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Saran S, Saccomanno S, Viti S, Mastrapasqua RF, Viti G, Giannotta N, Fioretti P, Lorenzini E, Raffaelli L, Levrini L. Analysis of General Knowledge on Obstructive Sleep Apnea Syndrome (OSAS) among Italian Pediatricians. Children (Basel) 2024; 11:148. [PMID: 38397260 PMCID: PMC10887165 DOI: 10.3390/children11020148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is a disorder characterized by partial or total airway obstruction during sleep. Studies have shown variability in the level of knowledge and awareness about OSAS among pediatricians. The management of childhood obstructive sleep apnea syndrome (OSAS) depends on the severity of the disease, the presence of comorbidities, and the child's age. The American Pediatric Academy recommends a multidisciplinary approach involving a pediatrician, a sleep specialist, and an otolaryngologist to provide comprehensive care for children with OSAS. The aim of this cross-sectional study is to evaluate the level of knowledge among pediatricians in Italy regarding the diagnosis of pediatric OSAS. MATERIAL AND METHODS An anonymized survey was conducted among Italian pediatricians. The survey was administered electronically using Google Forms, and a total of 350 pediatricians were invited to participate. Out of the 350 invitations, 299 pediatricians responded to the survey. The statistical analysis performed consisted of descriptive analysis. The study included 297 pediatricians. RESULTS Pediatricians demonstrated proficiency in identifying common nocturnal and day symptoms of OSAS. A majority (68.9%) considered the oral and otorhinolaryngologist areas during checkups. Approximately 70.6% took patient weight into account, and 62.8% were aware of the regional diagnostic-therapeutic-assistance pathway. CONCLUSIONS According to the results of this manuscript, there is evidence of a good level of knowledge about OSAS, but disseminating more information about OSAS and all the health issues associated with this syndrome is suggested. This study also has limitations caused by the complexity of the pathology.
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Affiliation(s)
- Stefano Saran
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy (N.G.); (L.L.)
| | - Sabina Saccomanno
- Orthodontic Residency, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Simonetta Viti
- Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | | | - Grazia Viti
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy (N.G.); (L.L.)
| | - Nicola Giannotta
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy (N.G.); (L.L.)
| | - Paola Fioretti
- Department of Medicine and Surgery, Hygiene and Public Health Section, University of Perugia, 06123 Perugia, Italy; (P.F.); (E.L.)
| | - Elisa Lorenzini
- Department of Medicine and Surgery, Hygiene and Public Health Section, University of Perugia, 06123 Perugia, Italy; (P.F.); (E.L.)
| | - Luca Raffaelli
- Dental School, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Luca Levrini
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy (N.G.); (L.L.)
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Rigas N, Kyritsis Z, Dagla M, Soldatou A, Orovou E, Tzitiridou-Chatzopoulou M, Eskitzis P, Antoniou E. Post-Traumatic Stress Disorder Symptoms among Pediatric Healthcare Workers. Nurs Rep 2024; 14:115-127. [PMID: 38251188 PMCID: PMC10801477 DOI: 10.3390/nursrep14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Post-traumatic stress disorder symptoms related to work in pediatric departments aremajor public health problems, as they directly affect health organizations, healthcare workers, and, due to the poor quality of care, the patients as well. The post-traumatic symptoms that a healthcare worker may experience are related to intrusion, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. The aim of the present investigation was to identify risk factors that contribute to the development of PTSD in pediatric healthcare workers, in order to implement necessary workplace measures. A sample of four hundred and forty-five pediatric workers at seven Greek public hospitals consented to participate in the survey. Socio-demographic data and a post-traumatic checklist (5th edition) were used to diagnose post-traumatic stress disorder. According to the results, risk factors for the development of post-traumatic symptoms include medical or nursing errors, threats to a child's life, and incidents of workplace bullying. More specifically, 25.2% of the participants had a provisional PTSD diagnosis, 72.8%of the sample experienced an incident involving a medical or nursing error in their workplace related to the treatment or care of a child, 56% experienced an incident involving a child's death or a threat to a child's life due to a serious illness or injury, and 55.5% experienced an incident of workplace bullying. In addition, it was found that having a university-level education, master's, or PhD, working in a circular shift, being assigned to a department by management rather than the worker, and dissatisfaction with salary were associated with post-traumatic stress disorder. The high rates of PTSD symptoms among participants highlight the need for prevention and management measures to protect and support the mental health of workers in pediatric departments. We propose frequent evaluations of the mental health of employees, more time for rest, incentives for professional development, utilization of their specializations and specialties, support from mental health specialists when symptoms are diagnosed, and the option for employees to change departments if they wish or if they show symptoms of mental trauma.
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Affiliation(s)
- Nikolaos Rigas
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| | - Zacharias Kyritsis
- Department of Mathematics, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Maria Dagla
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| | - Alexandra Soldatou
- Faculty of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Eirini Orovou
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece; (E.O.); (M.T.-C.); (P.E.)
| | | | - Panagiotis Eskitzis
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece; (E.O.); (M.T.-C.); (P.E.)
| | - Evangelia Antoniou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
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Tiao MM, Chang YC, Ou LS, Hung CF, Khwepeya M. An Exploration of Pediatricians' Professional Identities: A Q-Methodology Study. Healthcare (Basel) 2024; 12:144. [PMID: 38255033 PMCID: PMC10815713 DOI: 10.3390/healthcare12020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Professional identities may influence a wide range of attitudes, ethical standards, professional commitments and patient safety. This study aimed to explore the important elements that comprise pediatricians' professional identities. A Q-methodology was used to identify the similarities and differences in professional identity. Forty pediatricians were recruited from two tertiary referral hospitals in Taiwan. A list of statements was developed by five attending physicians and three residents. R software was used to analyze the Q-sorts to load the viewpoints and formulate the viewpoint arrays. Additional qualitative data-one-to-one personal interviews-were analyzed. Twenty-eight of forty pediatricians, 11 males and 17 females, with an average age of 39.9 (27-62) years, were associated with four viewpoints. We labeled the four viewpoints identified for professional identity as (1) professional recognition, (2) patient communication, (3) empathy and (4) insight. The professional recognition viewpoint comprised of youngest participants-28-36 years-with the majority as residents (77.8%), while the empathy viewpoint comprised the oldest participants-38-62 years-with all as attending physicians. All participants in the empathy and insight viewpoints were married. This study found professional identity to be a multifaceted concept for pediatricians, especially in the areas of professional recognition, patient communication, empathy and insight into patient care.
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Affiliation(s)
- Mao-Meng Tiao
- Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Yu-Che Chang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Liang-Shiou Ou
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
| | - Chi-Fa Hung
- Department of Psychology, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Madalitso Khwepeya
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
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Sargin F, Buldu E. Turkish Pediatrician Beliefs About Third-hand Smoking. J Pediatr Health Care 2024; 38:97-104. [PMID: 37831029 DOI: 10.1016/j.pedhc.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Although third-hand smoke (THS) is a relatively new concept, it emerges as an important health problem. This study evaluated the beliefs of Turkish Pediatricians about THS. METHOD The survey, designed to be self-filled by pediatricians, provided information on demographic data, lifestyle factors, and beliefs about THS. Participant beliefs about THS were evaluated using the Beliefs About Third-Hand Smoke scale. This study was conducted by applying a web-based survey to pediatricians in Turkey. RESULTS The Beliefs About Third-Hand Smoke scale scores were lower in participants who were male (odds ratio [OR] = 1.479; 95% confidence interval [CI], 0.246-0.526; p < .001), have children (OR = 0.656; 95% CI, 0.156-0.665; p = .002), widowed/separated (OR = 0.498; 95% CI, -1.072 to -0.360; p < .001), a smoker (OR = 0.586; 95% CI, -0.711 to -0.355; p < .001), worked in State Hospital (OR = 0.574; 95% CI, -0.768 to -0.423; p < .001), and specialists (OR = 0.621; 95% CI, -0.608 to -0.207; p < .001). DISCUSSION This study showed that pediatricians who were male, widowed/separated, a smoker, with children, working in a State Hospital, and specialists had less belief in the side effects of THS.
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Rigas N, Kyritsis Z, Gouroundi K, Soldatou A, Dagla M, Orovou E, Antoniou E. The Mediating Role of Anxiety in the Relationship between Job Satisfaction and Psychosocial Functions of Nurses and Pediatricians in PICUs. Mater Sociomed 2024; 36:26-32. [PMID: 38590601 PMCID: PMC10999150 DOI: 10.5455/msm.2024.36.26-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/26/2024] [Indexed: 04/10/2024] Open
Abstract
Background Job satisfaction refers to an individual's overall attitude towards their job. It is influenced by various factors such as work environment, job role, work-life balance, compensation, anxiety, opportunities for growth and development. However, low levels of job satisfaction can have a significant impact on an individual's mental health and overall well-being. Objective We contacted this study in order to assess the effect of PICU nurses' and pediatricians' job satisfaction on their psychosocial functioning and to examine the role of anxiety as a mediating factor in this relationship. Methods A sample of 155 nurses and pediatricians at 7 University Hospitals in Greece has consented to participate in the study. Socio-demographic data, Hamilton Rating Scale for Anxiety, Minnesota Satisfaction Questionnaire -short form and a Brief Inventory of Psychosocial Functioning were used to evaluate anxiety, job satisfaction and psychosocial functions. Results According to our results, participants with moderate or severe levels of anxiety showed moderate or low job satisfaction, while moderate or severe anxiety was also associated with low levels of participants' psychosocial functioning. Job satisfaction is a dynamic situation that is affected by the levels of anxiety of each worker in PICU. Conclusion The presence of anxiety may be related to comorbid mental health disorders since it affects the psychosocial functions of the worker. We propose a longer rest period, a change of department in case an employee wishes it or shows symptoms of increased stress or another mental health disorder, regular assessments by mental health experts for all PICU's staff and support after a diagnosis of a mental health problem.
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Affiliation(s)
- Nikolaos Rigas
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | - Zacharias Kyritsis
- Department of Mathematics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Alexandra Soldatou
- Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Dagla
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | - Eirini Orovou
- Department of Midwifery, University of Western Macedonia, Ptolemaida, Greece
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Tadin A, Dzaja K. Assessment of Pediatricians' and General Practitioners' Knowledge and Practice Regarding Oral Health, Dental Caries and Its Prevention in Children: A Cross-Sectional Study. Dent J (Basel) 2023; 11:259. [PMID: 37999023 PMCID: PMC10670318 DOI: 10.3390/dj11110259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/28/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate and compare the knowledge and practices of family physicians (general practitioners) and pediatricians concerning children's oral health. MATERIALS AND METHODS This research involved a cross-sectional survey with 446 respondents, consisting of 77.8% women and 22.1% men, with 81.6% being general (family) practitioners and 18.4% pediatricians. The survey comprised five sections, gathering information on participants' sociodemographic characteristics, routine oral cavity examination in clinical practice, knowledge about dental caries and its prevention, teething symptoms, and alternatives to fluorides for preventing dental caries. RESULTS The findings revealed an overall poor understanding of dental caries and its prevention, with an average score of 5.1 ± 1.6 out of a possible 10 points. Notably, practitioners with fewer pediatric patients during the workday, no training on oral health, and uncertainty about physicians' active role in oral health prevention exhibited lower knowledge levels (p ˂ 0.05). Over 90% of participants conducted dental and oral mucosal examinations on their patients. About 25% had received continuing education on children's oral health, and 70.6% expressed interest in further education on the subject. CONCLUSIONS This study highlights insufficient knowledge among physicians regarding dental caries and its prevention. With most participants eager to learn and actively promote children's oral health, providing training is essential to boost their knowledge and support children's oral health.
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Affiliation(s)
- Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, University of Split School of Medicine, 21000 Split, Croatia
- Department of Oral and Maxillofacial Surgery, Clinical Hospital Centre Split, 21000 Split, Croatia
| | - Karmela Dzaja
- Study of Dental Medicine, University of Split School of Medicine, 21000 Split, Croatia
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Lee SS, Kaushik A, Natsis N, Kusari A, Schairer D, Lindback S, Levenberg M, Mills JR, Peeples K, Smith R, Eichenfield LF. A multimodal initiative improves general pediatric provider management of atopic dermatitis in children: A prospective interventional study. J Am Acad Dermatol 2023; 89:1041-1044. [PMID: 37516950 DOI: 10.1016/j.jaad.2023.02.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/15/2022] [Accepted: 02/07/2023] [Indexed: 07/31/2023]
Affiliation(s)
- Stephanie S Lee
- Department of Dermatology, San Diego School of Medicine, University of California, La Jolla, California; Rady Children's Hospital San Diego, San Diego, California
| | - Anshika Kaushik
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Nicola Natsis
- Department of Dermatology, San Diego School of Medicine, University of California, La Jolla, California; Rady Children's Hospital San Diego, San Diego, California
| | - Ayan Kusari
- Department of Dermatology, University of California, San Francisco, San Francisco, California
| | - David Schairer
- Department of Dermatology, San Diego School of Medicine, University of California, La Jolla, California; Rady Children's Hospital San Diego, San Diego, California
| | - Sarah Lindback
- Rady Children's Hospital San Diego, San Diego, California
| | | | | | | | | | - Lawrence F Eichenfield
- Department of Dermatology, San Diego School of Medicine, University of California, La Jolla, California; Rady Children's Hospital San Diego, San Diego, California; Department of Pediatrics, San Diego School of Medicine, University of California, La Jolla, California.
