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General Pediatrics

Primary Care Provider Guide to Neonatal Abstinence Syndrome Follow Up
 Primary Care Provider Guide to Neonatal Abstinence Syndrome Follow Up 150 150 Nationwide Children's
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Pediatricians have a unique challenge when it comes to caring for the broad spectrum of needs associated with opioid-exposed infants. Some babies who were treated with pharmacological methods in a hospital will be discharged home still on neuro-active medications. Other babies did not receive a neonatal abstinence syndrome (NAS) diagnosis or specific treatment after birth…

QI Project Increases Value of Asthma Care in a Large Primary Care Network
 QI Project Increases Value of Asthma Care in a Large Primary Care Network 1024 393 Kevin Mayhood
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Multiple steps lead to better control of disease, fewer emergency department visits and $5 million in savings. A quality improvement project helped kids achieve better control of their asthma, reduced emergency room visits and cut costs in a primary care network serving 10,000 children with the disease. Through multiple steps, including standardizing assessments and documentation,…

Opening the Door to Adult Medicine
 Opening the Door to Adult Medicine 1024 575 Katie Brind'Amour, PhD, MS, CHES
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Care transition plans aren’t just for kids with congenital conditions anymore. Could your practice benefit from a proactive transition plan for all patients? In the shift from pediatric to adult care, young patients have the responsibility to adjust to a new life of self-management. But health care providers also play an important role in this…

Managing Pain in an Era of Opioid Abuse
 Managing Pain in an Era of Opioid Abuse 1024 575 Abbie Miller
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A black-and-white image of an adolescent White boy, a young Black girl, an adolescent White girl, a Black teen boy, and a young White mom and her infant, all in a row across the screen, all in white shirts, and all with solemn expressions.

Managing pain is complicated. Not that long ago, perhaps 50 years or so, pain was understood to be a multidisciplinary issue requiring many different approaches. Doctors would recommend lifestyle changes, complementary therapies and medications to treat chronic pain. Then something changed. Opioids began being marketed as “nonaddictive.” Pain became the “5th vital sign,” and physicians…

The Opioid Education Toolkit: For Providers and Parents
 The Opioid Education Toolkit: For Providers and Parents 1024 575 Nationwide Children's
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Do you know all the options for safe medication disposal? What are evidence-based methods for screening and assessing risk of opioid abuse? Find answers and resources in the Opioid Toolkit. Opioid Safety Protocol for the Home Four Points to Remember When Taking Opioids Monitor: Know where the medications are at all times. Keep a count of…

Is Your Patient Really Allergic to Penicillin?
 Is Your Patient Really Allergic to Penicillin? 150 150 Abbie Miller
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Quality Improvement Study Shifts HPV Vaccine Initiation to Earlier Age
 Quality Improvement Study Shifts HPV Vaccine Initiation to Earlier Age 150 150 Aimee Swartz, MPH
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A QI project shows that it is feasible, and possibly beneficial, to routinely administer HPV vaccine at age 9. It is feasible, and possibly beneficial, to routinely administer the human papillomavirus (HPV) vaccine beginning at age 9 — two to three years earlier than currently recommended — according to findings from a recent study conducted…

The Pediatrician’s Role in Health and Hope after Trauma
 The Pediatrician’s Role in Health and Hope after Trauma 150 150 Anna Kerlek, MD
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A primary care provider’s ability to identify and treat symptoms associated with trauma can increase positive outcomes for patients and families. Almost two-thirds of the children and their caretakers in your office have experienced at least one trauma. Many have experienced more. As a primary care provider, you can provide early intervention and support for…

Considerations for Integrating Behavioral Health and Primary Care
 Considerations for Integrating Behavioral Health and Primary Care 150 150 Cody Hostutler, PhD
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As increasing numbers of pediatric patients require behavioral health care, primary care providers look to integrate behavioral health providers in their practice. You know the story. It’s the middle of a busy Friday afternoon, you just finished up an adolescent well-visit, your hand is on the door and you hear, “Doc, one more question?” The…

