Category: Pediatrician

Many people dream of making a difference in the world by either being a doctor or being a police officer. Not all pathways to making a difference are easy, for example studying to become a Pediatrician is very difficult. It’s a very high skilled job that may not be for all people. A pediatrician specializes in caring for babies up until they are young adults. They also get paid a very high pay, which can be very beneficial. Although the education is more challenging and sometimes can take more time to finish.

As a pediatrician you specialize in caring for babies, they usually take care of your child’s physical, behavior and as well as their mental health issues. Pediatrician can also oversee vaccinations, diagnose and treat the child’s injuries, nutrition information, their development and any other care. In the article “What Is a Pediatrician?” it states that a pediatrician usually they would have to be graduated from medical school and completed a 3-year residency program in pediatrics and complete phycology, medical sciences, neuroanatomy and many others more. When thinking of becoming a pediatrician undergrad student must place high on their academic standing, because medical school is very hard to get into and most of the time, they only accept top students.

Salary is a very important in a job, it’s what a person is going to be living off. A pediatrician is one of the jobs in the medical field that gets the highest pay “The U.S. Bureau of Labor Statistics reports the average salary of a pediatrician at $184,240 annually (Pediatrician Career). The range can go from 180,000 up to 270,000. The working condition of a pediatrician is very hectic, they work up to 9 to 12 hours a day, or 45 to 60 hours a week. They sometimes can have irregular schedules and they even must work on weekends whenever it’s necessary. Pediatricians don’t’ only work in medical office setting but they can also work in many places like schools, hospitals, or urgent care settings.

There are many other jobs in the medical field that are like a pediatrician. There is Registered nurses, nurse midwives, nurse practitioner and many other more similar occupations. These all have to do with babies and up to young adults, and just adults. These jobs are challenging in the education because they still specialize in babies and kids and people’s overall health. These jobs are also the tops of the most paid jobs in the medical field, which is good if people want o earn good income but don’t want to spend more time than needed on education.

This is a great for me because I’ve always liked the medical field, especially working with babies and kids, I knew that it was my passion since I was in Elementary school. A pediatrician is a very motivated person, since they put all their time, effort and soul to their career. Later, in life their hard work pays off, I want that kind of motivation in my life to know that I can be able to finish college and pursue my dreams.

Overall, being a pediatrician is very beneficial if you know you can give your full time and effort on the education. It may come with challenges, but If you decide to become a pediatrician you will have to put in as much effort and have a lot of motivation because it can be very intensive. At the end of the journey you will see that the hard work you put in paid off, and it will be rewarding and fulfilling.

Choosing a career for a lifetime is one of the most difficult decisions in life. The career paths that an individual chooses can turn into a success or a failure. Therefore it is really important to think about what the goals to achieve and why. But sometimes life happens and things do not go as planned, therefore we have to take a leap of faith and risks. In the past, I have considered many career paths such as social worker, pediatrician, school counselor, child psychologist, and nutritionist. Every career that I was leaning towards to involved children. Working with children offers opportunities to help them advance, develop, and learn, which are the things I love doing.

I love working with children and the path that stood out to me the most is being a pediatrician. I first started working with children in my sophomore year in High School in 2011 when my then neighbor asked me to watch her child for her and that she would pay me. Since then, my passion grew and I have worked with children for almost 8 years. I babysat, worked in a pre-K as an assistant, and currently working as a nanny. I’m interested in childhood development, their behaviors, and their characteristics, and mostly how to treat them. I am also interested in the medical field, with my love for chemistry and biology, which goes more in-depth into their health, treatment, and recovery.

After completing the career module, I found out a lot about myself. As of now, the career path that I want is to be in the medical field. Based on my results on the interest profiler, pediatrician was listed as a career. My scores were as such; 33 for investigative, 14 for social, 11 for enterprising, 11 for conventional, 11 for artistic and 2 for realistic. My score for investigative is really high compared to the others which are not surprising to me because I like to ask questions, investigate, and challenge myself.

