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International Journal of Environmental... Jun 2024In recent years, the use of dietary supplements has increased in all age groups. Parents may also use these supplements for their children for different reasons. This...
INTRODUCTION
In recent years, the use of dietary supplements has increased in all age groups. Parents may also use these supplements for their children for different reasons. This study aims to determine the use of dietary supplements by children, the factors affecting this use, and the attitudes of parents about these products.
METHODS
A total of 1038 children aged 2-18 years without any chronic disease who presented to the pediatric outpatient clinics of Ege University Children's Hospital were included in this study. Parents ( = 1000) who agreed to participate in the study were interviewed face-to-face, and a comprehensive questionnaire including questions about children's use of dietary supplements, sociodemographic characteristics, and parents' attitudes towards dietary supplements was administered. Analyses were performed with SPSS 25.0.
RESULTS
The mean age of the children included in our study was 8.6 ± 4.8 years, and 51% ( = 510) were male. It was found that 32.5% of the children used nutritional supplements, and vitamin-mineral preparations (23.2%) were the most frequently used. Omega-3 (19.3%) and immune support products (9.4%) were the second and third most frequently used supplements, respectively. A significant relationship was found between the use of dietary supplements and the child's age, body weight, body mass index, parents' educational level, being health worker, and economic status ( < 0.05). It was found that most of the families thought that vitamin-mineral and omega-3 products were beneficial for growth and development and that they received information from doctors most frequently before taking these products. However, it was found that families followed the media as the second most frequent source of information for these products.
CONCLUSIONS
Approximately one-third of the children in our study use dietary supplements. It is very important to raise awareness among families about the use of these products when necessary and with the recommendation of a physician. To prevent families from using dietary supplements that are not necessary for their children, especially due to misinformation in the media, pediatricians should provide correct information to parents about these products at every clinic visit. A concerted effort is needed from policy makers, media organizations, and health care providers to guide the safe use of DS. The results obtained from this study will shed light on future randomized controlled prospective studies.
Topics: Humans; Dietary Supplements; Male; Child; Female; Child, Preschool; Adolescent; Parents; Surveys and Questionnaires; Health Knowledge, Attitudes, Practice; Turkey
PubMed: 38928980
DOI: 10.3390/ijerph21060734 -
BMC Primary Care Jun 2024Delayed transitions from pediatric to adult primary care leads to gaps in medical care. State all-payer claims data was used to assess multilevel factors associated with...
OBJECTIVE
Delayed transitions from pediatric to adult primary care leads to gaps in medical care. State all-payer claims data was used to assess multilevel factors associated with timely transition from pediatric to adult primary care.
MATERIALS AND METHODS
We created a cohort of 4,320 patients aged 17-20 in 2014-2017 continuously enrolled in health insurance 36 months between 2014 and 2019 and attributed to a pediatric provider in months 1-12. We also constructed primary care provider networks identifying links between providers who saw members of the same family. Logistic regression was used to predict adult primary care in months 25-36 on family, provider, and county-level factors. Finally, we modeled the effect of county and network cluster membership on care transitions.
RESULTS
Male sex, having another family member seeing a pediatrician, and residing in a county with high pediatric care capacity or low adult primary care capacity were associated with lower odds of adult primary care transition.
DISCUSSION
We investigated factors associated with successful transitions from pediatric to adult primary care. Family ties to a pediatrician and robust county capacity to provide primary care to children were associated with non-transition to adult primary care.
CONCLUSION
Multiple level factors contribute to non-transition to adult primary care. Understanding the factors associated with appropriate transition can help inform state and national policy.
Topics: Humans; Male; Primary Health Care; Female; Adolescent; Young Adult; Transition to Adult Care; United States; Insurance Claim Review; Sex Factors; Insurance, Health
PubMed: 38926646
DOI: 10.1186/s12875-024-02463-9 -
Pediatric Research Jun 2024The American Pediatric Society 'Issue of the Year' (2023-2024) has been focused on increasing access to quality healthcare for children who are incarcerated. Addressing...
