Medical Student Perspectives on the use of Immersive Virtual Reality for Clinical Assessment Training
Publication date: Available online 12 June 2019Source: Academic PediatricsAuthor(s): Matthew W. Zackoff, Francis J. Real, Bradley Cruse, David Davis, Melissa Klein (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 13, 2019 Category: Pediatrics Source Type: research

Funding Sources and Perceived Financial Insecurity in Pediatric Subspecialty Fellowship Programs
ConclusionsPerceived financial insecurity of fellowship programs was strongly associated with program size, funding source and unfilled positions, limiting recruitment and resources. Stable funding of fellowship programs is critical to maintain an adequate pediatric subspecialty workforce. (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 12, 2019 Category: Pediatrics Source Type: research

The Pediatric Match Frenzy: An Overview and an Approach for Mentoring Medical Students
Publication date: Available online 12 June 2019Source: Academic PediatricsAuthor(s): Nancy N Liao, John D Mahan, Rebecca ScherzerAbstractApplying for a pediatric residency position has become an increasingly stressful event and recently medical educators have described it as a “Match Frenzy.” Match statistics demonstrate increased competition for pediatric residency positions and a record number of applications. Faculty who mentor medical students are now challenged to counsel them through the intensified process and pediatric residency programs are now forced to navigate the rising number of applications. We d...
Source: Academic Pediatrics - June 12, 2019 Category: Pediatrics Source Type: research

Stimulant diversion risk among college students treated for ADHD: Primary care provider prevention training
ConclusionsThis study provides initial evidence for a PCP-delivered intervention to reduce stimulant diversion. Research is needed on the efficacy of targeting college students directly, working with pharmacies and student health centers, and preventing misuse among teenagers. (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 10, 2019 Category: Pediatrics Source Type: research

We have all been working in our own little silos forever: Exploring a cross-sector response to child maltreatment
ConclusionsOur project extends previously published research by describing potential benefits of child welfare and child health care collaboration in cases of suspected maltreatment. Lack of effective cross-sector communication and concerns about confidentiality present significant barriers to uptake of these collaborative practices. (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 9, 2019 Category: Pediatrics Source Type: research

The Development of a Pediatric Osteopathic Recognition Track
Publication date: Available online 8 June 2019Source: Academic PediatricsAuthor(s): Alexander Rakowsky, Carl Backes, John D. Mahan, Kimberly Wolf, Elizabeth Zmuda (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 9, 2019 Category: Pediatrics Source Type: research

Trends in Pediatric Emergency Department Visits for Mental Health Conditions and Disposition by Presence of a Psychiatric Unit
Publication date: Available online 5 June 2019Source: Academic PediatricsAuthor(s): Gretchen J. Cutler, Jonathan Rodean, Bonnie T. Zima, Stephanie K. Doupnik, Alicia L. Zagel, Kelly R. Bergmann, Jennifer A. Hoffmann, Mark I. NeumanAbstractObjectiveTo examine trends in mental health (MH) visits to pediatric emergency departments (EDs) and identify whether ED disposition varies by presence of a hospital inpatient psychiatric unit (IPU).Study DesignCross-sectional study of 8,479,311 ED visits to 35 children's hospitals from 2012 to 2016 for patients aged 3 to 21 years with a primary MH or non-MH diagnosis. Multivariable gener...
Source: Academic Pediatrics - June 6, 2019 Category: Pediatrics Source Type: research

Parent Partners: Evaluation of a Novel Peer-Support Intervention for the Caregivers of Children Hospitalized for Behavioral Health Conditions
ConclusionsThis novel intervention was implemented successfully, and although our study did not find statistically significant impacts on health care use after discharge, the findings for ED visits are suggestive of benefits. Parent peer support in inpatient settings warrants additional investigation. (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 6, 2019 Category: Pediatrics Source Type: research

Characteristics of High-Performing Primary Care Pediatric Practices: A Qualitative Study
ConclusionsThis study suggested that elements of organizational culture may play as important a role in the quality of care delivered as specific quality improvement strategies. Interventions to further test this relationship may aid practices seeking to improve the care they deliver. (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 4, 2019 Category: Pediatrics Source Type: research

Food Insecurity Associated With Underestimation of Weight Status in Children With a Healthy Weight
ConclusionsFood insecurity was associated with a decrease in the accuracy of parental weight perceptions in children with healthy weight. Pediatricians should clearly communicate about weight status, as families with HFI may adopt unhealthy eating behaviors under the incorrect assumption that their child is underweight. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 30, 2019 Category: Pediatrics Source Type: research

