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Publisher: Elsevier   (Total: 3044 journals)

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Showing 1 - 200 of 3044 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 22, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 21, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 84, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 23, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 29, 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: 343, 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: 215, 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: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 23, 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: 3)
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: 5)
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: 134, 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: 25, 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: 10, 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 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: 26, 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: 10, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, 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: 5)
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: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, 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: 40, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 48, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 15)
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: 11)
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: 21, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
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: 35, 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 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: 15, 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: 7, 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 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: 7, 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: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 61)
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 Research     Full-text available via subscription   (Followers: 348, 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: 43, 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: 318, 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: 408, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 39, 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: 54, 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: 9, 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  
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: 8, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 47, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 45, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 39, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 16, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 24, 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: 193, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 56, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 4)
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: 24, 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: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, 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: 55, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 9)
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: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 166, 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: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, 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: 157, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 1, SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

        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]   [22 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1876-2859
   Published by Elsevier Homepage  [3044 journals]
  • 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
       
  • Aligning Community Capacity, Networks, and Solutions to Address Adverse
           Childhood Experiences and Increase Resilience
    • Authors: Margaret B. Hargreaves; Peter J. Pecora; Greg Williamson
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Margaret B. Hargreaves, Peter J. Pecora, Greg Williamson


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.04.004
       
  • The Community and Public Well-being Model: A New Framework and Graduate
           Curriculum for Addressing Adverse Childhood Experiences
    • Authors: David E. Ford
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): David E. Ford


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.04.011
       
  • Reclaiming the Patient Encounter
    • Authors: Sandra G. Hassink
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Sandra G. Hassink


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.08.008
       
  • Prevent, Screen, Heal: Collective Action to Fight the Toxic Effects of
           Early Life Adversity
    • Authors: Nadine Burke Harris; Sara Silvério Marques; Debora Oh; Monica Bucci; Mark Cloutier
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Nadine Burke Harris, Sara Silvério Marques, Debora Oh, Monica Bucci, Mark Cloutier


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.11.015
       
  • ACEs Implications for Nurses, Nursing Education, and Nursing Practice
    • Authors: Shirley Girouard; Nellie Bailey
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Shirley Girouard, Nellie Bailey


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.09.008
       
  • Lessons From ACEs: Pay Now or Pay (More) Later
    • Authors: Katherine E. Grimes
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Katherine E. Grimes


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.12.013
       
  • Culture Matters: Direct Service Programs Cannot Solve Widespread, Complex,
           Intergenerational Social Problems. Culture Change Can
    • Authors: Laura Porter; Kim Martin; Robert Anda
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Laura Porter, Kim Martin, Robert Anda


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.11.006
       
  • Translating Brain Science Research into Community-Level Change
    • Authors: Jennifer Jones; M. Clare Reidy; Margaret Hargreaves; Debra Rog
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Jennifer Jones, M. Clare Reidy, Margaret Hargreaves, Debra Rog


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.09.007
       
  • How Social Journalism Accelerates the ACEs Movement
    • Authors: Jane Stevens
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Jane Stevens


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.12.015
       
  • Mitigating Adverse Childhood Experiences Through Investments in Early
           Childhood Programs
    • Authors: Katherine A. Beckmann
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Katherine A. Beckmann


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.09.004
       
  • ACEs and State Maternal Child Health Programs
    • Authors: Bradley Planey
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Bradley Planey


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.11.003
       
  • ACEs in the Criminal Justice System
    • Authors: James Garbarino
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): James Garbarino


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.09.003
       
  • ACEs and Child Health Policy: The Enduring Case for EPSDT
    • Authors: Sara Rosenbaum
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Sara Rosenbaum


