Young Pediatricians Research Articles

Robert Haggerty, the New Morbidities, and the Dissonance between Education and Child Health Needs.

1. Julia A. McMillan, MD* 1. *Johns Hopkins School of Medicine, Baltimore, MD > In April 2018, the American Board of Pediatrics Foundation; the National Academies of Sciences, Engineering, and Medicine; and invited pediatric department chairs and pediatric residency program directors participated in a 2-day workshop dedicated to developing ways to prepare future pediatricians to meet the behavioral and mental health needs of children, needs that are increasing each year. Each participant pledged to develop a way. One way is to spread the word of such needs. What follows is a commentary by one of the workshop facilitators. > > —JZ Anniversaries are appropriate occasions to mark longevity and to celebrate achievements and progress, and the 40th anniversary of Pediatrics in Review (PIR) is no exception. As we celebrate the achievements of the past 40 years, however, it is also important to recognize opportunities that have been missed, warnings that have not been heeded. Robert J. Haggerty was the first editor-in-chief of PIR , and he served in that capacity for 25 years. Although Dr Haggerty is well-known and respected for his service as the founding editor of PIR, it is his recognition of the importance of what he called the biosocial aspects of pediatrics for which he may be best remembered. Just 4 years before the first issue of PIR was published, Dr Haggerty and coeditors Klaus Roghman and Ivan Pless wrote of the importance of biosocial considerations in child health. They cited, in particular, behavior disorders in preschool children, inadequate functioning in schools, and adjustment issues during adolescence. They called for a shift in the orientation of pediatric training programs and for allowing for more time during pediatric office visits to address these problems, which they called the new morbidities . (1) Dr Haggerty and his colleagues at the University of Rochester advocated a multidisciplinary approach to child health, addressing psychological problems and …

Paediatric Virology and innovation in medical education: An interview with Dr Ioannis N. Mammas, Consultant Paediatrician on the island of Euboea (Greece) and Coordinator of the Paediatric Virology Study Group.

Born in Chalkida in Greece, Dr Ioannis N. Mammas, Consultant Paediatrician on the island of Euboea, studied Medicine at the University of Crete School of Medicine, where he received his MD in 2002 and his PhD in Clinical Virology in 2006. He was trained in Paediatrics and Neonatology in Merseyside (UK), attending the ‘Alder Hey’ Children's Hospital's specialty training (ST) rotation programme and in Athens (Greece) at the ‘Penteli’ Children's Hospital and the ‘MAKKA’ Paediatric Infectious Diseases (PID) Unit of the ‘Aghia Sophia’ Children's Hospital. On October 10th, 2015, he presented the Paediatric Virology subspecialty's proposal, which up-to-date has attracted the critical interest of several international experts in the scientific fields of Neonatology, Paediatrics, PID and Virology and has been evaluated as a unique project of innovation in medical education. According to Dr Mammas, Paediatrics is the specialty, which daily provides the opportunity to support with responsibility the children's smile, the hope of life and future. He highlights the significant role of the Paediatric Virology Study Group (PVSG), a paediatric think tank, which was established by a group of paediatric trainees and young paediatricians in 2007 and since then has been involved with enthusiasm in the perspectives of Paediatric Virology in medical education. Dr Mammas strongly believes that in the future, Paediatric Virology subspecialists will have a strategically principal role, both clinical and academic, at the fight against viral infections in childhood. This aim will be supported by the newly founded Institute of Paediatric Virology (IPV), the first scientific initiative in the world committed to medical education on neonatal and paediatric viral infections.

The wisdom and eudaimonia of Paediatrics: An interview with Professor George P. Chrousos, Professor of Paediatrics and Endocrinology at the University of Athens, Greece.

Professor George P. Chrousos, Professor Emeritus of Paediatrics and Endocrinology at the University of Athens School of Medicine, in Athens, Greece, is the most distinguished Professor of Paediatrics in the modern history of Hellenic Paediatrics and among the 100 most prominent clinical investigators worldwide. According to Professor Chrousos, viruses frequently interact with the host endocrine signaling pathways, while stress triggers acutely an early inflammatory response termed ‘neurogenic inflammation’. Soon after, however, stress suppresses innate immunity and causes a shift from T-helper 1- to T-helper 2- driven immunity. The natural history of the response to a viral infection is for immune and stress changes to take place in a highly coordinated process that results in the full return to the basal health state. He believes that over the past decades, our armamentarium against viruses has increased significantly as novel anti-viral agents, monoclonal antibodies and vaccines, have been and are continually being developed. Professor Chrousos declares that Paediatrics is a very broad scientific field, where paediatric trainees have many avenues to follow beyond clinical practice and into basic, preclinical, translational, clinical, applied, or epidemiologic research. He supports that researching and producing new knowledge to the benefit of humanity is a product of practicing Aristotle's ancient Greek virtues and a worthy cause of life's meaning. He completes our interview calling young paediatricians to ‘listen to their minds and hearts’ to select a life course that would lead them to acquire personal wisdom and eudaimonia.

