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IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102682

Kelsey Thetford MD, Michele Nichols MD, Jordan Newman MD

引用次数: 0

UNCOVERING A NEED: DERMATOLOGY EDUCATION IN PEDIATRIC RESIDENCY TRAINING

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102649

Leah Lalor MD , Sonal Shah MD

引用次数: 0

ENHANCING PEDIATRIC TRAINEE UNDERSTANDING OF HEALTHCARE COSTS AND FINANCIAL TOXICITY: A NOVEL BILLING DIDACTIC AND INSURANCE SIMULATION APPROACH

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102635

Jeremy Jones MD, Michelle Rose MD, Noreena Lewis JD, Brooks Lanham MD, MBA

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MORE GRADUATING RESIDENTS FROM SMALL PROGRAMS ARE READY FOR UNSUPERVISED PRACTICE FOR THE 17 ABP GENERAL PEDIATRICS EPAS WHEN COMPARED TO MEDIUM AND LARGE PROGRAMS

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102685

Daniel Schumacher MD, PhD, MEd , David Turner MD , Benjamin Kinnear MD, MEd , Ariel Winn MD , Catherine Michelson MD, MMSc , Alan Schwartz PhD

引用次数: 0

ALONE WE SURVIVE, TOGETHER WE THRIVE: INTERNATIONAL MEDICAL GRADUATE EMPOWERMENT INITIATIVE

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102690

Elif Erkan MD, MS, Shruthi Mohan MD, Daniela Bullard-Elias MD, Laura Rangel Rodriguez MD, Jose Antonio Elizondo Leal MD

引用次数: 0

Postpartum Depression Screening in Pediatric Primary Care Clinics and Infant Receipt of Preventive or Acute Care 儿科初级保健诊所的产后抑郁症筛查与婴儿接受预防性或急性护理的关系。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.08.001

Danielle P. Tyson MS , Leah V. Utset MD , Rose Y. Hardy PhD, MPH , Mattina A. Davenport PhD , Kierra S. Barnett PhD, MPH , Deena J. Chisolm PhD, MS , Laura J. Chavez PhD, MPH

Objective

To evaluate the association between postpartum depression (PPD) screening results in pediatric primary care and subsequent infant preventive and acute care utilization.

Methods

This was a retrospective cohort analysis of 5341 infants born in 2021 whose mothers were screened for PPD at a well-child visit during the first 6 months. Logistic regression was used to examine the association between a positive PPD screen and 1) adherence to the 12-month well-child visit, and 2) any acute care visits (urgent care or emergency department visits) from 6–15 months. The association between PPD screen and number of acute care visits was examined with negative binomial regression.

Results

The incidence of positive PPD screens was 15.6% in the first 6 months. There was no significant difference in 12-month well-child visit adherence based on PPD screening (adjusted odds ratio (aOR): 0.91; 95% confidence interval (CI): 0.77–1.06; P-value: 0.206). The odds of having any acute care visit were higher among infants whose mothers screened positive for PPD (aOR: 1.2; 95% CI: 1.0–1.3; P-value: 0.009). There was a significant difference in the incidence rate of acute care visits based on PPD screening results (incidence rate ratio: 1.1; 95% CI: 1.0–1.2; P-value: 0.005).

Conclusions

Screening positive for PPD was associated with subsequent acute care utilization but not 12-month preventive care. Primary care providers may need to proactively follow-up after acute care visits to ensure both infant health and maternal needs are met, connecting mothers to resources as needed.

目的评估儿科初级保健中产后抑郁症（PPD）筛查结果与随后婴儿预防和急症护理使用之间的关联：这是一项回顾性队列分析，研究对象是 2021 年出生的 5341 名婴儿，这些婴儿的母亲在头 6 个月的儿童健康检查中接受了 PPD 筛查。采用逻辑回归法研究了 PPD 筛查阳性与 1) 12 个月儿童健康检查的坚持率，以及 2) 6-15 个月期间任何急诊就诊（紧急护理或急诊就诊）之间的关联。PPD 筛查与急诊就诊次数之间的关系采用负二项逻辑回归法进行检验：结果：PPD筛查阳性率在前6个月为15.6%。根据 PPD 筛查结果，12 个月的儿童保健就诊率没有明显差异（调整后的几率比 (aOR)：0.91；95% 置信区间 (CI)：0.77 至 1.06；P 值：0.206）。母亲 PPD 筛查呈阳性的婴儿接受任何急症护理的几率更高（aOR：1.2；95% CI：1.0 至 1.3；p 值：0.009）。根据 PPD 筛查结果，急诊就诊率存在明显差异（发病率比：1.1；95% CI：1.0 至 1.2；P 值：0.005）：结论：PPD筛查结果呈阳性与随后的急症护理使用率有关，但与12个月的预防性护理无关。初级医疗服务提供者可能需要在急诊就诊后主动跟进，以确保婴儿健康和孕产妇需求得到满足，并根据需要将母亲与资源联系起来。