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Jafari S, Memarpour M, Pakniyat Jahromi M, Vossoughi M, Hamidi SA. Assessment of knowledge, attitude, and behavior related to children's oral health in pediatricians and students in the pediatric field in Iran: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:4725-4730. [PMID: 37811012 PMCID: PMC10553059 DOI: 10.1097/ms9.0000000000000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/12/2023] [Indexed: 10/10/2023] Open
Abstract
Background Pediatricians have an important role to play in motivating and instructing parents on oral health in children. The aim of this study was to assess knowledge of, attitude to, and behavior regarding oral health care in children among pediatricians and students in the pediatric field in Iran. Methods This cross-sectional study included all students in the pediatric field (those who had started a residency or fellowship) and practicing pediatricians in provincial centers and universities (61 setting centers) throughout Iran in the course of 2021. Participants completed an online questionnaire assessing details of the parameters of knowledge of, attitude to, and behavior toward oral health for each individual. A convenience sampling technique was used to gather the study sample. All data were coded for each of the parameters. The data were analyzed by one-way ANOVA (Analysis of Variance)/Tukey and Pearson's correlation tests and path analysis. Results Out of 582 participants who visited the website, a total of 217 completed the entire questionnaire (participation rate of 37.2%). On the attitude parameter, 84.8% of participants scored above 75% of the possible attainable score, while only 37.9% and 48.1% of them had adequate knowledge and behavior for the possible score, respectively. Specialists had a higher mean score on behavior and knowledge than residents (P=0.001). There was a significant correlation between the scores on attitude and behavior (r=0.42, P<0.001), attitude and knowledge (r=0.19, P=0.005), and behavior and knowledge (r=0.25, P<0.001). Nearly all of the participants, 216 (99.5%), felt the need for the principles of dentistry to be included in the curriculum. Conclusions Pediatricians showed a favorable attitude to oral health, but their knowledge of and behavior in the field was inadequate. Improvement of pediatricians' interest and performance in oral health in children should be encouraged through the inclusion of these parameters in the curriculum for students of the pediatric field. Implementing training programs for practical pediatricians or incorporating independent theoretical and clinical courses offered by pediatric dentists in dental school departments into the field curriculum of the students in the pediatric field is recommended.
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Affiliation(s)
- Saba Jafari
- Student Research Committee, Department of Pediatric Dentistry
| | - Mahtab Memarpour
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry
| | | | - Mehrdad Vossoughi
- Oral and Dental Disease Research Center, Department of Dental Public Health
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Potura E, Klemm V, Roesner H, Sitter B, Huscsava H, Trifunovic-Koenig M, Voitl P, Strametz R. Second Victims among Austrian Pediatricians (SeViD-A1 Study). Healthcare (Basel) 2023; 11:2501. [PMID: 37761698 PMCID: PMC10531173 DOI: 10.3390/healthcare11182501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The second victim phenomenon (SVP) plays a critical role in workplace and patient safety. So far, there are limited epidemiological data on the SVP in German-speaking countries. Some studies have been carried out in Germany, but so far, no quantitative studies have been carried out in Austria examining the prevalence, symptom load and preferred support measures for second victims (SVs). This study therefore examines the SVP among Austrian pediatricians. (2) Methods: A nationwide, cross-sectional and anonymous online study was conducted using the SeViD questionnaire (Second Victims in Deutschland) including the Big Five Inventory-10 (BFI-10). Statistical analysis included binary-logistic and multiple linear regression with the bootstrapping, bias-corrected and accelerated (BCa) method based on 1000 bootstrap samples. (3) Results: Of 414 Austrian pediatricians, 89% self-identified as SVs. The main cause of becoming an SV was the unexpected death or suicide of a patient. High neuroticism and extraversion values as well as working in outpatient care positively correlated with having experienced the SVP. A preferred support strategy was access to legal counseling. (4) Conclusions: Austrian pediatricians have the highest SVP prevalence measured with the SeViD questionnaire. Further research should focus on prevention strategies and intervention programs.
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Affiliation(s)
- Eva Potura
- The Second Victim Association Austria, 11900 Vienna, Austria; (E.P.)
| | - Victoria Klemm
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany
| | - Hannah Roesner
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany
| | - Barbara Sitter
- The Second Victim Association Austria, 11900 Vienna, Austria; (E.P.)
| | - Herbert Huscsava
- The Second Victim Association Austria, 11900 Vienna, Austria; (E.P.)
| | | | - Peter Voitl
- First Vienna Pediatric Medical Center, Sigmund Freud University Vienna, 1220 Vienna, Austria
| | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany
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Suqaty R, Alomran AK, Alkhalifah MK, Aldughaythir SS, Albeshry AM, Aldilaijan Y, Alzahrani MT, Alhussainan T. How Ready are Pediatricians and Family Physicians in Saudi Arabia to Perform Clinical Screening of Developmental Dysplasia of the Hip? J Multidiscip Healthc 2023; 16:2567-2576. [PMID: 37667798 PMCID: PMC10475280 DOI: 10.2147/jmdh.s416459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023] Open
Abstract
Background Developmental dysplasia of the hip (DDH) is one of the most common hip pathologies in pediatric age group and late diagnosis remains a major concern in Saudi Arabia. Objective The aim of this study is to examine the ability of Saudi Arabian pediatricians and family physicians to conduct clinical screening for (DDH) by estimating their clinical knowledge and skills and analyzing the gaps therein to determine whether there is potential to launch a national screening protocol for DDH in Saudi Arabia. Methods This is a multicenter cross-sectional study from three major regions in Saudi Arabia (Central, Eastern and Western provinces). The assessed aspects are risk factors, age of screening, incidence in Saudi Arabia, physical signs and diagnostic markers, and treatment, along with their 'clinical knowledge and skills' score. Results Half of the participants were pediatricians, while the rest were family physicians. More than a third of the participants were considered to have adequate knowledge, ie, above the mean score. Dimensions with the most significant knowledge gaps included the incidence of DDH in Saudi Arabia, adverse effects of swaddling, and the management of a high-risk infants presenting with a negative physical examination. Additionally, there were relatively low rates of awareness regarding positive risk factors as well as a generally poor ability to identify physical signs. Clinical knowledge and skill levels were significantly lower among family physicians. Conclusion Pediatricians and family physicians in Saudi Arabia still need further training to improve their clinical skills for DDH screening. The proper administration of training programs could eventually enable the gradual implementation of a national systematic screening program.
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Affiliation(s)
- Rayyan Suqaty
- Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ammar K Alomran
- Department of Orthopedics, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed K Alkhalifah
- Department of Family Medicine & Polyclinics King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Saad S Aldughaythir
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdulrahman M Albeshry
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Yousif Aldilaijan
- Primary Health Care Centers, Eastern Health Cluster, Khobar, Saudi Arabia
| | - Mohammed T Alzahrani
- Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Thamer Alhussainan
- Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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Blaine RE, Blaine KP, Cheng K, Banuelos C, Leal A. Priorities, barriers, and facilitators for nutrition-related care for autistic children: a qualitative study comparing interdisciplinary health professional and parent perspectives. Front Pediatr 2023; 11:1198177. [PMID: 37650046 PMCID: PMC10465129 DOI: 10.3389/fped.2023.1198177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/27/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Children with autism spectrum disorder often face nutrition-related challenges, such as food selectivity, gastrointestinal issues, overweight and obesity, and inadequate nutrient intake. However, the role of routine nutrition-related screening or care by interdisciplinary health professionals is not well understood. This study aimed to compare the beliefs of health professionals with those of parents of autistic children regarding high-priority nutrition-related challenges, barriers and facilitators to care, and desired education and resources related to nutrition for autistic children. Participants Interdisciplinary health professionals (n = 25) (i.e., pediatricians, occupational therapists, speech-language pathologists, board certified behavior analysts, registered dietitians) and parents of autistic children (n = 22). Methods The study used semi-structured phone interviews, which were recorded, transcribed, verified, and double-coded using the Framework Method. Results Thematic analysis of transcripts revealed that while health professionals and parents of autistic children shared some perspectives on nutrition-related challenges and care, they also had distinct viewpoints. Parents emphasized the importance of addressing food selectivity, behavioral eating challenges, sensory issues, and sleep disturbances affecting appetite. Both groups acknowledged the need for tailored support, access to an interdisciplinary care team, and reasonable expectations. Some health professionals perceived parents as lacking motivation or the ability to make changes. In contrast, many parents felt that health professionals lacked the knowledge and motivation to take nutrition or growth concerns seriously. Health professionals acknowledged that their lack of knowledge or capacity to provide nutrition education or referrals was a common barrier to care, particularly given limited community resources. Discussion Health professionals who serve autistic children are motivated to address nutrition-related challenges but lack resources related to nutrition. To promote better health outcomes for autistic children, professionals should identify and support parent motivations around nutrition-related care. Both groups expressed interest in accessing autism-specific resources for education, referral, and screening guidance. Future research could explore the development of healthcare training models that improve the competency of health professionals in providing nutrition care and referral for autistic children.
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Affiliation(s)
- Rachel E. Blaine
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, United States
| | - Kevin P. Blaine
- Research Institute, Children’s Hospital of Orange County, Orange, CA, United States
| | - Katie Cheng
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, United States
| | - Cynthia Banuelos
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, United States
| | - Aaron Leal
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, United States
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12
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Wood C, Rosati P, Lynn T. #Putkids1st: Health Professionals Using Social Media for Public Policy Advocacy-From Collective Action to Connective Action. Children (Basel) 2023; 10:1343. [PMID: 37628342 PMCID: PMC10453826 DOI: 10.3390/children10081343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023]
Abstract
This study examines public policy advocacy by pediatricians and other health professionals in the hashtag community: #putkids1st. The study explores 4321 tweets that feature the hashtag, generated by 1231 unique users largely drawn from the American Association of Pediatricians and its members. The data are used to explore the structural dynamics of the hashtag community, the role of homophily, and to test a source-message framework to predict and recommendations to help improve engagement and retransmission of professional health advocacy messages.
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Affiliation(s)
- Charles Wood
- Collins College of Business, The University of Tulsa, Tulsa, OK 74104, USA;
| | - Pierangelo Rosati
- J.E. Cairnes School of Business and Economics, University of Galway, H91 YK8V Galway, Ireland
| | - Theo Lynn
- Irish Institute of Digital Business, Dublin City University, D09 RFK0 Dublin, Ireland;
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13
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Alfaqih MA, Ababneh EY, Almansi GA, Marashdeh SA, Khazandar AA, Said AM, Mustafa AG. The attitude and knowledge of pediatricians and family physicians toward COVID-19 vaccination in children: A cross-sectional study. Hum Vaccin Immunother 2023:2230104. [PMID: 37395614 DOI: 10.1080/21645515.2023.2230104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
COVID-19 vaccines to children are expected to reduce the transmission of the disease to high-risk groups and achieve herd immunity in younger populations. A positive attitude toward COVID-19 vaccination in children among healthcare workers (HCWs) is predicted to reduce parents' hesitancy to vaccinate their children. This study aimed to assess the knowledge and attitude of pediatricians and family physicians toward COVID-19 vaccination in children. A total of 112 pediatricians and 96 family physicians (specialists and residents) were interviewed to assess the level of knowledge, attitude, and perceived safety of COVID-19 vaccines for children. Physicians willing to receive regular COVID-19 vaccination (analogous to the influenza vaccine) had significantly higher knowledge and attitude scores (P < .05). Multivariate analysis indicated that a higher knowledge score and having at least five years of experience as a specialist were significantly associated with a positive attitude among pediatricians or family physicians (P < .05). Pfizer/BioNTech was the preferred COVID-19 vaccine in children among physicians of both groups (>67%). Around 71% of physicians believed COVID-19 vaccines for children do not cause or worsen any health condition. Educational and training programs that increase the knowledge of physicians about COVID-19 vaccines and their safety in children are recommended to inform a more positive attitude.
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Affiliation(s)
- Mahmoud A Alfaqih
- Department of Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ebaa Y Ababneh
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Galya A Almansi
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sara A Marashdeh
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Alaa A Khazandar
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmad M Said
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ayman G Mustafa
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
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14
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Hotez E, Giwa Onaiwu M. A Neurodiversity-Oriented Approach to Address Autism Wandering as a "Problem Behavior" in Pediatrics. Cureus 2023; 15:e40862. [PMID: 37492814 PMCID: PMC10363653 DOI: 10.7759/cureus.40862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/19/2023] [Indexed: 07/27/2023] Open
Abstract
Pediatricians are frequently tasked with addressing autism "problem behaviors," including wandering, defined as leaving the safety of a responsible person's care or a safe area (alternatively referred to as elopement). In the following commentary, we - as autism researchers and individuals with lived experience - discuss the prevalence and public health consequences of wandering. We conceptualize wandering in the context of "problem behaviors" for autistic individuals and describe the current state of the evidence on wandering prevention and intervention. We emphasize that pediatricians have a unique opportunity to optimize their efforts to address wandering - as well as related "problem behaviors" - utilizing a neurodiversity orientation. This will allow them to enact approaches that address the potential upstream mechanisms underlying wandering to make these efforts more effective and provide critical assistance to families. In this manuscript, we provide recommendations to pediatricians to more effectively address the mechanisms underlying and exacerbating these challenges to improve the health, well-being, and quality of life of autistic children and their families. In particular, we recommend that pediatricians focus efforts toward 1) addressing the link between chronic stress and "problem behaviors"; 2) engaging individuals, caregivers, and families as experts in their health and development; and 3) collaborating with the systems and sectors relevant to autistic individuals and their families.