8 Ways You Can Support Families in Need of Behavioral Health Services
 8 Ways You Can Support Families in Need of Behavioral Health Services 150 150 Nancy Cunningham, PsyD
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Long wait times and difficulties accessing behavioral health services cause stress for many patients and families. As awareness grows about the prevalence of behavioral health challenges for children and adolescents, more patients and families are seeking specialized care. However, due to a shortage of behavioral health specialists, wait times can seem daunting. As the pediatrician,…

Managing Depression, Anxiety and Other Behavioral Health Issues in Primary Care
 Managing Depression, Anxiety and Other Behavioral Health Issues in Primary Care 1024 575 Rachael Hardison
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Teen girl with backpack

An estimated 20 percent of children struggle with mental health illness. As awareness grows, the call for primary care physicians to play a leading role in care grows louder. One in five children will struggle with a mental health illness by the age of 12, but a recent survey by the American Academy of Pediatrics…

Needle-free Immunization Prevents Experimental Otitis Media
 Needle-free Immunization Prevents Experimental Otitis Media 1024 575 Tiasha Letostak, PhD
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Close up, color image of someone extending a gloved hand with a small patch face up on their pointer finger that resembles a circular adhesive bandage that has a smaller, blue square patch on its center

The first data to demonstrate the efficacy of a simple, needle-free vaccine delivery system for middle ear infections. Otitis media (OM), or middle ear infection, accounts for approximately 30 million doctor visits a year in the U.S. The pathogen nontypeable Haemophilus influenzae (NTHI) causes the majority of cases of ear infection, including chronic OM, recurrent OM, and…

When Talking About Birth Control, Don’t Leave Boys Out of the Conversation
 When Talking About Birth Control, Don’t Leave Boys Out of the Conversation 150 150 Sarah Saxbe, MS, MSW, LISW-S
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Sex education for boys should include information about all forms of birth control, even those for females. When a child arrives in his or her pediatrician’s office each year for their well visit, the nurse and provider often go over a long list of questions for the parents and child. Many are related to daily…

Survey: Physical Barriers, Not Fear, Keep Homeless Youth From Receiving Care
 Survey: Physical Barriers, Not Fear, Keep Homeless Youth From Receiving Care 150 150 Brianne Moore
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Research survey investigates barriers to care in unstably-housed youth. Every year, an estimated 1.6 to 1.7 million youth in the United States are living on the streets, in shelters or in other temporary living situations. Earlier studies have suggested that homeless youth do not seek medical services because of fear-based barriers – distrust of doctors,…

Human Trafficking: How many victims have you treated?
 Human Trafficking: How many victims have you treated? 1024 575 Abbie Miller
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Data shows that health care providers may be coming into contact with victims and those at risk with more frequency than expected. How many victims have you treated? The answer is probably higher than you think. According to a report published in the Annals of Health Law, 88 percent of sex trafficking survivors reported contact with…

U.S. Poison Control Centers Receive 32 Calls a Day About Pediatric Exposures to Prescription Opioids
 U.S. Poison Control Centers Receive 32 Calls a Day About Pediatric Exposures to Prescription Opioids 150 150 Tracy Mehan, MA
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Researchers call for changes to prescribing practices and increased education about safe storage at home. A new study published online today by Pediatrics and conducted by the Center for Injury Research and Policy and the Central Ohio Poison Center at Nationwide Children’s Hospital found that there were more than 188,000 calls to U.S. Poison Control Centers for…

Evaluating and Treating Pediatric Lower Back Pain in the Primary Care Setting
 Evaluating and Treating Pediatric Lower Back Pain in the Primary Care Setting 150 150 Jeb Phillips
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While pediatric training often focuses on etiology, recent studies have found that most cases of lower back pain in school-aged children have no definitive diagnosis and are benign and self-limiting. Primary care pediatricians are often taught that lower back pain in school-aged children has a definitive cause. As a recent review published in JAMA Pediatrics highlights, studies conducted over…

