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JPMA. the Journal of the Pakistan... Feb 2023
Topics: Child; Humans; Pakistan; Internship and Residency; Pediatrics
PubMed: 36800700
DOI: 10.47391/JPMA.09-23 -
Pediatrics Feb 2022Racism and discrimination are the root of many pediatric health inequities and are well described in the literature. Despite the pervasiveness of pediatric health...
Racism and discrimination are the root of many pediatric health inequities and are well described in the literature. Despite the pervasiveness of pediatric health inequities, we have failed to adequately educate and prepare general pediatricians and pediatric subspecialists to address them. Deficiencies within education across the entire continuum and in our health care systems as a whole contribute to health inequities in unacceptable ways. To address these deficiencies, the field of pediatrics, along with other specialties, has been on a journey toward a more competency-based approach to education and assessment, and the framework created for the future is built on entrustable professional activities (EPAs). Competency-based medical education is one approach to addressing the deficiencies within graduate medical education and across the continuum by allowing educators to focus on the desired equitable patient outcomes and then develop an approach to teaching and assessing the tasks, knowledge, skills, and attitudes needed to achieve the goal of optimal, equitable patient care. To that end, we describe the development and content of a revised EPA entitled: Use of Population Health Strategies and Quality Improvement Methods to Promote Health and Address Racism, Discrimination, and Other Contributors to Inequities Among Pediatric Populations. We also highlight the ways in which this EPA can be used to inform curricula, assessments, professional development, organizational systems, and culture change.
Topics: Female; Health Inequities; Health Promotion; Humans; Male; Pediatrics; Professional Role; Racism
PubMed: 35001103
DOI: 10.1542/peds.2021-054604 -
Pediatric Rheumatology Online Journal May 2021Pediatric Rheumatology is an orphan specialty in Africa which is gradually gaining importance across the continent.
BACKGROUND
Pediatric Rheumatology is an orphan specialty in Africa which is gradually gaining importance across the continent.
MAIN BODY
This commentary discusses the current state of affairs in the sphere of Pediatric Rheumatology across Africa and offers practical strategies to navigate the challenges encountered in research, models of care, education and training. We outline the establishment, opportunities of growth and achievements of the Pediatric Society of the African League Against Rheumatism (PAFLAR).
CONCLUSION
This commentary lays the foundation for establishment of a formidable framework and development of partnerships for the prosperity of Pediatric Rheumatology in Africa and beyond.
Topics: Africa; Child; Child Health Services; Health Services Needs and Demand; Humans; Models, Organizational; Patient Care Management; Pediatrics; Practice Patterns, Physicians'; Rheumatic Diseases; Rheumatology
PubMed: 33962643
DOI: 10.1186/s12969-021-00557-7 -
British Journal of Clinical Pharmacology Dec 2022The safety and efficacy of pharmacotherapy in children, particularly preterms, neonates and infants, is limited by a paucity of good-quality data from prospective... (Review)
Review
The safety and efficacy of pharmacotherapy in children, particularly preterms, neonates and infants, is limited by a paucity of good-quality data from prospective clinical drug trials. A specific challenge is the establishment of valid biomarkers. OMICs technologies may support these efforts by complementary information about targeted and nontargeted molecules through systematic characterization and quantitation of biological samples. OMICs technologies comprise at least genomics, epigenomics, transcriptomics, proteomics, metabolomics and microbiomics in addition to the patient's phenotype. OMICs technologies are in part hypothesis-generating, allowing an in depth understanding of disease pathophysiology and pharmacological mechanisms. Application of OMICs technologies in paediatrics faces major challenges before routine adoption. First, developmental processes need to be considered, including a subdivision into specific age groups as developmental changes clearly impact OMICs data. Second, compared to the adult population, the number of patients is limited as are the type and amount of necessary biomaterial, especially in neonates and preterms. Thus, advanced trial designs and biostatistical methods, noninvasive biomarkers, innovative biobanking concepts including data and samples from healthy children, as well as analytical approaches (eg liquid biopsies) should be addressed to overcome these obstacles. The ultimate goal is to link OMICs technologies with innovative analysis tools, such as artificial intelligence at an early stage. The use of OMICs data based on a feasible approach will contribute to the identification complex phenotypes and subpopulations of patients to improve the development of medicines for children with potential economic advantages.
Topics: Humans; Child; Artificial Intelligence; Biological Specimen Banks; Prospective Studies; Metabolomics; Biomarkers; Drug Development; Pediatrics
PubMed: 34997627
DOI: 10.1111/bcp.15216 -
Anales de Pediatria Jan 2020
Topics: Age Factors; Arrhythmias, Cardiac; Cardiology; Catheter Ablation; Child; Humans; Pediatrics
PubMed: 31812461
DOI: 10.1016/j.anpedi.2019.11.001 -
Pediatrics Sep 2019There is an urgent need to advance mental health (MH) education and/or training in pediatric residency programs, yet no consensus on how to achieve this. We created an...
BACKGROUND AND OBJECTIVES
There is an urgent need to advance mental health (MH) education and/or training in pediatric residency programs, yet no consensus on how to achieve this. We created an operational framework from ideas provided by a diverse group of stakeholders on how to advance MH education.
