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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Examining Audiometric Screening Outcomes in Non-Native English-Speaking Pediatric Patients.

Christopher P Kruglik1, John L Rustad1, Josephine Yalovitser1

  • 1University of Vermont, Larner College of Medicine, Burlington, USA.

Journal of Immigrant and Minority Health
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PubMed
Summary

Non-native English-speaking children showed lower adherence to pediatric hearing screenings at ages four and six. However, screening failure and referral rates were similar to native English-speaking peers, highlighting a need for improved access and standardized guidelines.

Keywords:
Health care outcome assessmentHearingImmigrantLimited english proficiencyPediatric otolaryngologyPediatricsPure-tone audiometry

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Area of Science:

  • Pediatric Audiology
  • Public Health
  • Healthcare Disparities

Background:

  • Early identification of hearing loss via pure-tone audiometry is vital for pediatric preventive care.
  • Non-native English-speaking (NNES) children face healthcare barriers limiting access to recommended screenings.
  • This study is the first to compare audiometric screening adherence and outcomes between NNES and native English-speaking (NES) children.

Purpose of the Study:

  • To investigate differences in audiometric screening adherence and outcomes between NNES and NES children.
  • To identify potential disparities in accessing crucial hearing health services.
  • To inform strategies for improving pediatric hearing screening equity.

Main Methods:

  • Retrospective cohort analysis of 176 pediatric patients (88 NNES, 88 NES).
  • Data collected from well-child checks (WCC) at ages 4, 5, 6, and 8.
  • Statistical comparison of audiometric screening adherence and outcomes between NNES and NES groups.

Main Results:

  • NNES children exhibited lower audiometric screening rates at the 4-year (p=0.04) and 6-year (p=0.04) WCCs.
  • No significant disparities were observed in screening failure rates between the groups.
  • Referral rates to audiologists or pediatric otolaryngologists did not differ between NNES and NES children.

Conclusions:

  • NNES children demonstrate lower adherence to recommended pediatric hearing screenings, indicating a need for targeted interventions.
  • Similar screening failure and referral rates suggest that access to follow-up care may be equitable once screened.
  • Implementing cultural competency training and standardized screening guidelines is crucial to reduce provider bias and improve equitable access to pediatric hearing health services.