scholarly journals Cannabinoids in Pediatrics

2017 ◽  
Vol 22 (3) ◽  
pp. 176-185 ◽  
Author(s):  
Christopher T. Campbell ◽  
Marjorie Shaw Phillips ◽  
Kalen Manasco
Keyword(s):  
Health Care Providers ◽  
Medical Marijuana ◽  
The United States ◽  
Care Providers ◽  
Pediatric Health Care ◽  
Wide Range ◽  
History Of ◽  
Pediatric Use ◽  
Recreational Use ◽  
Controversial Nature

Despite its controversial nature, the use of medical marijuana and cannabis-derived medicinal products grows more popular with each passing year. As of November 2016, over 40 states have passed legislation regarding the use of either medical marijuana or cannabidiol products. Many providers have started encountering patients experimenting with cannabis products for a wide range of conditions. While the debate continues regarding these agents for both medicinal and recreational use in the general population, special consideration needs to be made for pediatric use. This review will deliver the history of marijuana use and legislation in the United States in addition to the currently available medical literature to equip pediatric health care providers with resources to provide patients and their parents the best recommendation for safe and appropriate use of cannabis-containing compounds.

Pediatric Collections: Vaping: Effects and Solutions

2020 ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Health Care Providers ◽  
Electronic Cigarettes ◽  
The United States ◽  
Care Providers ◽  
Tobacco Products ◽  
Pediatric Health ◽  
Pediatric Health Care

Electronic cigarettes are the tobacco products most commonly used by youths in the United States. The use of e-cigarettes, also known as vaping or JUULing, is a public health epidemic. This collection offers reviews and research to assist pediatric health care providers in identifying and treating adolescent use and exposure to e-cigarettes. https://shop.aap.org/pediatric-collections-vaping-effects-and-solutions-paperback/

Fatal Dog Attacks, 1989-1994

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 891-895
Author(s):  
Jeffrey J. Sacks ◽  
Randall Lockwood ◽  
Janet Hornreicht ◽  
Richard W. Sattin
Keyword(s):  
United States ◽  
Health Care Providers ◽  
The United States ◽  
Prior History ◽  
Care Providers ◽  
Dog Bite ◽  
Control Laws ◽  
Dog Bites ◽  
Pediatric Health Care ◽  
Order Of Magnitude

Objectives. To update data on fatal dog bites and see if past trends have continued. Design. To merge data from vital records, the Humane Society of the United States, and searches of electronic news files. Setting. United States. Subjects. U.S. residents dying in the U.S. from 1989 through 1994 from dog bites. Results. We identified 109 dog bite-related fatalities, of which 57% were less than 10 years of age. The death rate for neonates was two orders of magnitude higher than for adults and the rate for children one order of magnitude higher. Of classifiable deaths, 22% involved an unrestrained dog off the owner's property, 18% involved a restrained dog on the owner's property, and 59% involved an unrestrained dog on the owner's property. Eleven attacks involved a sleeping infant; 19 dogs involved in fatal attacks had a prior history of aggression; and 19 of 20 classifiable deaths involved an unneutered dog. Pit bulls, the most commonly reported breed, were involved in 24 deaths; the next most commonly reported breeds were rottweilers (16) and German shepherds (10). Conclusions. The dog bite problem should be reconceptualized as a largely preventable epidemic. Breedspecific approaches to the control of dog bites do not address the issue that many breeds are involved in the problem and that most of the factors contributing to dog bites are related to the level of responsibility exercised by dog owners. To prevent dog bite-related deaths and injuries, we recommend public education about responsible dog ownership and dog bite prevention, stronger animal control laws, better resources for enforcement of these laws, and better reporting of bites. Anticipatory guidance by pediatric health care providers should address dog bite prevention.

