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The Turkish Journal of Pediatrics 2022Pediatricians are regularly involved in the initial examination of children presenting with strabismus, a common ocular condition occurring in 3% of children. The... (Review)
Review
BACKGROUND
Pediatricians are regularly involved in the initial examination of children presenting with strabismus, a common ocular condition occurring in 3% of children. The objective of this review was to gain insight into pediatric residents, fellows and attendings` understanding of strabismus, and to propose an etiology-based strabismus classification scheme to aid this understanding.
METHODS
A survey was conducted in a single Department of Pediatrics in a university academic institution in order to assess the degree of understanding of the classification, etiology and nomenclature of strabismus. A targeted literature review, pertinent to our classification scheme for strabismus in the pediatric age group, is provided to clarify the various underlying etiological conditions for pediatricians.
RESULTS
The surveyed cohort (n=26) consisted of 10 (38.5%) attendings and 16 (61.5%) pediatricians-in-training. Although 69% of survey participants felt comfortable performing an ocular motility evaluation, only 19% had a clear understanding of the underlying etiology of strabismus, 8% had a clear understanding of strabismus nomenclature and none of the participants had clear knowledge of a classification scheme of strabismus. We propose an etiologic-based strabismus classification scheme with streamlined nomenclature geared towards Pediatricians to facilitate the management of pediatric patients with various ocular misalignments. Eight major categories of this classification scheme include (1) physiologic, (2) comitant, (3) paralytic, (4) sensory, (5) syndromic, (6) orbital, (7) supranuclear and (8) pseudostrabismus.
CONCLUSIONS
Pediatricians at all levels of professional experience have a limited command of strabismus. An etiology-based classification scheme of strabismus may assist in understanding the underlying causes and facilitate the management of strabismus in the pediatrician`s office.
Topics: Child; Cohort Studies; Humans; Pediatricians; Strabismus; Surveys and Questionnaires
PubMed: 35611422
DOI: 10.24953/turkjped.2020.2372 -
The Journal of Pediatrics Jul 2022
Topics: Hospitals; Humans; Pediatricians; Workload
PubMed: 34843709
DOI: 10.1016/j.jpeds.2021.11.063 -
JAMA Pediatrics May 2017
Topics: Attitude to Death; Child; Emotions; Humans; Intensive Care Units, Pediatric; Pediatricians; Physician-Patient Relations
PubMed: 28288258
DOI: 10.1001/jamapediatrics.2016.4836 -
Pediatric Clinics of North America Jun 2023Owing to the lack of trained professionals in amputee care, the pediatrician is often required to assist in the care of children with limb deficiencies. An overview of... (Review)
Review
Owing to the lack of trained professionals in amputee care, the pediatrician is often required to assist in the care of children with limb deficiencies. An overview of the causes and epidemiology of limb deficiency is provided, as well as an evaluation and diagnostic workup. Important considerations for surgical interventions are discussed and an introduction to prosthetic prescribing and care of the amputee is described. Common overuse syndromes and mental health issues are also reviewed. Finally, resources for funding of prosthetic devices, as well as support and education for clinicians and families are provided.
Topics: Child; Humans; Amputation, Surgical; Artificial Limbs; Cumulative Trauma Disorders; Pediatricians
PubMed: 37121641
DOI: 10.1016/j.pcl.2023.01.011 -
The Journal of Maternal-fetal &... Sep 2017Cesarean sections (CS) have greatly increased and many reasons are often evoked. Safer anesthetics and surgical procedures have rendered CS a popular choice for both... (Review)
Review
Cesarean sections (CS) have greatly increased and many reasons are often evoked. Safer anesthetics and surgical procedures have rendered CS a popular choice for both professionals and mothers alike. CS on maternal request, for nonmedical reasons, is the subject of scientific, legal and ethical dispute. We shall address the CS issues, primarily, from the pediatrician's point of view. The immediate neonatal problems of the more mature neonate are well recognized. For preterm birth, contradictory results on mid- and long-term outcomes do not confirm the earlier reports on neonatal advantages of CS over vaginal delivery; therefore, their mode of delivery should be based on individual circumstances. The intestinal flora of neonates delivered by CS is often deprived of the normal colonization by maternal vulvovaginal and rectal flora. Whether this adverse microbiome will play a role in the late development of multiple morbidities in children and adults is an interesting possibility open to consideration. The consequences of unnecessary CS demands a reflection for all the involved parties and the decision to perform a CS shall, then, be based on the net clinical benefit to all: the mother, the child and the future adult.
