目的了解云南省不同等级医院儿科医生对《中国儿童哮喘行动计划》(China Children Asthma Action Plan,CCAAP)及哮喘指南的认知状况。方法2022年7—12月,对云南省保山、昆明、大理、德宏、红河、玉溪、西双版纳、楚雄、曲靖、临沧、文...目的了解云南省不同等级医院儿科医生对《中国儿童哮喘行动计划》(China Children Asthma Action Plan,CCAAP)及哮喘指南的认知状况。方法2022年7—12月,对云南省保山、昆明、大理、德宏、红河、玉溪、西双版纳、楚雄、曲靖、临沧、文山11个州市的41家不同级别医院395名儿科医师(男132人,女263人,年龄20岁以上)进行了有效调查。采用线上、线下相结合方式进行问卷调查。采用χ^(2)检验、方差分析。结果共收回来自41家医院有效问卷395份。各级别被调查医院儿科医生对儿童哮喘基础知识各问题回答正确率为32.78%(59/180)~97.50%(39/40)、急性期治疗各问题回答正确率为24.44%(44/180)~92.50%(37/40)、后续治疗各问题回答正确率为35.56%(64/180)~100.00%(40/40)。省级三级医院、地市级三级医院儿科医生对儿童哮喘认知情况总体优于二级及一级医院(均P<0.05)。结论云南省各级别医院儿科医生对CCAAP及哮喘指南普遍认知不足,基层医院尤其薄弱。展开更多
目的了解我国县级医疗机构儿科医师在继续医学教育(continuing medical education,CME)授课内容方面的需求,以及参加CME的影响因素,为提升县级医疗机构儿科医师诊疗能力提供参考。方法对参加"全国儿科医师培训项目"的九省市...目的了解我国县级医疗机构儿科医师在继续医学教育(continuing medical education,CME)授课内容方面的需求,以及参加CME的影响因素,为提升县级医疗机构儿科医师诊疗能力提供参考。方法对参加"全国儿科医师培训项目"的九省市县级医疗机构儿科医师进行问卷调查。调查内容包括:一般资料、CME授课内容需求及参加CME的影响因素。采用SPSS 22.0软件进行卡方检验。结果共收回调查问卷465份,其中合格问卷463份,合格率99.6%。研究结果显示:①能力培训需求方面,县级医疗机构儿科医师对儿童疾病诊疗、儿科相关基本技能及儿童保健相关技能有较高需求。初中级职称儿科医师对自主学习和获得学习资源能力培训需求更高(P<0.01);高级职称儿科医师对教学能力培训需求更高(P<0.05)。②儿童专科培训需求方面,需求较高的依次是:新生儿、感染、呼吸、重症、发育行为、消化。③参加CME的影响因素方面,机会少、没时间、课程安排缺陷是影响县级医疗机构儿科医师参加CME的主要因素。结论不同职称的儿科医师对于CME授课内容需求存在差异。CME资源缺乏、工学矛盾和课程缺陷可能是影响县级医疗机构儿科医师参加CME的主要因素。展开更多
Objective: To assess current practices, attitudes, and perceived barriers toward pediatric vision screening. Patients and Methods: A link to a 9-question survey was electronically distributed to a national sample of 6...Objective: To assess current practices, attitudes, and perceived barriers toward pediatric vision screening. Patients and Methods: A link to a 9-question survey was electronically distributed to a national sample of 6000 pediatricians through Medical Marketing Services Inc. Data were collected using Survey Monkey. Results: Email open rate was 11%;37% of those who opened the email responded (225 respondents). Over ninety percent of respondents perform some type of vision screening at least yearly, although age at which screening began varied, with two thirds of respondents instituting formal vision screening after three years. Fifty eight percent of respondents were either extremely unsatisfied, unsatisfied or only somewhat satisfied with their current screening method. Preferred methods of screening and confidence of pediatricians in their ability to detect pathology varied for children under versus over age three. The least frequently used methods for all age groups were autorefraction and photoscreening. The most commonly reported barriers to screening were inadequate training (48%), time required for exam (42%), and inadequate reimbursement (32%). Conclusions: Perceived barriers to vision screening in the pediatrician office have been previously identified, and photoscreening and autorefraction have been identified as a possible means to circumvent them. In spite of the addition of new procedural codes, pediatricians continue to report similar barriers to screening.展开更多
Background: The inappropriate, irrational use or misuse of antibiotics is observed in all health systems and in all patients’ groups worldwide, especially for children, where antibiotics continue to be the drugs most...Background: The inappropriate, irrational use or misuse of antibiotics is observed in all health systems and in all patients’ groups worldwide, especially for children, where antibiotics continue to be the drugs most commonly prescribed. Methods: A cross-sectional study was conducted in all public pediatric clinics in the Republic of Cyprus, from April to May 2015. A questionnaire was distributed to pediatricians in order to identify the antibiotic prescription practices