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PubMed1996

Content analysis of prime-time television medical news. A pediatric perspective.

OBJECTIVES: To assess child health news broadcasts by a major regional television station and to evaluate the attitudes of parents and pediatricians about the context and value of television news reports. DESIGN: Videotaping 6 months of consecutive evening news telecasts (Monday and Friday). Self-administered surveys given to a convenience sample of parents and mailed to community pediatricians. SETTING: Local and national newscasts of prime-time coverage by a major metropolitan television station. PARTICIPANTS: One hundred forty-four members of the Buffalo (NY) Pediatric Society and 87 parents of children in the outpatient or inpatient departments of The Children's Hospital, Buffalo. RESULTS: Pediatric issues were presented in 15% of local and 21% of national medical news stories. Adult-specific issues were addressed in 48% of local and 33% of national medical news reports. Local pediatric news reports focused on behavior (22%) and major illnesses (22%); national pediatric news concentrated on nutrition (30%), allergy (21%), and major illnesses (21%). Seventy percent of local and 85% of national pediatric news reports referenced an informative source. Fifty-one (59%) of the 87 parents and 69 (48%) of the 144 pediatricians consider television news to be an effective means of increasing awareness of child health issues. Parents and physicians recommended pediatric emergencies, safety, disease prevention, and adolescent issues as important areas of emphasis for television news. Fifty-one percent of the parents (44) and 48% of the pediatricians (69) believed that television reports increase knowledge of how to access local health resources. CONCLUSIONS: Television news reports are important sources of child health information. Pediatric topics on local and national news programs often do not focus on topics considered of highest priority by parents and pediatricians. Greater awareness by pediatricians of the potential value of television news as a tool for public health education is warranted.

Adult↗

PubMed1996

Population requirements for capitation planning in pediatric cardiac surgery.

OBJECTIVE: To determine the population number necessary to generate a sufficient volume of pediatric cardiac surgeries to allow accurate prediction of resource utilization. DESIGN: All pediatric cardiac surgical patients receive care in our institution by means of only four clinical pathways that are based on acuity, not diagnosis or procedure. This allows accurate tracking of resource utilization. Based on available information, 750 consecutive surgically treated patients were retrospectively assigned to a pathway. They were subsequently subdivided into study groups of decreasing sizes from 150 to 35. Variability of pathway distribution from group to group was examined as a measure of the ability to predict resource utilization based on group size. Pediatric cardiac statistics from the state of Ohio were then used to extrapolate to the population base necessary to generate each group size. SETTING: A regional pediatric cardiac referral center. PATIENTS: All sequential patients who underwent pediatric cardiac surgery between July 1991 and January 1994. RESULTS: Statewide statistics showed that a population base of 1 million people generates 100 pediatric cardiac operations. Groups of 100 patients or greater had minimal variation in pathway distribution from group to group, allowing accurate prediction of hospital charges. This was not true for groups of 50 patients or less. CONCLUSIONS: Resource utilization for pediatric cardiac surgery can be accurately predicted in a capitated setting for populations of 1 million covered lives (100 procedures) or greater. For populations of 500 000 covered lives or less, variability of case mix is great enough to suggest the need for a more individualized payment mechanism.

Capitation Fee↗

PubMed1996

Improving participation and interrater agreement in scoring Ambulatory Pediatric Association abstracts. How well have we succeeded?