The Challenge of Child Management During Dental Care: Use of Nonpharmacological Approaches
Publication date: Available online 26 April 2019Source: Academic PediatricsAuthor(s): Marília Leão Goettems, Francine dos Santos Costa, Vanessa Polina Pereira da Costa (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 30, 2019 Category: Pediatrics Source Type: research

Routine cholesterol tests and subsequent change in BMI among overweight and obese children
ConclusionsIndividual risk assessment in the form of cholesterol testing is not associated with change in BMI trajectory among overweight and obese children. Though testing may identify familial hypercholesterolemia, results suggest testing does not change BMI trajectory, a key strategy to reduce cardiovascular risk. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 30, 2019 Category: Pediatrics Source Type: research

PACK for Wellness: a model for supporting resident well-being during global child health experiences
Publication date: Available online 28 May 2019Source: Academic PediatricsAuthor(s): Sarah Webber, Stephanie M. Lauden, Philip R Fischer, Larissa Beyerlein, Charles Schubert, Midwest Consortium of Global Child Health Educators S-PACK WorkgroupMidwest Consortium of Global Child Health Educators S-PACK Workgroup: Denise Bothe, University Hospitals Rainbow Babies & Children's Hospital; Sabrina Butteris, University of Wisconsin School of Medicine and Public Health; Carmen Cobb, Medical College of Wisconsin; Emilia Connolly, Cincinnati Children's Hospital Medical Center; James Conway, University of Wisconsin School of Medici...
Source: Academic Pediatrics - May 29, 2019 Category: Pediatrics Source Type: research

A Learning Loop Model of Collaborative Decision-Making in Chronic Illness
Publication date: Available online 19 April 2019Source: Academic PediatricsAuthor(s): Sarah D. Ronis, Lawrence C. Kleinman, Kurt C. StangeAbstractShared decision-making is a core attribute of quality health care that has proved challenging to implement and assess in pediatric practice. Current models of shared decision-making are limited, including their capacity to incorporate multiple stakeholders; to integrate downstream effects of subacute or minor decisions; and to account for the context(s) in which such decisions are being made and enacted. Based on a review of literature from organizational psychology, cognitive sc...
Source: Academic Pediatrics - May 24, 2019 Category: Pediatrics Source Type: research

Longitudinal effect of ambient air pollution and pollen exposure on asthma control: the PROMIS® Pediatric Asthma Study
This study investigated effects of exposure to PM2.5, O3, and pollen on asthma control status among pediatric patients with asthma.MethodsA total of 229 dyads of pediatric patients with asthma and their parents were followed-up for 15 months. The Asthma Control and Communication Instrument was used to measure asthma control, which was reported weekly by parents during a 26-week period. PM2.5 and O3 data were collected from the U.S. Environmental Protection Agency Air Quality System. Pollen data were obtained from Intercontinental Marketing Services Health. Mean air pollutant and pollen exposures within 7 days prior to the ...
Source: Academic Pediatrics - May 23, 2019 Category: Pediatrics Source Type: research

Clinician diagnoses of failure to thrive before and after switch to World Health Organization growth curves
Publication date: Available online 23 May 2019Source: Academic PediatricsAuthor(s): Carrie Daymont, Noah Hoffman, Eric Schaefer, Alexander G. FiksAbstractObjectiveTo evaluate change in the incidence of FTT based on selected growth percentile criteria and diagnostic codes before and after a switch in growth curves.MethodsWe performed a retrospective cohort study of children 2 to 24 months of age in a large primary care network that switched its default growth curve from the Centers for Disease Control (CDC) reference to the World Health Organization (WHO) standards in 2012. We compared the incidence of FTT defined by growth...
Source: Academic Pediatrics - May 23, 2019 Category: Pediatrics Source Type: research

Care Management for Youth with Co-Morbid Developmental and Mental Health Conditions: A Discrete Choice Experiment Pilot Study
ConclusionThe DCE was sensitive to caregivers’ preferences for managing their child's co-existing cognitive/intellectual and emotional/behavior/developmental disability. Findings may help providers gauge treatment in a broader context of health outcomes. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 23, 2019 Category: Pediatrics Source Type: research

Parents’ willingness to pay for pediatric weight management programs
ConclusionsMost parents of children in a weight management program were interested in continuing it after it ended, but fewer were willing to pay out of pocket for it. A greater proportion of parents were willing to pay if the program included individualized health coaching. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 23, 2019 Category: Pediatrics Source Type: research