Hormonal Contraception Safer Than Expected For Women With Diabetes
 Hormonal Contraception Safer Than Expected For Women With Diabetes 150 150 Abbie Miller
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Women with diabetes often fall through the cracks when it comes to prescription contraception. A new study illuminates the issues and highlights safe options. The use of contraception to prevent unplanned pregnancies is an important aspect of women’s health. For women with chronic health conditions, family planning has important implications for the health of the…

Subclinical Muscle Involvement May be Missed With Amyopathic Juvenile Dermatomyositis Diagnosis
 Subclinical Muscle Involvement May be Missed With Amyopathic Juvenile Dermatomyositis Diagnosis 150 150 Abbie Miller
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Study shows that some children diagnosed with amyopathic dermatomyositis have subclinical muscle involvement, highlighting the need for standardized workup and treatment protocols. Juvenile dermatomyositis (JDM) is an autoimmune disease that classically presents in preschool to school aged children with a rash and muscle weakness. In some cases, children may present with the rash, but no muscle…

Promising Practices and Patient-Centered Medical Neighborhoods for Childhood Obesity
 Promising Practices and Patient-Centered Medical Neighborhoods for Childhood Obesity 150 150 Tiasha Letostak, PhD
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An algorithm for assessment and management of childhood obesity, along with patient-centered medical neighborhoods, provides avenues for comprehensive weight management for children 2 years and older. Although childhood obesity affects 17 percent of children in the United States, and nearly one-quarter of these children are overweight, only a few centers in the country provide evidence-based…

Should Melatonin Be Used To Treat Childhood Insomnia?
 Should Melatonin Be Used To Treat Childhood Insomnia? 150 150 Mark Splaingard, MD
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Mark L. Splaingard, MD, director of the Sleep Disorders Center at Nationwide Children’s Hospital, answers a question often asked by primary care providers. With some reports that insomnia symptoms are experienced by 20 percent or more of children, health care providers (and parents) often want to know if melatonin is appropriate to use in the…

Pediatricians and Subspecialists May Need to Up Their ADHD Game
 Pediatricians and Subspecialists May Need to Up Their ADHD Game 150 150 Kevin Mayhood
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From sixth to eighth grade, Stacy Gibson sought out kids he knew had attention-deficit/hyperactivity disorder and bought their Ritalin or Adderall, sometimes by the handful. “I would party all night,then I’d take the pills to get through class. It gave me a rush of energy that I needed,” says Gibson, now 32 and in his…

How Can We Increase the HPV Vaccination Rate?
 How Can We Increase the HPV Vaccination Rate? 150 150 Michael T. Brady, MD
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Cancer is a terrifying diagnosis for a patient to receive or a doctor to give. So it would make sense that a vaccine proven to prevent cancer would be welcomed by everyone. The human papillomavirus (HPV) vaccine could prevent 28,500 HPV-related cancer cases – cervical, vaginal, vulvar, anal, rectal, penile and oropharyngeal – each year. The Centers…

Novel Practice Pathway Addresses Problem Behaviors Among Patients With Autism
 Novel Practice Pathway Addresses Problem Behaviors Among Patients With Autism 150 150 Kevin Mayhood
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Pediatricians urged to investigate underlying causes. Issues causing children with autism spectrum disorder to be irritable or belligerent can be difficult for parents, teachers and other care providers to uncover. And, wait times to see a specialist may leave a child frustrated, distressed or in physical pain for months. Primary care physicians who see the…

How Can You Optimize Care for Homeless Patients?
 How Can You Optimize Care for Homeless Patients? 150 150 Tiasha Letostak, PhD
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A recent policy statement from the AAP describes how pediatricians can help improve the health and well-being of homeless children in America. As of 2014, the National Center on Family Homelessness reported that a staggering 2.5 million children are homeless each year in America, a historic high representing one in every 30 children in the country. These…

A Better Approach to Prescribing Medication
 A Better Approach to Prescribing Medication 150 150 Jeb Phillips
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A small change in the way a doctor prescribes a medication can make a big difference. Officials from the accountable care organization Partners For Kids use this example all the time: Abilify, a behavioral health drug, is usually priced per pill, not by strength of dose. Two 5 mg pills cost nearly twice the amount of…