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引用次数: 0

Sexual Identity Is Associated With Adverse Childhood Experiences in US Early Adolescents 美国早期青少年的性别认同与童年不良经历（ACEs）有关。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.07.022

Julia H. Raney MD , Shayna Weinstein MPH , Alexander Testa PhD , Kyle T. Ganson PhD, MSW , Zain Memon , David V. Glidden PhD , Fiona C. Baker PhD , Claire D. Brindis DrPH , Jason M. Nagata MD, MSc

Objective

To determine disparities in adverse childhood experiences (ACEs) by sexual identity in a national cohort of early adolescents.

Methods

We analyzed cross-sectional data from year 2 of the Adolescent Brain Cognitive Development study (N = 10,934, 2018–20, ages 10–14 years). Disparities in ACE scores across lesbian, gay, or bisexual (LGB), not sure, and heterosexual adolescents were assessed using multinomial logistic regression analyses. Logistic regressions estimated the associations between sexual identity and each individual ACE. Analyses were adjusted for potential confounders.

Results

In adjusted models, LGB adolescents had a higher risk of experiencing 2, 3, or ≥4 ACEs (relative risk ratios [RRR] = 1.57, 95% Confidence Interval (CI) 1.01–2.42), 3 (RR = 1.78, 95% CI 1.100–2.88), or ≥4 ACEs (RRR = 3.20, 95% CI 1.92–5.32), and not sure adolescents had a higher risk of having ≥4 ACEs (RRR = 2.17, 95% CI 1.22–3.87), compared to heterosexual adolescents. LGB and not sure adolescents had higher risks of reporting emotional abuse (“yes” OR = 4.21, 95% CI 1.84–9.61; “maybe” OR = 6.20, 95% CI 2.91–13.19) and parent mental illness (“yes” OR = 1.95, 95% CI 1.48–2.57; “maybe” OR = 1.63, 95% CI 1.21–2.18) compared to heterosexual adolescents.

Conclusions

LGB adolescents and those questioning their sexual identity were at greater risk of having higher ACE scores, with LGB adolescents experiencing the highest risk of experiencing ACEs. LGB adolescents also had higher odds of reporting emotional and parent mental illness. Recognizing this heightened risk of ACEs in early adolescence is critical for designing clinic and school-based interventions.

目的确定全国早期青少年队列中不同性别身份的儿童不良经历（ACE）的差异：我们分析了青少年大脑认知发展研究第二年的横截面数据（N=10934，2018-2020 年，10-14 岁）。我们使用多项式逻辑回归分析评估了女同性恋、男同性恋或双性恋（LGB）青少年、不确定青少年和异性恋青少年之间 ACE 分数的差异。逻辑回归估算了性身份与每个个体 ACE 之间的关联。分析对潜在的混杂因素进行了调整：在调整后的模型中，LGB 青少年经历 2、3 或≥4 个 ACE 的风险较高（相对风险比 [RRR] =1.57，95% CI 1.01-2.42），经历 3 个 ACE 的风险较高（RR=1.78，95% CI 1.100-2.88），经历≥4 个 ACE 的风险较高（相对风险比 [RRR] =1.57，95% CI 1.01-2.42）。与异性恋青少年相比，男女同性恋、双性恋和变性青少年以及不确定青少年发生≥4次ACE的风险更高（RRR=2.17，95% CI 1.22-3.87）。与异性恋青少年相比，男女同性恋、双性恋和变性青少年以及不确定青少年报告情感虐待（"是 "OR=4.21，95% CI 1.84-9.61；"可能 "OR=6.20，95% CI 2.91-13.19）和父母患有精神疾病（"是 "OR=1.95，95% CI 1.48-2.57；"可能 "OR=1.63，95% CI 1.21-2.18）的风险更高：结论：男女同性恋、双性恋和变性青少年以及那些对自己的性身份有疑问的青少年有更高的 ACE 评分风险，其中男女同性恋、双性恋和变性青少年经历 ACE 的风险最高。此外，LGB 青少年报告患有情绪病和父母精神疾病的几率也更高。认识到青春期早期发生 ACE 的高风险对于设计诊所和学校的干预措施至关重要。

