Majority Of Pediatricians Research Articles

Pediatrician’s Perception of Air Pollution and its Impact on Children’s Health in Indonesia

Introduction: Air pollution is an unseen threat to children's health as it increases the risk of respiratory infection by impairing immune responses to the respiratory tract. Nevertheless, health promotion emphasizing the impact of air pollution is not popular, even among health professionals. Therefore, this study aimed to explore the perceptions of paediatricians regarding its impact on children’s health in Indonesia. Materials and Methods: A cross-sectional design using an online questionnaire was employed in this study. It was composed of 30 items and divided into 4 sections, i.e. section 1 explored the demographic variables, section 2 measured the respondent’s information-seeking behavior on the issue of air pollution, section 3 measured the perception of issues related to air pollution and its impact on children’s health, and section 4 explored the respondent’s experience in practicing environmental health education with respect to their patients. Only completed surveys were analysed. Results: Of the 171 pediatricians who were accessed for the survey, 120 (70.2%) completed it. The majority of respondents (69%) resided in Java island and worked in urban areas (84%). About 41.7% of the respondents had little to no information on the impact of air pollution on children’s health. More than 80% of the respondents received information from scientific articles, followed by seminars (61.5%), the internet (53.8%), colleagues (30.7%), and workshops/training (17.3%). Nearly one-third of the respondents considered air quality as poor in their working environment. Almost all agreed that air pollution can affect children’s health and increase the risk of respiratory allergies and even the risk of skin allergies for children under two years of age. In daily practice, most respondents (53.3%) admitted that they never or rarely treated patients with diseases related to air pollution. About one-third of the respondents (36.7%) had never or rarely asked their patients about their living environment. Conclusion: Pediatricians are aware of the impact of air pollution on the risk of respiratory allergies and infection, and therefore often provide environmental health education to patients. This study has reported that the majority of pediatricians in Indonesia have an understanding of the impact of air pollution on children’s health; however, there is still a lack of health promotion to be communicated to the patients and their families in their daily practice.

Management of atopic dermatitis by pediatricians: A French national survey-based study

PurposeAtopic dermatitis (AD) is a chronic skin disease affecting 10% of children in Europe. The treatment of AD is well codified; however, a gap sometimes exists between recommendations and medical practice. The objective of this study was to assess the practice of French pediatricians regarding the management of AD. MethodsWe conducted a national practice survey from September 2021 to October 2021, using an online questionnaire emailed to pediatric physicians. ResultsA total of 83 pediatricians from 33 different departments responded to the survey. The clinical features of AD were known by the majority of pediatricians, but 15 (18%) found the diagnosis difficult to establish. All pediatricians prescribed daily applications of emollients and 78 (94%) prescribed topical corticosteroids (TCS) during AD flares, but misuses remained: only 29 (35%) pediatricians prescribed TCS when eczema (even if minimal) appeared and 43 (52%) did so at the onset of pruritus, while 45 (54%) prescribed them for extensive or disabling eczema, and 53 (64%) when eczema persisted after an initial treatment with emollients. Regarding diet, 12 (14%) pediatricians recommended a diet low on or free of cow milk, 10 (12%) systematically referred children with AD to an allergist, and 20 (24%) delayed food diversification. ConclusionDespite improvements in AD management by French pediatricians in the past 15 years, barriers to its appropriate management still persist, including the misuse of TCS and inappropriate diets.

Attitude, knowledge and practice of pediatricians in the prevention of early childhood caries

Background/Aim: The aim of the research was to examine the general attitude, knoweledge and practice of pediatricians about caries in children of preschool age. Material and Methods: The research was conducted from November 2019 to the end of January 2020. The research consisted of a survey of pediatricians. The questionnaire consisted of 4 modules and 37 questions, which related to the attitude, knowledge and practice of pediatricians on the prevention of early childhood caries. Results: The majority of pediatricians (84.9%) stated that they assess the nutrition of their patients, while 32.1% of them always do oral health assessment, and half of them in the second month of the child's life; and 39.6% assess oral health only if there is a problem. The majority of pediatricians (86.8%) recommended the first dental examination, most often in the first year of the child's life (79.5%), and then every 6 months (43.5%). The majority of respondents did not required information about the dental health of their patients' mothers, fluoride toothpastes and topical application of fluoride as well (62.3-75.5%). The majority of pediatricians (79.2%) have never provided or sometimes provided educational material on caries prevention and control to the parents of their patients. The most accurate answers and the highest percentage of correct answers that the pediatricians had were about attitudes (Z=8.98, 66.63%), while the fewest correct answers and the lowest percentage of correct answers regarding the practices on the prevention of early childhood caries (Z=11.91, 58.90%). Conclusions: The research showed that pediatricians have the good attitudes and knowledge, but do not implement prevention of early childhood caries in practice. The basic deficiency of attitude, knowledge and perception of the importance of prevention is a consequence of insufficient education of pediatricians.