I found out that I also like to find solutions to difficult problems. For social, my score might depict my love for interacting with children, learning about them, as well as helping them. I am currently a child care provider/nanny, therefore social fits right in. For me, conventional equals perfection, as I am a perfectionist, because I like to pay attention to details and follow clear set procedures, routines, and rules. For artistic, I am creative, like to draw, and used to play the violin, so that can explain my score.

There are also two more tests that I took based on personalities. The first one is the Human Metrics Jung Typology Test. I found out that my type is ENFJ, which stands for Extraverted, iNtuitive, Feeling, and Judging. I am 16 percent extravert, 50 percent intuitive, 41 percent feeling, and 25 percent judging. What really amazed me was that the results of the previous test matches with the results of the second personality test, which is called 16 personalities, created by Katherine Briggs and Isabel Myers. My type is also ENFJ-A, and A stands for Assertive. This means that I am self-assured, even-tempered, and resistant to stress. Mind:61 percent extravert, energy: 62 percent intuitive, nature: 29 percent thinking, tactics: 67 percent judging, and identity: 53 percent assertive. Therefore that goes to show that my decisions are firmly decided and that I am one of the benevolent pedagogues of humanity.

The primary responsibilities of pediatricians are to examine children regularly, treat their minor illnesses, acute and chronic health problems, and make sure that they are growing and developing. Pediatricians provide health care for children from birth until they are teenagers. Pediatricians mend children’s broken bones, treat asthma, administer vaccinations, treat chickenpox and take countless calls from in the middle of the night from distraught parents who are worried about their children’s health.

The journey to become a pediatrician takes at least nine years to complete. A bachelor’s degree is required followed by a medical degree and then completion of a residency program. During summer after junior of college, a student must take the MCAT if she or he is not taking year. If the student is not a gap year, then the MCAT should be taken during late spring or early summer of senior year of college. MCAT stands for Medical College Admission Test, which confirms the mastery of the knowledge acquired from the required prerequisite courses taken during bachelor. As for choosing a major, a student does not have to major in biology or chemistry. In the article “Premed 101: How to Get Into Medical School” Medical School headquarters website states that a student can major in any subject and still get into medical school. He points out that only 63% of students accepted to medical school majored in the physical and biological sciences in college. Therefore a student can choose the thing the enjoy doing the most and take the required medical courses at the same time.

After completing the residency program, a license must be obtain from the state in which an individual plan to practice medicine. In order to obtain the license, a medical student graduate must pass the National Medical Licensing Examination(NMLE). In the article “Obtaining a Medical License” AMA website(1995-2019) states that The process of obtaining a medical license can be challenging and time consuming. It also states that physicians seeking initial licensure or applying for a medical license in another state experience delays due to the investigation of credentials and past practice as well as the need to comply with licensing standards. The skills required are listening, not interrupting, asking questions, problem solving, and being good with people and technology.

After accepting a position as a general pediatrician, there are a lot of things to consider such as working conditions, work schedule, salary and benefits, training availability, and opportunity for advancement. Pediatricians have a lot on their plate, hence they need to be organized. The work conditions can be really stressful which can lead to anxiety, fear, and exhaustion, and sometimes guilt.

There are a lot of issues that may surface for a student in a path of becoming a doctor and also when that student becomes one.

Pediatricians are physicians trained to care for the medical and health needs of patients below the age of 21. They are also responsible for handling uneasy toddlers and making them feel safe and secure. They also answer calls from parents worried about feverish children at odd times.

Pediatricians are equipped with the knowledge and skill to treat, diagnose and prevent common, and uncommon, diseases and conditions affecting the society’s younger generation. On an average, they go through 13 years of training and education to become one.

What is a Pediatrician?

A pediatrician is a specialist in giving younger patients (from birth to adulthood) medical care. This can be all the way until they are 21 years old or at the very least up to their late teens.

It is the duty of all pediatricians to diagnose & treat ailments generally affecting infants, babies, children, adolescents and young adults. They also assist younger patients in maintaining good health and diet patterns.

