Search

Objective: To analyze the perception of pediatric guidelines by mothers at the time of consultation in private offices, in order to know how they assimilate, process and use the information received from the pediatricians. Methods: Data collection was carried out by a questionnaire sent to participants by a total of 200 mothers from a virtual community in social networks participated in the research. The answers were transcribed using the Discourse of the Collective Subject method. The analyses were supported by the research qualitative perspective, from the viewpoint of the social representation theory. Results: Three categories were obtained through data analysis: (1) assessing the pediatric guidelines, (2) confronting theory and practice and (3) developing a critical view of the pediatric guidelines. These categories have elucidated that the level of knowledge of pediatric issues by mothers and their ability to use them when making decisions about the care of their babies, have a direct association between following or not the pediatric guidelines. Conclusions: The mother's decision on following the pediatrician's recommendations depends on two main factors: (a) certification of the updated and proven recommendations, according to the official health agencies; (b) support and recognition by the pediatrician of the maternal empowerment during the follow-up process. The mothers' practice of accessing knowledge through social networks hinders the pediatric monitoring. Resumo Objetivo: Analisar a percepção das orientações pediátricas pelas mães na ocasião do atendimento em consultórios particulares, para conhecer de que maneira assimilam, processam e usam as informações recebidas de seu pediatra. Métodos: A coleta de dados foi feita por questionário enviado às participantes. Participaram da pesquisa 200 mães de uma comunidade virtual nas redes sociais. As respostas foram transcritas por meio do método do discurso do sujeito coletivo. As análises foram respaldadas na perspectiva qualitativa de pesquisa, sob a ótica da teoria das representações sociais. Resultados: Obtiveram-se três categorias por meio da análise de dados: (1) avaliação das orientações pediátricas, (2) confronto da teoria e prática e (3) desenvolvimento de um olhar crítico acerca das orientações pediátricas. Tais categorias elucidaram que o nível de conhecimento de temas pediátricos por parte das mães e a sua capacidade de usá-los na tomada de decisões sobre os cuidados dos seus bebês apresentam uma relação direta entre seguir ou não as orientações pediátricas. Conclusões: A decisão das mães quanto a seguir as recomendações do pediatra depende de dois fatores principais: (a) certificação das recomendações atualizadas e comprovadas, de acordo com os órgãos oficiais de saúde; (b) apoio e reconhecimento por parte do pediatra do papel materno durante o processo de acompanhamento. A prática do acesso ao conhecimento das mães por meio de redes sociais dificulta o acompanhamento pediátrico.

An increasing trend of C-section delivery In Indonesia was found from 2% in 1986 to 16% in 2012. This delivery method was introduced to save women and their newborn baby’s life. On the other side, it can increase short and long-term health risks for children. This study aims to assess and give an overview of the perspective on pediatrician as medical specialist in managing children of the C-section delivery history. A survey was conducted on 89 Indonesian Pediatricians using an online questionnaire. It was found that most pediatrician chose combination partial hydrolyze milk combined with synbiotic (a combination of prebiotic and probiotic) combination as nutrition intervention to decrease the allergy risk on children with C-section delivery mode, and there is a need to emphasize information about short and long-term health effects of C-section, especially in causing gut dysbiosis and its mechanism, information on non-medical causes of gut dysbiosis to increase awareness of recommending right symbiotic to decrease allergy risk in children with C-section history.

