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Pediatric Clinics of North America Apr 2020Child abuse affects more than 10% of children in the United States. For most children it is the result of family dysfunction. Child abuse affects children from all... (Review)
Review
Child abuse affects more than 10% of children in the United States. For most children it is the result of family dysfunction. Child abuse affects children from all socioeconomic classes. Pediatricians have an important role to play in prevention and early detection of abuse. There are sentinel injuries, now summarized as Clinical Prediction Rules that can guide the general pediatrician to take more definitive steps to suspect and report child abuse and neglect. Primary prevention should be part of the anticipatory guidance and support that pediatricians provide to all of their families.
Topics: Child; Child Abuse; Humans; Pediatricians; Physician's Role; Primary Health Care
PubMed: 32122563
DOI: 10.1016/j.pcl.2019.11.001 -
Pediatrics Dec 2018The American Board of Pediatrics (ABP) certifies that general and subspecialty pediatricians meet standards of excellence established by their peers. Certification helps... (Review)
Review
The American Board of Pediatrics (ABP) certifies that general and subspecialty pediatricians meet standards of excellence established by their peers. Certification helps demonstrate that a general pediatrician or pediatric subspecialist has successfully completed accredited training and fulfills continuous certification requirements (Maintenance of Certification [MOC]). One current component of the MOC program is a closed-book examination administered at a secure testing center (ie, the MOC Part 3 examination). In this article, we describe the development of an alternative to this examination termed the "Maintenance of Certification Assessment for Pediatrics" (MOCA-Peds) during 2015-2016. MOCA-Peds was conceptualized as an online, summative (ie, pass/fail), continuous assessment of a pediatrician's knowledge that would also promote learning. The system would consist of a set number of multiple-choice questions delivered each quarter, with immediate feedback on questions, rationales clarifying correct and incorrect answers, references for further learning, and peer benchmarking. Questions would be delivered quarterly and taken at any time within the quarter in a setting with Internet connectivity and on any device. As part of the development process in 2015-2016, the ABP actively recruited pediatricians to serve as members of a yearlong user panel or single-session focus groups. Refinements to MOCA-Peds were made on the basis of their feedback. MOCA-Peds is being actively piloted with pediatricians in 2017-2018. The ABP anticipates an expected launch in January 2019 of MOCA-Peds for General Pediatrics, Pediatric Gastroenterology, Child Abuse, and Pediatric Infectious Diseases with launch dates for the remaining pediatric subspecialties between 2020 and 2022.
Topics: Certification; Child; Clinical Competence; Education, Medical, Graduate; Educational Measurement; Humans; Internship and Residency; Pediatricians; Program Evaluation; Specialty Boards; United States
PubMed: 30510031
DOI: 10.1542/peds.2018-1428 -
Pediatrics Aug 2018Pediatric practitioners whose expertise is primarily focused on the care of children within health settings in the United States are increasingly engaged in global child... (Review)
Review
Pediatric practitioners whose expertise is primarily focused on the care of children within health settings in the United States are increasingly engaged in global child health (GCH). The wide spectrum of this involvement may include incorporating short-term or longer-term GCH commitments in clinical care, teaching and training, mentoring, collaborative research, health policy, and advocacy into a pediatric career. We provide an overview of routes of engagement, identify resources, and describe important considerations for and challenges to better equipping US pediatric practitioners to participate in meaningful GCH experiences. This article is part of a series on GCH describing critical issues relevant to caring for children from an international perspective.
Topics: Child; Global Health; Humans; Pediatricians; Physician-Patient Relations
PubMed: 30054345
DOI: 10.1542/peds.2017-2964 -
JAMA Mar 2019
Topics: Humans; Interpersonal Relations; Male; Pediatricians; Psychiatry; Psychotherapy; Stress, Psychological
PubMed: 30912841
DOI: 10.1001/jama.2019.2137 -
Pediatrics Oct 2019The US physician workforce includes an increasing number of women, with pediatrics having the highest percentage. In recent research on physicians, it is indicated that...
BACKGROUND
The US physician workforce includes an increasing number of women, with pediatrics having the highest percentage. In recent research on physicians, it is indicated that men earn more than women. It is unclear how this finding extends to pediatricians.
METHODS
We examined cross-sectional 2016 data on earnings from the American Academy of Pediatrics Pediatrician Life and Career Experience Study, a longitudinal study of early- and midcareer pediatricians. To estimate adjusted differences in pediatrician earnings between men and women, we conducted 4 ordinary least squares regression models. Model 1 examined gender, unadjusted; model 2 controlled for labor force characteristics; model 3 controlled for both labor force and physician-specific job characteristics; and model 4 controlled for labor force, physician-specific job, and work-family characteristics.
RESULTS
Sixty-seven percent of Pediatrician Life and Career Experience Study participants completed the 2016 surveys (1213 out of 1801). The analytic sample was restricted to participants who completed training and worked in general pediatrics, hospitalist care, or subspecialty care ( = 998). Overall pediatrician-reported mean annual income was $189 804. Before any adjustment, women earned ∼76% of what men earned, or ∼$51 000 less. Adjusting for common labor force characteristics such as demographics, work hours, and specialty, women earned ∼87% of what men earned, or ∼$26 000 less. Adjusting for a comprehensive set of labor force, physician-specific job, and work-family characteristics, women earned ∼94% of what men earned, or ∼$8000 less.
