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Confidential Care For Adolescents In The U.S. Health Care System, Priya R. Pathak, Adriana Chou 2019 Harvard T.H. Chan School of Public Health

Confidential Care For Adolescents In The U.S. Health Care System, Priya R. Pathak, Adriana Chou

Journal of Patient-Centered Research and Reviews

In providing care for adolescents, maintaining confidentiality should be considered a human right and an evidence-based component of quality care. Unfortunately, complexities in the U.S. legal and health care systems have created a setting in which confidential care is inaccessible to many adolescent patients. Federal laws provide a minimum standard for confidentiality protections, but variations in state legislation relating to minor consent, special health care services, and confidentiality exemptions create large variability in adolescent confidentiality rights across the country. In certain contexts, such as consensual sexual activity, legal provisions may not align with professional ethical standards in adolescent care ...


The Use Of Dietary Interventions In Pediatric Patients, Shirin Madzhidova, Lusine Sedrakyan 2019 Philadelphia College of Osteopathic Medicine

The Use Of Dietary Interventions In Pediatric Patients, Shirin Madzhidova, Lusine Sedrakyan

PCOM Scholarly Papers

Complementary and alternative treatment approaches are becoming more common among children with chronic conditions. The prevalence of CAM use among US adults was estimated to be around 42% in 2015 and around 44% to 50% among adults with neurologic disorders. Studies demonstrate that children with certain chronic illnesses such as asthma, cancer, genetic disorders, attention-deficit/hyperactivity disorder (ADHD), and other neurodevelopmental disorders are treated with complementary and alternative treatments at higher rates. Dietary therapies are gaining increasing popularity in the mainstream population. Although the majority of "fad" diets do not have enough supporting evidence, some dietary therapies have been utilized ...


Who Speaks For Me?: Addressing Variability In Informed Consent Practices For Minimal Risk Research Involving Foster Youth, Mary V. Greiner, Sarah J. Beal, Antonio Allen, Vikash Patel, Jareen Meinzen-Derr, Armand Antommaria 2019 Cincinnati Children's Hospital Medical Center and the University of Cincinnati

Who Speaks For Me?: Addressing Variability In Informed Consent Practices For Minimal Risk Research Involving Foster Youth, Mary V. Greiner, Sarah J. Beal, Antonio Allen, Vikash Patel, Jareen Meinzen-Derr, Armand Antommaria

Journal of Health Disparities Research and Practice

Background: Youth in protective custody (i.e., foster care) are at higher risk for poorer physical and mental health outcomes compared with those who are not. These differences may be due in part to the lack of research on the population to create evidence-based recommendations for health care delivery. A potential contributor to this lack of research is difficulties in obtaining informed consent for empirical studies in this population. The objective of this study was to describe the approaches to obtaining informed consent in minimal risk studies of foster youth and provide recommendations for future requirements.

Methods: We conducted a ...


Csf Inflammatory Markers Differ In Gram-Positive Versus Gram-Negative Shunt Infections., Gwenn Skar, David Synhorst, Matthew K. Beaver, Jessica N. Snowden 2019 University of Nebraska Medical Center

Csf Inflammatory Markers Differ In Gram-Positive Versus Gram-Negative Shunt Infections., Gwenn Skar, David Synhorst, Matthew K. Beaver, Jessica N. Snowden

Journal Articles: Pediatrics

BACKGROUND: Cerebrospinal fluid (CSF) shunt placement is frequently complicated by bacterial infection. Shunt infection diagnosis relies on bacterial culture of CSF which can often produce false-negative results. Negative cultures present a conundrum for physicians as they are left to rely on other CSF indices, which can be unremarkable. New methods are needed to swiftly and accurately diagnose shunt infections. CSF chemokines and cytokines may prove useful as diagnostic biomarkers. The objective of this study was to evaluate the potential of systemic and CSF biomarkers for identification of CSF shunt infection.

METHODS: We conducted a retrospective chart review of children with ...