Background Pediatricians play an important role in promoting smoking cessation among the parents of young children as more behavioral counseling and cessation treatment are made available in the Chinese healthcare system. However, beliefs about the effectiveness of these interventions can influence pediatricians’ recommendations to their patients. This study examined pediatricians’ beliefs regarding effectiveness of counseling and medications for smoking cessation. Methods A cross-sectional survey of pediatricians was conducted in thirteen conveniently selected southern Chinese hospitals, during September to December 2013. A self-administered questionnaire was used for data collection. We used chi square tests and multinomial logistic regression analysis to identify factors associated with beliefs regarding effectiveness of counseling and medications for smoking cessation. Results Beliefs of the respondents (504/550; 92% response rate) were divided regarding the effectiveness of counseling and medications for smoking cessation. Sixty percent believed that physician counseling is effective for smoking cessation; 53% believed pharmacological products (or medications) are effective. Factors that were associated with positive beliefs towards the effectiveness of counseling included: believing about the professional responsibility to discuss smoking cessation, being confident in discussing smoking cessation or SHS exposure reduction with patients’ parents, believing that health professionals should routinely ask about their patients smoking habits, believing that health professionals should routinely advise their smoking patients to quit smoking, possessing adequate knowledge in quitting smoking, and being able to assess smokers different stages of readiness to quit. Most of the above factors were also associated with the belief that medication is effective for smoking cessation. Conclusions A substantial proportion of Chinese pediatricians believed that cessation counseling and medications are not effective, which is not supported by current evidence in the field. Several factors including individual, practice level and health system level characteristics were associated with their belief. Training efforts are needed to influence pediatricians’ beliefs regarding the effectiveness of cessation counseling and medications.

WOS: 000300538400023, Objective: The purpose of this article is to determine nurses' and paediatricians' knowledge regarding the sleeping positions and environment of infants. Methods: This descriptive and cross-sectional study was conducted at 18 randomly selected hospitals in eight different cities in Turkey. There were 1,156 participants in the study (252 physicians and 904 nurses). The data were collected by means of a questionnaire form developed by the investigators. Data analysis included percentage and chi-square analyses. Results: Among the nurses, 74.1% were between the ages of 21 and 35, 32.0% had a bachelor's degree, 65.0% had job experience of six years or more. Among the paediatricians, 69.0% were between the ages of 21 and 35; 42.5% had job experience of six years or more. 88.8% of the nurses said that the mother should share same room with the infant but in a separate bed. Over two-thirds of the nurses said that a pillow should not be used when an infant was asleep, and 98.0% would not cover an infant's face. 86.5% of the paediatricians said that the mother could share same room with the infant but in a separate bed. 76.2% of the paediatricians said that they would not use a pillow when the infant were asleep, and 97.2% would not cover an infant's face. Most nurses and physicians responded that infants of 0-6 months of age slept on their sides during the daytime, in the nighttime, when left alone in a room, and after feeding. 140 Conclusions: The results showed that physicians and nurses were not sufficiently knowledgeable about infant sleeping positions; however, they had sufficient knowledge about the risk factors for sudden infant death syndrome. The education of both nurses and physicians working in pediatric wards about the risk factors of SIDS may decrease SIDS deaths in Turkey., Akdeniz University Scientific Research Projects Management Unit, We are grateful to all the individuals who participated in this study. This research was supported by the Akdeniz University Scientific Research Projects Management Unit.

Background This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Methods Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Results Three main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy. Conclusions An integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of professionals.

Background The goal of newborn screening is early identification of babies with a high risk for disorders that may not be clinically evident at birth, but have severe consequences if untreated. New insight into inherited diseases and the ability to test for numerous diseases using new technique such as tandem mass spectrometry have made it practical to greatly expand the number of conditions tested. The expanded neonatal screening is now available and relatively simple, but this represents only a part of the picture. Positive results require follow-up confirmation. Most disorders screened require confirmatory biochemical or genetic tests and specialist visits. An efficient system is needed for managing the care of affected newborns. Expanded newborn screening is not yet available in all Regions of Italy, but discussions aimed at organizing universal access are underway. If these are successful, the role of the pediatrician as the primary contact with the parents is expected to become even more important. Methods We have conducted a survey of Italian pediatricians to assess their familiarity and opinions on newborn screening in general and on expanded newborn screening. All members of the Italian Association of Pediatricians (n = 9000) were invited to compile a 10-item questionnaire online. Results The response rate was 10 %, corresponding to 605 of 6000 active members. Respondents were from all Regions of Italy, with the highest number of responses coming from Lombardy (138, 22.8 %), Campania and Puglia (n = 61; 10.1 %). Interestingly, expanded neonatal screening was not available in any of these Regions at the time of the survey. Regarding their understanding of neonatal screening in general, most respondents (n = 552; 91.1 %) considered that they had at least a sufficient level of knowledge; however, only 59.6 % thought they had sufficient knowledge of expanded newborn screening. Conclusions Successful implementation of a universal expanded NBS program will require efficient procedures for follow-up, diagnosis and treatment to prevent morbidity and mortality of infants and to reduce the period of uncertainty for unaffected families. Pediatricians may need additional training to allow them to fulfill their tasks of coordinating this process while keeping families informed and reassured. Electronic supplementary material The online version of this article (doi:10.1186/s13052-015-0147-1) contains supplementary material, which is available to authorized users.