Can We Prime the Pump for Developing Pediatric Physician-Scientists?

* Abbreviations: ABP — : American Board of Pediatrics DRSP — : Duke Pediatric Research Scientist Program NIH — : National Institutes of Health Who will become the next generation of pediatric physician-scientists? This question has provoked increasing calls of alarm because a robust cadre of well-trained, clinically knowledgeable pediatric physician-scientists is critical to fully capture the immense potential of scientific advancements to improve child health. The evidence, however, suggests that fewer, rather than more, young pediatricians are entering scientific careers.1–4 A number of factors are generally accepted as current problems for someone who is considering, and later succeeding, in a career as a physician-scientist. Factors considered to negatively influence those who are considering a career as physician-scientists include the following: lack of exposure to research as undergraduates, medical students, or residents; a paucity of mentors at all levels of education; a lack of a diverse scientific workforce; and exorbitant educational debt. Once a physician embarks on a research career, additional hurdles to becoming successful include excessive clinical demands, time constraints, lack of mentors, limited initial funding for salary and laboratory support, and the lengthy period to obtain independent funding. In this issue of Pediatrics , Hurst et al5 describe the … Address correspondence to F. Bruder Stapleton, MD, Seattle Children’s Research Institute, 818 Stewart St, Suite 603, Seattle, WA 98101. E-mail: bruder.stapleton{at}seattlechildrens.org

Swiss paediatrician survey on complementary medicine.

In Switzerland, complementary medicine (CM) is officially recognised within the healthcare system and mainly practised in an integrative manner, in conjunction with conventional medicine. As in other countries, there is high demand for and use of CM with children. However, there has so far been no research into the attitude towards, training in and offer of CM among paediatricians in Switzerland. Our study addresses this gap by investigating these topics with an online survey of paediatricians in Switzerland. We conducted a national online survey using a 19-item, self-reporting questionnaire among all ordinary and junior members of the Swiss Society of Paediatrics (SSP). A comparison of the study sample with the population of all paediatricians registered with the Swiss Medical Association (FMH) allowed an assessment of the survey’s representativeness. The data analysis was performed on the overall group level as well as for predefined subgroups (e.g. sex, age, language, workplace and professional experience). 1890 paediatricians were approached and 640, from all parts of Switzerland, responded to the survey (response rate 34%). Two thirds of respondents were female, were aged between 35 and 55 years, trained as paediatric generalist and worked in a practice. Apart from young paediatricians in training, the study sample was representative of all Swiss paediatricians. 23% had attended training in CM, most frequently in phytotherapy, homeopathy, acupuncture/traditional Chinese medicine (TCM) and anthroposophic medicine. 65% were interested in CM courses and training. 16% provide CM services to their patients and almost all paediatricians (97%) are asked by patients/parents about CM therapies. More than half of the responding paediatricians use CM for themselves or their families. 42% were willing to contribute to paediatric CM research. In a representative sample of paediatricians in Switzerland, their personal attitude towards CM is positive, emphasised by great interest in CM training, a willingness to contribute to CM research and a high rate of paediatricians who use CM for themselves and their families. In contrast, the percentage of paediatricians offering CM is currently rather low despite strong demand for CM for children. This study provides key pointers for the future development of complementary and integrative medicine for children in Switzerland.

Awareness, Attitudes, and Practices Toward Meningococcal B Vaccine among Pediatricians in Italy.