Pediatricians are often primarily trained to:

• Diagnose & treat illnesses associate typically with children.
• Addressing special medical needs of younger patients, like genetic defects, malignancies, childhood infections and injury.
• Assessing proper treatment approaches catering to the patient’s specific age.
• Performing annual check-ups, routine examinations and immunizations.
• Determining whether a child is experiencing normal growth & development (or not).
• Ordering needed tests, prescribing appropriate medications and performing medical procedures.
• Providing medical care for children who are acutely or chronically ill.
• Working towards reducing infant & child mortality.

A child’s physical well-being is a critical part of a pediatrician’s job. Preventive health maintenance, counseling provided to children and patients may pertain to various issues (diet, exercise, hygiene and the like).

Pediatricians are also involved with early detection and management of health issues (and other ones) affecting the development, growth, safety and health of children. Among the issues detected are difficulties in behavior. Social issues, development issues, basic function difficulties, depression and anxiety disorders are among the issues diagnosed.

In short, pediatrics is a specialty of medicine that is chiefly concerned with the physical, emotional and social health of children. A top-notch Caribbean school of medicine also offers studies in pediatric sciences and pediatric medicine.

There are also many sub-specialties a pediatrician can choose to pursue in order to provide care to patients with more specific conditions. For instance:

• Pediatric allergists treat and oversee children having issues in their immune systems such as allergies, asthma, eczema and the like.
• Pediatric anesthesiologists assist in managing infants and children undergoing surgical procedures.
• Pediatric development specialists treat infants and children with medical issues that affect their development, like muscular dystrophy, physical deformities, ADHD and the like.
• Pediatric cardiologists are trained to perform echocardiograms on children having heart and coronary issues.
• Pediatric dermatologists specialize in treating skin issues in children.
• Pediatric urologists perform genital and urinary tract surgeries on infants and children.

A pediatrician’s educational track

How to become a pediatrician is a question a medicine enthusiast asks when they think of studying to become one. The following points can help explain the process of becoming a pediatrician:

Earning a bachelor’s degree in related disciplines

At least 3 years of studies at a college or university in a biological sciences degree, or a pre-med complete are needed to gain admission in a medical school for pediatric studies. Most medical students at that time earn an undergraduate or an advanced degree by the time they enter medical school.

Other students satisfy such prerequisites by studying math & science courses in physics, biology, inorganic and organic chemistry.

Students with a clear goal of becoming a pediatrician upon starting an undergraduate program can choose to major in child psychology or another discipline in close relation to pediatrics.

Applying to medical school for pediatric studies

Earning a Doctor of Medicine (M.D) degree or Doctor of Osteopathy (O.D) degree is a prime need if medical students wish to become a pediatrician. Often medical schools’ applicants need to submit their pre-med and MCAT scores in order to enter medical school.

The MCAT (Medical College Admissions Test) is a standardized examination that measures a student’s knowledge and understanding of physical & biological sciences. Students usually take this exam during his or her third year of undergraduate studies.

Completing a medical school program

Medical school usually takes 4 years to complete. Coursework during the first 2 years consists of training relating to anatomy, biochemistry, physiology, pharmacology, and medical ethics. The remaining two years of training are spent learning how to care for patients in practical medical settings under the guidance and supervision of experienced physicians.

Job analysis attempts to develop a theory of human behavior about the job in question. According to the text book work in the 21st century, this theory includes performance expectations as well as the experience and KSAOs necessary to meet those expectations. (Conte, J.M $ Landy, F.J, 2016 p 182). In this essay I am going to talk about the job analysis of a pediatrician. According to O’net online, the description of a pediatrician is a Physicians who diagnose, treat, and help prevent children’s diseases and injuries. Pediatrician’s job task include; examining children regularly to assess their growth and development, to Treat children who have minor illnesses, acute chronic health problems, growth and development concerns, Collect, record, and maintain patient information, such as medical history, reports, or examination results, Prescribe or administer treatment, therapy, medication, vaccination, and other specialized medical care to treat or prevent illness, disease, or injury in infants and children, Examine patients or order, perform, and interpret diagnostic tests to obtain information on medical condition and determine diagnosis, Advise patients, parents or guardians, and community members concerning diet, activity, hygiene, and disease prevention., Explain procedures and discuss test results or prescribed treatments with patients and parents or guardians, Monitor patients’ conditions and progress and reevaluate treatments as necessary and so on.(o*net online, 2018). Pediatricians need to be able to use medical equipment with ease and comfort, including anything from medical software – Advanced Data Systems MedicsDocAssistant for Pediatrics; EMR Experts Pediatric EMR; Patient electronic medical record EMR software; StatCoder.com STAT E&M Coder, Electronic mail software which is email software, Data base user interface and query software -Microsoft Access, to Information retrieval or search software -Drug reference software; Medical information databases. (O*net online, 2018).