Background The shortage of physicians in Japan is a serious concern, particularly in specialties like pediatrics. The purpose of this study was to investigate recent changes in the geographic distribution of pediatricians and the factors underlying this change. Methods We investigated the numerical changes in the pediatrician workforce (2002 to 2007) per 100,000 of the population under the age of 15 years in 369 secondary medical areas throughout Japan, using attributive variables such as population size, social and economic status, and pediatric service delivery. We performed principal component analysis and multiple regression analysis. Results We obtained two principal components: one that reflected the degree of urbanization and another that reflected the volume of pediatric service delivery. Only the first component score was positively correlated with an increased pediatrician workforce per 100,000 of the population under the age of 15 years. We classified the secondary medical areas into four groups using component scores. The increase in pediatrician workforce during this period was primarily absorbed into the two groups with higher levels of urbanization, whereas the two rural groups exhibited little increase. Pediatricians aged 50 to 59 years increased in all four groups, whereas pediatricians aged 30 to 39 years decreased in the two rural groups and increased in the two urban groups. Conclusions The trends of the pediatrician workforce increase generally kept pace with urbanization, but were not associated with the original pediatrician workforce supply. The geographic distribution of pediatricians showed rapid concentration in urban areas. This trend was particularly pronounced among female pediatricians and those aged 30 to 39 years. Given that aging pediatricians in rural areas are not being replaced by younger doctors, these areas will likely face new crises when senior physicians retire.

Abstract Background: The ministry of health and medical education of Iran and many other countries advice physicians to use this guideline for diagnosis and treatment of acute otitis media (AOM), but there is not any evaluation of effectiveness and obedience of this guideline, so the aim of this study was to evaluate the attitude of pediatricians, the most important group that interfere with these patients in treatment of acute otitis media. Methods: A total of 120 anonymous surveys were mailed to 120 pediatrician in Tehran (Iran) to evaluate pattern of diagnosis and treatment of AOM in these physicians. Age, gender, place of work, attitude of diagnosis and treatment were asked by anonymous survey. Results: Sixty-two completed surveys were received, for a response rate of 51%. There was no significant difference between responders in these survey and scenarios, according to sex, age, practice setting, graduation year or the number of AOM patients visiting each month. Conclusion: Our study seems to add new insights to the previous literature on management of AOM according to guideline. We can assess the impact of guidelines on the usual practice of practitioners in evidencedbased management of AOM.