Health providers’ perspectives on medical marijuana use.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 235-235 ◽  
Author(s):  
Diana Martins-Welch ◽  
Christian Nouryan ◽  
Myriam Kline ◽  
Sony Modayil
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Side Effects ◽  
Health Care Providers ◽  
Prescription Drugs ◽  
Medical Marijuana ◽  
The United States ◽  
Care Providers ◽  
Opioid Use ◽  
Cord Injury

235 Background: According to the CDC, 117 million Americans have one or more chronic health conditions and 31% have used two or more prescription drugs in the past month. Approximately 40% of adults in the United States are using some form of Complementary and Alternative Medicine. Medical marijuana is one such medicine, and to date 29 states have legalized medical marijuana. Methods: A multicenter, anonymous, on-line survey of health care providers was distributed via e-mail within a large health system in the NY Metropolitan area. The survey was distributed in April and May of 2017. The specific aim was to collect information about health care providers’ perspectives on the use of MM in general and for specific medical conditions. Results: The sample (n = 137) consisted of 4% RNs, 10% NPs, 10% fellows, 21% resident physicians, and 52% attending physicians. Average experience was 13 years (range: 0-43), half (53%) were under 40 years old and just over half (56%) were female. Most practitioners recognized a benefit of MM for the treatment of cancer-associated symptoms, few were concerned with side effects and 5% of responders answered that MM was not appropriate at any stage of illness. Responders were “most likely to recommend or refer MM if other therapies were not effective” for cancer (83%), chronic pain (68%), spinal cord injury with spasticity (50%), MS (46%), epilepsy (42%), neuropathy (42%) and Parkinson’s disease (41%). Most providers (77%) believed that MM has the potential to reduce overall opioid use, this was found to be statistically more common in younger providers. The most common conditions that providers reported their patients were requesting MM for were cancer (37%), chronic pain (26%) and neuropathy (10%). The most common concerns about MM use were side effects (16%), addiction (13%), legal consequences (11%), cost (7%) and that other providers would judge MM use (7%). Conclusions: Our survey shows that providers are overwhelmingly in support of MM use in patients with chronic illness, particularly in cancer patients. However providers describe significant and practical concerns about MM utilization. Given the rate at which MM is being legalized throughout the country, it is imperative that there be increased focus on education and clinical studies on MM.

scholarly journals Mobile Phone Ownership, Health Apps, and Tablet Use in US Adults With a Self-Reported History of Hypertension: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Aisha T Langford ◽  
Craig A Solid ◽  
Ebony Scott ◽  
Meeki Lad ◽  
Eli Maayan ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Mobile Devices ◽  
Health Care Providers ◽  
Mobile Device ◽  
The United States ◽  
Medical Decision ◽  
Care Providers ◽  
Health Apps ◽  
Health Related ◽  
History Of

BACKGROUND Mobile phone and tablet ownership have increased in the United States over the last decade, contributing to the growing use of mobile health (mHealth) interventions to help patients manage chronic health conditions like diabetes. However, few studies have characterized mobile device ownership and the presence of health-related apps on mobile devices in people with a self-reported history of hypertension. OBJECTIVE This study aimed to describe the prevalence of smartphone, tablet, and basic mobile phone ownership and the presence of health apps by sociodemographic factors and self-reported hypertension status (ie, history) in a nationally representative sample of US adults, and to describe whether mobile devices are associated with health goal achievement, medical decision making, and patient-provider communication. METHODS Data from 3285 respondents from the 2017 Health Information National Trends Survey were analyzed. Participants were asked if they owned a smartphone, tablet, or basic mobile phone and if they had health apps on a smartphone or tablet. Participants were also asked if their smartphones or tablets helped them achieve a health-related goal like losing weight, make a decision about how to treat an illness, or talk with their health care providers. Chi-square analyses were conducted to test for differences in mobile device ownership, health app presence, and app helpfulness by patient characteristics. RESULTS Approximately 1460 (37.6% weighted prevalence) participants reported a history of hypertension. Tablet and smartphone ownership were lower in participants with a history of hypertension than in those without a history of hypertension (55% vs 66%, P=.001, and 86% vs 68%, P<.001, respectively). Participants with a history of hypertension were more likely to own a basic mobile phone only as compared to those without a history of hypertension (16% vs 9%, P<.001). Among those with a history of hypertension exclusively, basic mobile phone, smartphone, and tablet ownership were associated with age and education, but not race or sex. Older adults were more likely to report having a basic mobile phone only, whereas those with higher education were more likely to report owning a tablet or smartphone. Compared to those without a history of hypertension, participants with a history of hypertension were less likely to have health-related apps on their smartphones or tablets (45% vs 30%, P<.001) and report that mobile devices helped them achieve a health-related goal (72% vs 63%, P=.01). CONCLUSIONS Despite the increasing use of smartphones, tablets, and health-related apps, these tools are used less among people with a self-reported history of hypertension. To reach the widest cross-section of patients, a mix of novel mHealth interventions and traditional health communication strategies (eg, print, web based, and in person) are needed to support the diverse needs of people with a history of hypertension.