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.03.010
       
  • Methods to Assess Adverse Childhood Experiences of Children and Families:
           Toward Approaches to Promote Child Well-being in Policy and Practice
    • Authors: Christina D. Bethell; Adam Carle; James Hudziak; Narangerel Gombojav; Kathleen Powers; Roy Wade; Paula Braveman
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Christina D. Bethell, Adam Carle, James Hudziak, Narangerel Gombojav, Kathleen Powers, Roy Wade, Paula Braveman
      Background Advances in human development sciences point to tremendous possibilities to promote healthy child development and well-being across life by proactively supporting safe, stable and nurturing family relationships (SSNRs), teaching resilience, and intervening early to promote healing the trauma and stress associated with disruptions in SSNRs. Assessing potential disruptions in SSNRs, such as adverse childhood experiences (ACEs), can contribute to assessing risk for trauma and chronic and toxic stress. Asking about ACEs can help with efforts to prevent and attenuate negative impacts on child development and both child and family well-being. Many methods to assess ACEs exist but have not been compared. The National Survey of Children's Health (NSCH) now measures ACEs for children, but requires further assessment and validation. Methods We identified and compared methods to assess ACEs among children and families, evaluated the acceptability and validity of the new NSCH-ACEs measure, and identified implications for assessing ACEs in research and practice. Results Of 14 ACEs assessment methods identified, 5 have been used in clinical settings (vs public health assessment or research) and all but 1 require self or parent report (3 allow child report). Across methods, 6 to 20 constructs are assessed, 4 of which are common to all: parental incarceration, domestic violence, household mental illness/suicide, household alcohol or substance abuse. Common additional content includes assessing exposure to neighborhood violence, bullying, discrimination, or parental death. All methods use a numeric, cumulative risk scoring methodology. The NSCH-ACEs measure was acceptable to respondents as evidenced by few missing values and no reduction in response rate attributable to asking about children's ACEs. The 9 ACEs assessed in the NSCH co-occur, with most children with 1 ACE having additional ACEs. This measure showed efficiency and confirmatory factor analysis as well as latent class analysis supported a cumulative risk scoring method. Formative as well as reflective measurement models further support cumulative risk scoring and provide evidence of predictive validity of the NSCH-ACEs. Common effects of ACEs across household income groups confirm information distinct from economic status is provided and suggest use of population-wide versus high-risk approaches to assessing ACEs. Conclusions Although important variations exist, available ACEs measurement methods are similar and show consistent associations with poorer health outcomes in absence of protective factors and resilience. All methods reviewed appear to coincide with broader goals to facilitate health education, promote health and, where needed, to mitigate the trauma, chronic stress, and behavioral and emotional sequelae that can arise with exposure to ACEs. Assessing ACEs appears acceptable to individuals and families when conducted in population-based and clinical research contexts. Although research to date and neurobiological findings compel early identification and health education about ACEs in clinical settings, further research to guide use in pediatric practice is required, especially as it relates to distinguishing ACEs assessment from identifying current family psychosocial risks and child abuse. The reflective as well as formative psychometric analyses conducted in this study confirm use of cumulative risk scoring for the NSCH-ACEs measure. Even if children have not been exposed to ACEs, assessing ACEs has value as an educational tool for engaging and educating families and children about the importance of SSNRs and how to recognize and manage stress and learn resilience.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.04.161
       
  • Income Inequality and the Differential Effect of Adverse Childhood
           Experiences in US Children
    • Authors: Neal Halfon; Kandyce Larson; John Son; Michael Lu; Christina Bethell
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Neal Halfon, Kandyce Larson, John Son, Michael Lu, Christina Bethell
      Objective Adverse childhood experiences (ACEs) can affect health and development across the life course. Despite a general understanding that adversity is associated with lower income, we know less about how ACEs manifest at different income levels and how these income-related patterns affect children's health and development. Methods Data from the 2011 to 2012 National Survey of Children's Health were used to examine the prevalence of 9 ACEs in US children, across 4 levels of household income, and in relationship to 5 parent-reported measures of child health. Bivariate analyses and multivariable logistic regression models were used to examine the associations between number of ACEs and children's health outcomes on the basis of the 4 income groups. Results When partitioned according to income strata, the proportion of children who experienced ACEs showed a steep income gradient, particularly for children who experienced ≥4 ACEs. The linear gradient across income groups was less pronounced for each specific ACE, with several ACEs (experience of divorce, drug and alcohol exposure, parental mental illness) showing high reported prevalence in all but the highest income group. Multivariate analysis showed a consistent income-related gradient for each of the health outcomes. However, higher income was not necessarily found to be a protective factor against ACEs. Conclusions ACEs are distributed across the income ladder and not just concentrated below the poverty level. This suggests that a more comprehensive policy strategy that includes targeted as well as universal interventions is warranted.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.11.007
       