A Cross-sectional Survey on the Perception of Pediatricians about Constipation in Indian Pediatric Patients (CROSCIP)

Background: Constipation accounts for more than 50% of the workload in pediatric outpatient clinics, with functional constipation being the most frequently diagnosed condition. Pediatricians have varied perceptions about constipation and its management. Objective: A national prospective questioner based cross-sectional survey was conducted to understand the perceptions and practices of Indian pediatricians on the current management of pediatric constipation. Methods: A 14-item questionnaire with open and closed-ended questions was developed with a focus on understanding the prevalence of constipation in the pediatric setting, common clinical presentations, management approaches, treatment choices, and patient compliance. Pediatricians PanIndia, among varied practice backgrounds, were invited to participate in the survey. Results: A total of 1150 pediatricians were invited, of which 1042 completed the survey. The majority of the responding pediatricians were based in the outpatient clinic setting. The most common age group of children presenting with functional constipation was 2-4 years. The most commonly reported symptoms were painful passage of hard and dry stools with a frequency of fewer than two stools per week. Polyethylene glycol (PEG) 4000 was the preferred choice for fecal disimpaction and maintenance by the majority of pediatricians. Most pediatricians prescribe laxatives for 1-3 months. The major challenge with PEG 3350 was the volume to be consumed and poor palatability. The survey results showed poor compliance and a high relapse rate in children with functional constipation. Conclusion: Functional constipation is prevalent in toddlers with growing incidence and is managed by pediatricians in outpatient clinics. We found that Indian pediatricians prefer PEG 4000 for fecal disimpaction and maintenance therapy.

RETRACTED: Pediatricians' Knowledge of Children's Oral Health: A National Survey

A high percentage of dental caries (∼70%) was reported amongst 4- and 5-year-old Kuwaiti kindergarten children. Parents contact paediatricians several times during the child's early life. Paediatricians can play an important role in improving the oral health of their patients. The objective of the study is to evaluate the knowledge level and awareness of paediatricians and paediatric residents regarding children's oral health in Kuwait. A national cross-sectional survey was distributed to paediatricians and paediatric residents practicing in Kuwait. Data concerning demographic variables, knowledge on dental caries preventive measures, current anticipatory guidance, and experience with dental problems and oral care were collected using online and paper-based surveys. A total of 230 participants completed the survey, with a response rate of 50.1%. Most respondents (81%) had frequently noticed dental caries in children in their practice. Two-thirds of respondents felt confident in detecting dental caries. However, more than two-thirds were unfamiliar with preventive dental practices and the management of dental trauma. Only 16.5% of the respondents got a satisfactory knowledge score on the preventive measure questions, and nearly 51% had satisfactory knowledge on the recent anticipatory guidance questions. No significant correlations were found between gender or years of practice and knowledge scores. Respondents' confidence in detecting caries was significantly associated with the knowledge score of the anticipatory guidance (P=.003). Fewer than half of the respondents considered prescribing sugar-free syrup (47.4%) and counselled patients regarding the use of mouthguards during sports for schoolchildren (39%). The majority of paediatricians have adequate knowledge of the current anticipatory guidance of oral health issues, but they have insufficient knowledge of oral preventative measures and dental trauma. Adequate education and training in oral health are highly recommended.

Phimosis - Are we on right track?

