Pediatr Ann
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The Center for Pediatric Integrative Medical Education and Boston Healing Landscape Project represent diverse approaches to integrative medicine and its practice. The relationship and collegial collaboration between the two programs illustrates the extent to which they complement one another. Both recognize the importance of curriculum geared to different levels of learners and of interventions introduced across the full curriculum. ⋯ The Center for Pediatric Integrative Medical Education promotes interactive didactics with hands-on, direct experiential learning. The BHLP applies active-learning pedagogy, through experiential learning and its teaching case model. Both programs understand that, given the ongoing interaction among medical students, residents, fellows, and faculty, each group's training in CAM must reinforce the others for a larger system to change.
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The use of hospitalists in the care of newborns appears to be increasing and may be advantageous for several reasons, including decreased cost, decreased length of stay, increased patient survival, increased availability, and greater experience among hospitalists. Research specific to the use of hospitalists in newborn medicine needs to be done to support this hypothesis. ⋯ It is essential that hospitalists who provide care in nurseries work to smooth the transition to a PCP and not act as a barrier. Relatively speaking, the care provided by hospitalists is most often short-term, and the relationship between infants and their parents with the PCP should begin as soon as possible.
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The role of the pediatric hospitalist has an extremely bright future in many facets of the pediatric healthcare spectrum. The role of the hospitalist in the PICU is only one of many that shows great promise and will likely change our current models of care for children. The greatest challenge will be the education of healthcare providers who may see these changes as erosion in care, rather than as an important asset in providing quality care for children.
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The past 20 years have yielded little success in reducing prematurity rates or decreasing the major morbidities of premature infants. Determination of interventions to decrease prematurity rates, and the development of methods to reduce premature neurologic damage, are the challenges for the next 20 years. With the advent of genetic analysis and the ability to study environmental and genetic interactions, we may be on the threshold of another significant decrease in mortality and morbidity in the premature infant.