  • Responding to ACEs With HOPE: Health Outcomes From Positive Experiences
    • Authors: Robert D. Sege; Charlyn Harper Browne
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Robert D. Sege, Charlyn Harper Browne
      This article introduces a framework called “HOPE: Health Outcomes From Positive Experiences.” The HOPE framework focuses on the need to actively promote positive childhood experiences that contribute to healthy development and well-being, as well as prevent or mitigate the effect of adverse childhood experiences and other negative environmental influences. Key positive childhood experiences fall within 4 broad categories: being in nurturing, supportive relationships; living, developing, playing, and learning in safe, stable, protective, and equitable environments; having opportunities for constructive social engagement and connectedness; and learning social and emotional competencies. The HOPE framework grows out of and complements prior holistic approaches to child health care.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.03.007
       
  • A New Framework for Addressing Adverse Childhood and Community
           Experiences: The Building Community Resilience Model
    • Authors: Wendy R. Ellis; William H. Dietz
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Wendy R. Ellis, William H. Dietz
      Objective We propose a transformative approach to foster collaboration across child health, public health, and community-based agencies to address the root causes of toxic stress and childhood adversity and to build community resilience. Methods Physicians, members of social service agencies, and experts in toxic stress and adverse childhood experiences (ACEs) were interviewed to inform development of the Building Community Resilience (BCR) model. Through a series of key informant interviews and focus groups, we sought to understand the role of BCR for child health systems and their partners to reduce toxic stress and build community resilience to improve child health outcomes. Results Key informants indicated the intentional approach to ACEs and toxic stress through continuous quality improvement (data-driven decisions and program development, partners testing and adapting to changes to their needs, and iterative development and testing) which provides a mechanism by which social determinants or a population health approach could be introduced to physicians and community partners as part of a larger effort to build community resilience. Structured interviews also reveal a need for a framework that provides guidance, structure, and support for child health systems and community partners to develop collective goals, shared work plans, and a means for data-sharing to reinforce the components that will contribute to community resilience. Conclusions Key informant interviews and focus group dialogues revealed a deep understanding of the factors related to toxic stress and ACEs. Respondents endorsed the BCR approach as a means to explore capacity issues, reduce fragmented health care delivery, and facilitate integrated systems across partners in efforts to build community resilience. Current financing models are seen as a potential barrier, because they often do not support restructured roles, partnership development, and the work to sustain upstream efforts to address toxic stress and community resilience.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2016.12.011
       
  • The Central Role of Relationships With Trauma-Informed Integrated Care for
           Children and Youth
    • Authors: Jonathan D. Brown; Melissa A. King; Lawrence S. Wissow
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Jonathan D. Brown, Melissa A. King, Lawrence S. Wissow
      Objective Primary care plays an essential role in the primary and secondary prevention of children's mental health problems. A growing series of trials have shown the capacity of primary care providers to deliver care that specifically addresses risks to healthy social and emotional development by incorporating mental health services into their routines and integrating their work with the mental health care system. In this article elements common to various integration schemes that seem essential to their success are described. Methods Narrative review, combining conclusions from 3 previous systematic reviews. Results Trusting, personal relationships between patients and providers, and among collaborating providers, are a critical element of successful trauma-informed integrated care. Patient-provider relationships are essential to disclosure of sensitive concerns, to engaging patients in care, and to designing care that is responsive to individual patient needs. Studies of patient-centered care and psychotherapy suggest ways that these relationships can be built and maintained. Provider-provider relationships are, in turn, essential to coordinating the work of the range of providers and services needed to address trauma prevention and treatment. These relationships can form within a variety of organizational structures but building them might require staff training, redesign of work flows, and support from organizational structures and goals. Conclusions A variety of interventions at the patient-provider, clinical site, system, and policy levels can foster relationships and provide the foundation for care capable of addressing promotion of social and emotional well-being in general and trauma prevention and treatment in particular.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.01.013
       
  • Best Practices in Relational Skills Training for Medical Trainees and
           Providers: An Essential Element of Addressing Adverse Childhood
           Experiences and Promoting Resilience
    • Authors: Eran Magen; Horace M. DeLisser
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Eran Magen, Horace M. DeLisser
      Medical providers' ability to form strong therapeutic alliances with patients is an essential clinical skill that is associated with a higher quality of care and improved provider well-being. However, comparatively few medical providers exhibit adequate relational skills, which serve to convey respect, communicate caring, and build trust between the medical provider and the patient. A growing number of medical training programs and continuing medical education programs have begun to incorporate relational skills training, but the results have been highly variable in terms of training methods and effect. To support administrators who are considering the implementation (or improvement) of relational skills training in their organization, we provide a set of best practices for relational skills training, in the basis of a review of the literature and on our experience as clinical educators, and show the application of these best practices through a case study. We conclude with a discussion of challenges for implementing a high-quality relational skills training program, policy-level solutions for these challenges, and recommendations for future research.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.03.006
       