Childhood Kidney Stones: Their Surprising Connection to Future Disease
 Childhood Kidney Stones: Their Surprising Connection to Future Disease 150 150 Jeb Phillips
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Once thought to be an adult condition, urinary stone disease is increasingly found in children – and may be related to the development of cardiovascular disease, chronic kidney disease and low bone density. By one well-regarded estimate, the risk of developing urinary stone disease in childhood doubled between 1997 and 2012. That’s worrying enough on…

Use Caution When Prescribing a Gluten-Free Diet
 Use Caution When Prescribing a Gluten-Free Diet 150 150 Kevin Mayhood
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A gluten-free diet makes diagnosing underlying conditions difficult and can leave potential, long-term consequences unaddressed. The growing popularity of a gluten-free diet among adults appears to be spilling over to children, with help from the pediatrician’s office. “An increasing number of primary care physicians, who are seeing children with symptoms possibly related to gluten intolerance,…

Personal, Familial and Social Factors Surrounding Child Suicide
 Personal, Familial and Social Factors Surrounding Child Suicide 150 150 Brianne Moore
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As suicide rates among children climb, researchers publish the first study exclusively focused on the precipitating circumstances of children and young adolescents who die by suicide. According to the Centers for Disease Control and Prevention (CDC), suicide was the 10th leading cause of death for children ages 5 to 11 in 2014. This was the first…

What Pediatricians Need to Know About the New Meningococcal B Vaccine
 What Pediatricians Need to Know About the New Meningococcal B Vaccine 150 150 Michael T. Brady, MD
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Michael T. Brady, MD, infectious diseases specialist at Nationwide Children’s Hospital and primary author of the recent American Academy of Pediatrics position paper on the meningococcal B vaccine, shares what you need to know about this controversial vaccine. Meningococcal serotype B (MenB) causes the majority of invasive meningococcal disease in infants and young children. Though…

Nine Factors for Predicting the Duration of Post-Concussion Symptoms
 Nine Factors for Predicting the Duration of Post-Concussion Symptoms 150 150 Jeb Phillips
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Concussion recovery is poorly understood, but new research suggests that some factors are predictive of recovery time. Several factors, including continued physical activity following a concussion, worsening symptoms from the time of injury to the time a patient seeks care, and a previous history of headaches, help predict which children are likely to have a…

Finding a Better Way to Diagnose and Treat Iron Deficiency in Young Women
 Finding a Better Way to Diagnose and Treat Iron Deficiency in Young Women 150 150 Brianne Moore
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Iron deficiency without anemia often goes undiagnosed in young women, and when caught, the standard treatment is often associated with poor compliance due to side effects. Dr. Sarah O’Brien’s research is focused on finding a solution. Even in developed countries, iron deficiency continues to be a prevalent nutritional disorder. It is common in women, especially…

Long Acting Reversible Contraceptives: A First-Line Approach to Prevent Teen Pregnancy
 Long Acting Reversible Contraceptives: A First-Line Approach to Prevent Teen Pregnancy 150 150 Elise Berlan, MD, MPH
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Unplanned teen pregnancies remain a problem in American society. In the United States, 82 percent of teen pregnancies are unplanned, and the United States has the highest teenage pregnancy rate among high income nations. Despite being highly effective and safe, misconceptions around long acting reversible contraceptives (LARC), such as etonogestrel implants and intrauterine devices (IUDs),…

Creating the Patient-Centered Medical Neighborhood
 Creating the Patient-Centered Medical Neighborhood 1024 575 Tiasha Letostak, PhD
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How do we create a more integrated healthcare delivery system to improve outcomes in our community? The Agency for Healthcare Research and Quality (AHRQ) conceptualizes the medical neighborhood as a patient-centered medical home (PCMH) and the network of other clinicians providing health care services to patients within it, along with community and social service organizations, as well…

