An Approach to Family-Centered Electronic Health Records in Pediatrics.

Over the years, family-centered care in the field of pediatrics has become more prevalent and has improved the patient experience. Recent innovations within electronic health records (EHR), such as patient portals, have provided a more "patient-centered" approach by allowing patients to be interactive with the EHR and have greater agency of their own healthcare. There are also ample opportunities within an EHR to improve the patient experience with delivery of family-centered care.

Dietary Risk Factors for Pediatric Kidney Stones: A Case-Control Study.

Purpose: Data are scarce regarding dietary risk factors for pediatric nephrolithiasis. Our objective was to perform a case-control study (nonmatched) of the association of dietary nutrients with pediatric urolithiasis.

Materials And Methods: We obtained dietary information from pediatric urolithiasis patients (from stone clinic in 2013-2016) and healthy controls (well-child visit at primary care in 2011-2012).

Preventing Toxic Childhood Stress in the COVID Era: A Role for Telemedicine.

The coronavirus pandemic has resulted in unprecedented stress for families and children. Curve-flattening measures have disrupted the relational networks of millions. Stress in the absence of protective relationships can quickly become toxic, harming mental and physical health.

The Relationship Between Housing Instability and Poor Diet Quality Among Urban Families.

Objective: To examine associations between housing instability and poor diet quality in a sample of urban parents and children.

Methods: Cross-sectional study of 340 parent/guardian-child dyads visiting a pediatric primary care center in Boston, Massachusetts. The parent/guardian (hereafter, parent) completed 2 Harvard Service Food Frequency Questionnaires, one regarding their own dietary intake and one regarding their child's intake, and an assessment of health-related social needs.

Improving rates of ferrous sulfate prescription for suspected iron deficiency anaemia in infants.

Background: Iron deficiency anaemia (IDA) in infancy is prevalent and associated with impaired neurodevelopment; however, studies suggest that treatment and follow-up rates are poor.

Objectives: To improve the rate of ferrous sulfate prescription for suspected IDA among infants aged 8-13 months to 75% or greater within 24 months.

Methods: We implemented a multidisciplinary process improvement effort aimed at standardising treatment for suspected IDA at two academic paediatric primary care clinics.

Child Life Specialists' Experiences Addressing Social Determinants of Health: A Web-Based Survey.

We used Google Forms to survey 110 child life specialists on their experiences addressing family psychosocial issues. Most respondents were female (99%) and white (95%), with mean age 34 ± 10 years. Ninety-five percent reported addressing family psychosocial issues during the previous 3 months, including parental separation/divorce (71%), poverty/financial needs (64%), parental mental illness (59%), substance abuse at home (54%), homelessness/housing problems (54%), bullying (49%), physical neglect (46%), physical abuse (46%), unemployment (46%), emotional neglect (45%), and hunger/food insecurity (42%).

Can Clinical Empathy Be Communicated by Text Message? A Case Report.

This case report examines a text message communication between a pediatric primary care provider and the mother of a medically complex child for indicators of clinical empathy. First, some clinical background information is provided; second, indicators of clinical empathy are evaluated using a validated instrument; and third, some benefits, limitations, and future directions informed by the case are discussed.

Associations Between Patient-Reported Outcome Measures of Asthma Control and Psychosocial Symptoms.

There is growing emphasis on using patient-reported outcome measures to enhance clinical practice. This study was a retrospective review of scores on the Childhood Asthma Control Test (C-ACT) and the Pediatric Symptom Checklist-17 (PSC-17) at a pediatric primary care center in Boston, Massachusetts. A total of 218 patients were selected at random using billing codes for well-child (WC) care and asthma, excluding complex medical conditions.

Primary Care Group Visits for Childhood Obesity: Clinical Program Evaluation.

We conducted 29 group visits targeting children with elevated body mass index (BMI) and their families. Visit activities focused on social support, mind-body techniques, exercise, and nutrition. Measures included attendance, family satisfaction scores, and per-patient change in BMI percentile.

Food Insecurity Screening in Pediatric Primary Care: Can Offering Referrals Help Identify Families in Need?

Objective: To describe a clinical approach for food insecurity screening incorporating a menu offering food-assistance referrals, and to examine relationships between food insecurity and referral selection.

Methods: Caregivers of 3- to 10-year-old children presenting for well-child care completed a self-administered questionnaire on a laptop computer. Items included the US Household Food Security Survey Module: 6-Item Short Form (food insecurity screen) and a referral menu offering assistance with: 1) finding a food pantry, 2) getting hot meals, 3) applying for Supplemental Nutrition Assistance Program (SNAP), and 4) applying for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Associations between Public Library Use and Reading Aloud among Families with Young Children.

Objective: To measure public library use in a sample of families with young children and examine associations with reading aloud.