Screening and Referral for Low-Income Families’ Social Determinants of Health by US Pediatricians
ConclusionsA minority of pediatricians report routinely screening for social needs. Pediatricians were more likely to report that they screen and refer if they had positive attitudes towards the importance of screening, felt prepared, and had support staff to assist families in need. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 23, 2019 Category: Pediatrics Source Type: research

Impact of Child Abuse Clinical Pathways on Skeletal Survey Performance in High-Risk Infants
Publication date: Available online 14 March 2019Source: Academic PediatricsAuthor(s): Natalie Stavas, Christine Paine, Lihai Song, Justine Shults, Joanne WoodAbstractObjectiveWe sought: 1) to examine the association between the presence of a child abuse pathway and the odds of skeletal survey performance in infants with injuries associated with high risk of abuse and 2) to determine whether pathway presence decreased disparities in skeletal survey performance.‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬MethodsIn this retrospective study of children
Source: Academic Pediatrics - May 22, 2019 Category: Pediatrics Source Type: research

Disparities in HPV vaccine series completion by adolescent males: a retrospective cohort study
ConclusionsThere are significant disparities in HPV vaccine series completion rates among males based on race and insurance, unchanged based on era of initiation or visit frequency. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 19, 2019 Category: Pediatrics Source Type: research

Socioeconomic and Environmental Risk Factors for Pediatric Asthma in an American Indian Community
Publication date: Available online 17 May 2019Source: Academic PediatricsAuthor(s): BreAnna Kinghorn, Amanda M. Fretts, Rae A. O'Leary, Catherine J. Karr, Margaret Rosenfeld, Lyle G. BestABSTRACTBackgroundAmerican Indian (AI)/Alaska Native (AN) children have increased asthma prevalence, morbidity, and mortality compared to non-Hispanic white children. Our study sought to examine environmental and socioeconomic factors of asthma among children in an AI community.MethodsThis case-control study included children with physician-diagnosed asthma and age-matched controls, ages 6 through 17 years, in an AI community. Diagnosis an...
Source: Academic Pediatrics - May 17, 2019 Category: Pediatrics Source Type: research

Look Who's Talking: A survey of Pediatric Program Directors on communication skills education in pediatric residency programs
ConclusionsWhile teaching and assessment of communication skills is common in pediatric residency programs, it is inconsistent and variable, and many programs are not satisfied with their current communication training. There is need for development of and access to appropriate and useful curricula as well as a practical tool for assessment which has been evaluated for validity evidence. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 17, 2019 Category: Pediatrics Source Type: research

Using hair cortisol to examine the role of stress in children's health inequalities at 3 years
ConclusionsIn 3-year-old children, we found no evidence that physiological stress (hair cortisol) mediated associations between adversity risk and children's health. Hair cortisol may be limited as a single measure of stress, or physiological stress may not be a mechanism for explaining the effects of adversity on these young children's health. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 17, 2019 Category: Pediatrics Source Type: research

Do Urban Minority Parents and Children Agree on Asthma Symptoms with Exercise, Worries, and Confidence in Disease Management?
Publication date: Available online 16 May 2019Source: Academic PediatricsAuthor(s): Florinda Islamovic, Ellen Johnson Silver, Marina ReznikABSTRACTObjectiveProviders commonly rely on parent report of child's asthma symptoms. However, children as young as 7 years can report on their own health. Our study compared parent and child reports of asthma symptoms with exercise, worry about developing an asthma attack, and confidence in disease management.MethodsChildren aged 7-10 years with asthma and their parents were recruited from four Bronx, NY schools. Parents and children completed interview surveys with parallel questions ...
Source: Academic Pediatrics - May 16, 2019 Category: Pediatrics Source Type: research

Medical Education Journal Club for the Millennial Resident: An Interactive, No Prep Approach
ConclusionsOur JC approach utilizing active learning principles and requiring no advance preparation is proof of concept that faculty needs to teach critical literature evaluation and millennial needs for engagement can be simultaneously met. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 14, 2019 Category: Pediatrics Source Type: research

Implementation of Recommendations for Long-Acting Contraception Among Women Aged 13 to 18 Years in Primary Care
Publication date: Available online 6 April 2019Source: Academic PediatricsAuthor(s): Sharisse M. Arnold Rehring, Liza M. Reifler, Jennifer H. Seidel, Karen A. Glenn, John F. SteinerAbstractObjectiveClinical specialty societies recommend long-acting reversible contraceptives (LARCs) as first-line contraception for adolescent women. We evaluated whether a combined educational and process improvement intervention enhanced LARC placement in primary care within an integrated health care system.MethodsThe intervention included journal clubs, live continuing education, point-of-care guidelines, and new patient materials. We condu...
Source: Academic Pediatrics - May 10, 2019 Category: Pediatrics Source Type: research