Topics: Attitude of Health Personnel; Cesarean Section; Elective Surgical Procedures; Female; Humans; Infant, Newborn; Mothers; Pediatricians; Pregnancy; Unnecessary Procedures
PubMed: 27659100
DOI: 10.1080/14767058.2016.1237496 -
The Journal of Pediatrics Oct 2021
Topics: Cultural Diversity; Health Workforce; Humans; Internship and Residency; Medically Underserved Area; Pediatricians; Pediatrics; United States
PubMed: 33561468
DOI: 10.1016/j.jpeds.2021.02.004 -
Paediatric Respiratory Reviews Mar 2022The legal profession depends on expert witnesses, and indeed the first time an English Court relied on an expert medical witness was in the 14th century. Asking a... (Review)
Review
The legal profession depends on expert witnesses, and indeed the first time an English Court relied on an expert medical witness was in the 14th century. Asking a specialist to comment on the standard of professional practice expected in their own specialty was first introduced in a 1767 case [1]. This article draws on 20 years of experience in medicolegal work relating to paediatric respiratory medicine. It highlights some of the legal principles that lie behind an expert opinion and what constitutes clinical negligence. It aims to set out lessons for medicolegal experts and clinicians, but also offers some advice to lawyers and parents. Finally, it illustrates some issues that arise more commonly in paediatric respiratory practice.
Topics: Child; Expert Testimony; Humans; Malpractice; Pediatricians
PubMed: 29108867
DOI: 10.1016/j.prrv.2017.09.001 -
Anales de Pediatria Oct 2019
Topics: Humans; Infant; Infant Death; Infant Mortality; Pediatricians
PubMed: 31477434
DOI: 10.1016/j.anpedi.2019.08.001 -
Pediatric Annals Jun 2023
Topics: Humans; Mental Health; Primary Health Care; Pediatricians
PubMed: 37280001
DOI: 10.3928/19382359-20230508-01 -
Pediatrics Jun 2023From 2019 to 2022, the For Our Children project gathered a team of Chinese and American pediatricians to explore the readiness of the pediatric workforce in each country...
From 2019 to 2022, the For Our Children project gathered a team of Chinese and American pediatricians to explore the readiness of the pediatric workforce in each country to address pressing child health concerns. The teams compared existing data on child health outcomes, the pediatric workforce, and education and combined qualitative and quantitative comparisons centered on themes of effective health care delivery outlined in the World Health Organization Workforce 2030 Report. This article describes key findings about pediatric workload, career satisfaction, and systems to assure competency. We discuss pediatrician accessibility, including geographic distribution, practice locations, trends in pediatric hospitalizations, and payment mechanisms. Pediatric roles differed in the context of each country's child health systems and varied teams. We identified strengths we could learn from one another, such as the US Medical Home Model with continuity of care and robust numbers of skilled clinicians working alongside pediatricians, as well as China's Maternal Child Health system with broad community accessibility and health workers who provide preventive care.In both countries, notable inequities in child health outcomes, evolving epidemiology, and increasing complexity of care require new approaches to the pediatric workforce and education. Although child health systems in the United States and China have significant differences, in both countries, a way forward is to develop a more inclusive and broad view of the child health team to provide truly integrated care that reaches every child. Training competencies must evolve with changing epidemiology as well as changing health system structures and pediatrician roles.
Topics: Humans; Child; United States; Workforce; Delivery of Health Care; Health Workforce; Pediatricians; Patient-Centered Care
PubMed: 37158018
DOI: 10.1542/peds.2022-059143