  • 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
       
  • Housing Instability and Children's Health Insurance Gaps
    • Authors: Anne Carroll; Hope Corman; Marah A. Curtis; Kelly Noonan; Nancy E. Reichman
      Pages: 732 - 738
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Anne Carroll, Hope Corman, Marah A. Curtis, Kelly Noonan, Nancy E. Reichman
      Objective To assess the extent to which housing instability is associated with gaps in health insurance coverage of preschool-age children. Methods Secondary analysis of data from the Early Childhood Longitudinal Study—Birth Cohort, a nationally representative study of children born in the United States in 2001, was conducted to investigate associations between unstable housing—homelessness, multiple moves, or living with others and not paying rent—and children's subsequent health insurance gaps. Logistic regression was used to adjust for potentially confounding factors. Results Ten percent of children were unstably housed at age 2, and 11% had a gap in health insurance between ages 2 and 4. Unstably housed children were more likely to have gaps in insurance compared to stably housed children (16% vs 10%). Controlling for potentially confounding factors, the odds of a child insurance gap were significantly higher in unstably housed families than in stably housed families (adjusted odds ratio 1.27; 95% confidence interval 1.01–1.61). The association was similar in alternative model specifications. Conclusions In a US nationally representative birth cohort, children who were unstably housed at age 2 were at higher risk, compared to their stably housed counterparts, of experiencing health insurance gaps between ages 2 and 4 years. The findings from this study suggest that policy efforts to delink health insurance renewal processes from mailing addresses, and potentially routine screenings for housing instability as well as referrals to appropriate resources by pediatricians, would help unstably housed children maintain health insurance.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.02.007
       
  • Surveillance or Engagement: Children's Conflicts During Health Maintenance
           Visits
    • Authors: Sarah Polk; Russell Horwitz; Shaina Longway; Alfonso Bonilla; Kate Fothergill; Marc Karver; Peter Salmon; Lawrence Wissow
      Pages: 739 - 746
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Sarah Polk, Russell Horwitz, Shaina Longway, Alfonso Bonilla, Kate Fothergill, Marc Karver, Peter Salmon, Lawrence Wissow
      Objective School-aged health maintenance visits seek to prevent or intervene early with health issues of lifelong importance. Little is known about what children expect to happen in these visits or how they experience them, factors related to their engagement as active collaborators in care. Methods Thirty children (53% Latino, 27% African-American, and 20% white) ages 7 to 11 years were video recorded during a health maintenance visit and then interviewed while reviewing the videos. Interview transcripts were analyzed for understanding the purpose of the visit, feelings of comfort and discomfort, and decisions about how much to participate. Results Children expected doctors to be helpful, caring, and a source of important information. They anticipated visits to include immunizations, a physical examination, and praise for accomplishments, but could be surprised by questions about behavior, family function, and lifestyle. During visits, feelings varied from warmth toward providers to embarrassment, wariness, irritation, and boredom. Even when bored or irritated, children hesitated to interrupt parent-provider conversations or correct perceived provider misunderstandings, not wanting to be seen as inappropriate or rude. When asked questions they considered off topic, likely to reveal sensitive information, or that could lead to changes in their lifestyle, some were silent or answered evasively. Some said they would have spoken more freely without their parent present but valued parental support and wanted parents to make important decisions. Conclusions School-aged children's limited knowledge of what to expect in health maintenance visits, uncertainty about conversational norms with adults, and desire to assert control over their lives compete with their desire to access expert advice and form bonds with providers. Engaging children in health maintenance visits might require more relationship-building and education about the visit's goals.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.02.005
       