scholarly journals Evolution or Revolution in Telehealth Regulation

2021 ◽  
Vol 9 (4) ◽  
pp. 12-24
Author(s):  
George Horvath
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ad Hoc ◽  
Integrative Approach ◽  
Care Providers ◽  
Current Crisis ◽  
Wide Range ◽  
The Future ◽  
History Of ◽  
The Moment

A frequently repeated adage, attributed to a wide range of authors and orators, holds that a serious crisis should never be allowed to go to waste. The moment in which we find ourselves renders this adage particularly timely. Responses to one of the defining crises of our age—the COVID–19 pandemic—have mostly been reactive. This includes the responses of multiple actors involved with telehealth. Congress, federal regulators, state legislatures, state regulators, private insurers, and health care providers, confronting the challenges of the pandemic, have responded by making ad hoc adjustments to the regulation and use of telehealth. Moving the conversation beyond this reactive posture, Professor Deborah Farringer’s article, A Telehealth Explosion: Using Lessons from the Pandemic to Shape the Future of Telehealth Regulation, surveys the history of telehealth regulation, the pandemic-era adjustments, and recent proposals for the future finds an opportunity instead. The article seeks to put a crisis to good use—taking “advantage of the momentum that the COVID–19 public health emergency has created”—to inform the creation of “a comprehensive and integrative approach” to telehealth regulation. I find it possible to read A Telehealth Explosion in two ways: as an article with narrow aims and as an article with much broader aims. Parts I and II present these two readings. In Part III, I situate the broader reading within the context of earlier expansions of federal regulation of the health care enterprise to pose the question of how likely it is that the current crisis can be put to the good use that Professor Farringer seeks.

scholarly journals Post-COVID-19 Syndrome: Theoretical Basis, Identification, and Management

2021 ◽  
pp. e1-e8
Author(s):  
Kristine Anne Scordo ◽  
Misty M. Richmond ◽  
Nancy Munro
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Organ Damage ◽  
The United States ◽  
Care Providers ◽  
Short History ◽  
Comprehensive Plan ◽  
Care Workers ◽  
History Of

As COVID-19 continues to spread, with the United States surpassing 29 million cases, health care workers are beginning to see patients who have been infected with SARS-CoV-2 return seeking treatment for its longer-term physical and mental effects. The term long-haulers is used to identify patients who have not fully recovered from the illness after weeks or months. Although the acute symptoms of COVID-19 have been widely described, the longer-term effects are less well known because of the relatively short history of the pandemic. Symptoms may be due to persistent chronic inflammation (eg, fatigue), sequelae of organ damage (eg, pulmonary fibrosis, chronic kidney disease), and hospitalization and social isolation (eg, muscle wasting, malnutrition). Health care providers are instrumental in developing a comprehensive plan for identifying and managing post–COVID-19 complications. This article addresses the possible etiology of postviral syndromes and describes reported symptoms and suggested management of post-COVID syndrome.

