Academic pediatrics
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Academic pediatrics · Sep 2013
ReviewMoving from research to practice in the primary care of children with autism spectrum disorders.
Autism spectrum disorders (ASD), once thought rare, are now commonly encountered in clinical practice. Academic pediatricians may be expected to teach medical students and pediatric residents about ASD, but most likely received limited exposure to ASD during their training. In recent years, research that informs the clinical guidance provided to pediatricians regarding surveillance, screening, and ongoing management of children with ASD has accelerated. ⋯ Providing appropriate medical care for children with ASD improves both child and family outcomes. Recent research regarding sleep disturbances, gastrointestinal problems, and epilepsy in children with ASD has led to clinical pathways to evaluate and address these issues within the context of primary care. By being aware of and disseminating these research findings, academic pediatricians can help future and current clinicians improve the care of children with ASD.
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Academic pediatrics · May 2013
Primary care spatial density and nonurgent emergency department utilization: a new methodology for evaluating access to care.
To determine the spatial and demographic characteristics of pediatric patients who make nonurgent visits (NUVs) to an urban pediatric emergency department (ED). We hypothesized that the rate of NUVs would be inversely associated with the spatial density of primary care providers (PCPs). ⋯ Low spatial density of primary care is strongly associated with nonurgent ED utilization. Improving spatial distribution of primary care may decrease ED misuse and improve access to the medical home.
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Academic pediatrics · May 2013
Do high-risk preschoolers or overweight mothers meet AAP-recommended behavioral goals for reducing obesity?
The American Academy of Pediatrics (AAP) has issued specific behavioral recommendations to prevent obesity. It is unclear how often high-risk preschoolers and overweight mothers meet recommended behavior goals and whether meeting these goals is negatively associated with overweight/obesity. ⋯ Few high-risk preschoolers or overweight mothers meet AAP-recommended behavior goals. Meeting a greater number of behavior goals may be particularly important for maternal weight. Preschoolers have greater odds of meeting behavior goals when mothers meet behavior goals.
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Academic pediatrics · May 2013
Annual report on health care for children and youth in the United States: trends in racial/ethnic, income, and insurance disparities over time, 2002-2009.
To examine trends in children's health access, utilization, and expenditures over time (2002-2009) by race/ethnicity, income, and insurance status/expected payer. ⋯ Despite significant improvement in insurance coverage, disparities by race/ethnicity and income persist in access to and use of care. Hispanic children experienced progress in a number of measures, while black children did not. Because racial/ethnic and socioeconomic disparities are often reported as single cross-sectional studies, our approach is innovative and improves on prior studies by examining population trends during the time period 2002-2009. Our study sheds light on children's disparities during the most recent economic crisis.
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Academic pediatrics · May 2013
Comprehension on family-centered rounds for limited English proficient families.
To describe communication with limited English proficient (LEP) families during family-centered rounds (FCR); to examine differences in family understanding of diagnosis and plan by English proficiency and provider and interpreter rounding behaviors. ⋯ Having initial medical discussions without the family and information filtering are common for LEP patients; filtering may be associated with poorer diagnosis comprehension. Experience with a hospitalized child is associated with increased comprehension among LEP parents.