A serious medical career like that of a pediatrician demands sizable data within the physical and mental understanding of the duty. Pediatricians ought to be aware of courses like biology which is about data of plant and animal organisms, their tissues, cells, functions, interdependencies, and interactions with one another and the atmosphere, psychology, arithmetic, and chemistry to perform their job duties. This occupation conjointly needs an exact level of information in coaching others (for educating workers members on procedural guidelines), direction (for if facilitate and steerage with sure mental issues), client service (for making certain that their patients continuously leave feeling comfortable and confident), and communication skills (for ensuring that patients perceive everything that’s happening). Lastly, pediatricians World Health Organization manages their own practices that might also be a foundation in business, accounting, advertising, and different skills that may keep patients coming back and recommending their services to others. Like any health profession, the sensitivity and depth of information necessary for this occupation sometimes comes with a scholarly person or skilled degree, so this occupation requires, graduate school, a master’s degree or Ph.D. Their average salary of 2017 was $83.00 hourly, $172,650 annual according to o*net online.

The description of individual differences or attributes needed for the job are ability, personality traits values and experience. Individual differences are also known as KSAO and it can be defined as Individual attributes of knowledge, skills, abilities, and other characteristics that are required to successfully perform job tasks. (Conte, J.M $ Landy, F.J, 2016 p 180). But I will talk about ability, values, performance and personality traits. Several domains for ability is Cognitive ability. “Cognitive ability is abilities that influence the acquisition and application of knowledge in problem solving. Some examples are category flexibility which is the ability to generate or use different sets of rules for combining or grouping things in different ways, oral expression which is the ability to communicate information and ideas in speaking so others will understand, originality is the ability to come up with unusual or clever ideas about a given topic or situation, or to develop creative ways to solve a problem, memorization is the ability to remember information such as words, numbers, pictures, and procedures, selective attention which is the ability to concentrate on a task over a period of time without being distracted”. (O*net online, 2018).

Individual differences contribute collectively to performance (Motowidlo & Schmitt, 1999). Traditionally ability has been an important factor in performance. Changing structure environments won’t solely sustain however it will additionally increase the importance of ability as organizational necessities still use it. Additionally personality has been a very important focus of individual variations that may become additional important within the future as organizations focus more on the discourse of performance. Together personality and ability and applicable knowledge and skills become the critical individual differences that need to be measured in the rapidly evolving organizational environments (Motowidlo, Borman & Schmitt, 1997; Motowidlo & Schmitt, 1999). Another individual differences is work value, According to o*net online, the three work values are achievements, recognition, and relationships. Achievement in the sense that jobs that fulfil this value are outcomes position and it enables members of staff to utilize their most grounded capacity giving them a sentiment of achievement, loyalty and ability. Recognition is Occupations that satisfy this work value offer advancement, potential for leadership, and are often considered prestigious. Corresponding needs are Advancement, Authority, Recognition and Social Status. Relationships is Occupations that satisfy this work value allow employees to provide service to others and work with co-workers in a friendly non-competitive environment. Corresponding needs are Co-workers, Moral Values and Social Service. (O*net online, 2018).