Background:Phimosis, a common paediatric condition, is defined as the inability to retract the preputial skin behind the glans. Current practice shows there is some confusion among the paediatricians towards this common condition and in differentiating it from the more common physiological preputial adhesion; leading to frequent referrals to a paediatric surgeon or a general surgeon, which can be addressed by the parents and the child physicians themselves.Aim:To find out the awareness towards the management of phimosis among the paediatricians.Materials and Methods:A questionnaire on this topic was generated using ‘Google Forms’ and was circulated among junior and senior residents, faculty in various medical colleges and consultants in private practice all over India and their response was collected and analysed.Results:We received a total of 221 responses from all over India from paediatric medicine trainees and consultants. Among them, majority (48%) were senior residents. According to the survey participants, the most (46%) find inability to retract the prepuce as the major presenting complaint. A straight away reference to a paediatric surgeon was preferred by majority of paediatricians (62.9%), though most of them were aware of them were aware of physiological adhesions and conservative management (94.2%). There was a belief among 43% about counselling each and every patient presenting with phimosis for circumcision. Among the respondents, 60.2% advised ultrasound of kidneys, ureter, and bladder to their patients and believed that backpressure changes alter the management of the child. A urine routine examination was advised by 70.1% of participants, with 46.6% believing that the presence of urinary tract infection changes the management of phimosis. Waiting up to 1 year of age before going for surgery was advocated by 71.5%. A major proportion of respondents (76%) believed all cases of phimosis should be referred to a surgeon, only 58.8% would voluntarily follow them up. There is still a belief among 69.7% of participants that all cases of phimosis should be referred to a paediatric surgeon and only few of them, 5.4% feel referring only indicated cases.Conclusion:Physiological phimosis is a common condition which can be addressed by the paediatricians themselves. Awareness is to be increased among them, especially during the training period regarding the proper management of this common condition, avoiding unnecessary circumcisions.

Knowledge of and attitude to eye disorders among pediatricians in North Jordan

PurposeTo assess the general knowledge of and attitude to various common eye conditions in children among pediatricians in north Jordan. MethodsThis was a descriptive cross-sectional study. An exploratory questionnaire was developed by the research team to collect the necessary qualitative information. ResultsIn total, 48 pediatricians participated in the study. Around two-thirds performed eye examinations in children; however, only 10.4% (n = 5) carried out eye exams routinely as part of every child's health visit. The most common test done was assessment of red reflex, which was performed by only 60.4% (n = 29) of responders. Almost all participants (95.8%, n = 46) recognized the risk factors for retinopathy of prematurity (ROP). The majority of pediatricians (n = 46, 95.8%) would immediately refer a child with suspected glaucoma to an ophthalmologist. In regard to leukocoria, the majority recognized cataract (n = 38, 79.2%) and retinoblastoma (n = 40, 83.3%) as major causes of this condition. Almost all pediatricians (n = 46, 95.8%) would immediately refer a child with leukocoria to an ophthalmologist. On the subject of refractive errors, only 62.5% (n = 30) of physicians confirmed that refractive errors could occur in children of any age and that they may need glasses. Nonetheless, 70.8% (n = 34) stated that refractive errors could be a cause of squint in children. Amblyopia and underlying central causes of squint were a major concern for most responders with 68.8% (n = 33) and 75% (n = 36), respectively. ConclusionAlthough the knowledge of and attitude to eye disease among pediatricians were at a satisfactory level, the degree of collaboration with ophthalmologists is limited. More workshops need to be held for pediatricians.

Awareness of newborn hearing screening in pediatricians and gynaecologists in Maharashtra, India

<p class="abstract"><strong>Background:</strong> A successful implementation of newborn hearing screening program requires the active participation of several health care professionals like pediatricians, gynaecologists, neonatologists, nurses and audiologists. These professionals help the parents through the process of screening, diagnosis and intervention. If they are made alert and informed regarding the importance of hearing screening, then accurate diagnosis and early intervention of hearing loss will be possible. Hence, the aim was to study the awareness of newborn hearing screening among pediatricians and gynaecologists in the state of Maharashtra, India.</p><p class="abstract"><strong>Methods:</strong> Questionnaire was prepared based on the review of literature and after content validation it was administered on 50 paediatricians and 50 gynaecologists via electronic mail and hard copy. Each participant had to place a tick against correct alternative out of 2 alternatives for each question.</p><p class="abstract"><strong>Results:</strong> The present study revealed that overall awareness level of newborn hearing screening was moderate to high in pediatricians and moderate in gynaecologists. Independent sample t test indicated that there was a significant difference present in the awareness level of pediatricians and gynaecologists.</p><p class="abstract"><strong>Conclusions:</strong> Majority of paediatricians and gynaecologists lacked complete information regarding the protocol, test procedures used in hearing screening and role of audiologists. Thus, continued education programs are necessary for updating the knowledge base regarding newborn hearing screening in primary care physicians.</p>

Effects of the COVID-19 Pandemic on childhood immunization in Morocco: electronic survey of 103 pediatricians