Background and objectives: Vaccination against bacterial pathogens is decisive for preventing invasive meningococcal disease and pediatricians play a pivotal role in vaccination compliance and coverage. The aim of this study was to investigate awareness, attitude, and practices toward the vaccine against Meningococcal B serogroup (4CMenB) among a sample of Italian pediatricians. Materials and Methods: A cross-sectional study was carried out using an online questionnaire from March to May 2015. Three multivariate logistic regression models were built to identify factors associated with the outcomes of interest. Results: The data showed that 95.5% of the interviewees correctly responded about the availability of 4CMenB vaccine in Italy, while only 28.0% knew the vaccination schedule for children aged two years or under. This knowledge was significantly higher in younger pediatricians and in those who worked a higher number of hours per week. Pediatricians self-reported a positive attitude toward the utility and safety of 4CMenB vaccine. Those pediatricians with a strong positive attitude toward the utility of the vaccine, who knew the vaccination schedules for children of two years or under, and who declared a satisfactory or good knowledge about the vaccine were more likely to inform parents about its availability in Italy, recommend the vaccination, and verify patients’ vaccination status, in their daily practice. Conclusions: The study highlights factors that currently influence pediatricians’ practices regarding the 4CMenB vaccine. The results showed the possible actions recommended to improve physicians’ awareness and behaviors in order to improve the vaccination compliance and invasive meningococcal diseases prevention.

A Shelter Is Not a Home: The Crisis of Family Homelessness in the United States.

* Abbreviations: AAP — : American Academy of Pediatrics ACE — : adverse childhood experience NYC — : New York City Family homelessness in the United States became an egregious problem in the 1980s and was the reason that I, as a young pediatrician, discovered the importance of advocacy. In my hometown, New York City (NYC), because of increasing income inequality, neighborhood gentrification, and poor housing policies nationally and locally (all leading to dramatically decreased availability of affordable housing for low-income families), there was a growing number of children living in so-called “welfare hotels.” This number increased from 5000 each night in 1983 to 12 000 each night in 1988.1 Because many of these families were sheltered in hotels in midtown Manhattan, my program at Bellevue Hospital Center provided many of these children with health care within our hospital as well as in a clinic that we ran in one of the biggest hotels. I became active in my American Academy of Pediatrics (AAP) chapter and started the Committee on Homeless Families in New York Chapter 3. My colleagues and I learned how to collaborate with community-based advocacy organizations to fight for better treatment of homeless families in the shelter system as well as for better housing policies, at least in NYC. The result of those efforts by many advocates was that by 1990–1991, the number of children without a home being sheltered each night was back down to ∼5000.1 The nightmarish conditions of the lawless hotels were gone, and instead, safer and better-resourced, city-run shelters housed these families. Today, however, there are more homeless families in NYC than ever, with 22 000 children in 15 000 families being housed … Address correspondence to Benard P. Dreyer, MD, Department of Pediatrics, New York University School of Medicine, 462 First Ave, NBV 8E-11, New York, NY 10016. E-mail: bpd1{at}nyulangone.org

National Trends in Pediatricians' Practices and Attitudes About Breastfeeding: 1995 to 2014.

The American Academy of Pediatrics (AAP) has affirmed breastfeeding as the preferred method of infant feeding; however, there has been little systematic examination of how pediatricians' recommendations, affiliated hospitals' policies, counseling practices, and attitudes toward breastfeeding have shifted over the past 2 decades. These trends were examined from 1995 to 2014. Data are from the Periodic Survey (PS) of Fellows, a nationally representative survey of AAP members. PS #30 (1995; response rate = 72%; N = 832), PS #57 (2004; response rate = 55%; N = 675), and PS #89 (2014; response rate = 51%; N = 620) collected demographics, patient and practice characteristics, and detailed responses on pediatricians' recommendations, affiliated hospitals' policies, counseling practices, and attitudes toward breastfeeding. By using bivariate statistics and logistic regression models, the analysis investigated changes over time with predicted values (PVs). From 1995 to 2014, more pediatricians reported their affiliated hospitals applied for "baby-friendly" designation (PV = 12% in 1995, PV = 56% in 2014; P < .05), and more reported that they recommend exclusive breastfeeding (65% to 76% [P < .05]). However, fewer respondents indicated that mothers can be successful breastfeeding (PV = 70% in 1995, PV = 57% in 2014; P < .05) and that the benefits outweigh the difficulties (PV = 70% in 1995, PV = 50% in 2014; P < .05). Younger pediatricians were less confident than older pediatricians in managing breastfeeding problems (P < .01). Pediatricians' recommendations and practices became more closely aligned with AAP policy from 1995 to 2014; however, their attitudes about the likelihood of breastfeeding success have worsened. These 2 divergent trends indicate that even as breastfeeding rates continue to rise, continued efforts to enhance pediatricians' training and attitudes about breastfeeding are necessary.

In Memoriam: Herbert L. Needleman

In Memoriam: Herbert L. Needleman

Paediatric Virology as a new educational initiative: An interview with Nobelist Professor of Virology Harald zur Hausen.