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Affiliation(s)
- Emily Hotez
- General Internal Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, USA
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15
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Lee M, Bin Mahmood ABS, Lee ES, Smith HE, Tudor Car L. Smartphone and Mobile App Use Among Physicians in Clinical Practice: Scoping Review. JMIR Mhealth Uhealth 2023; 11:e44765. [PMID: 37000498 PMCID: PMC10131676 DOI: 10.2196/44765] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/08/2023] [Accepted: 03/12/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Health care professionals are increasingly using smartphones in clinical care. Smartphone use can affect patient quality of care and clinical outcomes. OBJECTIVE This scoping review aimed to describe how physicians use smartphones and mobile apps in clinical settings. METHODS We conducted a scoping review using the Joanna Briggs Institute methodology and reported the results according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. We used the following databases in our literature search: MEDLINE, Embase, Cochrane Library, Web of Science, Google Scholar, and gray literature for studies published since 2010. An additional search was also performed by scanning the reference lists of included studies. A narrative synthesis approach was used. RESULTS A total of 10 studies, published between 2016 and 2021, were included in this review. Of these studies, 8 used surveys and 2 used surveys with focus group study designs to explore smartphone use, its adoption, experience of using it, and views on the use of smartphones among physicians. There were studies with only general practitioners (n=3), studies with only specialists (n=3), and studies with both general practitioners and specialists (n=4). Physicians use smartphones and mobile apps for communication (n=9), clinical decision-making (n=7), drug compendium (n=7), medical education and training (n=7), maintaining health records (n=4), managing time (n=4), and monitoring patients (n=2) in clinical practice. The Medscape medical app was frequently used for information gathering. WhatsApp, a nonmedical app, was commonly used for physician-patient communication. The commonly reported barriers were lack of regulatory oversight, privacy concerns, and limited Wi-Fi or internet access. The commonly reported facilitator was convenience and having access to evidence-based medicine, clinical decision-making support, and a wide array of apps. CONCLUSIONS Smartphones and mobile apps were used for communication, medical education and training, clinical decision-making, and drug compendia in most studies. Although the benefits of smartphones and mobile apps for physicians at work were promising, there were concerns about patient privacy and confidentiality. Legislation is urgently needed to protect the liability of health care professionals using smartphones.
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Affiliation(s)
- Mauricette Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Eng Sing Lee
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- National Health Group Polyclinics, Singapore, Singapore
| | - Helen Elizabeth Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
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16
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Jovičić M, Milosavljević MN, Folić M, Pavlović R, Janković SM. Predictors of Mortality in Early Neonatal Sepsis: A Single-Center Experience. Medicina (Kaunas) 2023; 59:medicina59030604. [PMID: 36984605 PMCID: PMC10057658 DOI: 10.3390/medicina59030604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
Background and Objectives: Early neonatal sepsis is associated with a significant mortality rate despite modern treatment strategies. Our aim was to identify risk factors contributing to the occurrence of death in newborns with early neonatal sepsis. Materials and Methods: We conducted a retrospective cross-sectional study that included newborns with early sepsis who received care in the intensive and semi-intensive care units at the Institute of Neonatology, Belgrade, Serbia. Newborns with early neonatal sepsis who died comprised the case group, whereas those who survived made up the control group. The diagnostic and therapeutic approach to the septic condition was carried out independently of this study, according to valid hospital protocols and current good practice guidelines. The influence of a large number of variables on the examined dichotomous outcome, as well as the mutual interaction of potential predictor variables, was examined by binary logistic regression. Results: The study included 133 pregnant women and 136 newborns with early neonatal sepsis, of which 51 (37.5%) died, while the remaining 85 newborns (62.5%) survived. Newborns who died had a statistically significantly lower birth weight compared to those who survived (882.8 ± 372.2 g vs. 1660.9 ± 721.1 g, p = 0.000). Additionally, compared to newborns who survived, among the deceased neonates there was a significantly higher proportion of extremely preterm newborns (74.5% vs. 22.4%, p = 0.000). The following risk factors for the occurrence of death in early neonatal sepsis were identified: low birth weight, sepsis caused by gram-negative bacteria, and the use of double-inotropic therapy and erythrocyte transfusion during the first week. Conclusions: Pediatricians should pay special attention to infants with early neonatal sepsis in whom any of the identified risk factors are present in order to prevent a fatal outcome.
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Affiliation(s)
| | - Miloš N Milosavljević
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Marko Folić
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Clinical Pharmacology Department, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia
| | - Radiša Pavlović
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Slobodan M Janković
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Clinical Pharmacology Department, University Clinical Centre Kragujevac, 34000 Kragujevac, Serbia
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17
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Werner KM, Mercurio MR, Shabanova V, Hull SC, Taylor SN. Pediatricians' Reports of Interaction with Infant Formula Companies. Breastfeed Med 2023; 18:219-225. [PMID: 36795978 DOI: 10.1089/bfm.2022.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Introduction: Seventy percent of countries follow the World Health Organization International Code of Marketing Breast Milk Substitutes that prohibits infant formula companies (IFC) from providing free products to health care facilities, providing gifts to health care staff, or sponsoring meetings. The United States rejects this code, which may impact breastfeeding rates in certain areas. Objective: We aimed at gathering exploratory data about interactions between IFC and pediatricians. Methods: We distributed an electronic survey to U.S. pediatricians asking about practice demographics, interactions with IFC, and breastfeeding practices. Using the zip code of the practice, we obtained additional information from the 2018 American Communities Survey, including median income, percent of mothers who had graduated college, percent of mothers working, and racial and ethnic identity. We compared demographic data for those pediatricians who had a formula company representative visit versus not and those who had a sponsored meal versus not. Results: Of 200 participants, the majority reported a formula company representative visit to their clinic (85.5%) and receiving free formula samples (90%). Representatives were more likely to visit areas with higher-income patients (median = $100K versus $60K, p < 0.001). They tended to visit and sponsor meals for pediatricians at private practices and in suburban areas. Most of the reported conferences attended (64%) were formula company-sponsored. Conclusion: Interactions between IFC and pediatricians are prevalent and occur in many forms. Future studies may reveal whether these interactions influence the advice of pediatricians or the behavior of mothers who had planned to exclusively breastfeed.
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Affiliation(s)
- Kelly M Werner
- Division of Neonatology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Mark R Mercurio
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.,Program for Biomedical Ethics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Veronika Shabanova
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Biostatistics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sarah C Hull
- Program for Biomedical Ethics, Yale University School of Medicine, New Haven, Connecticut, USA.,Section of Cardiology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sarah N Taylor
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
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18
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Lucy CA, Wojtaszek J, LaLonde L, Bruni TP, Ham HL, Sunde E, Lancaster B, Maragakis A. Pediatrician Burnout Before and After the COVID-19 Pandemic. J Prim Care Community Health 2023; 14:21501319231194148. [PMID: 37599442 PMCID: PMC10441537 DOI: 10.1177/21501319231194148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/10/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023] Open
Abstract
OBJECTIVE During the surge of the COVID-19 pandemic, burnout among physicians increased significantly. In the spring of 2023, the COVID national emergency was terminated in the U.S. To investigate whether provider burnout rates have returned to pre-pandemic levels, the current study compared dimensions of burnout among pediatricians pre- and post-pandemic. METHOD As part of 2 separate behavioral health trainings held at a Midwest academic health center in 2019 and virtually in 2023, data on burnout was collected from 52 pediatricians pre-pandemic and 38 pediatricians post-pandemic. Participants completed an online survey during the trainings and responded to items reflecting 3 dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment. RESULTS There were no statistically significant differences in pre- and post-pandemic burnout amongst pediatricians in terms of total scores, number of pediatricians who met the clinical cutoff for each dimension, number of cutoffs met, or number of providers reporting elevated burnout on at least 1 dimension (p > .05 for all comparisons). Participants were 1.77 times more likely to meet the cutoff for emotional exhaustion post-pandemic than pre-pandemic. Over half of providers met this cutoff post-pandemic, compared to only 35% pre-pandemic. CONCLUSIONS While post-pandemic rates of burnout among pediatricians appear to be statistically similar to pre-pandemic levels, there appear to be clinically significant differences in emotional exhaustion between groups. With 63% of the post-pandemic group meeting the cutoff score for at least 1 dimension, it is imperative for the healthcare system to consider ways to mitigate burnout.
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Affiliation(s)
| | | | - Leah LaLonde
- Oregon Health Sciences University, Portland, OR, USA
| | | | | | - Eleah Sunde
- Eastern Michigan University, Ypsilanti, MI, USA
- Michigan Medicine, Ann Arbor, MI, USA
| | | | - Alexandros Maragakis
- Eastern Michigan University, Ypsilanti, MI, USA
- Deree College, The American College of Greece, Athens, Greece
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19
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Bjelakovic L, Stosic L, Klisic A, Jovic M, Stankovic S, Stankovic A, Pantelic S, Zivkovic D, Vukovic V, Bjelakovic B. Awareness and knowledge of heterozygous familial hypercholesterolemia among Serbian pediatricians. Front Pediatr 2023; 11:1096478. [PMID: 36824651 PMCID: PMC9942926 DOI: 10.3389/fped.2023.1096478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/17/2023] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE Published reports describing awareness and knowledge of familial hypercholesterolemia (FH) among pediatricians are few and differ considerably across countries. We aimed to assess awareness and knowledge of the FH among pediatricians in Serbia. METHODS A web-based cross-sectional study using a self-designed questionnaire was conducted during the annual congress of the Serbian Association of Preventive Pediatrics in 2020. RESULTS A total of 141 pediatricians completed the questionnaire (response rate 16.1%). Overall, 91% of participants have knowledge about genetic inheritance of FH, 84.3% were aware of long-term health risks of FH, 77% were familiar with normal cholesterol values in children and 71% knew the FH prevalence in the general population. On the other hand, only 36.8% declared that they were familiar with international guidelines for FH drug treatment and only 26.2% declared to have patients with FH. CONCLUSION There is a substantial lack of practical clinical knowledge among Serbian pediatricians on managing children with FH. In addition, an extremely low questionnaire response rate (16.1%) suggests that most pediatricians are not aware of the clinical importance of FH in childhood.
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Affiliation(s)
- Ljiljana Bjelakovic
- Department of Medical Science, Faculty of Sport and Physical Education, University of Nis, Nis, Serbia
| | - Lazar Stosic
- Faculty of Medicine, University of Nis, Nis, Serbia
| | - Aleksandra Klisic
- Primary Health Care Center, University of Montenegro-Faculty of Medicine, Podgorica, Montenegro
| | - Marko Jovic
- Faculty of Medicine, University of Nis, Nis, Serbia
| | - Sanja Stankovic
- Faculty of Medicine, Institute of Biochemistry, University of Kragujevac, Kragujevac, Serbia
| | | | - Sasa Pantelic
- Department of Medical Science, Faculty of Sport and Physical Education, University of Nis, Nis, Serbia
| | - Danijela Zivkovic
- Department of Medical Science, Faculty of Sport and Physical Education, University of Nis, Nis, Serbia
| | - Vladimir Vukovic
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia.,Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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20
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Li STT, Turner AL, Naifeh MM, Stevenson MD, Abramson EL, Winn AS, Gregg C, Leslie LK. COVID-19 Pandemic Impact on Pediatricians Entering the Pediatric Workforce. Acad Pediatr 2022:S1876-2859(22)00627-1. [PMID: 36566950 PMCID: PMC9773697 DOI: 10.1016/j.acap.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 11/04/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Determine extent of impact of coronavirus disease 2019 (COVID-19) pandemic on career choice and employment of pediatricians entering pediatric workforce. METHODS A national, cross-sectional electronic survey of pediatricians registering for the 2021 American Board of Pediatrics initial general certifying examination on the impact of the COVID-19 pandemic on 3 aspects of career (career choice, employment search, employment offers) was performed. Data were analyzed using descriptive statistics and multivariate logistic regression to determine factors associated with the pandemic's impact on career. Thematic analysis was used to generate themes for open-ended survey questions. RESULTS Over half (52.3%, 1767 of 3380) of pediatricians responded. Overall, 29.1% reported that the pandemic impacted their career (career choice [10.4%], employment search [15.6%], or employment offers [19.0%]); applicants to general pediatrics (GP) (52.9%) or pediatric hospitalist (PH) positions (49.3%) were most affected. Multivariate logistic regression modeling found those applying to GP (odds ratio [OR]: 3.83, 95% confidence interval [CI]: 2.22-6.60), PH (OR: 9.02, 95% CI: 5.60-14.52), and International Medical Graduates (IMGs) (OR: 1.90; 95% CI: 1.39-2.59) most likely to experience any career impact. CONCLUSIONS Almost one third of pediatricians registering for the initial general pediatrics certifying examination reported their careers were impacted by the COVID-19 pandemic, with 10% of respondents reporting the pandemic impacted their career choice. Half of new pediatricians seeking employment reported being impacted by the pandemic, particularly IMGs. As the pandemic evolves, career advising will continue to be critical to support trainees in their career choices and employment.