Introductionnul ne peut nier les résultats protecteurs satisfaisants de la vaccination contre plusieurs maladies graves dans le monde et particulièrement au Maroc. L´extension de la pandémie COVID-19 dans notre pays a entrainé une baisse importante de la vaccination des enfants, ce qui pourrait causer des flambées épidémiques dans le futur. D´où l´intervention du ministère de la santé pour pallier à cette situation. L´objectif était de montrer l´ampleur du relâchement de la vaccination en temps COVID-19 et sortir avec des recommandations visant à rétablir ce changement.Méthodesil s´agit d´une étude transversale sur l´impact de cette pandémie sur le suivi vaccinal des enfants. Nous avons mené une enquête nationale auprès des pédiatres sous forme d´un questionnaire électronique via Google Forms. Nous avons procédé à la collecte, l´analyse et l´interprétation des résultats.Résultatscent trois pédiatres marocains ont répondu au questionnaire. Plus de 2 tiers des pédiatres exercent au secteur privé et pratiquent tout le calendrier vaccinal. La majorité des pédiatres (95%) ont reçu des questions émanant des craintes des parents sur la vaccination. Nous avons noté que 82,5% des parents hésitent à venir au cabinet et 5,8% refusent de faire la vaccination pendant cette période. Environ 22% des pédiatres ont arrêté totalement la vaccination et 72,8% ont décalé les vaccins d´un mois.Conclusionil est essentiel de maintenir la confiance de la population dans la vaccination. Une évaluation continue de la couverture vaccinale, des recommandations claires et une large sensibilisation du grand public seront nécessaire pour répondre aux changements vaccinaux durant la pandémie de COVID-19.

Clinical assessment of micronutrient deficiencies in 2-6 years old children: a survey with pediatricians

Background: Worldwide, at least fifty percent of children, younger than 5 years of age, suffer from micronutrient, protein and calorie deficiencies causing negative impact on health. Our study aims to understand the pediatricians’ perspectives on diagnosis and management of these micronutrient deficiencies (MND).Methods: A cross sectional questionnaire-based survey of 490 pediatricians, wherein the questionnaire focused on prevalence, causes, diagnosis, management and long-term impact of micronutrient deficiencies in children aged 2 to 6 years.Results: Majority of pediatricians (94%) commonly see MNDs in their clinical practice; with 94% pediatricians seeing MNDs in stunted children, 93% in wasted and 89.0% in obese children. About 50–90% pediatricians reported calorie, protein, vitamins and mineral deficiencies. Not eating a balanced diet was the cause of nutrient deficiency as per 97% pediatricians, while about 93-97% opined MNDs also cause frequent illness, lack of energy/weakness, loss of weight or causes thinness. All pediatricians believe that minerals, vitamins and proteins are important for immunity and bone development. Also, 88% pediatricians believe multiple MNDs can be evaluated by physical examination and clinical history; and about 40% pediatricians suggest intervention to 25-50% children. Also, they believe that MNDs impact long-term health outcomes like growth, cognitive development, metabolic development and social development.Conclusions: Micronutrient deficiencies contribute to lack of energy, frequent illness, and compromised immune system which in turn have short-term and long-term impact on overall growth and development. Hence there is a need to assess and address the MNDs at the earliest.

Diagnosis and management of protracted bacterial bronchitis: a survey of Chinese pediatricians.

BackgroundProtracted bacterial bronchitis (PBB) is a common cause of chronic wet cough in children. However, it is often misdiagnosed and inappropriately treated in clinical practices. This study aims to investigate the current diagnosis and management of PBB among Chinese pediatricians.MethodsAn electronic questionnaire designed to assess the diagnosis and management of PBB was sent to pediatricians in China.ResultsA total of 1,022 pediatricians completed the questionnaire. Most (68.8%) of the pediatricians diagnosed PBB in compliance with the guidelines, 44.3% and 24.5% of them followed microbiology-based and clinical-based diagnosis criteria, respectively. Only 40.4% of the pediatricians chose amoxicillin-clavulanate as the first-line antibiotic for PBB treatment, 23.7% and 23.5% of them chose third-generation cephalosporins and macrolides, respectively. The majority of pediatricians (75.4%) reported 2–4 weeks of antibiotics course, 19.3% of them prescribed a shorter course and 5% of them selected a longer course. Only 26.3% of the pediatricians performed combined investigations of chest high-resolution computed tomography scan (c-HRCT), bronchoscopy, and immunological tests for recurrences of PBB. Compared with general pediatricians (GP), pediatric pulmonologists (PP) preferred microbiology-based diagnosis criteria, prescribed more amoxicillin-clavulanate, and performed more investigations for recurrent patients (P<0.05).ConclusionsThe majority of Chinese pediatricians diagnosed PBB in compliance with guidelines. However, the reasonable antibiotics applications and the investigations for recurrent PBB need to be improved.