scholarly journals Kwashiorkor in Upper Middle Class Suburbia in the United States (FS17-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Anupama Chawla ◽  
Denease Francis ◽  
Sherin Daniel ◽  
Michelle Tobin
Keyword(s):  
Health Care Providers ◽  
The United States ◽  
Food Allergies ◽  
Nutritional Deficiencies ◽  
Vitamin Supplementation ◽  
Severe Malnutrition ◽  
Care Providers ◽  
Caucasian Male ◽  
Vitamin Deficiencies ◽  
History Of

Abstract Objectives Malnutrition continues to be a major cause of death worldwide among children aged 5 years and under. We describe two patients who developed kwashiorkor while being predominantly fed rice milk. Methods An 11-month old Caucasian male presented with a 3-day history of worsening edema, decreased oral intake, diffuse maculopapular rash, and poor weight gain. He was diagnosed with dairy, soy, and sesame allergies by two allergists and was placed on rice milk. Labs revealed hypoalbuminemia, anemia, transaminitis, zinc and copper deficiency. He was started on Elecare Jr and vitamin supplementation with clinical improvement. A 2-year-old Caucasian male presented with a 7-day history of abdominal distension, abdominal pain, edema, and rash. He had multiple food allergies. His diet consisted of diluted almond and rice milk, chips, apples, and corn. He had hypoalbuminemia and anemia with multiple vitamin deficiencies. Results Kwashiorkor is characterized by severe malnutrition, hypoalbuminemia, edema, irritability, and rash. It is rare in the US but is being reported in patients receiving rice milk as their major source of nutrition. Previously described cases were due to dietary manipulations by the parents. Both our patients were under the guidance of physicians. Rice milk has been suggested as an alternative for patients with milk protein allergy however; not all products on the market have the same nutritional value, with significantly varied fortification. A recent study examined patients diagnosed with CMPA fed an extensively hydrolyzed rice protein-based formula called Novarice. This formula contains 21.9 calories and 0.6 grams of protein per ounce. Both our patients were ingesting Rice Dream which contains only 15 calories and 0.13 g of protein per ounce. Conclusions Infants who ingest rice milk are at high risk of developing severe malnutrition with hypoalbuminemia, edema, and nutritional deficiencies. It is important to educate not only consumers but health care providers on nutritional composition of these products. Translating an evidence-based study on the benefits of fortified rice milk into clinical practice needs to be performed cautiously since not all rice milk products are nutritionally alike. Funding Sources None. Supporting Tables, Images and/or GraphsTable 1

scholarly journals “SPORTS ARE FUN”: A Guide for the Discussion of Sport-Related Films

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986065
Author(s):  
Robert P. Olympia ◽  
Christy Lucas ◽  
Vignesh Doraiswamy ◽  
Cristina Funghi ◽  
Hannah M. Wakefield ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Health Care Providers ◽  
Sport Participation ◽  
Athletic Trainers ◽  
The United States ◽  
Care Providers ◽  
Athletic Coaches ◽  
Pediatric Health Care ◽  
Performance Enhancing Drugs ◽  
Education And Development

Sport participation is an important part of the development of children and adolescents in the United States. Due to the popularity of sport-related films, coaches, athletic trainers, and parents have used these films to both educate and motivate pediatric athletes. The objective of this study was to develop a discussion guide template based on common positive and negative themes depicted in sport-related films, and demonstrate the application of this discussion guide template to a select number of sport-related films released from 2014 to 2018. A discussion guide template (“SPORTS ARE FUN”) was developed by the co-investigators, reflecting common themes of “ Sportsmanship, Participation for All, Obstacles, Relationships, Teamwork, Setting Realistic Goals, Academics, Responsibility, Exercise/Nutrition/Rest/Drugs/Performance Enhancing Drugs, Fun, Unrelenting Spirit, and “ No Pain, No Gain.” The authors hope that pediatric health care providers, athletic coaches/staff, and parents can utilize this discussion guide template in the education and development of children and adolescents who participate in sports.

scholarly journals Addressing Decision Making in Progesterone Treatment for History of Preterm Delivery