Born in Gelsenkirchen-Buer in Germany on March 11th, 1936, Professor Harald zur Hausen, Emeritus Professor of Virology at the University of Freiburg and 2008 Nobel Prize Laureate in Physiology or Medicine for his discovery of human papillomavirus (HPV), which causes cervical cancer, believes that good knowledge of virological methods and diagnostic possibilities are an asset for all young paediatricians. Professor zur Hausen considers that the creation of an educational platform on Paediatric Virology is definitely very beneficial for young paediatricians, as this will greatly enhance their knowledge in the field of Virology. He very actively advocates the vaccination of boys for the eradication of HPV infection and emphasises that male HPV vaccination should be included into the current vaccination programmes. He would have certainly considered Dr George N. Papanicolaou (Kyme, Island of Euboea, Greece, 1883 - Miami, Florida, USA, 1962) as an excellent candidate for the Nobel Prize, stating that the contribution of Dr Papanicolaou did not find sufficient recognition in the past. In the context of the 3rd Workshop on Paediatric Virology, which will be held in Athens, Greece, on October 7th, 2017, Professor zur Hausen will give his plenary lecture on ‘Paediatric Virology and Oncology: Virus persistence and the important first years of life’.

Epigenomic Susceptibility to the Social World: Plausible Paths to a “Newest Morbidity”

This article—presented on the celebratory occasion of Dr Robert Haggerty's 91st birthday—describes how a 1962 article by Dr Haggerty and his colleague Dr Roger Meyer launched a previously unexplored, pediatric research enterprise by asserting that: “There are little precise data to explain why one person becomes ill with an infecting agent and another not.” Noting a prospective association between family stressors and the acquisition of β-hemolytic streptococcal infections, the article introduced a generation of young academic pediatricians—the author of the present article among them—to the possibility of causal linkages among children's adversity exposures, compromised immunological processes, and the development of immune-mediated, acute or chronic diseases of childhood. That research agenda has led, over the past 40 years, to the advent of psychoneuroimmunology as a field of study, to the recognition of childhood stress and adversity as potential etiologic agents among childhood morbidities, and to the discovery of differential susceptibility to social adversities within populations of children.

Choosing to Care for Children Who Might Die: Conversations with Pediatric Residents.

This essay evolved from observations that pediatric resident physicians' experiences with patient deaths might influence their career paths after completing residency training. The author's journey as a physician led her to wonder whether young pediatricians who gravitated toward careers in primary care had qualitatively different experiences with death and dying during their medical training compared to those who chose fields in which they were more likely to confront death and dying on a regular basis, such as pediatric critical care, neonatology, or pediatric oncology. Ten pediatric residents agreed to participate in conversations that were then expanded to encompass related concepts of "devastating diagnoses" and of "giving bad news." Three central themes-the privilege of supporting families through difficult times, the challenge of navigating between expectations and uncertainty, and the resilience of children experiencing illness-emerged as having profoundly influenced pediatricians' understanding of their professional journeys and identities.

Residência de Pediatria nos Cuidados Primários e o Futuro dos Pediatras em Portugal

RESUMO Introdução O objetivo do estudo foi conhecer a opinião dos pediatras sobre o estágio de Cuidados de Saúde Primários (CSP) e suas expectativas relativamente aos Cuidados de Saúde Primários Pediátricos em Portugal. Métodos Questionário online dirigido a residentes de Pediatria e pediatras de 22 hospitais portugueses de 1 de julho a 31 de agosto de 2010. Foram analisados dados demográficos e profissionais, e suas expectativas relativamente aos CSP. Resultados Foram enviados 270 e-mails (taxa de resposta de 57%). Quinze (37,5%) supervisionados por pediatras consideraram que a duração ideal do estágio seria de três a seis meses, enquanto 45 (60,8%) supervisionados por médicos de família (MF) consideraram de zero a três meses (p &lt; 0,0001). Os inquiridos supervisionados por pediatras ficaram globalmente satisfeitos/muito satisfeitos em 37 (92,5%) casos versus 51 (68,9%) coordenados por MF (p = 0,005). Setenta e dois (52,2%) consideraram que a vigilância pediátrica nos CSP deve ser assegurada por MF e pediatras consultores. Oitenta e oito (63,8%) inquiridos gostariam de assumir a função de pediatra consultor nos CSP. Conclusões O estágio de CSP é importante na formação dos pediatras, e alguns aspetos devem ser melhorados. É necessário investir na saúde pública integrada nos CSP.

John Stuart Garrow, MD, PhD, FRCP(E), FRCP (London) (1929-2016).