The American Pediatric Society 'Issue of the Year' (2023-2024) has been focused on increasing access to quality healthcare for children who are incarcerated. Addressing the future of youth in the juvenile justice system requires that pediatricians understand the history of how that system has gotten to where it is now. This commentary examines the creation and growth of the United States juvenile justice system since its establishment 125 years ago, so as to guide a way forward.
PubMed: 38926551
DOI: 10.1038/s41390-024-03334-w -
Archives of Disease in Childhood.... Jun 2024With numbers of children and young people waiting for treatment rising to record-high levels in the UK, the need for paediatricians is emphasised. In order to...
With numbers of children and young people waiting for treatment rising to record-high levels in the UK, the need for paediatricians is emphasised. In order to accommodate these demands, it is essential that more medical students are encouraged to pursue paediatric careers. By providing vital career support to aspiring paediatricians at an undergraduate level, recruitment into paediatrics can be amplified. An important way in which medical students gain early exposure to paediatrics is through local paediatric organisations like university societies, who can nurture interest towards the specialty and provide links to exploring and building upon paediatric career development. By empowering student initiatives to create opportunities for students to pursue paediatrics, we can build and support the next generation of paediatricians from the ground up. This was demonstrated by the Edinburgh University Paediatrics Society's free virtual career building series TODDLE: 'The building blOcks to Developing your paeDiatric portfoLio and carEer'. Feedback from the TODDLE series evidently showed an appetite for paediatric career support at an undergraduate level internationally, with attendees commenting on the usefulness, novelty and accessibility of the series. TODDLE emphasised the importance of providing paediatric career advice to medical students and showed the feasibility and practicality of student-led initiatives in providing this support as well as other paediatric exposures. Through collaborative work and the sharing of resources, any organisation at a student level can offer opportunities for engagement in paediatrics on a national and international basis.
PubMed: 38925905
DOI: 10.1136/archdischild-2023-325409 -
Ceska a Slovenska Oftalmologie :... 2024The authors present a case of a thirty-eight-year-old patient with Alport syndrome. The patient had several ocular symptoms of the disease and has been treated for...
The authors present a case of a thirty-eight-year-old patient with Alport syndrome. The patient had several ocular symptoms of the disease and has been treated for systemic problems in connection with Alport syndrome since he was fifteen years old. At that age the patient also underwent a kidney transplant in order to deal with renal insufficiency. To date, he still uses immunosuppressants and antihypertensives. Furthermore, the patient suffers from perceptive deafness. The patient visited our clinic in 2021 with a request to solve his high refractive error, in which the diopters were so high that it was not possible to place them in spectacles. The patient's best corrected visual acuity was 0.6 with -8.0sph/-4.0cyl/ax15 in the right eye and 0.7partim with -8.0sph/-4.0cyl/ax155 in the left eye. The autorefractometer values were -6.25sph/-6.75cyl/ax17 in the right eye and -6.75sph/-6.5cyl/ax155 in the left eye. During the eye examination we found a number of ocular manifestations that are typical of Alport syndrome. On the cornea there were opacities as a residue of corneal erosions, and at one of the following check-ups we also found a newly developed corneal erosion. Subsequently, we found an anterior lenticonus and incipient cataract. Upon performing OCT, a typical temporal macular atrophy was evident. Fundus examination in artificial mydriasis showed just a minimal manifestation of fleck retinopathy. Due to the clinical manifestation we decided to perform cataract surgery and implant a monofocal toric intraocular lens in both eyes. There were no complications during the operations, however the surgeon registered a non-standard structure of the lens capsule. The capsule was more fragile, and performing capsulorhexis was much more complicated. A week after the surgery, higher cylinder diopters were still present. A decrease of the higher diopters was noticeable one month after surgery. The time interval between the first operation and the second operation was one month. The patient was highly satisfied with result, and uncorrected visual acuity improved by over four lines. After surgery the patient needed low diopters for near as well as far distance. In the case of this patient, the ocular manifestations were detected and treated in adulthood. Nevertheless, early detection of ocular symptoms of Alport syndrome in young patients before renal failure could lead to timely start of the treatment and delay a possible renal transplant. In case of any suspicion of Alport syndrome it is advised to send the patient to a pediatrician, and at an older age to an internal medicine specialist, for further examination.
