T02:36:30Z
      DOI: 10.1016/j.acap.2017.09.004
       
  • Identifying which urban children with asthma benefit most from clinician
           prompting: Sub-analyses from the PAIR-UP Trial
    • Authors: Nicolas P.N. Goldstein; Sean M. Frey; Maria Fagnano; Sande O. Okelo; Jill S. Halterman
      Abstract: Publication date: Available online 9 September 2017
      Source:Academic Pediatrics
      Author(s): Nicolas P.N. Goldstein, Sean M. Frey, Maria Fagnano, Sande O. Okelo, Jill S. Halterman
      Objective Clinician prompts increase the likelihood of guideline-recommended corrective actions (preventive medication prescription, dose change, and/or adherence promotion) for symptomatic children with poorly controlled or persistent asthma in the primary care setting, but it is unclear if all children benefit equally. The objectives of this study were to identify whether asthma severity, visit type, and current preventive medication use were predictive of corrective actions during visits for children with symptomatic asthma, and determine whether these factors modified the impact of a prompting intervention. Methods We conducted pre-specified subgroup analyses of a cluster randomized controlled trial of physician prompting that promoted guideline-based asthma management for urban children with symptomatic asthma. We tested predictors of corrective actions with bivariate and multivariate multilevel logistic regressions; compared intervention effects across factor categories via stratified analyses; and characterized effect modification with interaction term analyses. Results Prompting intervention exposure, moderate/severe disease, asthma-focused visits, and current preventive medication use were predictive of corrective actions. The prompting intervention significantly increased the rate of corrective actions for children across categories of disease severity, visit type, and preventive medication use. However the intervention effect was significantly smaller for children already using a preventive medication (adjusted OR=2.01; 95% CI 1.19 to 3.38) compared to children without preventive medication use (adjusted OR=6.25; 95% CI 3.39 to 11.54). Conclusions Prompting increases the likelihood of corrective actions during clinic encounters; however, children already using preventive medication benefit less. It is critical for providers to recognize the need for corrective actions among these symptomatic children.

      PubDate: 2017-09-13T02:09:56Z
      DOI: 10.1016/j.acap.2017.08.015
       
  • Association of Picky Eating with Weight Status and Dietary Quality among
           Low-Income Preschoolers
    • Authors: Callie L. Brown; Eliana M. Perrin; Karen E. Peterson; Holly E. Brophy Herb; Mildred A. Horodynski; Dawn Contreras; Alison L. Miller; Danielle P. Appugliese; Sarah C. Ball; Julie C. Lumeng
      Abstract: Publication date: Available online 5 September 2017
      Source:Academic Pediatrics
      Author(s): Callie L. Brown, Eliana M. Perrin, Karen E. Peterson, Holly E. Brophy Herb, Mildred A. Horodynski, Dawn Contreras, Alison L. Miller, Danielle P. Appugliese, Sarah C. Ball, Julie C. Lumeng
      Background Picky eating is common in children. Few studies have examined predictors of picky eating, and the association of picky eating with weight status and dietary quality is inconsistent in prior literature. We aimed to identify predictors of picky eating and to test the association of picky eating with child body mass index z-score (BMIz), dietary quality, and micronutrient intake. Methods This was a cross-sectional analysis of baseline data from a randomized controlled trial to prevent obesity among 506 preschoolers attending Head Start. Parents completed questionnaires to assess picky eating and child temperament. Three 24-hour dietary recalls were collected to assess dietary intake. Multivariate regression models assessed child, parent, and family predictors of picky eating; additional models tested adjusted associations of picky eating with child BMIz, dietary quality (measured by the Healthy Eating Index [HEI]), and micronutrient intake. Results Picky eating was predicted by male sex, older child age, and more difficult temperament but not race/ethnicity, maternal BMI, maternal depressive symptoms, household food insecurity, or single parent home. Picky eating was not associated with child BMIz or micronutrient deficiencies; it was inversely associated with total HEI score and servings of whole fruit, total vegetables, greens and beans, and total protein foods. Conclusions Pediatric providers should support parents in expanding the number of healthy foods the child eats to improve dietary quality, but reassure parents that picky eating is not associated with children’s weight status or micronutrient deficiencies.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.08.014
       
 
 
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