OBJECTIVE: To determine whether increasing the number and types of raters affected interrater agreement in scoring abstracts submitted to the Ambulatory Pediatric Association. METHODS: In 1990, all abstracts were rated by each of the 11 members of the board of directors of the Ambulatory Pediatric Association. In 1995, abstracts were reviewed by four to five raters, including eight members of the board of directors, two chairpersons of special interest groups, and 10 regional chairpersons, for a total of 20 potential reviewers. Submissions were divided into the following three categories for review: emergency medicine, behavioral pediatrics, and general pediatrics. Weighted percentage agreement and weighted kappa scores were computed for 1990 and 1995 abstract scores. RESULTS: Between 1990 and 1995, the number of abstracts submitted to the Ambulatory Pediatric Association increased from 246 to 407, the number of reviewers increased from 11 to 20, the weighted percentage agreement between raters remained approximately 79%, and weighted kappa scores remained less than 0.25. Agreement was not significantly better for the emergency medicine and behavioral pediatrics abstracts than for general pediatrics, nor was it better for the raters who reviewed fewer abstracts than those who reviewed many. CONCLUSIONS: The number and expertise of those rating abstracts increased from 1990 to 1995. However, interrater agreement did not change and remained low. Further efforts are needed to improve the interrater agreement.

Abstracting and Indexing↗

PubMed1996

Pediatric resident training in a school environment. A prescription for learning.

OBJECTIVE: To describe our experience with developing, implementing, and evaluating the educational effect of a school health experience for pediatric residents. DESIGN: Descriptive. SETTING: University-based pediatric residency program and five public elementary and middle schools in surrounding communities. PARTICIPANTS: Eleven pediatric residents. INTERVENTION: A school health experience for pediatric residents was developed in response to the report of the American Academy of Pediatrics Task Force on Pediatric Education and the new training recommendations of the Residency Review Committee of the American Council for Graduate Medical Education. Residents spent 3 weeks in the schools engaged in teaching and observational activities. MAIN OUTCOME MEASURES: Questionnaires of residents' attitudes and knowledge, structured resident interviews, and teacher questionnaires. RESULTS: Positive effect on resident's knowledge of school structure, child development, communication with children, school-related problems, and special education. Positive effects on resident's attitudes about teamwork between teachers and pediatricians and roles of pediatricians in schools. Teacher feedback showed acceptance by the school community. CONCLUSIONS: Pediatric residents benefit from exposure to children in school settings. Schools provide an opportunity to observe normal childhood development and behavior in a more natural setting than that provided in the hospital.

Adult↗

PubMed1996

Impact of maternal group B streptococcal screening on pediatric management in full-term newborns.

BACKGROUND: The American Academy of Pediatrics strategy to prevent early-onset neonatal sepsis with group B streptococcus (GBS) relies on maternal antepartum GBS cultures, while the American College of Obstetrics and Gynecology strategy does not. OBJECTIVE: To evaluate the impact of the 2 strategies on the care of asymptomatic full-term newborns. DESIGN/SETTING: Self-administered survey mailed to a national random sample of US pediatricians who were members of the American Academy of Pediatrics. PARTICIPANTS: A total of 461 members of the American Academy of Pediatrics who routinely care for newborns. MAIN OUTCOME MEASURE: Self-report of diagnostic and treatment strategies for asymptomatic full-term newborns who were born under different clinical scenarios. Maternal risk factors, antepartum maternal GBS screening status, and maternal treatment with intrapartum antibiotics were varied across the scenarios. RESULTS: Pediatricians treating asymptomatic full-term newborns born to risk factor-negative mothers reported ordering tests (63.3% in GBS-positive cases vs 6.7% with GBS unknown; P = .001) and antibiotics (21.5% in GBS-positive cases vs 0.9% with GBS unknown; P = .001) more frequently when presented with a positive maternal GBS screening result. Maternal intrapartum treatment had little impact on pediatric practice when risk factors were absent. In risk factor-positive mothers, pediatricians reported an increase in their antibiotic usage in response to a positive maternal GBS screen (61.8% in GBS-positive cases vs 36.9% with GBS unknown; P = .001). In risk factor-positive mothers with unknown results of GBS screening, use of intrapartum antibiotics increased the number of pediatricians who reported that they would prescribe antibiotic therapy. CONCLUSIONS: Obstetrical strategies to decrease the risk of neonatal GBS sepsis increase pediatric services provided to full-term healthy newborns. This increase in services by pediatric practices is likely to be greater with the screening-based strategy recommended by the American Academy of Pediatrics.