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Affiliation(s)
- Su-Ting T. Li
- Department of Pediatrics, University of California Davis (S-TT Li), Sacramento, Calif,Address correspondence to Su-Ting T. Li, MD, MPH; Department of Pediatrics, University of California Davis, 2156 Stockton Blvd, Sacramento, CA 95817
| | - Adam L. Turner
- Department of Pediatrics, American Board of Pediatrics (AL Turner, C Gregg, and LK Leslie), Chapel Hill, NC
| | - Monique M. Naifeh
- Department of Pediatrics, University of Oklahoma Health Sciences Center (MM Naifeh), Oklahoma City, Okla
| | - Michelle D. Stevenson
- Norton Children's Affiliated With the University of Louisville School of Medicine (MD Stevenson), Louisville, Ky
| | - Erika L. Abramson
- Department of Pediatrics, Weill Cornell Medical Graduate School of Medical Sciences, Cornell University (EL Abramson), New York, NY
| | - Ariel S. Winn
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School (AS Winn), Boston, Mass
| | - Crista Gregg
- Department of Pediatrics, American Board of Pediatrics (AL Turner, C Gregg, and LK Leslie), Chapel Hill, NC
| | - Laurel K. Leslie
- Department of Pediatrics, American Board of Pediatrics (AL Turner, C Gregg, and LK Leslie), Chapel Hill, NC
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21
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Kelly JM, Piotrowski J, Zonfrillo MR, Riese A. Changes in Pediatricians' Child Passenger Safety Counseling With Initiation of a Booster Seat Program. Clin Pediatr (Phila) 2022:99228221139824. [PMID: 36503304 DOI: 10.1177/00099228221139824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Booster seats reduce injury in motor vehicle crashes, yet they are used less frequently than car seats and seat belts. Primary care providers are well positioned to educate and encourage families to use booster seats. We aimed to assess how a booster seat distribution program affected the documentation of restraint usage and anticipatory guidance at well-child visits at a pediatric primary care practice. We performed a retrospective chart review of patients aged 4 to 12 years from June to December in 2019 and 2020, representing before and after a booster seat program. The most frequently documented restraints in 2019 and 2020 were seat belts (51% vs 30%), booster seats (25% vs 27%), and not documented/unclear (17% vs 25%) (P < .001). The program significantly increased referrals for booster seats (P < .001). Despite significant differences in the proportion of children in each restraint category, overall booster seat use was similar between years.
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Affiliation(s)
- Jessica M Kelly
- Department of Pediatrics, The Alpert Medical School of Brown University, Providence, RI, USA
| | - Joy Piotrowski
- Department of Pediatrics, The Alpert Medical School of Brown University, Providence, RI, USA
| | - Mark R Zonfrillo
- Department of Pediatrics, The Alpert Medical School of Brown University, Providence, RI, USA.,Department of Emergency Medicine, The Alpert Medical School of Brown University, Providence, RI, USA
| | - Alison Riese
- Department of Pediatrics, The Alpert Medical School of Brown University, Providence, RI, USA
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22
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Tomasetto C, LeFevre JA, Passolunghi MC, De Vita C, Guardabassi V, Brunelli A, Ciotti F, Biasini G. With a little help from our pediatrician: An intervention to promote mathematics-related home activities through regular well-child visits. Front Psychol 2022; 13:1051822. [PMID: 36544453 PMCID: PMC9763055 DOI: 10.3389/fpsyg.2022.1051822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Children's involvement in mathematics-related activities in the home environment is associated with the development of their early numeracy over the preschool years. Intervention studies to promote parents' awareness and provision of mathematics-related home activities are however scant. In this study we developed and tested the effectiveness of a non-intensive intervention program delivered by community pediatricians to promote mathematics-related activities in the home environment. Methods Parents of 204 Italian children were invited to report on the frequency of mathematics-related home activities when children attended the first preschool year (3 years, 8 months of age on average) and, subsequently, the third preschool year (5 years, 6 months of age on average). At both waves, children were also assessed on their early numeracy. In occasion of the routine well-child visit at age 5, parents who were randomly allocated to the intervention condition (vs. a business-as-usual control condition) received guidance on age-appropriate home mathematics-related practices to sustain children's numerical development. Results Results revealed that parents in the intervention group improved their provision of home mathematics-related activities at the post-intervention assessment (relative to baseline) to a greater extent than parents in the control condition. No effect was observed on children's early numeracy. Discussion Overall, results are promising in suggesting that community pediatricians may be a resource to promote home mathematics-related activities though non-intensive low-cost interventions.
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Affiliation(s)
- Carlo Tomasetto
- Department of Psychology Renzo Canestrari, University of Bologna, Bologna, Italy,*Correspondence: Carlo Tomasetto,
| | - Jo-Anne LeFevre
- Department of Psychology, Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | | | - Chiara De Vita
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Veronica Guardabassi
- Department of Psychology Renzo Canestrari, University of Bologna, Bologna, Italy
| | - Antonella Brunelli
- Azienda Unità Sanitaria Locale (AUSL) della Romagna, Cesena, Italy,Associazione Culturale Pediatri – Romagna (ACPR), Cesena, Italy
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Schmit EO, Molina AL, Stoops C, Rahman AF, Dye C, Tofil NM. Infant Safe Sleep Knowledge, Attitudes, and Behaviors by Physicians at an Academic Children's Hospital. Clin Pediatr (Phila) 2022. [PMID: 35762067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Sudden unexpected infant death (SUID) is the leading cause of death for infants. Physician advice on safe sleep is an important source of information for families. We sought to evaluate the safe sleep knowledge, attitudes, and behaviors of physicians by distributing a cross-sectional survey at a freestanding children's hospital. The survey included demographics, knowledge items, attitudinal assessment, and frequency of providing safe sleep guidance. Multivariable linear regression and logistic regression were used to evaluate associations between variables. 398 physicians were surveyed with 124 responses (31%). Females, those who received safe sleep training, and those who see infants in daily practice had higher knowledge scores. Physicians with higher knowledge scores had more positive attitudes toward safe sleep and provided safe sleep education to patients more often. Our study underlies the importance of education and repeated exposure in forming positive attitudes toward safe sleep recommendations and leads to increased provision of safe sleep guidance.
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Affiliation(s)
- Erinn O Schmit
- Division of Pediatric Hospital Medicine, Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adolfo L Molina
- Division of Pediatric Hospital Medicine, Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christine Stoops
- Division of Neonatology, Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Akm Fazlur Rahman
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Candice Dye
- Division of Academic General Pediatrics, Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nancy M Tofil
- Division of Pediatric Critical Care, Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA
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Li ZZ, Chang YC, Gu L, Zhou JF, Wei BR, Peng NH. Knowledge of Chinese Pediatric Professionals Regarding Pediatric Pain Management. Children (Basel) 2022; 9. [PMID: 36421234 DOI: 10.3390/children9111785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
Many healthcare professionals base their perceptions of pediatric pain on their knowledge of the subject. Therefore, knowledge deficits in this area may yield negative attitudes toward pain management and add to the complexity of pain management in hospitalized children. This study evaluated the knowledge of pediatric clinicians in China regarding pediatric pain management. Adopting a cross-sectional descriptive comparative design, we surveyed pediatric clinicians using a structured questionnaire. Inclusive criteria were pediatric clinicians, both pediatricians and nurses, with professional pediatric experience of over one year. A total of 507 pediatric clinicians participated. Most were aware of the importance of pain management in sick children but misunderstood pediatric pain, lacked knowledge for performing pediatric pain assessments and lacked knowledge for providing pain relief interventions. Background factors including differing professions (pediatricians and nurses; p = 0.012), age (p < 0.05) and hospital setting of employment (p = 0.003) were significantly related to clinicians’ knowledge regarding pain management. Participating pediatricians had higher levels of knowledge of pediatric pain management than nurses. Research revealed four barriers affecting clinicians’ knowledge, including misconception of pain in children, lack of professional knowledge and confidence in the practice of pediatric pain assessment, lack of professional knowledge to provide pain relief interventions, and a significant knowledge gap between pediatricians and nurses. The results point out a crucial need for multidisciplinary education to remedy these deficiencies. Further study is needed to explore strategies to strengthen clinicians’ knowledge of this vital area of practice.
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25
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Samant S, Petigara T, Aggarwal J, Mercer M, Nelson CB, Zormpas E, Houston AM, Pena-Molina A, Marshall GS. Physician preferences for attributes of pediatric combination vaccines in the United States. Curr Med Res Opin 2022; 38:2003-2009. [PMID: 35621019 DOI: 10.1080/03007995.2022.2079262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To understand physician preferences for various attributes of pediatric combination vaccines. METHODS An online survey was completed by 400 US physicians (pediatricians and family physicians) who routinely administer vaccines to infants aged 1-12 months in outpatient settings. Respondents completed a discrete choice experiment (DCE) by selecting their preferred options from different hypothetical vaccine profiles with systematic variation in the levels of five attributes: vaccine presentation, number of injections administered at a single visit, completion rates, timeliness rates (within 30 days of recommended age), and years of availability for routine use, assuming similar cost, safety, and efficacy. Odds ratios and relative attribute importance scores were estimated using a random parameters logit model. RESULTS Physicians (mean age 50.4 years, 52.5% women) preferred combination vaccines that reduced the number of injections administered at a single visit, facilitated higher completion and timeliness rates for the primary DTaP series, were available as a pre-filled syringe rather than a vial needing reconstitution and had been available for routine use for more than 1 year. All odds ratios were statistically significant. Physicians were twice as likely to prefer administering three injections in a single visit instead of four. The most important attribute was the number of injections administered at a single visit (relative importance 38%), followed by timeliness, completion rates, and vaccine presentation; years a vaccine has been available was the least important attribute. CONCLUSION US physicians prefer pediatric combination vaccines that enable fewer injections to be administered at a single visit, facilitate higher completion and timeliness rates, are offered as a pre-filled syringe, and have been available for routine use for more than 1 year. The most important attribute of pediatric combination vaccines was a reduction in the number of injections administered at a single visit.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Gary S Marshall
- Norton Children's and University of Louisville School of Medicine, Louisville, KY, USA
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26
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McGowan A, Boundy EO, Nelson JM, Hamner HC. Patterns in Mothers' Recollection of Health Care Providers' Young Child Feeding Recommendations. J Nutr Educ Behav 2022; 54:1024-1033. [PMID: 36357041 PMCID: PMC11036331 DOI: 10.1016/j.jneb.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Characterize feeding guidance mothers recall receiving from their child's health care provider (HCP). DESIGN Cross-sectional study of mothers participating in the 2017-2019 National Survey of Family Growth. PARTICIPANTS US mothers reporting (n = 1,302) information about their youngest child (aged 6 months to 5 years). VARIABLES MEASURED Weighted percentage of mothers who recalled their child's HCP discussing 6 different feeding topics by demographic characteristics. ANALYSIS Logistic regression assessing the relationship between recall of feeding guidance and demographics. RESULTS In this sample, 36.9% of mothers (95% confidence interval, 32.3-41.4) recalled HCPs recommending solid food before 6 months old (34.6% at 4-5 months, and 2.3% before 4 months). Mothers who were older or had a higher education level were more likely than their counterparts to recall their HCP discussing several of the feeding topics examined. CONCLUSION AND IMPLICATIONS Mothers reported high recollection of early childhood nutrition guidance from their HCP; however, certain topics (eg, appropriate timing of solid food introduction) could be prioritized, and some subpopulations may need additional focus to improve receipt of messages. A better understanding of variability in recall of feeding guidance could provide information for interventions to address barriers to receiving and retaining guidance.
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Affiliation(s)
- Andrea McGowan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Ellen O Boundy
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; US Public Health Service, Rockville, MD
| | - Jennifer M Nelson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; US Public Health Service, Rockville, MD
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
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Thiekötter L, Schmidt P, Scheiderer ML, Wunram HL, Paulussen M, Reis D, Fricke O. How Stressful Is Examining Children with Symptoms of Child Abuse?-Measurement of Stress Appraisal (SAM) in German Physicians with Key Expertise in Pediatrics. Children (Basel) 2022; 9:1578. [PMID: 36291514 DOI: 10.3390/children9101578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pediatricians frequently feel uncertain about their ability to detect early symptoms of child abuse and how to respond in suspected cases. AIM This study investigated the transactional stress model in German pediatricians who experienced imagination stories with a child protection scenario and another potentially stress-triggering scenario. METHODS A two-part survey was conducted online. Each part included a different imagination story and evaluation of the Stress Appraisal Measure (SAM), as well as questions on child protection, current problematics, and suggested remedies. In total, 96 pediatricians participated. The child abuse scenario was perceived as significantly more threatening and more stressful than a medical emergency. The pediatricians declared moderate familiarity with the Child Protection Guidelines and the Federal Child Protection Act and an average confidence in their application. The greatest perceived problems were communication difficulties with parents and youth welfare services. Suggested improvements were concrete procedural directives, more training programs, better interdisciplinary networks, and greater exchange among colleagues. CONCLUSIONS To optimize their potential in the child protection system, pediatricians need to be better supported in coping with the identified stressors in child abuse scenarios.