And lastly personality traits, in 2016 a group of medical doctors presented a research at the Pediatric Academic Societies Annual Meeting. The background of their meeting was to show that research has shown a link between physician personality and important outcomes including satisfaction and well-being. And their objective was to Compare personality traits of early career pediatricians to normative data, and examine the relationship between personality dimensions and career satisfaction and burnout. (Schott, et al., 2016). The methods the used were drawn from ten item personality inventory (TIPI) which pediatricians completed, the TIPI according to aap.org is a brief measure of the Big Five personality dimensions: Openness, Conscientiousness, Extraversion, Agreeableness, and Emotional Stability. The results and conclusion of this research were compared to TIPI norms, pediatricians scored higher on Conscientiousness, Agreeableness and Emotional Stability, and lower on Openness and Extraversion for all. According to American Academy of Pediatrics, early career pediatricians have unique personality traits, including high Conscientiousness, Agreeableness and Emotional Stability. The personality dimension of Emotional Stability was positively related to pediatrician career satisfaction and negatively related to burnout. (Schott, et al., 2016).

References

1. Motowidlo, S., & Schmitt, M. (1999). Performance assessment in unique jobs. In D. Ilgen & E. Pulakos (Eds.), The changing nature of performance (pp. 56-86). San Francisco, CA: Jossey-Bass (1999).
2. Motowidlo, S. J., Borman, W. C. & Schmitt, M. J. (1997). A theory of individual differences in Task and contextual performance. Human Performance, 10 (2), pp. 71-83.
3. Conte, J. M., & Landy, F. J. (2018). Work in the 21st century: An introduction to industrial and organizational psychology. Hoboken: Wiley. 29-1065.00 – Pediatricians, General. (2018). Retrievedfrom https://www.onetonline.org/link/summary/29-1065.00#Tasks
4. Schott, E., Frintner, M., Katakam, S. and Leslie, L. (2016). Relationship of the Personality Traits of Early Career Pediatricians and Career Satisfaction and Burnout. [Online] Aap.org. Available at: https://www.aap.org/en-us/professional-resources/Research/research-findings/Pages/Relationship-of-the-Personality-Traits-of-Early-Career-Pediatricians-and-Career-Satisfaction.aspx.

Pediatricians are highly experienced doctors who manage the health and well being of all individuals aged 21 years old or younger. They are trained to diagnose and treat infant illnesses, from minor to severe sickness. Pediatricians are an important asset to children’s overall health as they grow and develop. They motivate children to live long and healthy lives while improving illnesses that develop in the early years. To become a pediatrician, each pediatric field has a distinct routine, study requirements, and proper training before taking care of young people before becoming certified.

Students with intense fervor to take care of sick children often find a medical career path in pediatrics. Many pediatric subspecialties include adolescent medicine, oncology, surgeon, pulmonology, etc. Adolescent medicine pediatricians are the most fundamental compared to all the other pediatric subspecialties. The shift from childhood to young adult can be challenging, especially mentally and physically. According to Kyleigh Rossner, ´´That’s why adolescent medicine specialists train to address the range of issues particular to growing patients with rapidly changing bodies, usually those in the 12-25 age range. These physicians frequently deal with concerns related to sexual health, eating disorders, sports medicine, chronic fatigue, and more´´(Source 1). Oncology/hematology pediatricians, on the other hand, treat and diagnose patients who have developed cancer. Their job revolves around comforting the child and their family members through treatment. Kyleigh Rossner stated,´´ According to the American Cancer Society, more than 80% of child cancer patients survive for five or more years. The work of pediatric hematologists/oncologists plays a critical role in this inspiring statistic. Responsible for diagnosing and treating childhood cancer, pediatric hematologists/oncologists save and improve the lives of their patients´´(Source 1). Each pediatric subspecialties plays a critical role in improving childrenś physical and mental health and motivating them to live a healthy life.