Adult↗

PubMed1996

How rational is the crossmatching of blood in a pediatric emergency department?

OBJECTIVE: To determine if typed and crossmatched blood ordered in a pediatric emergency department (ED) is actually used for transfusion and if some ordering patterns are not cost-effective. DESIGN: Retrospective medical record review. Emergency department records and blood bank logs were reviewed daily to identify patients who had a type and crossmatch (T&C) ordered; inpatient records were then reviewed. A priori diagnostic and patient care categories were determined. Physicians and nurses providing care were unaware of the study. SETTING: An inner-city, tertiary care, pediatric trauma center ED. PATIENTS: A consecutive sample of ED patients who had a T&C ordered from October 1, 1993, through January 31, 1994. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Outcome measures included age, general category of diagnosis, number of units of blood crossmatched and transfused within 7 days, hemoglobin concentration in the ED, surgical procedures in the operating room, and hospital charges for typed and crossmatched blood. For trauma patients, the Pediatric Trauma Score was recorded. The crossmatch-to-transfusion (C/T) ratio was calculated for each diagnostic category (the typical C/T ratio for US hospitals is 2). We calculated a new ratio, the patient-to-transfusion (P/T) ratio, to correct for the transfusion of numerous units of blood in a few patients. RESULTS: Two hundred eighty-two patients had 468 U of blood typed and crossmatched. Fifty-six patients received a total of 110 U of blood. The mean hemoglobin concentration was 81 g/L for patients who received a transfusion and 117 g/L for patients who did not receive a transfusion (P < .001). The C/T ratio for all patients was 4.3. The P/T ratio for all patients was 5.3. Sixty-four surgery patients had 78 U of blood typed and crossmatched; 1 U of blood was transfused to 1 patient, yielding a C/T ratio of 78 and a P/T ratio of 64. Ninety-one units of blood were typed and crossmatched for 38 major trauma patients; 20 U of blood were transfused to 2 patients, 19 U were transfused to 1 patient with a Pediatric Trauma Score of 4, and 1 U was transfused to a patient with a Pediatric Trauma Score of 7. The C/T ratio for major trauma patients was 4.6, and the P/T ratio was 19. Forty-five children with ventriculoperitoneal shunt problems had 51 U of blood typed and crossmatched, but no blood was transfused. Children with sickle-cell disease had a C/T ratio of 2.2 and a P/T ratio of 3.3; those with cancer diagnoses had a C/T ratio of 1.6 and a P/T ratio of 1.3. During the 4-month study period, the hospital charged $84,726 for these T&Cs. The charge for T&Cs never used for transfusion was $65,643 (77.5%). CONCLUSIONS: Most typed and crossmatched units of blood ordered in our pediatric ED were never used for transfusion. The C/T and P/T ratios were high for many diagnostic categories, suggesting inefficient blood ordering and patient management. Transfusions were uncommon in children with the following problems: ventriculoperitoneal shunt malfunction, virtually all surgical diagnoses, cancer with a hemoglobin concentration greater than 105 g/L, and trauma patients with a Pediatric Trauma Score of greater than 7.

Adolescent↗

PubMed1997

Current positions of graduates of internal medicine-pediatrics training programs.

OBJECTIVE: To determine what positions graduates of internal medicine-pediatrics programs currently hold. DESIGN: A survey of the program directors of residencies in internal medicine-pediatrics. PARTICIPANTS: Program directors of the 85 internal medicine-pediatrics training programs listed in the 1993-1994 Graduate Medical Education Directory. MAIN OUTCOME MEASURES: A 1-page survey that described the current positions of trainees graduating between 1987 and 1993. RESULTS: Seventy-four (87%) of the 85 program directors completed the survey. Of the 708 graduates reported on, 68% were practicing as generalists. The generalists of this cohort (n = 480) were primarily in private practice settings (n = 390, 81%) and most were practicing internal medicine-pediatrics (n = 416, 85%). Only 12% of the generalists had chosen to practice either pediatrics or internal medicine. Twenty-one percent of the total graduates had entered subspecialty training. CONCLUSIONS: To our knowledge, the sample of 708 graduates is the largest survey of graduates of internal medicine-pediatrics programs to date and shows that 68% of graduates are practicing in primary care fields. Graduates of internal medicine-pediatrics programs should be considered as an important source of primary care physicians.