BACKGROUND AND OBJECTIVE:Female physicians, especially gynecologists and pediatricians, have a comprehensive knowledge of the complications caused by Cesarean section. These specialists play a pivotal role in raising maternal awareness, providing prenatal care, performing screening tests and delivery of healthy infants. Given the significant correlation between the type of delivery and the mental development of neonates, this study aimed to compare the rate of Cesarean section among female gynecologists and pediatricians with other specialists. METHODS:This cross-sectional study was conducted on 179 female physicians with at least one living, healthy child in 2012. Data were collected using questionnaires including the degree of specialty, mode of delivery and the reason (medical or non-medical), maternal age at birth time and the employment status of the subjects. FINDINGS:In total, more than 60% of the studied specialists chose Cesarean delivery for non-medical reasons, and the rate of C-section among gynecologists and pediatricians was 2.36 times higher compared to other specialists. In addition, the possibility of C-section declined to 42% with the increasing number of childbirths, and the risk of C-section increased between 25-30% with the age. Gynecologists and pediatricians preferred C-section 4.2 times than other specialists, and no significant differences were observed between the employment status of the subjects (faculty members vs. Others) and the choice of delivery mode. CONCLUSION:According to the results of this study, the preference of C-section for non-medical reasons was noticeably higher among gynecologists and pediatricians compared to other specialists. Therefore, these two groups could not be considered as a proper model to reduce the rate of C-section

Girifl: Ulusal akılcı antibiyotik kullanım politikalarının iyileştirilmesine yön vermek amacıyla çocuk doktorları, aile hekimleri ve pratisyen hekimlerin çocuklarda üst solunum yolu enfeksiyonlarında antibiyotik yazma davranışlarını etkileme olasılığı olan sosyokültürel, sosyodemografik ve düşünsel faktörler araştırıldı. Gereç ve Yöntem: Etik kurul onayı alındıktan sonra ülkenin farklı bölgelerinde çalışan 7421 hekime anketler dağıtıldı. Reçete etme davranışlarını etkileyen her bir faktörün bağımsız etkisini ortaya koyabilmek için, bu kişilerden elde edilen 1477 anket sonucu çok değişkenli analiz ile incelendi. Bulgular: Sonuçlarımız; çocuk hekimi olmanın, tıp fakültesinde çalışmanın ve fizik muayene için yeterli vakit ayırmanın bağımsız olarak az antibiyotik reçete edilmesi ile ilişkili olduğunu gösterdi. Aile hekimi ve pratisyen hekimler çocuklarda üst solunum yolu enfeksiyonları için daha fazla antibiyotik yazmaktaydılar. Sonuç: Çocuklarda üst solunum yolu enfeksiyonlarında antibiyotik reçete etme davranışını düzenleyen en önemli faktörler fizik muayene süresi ve eğitimin kalitesiydi. Güncel Pediatri 2013; 11: 45-50, Introduction: In order to guide the improvement in the national judicious antibiotic use policy, the socio-cultural, socio-demographic, and cognitive factors that may potentially influence the prescribing habits of pediatricians, family physicians and general practitioners to upper respiratory tract infections in children were investigated. Materials and Methods: After receiving approval from ethic committee, questionnaire was sent to 7421 physicians who had been practicing in the different regions of the country. Responses obtained from 1477 of them were evaluated by multivariate analysis to demonstrate independent effect of each factor influencing the prescribing habits. Results: Our results have shown that being a pediatrician, working in medical school, and spending enough time for physical examination were independently associated with less antibiotic prescription. Family physicians and general practitioners were more likely to prescribe antibiotics for viral upper respiratory infections in children. Conclusions: The most important modifying factors about antibiotic prescription habits for upper respiratory tract infections in children were physical examination period and quality of education. Journal of Current Pediatrics 2013; 11: 45-50

Background Advances in medical science have enabled many children with chronic diseases to survive to adulthood. The transition of adult patients with childhood-onset chronic diseases from pediatric to adult healthcare systems has received attention in Europe and the United States. We conducted a questionnaire survey among 41 pediatricians at pediatric hospitals and 24 nurses specializing in adolescent care to compare the perception of transition of care from pediatric to adult healthcare services for such patients. Findings Three-fourths of the pediatricians and all of the nurses reported that transition programs were necessary. A higher proportion of the nurses realized the necessity of transition and had already developed such programs. Both pediatricians and nurses reported that a network covering the transition from pediatric to adult healthcare services has not been established to date. Conclusions It has been suggested that spreading the importance of a transition program among pediatricians and developing a pediatric-adult healthcare network would contribute to the biopsychosocial well-being of adult patients with childhood-onset chronic disease.