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Al-Qatami HM, Al-Jaber AS, Abed Al Jawad FH. An Investigation of the Knowledge, Attitudes, and Practices of Physicians Regarding Child Oral Health at Primary Health Centers in Qatar: A Cross-Sectional Study. Eur J Dent 2022; 17:107-114. [PMID: 36063843 PMCID: PMC9949930 DOI: 10.1055/s-0042-1743157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate physicians' knowledge, attitudes, and practices (KAP) in relation to oral health in children attending baby well clinics in primary health care centers (PHCC) in Qatar. MATERIALS AND METHODS A cross-sectional design was adopted in which a piloted self-administered questionnaire was sent electronically to 417 physicians (pediatricians/family physicians) practicing in all PHCCs in Qatar. The questionnaire gathered information concerning demographic characteristics and KAP in relation to oral health in children. A score for each domain was given based on the percentage of correct answers. STATISTICAL ANALYSIS Descriptive and analytical statistics were employed. For descriptive statistics, the frequency of distribution in relation to demographic data and responses to items of the questionnaire was presented. For analytical statistics, associations between independent variables (predictors) and KAP were assessed by employing univariate and multivariate logistic regressions. Predictors which were significantly associated in the unadjusted regression were entered into a final multivariate logistic regression to evaluate their effects after adjustment. RESULTS The response rate was 24%. The overall mean scores of KAP were 61, 60, and 44.4%, respectively. Females were more likely to give positive answers than males (odds ratio [OR] = 12.3, 95% confidence interval [CI] 2.4-62.2, p = 0.02). Age groups 35 to 45 and >45 years had significantly more correct answers than <35 years age group (OR= 7.5, 95% CI = 1.1-56.6 and 9.2, 95% CI 1.2-44.6, respectively, p = 0.05). No significant associations were found between any of the independent variables with attitudes. With respect to practices, multivariate logistic regression revealed that specialty was significantly associated with practices. Pediatricians were more likely to adopt positive practices when compared with family medicine physicians (OR, 95% CI = 5.3 (1-25.6), p = 0.04). CONCLUSION Although physicians demonstrated moderate levels of knowledge and attitudes, this did not reflect positively on their practices. The overall score of practices was considered poor (44.4%). Poor practices in our sample reflected an urgent need for actions and plans to improve this aspect and confirmed other findings which stated that acceptable levels of knowledge or attitudes do not necessarily translate into favorable practices.
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Affiliation(s)
| | - Aisha Saleh Al-Jaber
- Pediatric Dentistry Section, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar
| | - Feras Hasan Abed Al Jawad
- Orthodontics Section, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar,Address for correspondence Feras Hassan Abed Al Jawad, BDS, MSc, PhD Orthodontics Section, Hamad Dental Center, Hamad Medical CorporationAl Rayaan Street, DohaQatar
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29
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Rolovic JS, Bokonjic D, Masic S, Stevanovic N. Pediatricians' Attitudes Toward Child Sexual Abuse in the Republic of Srpska. J Child Sex Abus 2022; 31:707-725. [PMID: 36004396 DOI: 10.1080/10538712.2022.2112641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 05/30/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Child sexual abuse (CSA) affects all cultures and sociodemographic sections. As health professionals, pediatricians are often the first line of defense when it comes to CSA identification and reporting. Our previous study examined encounters, competence, beliefs, and reporting regarding CSA among pediatricians in countries of the former Yugoslavia, Serbia, and Montenegro. Following up on this work, we expanded our research to another neighboring country, the Republic of Srpska (RS). Sixty pediatricians were surveyed in 2020, comprising 30% of all practicing pediatricians in the Republic of Srpska. Compared to their colleagues from Serbia and Montenegro, RS pediatricians revealed an increased perception that children are often abused by someone they do know well, were more confident in their abilities to detect CSA, reported a higher number of CSA cases, and were more interested in further trainings on the subject of CSA. Despite this, the level of underreporting remained high (40%). To our knowledge, this is the first study to both assess and compare CSA-related attitudes in this part of the world. Key differences between RS, other two neighboring countries as well as from other countries worldwide are likely to stem from the level of pediatricians' training and education, as well as from the socio-cultural and legislation context. Although encouraging, our data indicate a need for further research in the countries of the former Yugoslavia.
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Affiliation(s)
| | - Dejan Bokonjic
- University of East Sarajevo, Republic of Srpska, Bosnia and Herzegovina, Banja Luka, Bosnia and Herzegovina
| | - Srdjan Masic
- University of East Sarajevo, Republic of Srpska, Bosnia and Herzegovina, Banja Luka, Bosnia and Herzegovina
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McCrady E, Strychowsky JE, Woolfson JP. Experience of Pediatricians and Pediatric Surgeons With Virtual Care During the COVID-19 Pandemic: Descriptive Study. JMIR Pediatr Parent 2022; 5:e34115. [PMID: 35666938 PMCID: PMC9202653 DOI: 10.2196/34115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prior to the COVID-19 pandemic, in-clinic visits were the standard of care for pediatric physicians and surgeons at our center. At the pandemic onset, web-based care was adopted at an unprecedented scale and pace. OBJECTIVE This descriptive study explores the web-based care experience of pediatric physicians and surgeons during the pandemic by determining factors that supported and challenged web-based care adoption. METHODS This study took place at the Children's Hospital at London Health Sciences Centre, a children's hospital in London, Ontario, Canada, which provides pediatric care for patients from the London metropolitan area and the rest of Southwestern Ontario. The Donabedian model was used to structure a web-based survey evaluating web-based care experience, which was distributed to 121 department-affiliated pediatric physicians (including generalists and subspecialists in surgery and medicine). Recruitment occurred via department listserv email. Qualitative data were collected through discrete and free-text survey responses. RESULTS Survey response rate was 52.1% (63/121). Before the pandemic, few physicians within the Department of Paediatrics used web-based care, and physicians saw <10% of patients digitally. During March-May 2020, the majority transitioned to web-based care, seeing >50% of patients digitally. Web-based care use in our sample fell from June to September 2020, with the majority seeing <50% of patients digitally. Telephone and Ontario Telemedicine Network were the platforms most used from March to September 2020. Web-based care was rated to be convenient for most providers and their patients, despite the presence of technical difficulties. Challenges included lack of physical exam, lower patient volumes, and poor patient digital care etiquette. Regardless of demographics, 96.4% (116/121) would continue web-based care, ideally for patients who live far away and for follow-ups or established diagnoses. CONCLUSIONS Transition to web-based care during COVID-19 was associated with challenges but also positive experiences. Willingness among pediatricians and pediatric surgeons to continue web-based care was high. Web-based care experiences at our center could be improved with patient education and targeting select populations. Future research is needed to improve practice efficiency and to inform regulatory guidelines for web-based care.
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Affiliation(s)
- Emma McCrady
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.,Department of Pediatrics, London Health Sciences Centre Children's Hospital, London, ON, Canada
| | - Julie E Strychowsky
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.,Department of Pediatrics, London Health Sciences Centre Children's Hospital, London, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - Jessica P Woolfson
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.,Department of Pediatrics, London Health Sciences Centre Children's Hospital, London, ON, Canada.,Division of Pediatric Gastroenterology, London Health Sciences Centre Children's Hospital, London, ON, Canada
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Yang C, Yang Y, Zhang L, Zhao L. Medication Choices in Children With Tic Disorders in Mainland China, Macao, Hong Kong, and Taiwan: Perspectives of Guardians and Physicians. Front Pharmacol 2022; 13:852414. [PMID: 35592414 PMCID: PMC9110660 DOI: 10.3389/fphar.2022.852414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: Survey pediatricians and guardians of children with tic disorder on medication needs and choices. Methods: We designed a cross-sectional survey for pediatricians in mainland China, Hong Kong, Macao, and Taiwan, as well as for the guardians of patients with tic disorder from West China Second University Hospital. We collected and analyzed information on clinicians’ medical behavior and medication choices and on guardians’ knowledge of tic disorder, medical treatment behaviors, and medication choices and needs. Results: We collected responses from 242 physicians and 610 guardians. For patients with tic disorder and without comorbidities, the first-line drugs selected by physicians were tiapride (60.74%), clonidine (32.64%), haloperidol (25.62%), aripiprazole (16.53%), and sulpiride (12.4%). Physicians reported making medication choices by considerations such as clinical guidelines, clinical efficacy, a low incidence of adverse drug reactions, sufficient clinical research evidence, convenient dosage forms, and patient adherence. Guardians reported making medication choices by considerations such as a low incidence of adverse drug reactions, physician recommendations, clinical efficacy, dose, dosage forms, and the convenience and steadiness of obtaining the medication. However, guardians exhibited insufficient knowledge of tic disorder and treatment options. Conclusions: Physicians and patient guardians differ in their considerations when selecting medications, highlighting a gap in optimizing treatment.
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Affiliation(s)
- Chunsong Yang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yaya Yang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Lingli Zhang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, China
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Abstract
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.
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Affiliation(s)
| | - Anna M Cushing
- Department of Cardiology, Boston Children's Hospital, Boston, MA
| | - Emily M Bucholz
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA
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Ozkaya G, Cubukcu CE, E Ozdel ZG. Development of Valid and Reliable Tools for Pediatricians' Knowledge and Self-Perceived Competency Towards Oral Health of Children in Turkey. Niger J Clin Pract 2022; 25:44-48. [PMID: 35046194 DOI: 10.4103/njcp.njcp_81_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background This study aimed to develop a valid and reliable questionnaire of knowledge about oral health in childhood and a scale of self-perceived competency for pediatricians. In this way, the contributions of Turkish pediatricians on oral health in childhood and their effects on children's oral health and caregivers will be evaluated. Subjects and Methods Items were generated from published scientific literature, other questionnaires, and interviewing notes with the pedodontists. The study group examined publications on the preventive oral health of children, and they included items related to children in the item pool. The initial knowledge questionnaire consisted of 23 items and 10 items for the self-perceived competency scale. The content validity of the questionnaire and scale were determined by the assessments of the expert team. The internal consistency of the knowledge questionnaire and test-retest reliability of the self-perceived competency scale was examined. Results Thirty pediatricians took part in the study. The pediatricians were: 63.3% (n = 19) female and 36.7% (n = 11) male; their mean age was 37.97 ± 3.86 years. Most of the pediatricians were specialists with 83.4% (n = 25). The medical specialization of all pediatricians was university and the working year mean was 10.93 ± 4.28. The knowledge questionnaire had 10 items after content validity and internal consistency reliability investigations. The initial number of items for the self-perception level scale was 10. We excluded five items due to the content validity index. ICC value for 5-item self-perception level scale was calculated as 0.816 (95% CI: 0.606-0.914). Therefore, the scale has a good reliability level. Conclusion Our knowledge questionnaire and self-perceived competency scale provide a validated and reliable tool in the assessment of pediatricians' knowledge and competency regarding oral health. Pediatricians can test themselves using this knowledge questionnaire and self-perceived competency scale.
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Affiliation(s)
- G Ozkaya
- Department of Biostatistics, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - C E Cubukcu
- Department of Pedodontics, Faculty of Dentistry, Bursa Uludag University, Bursa, Turkey
| | - Z G E Ozdel
- Department of Pediatrics, Special Medicana Bursa Hospital, Bursa, Turkey
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O'Neill LB, Bhansali P, Bost JE, Chamberlain JM, Ottolini MC. "Sick or not sick?" A mixed methods study evaluating the rapid determination of illness severity in a pediatric emergency department. Diagnosis (Berl) 2021; 9:207-215. [PMID: 34890171 DOI: 10.1515/dx-2021-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/29/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Experienced physicians must rapidly identify ill pediatric patients. We evaluated the ability of an illness rating score (IRS) to predict admission to a pediatric hospital and explored the underlying clinical reasoning of the gestalt assessment of illness. METHODS We used mixed-methods to study pediatric emergency medicine physicians at an academic children's hospital emergency department (ED). Physicians rated patients' illness severity with the IRS, anchored by 0 (totally well) and 10 (critically ill), and shared their rationale with concurrent think-aloud responses. The association between IRS and need for hospitalization, respiratory support, parenteral antibiotics, and resuscitative intravenous (IV) fluids were analyzed with mixed effects linear regression. Area under the curve (AUC) receiver operator characteristic (ROC) curve and test characteristics at different cut-points were calculated for IRS as a predictor of admission. Think-aloud responses were qualitatively analyzed via inductive process. RESULTS A total of 141 IRS were analyzed (mean 3.56, SD 2.30, range 0-9). Mean IRS were significantly higher for patients requiring admission (4.32 vs. 3.13, p<0.001), respiratory support (6.15 vs. 3.98, p = 0.033), IV fluids (4.53 vs. 3.14, p < 0.001), and parenteral antibiotics (4.68 vs. 3.32, p = 0.009). AUC for IRS as a predictor of admission was 0.635 (95% CI: 0.534-0.737). Analysis of 95 think-aloud responses yielded eight categories that describe the underlying clinical reasoning. CONCLUSIONS Rapid assessments as captured by the IRS differentiated pediatric patients who required admission and medical interventions. Think-aloud responses for the rationale for rapid assessments may form the basis for teaching the skill of identifying ill pediatric patients.
