Academic pediatrics
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Academic pediatrics · May 2014
Low caregiver health literacy is associated with higher pediatric emergency department use and nonurgent visits.
We sought to determine the association between low caregiver health literacy and child emergency department (ED) use, both the number and urgency of ED visits. ⋯ Over half of caregivers presenting with their children to the ED have low health literacy. Low caregiver health literacy is an independent predictor of higher ED use and use of the ED for nonurgent conditions. In children without a chronic illness, low health literate caregivers had more than 3 times greater odds of presenting for a nonurgent condition than those with adequate health literacy.
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Academic pediatrics · May 2014
Asthma treatment decisions by pediatric residents do not consistently conform to guidelines or improve with level of training.
To compare asthma treatment decisions by pediatric residents to current asthma guidelines and to learn whether treatment decisions vary by postgraduate year in training. ⋯ Pediatric residents' management of asthma is consistent with national guidelines in some cases but not in others. There were no differences in the outpatient asthma management decisions between residents by years in training. Educational efforts should be focused on strategies to facilitate pediatric resident adherence to national asthma guideline recommendations for outpatient asthma management.
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Academic pediatrics · Mar 2014
ReviewParental limited English proficiency and health outcomes for children with special health care needs: a systematic review.
One in 10 US adults of childbearing age has limited English proficiency (LEP). Parental LEP is associated with worse health outcomes among healthy children. The relationship of parental LEP to health outcomes for children with special health care needs (CSHCN) has not been systematically reviewed. ⋯ Parental LEP is independently associated with worse health care access and quality for CSHCN. Health care providers should recognize LEP as an independent risk factor for poor health outcomes among CSHCN. Emerging models of chronic disease care should integrate and evaluate interventions that target access and quality disparities for LEP families.
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Academic pediatrics · Mar 2014
Multicenter StudyPredictors of resident satisfaction in caring for limited English proficient families: a multisite study.
To assess residents' self-efficacy, satisfaction and frustration in the care of limited English proficient (LEP) families and to identify individual and programmatic factors associated with the above outcomes. ⋯ A majority of residents reported lacking self-efficacy in their ability to deliver care to LEP patients, which may influence overall satisfaction with such encounters. Strategies that promote resident self-efficacy and assess non-English language proficiency should be included in future training curricula. Exposing trainees to best practices in interpreter-based encounters may further promote resident satisfaction.
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Academic pediatrics · Mar 2014
Family-centered rounds in theory and practice: an ethnographic case study.
Family-centered rounds (FCR) seek to incorporate principles of family-centered care-including clear and open information sharing, respect, participation and collaboration-into inpatient settings. Although potential models designed to translate these principles into everyday clinical practice have been reported, few studies explore how FCR practices align with principles of family-centered care. ⋯ Although FCR practices may set the stage for family-centered care, they do not necessarily ensure that the principles of family-centered care are upheld. Efforts to more effectively deliver FCR should consider physical, organizational, and cultural factors that influence both patient/family and medical team behavior.