  • Well-Child Care Redesign: A Mixed Methods Analysis of Parent Experiences
           in the PARENT Trial
    • Authors: Naomi A. Mimila; Paul J. Chung; Marc N. Elliott; Christina D. Bethell; Sandra Chacon; Christopher Biely; Sandra Contreras; Toni Chavis; Yovana Bruno; Tanesha Moss; Tumaini R. Coker
      Pages: 747 - 754
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Naomi A. Mimila, Paul J. Chung, Marc N. Elliott, Christina D. Bethell, Sandra Chacon, Christopher Biely, Sandra Contreras, Toni Chavis, Yovana Bruno, Tanesha Moss, Tumaini R. Coker
      Background Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT), is a well-child care (WCC) model that has demonstrated effectiveness in improving the receipt of comprehensive WCC services and reducing emergency department utilization for children aged 0 to 3 in low-income communities. PARENT relies on a health educator (“parent coach”) to provide WCC services; it utilizes a Web-based previsit prioritization/screening tool (Well-Visit Planner) and an automated text message reminder/education service. We sought to assess intervention feasibility and acceptability among PARENT trial intervention participants. Methods Intervention parents completed a survey after a 12-month study period; a 26% random sample of them were invited to participate in a qualitative interview. Interviews were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis; survey responses were analyzed using bivariate methods. Results A total of 115 intervention participants completed the 12-month survey; 30 completed a qualitative interview. Nearly all intervention participants reported meeting with the coach, found her helpful, and would recommend continuing coach-led well visits (97–99%). Parents built trusting relationships with the coach and viewed her as a distinct and important part of their WCC team. They reported that PARENT well visits more efficiently used in-clinic time and were comprehensive and family centered. Most used the Well-Visit Planner (87%), and found it easy to use (94%); a minority completed it at home before the visit (18%). Sixty-two percent reported using the text message service; most reported it as a helpful source of new information and a reinforcement of information discussed during visits. Conclusions A parent coach–led intervention for WCC for young children is a model of WCC delivery that is both acceptable and feasible to parents in a low-income urban population.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.02.004
       
  • Financing of Vaccine Delivery in Primary Care Practices
    • Authors: Mandy A. Allison; Sean T. O'Leary; Megan C. Lindley; Lori A. Crane; Laura P. Hurley; Brenda L. Beaty; Michaela Brtnikova; Andrea Jimenez-Zambrano; Christine Babbel; Stephen Berman; Allison Kempe
      Pages: 770 - 777
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Mandy A. Allison, Sean T. O'Leary, Megan C. Lindley, Lori A. Crane, Laura P. Hurley, Brenda L. Beaty, Michaela Brtnikova, Andrea Jimenez-Zambrano, Christine Babbel, Stephen Berman, Allison Kempe
      Objective Vaccines represent a significant portion of primary care practice expenses. Our objectives were to determine among pediatric (Ped) and family medicine (FM) practices: 1) relative payment for vaccine purchase and administration and estimated profit margin according to payer type, 2) strategies used to reduce vaccine purchase costs and increase payment, and 3) whether practices have stopped providing vaccines because of finances. Methods A national survey conducted from April through September 2011 among Ped and FM practitioners in private, single-specialty practices. Results The response rate was 51% (221 of 430). Depending on payer type, 61% to 79% of practices reported that payment for vaccine purchase was at least 100% of purchase price and 34% to 74% reported that payment for vaccine administration was at least $11. Reported strategies to reduce vaccine purchase cost were online purchasing (81% Ped, 36% FM), prompt pay (78% Ped, 49% FM), and bulk order (65% Ped, 49% FM) discounts. Fewer than half of practices used strategies to increase payment; in a multivariable analysis, practices with ≥5 providers were more likely to use strategies compared with practices with fewer providers (adjusted odds ratio, 2.65; 95% confidence interval, 1.51–4.62). When asked if they had stopped purchasing vaccines because of financial concerns, 12% of Ped practices and 23% of FM practices responded ‘yes,’ and 24% of Ped and 26% of FM practices responded ‘no, but have seriously considered.’ Conclusions Practices report variable payment for vaccination services from different payer types. Practices might benefit from increased use of strategies to reduce vaccine purchase costs and increase payment for vaccine delivery.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.06.001
       