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引用次数: 0

A National Survey to Assess LGBTQ+ Curricular Needs in Pediatrics Residency Programs 评估儿科住院医师项目中 LGBTQ+ 课程需求的全国调查。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.07.016

Lauren T. Roth MD , Pamela Carpenter MEd , Alan Schwartz PhD, JD , Brian Lurie MD, MPH

Objective

Despite incremental increases in lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) health education, there are no uniform training requirements in graduate medical education and the extent to which pediatrics residency programs incorporate LGBTQ+ curricula remains unknown. We aimed to assess the current state of LGBTQ+ health education in pediatrics residency programs.

Methods

We surveyed all 202 Accreditation Council for Graduate Medical Education (ACGME)-accredited categorical pediatrics program directors (PDs) in the United States. PDs were contacted via the Association for Pediatrics Program Directors (APPD) listserv with a link to an anonymous electronic survey.

Results

We had a 53.4% response rate (107/202) with representation from all regions, sizes, and settings. Only 7.5% of programs have robust LGBTQ+ curricula, but many (71%) offer some sessions. About half (54.2%) believe their residents are not at all or somewhat prepared to care for LGBTQ+ patients after training. Many PDs are not at all or somewhat confident their residents learn about gender affirming care (49.5%) or are aware of community resources for LGBTQ+ youth (54.2%). In 91% of programs, 0–25% of faculty educate trainees about LGBTQ+ health. The majority (74.8%) of PDs are very or moderately likely to implement a standardized LGBTQ+ health curriculum. The most prominent barriers were inadequate time (55.1%) and lack of faculty training (51.4%).

Conclusion

Many pediatrics programs have implemented some LGBTQ+ health education; however, PDs lack confidence in residents’ abilities to independently care for LGBTQ+ youth after training. An accessible and standardized curriculum is not only needed but desired by programs.

目的：尽管女同性恋者、男同性恋者、双性恋者、跨性别者、同性恋者/质疑者（LGBTQ+）健康教育在逐步增加，但医学研究生教育中并没有统一的培训要求，儿科住院医师培训项目在多大程度上纳入了 LGBTQ+ 课程仍是未知数。我们旨在评估儿科住院医师培训项目中LGBTQ+健康教育的现状：我们调查了美国所有202个经毕业医学教育认证委员会（ACGME）认证的分类儿科项目主任（PDs）。我们通过儿科项目主任协会（APPD）的邮件列表与儿科项目主任取得联系，并提供了匿名电子调查的链接：我们的回复率为 53.4%（107/202），来自所有地区、规模和环境。仅有 7.5% 的项目开设了丰富的 LGBTQ+ 课程，但许多项目（71%）开设了一些课程。约有一半（54.2%）的住院医师认为，他们在接受培训后完全没有或在一定程度上没有做好护理 LGBTQ+ 患者的准备。许多 PD 对他们的住院医师是否了解性别平权护理（49.5%）或是否了解 LGBTQ+ 青少年的社区资源（54.2%）没有信心。在 91% 的项目中，0-25% 的教师会对学员进行 LGBTQ+ 健康教育。大多数项目主任（74.8%）非常有可能或比较有可能实施标准化的 LGBTQ+ 健康课程。最突出的障碍是时间不足（55.1%）和缺乏师资培训（51.4%）：结论：许多儿科项目已经实施了一些LGBTQ+健康教育；然而，儿科医师对住院医师在培训后独立护理LGBTQ+青少年的能力缺乏信心。儿科项目不仅需要，而且希望有一个易于使用的标准化课程。

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引用次数: 0

CREATION AND EVALUATION OF A SIMULATION-BASED TRAINING CURRICULUM FOR PEDIATRIC INTERNS: ASSESSING AN ACUTELY ILL HOSPITALIZED CHILD

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102659

Sabina Qasim DO, Amber Hartman DO, Rhett Lieberman MD, UPMC, Kendra Woods MD

引用次数: 0

Innovation in Advanced Advocacy Training Through Clinician Partnerships with Institutional Government Relations 通过临床医生与政府关系机构的合作，创新高级宣传培训。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.06.010

Amanda M. Stewart MD, MPH , Joshua Greenberg JD , Kate Warren Barnes MSW, MBA , Ariel Winn MD

引用次数: 0

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