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Archivos Argentinos de Pediatria Dec 2023
Topics: Child; Humans; Algorithms; Artificial Intelligence; Pediatrics
PubMed: 37471440
DOI: 10.5546/aap.2023-10090.eng -
Journal of Biopharmaceutical Statistics Nov 2023Unique challenges pertain when studying children, although many research principles are the same as those when studying adult populations. This truism extends to the use...
Unique challenges pertain when studying children, although many research principles are the same as those when studying adult populations. This truism extends to the use of real-world data (RWD). RWD are particularly relevant to pediatrics because they may potentially provide an additional source of data to inform pediatric labeling and practice patterns when clinical trials have not been or cannot be conducted. The purpose of this commentary is to provide a brief overview of the unique issues in using RWD to study the effectiveness or safety of medical therapies in children.
Topics: Child; Humans; Pediatrics; Data Analysis
PubMed: 36519238
DOI: 10.1080/10543406.2022.2152834 -
Epilepsy & Behavior : E&B Dec 2023Experience of how to become a pediatric epileptologist in Colombia.
Experience of how to become a pediatric epileptologist in Colombia.
Topics: Humans; Colombia; Pediatrics; Epilepsy
PubMed: 37935613
DOI: 10.1016/j.yebeh.2023.109510 -
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. Fetal... Nov 2023
Topics: Infant, Newborn; Humans; Seizures; Infant, Newborn, Diseases; Neonatology
PubMed: 37527943
DOI: 10.1136/archdischild-2023-325324 -
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 Research Apr 2024To describe pediatric Produce Prescription (PRx) interventions and their study designs, outcomes, and opportunities for future research. (Review)
Review
BACKGROUND
To describe pediatric Produce Prescription (PRx) interventions and their study designs, outcomes, and opportunities for future research.
METHODS
A scoping review framework was used to describe PRx interventions published between January 2000 and September 2023. Articles from online databases were uploaded into Covidence. Data on study characteristics, outcomes of interest (health, food insecurity (FI), nutritional and culinary efficacy, and fruit and vegetable (F/V) consumption), and feasibility were extracted. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment.
RESULTS
19 articles met inclusion criteria. Ten studies were quantitative, five were qualitative, and four used mixed-methods. Interventions included food vouchers (n = 14) or food box/pantries (n = 5). Four studies allowed food items in addition to F/Vs. Six studies measured changes in FI and five reported a statistically significant decrease. Seven studies measured changes in F/V consumption and five reported a statistically significant increase. One study reported a statistically significant reduction in child BMI z-score. Most studies reported high feasibility. Few studies used high-quality methods.
CONCLUSIONS
Pediatric PRx interventions show promising potential to reduce FI and improve diet quality and health-related outcomes. Future studies should utilize rigorous study designs and validated assessment tools to understand the impact of pediatric PRx on health.
IMPACT
This work offers a summary of programmatic outcomes including retention, redemption, incentives, nutrition education, study design and quality limitations to help inform future work. We found positive impacts of pediatric produce prescriptions (PRx) on FI, F/V consumption, and nutritional knowledge and culinary skills. More high-quality, rigorous studies are needed to understand the best delivery and design of PRx and their impact on child behavior and health outcomes. This work provides support for the need for rigorous studies and the potential for PRx to play a role in multi-pronged strategies that address pediatric FI and diet-related disease.
Topics: Adolescent; Child; Child, Preschool; Humans; Diet; Diet, Healthy; Food Insecurity; Fruit; Pediatrics; Prescriptions; United States; Vegetables
PubMed: 38049646
DOI: 10.1038/s41390-023-02920-8 -
Current Opinion in Pediatrics Jun 2024
Topics: Humans; Pulmonary Medicine; Child; Pediatrics
PubMed: 38655810
DOI: 10.1097/MOP.0000000000001344 -
Pediatric Rheumatology Online Journal Jun 2024Many children with rheumatic and musculoskeletal diseases are unrecognized. Identifying these children requires health care provider awareness, knowledge, and skills to... (Review)
Review
BACKGROUND
Many children with rheumatic and musculoskeletal diseases are unrecognized. Identifying these children requires health care provider awareness, knowledge, and skills to recognize disease features and how (and when) to refer to specialist care. The aim of this paper is to highlight the need for better access to health care, review the essential role that education and virtual care play to address unmet need in low resource areas and especially to expand workforce capacity. Using collaborative partnerships, virtual platforms, and innovative assessment methods, musculoskeletal care and education can be delivered to reach a greater audience than ever before. Increased awareness through multiple initiatives and readily available resources are imperative to improve global rheumatology care.
CONCLUSION
The needs of children with rheumatic diseases and musculoskeletal conditions are vastly underserved around the world resulting in preventable morbidity and mortality. Expanded implementation of virtual education and e-health care platforms provides an opportunity to increase access to care for children globally.
Topics: Humans; Rheumatology; Child; Pediatrics; Health Services Accessibility; Rheumatic Diseases; Musculoskeletal Diseases; Telemedicine
PubMed: 38840147
DOI: 10.1186/s12969-024-00978-0 -
The Journal of Pediatrics Sep 2023To estimate differences in scheduled and completed specialty referrals by race, ethnicity, language for care, and insurance type.
OBJECTIVE
To estimate differences in scheduled and completed specialty referrals by race, ethnicity, language for care, and insurance type.
STUDY DESIGN
We studied a retrospective cohort of 38 334 specialty referrals to a large children's hospital between March 2019 and March 2021. We included referrals for patients with primary care clinics within 5 miles of the hospital. We examined whether the odds of and time to scheduled and completed referrals differed by patient sociodemographic characteristics.
RESULTS
Of all referrals, 62% were scheduled and 54% were completed. Referral completion rates were lower for patients with Black race (45%), Native Hawaiian/Pacific Islander race (48%), Spanish language (49%), and public insurance (47%). Odds of scheduled and completed referral were lower for Asian (aOR scheduled: 0.94, [95% CI: 0.89, 0.99]; aOR completed: 0.92 [0.87, 0.97]), Black (aOR scheduled: 0.86 [0.79, 0.94]; aOR completed: 0.80 [0.73, 0.87]), and publicly insured patients (aOR scheduled: 0.71 [0.66, 0.75]; aOR completed: 0.70 [0.66, 0.75]). Time to scheduled and completed referral was longer for Black (adjusted hazard ratio [aHR] scheduled: 0.93 [0.88, 0.98]; aHR completed: 0.93 [0.87, 0.99]) and publicly insured patients (aHR scheduled: 0.85 [0.82, 0.88]; aHR completed: 0.84 [0.80, 0.87]) and families with a language other than English (aHR scheduled: 0.66 [0.62, 0.70]; aHR completed: 0.92 [0.86, 0.99]).
CONCLUSIONS
Within a geographically homogenous pediatric population, the odds and time to scheduled and completed specialty referrals differed by sociodemographic characteristics, suggesting the effects of discrimination. To improve access equity, health care organizations need clear and consistent referral workflows and more comprehensive metrics for access.
Topics: Child; Humans; Healthcare Disparities; Referral and Consultation; Retrospective Studies; Pediatrics
PubMed: 37196777
DOI: 10.1016/j.jpeds.2023.113485