Cardiovascular Magnetic Resonance Imaging Feature Tracking: Impact Of Training On Observer Performance And Reproducibility, Sören J. Backhaus, Georg Metschies, Marcus Billing, Johannes T. Kowallick, Roman J. Gertz, Tomas Lapinskas, Burkert Pieske, Joachim Lotz, Boris Bigalke, Shelby Kutty, Gerd Hasenfuß, Philipp Beerbaum, Sebastian Kelle, Andreas Schuster 2019 Georg-August Universitat Gottingen

Cardiovascular Magnetic Resonance Imaging Feature Tracking: Impact Of Training On Observer Performance And Reproducibility, Sören J. Backhaus, Georg Metschies, Marcus Billing, Johannes T. Kowallick, Roman J. Gertz, Tomas Lapinskas, Burkert Pieske, Joachim Lotz, Boris Bigalke, Shelby Kutty, Gerd Hasenfuß, Philipp Beerbaum, Sebastian Kelle, Andreas Schuster

Journal Articles: Pediatrics

BACKGROUND: Cardiovascular magnetic resonance feature tracking (CMR-FT) is increasingly used for myocardial deformation assessment including ventricular strain, showing prognostic value beyond established risk markers if used in experienced centres. Little is known about the impact of appropriate training on CMR-FT performance. Consequently, this study aimed to evaluate the impact of training on observer variance using different commercially available CMR-FT software.

METHODS: Intra- and inter-observer reproducibility was assessed prior to and after dedicated one-hour observer training. Employed FT software included 3 different commercially available platforms (TomTec, Medis, Circle). Left (LV) and right (RV) ventricular global longitudinal as well as LV circumferential ...


Assessment Of Inequalities In Coverage Of Essential Reproductive, Maternal, Newborn, Child, And Adolescent Health Interventions In Kenya, Emily Catherine Keats, Nadia Akseer, Zaid Bhatt, William Macharia, Anthony Ngugi, Arjumand Rizvi, Zulfiqar Ahmed Bhutta 2018 The Hospital for Sick Children

Assessment Of Inequalities In Coverage Of Essential Reproductive, Maternal, Newborn, Child, And Adolescent Health Interventions In Kenya, Emily Catherine Keats, Nadia Akseer, Zaid Bhatt, William Macharia, Anthony Ngugi, Arjumand Rizvi, Zulfiqar Ahmed Bhutta

Paediatrics and Child Health, East Africa

Importance: Previous work has underscored subnational inequalities that could impede additional health gains in Kenya.

Objective: To provide a comprehensive assessment of the burden, distribution, and change in inequalities in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) interventions in Kenya from 2003 to 2014.

Design, Setting, and Participants: This population-based cross-sectional study used data from the 2003, 2008, and 2014 Kenya Demographic and Health Surveys. The study included women of reproductive age (ages 15-49 years) and children younger than years, with national, regional, county, and subcounty level representation. Data analysis was conducted from April 2018 to November 2018.

Exposures ...


Effectiveness Of A Youth-Led Early Childhood Care And Education Programme In Rural Pakistan: A Cluster-Randomised Controlled Trial, Aisha Khizar Yousafzai, Muneera Rasheed, Arjumand Rizvi, Fariha Shaheen, Liliana A. Ponguta, Chin R. Reyes 2018 Aga Khan University

Effectiveness Of A Youth-Led Early Childhood Care And Education Programme In Rural Pakistan: A Cluster-Randomised Controlled Trial, Aisha Khizar Yousafzai, Muneera Rasheed, Arjumand Rizvi, Fariha Shaheen, Liliana A. Ponguta, Chin R. Reyes

Department of Paediatrics and Child Health

Background: The United Nation's Sustainable Development Goals encompass lifelong learning from birth to youth to adulthood (Goal 4) and economic opportunities for young people (Goal 8). The targets include improving access to quality early childhood care and education (ECCE) as well as learning and training opportunities for adolescents and youth. Cross-generational models for young children and youth may offer opportunities to address the interconnections between goals and targets for the next generation. We investigated whether an ECCE programme for young children (3.5-6.5 years) delivered by female youth (18-24 years) in rural Pakistan would be effective on children ...


Stakeholder Engagement In Developing An Electronic Clinical Support Tool For Tobacco Prevention In Adolescent Primary Care, Ramzi G. Salloum, Ryan P. Theis, Lori Pbert, Matthew J. Gurka, Maribeth Porter, Diana Lee, Elizabeth A. Shenkman, Lindsay A. Thompson 2018 University of Florida

Stakeholder Engagement In Developing An Electronic Clinical Support Tool For Tobacco Prevention In Adolescent Primary Care, Ramzi G. Salloum, Ryan P. Theis, Lori Pbert, Matthew J. Gurka, Maribeth Porter, Diana Lee, Elizabeth A. Shenkman, Lindsay A. Thompson

Open Access Articles

Following guideline recommendations to promote tobacco prevention in adolescent primary care, we developed a patient-facing clinical support tool. The electronic tool screens patients for use and susceptibility to conventional and alternative tobacco products, and promotes patient(-)provider communication. The purpose of this paper is to describe the iterative stakeholder engagement process used in the development of the tool. During the pre-testing phase, we consulted with scientists, methodologists, clinicians, and Citizen Scientists. Throughout the development phase, we engaged providers from three clinics in focus groups. Usability testing was conducted via in-depth, cognitive interviewing of adolescent patients. Citizen Scientists (n = 7) played ...