METHODS
Concept-mapping methodology was used, which involves brainstorming ideas by completing a focus prompt, sorting ideas into groups, and rating them for importance and feasibility. Multidimensional scaling and hierarchical cluster analysis grouped ideas into clusters. Average importance and feasibility were calculated for each statement and cluster and compared statistically in each cluster and between subgroups.
RESULTS
Ninety-nine ideas were generated. Sorted ideas yielded a 7-cluster concept map: (1) modalities for MH training, (2) prioritization of MH, (3) systems-based practice, (4) self-awareness and/or relationship building, (5) training in clinical assessment of patients, (6) training in treatment, and (7) diagnosis-specific skills. Two hundred and sixteen participants rated ideas for importance and 209 for feasibility. Four clusters had a statistically significant difference between their importance and feasibility ratings ( < .001). Suburban and rural area respondents (versus urban) rated clusters higher in importance and feasibility ( < .004), trainees rated all clusters higher in feasibility than practicing clinicians, and MH professionals rated prioritization of MH higher in feasibility (3.42 vs 2.98; < .001).
CONCLUSIONS
This comprehensive set of ideas, especially those rated highly in both importance and feasibility, should inform curricular and policy initiatives. Differences between importance and feasibility may explain why there has been little progress in this field.
Topics: Cluster Analysis; Consensus; Curriculum; Humans; Internship and Residency; Mental Health; Pediatrics; Program Development; Stakeholder Participation; United States
PubMed: 31383816
DOI: 10.1542/peds.2018-2596 -
Acta Paediatrica (Oslo, Norway : 1992) Apr 2022A follow-up conversation with bereaved parents is a relatively well-established intervention in paediatric clinical practice. Yet, the content and value of these... (Review)
Review
AIM
A follow-up conversation with bereaved parents is a relatively well-established intervention in paediatric clinical practice. Yet, the content and value of these conversations remain unclear. This review aims to provide insight into the content of follow-up conversations between bereaved parents and regular healthcare professionals (HCPs) in paediatrics and how parents and HCPs experience these conversations.
METHODS
Systematic literature review using the methods PALETTE and PRISMA. The search was conducted in PubMed and CINAHL on 3 February 2021. The results were extracted and integrated using thematic analysis.
RESULTS
Ten articles were included. This review revealed that follow-up conversations are built around three key elements: (1) gaining information, (2) receiving emotional support and (3) facilitating parents to provide feedback. In addition, this review showed that the vast majority of parents and HCPs experienced follow-up conversations as meaningful and beneficial for several reasons.
CONCLUSION
An understanding of what parents and HCPs value in follow-up conversations aids HCPs in conducting follow-up conversations and improves care for bereaved parents by enhancing the HCPs' understanding of parental needs.
Topics: Bereavement; Child; Communication; Follow-Up Studies; Humans; Parents; Pediatrics
PubMed: 34995378
DOI: 10.1111/apa.16248 -
Anales de Pediatria Mar 2020
Topics: Child; Humans; Pediatrics; Rheumatic Diseases; Rheumatology
PubMed: 32059830
DOI: 10.1016/j.anpedi.2020.01.003 -
The Journal of International Medical... Sep 2020Artificial intelligence (AI)-aided decision support has developed rapidly to meet the needs for effective analysis of substantial data sets from electronic medical... (Review)
Review
Artificial intelligence (AI)-aided decision support has developed rapidly to meet the needs for effective analysis of substantial data sets from electronic medical records and medical images generated daily, and computer-assisted intelligent drug design. In clinical practice, paediatricians make medical decisions after obtaining a large amount of information about symptoms, physical examinations, laboratory test indicators, special examinations and treatments. This information is used in combination with paediatricians' knowledge and experience to form the basis of clinical decisions. This diagnosis and therapeutic strategy development based on large amounts of information storage can be applied to both large clinical databases and data for individual patients. To date, AI applications have been of great value in intelligent diagnosis and treatment, intelligent image recognition, research and development of intelligent drugs and intelligent health management. This review aims to summarize recent advances in the research and clinical use of AI in paediatrics.
Topics: Artificial Intelligence; Child; Humans; Pediatrics
PubMed: 32924683
DOI: 10.1177/0300060520945141 -
Cancer Metastasis Reviews Dec 2019The advent of immunotherapy has revolutionized how we manage and treat cancer. While the majority of immunotherapy-related studies performed to date have focused on... (Review)
Review
The advent of immunotherapy has revolutionized how we manage and treat cancer. While the majority of immunotherapy-related studies performed to date have focused on adult malignancies, a handful of these therapies have also recently found success within the pediatric space. In this review, we examine the immunotherapeutic agents that have achieved the approval of the US Food and Drug Administration for treating childhood cancers, highlighting their development, mechanisms of action, and the lessons learned from the seminal clinical trials that ultimately led to their approval. We also shine a spotlight on several emerging immunotherapeutic modalities that we believe are poised to have a positive impact on the treatment of pediatric malignancies in the near future.
Topics: Animals; Antineoplastic Agents, Immunological; Child; Clinical Trials, Phase III as Topic; Forecasting; Humans; Immunotherapy; Neoplasms; Pediatrics; Randomized Controlled Trials as Topic
PubMed: 31828566
DOI: 10.1007/s10555-019-09819-z