Another key point is that pediatricians have distant roles including diagnosing, treating chronic illness, and screening with the sole purpose to care for his/her patients. They can improve multiple health concerns that develop in young adults that may even save their life. Yolanda Smith explained,´´ Pediatricians have specific knowledge about the health and medical care of young people. As the bodies of children grow and develop into adulthood, they have certain needs, which are distinct from the needs of adults. For this reason, a pediatrician has a valuable role in the medical care team to advocate for the best health decisions for all children´´(Source 2). A pediatrician’s role is crucial, and that is why school and training are involved to expand a pediatrician’s knowledge before becoming certified. Schooling and training may vary based on the pediatrician´s interest in the pediatric field. The average years of studying to become a pediatrician are eleven years. A pediatrician needs four years of college, four years of medical school, and 3-7 years of residency. The author said,´´ Pediatricians need at least 12,000 to 14,000 patient care hours during training´´(Source 3). Once pediatricians complete their schooling/training, the American Board of Pediatrics is in charge of certifying pediatricians. The certification process involves an exam on pediatrics. To maintain certification, pediatricians have to retake the exam every seven years, depending on the country. Pediatricians have a vital role in society that’s why school/training is an important asset to improve children’s needs.

College/ university is an enmours step when one is planning to become a pediatrician. Pediatricians have to consider the classes that he/she has to take and what major they would like to graduate. The most common pediatrician majors are biochemistry, chemistry, molecular biology, nutrition sciences, pre medicine, and psychology. Clases may differ depending on the pediatric field, but all pediatricians have to take biology, chemistry, and physics. School is a huge challenge pediatricians face to inorder to accomplish their goals. When it comes to school and future college options, I have very high expectations for myself. I aim for the stars and I am trying my absolute best to get accepted into Johns Hopkins University or University of California. The best college/universities for pediatricians include Harvard University, Johns Hopkins University, University of California–San Francisco, University of Cincinnati, Baylor College of Medicine, and University of Washington. Each of these schools have amazing pediatric programs and very high graduation rates. Johns Hopkins University has a children center clinic that treats children regardless of their financial status. Different departments are depending on a teenager´s necessities. Clinical expertise incorporates sexual disease prevention, breastfeeding counseling, injury prevention, obesity prevention, and so much more. University of California on the other hand, is ranked one of the top five schools for pediatricians. They have been classified as top four for training/ education, six for research, and second for patient care. Pediatric care is also available at UCSF Benioff Children’s Hospital and pediatricians can treat patients in the hospital or out post areas. Johns Hopkins University and University of California (San Francisco) have excellent medical programs for pediatricians, but their acceptance is less than 15% compared to other schools. Pediatricians have to be devoted to accomplish their dreams no matter how rocky the journey may be.

In addition, daily tasks may differ depending on the pediatric subspecialties, but that desire to care for children has its highs and lows. Caroline Barangan, MD, a 12-year veteran of adolescent medicine stated,´´ I get to my office around 8:30 a.m. I do paperwork and return emails and phone calls until the clinic starts at 8:45 a.m. If I’m scheduled to work with medical students, residents, and fellows, I see patients with them, supervise their decision-making, and provide in-the-moment teaching´´(Source 4). Caroline´s day revolves around children and medical students expanding their knowledge about health concerns that may arise. Unfortunately, Caroline mentions that most of the children she cares for are low-income families who don’t earn enough money to make the best decisions for themselves. That’s why most pediatric offices accept insurance that includes Anthem Blue Cross, Blue Shield, Aetna, Cign a, Colorado Access (CHP), Colorado Medicaid, Coventry/First Health, etc to provide opportunities for families to look out for themselves and their loved ones. Dr. Lloyd, a pediatrician at UCLA, faces the same experiences of Dr. Barangan. Dr. Lloyd explains,´´ But being a pediatrician isn’t always fun. Pediatricians face unique challenges, the most difficult of which are seeing children suffer and losing patients. ‘Seeing families go through so much pain is devastating and I still struggle to make sense of things. You can’t explain why illness happens to children. It’s unfair, but I have to process that and still have a good attitude at work´´ (Source 5). Overall Dr. Lloyd and Dr. Barangan love their job and develop a strong bond with their patients, which makes them forget about all the challenges. In my opinion, pediatricians are so much more than doctors, but companions who seek the wellbeing of others. Pediatricians often put their morals and desires aside to provide patients with the best care possible. My dream job is to become an Adolescent Medicine pediatrician, but I know that with my dream comes along challenges and long years of studying. I enjoy treating and caring for people, especially children. Whenever someone in my family is very sick, I am always by their side and looking for ways to improve their health. I have noticed that I am drawn to articles about medicine or discoveries made by doctors, that’s why becoming a pediatrician will be the best career path for me. A pediatrician´s day sounds exciting and exhausting at the same time. They have little to no breaks and their lunch varies depending on how many patients they have to attend.