Bronchopulmonary Dysplasia: Comparison Between The Two Most Used Diagnostic Criteria, Enrique Gomez Pomar, Vanessa A. Concina, Aaron Samide, Philip M. Westgate, Henrietta S. Bada 2018 University of Kentucky

Bronchopulmonary Dysplasia: Comparison Between The Two Most Used Diagnostic Criteria, Enrique Gomez Pomar, Vanessa A. Concina, Aaron Samide, Philip M. Westgate, Henrietta S. Bada

Pediatrics Faculty Publications

Objectives: To compare the Shennan's and the consensus definition of Bronchopulmonary Dysplasia (BPD) from the National Institutes of Health (NIH) workshop and analyze specific risk factors associated with each definition.

Study design: Retrospective analysis of records of 274 infants admitted to a level IV intensive care unit. Infants were classified as having BPD or no BPD by both definitions. Differences in incidence and risk factors were analyzed. Statistical methods included descriptive statistics, comparative tests, and marginal logistic regression modeling.

Results: The estimated difference in prevalence was 32% [95% CI: (26%, 37%), (p < 0.0001)] between both criteria. The prevalence of BPD was 80% higher based on the NIH criteria [RR = 1.80; 95% CI: (1.58, 2.06)]. Infants with no BPD by the Shennan definition were breathing room air with or without positive or continuous pressure support and were most likely to be discharged home on oxygen [OR = 4.47, 95% CI: (1.20, 16.61), p = 0.03]. Gestational age, birth weight ...


A Public Health Argument Against Arming Teachers, David I. Swedler 2018 Pacific Institute for Research and Evaluation

A Public Health Argument Against Arming Teachers, David I. Swedler

Health Behavior Research

The peer-reviewed scientific literature does not support the idea that arming teachers will prevent school shootings. In this commentary, I draw on the criminal justice, injury prevention, and firearm safety literature to demonstrate how arming teachers will do more harm than good.


Standardized Outcome Measures For Pregnancy And Childbirth, An Ichom Proposal., Malini Anand Nijagal, Stephanie Wissig, Caleb Stowell, Elizabeth Olson, Isis Amer-Wahlin, Gouke Bonsel, Allyson Brooks, Matthew Coleman, Shamala Devi Karalasingam, James M N Duffy, Tracy Flanagan, Stefan Gebhardt, Meridith E Greene, Floris Groenendaal, J Ravichandran R Jeganathan, Tessa Kowaliw, Marije Lamain-de-Ruiter, Elliott Main, Michelle Owens, Rod Petersen, Irwin Reiss, Carol Sakala, Anna Maria Speciale, Rachel Thompson, Oluwakemi Okunade, Arie Franx 2018 Providence St. Joseph Health

Standardized Outcome Measures For Pregnancy And Childbirth, An Ichom Proposal., Malini Anand Nijagal, Stephanie Wissig, Caleb Stowell, Elizabeth Olson, Isis Amer-Wahlin, Gouke Bonsel, Allyson Brooks, Matthew Coleman, Shamala Devi Karalasingam, James M N Duffy, Tracy Flanagan, Stefan Gebhardt, Meridith E Greene, Floris Groenendaal, J Ravichandran R Jeganathan, Tessa Kowaliw, Marije Lamain-De-Ruiter, Elliott Main, Michelle Owens, Rod Petersen, Irwin Reiss, Carol Sakala, Anna Maria Speciale, Rachel Thompson, Oluwakemi Okunade, Arie Franx

Journal Articles and Abstracts

BACKGROUND: Value-based health care aims to optimize the balance of patient outcomes and health care costs. To improve value in perinatal care using this strategy, standard outcomes must first be defined. The objective of this work was to define a minimum, internationally appropriate set of outcome measures for evaluating and improving perinatal care with a focus on outcomes that matter to women and their families.

METHODS: An interdisciplinary and international Working Group was assembled. Existing literature and current measurement initiatives were reviewed. Serial guided discussions and validation surveys provided consumer input. A series of nine teleconferences, incorporating a modified Delphi ...