Knowledge, attitudes, and practice toward multisystem inflammatory syndrome in children among pediatrician in Eastern India: An online cross-sectional survey

Background: Multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome-coronavirus-2 is a new life-threatening entity whose diagnosis and management warrant awareness and in-depth knowledge. This study intends to estimate the knowledge, attitudes, and practice toward MIS-C among pediatricians of eastern India. Subjects and Methods: A descriptive, web-based cross-sectional survey was conducted among pediatricians of eastern India between January 1 and March 31, 2021, where they were invited to participate irrespective of their experience in treating COVID-positive children. Results: The majority of pediatricians (≥95%) are aware of the terminology MIS-C, its clinical features, presence of raised inflammatory markers, its treatment, and follow-up. Although 75% were aware of the vulnerable age group, only 50% knew the exact timing of occurrence. Fever as a mandatory criterion for diagnosis was known to 62.6%. The majority (75%) agreed that positivity of any of the tests (reverse transcription polymerase chain reaction, antigen, or antibody) or history of contact with COVID is necessary for diagnosis. Kawasaki Disease and Toxic Shock Syndrome as a common differential diagnosis of MIS-C were agreed upon by 86%. Pediatricians working in COVID hospital were more confident in managing MIS-C than who are not working (72.8% vs. 38.6%). Steroid and intravenous immunoglobulin used as first-line treatment by 94% and 72%, respectively. Conclusion: Although the majority of pediatricians are now aware of MIS-C, still there is need for continuing medical education (CME) and interactive sessions with experts, to make them suspect, detect early and manage it more effectively.

Knowledge, approach and recommendations of paediatricians for preventing early childhood caries in children

Introduction: Childhood is an important stage in life and Early Childhood Caries (ECC) is the most common disease of this phase. Unlike paediatric dentists, pediatricians see the majority of children periodically during these first years of life and have the opportunity to sensitize parents to the oral health of their children and to prevent ECC. Aim and Objectives: To assess Paediatrician’s knowledge, approach and preventive care recommendations for ECC in children. Materials and Method: A cross-sectional survey was carried out among 36paediatricians selected randomly. A close ended validated questionnaire was solved by all the selected paediatricians. It had questions regarding the knowledge about ECC, child’s first dental visit and anticipatory guidance given to parents. This study also evaluated the recommendation for patients to regular dental visits. Results:Majority of paediatricians (83.3%) were aware of ECC and practiced regular oral screening of their patients. They recommend for the first dental visit at around 1 year of age. Among 36Paediatricians33 (91.7%) considered tooth brushing, regular dental check-up, control over sugary and sticky in between meal snacks as the measures for the prevention of ECC and 83.3% of the paediatricians agreed that syrupy medications containing sucrose as a potential risk factor. However, majority of them didn’t recommend any fluoride supplements in their daily practice. Conclusions:Paediatricians were well aware of ECC. They consider it to be the responsibility of the general practitioner, paediatrician, general dentist and the paediatric dentist together for the spread of awareness and prevention of ECC. Keywords: Child Oral health, Early Childhood Caries, paediatrician, preventive measures

Infantile Colic-The Perspective of German and Polish Pediatricians in 2020.

The objective of the study was to characterize how infantile colic is perceived and managed by German and Polish pediatricians. Data in both countries were collected by using a paper questionnaire with seven questions and predefined and free text fields for the answers. Answers from 160 German and 133 Polish pediatricians were collected. The average of the occurrence rates estimated by both responder groups were at the higher end of published rates. The majority of pediatricians from both countries rated the parental burden caused by infantile colic to be high or very high. Pediatricians’ awareness about the association between infantile colic and maternal depression and premature termination of breastfeeding is relatively well established in both countries. While more than 90% of German pediatricians stated knowledge of infantile colic being a major risk factor for shaken baby syndrome, this knowledge was only declared by half of the Polish responders. Pharmacological interventions, pro-/synbiotics or simethicone, are part of the treatment repertoire of nearly all responding pediatricians. In addition, non-pharmacological interventions (e.g., change of feeding, change of parental behavior) are also among the employed interventions. Results of this study will allow to better design and prioritize communication about infantile colic directed at pediatricians.

