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Pediatric Emergency Care Feb 2022The relationship between pediatrician availability and emergency department (ED) attendance is uncertain. We determined whether children in counties with more...
OBJECTIVES
The relationship between pediatrician availability and emergency department (ED) attendance is uncertain. We determined whether children in counties with more pediatricians had fewer ED visits.
METHODS
We conducted a cross-sectional study of all ED visits among children younger than 18 years from 6 states. We obtained ED visit incidences by county and assessed the relationship to pediatrician density (pediatricians per 1000 children). Possible confounders included state, presence of an urgent care facility in the county, urban-rural status, and quartile of county-level characteristics: English-speaking, Internet access, White race, socioeconomic status, and public insurance. We estimated county-level changes in incidence by pediatrician density adjusting for state and separately for all possible confounders.
RESULTS
Each additional pediatrician per 1000 children was associated with a 13.7% (95% confidence interval, -19.6% to -7.5%) decrease in ED visits in the state-adjusted model. In the full model, there was no association (-1.4%, 95% confidence interval, -7.2% to 4.8%). The presence of an urgent care, higher socioeconomic status score, urban status, and higher proportions of White race and nonpublic insurance were each associated with decreased ED visit rates.
CONCLUSIONS
Pediatrician density is not associated with decreased ED visits after adjusting for other county demographic factors. Increasing an area's availability of pediatricians may not affect ED attendance.
Topics: Ambulatory Care; Child; Cross-Sectional Studies; Emergency Service, Hospital; Humans; Pediatricians; Rural Population
PubMed: 34282091
DOI: 10.1097/PEC.0000000000002502 -
Acta Paediatrica (Oslo, Norway : 1992) Oct 2021
Topics: History, 20th Century; Humans; Pediatricians; Physicians
PubMed: 34382253
DOI: 10.1111/apa.16020 -
Pediatric Clinics of North America Feb 2023Pediatricians are effective advocates to improve the health and well-being of children, yet there are limited avenues by which to pursue academic promotion based on... (Review)
Review
Pediatricians are effective advocates to improve the health and well-being of children, yet there are limited avenues by which to pursue academic promotion based on these activities. Drawing on an expanded definition of scholarship, pediatric advocates can use the portfolio format to highlight the quantity, quality, and impact of advocacy activities. True congruence with research and education will only be achieved through recognition and value by institutions and organizations.
Topics: Child; Humans; Pediatricians
PubMed: 36402462
DOI: 10.1016/j.pcl.2022.09.001 -
Journal of Paediatrics and Child Health Mar 2022Paediatricians may face the notion of 'virginity' in various situations while caring for children and adolescents, but are often poorly prepared to address this...
Paediatricians may face the notion of 'virginity' in various situations while caring for children and adolescents, but are often poorly prepared to address this sensitive topic. Virginity is a social construct. Despite medical evidence that there is no scientifically reliable way to determine virginity, misconceptions about the hymen and its supposed association with sexual history persist and lead to unethical practices like virginity testing, certificate of virginity or hymenoplasty, which can be detrimental to the health and well-being of females of all ages. The paediatrician has a crucial role in providing evidence-based information and promoting positive sexual education to children, adolescents and parents. Improving knowledge can help counter misconceptions and reduce harms to girls and women.
Topics: Adolescent; Child; Female; Humans; Hymen; Parents; Pediatricians; Sexual Abstinence; Sexual Behavior
PubMed: 35000235
DOI: 10.1111/jpc.15887 -
European Journal of Pediatrics Jan 2021The current outbreak of COVID-19 raging globally is taking a heavy toll on the adult population, with a rapidly growing number of newly infected and critically ill...
The current outbreak of COVID-19 raging globally is taking a heavy toll on the adult population, with a rapidly growing number of newly infected and critically ill patients. However, to date, mortality rate among children is low as they mostly suffer from a mild disease. Yet, other more routinely encountered childhood diseases do not stand still and continue to be the main share of pediatricians' everyday challenges. Here we describe a case series of routinely seen pediatric diseases with delayed diagnosis due to different aspects of what we call "Corona-phobia". These cases were easily collected within a 1-week period which implies that this is a more widespread phenomenon.In conclusion, this raises the possibility that measures taken to mitigate this pandemic may be more damaging to children overall than the virus itself. We believe that pediatricians as well as policy makers should take this important aspect into consideration. What is Known: • COVID-19 manifests as a mild disease in most children; however, children are an important reservoir and may become spreaders of the disease. • Social distancing and isolation are important tools in mitigating COVID-19 transmission. What is New: • This case series describes 7 cases with delayed diagnosis of every-day pediatric diseases that were not caused by COVID-19 but were highly influenced by different aspects of "Corona-phobia". • Our objective is to highlight the possibility that measures taken to mitigate this pandemic may lead to a substantial delay in the diagnosis of other non-COVID-19 related diseases.