X + Y Scheduling in Pediatric Residency: Continuity, Handoffs, and Trainee Experience
Publication date: Available online 9 May 2019Source: Academic PediatricsAuthor(s): Rachel Osborn, Eliza Bullis, Ada M Fenick, Emily Powers, Sumeet Banker, Andrea AsnesAbstractBackgroundMany internal medicine residency programs have transitioned to an X + Y clinic schedule, in which weekly continuity clinics are removed and clinic experience is instead condensed into 2-week blocks interspersed throughout the year, but few pediatric training programs have adopted this approach. We initiated X + Y scheduling in the 2015 academic year, with the hypothesis that outpatient continuity could be maintained or improved while...
Source: Academic Pediatrics - May 10, 2019 Category: Pediatrics Source Type: research

Factors and Behaviors Related to the Promotion of Pediatric Hospital Medicine Fellow Autonomy: A Qualitative Study of Faculty
ConclusionsWe identified six themes related to faculty provision of autonomy to PHM fellows, as well as strategies employed by faculty to support fellow autonomy. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 10, 2019 Category: Pediatrics Source Type: research

Disparities in Caregivers’ Experiences at the Dentist With Their Young Child
ConclusionsFamilies with lower incomes and/or from ethnic and linguistic minority groups were more likely to report negative experiences at the dentist than higher income and Caucasian families. These data document the high prevalence of negative experiences and suggest ethnic, financial, and linguistic disparities in the quality of experiences. More research is needed on the role of dentists in facilitating or hindering oral health care utilization among diverse families. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 3, 2019 Category: Pediatrics Source Type: research

Table of Contents
Publication date: May–June 2019Source: Academic Pediatrics, Volume 19, Issue 4Author(s): (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 3, 2019 Category: Pediatrics Source Type: research

Editorial Board
Publication date: May–June 2019Source: Academic Pediatrics, Volume 19, Issue 4Author(s): (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 3, 2019 Category: Pediatrics Source Type: research

Key Studies in Medical Education from 2017: ANarrative Review
This article provides an overview of 18 articles from the literature in 2017 that the authors consider to be key articles in the field of pediatric medical education. The 7 authors, all medical educators with combined leadership experience and expertise across the continuum of pediatric medical education, used an iterative, staged process to review more than 1682 abstracts published in 2017. This process aimed to identify a subset of articles that were most relevant to educational practice and most applicable to pediatric medical education. In the process, pairs of authors independently reviewed and scored abstracts in 13 ...
Source: Academic Pediatrics - May 3, 2019 Category: Pediatrics Source Type: research

Building Capacity in Pediatric Environmental Health: The Academic Pediatric Association's Professional Development Program
ConclusionsThe APA's professional development program has contributed to the expansion of national capacity in PEH. Former trainees are populating the field, generating new knowledge, and moving into leadership positions. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 3, 2019 Category: Pediatrics Source Type: research

Planetary Pediatrics: The Next Generation
Publication date: Available online 27 April 2019Source: Academic PediatricsAuthor(s): Susan Bennett (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 28, 2019 Category: Pediatrics Source Type: research

Planetary Pediatrics
Publication date: Available online 26 April 2019Source: Academic PediatricsAuthor(s): Jeffrey Goldhagen (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 27, 2019 Category: Pediatrics Source Type: research

Family-Centered Care Across the Border: A Postmortem Reflection
Publication date: Available online 25 April 2019Source: Academic PediatricsAuthor(s): Zachary Foughty, Allison Silverstein (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 26, 2019 Category: Pediatrics Source Type: research

Let them speak for themselves: Improving adolescent self-report rate on pre-visit screening
ConclusionsTwo automated alerts directing clinic personnel and families to have adolescents self-report significantly and sustainably improved younger adolescent self-reporting on electronic patient-generated health data instruments. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 26, 2019 Category: Pediatrics Source Type: research

The challenge of child management during dental care: use of non-pharmacological approaches
Publication date: Available online 26 April 2019Source: Academic PediatricsAuthor(s): Marília Leão Goettems, Francine dos Santos Costa, Vanessa Polina Pereira da Costa (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 26, 2019 Category: Pediatrics Source Type: research