  • Noninitiation and Noncompletion of HPV Vaccine Among English- and
           Spanish-Speaking Parents of Adolescent Girls: A Qualitative Study
    • Authors: Karen Albright; Juliana Barnard; Sean T. O'Leary; Steven Lockhart; Andrea Jimenez-Zambrano; Shannon Stokley; Amanda Dempsey; Allison Kempe
      Pages: 778 - 784
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Karen Albright, Juliana Barnard, Sean T. O'Leary, Steven Lockhart, Andrea Jimenez-Zambrano, Shannon Stokley, Amanda Dempsey, Allison Kempe
      Objective The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) vaccination for female adolescents aged 11 to 12 years, yet vaccination rates remain low. We conducted a qualitative study to understand English- and Spanish-speaking parents' reasons for noninitiation or noncompletion of the HPV vaccine series for their daughters. Methods Parents of female adolescents aged 12 to 15 years who had not initiated or not completed the HPV vaccine series were identified through administrative data in 2 large urban safety net health care systems in Colorado. Focus groups and in-depth interviews were conducted with English-speaking parents and in-depth interviews were conducted with Spanish-speaking parents. All data were recorded, transcribed, and analyzed for thematic content by experienced analysts using established qualitative content analysis techniques. Results Forty-one parents participated in the study. Thirty parents participated in individual interviews and 11 parents participated in 1 of 2 focus groups. The most common reasons for noninitiation and noncompletion among English-speaking parents included a low perceived risk of HPV infection, vaccine safety concerns, and distrust of government and/or medicine. In contrast, Spanish-speaking parents most often reported that providers had either not encouraged initiation of the HPV vaccine series or had not explained the necessity of completing the series. Some noninitiating parents, particularly Spanish-speaking ones, also cited concerns that vaccination would encourage sexual activity. Conclusions The reasons for noninitiation and noncompletion of the HPV vaccine series differed substantially between English- and Spanish-speaking parents. To maximize uptake of HPV vaccine, varying approaches might be needed to effectively target specific populations.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.03.013
       
  • Complementary and Alternative Medicine Use by Children With Pain in the
           United States
    • Authors: Cornelius B. Groenewald; Sarah E. Beals-Erickson; Jaime Ralston-Wilson; Jennifer A. Rabbitts; Tonya M. Palermo
      Pages: 785 - 793
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Cornelius B. Groenewald, Sarah E. Beals-Erickson, Jaime Ralston-Wilson, Jennifer A. Rabbitts, Tonya M. Palermo
      Objective Chronic pain is reported by 15% to 25% of children. Growing evidence from clinical samples suggests that complementary and alternative medicine (CAM) therapies are desired by families and may benefit some children with pain conditions. The objective of this study was to provide estimates of CAM use by children with pain in the United States. Methods We analyzed data from the 2012 National Health Interview Survey (NHIS) to estimate patterns, predictors, and perceived benefits of CAM use among children 4 to 17 years of age with and without painful conditions in the United States. We used chi-square tests to compare the prevalence rates of CAM use among children with pain to CAM use among children without pain. Multivariable logistic regression was used to examine factors associated with CAM use within the group of children with pain conditions. Results Parents reported that 26.6% of children had pain conditions (eg, headache, abdominal, musculoskeletal pain) in the past year; of these children, 21.3% used CAM. In contrast, only 8.1% of children without pain conditions used CAM (χ2, P < .001). CAM use among children with pain was associated with female sex (adjusted odds ratio [aOR] = 1.49, P = .005), higher income (aOR = 1.61, P = .027), and presence of 4+ comorbidities (aOR = 2.01, P = .013). Among children with pain who used CAM, the 2 most commonly used CAM modalities were biology-based therapies (47.3%) (eg, special diets and herbal supplements) and manipulative or body-based therapies (46.3%) (eg, chiropractic and massage). Conclusions CAM is frequently used by children with pain in the United States, and many parents report benefits for their child's symptoms.

      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.02.008
       
  • Development and Pilot Implementation of a Trauma-Informed Care Curriculum
           for Pediatric Residents
    • Authors: Davida M. Schiff; Barry Zuckerman; Elizabeth Hutton; Carolyn Genatossio; Catherine Michelson; Megan Bair-Merritt
      Pages: 794 - 796
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7
      Author(s): Davida M. Schiff, Barry Zuckerman, Elizabeth Hutton, Carolyn Genatossio, Catherine Michelson, Megan Bair-Merritt


      PubDate: 2017-09-06T16:45:05Z
      DOI: 10.1016/j.acap.2017.03.011
       
  • 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
       
  • “Nothing About Us Without Us”
    • Authors: Melissa Clark; Vickers Nora Wells
      Abstract: Publication date: September–October 2017
      Source:Academic Pediatrics, Volume 17, Issue 7, Supplement
      Author(s): Melissa Clark Vickers, Nora Wells


      PubDate: 2017-09-06T16:45:05Z
       
 
 
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