The Use Of Milrinone In Neonates With Persistent Pulmonary Hypertension Of The Newborn - A Randomised Controlled Trial Pilot Study (Mint 1): Study Protocol And Review Of Literature., Afif F. El-Khuffash, Patrick J. McNamara, Colm Breatnach, Neidin Bussmann, Aisling Smith, Oliver Feeney, Elizabeth Tully, Joanna Griffin, Willem P. de Boode, Brian Cleary, Orla Franklin, Eugene Dempsey 2018 Royal College of Surgeons in Ireland

The Use Of Milrinone In Neonates With Persistent Pulmonary Hypertension Of The Newborn - A Randomised Controlled Trial Pilot Study (Mint 1): Study Protocol And Review Of Literature., Afif F. El-Khuffash, Patrick J. Mcnamara, Colm Breatnach, Neidin Bussmann, Aisling Smith, Oliver Feeney, Elizabeth Tully, Joanna Griffin, Willem P. De Boode, Brian Cleary, Orla Franklin, Eugene Dempsey

Department of Paediatrics Articles

Persistent pulmonary hypertension of the newborn (PPHN) is a relatively common condition which results in a mortality of up to 33%. Up to 40% of infants treated with nitric oxide (iNO) either have a transient response or fail to demonstrate an improvement in oxygenation. Milrinone, a selective phosphodiesterase 3 (PDE3) inhibitor with inotropic and lusitropic properties may have potential benefit in PPHN. This pilot study was developed to assess the impact of milrinone administration on time spent on iNO in infants with PPHN. This is a multicentre, randomized, double-blind, two arm pilot study, with a balanced (1:1) allocation of ...


Characterization Of Antibiotic Use For Acute Otitis Media In Pediatric Physician Practices, Jasica N. Truong PharmD, Kristin M. Held PharmD, BCOP, Jennifer E. Macfarlan MPH, Tibisay Villalobos MD, FAAP 2018 Lehigh Valley Health Network

Characterization Of Antibiotic Use For Acute Otitis Media In Pediatric Physician Practices, Jasica N. Truong Pharmd, Kristin M. Held Pharmd, Bcop, Jennifer E. Macfarlan Mph, Tibisay Villalobos Md, Faap

Department of Pharmacy

No abstract provided.


Assessment Of Dental Maturation On Orthopantomograms Among Children With Various Dental Malocclusions At A Tertiary Care Hospital, Hafiz Taha Mahmood, Mubassar Fida 2018 Aga Khan University

Assessment Of Dental Maturation On Orthopantomograms Among Children With Various Dental Malocclusions At A Tertiary Care Hospital, Hafiz Taha Mahmood, Mubassar Fida

Department of Paediatrics and Child Health

Objectives: To determine and compare the median dental age among males and females and in subjects with dental Class I, II and III malocclusions.
Methods: The retrospective study was conducted at Aga Khan University Hospital and comprised dental records of patients from July to December 2016 who were aged 9-16 years and had complete dentition excluding third molars. The sample was divided according to dental malocclusion which was further categorised according to chronological age groups. SPSS 21 was used for data analysis.
Results: Of the 270 sbjects whose radiographs were studied, 135(50%) each were males and females. Children aged ...


Infant Fall Prevention, Kristin Jensen, Nicole Roehrig, Caroline Truong, Jacklyn Wallace 2018 Swedish Medical Center

Infant Fall Prevention, Kristin Jensen, Nicole Roehrig, Caroline Truong, Jacklyn Wallace

Books, Presentations, Posters, Etc.

No abstract provided.


Common Practice For Behavioral Health Screening In Pediatric Primary Care Settings, Joseph A. Menand, Mario Cruz, MD 2018 Thomas Jefferson University

Common Practice For Behavioral Health Screening In Pediatric Primary Care Settings, Joseph A. Menand, Mario Cruz, Md

Phase 1

Mental health disorders in the United States are highly prevalent, affecting 14-20% of children yearly. Only 25-35% receive treatment after on average a six-plus year delay from symptom onset. Current recommendations suggest primary care physicians/providers (PCP) manage mental health conditions, however, PCPs are wary, citing lack of time, training and resources.This study evaluated pediatric/adolescent PCPs using a self-report questionnaire assessing knowledge/skill, clinical practice (e.g. screening tool) and perceived barriers when managing attention deficit hyperactivity disorder (ADHD), anxiety and depression (N = 11). Self-reported knowledge/skill diagnosing, treating and referring each disorder were recorded on a 5-point ...


