Pediatricians' knowledge and practices regarding parental use of alcohol

Article Abstract:

Alcoholism is a common problem in the United States that is often ignored by physicians, particularly those caring for children. The knowledge and practices of pediatricians concerning alcohol consumption by parents were assessed and compared with the knowledge and practices of family practitioners. Of 190 child health care providers who responded to a survey, 90 were pediatricians and 39 were family practitioners. Forty-six percent of pediatricians and 90 percent of family practitioners reported that they routinely asked about problems with alcohol when they took a family history. Thirty-eight percent of pediatricians who knew the actual frequency of alcoholism, and 47 percent of pediatricians who did not, included questions concerning problems with alcohol in taking a routine family history. Forty-six percent of pediatricians with alcoholism in their own family, but only 20 percent of pediatricians without a family history of alcohol problems, routinely discussed alcohol use with parents and children. When similar comparisons concerning knowledge of the frequency of alcoholism or personal experience were made among family practitioners, no differences with regard to discussion of alcohol use with patients were observed. These findings show that fewer than half of pediatricians include problems of alcohol use in taking a routine family history. The physician's own family history with alcohol problems, rather than a knowledge of alcoholism, influenced the likelihood that questions about alcohol problems would be included in the routine family history. Alcoholism in a parent causes adverse effects on the children, but interventions such as counseling and support groups can improve the function and adaptation of a child exposed to parental alcoholism. Hence, training and Continuing Medical Education courses are needed to improve pediatricians' knowledge and practices concerning parental use of alcohol. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Services, Surveys, Alcoholism, Family, Children of alcoholics

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Resident training in community pediatricians' offices: not a financial drain

Article Abstract:

Prior to the 20th century, medical training consisted of apprenticeships; it is only in this century that the emphasis has shifted to the training of groups within hospitals. This shift has reduced the amount of training received in treating the less sick patient, one who does not require hospitalization. With the change in patterns of hospital admission, characterized by limiting hospitalization to only the sickest patients and reducing time spent in the hospital, there has been increased interest in teaching clinical medicine in an ambulatory setting. Pediatric residents receive training in ambulatory medicine and continuous care of a set group of patients during outpatient clinic rotations. A study was undertaken to evaluate the economic impact of a program in which the community pediatrician's practices served as the place where residents received their training in ambulatory patient care. It was found that the presence of the resident did not adversely affect the number of patients seen or patient billings by pediatrician preceptors. This was true despite the fact that the preceptors provided significantly more supervision to the residents than residents receive in a hospital-based setting. The residents actually billed substantial revenues for the pediatricians. These billings, however, did not produce enough income to support their stipends, and so outside funding for ambulatory training is necessary. It is concluded that this approach to residency training is an economic possibility, if the resident's stipend is not dependent on the income generated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Residents (Medicine), Graduate medical education

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Clinic-based intervention to promote literacy: a pilot study

Article Abstract:

The inability to read is more common among children from socially disadvantaged homes and contributes to the cycle of poverty. Pediatricians have the opportunity to intervene and promote literacy, or reading. Studies show that early exposure of children to books influences the child's capacity to acquire reading skills. The practice of parents reading to young children teaches a child that the printed word conveys information and motivates the child to learn how to read. Reading also familiarizes the child with the question-and-answer format. In addition, parents tend to be more responsive to a child's comments while reading together than during playtime. A program was developed at the Pediatric Primary Care Clinic at Boston City Hospital to promote reading skills through parent-child book sharing. The parental response to this literacy program was assessed. The program consisted of placing readers in the waiting room, providing guidance about literacy development, and giving children's books at each visit to the pediatrician. The study involved 79 parents of children aged 6 months to 5 years of age. Parents who were given a book read to their children more often and had a more favorable perception of parent-child book sharing, compared with parents who were not given a book. These findings show that the pediatrician can play an important role in promoting literacy in children, particularly those from socially disadvantaged backgrounds. (Consumer Summary produced by Reliance Medical Information, Inc.)

Telecommunications systems, Study and teaching, Parent and child, Parent-child relations, Reading, Literacy programs

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