2019 ◽  
Vol 09 (03) ◽  
pp. e244-e250 ◽  
Author(s):  
Jacqueline Zuponcic ◽  
Connie Cottrell ◽  
Justin Lavin ◽  
Wendy Facchini ◽  
Marissa Li
Keyword(s):  
Health Care ◽  
Preterm Birth ◽  
Health Care Providers ◽  
The United States ◽  
Phone Call ◽  
Premature Delivery ◽  
Care Providers ◽  
Patient Counseling ◽  
History Of

Introduction The United States ranks 27th among nations worldwide for infant mortality with a rate of 6.1 deaths per 1,000 live births. The majority of perinatal morbidity and mortality is related to preterm birth, defined as delivery prior to 37 weeks' gestation. Among the risk factors for preterm birth is prior preterm birth, which is associated with a 1.5- to 2.0-fold increase in risk. At the present time, there is only one Food and Drug Administration approved treatment for the prevention of preterm birth among women with a history of prior spontaneous premature delivery, intramuscular 17-α-hydroxyprogesterone caproate (17-OHP), administered once weekly from 20 to 36 weeks' gestation. However, many eligible pregnant patients decline this therapy. Methods This was a prospective, cohort study involving patients who were identified as candidates for 17-OHP treatment at their first obstetric visit and asked to complete a short survey regarding their history of preterm birth. Those patients who consented to a follow-up phone call were asked to participate in a focus group discussion regarding their experience with progesterone and the health care system. Results During the 1-year study period, 55 progesterone candidates were identified, 43 accepted treatment, 7 refused, and 5 either initiated prenatal care too late to receive injections or did not follow-up. Those who accepted treatment appeared to cope better with treatment side effects, and/or had traumatic emotional reactions regarding their prior premature birth outcomes. Women who declined treatment often cited pain with injection, had fatalistic beliefs regarding their care, and/or had personal concerns related to full-term pregnancy. Discussion Maternal health care providers should always discuss the implications of prematurity at the time of the index premature delivery and again at the first prenatal visit of the subsequent pregnancy. Providers need to be prepared to employ various techniques for patient counseling and education. Small changes in office practice, like having fewer care providers involved in patient care or providing distractions for children, may make the difference between a patient who is open or closed to treatment options.

scholarly journals Best Practices in Counseling Young Female Cancer Survivors on Reproductive Health

2017 ◽  
Vol 35 (04) ◽  
pp. 378-389 ◽  
Author(s):  
Ksenya Shliakhtsitsava ◽  
Deepika Suresh ◽  
Tracy Hadnott ◽  
H. Su
Keyword(s):  
Reproductive Health ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Chromosomal Abnormalities ◽  
The United States ◽  
Reproductive Age ◽  
Care Providers ◽  
History Of ◽  
Adverse Pregnancy ◽  
History Of Cancer

AbstractIn the United States, there are more than 400,000 girls and young women of reproductive-age with a history of cancer. Cancer treatments including surgery, chemotherapy, targeted therapy, and radiation can adversely impact their reproductive health. This review discusses infertility, contraception, and adverse pregnancy and child health outcomes in reproductive-aged cancer survivors, to increase awareness of these health risks for survivors and their health care providers. Infertility rates are modestly higher, while rates of using contraception and using highly effective contraceptive methods are lower in cancer survivors than in women without a history of cancer. During pregnancy, preterm births are also more common in survivors, resulting in more low-birth-weight offspring. Children of cancer survivors do not have more childhood cancers, birth defects, or chromosomal abnormalities than the general population, with the exception of families with hereditary cancer. Reproductive risks in survivors depend on cancer treatment exposures. For example, women with prior abdominal or pelvic radiation have additional risks of spontaneous abortions, small-for-gestational-age offspring and stillbirths, while those with prior chest radiation or anthracycline exposures have higher risks of cardiomyopathy. To help survivors achieve their reproductive goals safely, family planning and preconception counseling are central to survivorship care.

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