JAMA Pediatrics最新文献

{"title":"Adolescent Mental Health Theme Issue-Adolescent Suicide, Eating Disorders, and the Role of Systems in Mental Health.","authors":"Megan A Moreno,Benjamin French,Dimitri A Christakis","doi":"10.1001/jamapediatrics.2025.3798","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3798","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"21 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous Nitroglycerin to Prevent Radial Artery Occlusion in Pediatric Patients: A Randomized Clinical Trial.","authors":"Jung-Bin Park,Sang-Hwan Ji,Eun-Hee Kim,Ji-Hyun Lee,Hee-Soo Kim,Jin-Tae Kim,Young-Eun Jang","doi":"10.1001/jamapediatrics.2025.3652","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3652","url":null,"abstract":"ImportancePediatric patients are at an increased risk of postprocedural radial artery occlusion (RAO) owing to their small vessels and high tendency for vasospasm after catheterization. Although subcutaneous nitroglycerin increases the success rate of radial artery catheterization by vasodilation and preventing vasospasm, its effect on RAO prevention after catheter removal remains unknown.ObjectiveTo evaluate the efficacy and safety of subcutaneous nitroglycerin for RAO prevention.Design, Setting, and ParticipantsThis double-blind randomized clinical trial was conducted at a single tertiary center and included pediatric patients younger than 3 years who required radial artery catheterization during general anesthesia. Study data were analyzed from April to July 2025.InterventionsPatients were randomized to receive either subcutaneous nitroglycerin (5 μg/kg/0.5 mL) or normal saline (0.5 mL) above the chosen radial artery before radial arterial catheterization and catheter removal under ultrasound guidance.Main Outcomes and MeasuresThe primary outcome was the RAO incidence after catheter removal, assessed using the reverse Barbeau test with pulse oximetry on the ipsilateral index finger.ResultsA total of 200 pediatric patients were initially enrolled, but 68 were excluded for protocol violations. In the per-protocol analysis with 132 participants (median [IQR] age, 5.5 [2.0-16.6] months; 73 female [55.3%]), RAO incidence was lower in the nitroglycerin group than in the control group (25.4% [17 of 67] vs 73.8% [48 of 65]; P < .001; odds ratio [OR], 0.12; 95% CI, 0.06-0.26; absolute risk reduction, 48.5%; 95% CI, 33.6%-63.4%). After catheter removal, the nitroglycerin group showed higher peak blood flow velocity (mean [SD], 13.0 [11.0] cm/s vs 7.4 [9.2] cm/s; 95% CI for mean difference, 2.1-9.1 cm/s; P = .002) and perfusion index (mean [SD], 1.37 [1.09] vs 0.65 [0.49]; 95% CI for mean difference, 0.43-1.01; P < .001) of the radial artery than did the control group. There was no significant intergroup difference in RAO duration. There was no hypotension or localized adverse effects.Conclusions and RelevanceSubcutaneous nitroglycerin injection before radial artery catheterization and catheter removal significantly reduced the incidence of RAO after catheter removal and may promote safe recovery in pediatric patients younger than 3 years.Trial RegistrationClinicalTrials.gov Identifier: NCT05443061.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"38 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Newborn Screening-A Long Road From Pilot to Public Policy.","authors":"François Boemer,Laurent Servais","doi":"10.1001/jamapediatrics.2025.3639","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3639","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"32 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence Without Impact?-Rethinking Home Visiting at Scale.","authors":"Zhihao Lei","doi":"10.1001/jamapediatrics.2025.3636","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3636","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"55 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician and Parent Perspectives on Essential Psychosocial Care in Pediatric Cancer.","authors":"Kimberly S Canter,Anne E Kazak,Natalie Koskela-Staples,Michele A Scialla,Kimberly Buff,Emily Pariseau,Victoria A Sardi-Brown,Julia B Tager,Lori Wiener","doi":"10.1001/jamapediatrics.2025.3671","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3671","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"18 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change to Open Access Status.","authors":"","doi":"10.1001/jamapediatrics.2025.4381","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4381","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Nurses' Subjective Workload in the Neonatal Intensive Care Unit.","authors":"Halley Ruppel,Elizabeth Schierholz","doi":"10.1001/jamapediatrics.2025.3674","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3674","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"27 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence Without Impact?-Rethinking Home Visiting at Scale-Reply.","authors":"Katarina Swanson,Alyna T Chien,Margaret McConnell","doi":"10.1001/jamapediatrics.2025.3633","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3633","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"8 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse Workload and Missed Nursing Care in Neonatal Intensive Care Units.","authors":"Heather L Tubbs-Cooley,Adam C Carle,Barbara A Mark,Ayse P Gurses,Rita H Pickler,Priya D Hall,Thomas Bartman","doi":"10.1001/jamapediatrics.2025.3647","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3647","url":null,"abstract":"ImportanceHigh nurse workload can compromise quality of care in neonatal intensive care units, leading to preventable harm and worsening clinical outcomes.ObjectiveTo evaluate differential effects of objective and subjective nurse workload on missed nursing care.Design, Setting, and ParticipantsThe prospective, observational, longitudinal design of this cross-sectional study was used to evaluate associations between shift-level workload of participating nurses and missed care for assigned infants from April 2021 to May 2023. This study was conducted at 10 level II, III, and IV neonatal intensive care units among a convenience sample of registered nurses who provided direct patient care at least 16 hours biweekly, completed unit orientation, owned a smartphone, and did not work in a supervisory capacity. Deidentified electronic health record data from infants assigned to nurse participants were extracted through an honest broker arrangement. Data analysis was conducted from July 2023 to July 2025.ExposureNurse workload was assessed each shift based on objective (maximum number of assigned infants, infant acuity score) and subjective (National Aeronautics and Space Administration [NASA] Task Load Index) measures.Main Outcome and MeasuresThe primary outcome, infant-specific missed nursing care on a shift, was measured by nurse self-report of omission of 17 essential types of neonatal nursing care.ResultsA total of 247 nurses involved in direct care provided reports of staffing and workload corresponding to the care of 1468 individual infants across 11 364 matched nurse-infant shifts. Nurses were 98% female, and nurses' mean (SD) neonatal intensive care unit experience was 5.7 (7.1) years. When modeling workload variables separately, a shift-level staffing ratio of 3 infants per nurse was significantly associated with increased odds of missed care for individual infants in 9 of 17 types of care; a 2:1 ratio was associated with increased odds in 2 of 17 types of care. Higher subjective workload ratings were associated with increased odds of missed care in all 17 types of care. Negative effects of higher subjective workload persisted across all types of care in joint workload models, while effects of staffing ratios diminished. Few clinically meaningful effects of infant acuity scores on missed care were observed.Conclusions and RelevanceIn this cross-sectional study, nurses' subjective workload and shift-level staffing ratios exerted direct effects on reliable care delivery. High subjective workload and staffing ratios greater than 2 infants per nurse should be targets for workload reduction in neonatal intensive care units.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"74 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Uncomplicated Appendicitis-Moving Past the Superiority Debate.","authors":"Shawn J Rangel","doi":"10.1001/jamapediatrics.2025.4150","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4150","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"73 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}