Dr. Garrow was born on April 19, 1929, in Dundee, Scotland. He studied at the Highgate School in London where his family moved. John obtained his Bachelor of Medicine/Bachelor of Surgery degree from the University of St. Andrews in Scotland in 1952. After graduation he continued his training in Jamaica where he became interested in problems of malnutrition and worked with Professor John Waterlow, a man he admired immensely. Dr. Garrow's first scientific post was as a member of the Medical Research Council External Staff at the Tropical Metabolism Research Unit at the University of the West Indies, Jamaica, where he published his first scientific paper in 1954 in the West Indian Medical Journal, followed by a number of articles measuring body composition in infants and children with malnutrition which lead to him receiving his MD in 1957. His single-authored article in Journal of Clinical Investigation in 1959 on the effect of protein depletion on protein synthesis and his method of removing the bias from measuring blood pressure, a device that “muddled” the zero value from one reading to the next, published in Lancet in 1963, were clear demonstrations of his scholarship and inventiveness. Dr. Garrow returned to the United Kingdom in 1957 to do his military service at the RAF Institute for Aviation Medicine in Farnborough. While there, he studied the effects of acceleration on antidiuretic hormone which resulted in a PhD from the University of St. Andrews in 1961. Because of his inventive skills, he was recruited by Professor Waterlow to participate in an expedition to the Andes Mountains to study altitude sickness, where he was successful in separating blood in the frozen environment. In 1969, Dr. Garrow was recruited to become head of the Nutrition Research Unit at the MRC Clinical Research Centre, Harrow, England. It was here that Dr. Garrow developed his international reputation in the study of energy balance. He designed and built both an indirect and a direct calorimeter which were used for many important studies. He was also a key adviser to the development of the metabolic chambers constructed at the NIH facilities in Phoenix, AZ, to allow measurement of energy expenditure in the Pima Indians who have the highest rate of diabetes in the U.S. He demonstrated the effectiveness of a simple “milk” diet for weight loss. He used “jaw wiring” to limit intake of food, and then used a nylon cord fastened round the waist to provide external feedback about fullness, since he was a strong believer in “external” regulation of food intake. His first and very well-written monograph titled Energy Balance and Obesity in Man was published in 1974 and provides a critical evaluation of the data available at that time. An equally important monograph Treat Obesity Seriously: A Clinical Manual was published in 1981 and presages the concept of obesity as a disease. During this time interval, Dr. Garrow conducted another experiment with himself as the subject. He stuffed himself to become obese and studied the consequence on weight loss using biopsies of his own muscles. This tradition of self-study is part of the medical tradition and one that Dr. Garrow used on several occasions. In 1987, Dr. Garrow was elected as the inaugural Rank Professor of Human Nutrition at the St. Bartholomew's Hospital Medical School in London and Consulting Physician at the hospital. During this 10-year interval, Dr. Garrow used his considerable “Socratic” teaching skills to help medical students learn the essentials of nutrition. He was a passionate advocate for “evidence-based” medicine and campaigned against fraudulent health claims. His final scholarly activity was as Editor of the European Journal of Clinical Nutrition from 1988 to 1999. This was an ideal position for Dr. Garrow since he could use his critical and objective mind to improve the quality of the publications that appeared in this journal. He has been active with HealthWatch (formerly the Campaign Against Health Fraud), where he was the chairman for three terms, from 1991 to 1993, 1997 to 1999, and 2003 to 2005. Dr. Garrow and his lifelong companion Katherine (née Thicknesse) Garrow met in Jamaica when she was there doing medical work as a young pediatrician. Katherine predeceased John in 2008, but he is survived by four children—Jennifer, Margaret, Diana, and Alan.

Simulation in pediatrics: Is it about time?

Pediatrics is a challenging field where “Time is Essence” and the interplay of time-bound dynamics has a huge influence on the outcomes, particularly in an acutely ill child. In this context, simulation based training appears to play a major role in training young Paediatricians to develop critical decision making skills and learning in a risk-free environment. In present times and in future, it is expected that simulation is used by practically every healthcare provider at some or multiple points in the training and certification process.

G320(P) Septic baby; have you considered parechovirus meningitis?