Topics: Humans; Nephritis, Hereditary; Male; Adult; Refractive Surgical Procedures; Visual Acuity
PubMed: 38925900
DOI: 10.31348/2024/28 -
Academic Medicine : Journal of the... Jun 2024In the United States, initial board certification remains focused on a high-stakes knowledge examination after completion of training. A more contemporary view supports...
In the United States, initial board certification remains focused on a high-stakes knowledge examination after completion of training. A more contemporary view supports a program of assessment that includes multiple types and sources of data with an emphasis on direct workplace observation to get the best picture of an individual's performance. In this article, the authors reimagine initial certification as a continuous assessment for learning that begins in residency, focuses on both knowledge acquisition and its application, and interdigitates intentionally with the first cycle of maintenance of certification to advance learning and smooth the transition from training to practice. A more expanded view of competence, as a 3-layered construct (canonical, contextual, and personalized), supports this proposal. Canonical competence (context-independent knowledge)-best assessed through examinations of knowledge-is most heavily weighted and assessed during medical school but remains critical throughout one's career. Contextual competence (context-dependent knowledge) is best assessed in the workplace and is key during residency and fellowship as trainees navigate a myriad of clinical work environments. Personalized competence, representing the totality of one's unique areas of expertise, is best demonstrated during the practice years when deliberate practice experience supports the growth of personalized expertise and discoveries that advance the field. Shifting initial board certification from relying on an anxiety-provoking, high-stakes, often single moment in time standardized examination to a nuanced approach that is part of an individual trainee's program of assessment offers a more just and robust decision about readiness for unsupervised practice. Such a model would also sow the seeds of meaningful individualization of learning needs that begins in training, continues through practice, and lays the foundation for improving the quality of care for patients within a given practice as well as shifting the current contiguous phases of training and practice into a true continuum.
PubMed: 38924498
DOI: 10.1097/ACM.0000000000005797 -
Journal of Cardiovascular Development... May 2024The congenital Gerbode defect is defined as an abnormal communication between the left ventricle and the right atrium. This review aimed to summarize existing evidence,... (Review)
Review
The congenital Gerbode defect is defined as an abnormal communication between the left ventricle and the right atrium. This review aimed to summarize existing evidence, shed light on the clinical implications, and identify knowledge gaps. The systematic literature search was conducted in the PubMed and Google Scholar medical databases using specifically selected keywords. The inclusion of each publication was assessed according to predefined eligibility criteria based on the PICOM (Population, Phenomenon of Interest, Context, Methodology) schema. Titles and abstracts were screened independently by two authors. Available full-text versions of included publications were reviewed and relevant information was extracted. A total of 78 reports were included. The compilation of all congenital Gerbode defect cases described in the literature revealed a variety of clinical presentations comprising dyspnea, palpitations, growth retardation, and asymptomatology. A suitable multimodal diagnostic approach for newborns consists of auscultation, TTE, and optionally TEE and MRI. Because of its rarity, diversity of findings, unknown pathophysiology, and similarity to more common cardiac diseases, the diagnostic challenge remains significant. To prevent untreated long-term sequelae, early individualized treatment is recommended. Surgical defect closure is preferred to device closure for evidence reasons, although major developments are currently taking place. In conclusion, the congenital Gerbode defect provides a diagnostic challenge for pediatricians to allow early diagnosis and intervention in order to improve patients' quality of life.
PubMed: 38921666
DOI: 10.3390/jcdd11060166 -
Healthcare (Basel, Switzerland) Jun 2024Attitudes, practices, and knowledge about bullying were evaluated in a sample of 274 primary care professionals, including general practitioners, pediatricians,...