Education↗

PubMedDate not supplied

A comprehensive pediatric rehabilitation nurse internship program.

A comprehensive internship program was conceived at Mount Washington Pediatric Hospital in Baltimore to recruit and train new nursing employees in pediatric rehabilitation. The Pediatric Nurse Internship Program was designed to provide extensive theory relevant to pediatric rehabilitation nursing, as well as preceptor-based clinical experiences, to ease the transition of new nurses into the pediatric rehabilitation arena. The program incorporated a strong interdisciplinary team approach. The content areas included all the functional parameters of health as well as didactic information about the diagnoses specific to the pediatric population. The goal was to allow the intern to achieve clinical competence in pediatric rehabilitative nursing. Four nursing interns were enrolled in the 12-week program, which involved completing an educational project, taking a written examination, and demonstrating evidence of clinical competencies. On completion of the program, three interns transferred into full-time positions at the hospital and demonstrated an extremely high level of functioning. Partial support for the program was provided through grant money from the Maryland Health Services Cost Review Commission.

Education, Nursing, Continuing↗

PubMed2026

Sacral Neuromodulation in the Management of Refractory Pediatric Lower Urinary Tract Dysfunction.

INTRODUCTION: Sacral neuromodulation is currently used in the pediatric patient population for refractory lower urinary tract dysfunction (LUTD). Evidence, however, is currently limited for institutional experiences of long-term outcomes for sacral neuromodulation in the pediatric patient population. OBJECTIVE: The objective of this study is to perform a retrospective review of a large multi-institutional cohort of pediatric patients that underwent sacral neuromodulation (SNM) for refractory LUTD, focused on rates of symptom improvement, quality of life, and bowel-bladder dysfunction measures following device implantation. Secondary objectives included assessing device complication rates and device removals due to failure or successful resolution of symptoms. METHODS: We performed a retrospective cohort study of pediatric patients at three children's hospitals that underwent SNM device implantation for refractory LUTD. Patients 4-18 years of age who were diagnosed with refractory LUTD and managed at a participating institution with follow-up were included. Outcomes were evaluated at baseline and post-operatively after two-stage device implantation at initial follow-up and annually until device removal or final follow-up. RESULTS: From 2010 to 2022, a total of 205 children underwent SNM procedures at three pediatric hospital centers. 204 patients completed the two-stage procedure for permanent device implantation with a median follow-up of 3.4 years (1.3, 4.9). One hundred seventy-eight patients reported partial (25%) or complete (54%) device response/symptom improvement by final follow-up. Comparison of patient-reported validated questionnaires completed at baseline and by final follow-up visit revealed significant improvement in median Pediatric Quality of Life Inventory (PedsQL) (p = 0.004) and Vancouver Nonneurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome bowel-bladder dysfunction (BBD) scores (p < 0.001). Of those with any device complication (n = 43;21%), 19 patients required device revision, and 20 required complete device removal. Separately, twenty-eight patients (13%) underwent device removal due to resolution of symptoms or treatment success at a median period of 5 years (4,7). CONCLUSION: SNM use demonstrated a majority of patients reporting at least partial subjective symptom improvement following device implantation across multiple institutions by final follow-up. SNM is a viable treatment option for refractory LUTD in the pediatric patient if willing to undergo an invasive procedure and in which thorough counseling of risks and benefits has occurred.

Humans↗

PubMed1992

The education and identification of a pediatric neurosurgeon.