Horn of plenty: Value of the international registry for pediatric chronic myeloid leukemia.

Chronic myeloid leukemia (CML) in minors is a rare disease which can be effectively treated by tyrosine kinase inhibitors (TKIs) since the year 2000. A majority of pediatricians will encounter one or two CML patients in the course of their careers and will typically have to rely on written information along with their own intuition to provide care. Knowledge of response to TKIs and of age-specific side effects has an impact on the design of pediatric CML trials in many ways aiming to contribute toward greater predictability of clinical improvements. Information from a registry on a rare disease like CML offers the enormous benefit of enabling treating physicians to interact and share their collective experience. The International Registry on Pediatric CML (IR-PCML) was founded at Poitiers/France almost 10 years ago. Since then, the number of collaboration centers and in parallel of registered patients continuously increased (> 550 patients as of December 2019). Ideally, from a given treatment center in a country data are transferred to a national coordinator who interacts with the IR-PCML. In the sense of quality assurance, the registry can offer dissemination of knowledge on state-of-the-art diagnostics (including reference appraisal), optimal treatment approaches, and follow-up procedures within a network that is exerting its strength via participation. With continuous growth during the recent years, very rare subgroups of patients could be identified (e.g., CML diagnosed at age < 3 years, children presenting with specific problems at diagnosis or during course of treatment) which had not been described before. Publications coming from the IR-PCML disseminated this useful information derived from patients who robustly participate and share information about their disease, among themselves and with their caregivers and clinicians. Patient input driving the collection of data on this rare leukemia is the basis for the considerable success of bringing new therapeutics into clinical use.

The Knowledge and Attitudes of Pediatricians in Israel Towards Vegetarianism.

Pediatricians have an important role in the dietary education of children, and in the nutritional health of their patients. We aimed to assess nutritional knowledge, familiarity with guidelines, and attitudes of pediatricians regarding vegetarian diets. A cross-sectional study using a previously implemented questionnaire, distributed amongst a convenience sample of pediatricians in Israel. For each participant, scores of knowledge and of attitudes towards vegetarian diets were calculated. Scores were analyzed and compared between various categorizations of the respondents. Of 270 respondents (60.4% female individuals), 14.1% were following a vegetarian or semi-vegetarian diet. The overall mean scores for knowledge and attitude were 37.9 ± 16.0% and 38.1 ± 20.7%, respectively. Among pediatricians currently following a vegetarian or semi-vegetarian diet, mean knowledge and attitude scores were higher by 12.2% (95% confidence interval [CI] 6.8-17.6, P < 0.001) and 17.4% (95% CI 10.5-24.2, P < 0.001), respectively, compared with nonvegetarians. Knowledge scores were found to be positively correlated with attitude scores. Only 13.4% of pediatricians felt that their medical degree studies prepared them well to deal with vegetarian patients. A higher knowledge score was correlated with inquiring of patients eating habits, and counseling on vegetarian diets. Pediatricians possess a low average knowledge base in vegetarian nutrition. The majority of pediatricians do not hold positive attitudes concerning vegetarian diets. We show a positive correlation between overall knowledge and overall attitude for individual participants. Increasing the knowledge base of pediatricians regarding vegetarian diets may lead them to conceive meatless diets in a more positive light and better counsel their patients.

Top 100-Cited Articles in Tinnitus: A Bibliometric Analysis

Neonatal hyperbilirubinemia is a widespread and significant clinical condition amongst neonates worldwide Methods: A specially designed questionnaire was distributed to a random sample of 200 pediatricians working in the main childhood hospitals in Sana'a. Results: The pediatricians involved in the study stated high use (61.8%) of the cephalo-caudal progression as a method to evaluate jaundice in the newborn. Less proportion of pediatricians tested total serum bilirubin levels in jaundiced neonates ahead of their discharge from the hospital as compared to jaundiced neonates examined at the post-discharge visit (73.9% vs. 83.4%). The majority of pediatricians did not believe neonatal jaundice noted after discharge and gestational ages 37–38 weeks as being risk factor for the development of acute bilirubin encephalopathy. A considerable number of our pediatricians initiated phototherapy as well as exchange transfusion at lower levels of serum bilirubin than the recommended by the AAP guidelines at age of 24-48 hr, (66.7% and 57.6% respectively). Conclusion: although Yemeni pediatricians in the study were liable to start up phototherapy and exchange blood transfusion at points lesser than those recommended, the study revealed an overall consistency of their practice with hyperbilirubinemia treatment guidelines of the American Academy of Pediatrics, 2004.