Introduction “Febrile baby” is a common presentation to paediatric departments. In young babies paediatricians are likely to perform a full septic screen to ascertain the source of the temperature. Part of this process involves requesting the correct tests for the best chance of achieving a diagnosis. We discuss three cases with a diagnosis that is perhaps not often considered yet may have potential consequences for development. Case presentation Three babies presented in the neonatal period with symptoms including temperature, poor perfusion, rash, shortness of breath and apnoea. All three were judged to be cardiovascularly unstable and received fluid boluses. They all had unremarkable CRP results (maximum 14mg/L). CSF demonstrated raised protein in all three but low white cell count (maximum 3 × 1000000/L). One of the babies required intubation and ventilation for three days for apnoeas. All of the babies improved clinically as soon as they became afebrile (around 3 days after admission). All babies were PCR positive for parechovirus on CSF. Discussion There are over ten types of parechovirus identified with type 3 most commonly associated with neonatal sepsis. Over 90% of five year olds have experienced parechovirus as a mild gastrointestinal or respiratory illness. In babies under 3 months of age it is more likely to present more dramatically. It is spread in respiratory droplets, saliva and faeces. Low CSF WCC and raised protein are typical findings. Management is supportive and there is no vaccine. Neurodevelopmental delay has been reported following the illness and animal data suggests persistent presence in CNS causing ongoing inflammation. Conclusion When assessing and investigating a febrile baby sending a CSF PCR for parechovirus may yield a result in a patient with otherwise unremarkable laboratory investigations. This diagnosis is important as it has the potential to cause neurodevelopmental problems and as such these patients may warrant follow up.

New pediatricians: first jobs and future workplace goals.

Concern is often expressed about the satisfaction of new physicians and the potential match of their workplace goals with available positions. We studied the interface of desired professional activities with actual initial positions. Survey study of all general pediatricians taking the 2012 General Pediatrics Certifying Examination. Of the 5210 who sat for the General Pediatrics Certifying Examination, 5163 (>99%) completed the survey. Of the total respondents, 45% self- identified as general pediatricians (N = 2327). Of those who completed training <2 years ago (N = 1365), most were currently engaged in clinical care (87%; N = 1190). The most important factor, cited most frequently by both men and women, in the choice of their first job was lifestyle and spousal or family considerations. Most (83%; N = 977) reported that the allocation of time for specific duties in their current position was consistent with their goals, with no differences between men and women. Most had no desire for inpatient activity. Despite concerns about young general pediatricians being able to find positions that meet their career goals, most were in jobs that approximated their desired allocation of professional time and focus of clinical work.

Obesity Prevention in Children from Birth to Age 5

Once obesity appears, it is difficult to reverse. Overweight infants/preschoolers tend to become overweight school children. Who frequently become overweight adolescents and, in turn, overweight adults. Thus it is imperative to prevent obesity as early in life as possible. Unfortunately, obesity diagnosis is difficult in young children, and both pediatricians and parents are reluctant to “label” an infant or young child as obese. Lack of diagnosis compounds the difficulty preventing obesity early in life. There are few obesity prevention interventions for infants: breastfeeding, no solid food supplementation until age 6 months, promoting active play and sleep. Obesity interventions for preschoolers include promoting a varied diet full of fruits and vegetables, restricting television and encouraging physical activity. Diet and not physical activity appears to be the primary determinant of obesity in infants; however, as the child grows, promotion of both healthy diet and physical activity becomes an important obesity prevention tool.

Research and young paediatricians

The fundamental role played by medical research in the diagnosis and treatment of diseases is well recognized. In the paediatric field, research is crucial for the health of future generations. For a young paediatrician, being engaged in research requires curiosity and enthusiasm, strong commitment and constant dedication, but represents a unique opportunity to contribute to the progress of medical knowledge as well as to the overall progress of the society. Education and training in research should be part of every level of the paediatric training, from premedical to postgraduate education. This will allow the development of research skills, which are useful not only for those who aim to pursue an academic career, but for the daily activity of every doctor. Research training can allow clinicians to keep up with the growing medical literature as well as improve their skills in finding the best evidence to answer questions arising from their daily clinical activity. Over the last years, national policies have affected the role of scientific research and employment opportunities for young researchers. Italy has a number of PhD students lower than in other European countries. Furthermore, Italian PhD students’ salary, even after adjusting for the cost of living, is lower than that of their colleagues from Western European countries. In recent years, post-doctoral programs have also undergone considerable downsizing in terms of funds and availability. Young people and their enthusiasm are essential for the advancement of research. Therefore, it is essential to promote and boost research in our country, through investments in scientific education of young doctors and by increasing the opportunities for those who wish to engage in medical research.

Celebrating 35 Years of Pediatrics in Review

Celebrating 35 Years of <i>Pediatrics in Review</i>