Pediatricians have a unique role in society, the work ethic that’s deep inside their hearts drives them to do what they love daily. The long years of studying and the certification process has allowed pediatricians to expand their thinking, providing patients with proper care. Becoming a pediatrician has its highs and lows but at the end of the day, it’s the smiles on children’s faces that matter.

The research methodology was based on obtaining information from Hospital Infantil Robert Reid Cabral, as well as reliable sources that were found on the web, most of them from data bases. Much of the epidemiology found in this research was based on both the information found field on HIRRC, along with other researches that included medical examinations and studies. Information has been obtained from the years 2006 up to 2019, in able to obtain a wider spectrum of the conditions of respiratory diseases in the Dominican Republic, in order to make data more reliable. The data collection comes from these obtained sources.

A ground researcher was able to visit Hospital Infantil Robert Reid Cabral and spoke to four doctors, three from the pulmonology department and one doctor in the emergency room in order to analyze the prevalence of respiratory diseases in the Dominican Republic. According to these doctors, more than 60 percent of pediatric patients that arrive to the emergency room present a respiratory condition, as a primary or secondary cause. This data alone shows that respiratory diseases are among the most common in the Dominican Republic’s population. Still according to HIRRC, asthma is the most common cause of hospitalizations in the pulmonology department. It accounts for about 70 to 80 percent. However, recently, they have only obtained few cases of asthma because there are other conditions that have been more prevalent because of the time of years. Asthma is more likely to occur in boys than in girls, only until they get to puberty. In the puberty years, the ratio of males to females with asthma levels. Recently, because it is winter, over 60% of hospitalizations in pneumology were due to bronchiolitis. Winter means more viral infections. Later on in this research, the most common causes of bronchiolitis will be studied. Children that develop bronchiolitis are more likely to develop asthma later on in life according to the experience of these doctors that have seen patients from their early years. Also, young children are more likely to develop this condition. Not seen as often in older children and young adults. This is because older children have most likely been exposed to the virus and so are less likely to incubate the disease. Other common causes of emergencies and hospitalizations due to respiratory conditions are pneumonia and atypical respiratory diseases, among others. ​These are the prevalence of respiratory diseases according to HIRRC in the last few months. According to an article from el dia from 2009, there were around 300 daily cases arriving at HIRRC due to respiratory diseases (El Dia, 2009).

According to an article by Paniagua published by CDN in 2016, between 40 and 60 percent of all emergencies admitted in Hospital Materno infantil San Lorenzo de los Mina and in Maternidad Infantil de Boca Chica are due to pediatric respiratory diseases (Paniagua, 2016). Also the following information comes from a study made by the Department of Pediatrics, Robert Reid Cabral Children’s Hospital Affiliated to the University Iberoamericana Unibe School of Medicine and by the Department of Pediatrics, Shanghai Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China. This cross sectional study was done on 600 children 3 to 11 years old were they aimed to study the prevalence of asthma and its risk factors in the Dominican Republic. (Mejias & Ramphul, 2018). According to their findings 22% (132 children) of children studied (300 children 3-11 y/o) were diagnosed with asthma (Mejias & Ramphul, 2018). Other important findings were:

According to age

• 14 aged between 3-5 years (9.3%)
• 33 aged between 5-7 years (22.0%)
• 43 aged between 7-9 years (28.6%)
• 42 aged between 9-11 years (28.0%)

According to gender

• 59 males (19.7%)
• 73 females (24.3%)

Family history

• 30 had a family history of asthma •
• 43 had a family history of allergy child number
• 42 were first-born children
• 68 were second-born
• 22 were the third or higher child in the family

Environmental exposures

• 48 of the asthmatics also had at least one pet at home
• 44 children with asthma were exposed to gas as a fuel source at home
• 88 had an electric source in the kitchen for cooking
• 60 exposed to tobacco smoke

Prevalence of conditions ​

• 98 children (74.2%) had 1-3 episodes of wheezing /12 months ​ ​
• 34 (25.8%) had more than three/ 12​ Months​ ​
• 103 children (78.0%) suffered from rhinitis​ ​
• 93 (70.5%) were diagnosed with atopic rashes/ 12 months

This study confirms that asthma is the most prevalent case of respiratory diseases in the Dominican Republic.