Helping the Sickest Children Navigate the Health Care System
 Helping the Sickest Children Navigate the Health Care System 150 150 Jeb Phillips
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Care coordination focuses on better outcomes for children with medical complexity. Consider a child with cerebral palsy who needs a feeding tube to eat. She has special equipment for a basic life function. She requires regular visits with a primary care physician and specialists in neurology, orthopedics and gastroenterology. She has frequent acute infections that lead to emergency department visits.…

On the Front Lines
 On the Front Lines 150 150 Anne FitzSimons
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Pediatricians can reverse health disparities among the LGBT population. A recent position paper from the American College of Physicians (ACP) examines health disparities experienced by the lesbian, gay, bisexual and transgender (LGBT) population in the United States and includes recommendations for improving access to care. The ACP found that some policies and accompanying social stigma of LGBT persons has led…

How to Increase Adherence to Screening Guidelines for Children With Down Syndrome
 How to Increase Adherence to Screening Guidelines for Children With Down Syndrome 150 150 Abbie Miller
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Recent study shows that while most families and physicians support the guidelines, patients are not receiving the recommended screenings. Children with Down syndrome have multiple medical conditions and cognitive impairments related to the additional genetic material from chromosome 21. Because of common comorbid conditions in the Down syndrome population such as heart defects, hearing loss,…

Can You Ration Health Care in a Just Society?
 Can You Ration Health Care in a Just Society? 150 150 Pedro Weisleder, MD, PhD
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How the Clinical Effectiveness Model enables the provision of uncompromised, yet fiscally responsible, medical care Health care costs in the United States are an unsustainable expense. In 2014, the United States’ gross domestic product (GDP) was about $17 trillion, and of that, close to $2.7 trillion was spent on health care. Per capita, we spend…

The Childhood Roots of Illness
 The Childhood Roots of Illness 1024 575 Dave Ghose
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Toddler playing with toys

A growing body of scientific evidence reveals the dramatic impact of early-life adversity on lifelong health. Kelly Kelleher, MD, compares childhood health to a boulder sitting on the peak of a mountain. A slight push could send the boulder in many directions. And once it starts rolling, it’s hard to change its path. The same…

What Do DALYs Mean for Pediatrics?
 What Do DALYs Mean for Pediatrics? 150 150 Dave Ghose
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An emerging, innovative metric could radically change childhood health policy. A new way of looking at illness is beginning to change how public health officials view life and death. The concept — called DALYs — offers a fuller view of disease that could have a big impact on pediatrics if embraced. Unlike death tolls —…

Digital Education for Patients and Families
 Digital Education for Patients and Families 150 150 Mike Patrick, MD
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When patients and parents want health information, they often turn to the Internet. Let’s make sure they’re finding the right sources. In the digital age, young patients and their parents have an encyclopedic world of health information at their fingertips. Answers are available on demand, and most people find them. In fact, according to recent…

1 in 8 Children Exposed to Violence 5 or More Times in a Year
 1 in 8 Children Exposed to Violence 5 or More Times in a Year 150 150 Tiasha Letostak, PhD
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The average pediatric subspecialist sees two to four child polyvictims each day. What can physicians do to help these children and their families? According to the National Survey of Children’s Exposure to Violence (NatSCEV), 60 percent of children have directly experienced or indirectly witnessed at least one act of violence in the previous year. Nearly…

Liquid Danger
 Liquid Danger 150 150 Dave Ghose
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Henry Spiller, MS, DABT, never used to worry too much about nicotine poisoning. If a child ate a cigarette, he might throw up but wasn’t going to die. Then e-cigarettes took off about seven years ago and changed the equation. Now, Spiller and other toxicologists fear the death of a child from nicotine poisoning is…

Witnessing a Parent’s Injury Can Leave Kids with PTSD, Study Suggests
 Witnessing a Parent’s Injury Can Leave Kids with PTSD, Study Suggests 150 150 Tiasha Letostak, PhD
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When parents have an injury, their children are more likely to experience symptoms of post-traumatic stress disorder, or PTSD. What can pediatric health professionals do to help these families? In June, Pediatrics published the first-ever study examining the effect of civilian parents’ injuries on their uninjured children. Researchers from the Harborview Injury Prevention and Research Center at…

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