Pediatrics
-
Training for pediatric residents who intend to pursue fellowship differs little from training for residents who intend to practice general pediatrics. It is unknown how well residents who intend to pursue subspecialty training believe that residency prepares them for subspecialty fellowships or future careers. To characterize the strengths and weaknesses of residency training and the factors influencing subspecialty choice from the perspective of subspecialty fellows, we conducted a survey of current fellows on these issues. ⋯ The finding that a large proportion of fellows would opt for shortened subspecialty training should prompt discussion and debate within the profession regarding the skills necessary for a pediatric subspecialist. Patient safety, physician-parent communication, and care coordination are emphasized primarily through informal training during residency. Although most clinicians believe themselves to be adequately prepared, research has identified gaps in clinician skills and understanding of these issues of great importance to patients and their families.
-
Comparative Study
Trends in the diagnosis of overweight and obesity in children and adolescents: 1999-2007.
Pediatric overweight and obesity are increasingly prevalent problems and have received much attention in recent years, but it is unclear whether this publicity has affected diagnosis by clinicians. We undertook the current study to assess trends in diagnosis rates of overweight and obesity in children. ⋯ Although clear BMI definitions of pediatric weight problems exist, a large percentage of overweight and obese patients remain undiagnosed. Diagnosis increased during the study period but remained low among overweight children, for whom early intervention may be more effective. Identification of overweight and obese patients is the first step in addressing this growing epidemic.
-
Comparative Study
Nutritional practices in the neonatal intensive care unit: analysis of a 2006 neonatal nutrition survey.
The goal of this investigation was to determine how current parenteral nutrition and enteral nutrition practice intentions for preterm infants compare with published recommendations and previous feeding practices. ⋯ Clinicians reported that they are initiating parenteral and enteral nutrition earlier and in larger volumes than in the past, reflecting increased knowledge about best nutritional practices in very preterm neonates. The data suggest that the persistent extrauterine growth failure of preterm infants is not attributable to a lack of best nutritional practice knowledge and intention.
-
The public sector plays an important role in promoting child health information technology. Public sector support is essential in 5 main aspects of child health information technology, namely, data standards, pediatric functions in health information systems, privacy policies, research and implementation funding, and incentives for technology adoption. Some innovations in health information technology for adult populations can be transferred to or adapted for children, but there also are unique needs in the pediatric population. Development of health information technology that addresses children's needs and effective adoption of that technology are critical for US children to receive care of the highest possible quality in the future.