A research also by Hospital Infantil Robert Reid Cabral, aimed to investigate the most common cause of bronchiolitis in the Dominican Republic. A total of 114 children from 0-24 months of age were admitted with diagnosis of bronchiolitis & acute respiratory infection. According to this study, the main cause of bronchiolitis was the Respiratory syncytial virus (RSV) with 48 percent of all the cases (54 children). Other significant information is that in most cases, 62 percent of the 54 cases, the affected individuals were males. 76 percent of the children affected were younger than 4 months old, confirming the information obtained by the field researchers at HIRRC. All 54 cases were affected between the months October to January also confirming that in winter, children are more likely to develop bronchiolitis. Their sign and symptoms were that 52 showed cough and respiratory distress, 46 showed wheezing, and 41 showed subcostal retraction. (Gómez-Alba, Feris-Iglesias, Florén, Sánchez, Fernández, 2006)

According to Feris-Iglesias, Fernández, Sánchez, et al.2014 the following are the main causes of Pneumococcal Pneumonia in the Dominican Republic (Pneumonia with effusion): (Feris-Iglesias, Fernández, Sánchez, et al.2014).

• Staphylococcus pneumoniae detected in 62 (51.2%) cases​
• Staphylococcus aureus detected in (15.7%)
• Streptococcus pyogenes (1.7%)​
• Streptococcus mitis (0.8%)​
• Candida spp. (0.8%)​
• No aetiology determined (29.8%)

This research was also done in HIRRC. Researchers studied every case of pneumonia from the years 2009 to 2011. All children less than 15 years old that had the need of a thoracocentesis were studied in order to analyze the cause of their pneumonia. A total of 121 patients were studied.

Viral outbreaks and contagious bacterial infections are also very common causes of respiratory diseases in the Dominican Republic. Children are more vulnerable since they have not yet developed a very strong immune system. Risk factors like quality of housing and allergies, to cockroaches for example, also may lead to pediatric respiratory diseases (Barnes, Brenner, 1996). According to the American Journal of Epidemiology, Acute Lower Respiratory Infection in children from charcoal-using households was 1.56 times higher, respectively, than those in children from households using gas. ​Respirable particulate matter existed in higher concentration in houses using charcoal. ​The acute lower respiratory infection was at higher risks when children were more exposed to respirable particulate matter (Bautista, Correa, Baumgartner, Breysse, Matanoski, 2009).

Children arriving to a Primary Care Center (UNAP) receive their attention depending on the severity of their respiratory disease. However, pediatric respiratory diseases are granted priority over the most common health conditions. Only urgent cases will receive attention first if the respiratory condition does not require immediate care. At entrance, children are evaluated by the physician in charge. ​If attention can be provided in the center, the child will most likely receive priority.​ If resources to treat the disease is not available, he or she would be translated to a nearby medical center where specialists are located (2nd or 3rd level).

The public health system in the Dominican Republic can do many things to improve the how respiratory diseases are treated and handled in the country. The following recommendations are made by the group of researchers in charge of this investigation. Reduce risk factors in homes and public places (like charcoal). Raise Awareness and Public knowledge on the topic so people learn to avoid harming lifestyles specially around children​ Train parents to provide asthma first aid if needed. Allow for faster access to medicines and medical attention.​ Promote and help in the reduction of pollution.

References

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2. Leonelo E. Bautista, Adolfo Correa, Jill Baumgartner, Patrick Breysse, Genevieve M. Matanoski, Indoor Charcoal Smoke and Acute Respiratory Infections in Young Children in the Dominican Republic, American Journal of Epidemiology, Volume 169, Issue 5, 1 March 2009, Pages 572–580, https://doi.org/10.1093/aje/kwn372​
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