Pediatrics最新文献

{"title":"The Needs and Experiences of Black Families in the Neonatal Intensive Care Unit.","authors":"Devlynne S Ondusko, Susanne Klawetter, Emily Hawkins Carter, Morinne Osborne, Jaime W Peterson, Veronica I Underwood Carrasco, Astrid Platteau, Roberta Suzette Hunte","doi":"10.1542/peds.2024-067473","DOIUrl":"https://doi.org/10.1542/peds.2024-067473","url":null,"abstract":"<p><p></p><p><strong>Objectives: </strong>To identify opportunities for improvement in quality of care, we explore Black families' experiences of family support in the neonatal intensive care unit (NICU) during their infant's hospital stay.</p><p><strong>Methods: </strong>Semistructured qualitative interviews or focus groups (FGs) were conducted to explore Black families' experiences of NICU hospitalization. Inclusion criteria were self-identification as a Black family member and infant admission to our NICU between January 2020 and February 2022. We conducted reflexive thematic analysis of recorded transcripts using Dedoose software.</p><p><strong>Results: </strong>Three interviews and 2 FGs were conducted with 9 unique families (n = 13 individuals). We organized 10 key themes into \"Experiences\" and \"Recommendations.\" Experience themes included distrust and fear of the medical setting, hypervigilance and trauma trajectory formation, the myth of \"Black hardiness,\" policing and surveillance, and undermining of Black parenting. Recommendation themes implored NICU staff to earn rather than assume trust, respect family concerns, improve mental health support, provide compassionate care, and support the parenting role.</p><p><strong>Conclusions: </strong>In this single-center qualitative study of Black families' NICU encounters, families continue to experience differential treatment, which reinforces an untrustworthy medical system perpetuating structural racism. Family recommendations for improving care through transparent communication, advocacy and mental health support, increased engagement in their parental role, and decreasing biased treatment and provision of resources may improve their experience and mitigate hypervigilance and trajectory formation in our NICU.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Children's Mental Health Needs in Disasters.","authors":"Jennifer A Hoffmann, Alba Pergjika, Kimberly Burkhart, Christopher Gable, Ashley A Foster, Mohsen Saidinejad, Trevor Covington, Desiree Edemba, Sara Mullins, Merritt Schreiber, Lee S Beers","doi":"10.1542/peds.2024-068076","DOIUrl":"https://doi.org/10.1542/peds.2024-068076","url":null,"abstract":"<p><p>Public health emergencies, including climate-related and manmade disasters such as active shooter incidents, occur regularly in the United States. A comprehensive approach is needed to ensure that children's mental health needs are adequately addressed following disasters. This article summarizes the latest evidence on how health systems can effectively address children's unique developmental, social, emotional, and behavioral needs in the context of disasters. To do so requires the integration of mental health considerations throughout all disaster phases, including preparedness, response, and recovery. We discuss the role of traditional emergency response systems and emerging models for responding to mental health crises. These include the national children's disaster mental health concept of operations and specific resources such as crisis lines, mobile crisis units, and telemental health. To achieve a broader reach in addressing children's mental health needs during disasters, health systems can foster a \"pediatric disaster system of care\" by partnering with community touch points such as schools, faith-based organizations, public health, and law enforcement. Unique considerations during disasters are required to maintain access to care for children with preexisting behavioral health conditions. During disasters, attention is needed to promote equitable identification of mental health needs and linkage to services, particularly for minoritized groups and children living in rural, frontier, and high-poverty areas. Strategies to address children's mental health needs during disasters include the provision of psychological first aid, screening for and triaging mental health needs, and stepped care approaches that progressively allocate higher-intensity evidence-based treatments to children with greater and enduring needs.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Listen Up: Autistic Youth Need to Be Heard.","authors":"Jace E Pooley","doi":"10.1542/peds.2024-069175","DOIUrl":"https://doi.org/10.1542/peds.2024-069175","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Outcomes 50 Years After Preterm Birth in Participants of a Trial of Antenatal Betamethasone.","authors":"Anthony G B Walters, Greg D Gamble, Caroline A Crowther, Stuart R Dalziel, Carl L Eagleton, Christopher J D McKinlay, Barry J Milne, Jane E Harding","doi":"10.1542/peds.2024-066929","DOIUrl":"https://doi.org/10.1542/peds.2024-066929","url":null,"abstract":"<p><strong>Background and objectives: </strong>Preterm birth results in neonatal and childhood morbidity and mortality. Additionally, population-based studies show poorer cardiovascular health in adult survivors, but a full range of health outcomes has not been investigated into midlife. We aimed to assess the health outcomes after preterm vs term birth at 50 years in survivors of a randomized trial of antenatal betamethasone.</p><p><strong>Methods: </strong>Participants were asked to complete a health questionnaire and for consent to access administrative data. Participants deceased prior to follow-up were assessed with administrative data alone. The primary outcome was a composite: any of diabetes mellitus, prediabetes, treated hypertension, treated dyslipidemia, or a previous major adverse cardiovascular event. Secondary outcomes included respiratory, mental health, educational, and other health outcomes.</p><p><strong>Results: </strong>We included 470 participants: 424 assessed at mean age 49.3 years and 46 who died after infancy. The primary outcome occurred in 34.5% (112/325) of those born preterm and 29.9% (43/144) of those born at term; adjusted relative risk (aRR) 1.14 (95% CI, 0.85-1.54; P = .37). Cardiovascular events were less common in those born preterm (9/326 [2.8%] vs 10/144 [6.9%]; aRR 0.33, 95% CI, 0.14-0.79), while self-reported hypertension was more common (101/291 [34.7%] vs 23/116 [19.8%]; aRR 1.74, 95% CI, 1.16-2.61), although treated hypertension was not statistically significantly different (66/323 [20.4%] vs 22/143 [15.4%]; aRR 1.32, 95% CI, 0.84-2.06). Other components of the composite endpoint were similar between those born preterm and at term.