Study Design: We interviewed 200 parents of 6- to 18-month-old children visiting a hospital-based pediatric clinic. We assessed public library card ownership, public library visitation, and awareness of public library programming.

Impact of an Electronic Template on Documentation of Obesity in a Primary Care Clinic.

Identification of obesity at well-child care (WCC) examinations is a step toward intervention. Studies have shown suboptimal documentation in primary care clinics that can improve with the use of electronic health records (EHRs). This study investigated the impact of a standardized EHR template on documentation of obesity at WCC visits and its impact on physician behavior.

Massachusetts Pediatricians' Views Toward Body Mass Index Screening in Schools: Continued Controversy.

Objective Evaluate Massachusetts pediatricians' views toward school-based body mass index screening since its implementation. Methods Survey of 286 members of the Massachusetts Chapter of the American Academy of Pediatrics on attitudes toward screening and perceived impact on clinical practice. Results Overall, 36.

Improving immunization rates in a hospital-based primary care practice.

Objective: We implemented a quality improvement initiative aimed at reaching a 95% immunization rate for patients aged 24 months. The setting was a hospital-based pediatric primary care practice in Boston, Massachusetts. We defined immunization as full receipt of the vaccine series as recommended by the Centers for Disease Control and Prevention.

Obesity-related behaviors of US- and non-US-born parents and children in low-income households.

Objective: To examine differences in obesity-related behaviors by parental US-born status among low-income, minority families participating in Healthy Habits, Happy Homes, an intervention trial to improve household routines for childhood obesity prevention. Evidence suggests lower obesity risk among adult immigrants, but research is inconclusive regarding the influence of having a non-US-born parent on childhood obesity.

Method: We sampled 57 US-born and 64 non-US-born families of children aged 2 to 5.

Healthy Habits, Happy Homes: randomized trial to improve household routines for obesity prevention among preschool-aged children.

Importance: Racial/ethnic and socioeconomic disparities exist across risk factors for childhood obesity.

Objective: To examine the effectiveness of a home-based intervention to improve household routines known to be associated with childhood obesity among a sample of low-income, racial/ethnic minority families with young children.

Design: Randomized trial.

Accelerating progress in reducing childhood obesity disparities: exploring best practices of positive outliers.

Childhood obesity rates may have plateaued in some U.S. population subgroups, yet overall rates remain high and racial/ethnic and socioeconomic disparities appear to be widening.

Healthy Habits, Happy Homes: methods and baseline data of a randomized controlled trial to improve household routines for obesity prevention.

Objective: To develop a home-based intervention for parents of 2-5 year old children to promote household routines to prevent overweight/obesity.

Methods: We recruited 121 children from health centers in Boston between 2011 and 2012 and randomized 62 to intervention and 59 to the control condition. The 6-month intervention included 1) motivational coaching at home and by phone with a health educator, 2) mailed educational materials, and 3) weekly text messages.

The association of urbanicity with infant sleep duration.

Short sleep duration is associated with multiple adverse child outcomes. We examined associations of the built environment with infant sleep duration among 1226 participants in a pre-birth cohort. From residential addresses, we used a geographic information system to determine urbanicity, population density, and closeness to major roadways.

Unstable distal radial fractures treated with external fixation, a radial column plate, or a volar plate. A prospective randomized trial.

Background: Optimal surgical management of unstable distal radial fractures is controversial, and evidence from rigorous comparative trials is rare. We compared the functional outcomes of treatment of unstable distal radial fractures with external fixation, a volar plate, or a radial column plate.

Methods: Forty-six patients with an injury to a single limb were randomized to be treated with augmented external fixation (twenty-two patients), a locked volar plate (twelve), or a locked radial column plate (twelve).

Biologic therapy for psoriasis: an update on the tumor necrosis factor inhibitors infliximab, etanercept, and adalimumab, and the T-cell-targeted therapies efalizumab and alefacept.

Psoriasis is a chronic skin disorder that affects approximately 2% of the US and European population. Over the last several years, one of the major focuses in psoriasis research has been the development of biologic therapies for this disease. The aim of these therapies is to provide selective, immunologically directed intervention with fewer side effects than traditional therapies.

Neuroprotective effects of bcl-2 overexpression in hippocampal cultures: interactions with pathways of oxidative damage.

Overexpression of bcl-2protects neurons from numerous necrotic insults, both in vitro and in vivo. While the bulk of such protection is thought to arise from Bcl-2 blocking cytochrome c release from mitochondria, thereby blocking apoptosis, the protein can target other steps in apoptosis, and can protect against necrotic cell death as well. There is evidence that these additional actions may be antioxidant in nature, in that Bcl-2 has been reported to protect against generators of reactive oxygen species (ROS), to increase antioxidant defenses and to decrease levels of ROS and of oxidative damage.