Pediatric neurosurgery very likely became an entity because of the admission of children with CNS diseases to children's hospitals and the development of subspecialization. This latter, in pediatric neurosurgery, has been more a result of events, such as the individual's working propinquity to other pediatric specialists and his being comfortable with children and their parents, than of methodical adherence to a philosophical precept. A fellowship in pediatric neurosurgery, in my opinion, has negative value, in that it would create a working/learning situation in which the fellow would take essential educational and responsibility experiences from the resident and would be delegated patient-care and teaching accountabilities he is not ready to assume. Two, more appropriate, alternatives could be either an additional year as a resident, or a proper staff appointment, depending upon the candidate and the institution. The pediatric neurosurgeon, like other subspecialists in our discipline, may be identified on the basis of what he does, how well he does it, and which societies recognize him as member. Since subspecialization as we see it today is inevitable and represents progress, a certificate (in the subspecialty of pediatric neurosurgery) awarded by the American Board of Neurosurgery would have positive implications, as would, for example, a Continuing Education Award, given by the AANS, the CNS, or the American Society for Pediatric Neurosurgery. Such certificates or awards could serve differing purposes or provide differing recognition as the life of our subspecialty unfolds.

Child↗

PubMed2003

Comparison of interhospital pediatric intensive care transport accompanied by a referring specialist or a specialist retrieval team.

OBJECTIVE: Interhospital transfers of critically ill pediatric patients in The Netherlands are accompanied by referring specialists or by specialist retrieval teams. We compared the interventions before and directly after transports and the complications and the equipment available during transports in the two groups. DESIGN AND SETTING: Prospective observational clinical study in pediatric intensive care units of Dutch university hospitals. PATIENTS: 249 pediatric patients requiring interhospital intensive care transport. METHODS: Data were collected on interhospital pediatric intensive care transports. We compared patient characteristics, interventions before and directly after transport, complications and equipment available during transport (137 accompanied by referring specialists, 112 by specialist retrieval teams). RESULTS: Interhospital transports accompanied by referring specialists had a longer average transport time (74.6 vs. 60.2 min), higher incidence of respiratory insufficiency (56.9% vs. 41.1%), and lower incidence of circulatory insufficiency (27.0% vs. 41.1%) than primary admission diagnoses. These transports had a lower percentage of ventilatory support (47.4% vs. 72.3%), higher need for acute interventions directly upon arrival on the pediatric ICU, and higher incidence of critical and serious complications. In 75% of the transfers accompanied by retrieval teams interventions before the transport were deemed to be necessary. During the transports accompanied by referring specialists the equipment and materials available proved rather limited. CONCLUSIONS: During pediatric intensive care transports accompanied by nontrained referring specialists there appears to be a higher incidence of complications, specialized equipment is more often not available, and more acute interventions are required upon arrival in the pediatric ICU.

Child↗

PubMedDate not supplied

The development of pediatric neurosurgery in Paris. How to create something out of nothing: reflexions on the methodology.

Up to 1960, children in need of neurosurgical treatment in France were treated either in neurosurgical departments where anesthetists, nurses and neurosurgeons had no specialized training in pediatrics or in departments of pediatric surgery in which the specific aspect of neurosurgery was ignored. Clearly a mutation was needed before any progress could be made: the development of pediatric neurosurgery services. This essay tells the story of the creation of the first pediatric neurosurgery service in France, of the difficulties encountered and of the strategies applied to overcome them. It also recalls the discussions about what size such a service should be and whether it should be located in a general hospital or in a pediatric hospital. During the second half of the twentieth century, progress in neurosurgery, and more specifically in pediatric neurosurgery, has been tremendous. The contribution of the pediatric neurosurgery service at Les Enfants Malades in Paris is briefly summarized.

Autobiographies as Topic↗

PubMedDate not supplied

Objectives to direct the training of emergency medicine residents in pediatric emergency medicine.

This article outlines the objectives for a resident rotation on a pediatric emergency medicine service that is geographically separate from adult-oriented facilities. In this setting, pediatric emergency department care is considered an off service. However, these objectives incorporate key pediatric knowledge and techniques in a practical format for emergency medicine trainees who have no separate pediatric emergency department experience. The content of the pediatric emergency department educational exposure can be attained in a concentrated 2-month exposure at a pediatric facility or extracted throughout the course of multiple pediatric encounters at a general emergency department. These objectives are a part of a continuing series on the goals and objectives to direct emergency medicine resident training on off-service rotations.

