Implication statement: Overuse of healthcare resources is prevalent, including among medical trainees. As front-line clinicians and near-peers, residents are well-positioned to teach resource stewardship to medical students and address barriers students may face while trying to “choose wisely.” We describe the implementation of two resident-led, case-based teaching sessions for medical students that focus on resource stewardship. Similar teaching models can be adapted by residents at their own institutions to enhance resource stewardship proficiency amongst trainees.
Background International travel, including by children, is increasing. Due to both biologic and behavioral factors, children face different risks for and disease outcomes in travel acquired illness compared to adults. This systematic literature review aims to identify gaps in knowledge about health outcomes in children under the age of 5 related to international travel. Methods We used MEDLINE and Embase databases and followed PRISMA guidelines to conduct a systematic literature review of publications that included extractable information on children under the age of 5 who acquired infectious diseases or other morbidities during international travel. Studies were excluded if they were published prior to 1990, reported on fewer than 5 cases in children under the age of 5, or were letters to the editor. Two independent reviewers completed the abstract screen, full text review and data extraction. In this study, we present results for specific important tropical infections (including malaria and typhoid fever), as well as gastrointestinal, respiratory, and dermatologic illnesses Systematic Review Flow Diagram Results Our literature search (completed on July 17th 2019) identified 8664 citations. 35 citations met our inclusion criteria. Information related to tropical diseases, gastrointestinal, dermatological and respiratory conditions were extracted. Young children, especially those visiting friends and relatives in South Asia and Sub-Saharan Africa are at a higher risk for acquiring tropical infections. Additionally, children in this age group appear to have worse outcomes for conditions such as diarrhea and malaria in comparison to other pediatric age groups. Tropical Disease Outcomes part 1 Tropical Disease Outcomes part 2 Conclusion In spite of unique biologic and behavioral traits that may affect risk, outcomes in children under the age of 5 years are rarely presented in the literature distinctly from the overall pediatric population. Future pediatric travel-health research should make efforts to report and analyze data by age in order to better understand the risk for tropical diseases infants face while travelling internationally. Disclosures All Authors: No reported disclosures
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