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Affiliation(s)
- Laura B O'Neill
- Division of Hospital Medicine at Children's National Hospital, and George Washington University of Medicine and Health Sciences, Washington, DC, USA
| | - Priti Bhansali
- Division of Hospital Medicine at Children's National Hospital, and George Washington University of Medicine and Health Sciences, Washington, DC, USA
| | - James E Bost
- Department of Biostatistics and Study Methodology at Children's National Hospital, and George Washington University of Medicine and Health Sciences, Washington, DC, USA
| | - James M Chamberlain
- Division of Emergency Medicine at Children's National Hospital, and George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Mary C Ottolini
- Tufts University School of Medicine and the George W. Hallett MD Chair of Pediatrics at the Barbara Bush Children's Hospital, Portland, ME, USA
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Alnafia A, Binyousef FH, Algwaiz A, Almazyed A, Alduaylij T, Alolaiwi O, Alajlan A, Alsuhaibani M, Alenazi KA. Attitudes Towards Complementary and Alternative Medicine Among Pediatricians in Saudi Arabia. Cureus 2021; 13:e20486. [PMID: 35070536 PMCID: PMC8761483 DOI: 10.7759/cureus.20486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Complementary and Alternative Medicine (CAM) refers to a variety of healthcare practices outside the domain of conventional medicine, which may be integrated with conventional medicine by many physicians. Objectives This study aims to assess the attitudes and beliefs of pediatricians toward the use of CAM on children and to evaluate their knowledge and experience regarding CAM therapies and their desire for additional CAM training courses. Methods This is a cross-sectional study that was conducted in Saudi Arabia. A self-administered electronic questionnaire consisting of 27 questions was distributed among pediatricians to assess the demographics, beliefs, experiences, and attitudes of pediatricians related to the use of CAM for children. Non-probability convenience sampling was used in selecting the sample of pediatricians. Data analysis was performed using SPSS version 21 (IBM Corp., Armonk, NY). Results In this study, 140 participants completed the questionnaires. Most of the participants were of the male gender (83, 59.3%) and Saudi nationals (127, 90.7%). With regards to questions related to the experiences and opinions of participants regarding the use of CAM, 101 (72.1%) subjects reported the use of CAM among family members. Pediatricians cited affirmative encounters of use of CAM in 94 (67.1%) by parents. Pediatricians were not in favor of the use of CAM for end-stage (114, 81.4%) and chronic disease (108, 77.1%). The overall median self-reported CAM knowledge score was statistically higher for males in comparison with females [3 (IQR 1-5)] versus 2 (IQR 2-4), P = 0.030]. Also for nationality, median scores were significantly greater for the Riyadh region in contrast to other regions [[3 (IQR 2-5)] versus 2 (IQR 1-4), P = 0.041]. There was a significant difference in median scores for qualification of participants (P = 0.002). A multiple pairwise comparison revealed a statistically significant (P = 0.012) difference between participants with the qualification of residents and specialization. No differences in median CAM scores were found for responses related to the experiences, opinions, and attitudes of pediatricians towards the use of CAM therapies. Conclusion Most of the pediatricians in Saudi Arabia don't recommend the use of CAM treatment in their practice, but they acknowledge that learning more about CAM and imparting appropriate knowledge regarding it may incorporate its use in their routine clinical practices in a safe way.
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Affiliation(s)
- Alwaleed Alnafia
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | | | - Anas Almazyed
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Tariq Alduaylij
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Osama Alolaiwi
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Abdullah Alajlan
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Kamel A Alenazi
- Pediatrics, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Vicens-Blanes F, Miró-Bonet R, Molina-Mula J. Analysis of Nurses' and Physicians' Attitudes, Knowledge, and Perceptions toward Fever in Children: A Systematic Review with Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph182312444. [PMID: 34886174 PMCID: PMC8656872 DOI: 10.3390/ijerph182312444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 02/05/2023]
Abstract
CONTEXT Fever is a common symptom in children that nurses and pediatricians treat. Although it is a common sign in clinical practice, fever instills irrational fears in parents that health professionals share. OBJECTIVE To investigate whether doctors' and nurses' knowledge, perceptions, and attitudes toward fever influence how this sign is managed. Furthermore, it intends to evaluate whether educational programs increase knowledge and change attitudes and/or perceptions of nurses about children's fever. DATA SOURCES A systematic review with meta-analysis was conducted with PRISMA international standards and the Cochrane recommendations. STUDY SELECTION Articles examining health professionals' (doctors and/or nurses) knowledge, perceptions, and/or attitudes toward fever in children and the use of antipyretics were selected for the study. DATA EXTRACTION The qualitative analysis was carried out by classifying the articles according to the applied educational programs for nurses related to fever care for children that evaluated different outcomes to determine their efficacies. RESULTS For the qualitative synthesis, 41 articles were included, and 5 of these were taken in meta-analysis, which measured the effectiveness of educational programs for fever management in nurses. LIMITATIONS All of the included studies generally had a high risk of bias. CONCLUSION According to the evidence reviewed, nurses' and physicians' perceptions and attitudes regarding fever management in children indicate an overtreatment of this sign. We can give a recommendation grade of D on the use of educational programs to modify attitudes, perceptions, and knowledge about fever in children and improve clinical practice in nurses.
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Hasosah M. Knowledge and Practice of Pediatric Providers Regarding Neonatal Cholestasis in the Western Region of Saudi Arabia. Saudi J Med Med Sci 2021; 9:248-253. [PMID: 34667472 PMCID: PMC8474005 DOI: 10.4103/sjmms.sjmms_462_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/22/2020] [Accepted: 04/20/2021] [Indexed: 11/05/2022]
Abstract
Background: Early detection of neonatal cholestasis (NC) is important for better clinical outcomes but can be challenging. Objective: The objective of this study was to evaluate the knowledge and practice styles of pediatric providers (PPs) regarding NC in the western region of Saudi Arabia. Methods: This cross-sectional, questionnaire study was conducted between November 2019 and February 2020 in three major cities of the western region of Saudi Arabia (namely, Taif, Makkah and Jeddah). PPs included pediatric residents, pediatric specialists, pediatric consultants and family physicians. The questionnaire included 15 items in five subscales (definition, causes, diagnosis and management of NC and knowledge of guidelines). Results: A total of 488 participants completed the questionnaire. Only 30.2% were aware of the correct definition of NC (P < 0.001). Two-thirds of the respondents did not consider a history of pale stool being important for evaluating NC. The importance of biliary atresia as a serious cause of NC was found to be significantly different between pediatric consultants and other pediatricians (P < 0.001). In cases of prolonged NC, 32.4% of the PPs refer to pediatric gastroenterologist. Only 18.9% of the respondents were aware of liver biopsy being the gold standard investigation of NC. The majority of the respondents (41.8%) used ursodeoxycholic acid as a supportive therapy of NC. Conclusions: This study found a significant deficit in the knowledge and practice styles of PPs in the western region of Saudi Arabia. These findings highlight the need for policymakers to develop educational materials for PPs to increase their knowledge of NC.
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Affiliation(s)
- Mohammed Hasosah
- Department of Pediatric Gastroenterology, King Abdullah International Medical Research Center, National Guard Hospital, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Chowichian M, Sonjaipanich S, Charuvanij S. Attitudes toward pediatric rheumatology among residency-trained pediatricians. Pediatr Int 2021; 63:1162-1169. [PMID: 33512045 DOI: 10.1111/ped.14621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 12/30/2020] [Accepted: 01/15/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Pediatric rheumatology (PR) is a relatively new and rare subspecialty in emerging countries. This study aimed to investigate physicians' attitudes toward and real-life clinical practice in PR among residency-trained pediatricians in Thailand. METHODS An electronic questionnaire was developed and sent via email to pediatricians from Thailand who completed their residency training between 2007 and 2015. Confidence in treating and managing children with rheumatic diseases was rated using a 5-point Likert scale. RESULTS The response rate was 281 out of 902 (31%), and the mean ± standard deviation age of respondents was 33.8 ± 2.7 years. Confidence was rated as adequate for history taking of children with rheumatic diseases (mean 2.76, 95% confidence interval [CI]: 2.66-2.91), but low for musculoskeletal (MSK) examination (2.42, 95% CI: 2.29-2.54), arthrocentesis (2.01, 95% CI: 1.91-2.11), and rheumatology investigation (2.49, 95% CI: 2.39-2.60). Confidence was high for diagnosis and management of Henoch-Schönlein purpura (3.83, 95% CI: 3.74-3.92) and Kawasaki disease (3.46, 95% CI: 3.38-3.55), but low for juvenile idiopathic arthritis (JIA) (2.41, 95% CI: 2.30-2.52) and chronic systemic vasculitis (1.97, 95% CI: 1.85-2.08). Confidence to perform an MSK examination and arthrocentesis was significantly higher in respondents who had a full-time pediatric rheumatologist working in their pediatric residency training center (P = 0.02, P = 0.01, respectively), and in those who had experienced a PR rotation (P < 0.001, P = 0.01, respectively). Most respondents agreed that more teaching in PR is essential (95.3%) and that case-based discussion was the preferred teaching method. CONCLUSION The self-rated confidence of pediatricians was low in MSK examination, arthrocentesis, and rheumatology investigation and therefore, teaching on PR is needed.
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Affiliation(s)
- Monthira Chowichian
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suprapath Sonjaipanich
- Division of Ambulatory Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sirirat Charuvanij
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Ma J, Zhang X, Wang W, Zhang R, Du M, Shan L, Li Y, Wang X, Liu Y, Zhang W, Li X, Qiao Y, Wei M, Chen H, Zhou J, Li J. Knowledge of HPV, its vaccines, and attitudes toward HPV vaccines among obstetrician-gynecologists, pediatricians and immunization services providers in Western China. Hum Vaccin Immunother 2021; 18:1-7. [PMID: 34520323 PMCID: PMC8920158 DOI: 10.1080/21645515.2021.1962150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In mainland China, HPV vaccines have been available to the public. However, only a few related studies among health care providers, as the key information providers, were reported although public concerns on HPV vaccines still exist. In this study, we aim to assess the knowledge of HPV, its vaccines, and attitudes toward HPV vaccines among the three most important groups of health care providers in Western China. Method This was a cross-sectional questionnaire-based study. Health care providers including obstetrician-gynecologists (OB-GYNs), pediatricians, and immunization service providers in Western China were investigated regarding their knowledge of HPV and its vaccines and their attitudes toward HPV vaccines. Results Of 1079 health care providers completing the survey, 1015 (94.1%) knew HPV infection is the primary cause of cervical cancer. However, lower knowledge levels of other HPV-related diseases were also found (43.2%). About three-quarters (74.1%) of practitioners interviewed would be willing to recommend HPV vaccination, which was found to be lower among the OB-GYNs (69.6%) and the pediatricians (73.2%). “Lack of relevant knowledge,” “concerns on safety and efficacy” and price were the three most important concerns surrounding HPV vaccination. Conclusion The interviewed practitioners did not have adequate knowledge of HPV and its vaccines in depth. Education interventions are highly recommended to the health care providers, especially for OB-GYNs and pediatricians, to increase the coverage of HPV vaccination among the population. For the currently high price of vaccines, a future co-sharing mechanism between the government, the providers, and the individuals might be a solution.
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Affiliation(s)
- Jianqiao Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xi Zhang
- Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Wang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Rong Zhang
- Postdoctoral Research Station, Xinjiang Center for Disease Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Mei Du
- Department of Obstetrics & Gynaecology, Dali Maternal & Child Health Hospital/Dali Children's Hospital, Dali, China
| | - Li Shan
- Department of Gynaecology, Northwest Women's and Children's Hospital, Shannxi, China
| | - Yucong Li
- Department of Gynecological Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Xiaohui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital/Gansu Provincial Academic Institute for Medical Research, Lanzhou, China
| | - Yijun Liu
- School of Public Health, Zunyi Medical University, Zunyi, China
| | - Wen Zhang
- Department of Gynecology, Kunming Women and Children's Hospital, Kunming, China
| | - Xiaoling Li
- Obstetrics and Gynecology Department, Yuxi Hospital of Traditional Chinese Medicine, Yuxi, China
| | - Youlin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengna Wei
- Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jing Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Parisi GF, Diaferio L, Brindisi G, Indolfi C, Umano GR, Klain A, Marchese G, Ghiglioni DG, Zicari AM, Marseglia GL, Miraglia del Giudice M. Cross-Sectional Survey on Long Term Sequelae of Pediatric COVID-19 among Italian Pediatricians. Children (Basel) 2021; 8:children8090769. [PMID: 34572201 PMCID: PMC8467017 DOI: 10.3390/children8090769] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022]
Abstract
The persistence of symptoms after recovery from Coronavirus 2019 (COVID-19) is defined as long COVID, an entity that had occurred among adults but which is not yet well characterized in pediatric ages. The purpose of this work was to present some of the data from a survey addressed to Italian pediatricians concerning the impact of long-COVID among children who recovered from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The questionnaire was designed and pre-tested in February 2021 by a working group of experts from the Italian Pediatric Society for Allergy and Immunology (SIAIP). The survey was emailed once in March 2021 to a sample of Italian pediatricians. A total 267 Italian pediatricians participated in our survey. According to most pediatricians (97.3%), the persistence of symptoms is found in less than 20% of children. Specifically, with regard to the symptoms that persist even after swab negativization, fatigue was the most mentioned one (75.6%). Long-COVID would seem to be a phenomenon of limited occurrence in pediatric ages, affecting less than 20% of children. Among all of the symptoms, the one that was most prevalent was fatigue, a pathological entity that is associated with many viral diseases.