in common childhood diseases and attitudes towards Pharmacovigilance. The SPSS 19.0 was used for the statistical analysis. In total 42 pediatricians and pediatric residents filled out the questionnaire. Results: A significant percentage of the respondents administered empirical therapy for possible group A streptococcus infection (59.5%), they implemented the “watchful waiting” tactic in acute otitis media (66.7%), whereas 11.9% of them administered antibiotics for the prevention of secondary respiratory tract infections. The majority of physicians did not feel diagnostic uncertainty leading to antibiotics prescribing (90.2%) and their prescribing habits were not influenced by parental demand (80.5%). Although 23.1% of physicians observed often/very often Adverse Drug Reactions (ADRs) after antibiotic administration during their clinical practice, however, 47.6% of the pediatricians declared that they did not report them. Conclusion: Health professionals’ continuing education on the use of therapeutic guidelines and protocols and the development of Pharmacovigilance programs could significantly contribute to the avoidance of the misuse of antibiotics in hospital care as well as to health professionals’ awareness on rational prescribing.展开更多
The purpose of this study was to identify vaccination patterns of both general pediatricians and subspecialists with regards to their own children and projected progeny. A 14 question survey was sent randomly to 1000 ...The purpose of this study was to identify vaccination patterns of both general pediatricians and subspecialists with regards to their own children and projected progeny. A 14 question survey was sent randomly to 1000 members of the Academy of Pediatrics in 2009. Two categories of questions included 1) how physicians with children vaccinated them in the past, and 2) how all respondents would vaccinate a child in 2009. A comparison was made between the answers of general and specialty pediatricians. 582 valid questionnaires were received (58.2% response rate) of which 431 were general pediatricians and 151 subspecialists. No statistical difference was found between general and specialty pediatricians on how they vaccinated their children up until 2009 (95% vs 93%). When asked about vaccinating a future child, a significant proportion of respondents would deviate from CDC guidelines, specialists more than general pediatricians (21% vs 9%). Generalists were more likely to give a future child Hepatitis A (OR: 3.6;95% CI 1.3 - 10.4), Rotavirus (OR: 2.2;95% CI 1.1 - 4.4), Meningococcal (OR: 9.9;95% CI 3.3-29.9), and influenza (OR: 5.4;95% CI 1.1 - 26.7) vaccines. Specialists were more likely to postpone MMR vaccinetion (OR: 4.4 95% CI 2.3 - 8.6). Safety was listed by both groups as the most common reason for altering the recommended immunization schedule. Until 2009, general pediatricians and pediatric specialists have largely adhered to ACIP recommendations, but due to vaccine safety and other concerns, both groups, albeit a higher percentage of specialists, reported greater numbers willing to diverge from these recommendations.展开更多
To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals...To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals of Sindh, Pakistan in 2013. There was a 55% increase in childhood TB notifications in 2014 compared to 2012 in facilities with screeners (n = 8) compared to 40% increase in facilities without screeners (n = 22). This apparent association disappeared when stratified by presence of “trained pediatrician” whose introduction was associated with a massive increase in notifications while transfer was associated with a marked decrease. In conclusion, screeners were not associated with increase in pediatric TB case notifications.展开更多