CONCLUSIONS
Early- to midcareer female pediatricians earned less than male pediatricians. This difference persisted after adjustment for important labor force, physician-specific job, and work-family characteristics. In future work, researchers should use longitudinal analyses and further explore family obligations and choices.
Topics: Career Mobility; Cross-Sectional Studies; Family; Female; Humans; Income; Least-Squares Analysis; Longitudinal Studies; Male; Pediatricians; Physicians, Women; Sex Factors; United States; Work; Work-Life Balance
PubMed: 31506302
DOI: 10.1542/peds.2018-3955 -
The Journal of Pediatrics May 2016
Topics: Biomedical Research; Child; Hospitals, Pediatric; Humans; Pediatricians; Program Development; Texas
PubMed: 27112081
DOI: 10.1016/j.jpeds.2016.02.002 -
The Journal of Pediatrics Nov 2018
Topics: Adolescent; Child; Child, Preschool; Delivery of Health Care; Europe; Female; Health Care Surveys; Health Planning; Health Services Needs and Demand; Humans; Infant; Infant, Newborn; Male; Outcome Assessment, Health Care; Pediatricians; Primary Health Care; Workforce
PubMed: 30360877
DOI: 10.1016/j.jpeds.2018.07.074 -
Pediatric Research Sep 2023
Topics: Humans; Surveys and Questionnaires; Pediatricians
PubMed: 37016002
DOI: 10.1038/s41390-023-02571-9 -
Journal of Nutrition Education and... Jan 2020Assess pediatrician practices around growth and nutrition for children under 2 years.
OBJECTIVE
Assess pediatrician practices around growth and nutrition for children under 2 years.
DESIGN
2017 cross-sectional survey of a national random sample of the American Academy of Pediatrics members.
SETTING
US.
PARTICIPANTS
Practicing primary care pediatricians and residents (n = 698).
MAIN OUTCOME MEASURES
World Health Organization growth chart use, solid food introduction recommendations, healthy behaviors discussion.
ANALYSIS
Descriptive statistics were calculated for nutrition-related questions. McNemar tests compared recommendations on the introduction of different solid foods at <6 months; chi-square tests of independence examined outcomes by pediatrician and practice characteristics.
RESULTS
Most respondents (82.2%) reported using the World Health Organization growth charts at all well visits. Nearly half (45.3%) recommended solid food introduction at 6 months; 48.2% recommended <6 months. Cereals were more frequently recommended at <6 months than fruits/vegetables or meats (P <.001). Topics most frequently discussed were limiting juice (92.3%), and sugar-sweetened beverages (92.0%), avoiding restrictive and permissive food practices (30.7%), and avoiding food as a reward (29.1%) were least discussed. Pediatricians in hospital/clinic settings discussed healthy behaviors less than group or solo/2-physician practices.
CONCLUSIONS AND IMPLICATIONS
For children under 2 years, most pediatricians reported using recommended growth charts and discussing healthy behaviors. Fewer discussed responsive feeding topics. Results for guiding solid food introduction were mixed. Continued efforts to support pediatricians' work could improve the implementation of recommended practices.
Topics: Adult; Cross-Sectional Studies; Female; Growth Charts; Health Promotion; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Male; Middle Aged; Pediatricians; Physician-Patient Relations; Practice Patterns, Physicians'
PubMed: 31759892
DOI: 10.1016/j.jneb.2019.10.006 -
Archives of Disease in Childhood Mar 2023Care of young children with neurodevelopmental disorders (NDD) is a major component of paediatric outpatient practice. However, cross-country practice reviews to date... (Review)
Review
BACKGROUND
Care of young children with neurodevelopmental disorders (NDD) is a major component of paediatric outpatient practice. However, cross-country practice reviews to date have been limited, and available data demonstrate missed opportunities for early identification, particularly in vulnerable population subgroups.
METHODS
Multicountry review of national paediatric body guidance related to developmental surveillance, early identification and early childhood intervention together with review of outpatient paediatrician practices for developmental assessment of children aged 0-5 years with/at risk of NDDs. Review included five countries with comparable nationalised universal child healthcare systems (ie, Australia, Canada, New Zealand, Sweden and the UK). Data were collected using a combination of published and grey literature review, supplemented by additional local sources with descriptive review of relevant data points.
RESULTS
Countries had broadly similar systems for early identification of young children with NDDs alongside universal child health surveillance. However, variation existed in national paediatric guidance, paediatric developmental training and practice, including variable roles of paediatricians in developmental surveillance at primary care level. Data on coverage of developmental surveillance, content and quality of paediatric development assessment practices were notably lacking.
CONCLUSION
Paediatricians play an important role in ensuring equitable access to early identification and intervention for young children with/at risk of NDDs. However, strengthening paediatric outpatient care of children with NDD requires clearer guidance across contexts; training that is responsive to shifting roles within interdisciplinary models of developmental assessment and improved data to enhance equity and quality of developmental assessment for children with/at risk of NDDs.
Topics: Child; Humans; Child, Preschool; Outpatients; Neurodevelopmental Disorders; Australia; Pediatricians; Risk Assessment
PubMed: 35764409
DOI: 10.1136/archdischild-2021-322799