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Affiliation(s)
- Giuseppe Fabio Parisi
- Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy;
| | - Lucia Diaferio
- Department of Pediatrics, Giovanni XXIII Hospital, University of Bari, 70126 Bari, Italy;
| | - Giulia Brindisi
- Department of Pediatrics, Allergology and Immunology Division, Sapienza University, Viale Regina Elena 324, 00161 Rome, Italy; (G.B.); (A.M.Z.)
| | - Cristiana Indolfi
- Department of Woman, Child and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.I.); (G.R.U.); (A.K.)
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.I.); (G.R.U.); (A.K.)
| | - Angela Klain
- Department of Woman, Child and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.I.); (G.R.U.); (A.K.)
| | | | - Daniele Giovanni Ghiglioni
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Via Francesco Sforza, 28, 20122 Milan, Italy;
| | - Anna Maria Zicari
- Department of Pediatrics, Allergology and Immunology Division, Sapienza University, Viale Regina Elena 324, 00161 Rome, Italy; (G.B.); (A.M.Z.)
| | - Gian Luigi Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy;
| | - Michele Miraglia del Giudice
- Department of Woman, Child and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.I.); (G.R.U.); (A.K.)
- Correspondence: ; Tel.: +39-0815-66-5922
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Saelim K, Uthairat M, Ruangnapa K, Prasertsan P, Anuntaseree W. Practice, self-confidence and understanding of pediatric obstructive sleep apnea survey among pediatricians. Turk J Pediatr 2021; 63:68-76. [PMID: 33686828 DOI: 10.24953/turkjped.2021.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pediatricians play an important role in the screening, diagnosis and management of childhood obstructive sleep apnea (OSA). This study used a questionnaire to explore the knowledge, self-confidence and general practices of childhood OSA among Thai pediatricians. METHODS This was a descriptive cross-sectional survey study, using a newly developed questionnaire; including: 21 knowledge items, 4 self-confidence items, questions regarding OSA screening, number of OSA cases per month and OSA management. RESULTS A total of 307, convenient pediatricians; from different types of hospitals across all regions of Thailand, participated in this study. The median, total knowledge score was 19 (range 14‒21). Two-thirds of the respondents felt confident/extremely confident in their ability to identify and manage children with OSA. The average number of OSA cases reported by pediatricians was 5.9 cases per month. During a general medical check-up, 86.6% of the respondents did not routinely ask about OSA symptoms. Significant odds ratios (ORs) for the use of montelukast, as the first-line drug for OSA in young children, were observed in pediatric allergists and pulmonologists (adjusted OR 2.58, 95% CI 1.11-6.01 and adjusted OR 2.20, 95% CI 1.2-4.02) (P = 0.008), respectively, compared to general pediatricians and other sub-specialties. CONCLUSIONS Pediatricians had a high level of overall OSA knowledge, and good self-confidence in identifying and managing children with OSA. However, a low recognition rate and unawareness of OSA screening were observed.
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Affiliation(s)
- Kantara Saelim
- Division of Pulmonary and Critical Care, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand
| | - Monthida Uthairat
- Division of Pulmonary and Critical Care, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand
| | - Kanokpan Ruangnapa
- Division of Pulmonary and Critical Care, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand
| | - Pharsai Prasertsan
- Division of Pulmonary and Critical Care, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand
| | - Wanaporn Anuntaseree
- Division of Pulmonary and Critical Care, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand
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Zhou R, Fang Y, Wang C, Zhou S. Knowledge, attitudes, and practices related to augmented renal clearance among pediatricians in China: A cross-sectional study. Medicine (Baltimore) 2021; 100:e26889. [PMID: 34397910 PMCID: PMC8360415 DOI: 10.1097/md.0000000000026889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 07/20/2021] [Indexed: 01/04/2023] Open
Abstract
Our purpose was to assess pediatricians' knowledge of augmented renal clearance (ARC).We conducted cross-sectional analyses of 500 pediatricians from 16 tertiary hospitals in Anhui Province, China. Pediatricians provided demographic information and were asked questions about their knowledge of ARC, including risk factors, evaluation tools, and the impact on patient prognosis, with a focus on the attitude and practice of pediatricians related to adjusting vancomycin regimens when ARC occurs.A total of 491 valid questionnaires were finally included, only 276 pediatricians stated that they "know about ARC." Compared with the "do not know about ARC" group, the "know about ARC" group was younger (43.7 ± 8.0 vs 48.0 ± 7.9, P < .001), and their main source of ARC knowledge was from social networking platforms. A total of 193 (70%) chose at least 4 of the following factors as risk factors for children with ARC: severe trauma, sepsis, burns, major surgery, lower disease severity, and hematological malignancies. A total of 110 (40%) and 105 (38%) pediatricians chose the Schwartz formula and cystatin C, respectively, as the indicators to evaluate the renal function of ARC children. Concerning the estimated glomerular filtration rate threshold to identify ARC children, 201 (73%) pediatricians chose 130 mL/min/1.73 m2, while 55 (20%) chose "age-dependent ARC thresholds." Overall, 220 (80%) respondents indicated that ARC would impact the treatment effect of vancomycin, but 149/220 (68%) were willing to adjust the vancomycin regimen; only 22/149 (8%) considered that the dose should be increased, but no one knew how to increase. Regarding the prognosis of ARC children, all respondents chose "unclear."ARC is relatively common in critically ill children, but pediatricians do not know much about it, as most of the current knowledge is based on adult studies. Furthermore, ARC is often confused with acute kidney injury, which would lead to very serious treatment errors. Therefore, more pediatric studies about ARC are needed, and ARC should be written into official pediatric guidelines as soon as possible to provide reference for pediatricians.
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Affiliation(s)
- Ran Zhou
- Department of Pharmacy, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Yuting Fang
- Department of Pharmacy, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Chunyan Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Shusheng Zhou
- Department of Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
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Gönüllü E, Soysal A, Atıcı S, Engin M, Yeşilbaş O, Kasap T, Fedakar A, Bilgiç E, Tavil EB, Tutak E, Yıldız İ, Akçay T, Ağladıoğlu SY, Tunç T, Can İ, Karaböcüoğlu M, Karabayır N. Pediatricians' COVID-19 experiences and views on the willingness to receive COVID-19 vaccines: a cross-sectional survey in Turkey. Hum Vaccin Immunother 2021; 17:2389-2396. [PMID: 33861165 PMCID: PMC8475573 DOI: 10.1080/21645515.2021.1896319] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/04/2021] [Accepted: 02/22/2021] [Indexed: 01/26/2023] Open
Abstract
Developing an effective and safe vaccine against Covid-19 will facilitate return to normal. Due to hesitation toward the vaccine, it is crucial to explore the acceptability of the COVID-19 vaccine to the public and healthcare workers. In this cross-sectional survey, we invited 2251 pediatricians and 506 (22%) of them responded survey and 424 (84%) gave either nasopharyngeal swap or antibody assay for COVID-19 and 71 (14%) of them got diagnosis of COVID-19. If the effective and safe COVID-19 vaccine was launched on market, 420 (83%) of pediatrician accepted to get vaccine shot, 422 (83%) of them recommended vaccination to their family members, 380 (75%) of them accepted to vaccine their children and 445 (85%) of them offered vaccination to their pediatric patients. Among the participated pediatricians 304 (60%) of them thought COVID-19 vaccine should be mandatory. We found that there are high COVID-19 vaccine willingness rates for pediatricians for themselves, their own children, family members and their pediatric patients. We also found that being a pediatric subspecialist, believing in achieving an effective vaccine, willingness to participate in the phase 1-2 clinical vaccine trial, willingness to get an influenza shot this season, believing a vaccine and vaccine passport should be mandatory were significant factors in accepting the vaccine. It is important to share all information about COVID-19 vaccines, especially effectiveness and safety, with the public in a clear communication and transparency. The opposite will contribute to vaccine hesitancy and anti-vaccine movement.
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Affiliation(s)
- Erdem Gönüllü
- Department of Pediatrics, Üsküdar University Medical School, İstanbul, Turkey
- Clinic of Pediatrics, Memorial Ataşehir Hospital, İstanbul, Turkey
| | - Ahmet Soysal
- Clinic of Pediatrics, Memorial Ataşehir Hospital, İstanbul, Turkey
| | - Serkan Atıcı
- Department of Pediatric Infectious Diseases, Okan University Hospital, İstanbul, Turkey
| | - Mesut Engin
- Department of Pediatrics, Düzce University Faculty of Medicine, Düzce, Turkey
| | - Osman Yeşilbaş
- Department of Pediatrics, Karadeniz Technical University, Trabzon, Turkey
| | - Tuba Kasap
- Department of Pediatrics, Tokat Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Atiye Fedakar
- Department of Pediatrics, Afiyet Hospital, Istanbul, Turkey
| | - Emre Bilgiç
- Clinic of Pediatrics, Bingöl State Hospital, Bingöl, Turkey
| | | | - Ercan Tutak
- Clinic of Pediatrics, Memorial Şişli Hospital, İstanbul, Turkey
| | - İsmail Yıldız
- Department of Pediatrics, Namık Kemal University School of Medicine, Tekirdağ, Turkey
| | - Teoman Akçay
- Clinic of Pediatrics, Memorial Şişli Hospital, İstanbul, Turkey
| | | | - Turan Tunç
- Clinic of Pediatrics, Memorial Ataşehir Hospital, İstanbul, Turkey
| | - İlkay Can
- Department of Dermatology, Burhaniye State Hospital, Balıkesir, Turkey
| | | | - Nalan Karabayır
- Department of Pediatrics, Prof. Dr. Medipol University School of Medicine, İstanbul, Turkey
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De Rosso S, Schwartz C, Ducrot P, Nicklaus S. The Perceptions and Needs of French Parents and Pediatricians Concerning Information on Complementary Feeding. Nutrients 2021; 13:nu13072142. [PMID: 34206652 PMCID: PMC8308433 DOI: 10.3390/nu13072142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/13/2022] Open
Abstract
Appropriate complementary feeding (CoF) is the key to preventing childhood obesity and promoting long-term health. Parents must be properly informed through the CoF process. Pediatricians have opportunities to interact with parents during the CoF transition and influence parental feeding decisions. They can convey public health nutrition messages to parents. With the release of new CoF recommendations in France in 2019, and from the perspective of their conversion into official public health communication material, the aim of this study was to explore parents’ and pediatricians’ perceptions and needs regarding information on CoF. Two online surveys were disseminated to gather information on CoF communication and guidance: one for parents (n = 1001, January 2020); one for pediatricians (n = 301, October 2019). The results showed that the importance of CoF for children’s healthy growth was well recognized by both parents and pediatricians. Parents acknowledged pediatricians as the most influential source of advice; and pediatricians were aware of their responsibility in counselling parents on CoF. However, pediatricians neglected the fact that parents gave high trust to their personal network when looking for advice. The Internet was a well-recognized source of information according to all. Diverging from what pediatricians considered useful, parents were interested in practical advice for implementing CoF. This study highlights common expectations and points of divergence between parents’ needs and pediatricians’ perceptions of those needs with regard to CoF information.
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Affiliation(s)
- Sofia De Rosso
- Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France; (S.D.R.); (C.S.)
| | - Camille Schwartz
- Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France; (S.D.R.); (C.S.)
| | - Pauline Ducrot
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France;
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France; (S.D.R.); (C.S.)
- Correspondence: ; Tel.: +33-3-80-69-35-18
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Shakeel S, Iffat W, Qamar A, Ghuman F, Yamin R, Ahmad N, Ishaq SM, Gajdács M, Patel I, Jamshed S. Pediatricians' Compliance to the Clinical Management Guidelines for Community-Acquired Pneumonia in Infants and Young Children in Pakistan. Healthcare (Basel) 2021; 9:healthcare9060701. [PMID: 34207813 PMCID: PMC8227315 DOI: 10.3390/healthcare9060701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022] Open
Abstract
Community-acquired pneumonia (CAP) is among the most commonly prevailing acute infections in children that may require hospitalization. Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current study was conducted to evaluate pediatricians’ compliance with the standard clinical practice guidelines and their antibiotic-prescribing behavior for the management of CAP in children. Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire; which was provided to pediatricians by the researchers. Statistical analysis was performed with SPSS 25 Statistics; χ2 tests (or Fisher-exact tests) with the p-value set at < 0.05 as the threshold for statistical significance. Results: The overall response rate was 59.2%. Male respondents were (n = 101; 42.6%), and the respondents (n = 163; 68.7%) were under 30 years of age. Amoxicillin (n = 122; 51.5%) was considered as the most commonly used first-line treatment for non-severe pneumonia, whereas a smaller proportion (n = 81; 34.2%) of respondents selected amoxicillin–clavulanate. Likewise, amoxicillin (n = 100; 42.2%) was the most popular choice for non-severe pneumonia in hospitalized children; however, if children had used antibiotics earlier to admission, respondents showed an inclination to prescribe a macrolide (n = 95; 40.0%) or second-generation cephalosporin (n = 90; 37.9%). More than 90% responded that children <6 months old with suspected bacterial CAP will probably receive better therapeutic care by hospitalization. Restricting exposure to the antibiotic as much as possible (n = 71; 29.9%), improving antibiotic prescribing (n = 59; 24.8%), and using the appropriate dose of antimicrobials (n = 29; 12.2%) were considered the major factors by the respondents to reduce antimicrobials resistance. Conclusions: The selection of antibiotics and diagnostic approach was as per the recommendations, but indication, duration of treatment, and hospitalization still can be further improved.