Behavioral health concerns are surging in pediatric practices.Fortunately,integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings...Behavioral health concerns are surging in pediatric practices.Fortunately,integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings to help shoulder the clinical load.Routine screening of behavioral health problems in primary care facilities enables early identification and treatment.However,deciding on sound,efficient,and scalable screening measures is sometimes arduous.Accordingly,this article presents a clinician-friendly review of three common instruments useful in screening pediatric behavioral health concerns including anxiety,depression,and conduct problems.Psychometric findings and clinical applications of the Pediatric Symptom Checklist-17(PSC-17),the Patient Health Questionnaire-9(PHQ-9),and the Screen for Child Anxiety Related Emotional Disorders(SCARED)are delineated.Finally,clinical implications and recommendations for practicing pediatricians and child psychiatrists are offered.展开更多
文摘目的了解云南省不同等级医院儿科医生对《中国儿童哮喘行动计划》(China Children Asthma Action Plan,CCAAP)及哮喘指南的认知状况。方法2022年7—12月,对云南省保山、昆明、大理、德宏、红河、玉溪、西双版纳、楚雄、曲靖、临沧、文山11个州市的41家不同级别医院395名儿科医师(男132人,女263人,年龄20岁以上)进行了有效调查。采用线上、线下相结合方式进行问卷调查。采用χ^(2)检验、方差分析。结果共收回来自41家医院有效问卷395份。各级别被调查医院儿科医生对儿童哮喘基础知识各问题回答正确率为32.78%(59/180)~97.50%(39/40)、急性期治疗各问题回答正确率为24.44%(44/180)~92.50%(37/40)、后续治疗各问题回答正确率为35.56%(64/180)~100.00%(40/40)。省级三级医院、地市级三级医院儿科医生对儿童哮喘认知情况总体优于二级及一级医院(均P<0.05)。结论云南省各级别医院儿科医生对CCAAP及哮喘指南普遍认知不足,基层医院尤其薄弱。
文摘目的了解我国县级医疗机构儿科医师在继续医学教育(continuing medical education,CME)授课内容方面的需求,以及参加CME的影响因素,为提升县级医疗机构儿科医师诊疗能力提供参考。方法对参加"全国儿科医师培训项目"的九省市县级医疗机构儿科医师进行问卷调查。调查内容包括:一般资料、CME授课内容需求及参加CME的影响因素。采用SPSS 22.0软件进行卡方检验。结果共收回调查问卷465份,其中合格问卷463份,合格率99.6%。研究结果显示:①能力培训需求方面,县级医疗机构儿科医师对儿童疾病诊疗、儿科相关基本技能及儿童保健相关技能有较高需求。初中级职称儿科医师对自主学习和获得学习资源能力培训需求更高(P<0.01);高级职称儿科医师对教学能力培训需求更高(P<0.05)。②儿童专科培训需求方面,需求较高的依次是:新生儿、感染、呼吸、重症、发育行为、消化。③参加CME的影响因素方面,机会少、没时间、课程安排缺陷是影响县级医疗机构儿科医师参加CME的主要因素。结论不同职称的儿科医师对于CME授课内容需求存在差异。CME资源缺乏、工学矛盾和课程缺陷可能是影响县级医疗机构儿科医师参加CME的主要因素。
文摘Objective: To assess current practices, attitudes, and perceived barriers toward pediatric vision screening. Patients and Methods: A link to a 9-question survey was electronically distributed to a national sample of 6000 pediatricians through Medical Marketing Services Inc. Data were collected using Survey Monkey. Results: Email open rate was 11%;37% of those who opened the email responded (225 respondents). Over ninety percent of respondents perform some type of vision screening at least yearly, although age at which screening began varied, with two thirds of respondents instituting formal vision screening after three years. Fifty eight percent of respondents were either extremely unsatisfied, unsatisfied or only somewhat satisfied with their current screening method. Preferred methods of screening and confidence of pediatricians in their ability to detect pathology varied for children under versus over age three. The least frequently used methods for all age groups were autorefraction and photoscreening. The most commonly reported barriers to screening were inadequate training (48%), time required for exam (42%), and inadequate reimbursement (32%). Conclusions: Perceived barriers to vision screening in the pediatrician office have been previously identified, and photoscreening and autorefraction have been identified as a possible means to circumvent them. In spite of the addition of new procedural codes, pediatricians continue to report similar barriers to screening.