Topics: Adolescent; COVID-19; Child; Child, Preschool; Female; Humans; Incidence; Infant, Newborn; Male; Occupational Exposure; Pandemics; Pediatricians; Phobic Disorders; SARS-CoV-2
PubMed: 32661937
DOI: 10.1007/s00431-020-03736-y -
Archives of Disease in Childhood.... Feb 2022In the UK, the number of junior doctors completing foundation programme, and the number of trainees applying to paediatrics has been in decline in recent years. The NHS... (Review)
Review
BACKGROUND
In the UK, the number of junior doctors completing foundation programme, and the number of trainees applying to paediatrics has been in decline in recent years. The NHS is at 'breaking point', exacerbated by workforce shortages, chronic underfunding, increasing service demand and poor job satisfaction within healthcare workers. Issues in recruitment and retention of paediatricians 'threaten the safety of our children's health', according to the Royal College of Paediatrics and Child Health.
AIM
To explore what strategies have been described in the literature to enhance recruitment and retention in paediatrics.
METHODS
A scoping review methodology was conducted, employing a qualitative approach to review the literature. The studies included were English-language studies. 16 full-text articles were reviewed and analysed.
STUDY FINDINGS
There is a paucity of data in the literature that describes evidence-based approaches to enhancing retention and recruitment in paediatrics. The most important strategies employed to help are identified and grouped into six main themes. These include professional advocacy, workforce diversity, mentorship, improving working conditions, career flexibility and enhancing educational opportunities. The authors have created a 'paediatric pipeline' paradigm of 'identify, engage, recruit, retain and champion', which allow us to present these themes in a pragmatic way for paediatricians and policymakers.
CONCLUSIONS
While some issues share similarities with other specialties in difficulty, much of the context and potential remedies within paediatrics are distinct. A strategic, multi-agency collaborative approach is required urgently to address the significant issues that face both paediatrics and the healthcare system.
Topics: Child; Humans; Pediatricians; Pediatrics; Workforce
PubMed: 33658289
DOI: 10.1136/archdischild-2020-319696 -
Current Problems in Pediatric and... Mar 2022Pediatricians are uniquely and well positioned to recognize risk factors for and experiences of labor and sex trafficking in children. While clinical and social...
Pediatricians are uniquely and well positioned to recognize risk factors for and experiences of labor and sex trafficking in children. While clinical and social interventions are well discussed in the literature, the underlying mechanisms that cause and contribute to trafficking are poorly addressed among healthcare professionals. A "colorblind" or otherwise "apolitical" approach to trafficking prevention is ineffective and may be detrimental to the patient-practitioner relationship. Pediatricians must be historico-socially aware of the contexts in which they practice to improve the health of pediatric populations. This article addresses the relevant trafficking legal terminology that may be unfamiliar to most pediatricians and focuses on a few "ism"-schisms (capitalism, racism, sexism, cis-heteronormativity, nativism, and classism) that create vulnerability to trafficking in pediatric populations. The article closes with some intervention recommendations and many more prevention-measure recommendations.
Topics: Child; Family; Human Trafficking; Humans; Pediatricians; Policy
PubMed: 35367130
DOI: 10.1016/j.cppeds.2022.101167 -
Advances in Pediatrics Aug 2022The COVID-19 pandemic is an unprecedented event with devastating effects on children and families, highlighting and broadening disparities in the care of children with... (Review)
Review
The COVID-19 pandemic is an unprecedented event with devastating effects on children and families, highlighting and broadening disparities in the care of children with developmental disabilities, while simultaneously catalyzing innovation. Children are vulnerable to the impacts of COVID-19, resulting in increased stress, anxiety, isolation, and health challenges, further amplified in autistic children and children with other neurodevelopmental disabilities. These children are uniquely vulnerable due to communication impairments, comorbid medical disorders, reduced adaptability, and reliance on therapeutic interventions. Abrupt reduction in services and access to care during the pandemic compromised physical and mental health and led to missed intervention opportunities at critical times. It is important to examine the effects that the pandemic triggered, address deficiencies, and recognize new opportunities to improve systems of care to prepare for unforeseen futures.
Topics: Autistic Disorder; COVID-19; Child; Humans; Mental Health; Pandemics; Pediatricians
PubMed: 35985716
DOI: 10.1016/j.yapd.2022.04.001 -
Pediatrics Jul 2023The American Academy of Pediatrics and its members recognize the importance of improving the physician's ability to recognize intimate partner violence (IPV) and...
The American Academy of Pediatrics and its members recognize the importance of improving the physician's ability to recognize intimate partner violence (IPV) and understand its effects on child health and development and its role in the continuum of family violence. Pediatricians are in a unique position to identify IPV survivors in pediatric settings, to evaluate and treat children exposed to IPV, and to connect families with available local and national resources. Children exposed to IPV are at increased risk of being abused and neglected and are more likely to develop adverse health, behavioral, psychological, and social disorders later in life. Pediatricians should be aware of these profound effects of exposure to IPV on children and how best to support and advocate for IPV survivors and their children.
Topics: Humans; Child; Intimate Partner Violence; Domestic Violence; Child Abuse; Pediatricians; Child Health
PubMed: 37337842
DOI: 10.1542/peds.2023-062509 -
Archives of Disease in Childhood Jul 2022
Topics: Evidence-Based Medicine; Humans; Pediatricians
PubMed: 35714987
DOI: 10.1136/archdischild-2022-324454