Attitudes, practices, and knowledge about bullying were evaluated in a sample of 274 primary care professionals, including general practitioners, pediatricians, community, pediatric and school nurses, and residents of these specialties. This study was based on a mixed method with a parallel convergent design without dominance between phases, data were collected concurrently, and conversion of the results from both phases was carried out during data interpretation. The quantitative phase had a cross-sectional observational design, using The Healthcare Provider's Practices, Attitudes, Self-confidence, and Knowledge Regarding Bullying Questionnaire as an instrument. Descriptive and bivariate analyses were performed, which showed a positive correlation between higher self-confidence and knowledge scores and a greater predisposition to detect cases. However, although the dimensions of attitudes and knowledge yielded generally high data, low self-confidence was evident in addressing this problem. In addition, a lack of clear guidelines in the workplace was expressed, highlighting the need to create and provide specific resources to intervene in bullying in said context, which could develop an improvement in self-confidence, leading to greater well-being for the educational community regarding bullying.
PubMed: 38921343
DOI: 10.3390/healthcare12121230 -
Annals of the Academy of Medicine,... Sep 2023Perinatal depression and anxiety are public health concerns affecting approximately 1 in 10 women in Singapore, with clear evidence of association with various adverse... (Review)
Review
INTRODUCTION
Perinatal depression and anxiety are public health concerns affecting approximately 1 in 10 women in Singapore, with clear evidence of association with various adverse outcomes in mother and child, including low birthweight, preterm birth and negative impact on infant neurodevelopment, temperament and behaviour. A workgroup was formed to develop recommendations to address the perinatal mental health needs of women with depression and anxiety. The approach was broad-based and aimed to incorporate holistic methods that would be readily applicable to the network of care providers supporting childbearing women.
METHOD
The Grading and Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision framework was employed to draw these guidelines. Workgroup members-comprising experts in the field of perinatal mental health and obstetric medicine-deliberated on the public health needs of the target population, and reviewed literature published from 2001 to 2022 that were relevant to improve the well-being of women with depression and anxiety during the preconception and perinatal periods.
RESULTS
A consensus meeting was held involving a wider professional network, including family physicians, paediatricians, psychiatrists, social services and the Health Promotion Board in Singapore.
CONCLUSION
Ten consensus statements were developed, focusing on the overall aim of achieving optimal perinatal mental health for women with depression and anxiety. They relate to awareness and advice on preconception mental health, screening and assessment, optimising care and treatment. Special considerations were recommended for women who suffered severe maternal events, tailoring care for adolescents and women with special needs, and addressing infant mental health needs.
Topics: Humans; Singapore; Female; Pregnancy; Anxiety; Depression; Pregnancy Complications; Perinatal Care; Mental Health; Consensus
PubMed: 38920193
DOI: 10.47102/annals-acadmedsg.2023148 -
Annals of the Academy of Medicine,... Nov 2023Rare paediatric eye diseases (RPEDs) threaten both vision and life. Recently, rare diseases were recognised as a global public health agenda, with children specified as... (Review)
Review
INTRODUCTION
Rare paediatric eye diseases (RPEDs) threaten both vision and life. Recently, rare diseases were recognised as a global public health agenda, with children specified as a priority in the World Health Organization's VISION 2020 against avoidable visual loss.
METHOD
We conducted a review through a query of online databases (PubMed, Embase and Cochrane Library). Articles related to RPEDs were selected based on relevance by 2 authors, with any disagreements adjudicated by the third author.
RESULTS
We synthesise the current state of knowledge regarding RPEDs, barriers to their care, and recommendations for the future. RPEDs often result in significant visual loss, profoundly impacting the way children comprehend and participate in the world. These diseases may also reduce life expectancy and even be life-threatening. Barriers to the care of RPEDs include an unclear definition of "rare diseases", missed or delayed diagnosis, inadequate knowledge and expertise in management, and challenging research environments.
CONCLUSION
Our findings provide an update on the diagnosis and management of RPEDs, which is of relevance to ophthalmologists, paediatricians, healthcare policymakers and social workers. We propose supportive policies and adequate resource allocation to these diseases, comprehensive and patient-centred care, alongside improved education and training, enhanced research capabilities and continued collaboration across institutions.
Topics: Humans; Rare Diseases; Child; Eye Diseases; Vision Disorders
PubMed: 38920150
DOI: 10.47102/annals-acadmedsg.202323