Curriculum↗

PubMed2006

The evolution of legislation to regulate pediatric clinical trials: Present and continuing challenges.

Children suffer from many of the same diseases as adults and are often treated with the same agents. However, it was not until 1997 that legislation mandating studies in children was introduced in the United States. A 2000 International Conference on Harmonisation (ICH) Guidance on the Clinical Investigation of Medicinal Products in the Pediatric Population intended to encourage and facilitate timely pediatric clinical trials detailed critical issues in pediatric drug development and ways to ethically study the safety and efficacy of drugs in the unique and vulnerable pediatric population. In 2005, there is draft legislation in Europe. In Japan, pediatric data are not currently required although studies in pediatric populations are encouraged. This chapter describes the history of legislation on the study of drugs in the pediatric population and details present and continuing challenges for the child, parent/guardian, manufacturer and health authority.

Child↗

PubMed2004

The pediatric burn unit: a profit center.

BACKGROUND: Establishment of a pediatric burn center represents a major commitment of resources. The impact of a Pediatric Burn Unit on the finances of a children's hospital has never been reported and was the purpose of this study. METHODS: Burn registry data for patients discharged from our Pediatric Burn Unit from 2000 to 2002 were integrated with financial and administrative data. Reimbursement was determined by calculating expected payments for each patient. The relationship between percent total body surface area (TBSA) burned and profit/loss margin was evaluated using regression analysis. RESULTS: During the study period, 264 pediatric burn patients were admitted to our burn service. One hundred forty-three (54%) had less than 10% TBSA burned, and their average loss margin was -179.03 dollars per patient. The 121 patients (46%) who had greater than 10% TBSA burned had an average profit margin of +349.68 dollars per patient (P =.22, SE+ 605.03) Patients treated operatively (49; 18%) had a profit margin of +2237.77 dollars per patient, whereas patients treated nonoperatively (215; 81%) had a profit margin of -432.30 dollars per patient (P =.0007, SE +249.65) The overall profit margin was +63.88 dollars per patient. CONCLUSIONS: Our pediatric burn service covered all hospital fixed costs and made a small profit. Pediatric burn care can be a profit center for children's hospitals. Investment in a Pediatric Burn Program provides adequate financial return for the hospital.

Burn Units↗

PubMed2006

Is the grass greener? A survey of female pediatric surgeons in the United Kingdom.

BACKGROUND/PURPOSE: Since 1990, at least 50% of UK medical school entrants have been females, although women comprise only 2% of surgical consultants. If women continue to reject surgical careers, recruitment will be limited to a decreasing pool of male applicants. A recent North American study suggested lack of mentorship and role models may be contributory factors. We undertook a survey of UK female pediatric surgeons to ascertain career satisfaction and professional development. METHODS: UK female pediatric surgeons were identified from the British Association of Pediatric Surgeons members' handbook 2004 and via personal communication. Postal or e-mail questionnaires were sent and anonymized responses were analyzed. RESULTS: Thirty-three questionnaires were distributed to all 16 female consultants (13% of BAPS consultant workforce) and 17 trainees (SpRs [specialist registrars/higher surgical trainees]). Twenty-seven (82%) replies were received. Of 27 (85%) respondents, 23 worked full time; "on-call" commitments range from 1 in 2 (2 consultants) to 1 in 8, with several trainees working shifts. Eighteen (67%) respondents had taken a career break-11 for maternity leave. Twelve (44%) are planning further "time-out," of whom 10 are SpRs. Ninety-three percent are contented with their career and would choose pediatric surgery again. However, 19 (70%) reported factors that had hindered their development, 13 (68%) included insufficient research time, whereas only 3 cited a lack of mentorship. CONCLUSIONS: Female representation in medicine is increasing. In contrast to North American experience, very few UK female pediatric surgeons felt hampered by lack of mentorship or role models. Education and training committees need to work proactively to ensure training programs achieve clinical excellence to continue to attract women into pediatric surgery. For women in the United Kingdom, pediatric surgery challenges will also be met by ensuring healthy "work-life balance," along with flexibility in training and established consultant practice.

