Workforce Trends and Analysis of Selected Pediatric Subspecialties in the United States.

Objective: To update pediatric subspecialty workforce data to support evidence-based legislation and public policy decisions by replicating the American Academy of Pediatrics' 1998 Future of Pediatric Education (FOPE II) workforce survey.

Methods: A descriptive and comparative analysis of survey responses from 9950 US pediatric subspecialists who completed an electronic survey.

Results: Pediatric subspecialists are working fewer hours and spending less of their time in direct patient care than they did in 1998 but the mean hours worked differs significantly according to subspecialty.

Factors Influencing Pediatrician Retirement: A Survey of American Academy of Pediatrics Chapter Members.

Objective: To assess the factors that may influence physicians' desire to retire through an analysis of data collected through the American Academy of Pediatrics (AAP) State Pediatrician Workforce Survey.

Study Design: An electronic survey was sent to retired and nonretired US pediatricians who held AAP membership. The respondents were asked about the importance of 12 factors that would influence or had influenced their decision to retire.

The Use of Telemedicine to Address Access and Physician Workforce Shortages.

The use of telemedicine technologies by primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists (henceforth referred to as "pediatric physicians") has the potential to transform the practice of pediatrics. The purpose of this policy statement is to describe the expected and potential impact that telemedicine will have on pediatric physicians' efforts to improve access and physician workforce shortages. The policy statement also describes how the American Academy of Pediatrics can advocate for its members and their patients to best use telemedicine technologies to improve access to care, provide more patient- and family-centered care, increase efficiencies in practice, enhance the quality of care, and address projected shortages in the clinical workforce.

Diversity and inclusion training in pediatric departments.

Background And Objective: The diversifying US population of children necessitates assessing the diversity of the pediatric academic workforce and its level of cultural competency training. Such data are essential for workforce and educational policies.

Methods: An 8-question survey was sent to 131 US pediatric chairs to assess plans for diversity, targeted groups, departmental diversity, diversity measures, perceived success in diversity, and presence and type of cultural competency training.

Pediatrician workforce policy statement.

This policy statement reviews important trends and other factors that affect the pediatrician workforce and the provision of pediatric health care, including changes in the pediatric patient population, pediatrician workforce, and nature of pediatric practice. The effect of these changes on pediatricians and the demand for pediatric care are discussed. The American Academy of Pediatrics (AAP) concludes that there is currently a shortage of pediatric medical subspecialists in many fields, as well as a shortage of pediatric surgical specialists.

Primary care pediatricians' satisfaction with subspecialty care, perceived supply, and barriers to care.

Objectives: To compare satisfaction with specialty care by primary care pediatricians (PCPs), perceived barriers to care, and adequacy of specialist supply.

Study Design: A survey of U.S.

Unexpected infant deaths associated with use of cough and cold medications.

Objective: The objective of this study was to determine whether caregivers had given infants who died unexpectedly over-the-counter cough and cold medications before the infant deaths to identify sociodemographic risk factors for their use.

Methods: The Arizona Child Fatality Review Program reviews the circumstances surrounding every child death that occurs in the state each year. By statute, the multidisciplinary review teams have access to all medical charts, autopsy reports, law enforcement reports, and other records for their review and use these data to determine the cause of death and its preventability.

Impact of Medicaid disenrollment on health care use and cost.

Objective: The objective of this study was to compare the health care use of children who are covered by public insurance and uninsured children who live in a large urban area and the potential impact of disenrollment on health care use and costs if these children become uninsured.

Methods: The 2004 health care transactions for 43,313 uninsured children and 168,722 children who were insured by Medicaid/State Children's Health Insurance Program and living in the Phoenix metropolitan area were analyzed using a community-wide administrative health database (Arizona HealthQuery). Using a multivariate model of health care use by currently uninsured children, we examined the effect of 10% disenrollment of the children who were currently insured by Medicaid/State Children's Health Insurance Program.

Physician practice revenues and use of information technology in patient care.

Objectives: Although information technology (IT) may improve efficiency and quality of patient care, the adoption of clinical IT by physicians has been limited. This study investigates the relationships between physician practice revenue and use of clinical IT.

Research Design: We undertook a cross-sectional analysis of data on 6849 U.

Substance abuse on the college campus.

Substance abuse is a major health and behavioral concern in college students. Alcohol and marijuana are the most commonly abused drugs on college campuses. Others include tobacco, 3,4-methylenedioxymethamphetamine, gamma-hydroxybutyrate, flunitrazepam (Rohypnol), lysergic acid, ketamine, methamphetamine, phencyclidine, cocaine, and psilocybin mushrooms.

Sexually transmitted infections: new guidelines for an old problem on the college campus.

Approximately 80% of college-age adolescents are sexually active and at risk for sexually transmitted infections (STIs). Over 4 million STIs occur in teenagers annually and young adults between the ages of 18 and 24, while adolescents 15 to 17 years of age have higher rates of STIs than any other age group in the United States. Thus, the prevention, diagnosis, and treatment of STIs are a critical part of college health care.

Contraception for college students.

An important issue for human beings is the acquisition of normal sexual health, including the understanding and application of reproductive health when needed. Comprehensive sexuality education is not a topic provided to many children, adolescents, or college students in the United States, however. Students who were sexually active in high school may continue to be at risk for unwanted pregnancies and sexually transmitted diseases in their college life; those who chose abstinence in high school may abandon this concept in college, choosing coital behavior at all levels of university life-freshman through graduate levels.

The effects of access to pediatric care and insurance coverage on emergency department utilization.

Objective: To compare children who used the emergency department (ED) in a rural, border community with those who did not over a 1-year period to estimate the effects of access to pediatric care, insurance coverage, ethnicity, gender, age, and area of residence on ED utilization.

Design: Multivariate logit models are used to estimate the independent influence of demographic characteristics, insurance coverage, and access to pediatric care on ED utilization during 1999 by children 0 to 19 years of age.

Results: Controlling for age, gender, ethnicity, and area of residence, children who received care from a private practice pediatric group were 73% less likely to utilize the ED if insured and 93% less likely if uninsured to use the ED than children who had not visited a pediatrician.

Can child deaths be prevented? The Arizona Child Fatality Review Program experience.

Objective: To determine the causes and preventability of child deaths; to assess the accuracy of death certificate information; and to assess the number of child abuse deaths that are misdiagnosed as deaths attributable to natural or accidental causes.

Methods: Analysis of deaths of children <18 years old that occurred between 1995-1999 using the data collected by the Arizona Child Fatality Review Program (ACFRP).

Results: From 1995-1999, local multidisciplinary child fatality review teams (CFRTs) have reviewed 95% of all deaths of children <18 years old in Arizona.

Adolescent sexuality and disability.

All human beings are sexual from birth to death and all adolescents, with or without chronic illness or disability, must incorporate appropriate concepts of sexuality into their process of development from child to adult. This chapter reviews normal adolescent development with specific reference to sexuality. Potential effects of chronic illness and disability on this process are reviewed, including coital behavior, sexual abuse, sexual dysfunction, and sexual offending.