Teaching Students How to Improve Safety and Quality in Two Children's Hospitals: Building a Pediatric Clerkship Patient Safety and Quality Experience
Publication date: Available online 25 April 2019Source: Academic PediatricsAuthor(s): Frank J. Genuardi, Maria N. Kelly, Eric I. Rosenberg, Erik W. Black, Kara Dawson (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 25, 2019 Category: Pediatrics Source Type: research

Food Insecurity Associated with Underestimation of Weight Status in Children with a Healthy Weight Status
ConclusionFood insecurity was associated with a decrease in accuracy of parental weight perceptions in children with healthy weight. Pediatricians should clearly communicate about weight status, as families with HFI may adopt unhealthy eating behaviors under the incorrect assumption that their child is underweight. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 25, 2019 Category: Pediatrics Source Type: research

A Learning Loop Model of Collaborative Decision Making in Chronic Illness
Publication date: Available online 19 April 2019Source: Academic PediatricsAuthor(s): Sarah D. Ronis, Lawrence C. Kleinman, Kurt C. StangeAbstractShared decision-making is a core attribute of quality healthcare that has proved challenging to implement and assess in pediatric practice. Current models of shared decision-making are limited, including their capacity: to incorporate multiple stakeholders; to integrate downstream effects of subacute or minor decisions; and to account for the context(s) in which such decisions are being made and enacted. Based on a review of literature from organizational psychology, cognitive sc...
Source: Academic Pediatrics - April 20, 2019 Category: Pediatrics Source Type: research

Characteristics of High Performing Primary Care Pediatric Practices: A Qualitative Study
ConclusionsThis study suggested that elements of organizational culture may play as important a role in the quality of care delivered as specific quality improvement strategies. Interventions to further test this relationship may aid practices seeking to improve the care they deliver. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 18, 2019 Category: Pediatrics Source Type: research

Material Hardships and Health Care Utilization Among Low-Income Children with Special Health Care Needs
ConclusionsMaterial hardships were associated with higher rates of ED visits and greater unmet health care need among low-income CSHCN. Future examination of the mechanisms of these associations is needed to enhance support for families of CSHCN. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 14, 2019 Category: Pediatrics Source Type: research

The relationship between housing instability and poor diet quality among urban families
CONCLUSIONSIn this urban primary care population, housing instability is associated with lower diet quality scores for parents but not children. Lower vegetable consumption appears to drive this association. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 14, 2019 Category: Pediatrics Source Type: research

Refusal of Vitamin K by Parents of Newborns: A Qualitative Study
DiscussionParents’ perception of risk, preference for alternative options, trust and communication with health care providers are pivotal factors when making decisions about IM vitamin K. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 11, 2019 Category: Pediatrics Source Type: research

Concordance of Child and Parent Reports of Children's Screen Media Use
ConclusionsParent and child reports of children's media use were generally concordant. However, there were important disagreements, such as TV use in the child's room and during meals. We discuss possible causes of discrepancies and implications. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 11, 2019 Category: Pediatrics Source Type: research

Parental Dual use of E-cigarettes and Traditional Cigarettes
We examined factors associated with dual use of e-cigarettes and cigarettes vs. cigarette-only smokers, assessed by self-report.ResultsOf 1382 smokers or recent quitters screened after their child's visit between April-October 2017, 943 (68%) completed the survey. Of these, 727 parents reported current use of cigarettes; and of those, 81 (11.1%) also reported e-cigarette use, meeting the definition of dual use. Compared to cigarette-only smokers, dual users were more likely to have a child younger than 1-year old, planned to quit in the next 6 months, and had tried to quit in the past (had a quit attempt in the past 3 mont...
Source: Academic Pediatrics - April 11, 2019 Category: Pediatrics Source Type: research

Parental and Provider Perceptions of Sugar-Sweetened Beverage Interventions in the First 1000Days: A Qualitative Study
ConclusionsMessages focused on infant health consequences and parental empowerment to evaluate and select healthier beverages based on sugar content should be tested in interventions to reduce SSB consumption in the first 1000days. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 6, 2019 Category: Pediatrics Source Type: research

Secondhand smoke exposure and sleep-related breathing problems in toddlers
ConclusionAlthough the cross-sectional nature of this study limits causality, evidence suggests a relationship exists between SHS exposure, as measured by log hair nicotine and sleep-related breathing problems at night. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 6, 2019 Category: Pediatrics Source Type: research