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Pediatric Annals Jan 2024Primary care pediatricians, family practitioners, and primary care advanced practice clinicians frequently need to examine male adolescent genitalia as part of a... (Review)
Review
Primary care pediatricians, family practitioners, and primary care advanced practice clinicians frequently need to examine male adolescent genitalia as part of a comprehensive physical examination. Although this part of the examination may be uncomfortable for clinicians, taking a structured approach to the examination can mitigate clinicians' apprehension as well as enhance their ability to use this evaluation to identify potential pathology for the patient. Familiarity with the male genitourinary examination will also allow clinicians to definitively identify medical urgencies and emergencies for timely intervention. This review will provide the clinician with a structured approach to the male genitourinary examination while highlighting common pathology that may be encountered during the examination. .
Topics: Adolescent; Male; Humans; Scrotum; Penis; Genitalia; Pediatricians; Physical Examination
PubMed: 38194659
DOI: 10.3928/19382359-20231114-03 -
Pediatrics Sep 2023Optimizing pulmonary health across the lifespan begins from the earliest stages of childhood and requires a partnership between the family, pulmonologist, and...
Optimizing pulmonary health across the lifespan begins from the earliest stages of childhood and requires a partnership between the family, pulmonologist, and pediatrician to achieve equitable outcomes. The Community Pediatrics session of the Defining and Promoting Pediatric Pulmonary Health workshop weaved together 4 community-based pillars with 4 research principles to set an agenda for future pediatric pulmonary research in optimizing lung and sleep health for children and adolescents. To address diversity, equity, and inclusion, both research proposals and workforce must purposefully include a diverse set of participants that reflects the community served, in addition to embracing nontraditional, community-based sites of care and social determinants of health. To foster inclusive, exploratory, and innovative research, studies must be centered on community priorities, with findings applied to all members of the community, particularly those in historically marginalized and minoritized groups. Research teams should also foster meaningful partnerships with community primary care and family members from study conceptualization. To achieve these goals, implementation and dissemination science should be expanded in pediatric pulmonary research, along with the development of rapid mechanisms to disseminate best practices to community-based clinicians. To build cross-disciplinary collaboration and training, community-academic partnerships, family research partnerships, and integrated research networks are necessary. With research supported by community pillars built on authentic partnerships and guided by inclusive principles, pediatric lung and sleep health can be optimized for all children and adolescents across the full lifespan in the community in which they live and thrive.
Topics: Adolescent; Child; Humans; Family; Pediatricians; Concept Formation; Pediatrics; Lung
PubMed: 37656028
DOI: 10.1542/peds.2023-062292G -
Pediatric Clinics of North America Aug 2023Pediatricians and other pediatric health providers collaborate with families and communities, including schools, health departments, and other partners to advance... (Review)
Review
Pediatricians and other pediatric health providers collaborate with families and communities, including schools, health departments, and other partners to advance pediatric health challenges and health equity. This article will discuss best practices and guiding principles to support engagement and effective partnership with families and communities. Models for engaging families and communities while promoting health equity will also be discussed. Case studies and examples will be shared, as well as how they may be applied by pediatric health providers to promote child health.
Topics: Humans; Child; Health Equity; Child Health; Pediatricians
PubMed: 37422308
DOI: 10.1016/j.pcl.2023.04.001 -
BMC Pediatrics Nov 2023Children in need of pediatric subspecialty care may encounter multiple barriers, and multiple strategies have been suggested to improve access. The purpose of this study...
BACKGROUND
Children in need of pediatric subspecialty care may encounter multiple barriers, and multiple strategies have been suggested to improve access. The purpose of this study was to describe the perceptions of general and subspecialty pediatric physicians regarding barriers to subspecialty care and the value of strategies to improve subspecialty access.
METHODS
We surveyed a national sample of 1680 general pediatricians and pediatric subspecialists in May and June 2020 regarding 11 barriers to subspecialty care and 9 strategies to improve access to subspecialty care, selected from recent literature. Using latent profile analysis, respondents were grouped according to the degree to which they believed each of the barriers impacted access to subspecialty care. Using chi-squared tests, we compared the profiles based on respondent characteristics and perspectives on strategies to improve access.
RESULTS
The response rate was 17%. In 263 responses completed and eligible for inclusion, the barriers most frequently described as "major problems" were wait times (57%), lack of subspecialists (45%) and difficulty scheduling (41%). Respondents were classified into 4 profiles: "Broad concerns," "Subspecialist availability concerns," "Clinician communication concerns," and "Few concerns." These profiles varied significantly by respondent specialty (pā<ā.001, with medical subspecialists overrepresented in the "Clinician communication" profile, psychiatrists in the "subspecialist availability" profile, and surgeons in the "few concerns" profile); and by respondents' typical wait time for appointments (pā<ā.001, with physicians with the longest wait times overrepresented in the "subspecialist availability" profile).
CONCLUSIONS
We found specific profiles in clinician views regarding barriers to subspecialty care which were associated with perspectives on strategies aimed at overcoming these barriers. These results suggest that health systems aiming to improve subspecialty access should first identify the barriers and preferences specific to local clinicians.
Topics: Child; Humans; Appointments and Schedules; Pediatricians; Referral and Consultation; Specialization; Surgeons; Health Services Accessibility; Telemedicine
PubMed: 37980515
DOI: 10.1186/s12887-023-04400-8 -
Archives of Disease in Childhood Dec 2023
Topics: Humans; Evidence-Based Medicine; Pediatricians; Physicians
PubMed: 38097253
DOI: 10.1136/archdischild-2023-326698 -
Archives of Disease in Childhood Dec 2023
Topics: Humans; Pediatricians; Physicians; Evidence-Based Medicine
PubMed: 37977595
DOI: 10.1136/archdischild-2023-326532 -
Archives of Disease in Childhood Nov 2023
Topics: Humans; Pediatricians; Physicians; Evidence-Based Medicine
PubMed: 37903535
DOI: 10.1136/archdischild-2023-326382 -
Archives of Disease in Childhood Oct 2023
Topics: Humans; Evidence-Based Medicine; Pediatrics
PubMed: 37726153
DOI: 10.1136/archdischild-2023-326276 -
Archives of Disease in Childhood Sep 2023
PubMed: 37591535
DOI: 10.1136/archdischild-2023-326113 -
The Lancet. Child & Adolescent Health Oct 2023Indigenous children and adolescents across the USA and Canada experience increased emotional, physical, and sexual violence resulting from the longstanding effects of... (Review)
Review
Indigenous children and adolescents across the USA and Canada experience increased emotional, physical, and sexual violence resulting from the longstanding effects of colonialism and historical trauma. There is a substantial lack of research exploring these issues and scarce efforts outside of Indigenous communities to support victims. However, the association between exposure to violence and abuse and adverse health outcomes among Indigenous children and adolescents is clear. In this Viewpoint, we explore this association, discuss historical context, highlight important work by governments and community organisations, and suggest actions for paediatricians and paediatric health-care providers.
Topics: Adolescent; Humans; Child; Female; Violence; Child Abuse; Canada; Colonialism; Emotions
PubMed: 37451299
DOI: 10.1016/S2352-4642(23)00135-9