Career Choice↗

PubMed2004

The Pediatric Residency Training on Tobacco Project: baseline findings from the resident tobacco survey and observed structured clinical examinations.

BACKGROUND: Residency training is an ideal time to prepare pediatricians to address tobacco, although few programs provide the necessary training. Barriers to training include competing priorities, lack of resources, and unavailability of expertise. Solutions for Smoking, a hybrid CD-ROM and web site training program for pediatric residents, may enable training directors to overcome these barriers and to include training on tobacco in their curriculum. The Pediatric Residency Training on Tobacco Project is a 4-year randomized prospective study that compares the effectiveness of a special training program, with Solutions for Smoking as the main teaching tool, to a standard training program in 15 pediatric residency-training programs. METHODS: Fifteen pediatric residency-training programs were assigned randomly to special and standard training conditions. Evaluation instruments include baseline and follow-up resident tobacco surveys and observed structured clinical examinations (OSCEs), patient tobacco surveys, and parent or guardian tobacco surveys. RESULTS: The present report describes the Pediatric Residency Training on Tobacco Project, the special and standard training conditions, and Solutions for Smoking, a hybrid CD-ROM and web site training program on tobacco for pediatric residents. Data from the baseline resident tobacco survey and OSCEs also are presented. While residents believed that pediatricians should play a leadership role in tobacco prevention and control, few had formal training in tobacco intervention, most were skeptical about the efficacy of intervention, and they were more likely to ask about tobacco and advise change than to help patients and parents to modify their behavior. CONCLUSIONS: The baseline findings underscore the importance of the proposed research, and the special training program may serve as a useful model for training pediatric residents to address tobacco in the future.

Adolescent↗

PubMed2006

Has the growth and development of subspecialization in pediatric urology affected scholarly activity?

PURPOSE: How has academic productivity changed in a decade in the American Academy of Pediatrics Section on Urology? Do academic pursuits slow as section members become older? What is the average number of publications yearly by section members? What percent of research is funded in pediatric urology? Has change occurred with multiple authorships? MATERIALS AND METHODS: American Academy of Pediatrics Urology Section active memberships for 1993 and 2003 were obtained. A PubMed study was performed by reviewing all manuscripts published by American Academy of Pediatrics Section on Urology active members for 1991 to 1993 and 2001 to 2003. The data recorded were author, year, PubMed identification number, the number of authors, financial support and journal. Parametric and nonparametric statistics were used for analysis. RESULTS: In the 1991 to 1993 era there were 245 active members, of whom 145 published a total of 972 manuscripts. There were 604 clinical authorships, 161 basic science articles, 42 reviews and 186 case reports, of which 154 manuscripts received funding. In the 2001 to 2003 era there were 252 members, of whom 177 published a total of 1,152 manuscripts. There were 773 clinical authorships, 140 basic science articles, 107 reviews and 124 case reports, of which 151 manuscripts receiving funding. For members in the 2 periods the mean number of articles decreased by 1.0 from 1 decade to the next (p = 0.002). CONCLUSIONS: Scholarly pursuit of pediatric urology as a subspecialty has remained remarkably steady, averaging about 2 authorships per author yearly in the recent decade. The percent of authorships with funding in pediatric urology has decreased. The number of funded authorships has remained steady. A higher percent of American Academy of Pediatrics members have published manuscripts in the last decade. More manuscripts were published during the last decade study period than during the prior decade. The mix of manuscript types has changed with more reviews, and fewer case reports and basic science authorships in the most recent decade. New members are more likely to publish with a low unpublished percent.

Bibliometrics↗