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Affiliation(s)
- Sadia Shakeel
- Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi 74200, Pakistan; (S.S.); (W.I.)
| | - Wajiha Iffat
- Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi 74200, Pakistan; (S.S.); (W.I.)
| | - Ambreen Qamar
- Department of Physiology, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences (DIKIOHS), Dow University of Health Sciences, Karachi 74200, Pakistan;
| | - Faiza Ghuman
- Dow University Hospital, Dow University of Health Sciences, Karachi 74200, Pakistan;
| | - Rabia Yamin
- Department of Pediatrics, National Institute of Child Health, Karachi 74200, Pakistan;
| | - Nausheen Ahmad
- Jinnah Postgraduate Medical Centre, Department of Chest Medicine, Karachi 74200, Pakistan;
| | - Saqib Muhammad Ishaq
- Scientific Assistant, Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN), Karachi 74200, Pakistan;
| | - Márió Gajdács
- Faculty of Medicine, Institute of Medical Microbiology, Semmelweis University, 1089 Budapest, Hungary;
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary
| | - Isha Patel
- School of Pharmacy, Marshall University, Huntington, WV 25755, USA;
| | - Shazia Jamshed
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, Universiti Sultan Zainal Abidin, (UniSZA), Kuala Terengganu 21300, Malaysia
- Qualitative Research-Methodological Application in Health Sciences Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia
- Correspondence:
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Yigit M, Ozkaya-Parlakay A, Senel E. Evaluation of COVID-19 vaccine acceptance of healthcare providers in a tertiary Pediatric hospital. Hum Vaccin Immunother 2021; 17:2946-2950. [PMID: 34018902 DOI: 10.1080/21645515.2021.1918523] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Objective: The aim of this study was to reveal the perceptions of healthcare providers who work in a tertiary children's hospital about domestic and foreign COVID-19 vaccines to determine the frequency of hesitancy toward COVID-19 vaccination prior to its availability in Turkey and to elucidate the reasons for its rejection and distrust.Methods: A questionnaire about COVID-19 vaccination was conducted with 343 healthcare providers, including pediatricians, pediatric nurses, and auxiliary health staff. The questionnaire was conducted online. In the survey, participants were asked about sociodemographic characteristics and opinions on domestic and foreign COVID-19 vaccines, and reasons for vaccine refusal.Results: Women were more likely to be reluctant to get a domestic (p < .001) or foreign (p < .001) COVID-19 vaccine than men. There was a significant relationship between age and vaccine acceptance (p = .01). The younger the age of the healthcare provider, the higher the rate of vaccine hesitancy (r = - 0.25). Years of professional experience were correlated with vaccine acceptance (r = 0,19, p < .05), but vaccine rejection and indecision did not change (p > .05). The factors predicting vaccine acceptance were status as a doctor, more than 10 years of professional experience, and male gender.Conclusion: More than half of the healthcare providers were willing to have a COVID-19 vaccine once available. Indecision rates were found to be high, although rejection rates were not. Status as a doctor, more than 10 years of professional experience, and male gender were factors associated with vaccination intention.
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Affiliation(s)
- Metin Yigit
- Pediatrics Department, Ankara City Hospital, Ankara, Turkey
| | - Aslinur Ozkaya-Parlakay
- Pediatric Infectious Diseases Unit, Yildirim Beyazit University Ankara City Hospital, Ankara, Turkey
| | - Emrah Senel
- Pediatric Surgery Department, Yildirim Beyazit University Ankara City Hospital, Ankara, Turkey
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Zanetti M, Clavenna A, Pandolfini C, Pansieri C, Calati MG, Cartabia M, Miglio D, Bonati M. Informatics Methodology Used in the Web-Based Portal of the NASCITA Cohort Study: Development and Implementation Study. J Med Internet Res 2021; 23:e23087. [PMID: 33709930 PMCID: PMC7998320 DOI: 10.2196/23087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/12/2020] [Accepted: 01/18/2021] [Indexed: 01/12/2023] Open
Abstract
Background Many diseases occurring in adults can be pinned down to early childhood and birth cohorts are the optimal means to study this connection. Birth cohorts have contributed to the understanding of many diseases and their risk factors. Objective To improve the knowledge of the health status of Italian children early on and how it is affected by social and health determinants, we set up a longitudinal, prospective, national-level, population-based birth cohort, the NASCITA study (NAscere e creSCere in ITAlia). The main aim of this cohort is to evaluate physical, cognitive, and psychological development; health status; and health resource use in the first 6 years of life in newborns, and potential associated factors. A web-based system was set up with the aim to host the cohort; provide ongoing information to pediatricians and to families; and facilitate accurate data input, monitoring, and analysis. This article describes the informatics methodology used to set up and maintain the NASCITA cohort with its web-based platform, and provides a general description of the data on children aged over 7 months. Methods Family pediatricians were contacted for participation in the cohort and enrolled newborns from April 2019 to July 2020 at their first well-child visit. Information collected included basic data that are part of those routinely collected by the family pediatricians, but also parental data, such as medical history, characteristics and lifestyle, and indoor and outdoor environment. A specific web portal for the NASCITA cohort study was developed and an electronic case report form for data input was created and tested. Interactive data charts, including growth curves, are being made available to pediatricians with their patients’ data. Newsletters covering the current biomedical literature on child cohorts are periodically being put up for pediatricians, and, for parents, evidence-based information on common illnesses and problems in children. Results The entire cohort population consists of 5166 children, with 139 participating pediatricians, distributed throughout Italy. The number of children enrolled per pediatrician ranged from 1 to 100. The 5166 enrolled children represent 66.55% (5166/7763) of the children born in all of 2018 covered by the same pediatricians participating in the cohort. The number of children aged over 7 months at the time of these analyses, and for whom the most complete data were available upon initial analyses, was 4386 (2226/4381 males [50.81%] and 142/4370 twins [3.25%]). The age of the mothers at birth of the 4386 children ranged from 16 to 54 years. Most newborns’ mothers (3758/4367, 86.05%) were born in Italy, followed by mothers born in Romania (101/4367, 2.31%), Albania (75/4367, 1.72%), and Morocco (60/4367, 1.37%). Concerning the newborns, 138/4386 (3.15%) were born with malformations and 352/4386 (8.03%) had a disease, most commonly neonatal respiratory distress syndrome (n=52), neonatal jaundice (n=46), and neonatal hypoglycemia (n=45). Conclusions The NASCITA cohort is well underway and the population size will permit significant conclusions to be drawn. The key role of pediatricians in obtaining clinical data directly, along with the national-level representativity, will make the findings even more solid. In addition to promoting accurate data input, the multiple functions of the web portal, with its interactive platform, help maintain a solid relationship with the pediatricians and keep parents informed and interested in participating. Trial Registration ClinicalTrials.gov NCT03894566; https://clinicaltrials.gov/ct2/show/NCT03894566
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Affiliation(s)
- Michele Zanetti
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Antonio Clavenna
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Pandolfini
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Claudia Pansieri
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maria Grazia Calati
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Massimo Cartabia
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Daniela Miglio
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio Bonati
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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LaVille Thoren K, Vista-Wayne J. The collaborative care model: Improving access to children's mental health care. J Child Adolesc Psychiatr Nurs 2021; 34:83-87. [PMID: 33625764 DOI: 10.1111/jcap.12309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/12/2021] [Accepted: 02/14/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Current accessibility to child and adolescent mental health services is negatively affected by the shortage of mental health providers. The primary care provider or pediatrician is in a key position to identify behavioral health concerns, coordinate services, and provide treatment to the patient. AIM This project aimed to improve access to children's mental health care by creating and implementing an educational course on the collaborative care model (CoCM), a model of integrated care that embeds mental health professionals into the primary care setting. METHODS Pre- and post-surveys were embedded in the online CoCM course to track course completion, identify clinical staff knowledge, and identify clinical staff interest in implementing the CoCM in practice. RESULTS Following project implementation, clinical staffs' responses from the pre- and post-surveys represented an increase in knowledge and interest in implementing the CoCM in practice after taking the online course. CONCLUSION This project suggests further exploration of funding and planning to implement a pilot of the CoCM in a primary care practice setting.
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Affiliation(s)
- Kennedy LaVille Thoren
- Eyerly Ball Outpatient Community Mental Health Center-UnityPoint Des Moines, Des Moines, Iowa, USA.,MercyOne Des Moines-Mercy College of Health Sciences, Des Moines, Iowa, USA
| | - Joyce Vista-Wayne
- MercyOne Des Moines-Pediatric Psychiatry Center, Des Moines, Iowa, USA
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HajiAhmadi M, Akhlaghi N, Aghajani F, Moshgelgosha H, Soltanian M. Comparison of information provided by pediatricians regarding tooth eruption and the information available on the internet. Dent Res J (Isfahan) 2021; 18:6. [PMID: 34084293 PMCID: PMC8122695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/03/2020] [Accepted: 05/03/2020] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Most parents believe that teething is associated with some symptoms and commonly use Internet to gain more information about the health of their children. Pediatricians can also serve as a source of information for health-related requirements of parents. This study aimed to compare the information provided by pediatricians regarding tooth eruption and the information available in Persian-language websites. MATERIALS AND METHODS This descriptive, analytical, cross-sectional study was performed in two phases. In the first phase, the questionnaire was designed by 85 pediatric pediatricians in Isfahan about children's dental eruption and internet resources. The second phase was the study of 22 Persian websites about children's tooth eruption using Google search engine and the keywords "tooth eruption," "tooth eruption symptoms." Then a checklist was prepared to evaluate the quality and completeness of the content. Data were analyzed by the Chi-square test and Fisher's exact test using SPSS (P < 0.05). RESULTS None of the retrieved websites had the health on the net code of conduct. The most common symptoms of teething reported by both pediatricians and websites included irritability, drooling, gingival tenderness, chewing tendency, decreased appetite and sleep disturbances. In non-pharmacological methods to control the symptoms related to tooth eruption in both groups, embracing the baby (P < 0.001), using soft tooth ring (P = 0.049) and chewing hard foods (0.016 P = significant. Use of oral pain medication (P = 0.01) and sedatives and medications (P = 0.04) were significant in the medication method. CONCLUSION None of the websites reviewed had a valid source code and author. Although websites cannot replace the instructions of pediatricians regarding growth and development of children and their teething, supplementary information can be acquired from high-quality websites because there seems to be no significant difference between these two information sources regarding tooth eruption symptoms and their management.
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Affiliation(s)
- Maryam HajiAhmadi
- Department of Pediatric Dentistry, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Najmeh Akhlaghi
- Department of Pediatric Dentistry, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Hadi Moshgelgosha
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahshad Soltanian
- Department of Pediatric Dentistry, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Mahshad Soltanian, Department of Pediatric Dentistry, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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Abstract
OBJECTIVE To improve understanding of current practices in the treatment of children and adolescents with chronic pain in Spain. METHODS A web-based survey was conducted with a representative sample of healthcare professionals (i.e. general practitioners [GP] and pediatricians [P]) in Spain. The survey included 23 questions on the pain education and training they had been given, and on organizational issues and current practices in the assessment and management of children and adolescents with chronic pain in their current work. RESULTS The survey was completed by 191 professionals (75 GP and 116 P) with wide experience (mean number of years = 21; SD = 8) in the management of children and adolescents with chronic pain. Half of the participants reported that they had not been given any specific education or training on pediatric chronic pain management during their studies, and 80% acknowledged important gaps in their training. Although the majority assessed pain when attending children with chronic pain (80%), and almost all (96%) believed that protocols to guide the management of chronic pain in young people were necessary, only a third reported that they usually use a specific protocol. Less than 25% were part of a multidisciplinary team addressing the needs of children and adolescents with chronic pain. CONCLUSIONS This survey has identified considerable limitations in the management of children and adolescents with chronic pain in Spain. This information can now be used by policy makers to improve the care given to children and adolescents suffering from chronic pain and their families.
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Affiliation(s)
- Jordi Miró
- Unit for the Study and Treatment of Pain-ALGOS, Chair in Pediatric Pain URV-FG, Research Center in Behavior Assessment and Measurement, Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Juan Antonio Micó
- Departamento de Neurociencias, Farmacología y Psiquiatría, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM), Universidad de Cádiz, Cádiz, Spain
| | - Francisco Reinoso-Barbero
- Servicio de Anestesiología-Reanimación Infantil, Unidad de Dolor Infantil, Hospital Universitario La Paz, Madrid, Spain
- Instituto de Investigación del Hospital Universitario La Paz IdiPaz, Madrid, Spain
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