Pediatrician Perspectives on Feasibility and Acceptability of the MOCA-Peds 2017 Pilot.

The American Board of Pediatrics (ABP) certifies that general and subspecialty pediatricians meet standards of excellence established by their peers, immediately after training and over the course of their careers (ie, Maintenance of Certification [MOC]). In 2015-2016, the ABP developed the Maintenance of Certification Assessment for Pediatrics (MOCA-Peds) as an alternative assessment to the current proctored, closed-book general pediatrics (GP) MOC examination. This article is 1 of a 2-part series examining results from the MOCA-Peds pilot in 2017. We conducted quantitative and qualitative analyses with 5081 eligible pediatricians who registered to participate in the 2017 pilot; 81.4% (n = 4016) completed a quarter 4 survey and/or end-of-year survey (January 2018) and comprise the analytic sample. The majority of pediatricians considered the MOCA-Peds to be feasible and acceptable as an alternative to the proctored MOC GP examination. More than 90% of respondents indicated they would participate in the proposed MOCA-Peds model instead of the examination. Participants also offered recommendations to improve the MOCA-Peds (eg, enhanced focus of questions on outpatient GP, references provided before taking questions); the ABP is carefully considering these as the MOCA-Peds is further refined. Pilot participant feedback in 2017 suggested that the MOCA-Peds could be implemented for GP starting in January 2019, with all 15 subspecialties launched by 2022. Current and future evaluations will continue to explore feasibility, acceptability, and learning and practice change as well as sustainability of participation.

Achieving the Pediatric Mental Health Competencies.

Mental health disorders affect 1 in 5 children; however, the majority of affected children do not receive appropriate services, leading to adverse adult outcomes. To meet the needs of children, pediatricians need to take on a larger role in addressing mental health problems. The accompanying policy statement, "Mental Health Competencies for Pediatric Practice," articulates mental health competencies pediatricians could achieve to improve the mental health care of children; yet, the majority of pediatricians do not feel prepared to do so. In this technical report, we summarize current initiatives and resources that exist for trainees and practicing pediatricians across the training continuum. We also identify gaps in mental health clinical experience and training and suggest areas in which education can be strengthened. With this report, we aim to stimulate efforts to address gaps by summarizing educational strategies that have been applied and could be applied to undergraduate medical education, residency and fellowship training, continuing medical education, maintenance of certification, and practice quality improvement activities to achieve the pediatric mental health competencies. In this report, we also articulate the research questions important to the future of pediatric mental health training and practice.

PEDIATRICIAN AND ALLERGIST RELATIONSHIPS IN THE TREATMENT OF PATIENTS WITH SEVERE ALLERGY AND ANAPHYLAXIS

Introduction The management of patients with severe allergies and anaphylaxis often spans multiple specialties. A research survey among pediatricians was conducted as a means of obtaining peer input to identify priorities for managing challenging cases of allergies and anaphylaxis, as well as referral relationships among specialties and rationale for patient referral. Methods An online survey was conducted among a sample of 150 US community-based pediatricians who treat >12 patients/month with severe food allergies/anaphylaxis. The survey queried general pediatricians about their consultation and referral practices as well as their frequency and reasons for referrals when treating allergy/anaphylaxis patients. Results In this survey, 87% of community pediatricians (N=131) indicated that they frequently or occasionally refer patients with severe allergic reactions or anaphylaxis outside of their practice. A majority of pediatricians (72%) reported consulting with their peers about challenging cases on at least an occasional basis. Virtually all of these patient referrals (93%) were made to allergists. Most common reasons for referral were (1) complex cases requiring more specialization and (2) the availability of resources that pediatricians may lack, eg, intradermal/skin testing. Patients most likely to be referred to outside specialists were infants with anaphylaxis (87%), patients with comorbidities (78%), and patients with peanut allergies (62%). Conclusions Most community pediatricians will frequently or occasionally refer patients with severe allergies/anaphylaxis outside their practice, most often to allergists. A meaningful percentage report consulting with their peers on challenging cases, demonstrating their willingness to reach out or refer complex cases to their colleagues.