Advancing Universal Health Coverage In South Asian Cities: A Framework, Alayne M. Adams, Devaki Nambiar, Sameen Siddiqi, Bushra Binte Alam, Srinath Reddy 2018 Georgetown University

Advancing Universal Health Coverage In South Asian Cities: A Framework, Alayne M. Adams, Devaki Nambiar, Sameen Siddiqi, Bushra Binte Alam, Srinath Reddy

Department of Paediatrics and Child Health

No abstract provided.


Measuring And Understanding Social-Emotional Behaviors In Preschoolers From Rural Pakistan, Jenna E. Finch, Aisha Khizar Yousafzai, Muneera Rasheed, Jelena Obradović 2018 Aga Khan University

Measuring And Understanding Social-Emotional Behaviors In Preschoolers From Rural Pakistan, Jenna E. Finch, Aisha Khizar Yousafzai, Muneera Rasheed, Jelena Obradović

Department of Paediatrics and Child Health

The Strengths and Difficulties Questionnaire (SDQ) is widely-used to measure symptoms of common childhood behavioral problems that may lead to mental health difficulties. In a sample of 1,302 highly-disadvantaged mothers and their preschoolers, we evaluated the factor structure and reliability of the parent-report version of the SDQ in rural Pakistan. Confirmatory factor analyses suggested that the original structure of the SDQ was not appropriate for our data. We created conceptually- and empirically-coherent measures of children’s externalizing behavior problems and prosocial skills. Child and family correlates of social-emotional behaviors were similar to those found in other countries, supporting the ...


Feasibility Of Using A Commercial Fitness Tracker As An Adjunct To Family-Based Weight Management Treatment: Pilot Randomized Trial., Thao-Ly Tam Phan, Nadia Barnini, Sherlly Xie, Angelica Martinez, Lauren Falini, Atiera Abatemarco, Maura Waldron, Jane M. Benton, Steve Frankenberry, Cassandra Coleman, Linhda Nguyen, Cindy Bo, George A. Datto, Lloyd N. Werk 2018 Thomas Jefferson University; Nemours Children's Health System

Feasibility Of Using A Commercial Fitness Tracker As An Adjunct To Family-Based Weight Management Treatment: Pilot Randomized Trial., Thao-Ly Tam Phan, Nadia Barnini, Sherlly Xie, Angelica Martinez, Lauren Falini, Atiera Abatemarco, Maura Waldron, Jane M. Benton, Steve Frankenberry, Cassandra Coleman, Linhda Nguyen, Cindy Bo, George A. Datto, Lloyd N. Werk

Department of Pediatrics Faculty Papers

BACKGROUND: Fitness trackers can engage users through automated self-monitoring of physical activity. Studies evaluating the utility of fitness trackers are limited among adolescents, who are often difficult to engage in weight management treatment and are heavy technology users.

OBJECTIVE: We conducted a pilot randomized trial to describe the impact of providing adolescents and caregivers with fitness trackers as an adjunct to treatment in a tertiary care weight management clinic on adolescent fitness tracker satisfaction, fitness tracker utilization patterns, and physical activity levels.

METHODS: Adolescents were randomized to 1 of 2 groups (adolescent or dyad) at their initial weight management clinic ...


“His Mind Will Work Better With Both Of Us”: A Qualitative Study On Fathers’ Roles And Coparenting Of Young Children In Rural Pakistan, Joshua Jeong, Saima Siyal, Günther Fink, Dana Charles McCoy, Aisha Khizar Yousafzai 2018 Aga Khan University

“His Mind Will Work Better With Both Of Us”: A Qualitative Study On Fathers’ Roles And Coparenting Of Young Children In Rural Pakistan, Joshua Jeong, Saima Siyal, Günther Fink, Dana Charles Mccoy, Aisha Khizar Yousafzai

Department of Paediatrics and Child Health

Background: Parents are the primary providers of nurturing care for young children’s healthy early development. However, the literature on parenting in early childhood, especially in low- and middle-income countries, has primarily focused on mothers. In this study, we investigate how parents make meaning of fathers’ parenting roles with regards to their young children’s early health and development in rural Pakistan.
Methods: Data were collected between January and March 2017 through in-depth interviews with fathers (N = 33) and their partners (N = 32); as well as separate focus group discussions with fathers (N = 7) and mothers (N = 7). Data were ...


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