文摘Background: The inappropriate, irrational use or misuse of antibiotics is observed in all health systems and in all patients’ groups worldwide, especially for children, where antibiotics continue to be the drugs most commonly prescribed. Methods: A cross-sectional study was conducted in all public pediatric clinics in the Republic of Cyprus, from April to May 2015. A questionnaire was distributed to pediatricians in order to identify the antibiotic prescription practices in common childhood diseases and attitudes towards Pharmacovigilance. The SPSS 19.0 was used for the statistical analysis. In total 42 pediatricians and pediatric residents filled out the questionnaire. Results: A significant percentage of the respondents administered empirical therapy for possible group A streptococcus infection (59.5%), they implemented the “watchful waiting” tactic in acute otitis media (66.7%), whereas 11.9% of them administered antibiotics for the prevention of secondary respiratory tract infections. The majority of physicians did not feel diagnostic uncertainty leading to antibiotics prescribing (90.2%) and their prescribing habits were not influenced by parental demand (80.5%). Although 23.1% of physicians observed often/very often Adverse Drug Reactions (ADRs) after antibiotic administration during their clinical practice, however, 47.6% of the pediatricians declared that they did not report them. Conclusion: Health professionals’ continuing education on the use of therapeutic guidelines and protocols and the development of Pharmacovigilance programs could significantly contribute to the avoidance of the misuse of antibiotics in hospital care as well as to health professionals’ awareness on rational prescribing.
文摘The purpose of this study was to identify vaccination patterns of both general pediatricians and subspecialists with regards to their own children and projected progeny. A 14 question survey was sent randomly to 1000 members of the Academy of Pediatrics in 2009. Two categories of questions included 1) how physicians with children vaccinated them in the past, and 2) how all respondents would vaccinate a child in 2009. A comparison was made between the answers of general and specialty pediatricians. 582 valid questionnaires were received (58.2% response rate) of which 431 were general pediatricians and 151 subspecialists. No statistical difference was found between general and specialty pediatricians on how they vaccinated their children up until 2009 (95% vs 93%). When asked about vaccinating a future child, a significant proportion of respondents would deviate from CDC guidelines, specialists more than general pediatricians (21% vs 9%). Generalists were more likely to give a future child Hepatitis A (OR: 3.6;95% CI 1.3 - 10.4), Rotavirus (OR: 2.2;95% CI 1.1 - 4.4), Meningococcal (OR: 9.9;95% CI 3.3-29.9), and influenza (OR: 5.4;95% CI 1.1 - 26.7) vaccines. Specialists were more likely to postpone MMR vaccinetion (OR: 4.4 95% CI 2.3 - 8.6). Safety was listed by both groups as the most common reason for altering the recommended immunization schedule. Until 2009, general pediatricians and pediatric specialists have largely adhered to ACIP recommendations, but due to vaccine safety and other concerns, both groups, albeit a higher percentage of specialists, reported greater numbers willing to diverge from these recommendations.
文摘To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals of Sindh, Pakistan in 2013. There was a 55% increase in childhood TB notifications in 2014 compared to 2012 in facilities with screeners (n = 8) compared to 40% increase in facilities without screeners (n = 22). This apparent association disappeared when stratified by presence of “trained pediatrician” whose introduction was associated with a massive increase in notifications while transfer was associated with a marked decrease. In conclusion, screeners were not associated with increase in pediatric TB case notifications.
文摘Behavioral health concerns are surging in pediatric practices.Fortunately,integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings to help shoulder the clinical load.Routine screening of behavioral health problems in primary care facilities enables early identification and treatment.However,deciding on sound,efficient,and scalable screening measures is sometimes arduous.Accordingly,this article presents a clinician-friendly review of three common instruments useful in screening pediatric behavioral health concerns including anxiety,depression,and conduct problems.Psychometric findings and clinical applications of the Pediatric Symptom Checklist-17(PSC-17),the Patient Health Questionnaire-9(PHQ-9),and the Screen for Child Anxiety Related Emotional Disorders(SCARED)are delineated.Finally,clinical implications and recommendations for practicing pediatricians and child psychiatrists are offered.