</p><p><strong>Conclusions: </strong>Those aged 50 years born preterm were more likely to have hypertension but had similar risk of diabetes, prediabetes, and dyslipidemia than those born at term, and their risk of cardiovascular events was lower.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newborn Screening for Critical Congenital Heart Disease: A New Algorithm and Other Updated Recommendations: Clinical Report.","authors":"Matthew E Oster, Nelangi M Pinto, Arun K Pramanik, Allison Markowsky, Bryanna N Schwartz, Alex R Kemper, Lisa A Hom, Gerard R Martin","doi":"10.1542/peds.2024-069667","DOIUrl":"https://doi.org/10.1542/peds.2024-069667","url":null,"abstract":"<p><p>Critical congenital heart disease (CCHD) screening was added to the US Recommended Uniform Screening Panel in 2011 and adopted by all US states and territories by 2018. In addition to reviewing key developments in CCHD screening since the initial American Academy of Pediatrics (AAP) endorsement in 2011, this clinical report provides 3 updated recommendations. First, a new AAP algorithm has been endorsed for use in CCHD screening. Compared with the original AAP algorithm from 2011, this new algorithm a) has a passing oxygen saturation threshold of ≥95% in both pre- and post-ductal measurements; and b) has only 1 retest instead of 2 for infants who did not pass the first screen. Second, to continue to improve screening, state newborn screening programs should collect a recommended minimum uniform dataset to aid in surveillance and monitoring of the program. Finally, stakeholders should be educated on the limitations of screening, the significance of non-CCHD conditions, and the importance of protocol adherence. Future directions of CCHD screening include improving overall sensitivity and implementing methods to reduce health inequities. It will remain critical that the AAP and its chapters and members work with health departments and hospitals to achieve awareness and implementation of these recommendations.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes 50 Years After Preterm Birth: A Golden Opportunity to Reflect on Pathways Toward Thriving.","authors":"Jonathan S Litt, Henning Tiemeier","doi":"10.1542/peds.2024-068441","DOIUrl":"https://doi.org/10.1542/peds.2024-068441","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Clinical Report.","authors":"","doi":"10.1542/peds.2024-070334","DOIUrl":"https://doi.org/10.1542/peds.2024-070334","url":null,"abstract":"<p><strong>I. introduction and background: </strong>The sudden onset of severe behavioral and neuropsychiatric symptoms in children is a frightening and potentially life-changing situation. The pediatric health care providers and clinicians to whom families turn need guidance on how to accurately diagnose and treat new-onset neuropsychiatric symptoms in children. They need expert guidance about whether these symptoms indicate a diagnosis compatible with pediatric acute-onset neuropsychiatric syndrome (PANS). The cause of PANS is unknown, but it is theorized to be triggered, in some cases, by a recent infection and/or autoimmunity issues (similar to Sydenham chorea, autoimmune encephalitis [AE], and Guillain-Barré syndrome). The condition is challenging from a clinical perspective, because it lacks disease-specific biomarkers, strong evidence for pathogenic causes, and consensus on treatment of clinical symptoms. Further, the evidence base for PANS encompasses multiple subspecialties, including child and adolescent psychiatry, pediatric rheumatology, pediatric neurology, pediatric infectious diseases, pediatric immunology, and developmental-behavioral pediatrics.Given this complexity, there is a clear need for guidance and advice for pediatric clinicians and the families they serve and support. To that end, with the encouragement of the Board of Directors, the American Academy of Pediatrics (AAP) has developed this clinical report. It focuses primarily on PANS, an umbrella condition that encompasses pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Although PANDAS is, by definition, associated with streptococcal infection,1 it is now considered by many to represent a subset of the larger spectrum of infection-induced acute-onset neuropsychiatric symptoms.2,3 This clinical report was developed after a comprehensive literature review and analysis of the findings. Because they are limited by the present level of evidence on the topic, the findings are presented as a report rather than a clinical practice guideline. The contents are intended to aid the pediatric health care provider in evaluating, diagnosing, and treating sudden-onset and severe behavioral changes in children that could indicate potential PANS and in supporting these children and their families.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The More Things Change, One Thing Stays the Same.","authors":"Lewis R First, Kate Larson, Joseph Puskarz, Alex R Kemper","doi":"10.1542/peds.2024-069567","DOIUrl":"https://doi.org/10.1542/peds.2024-069567","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Socialization to Keep Children Safe: All of Our Responsibility.","authors":"Joseph L Wright","doi":"10.1542/peds.2024-068817","DOIUrl":"https://doi.org/10.1542/peds.2024-068817","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of \"The Talk\" and Its Themes in Black Youths' Anticipatory Stress of Police Brutality.","authors":"Lindsey Webb, Monique Jindal, J'Mag Karbeah, Alexander Testa, Rebecca L Fix, Dylan B Jackson","doi":"10.1542/peds.2024-067065","DOIUrl":"https://doi.org/10.1542/peds.2024-067065","url":null,"abstract":"<p><strong>Background and objectives: </strong>Research on conversations between caregivers and their children about how to prepare or conduct themselves when stopped by police (ie, \"the talk\") has grown in recent years. However, little is known about how having \"the talk\" may influence youths' stress about future experiences of police brutality (ie, anticipatory stress of police brutality). The objective of the present study is to examine how youths' anticipatory stress regarding police brutality varies by whether they have had \"the talk\" with their caregivers.</p><p><strong>Methods: </strong>Data come from the Survey of Police-Adolescent Contact Experiences (SPACE), a cross-sectional survey of a community-based sample of Black youth aged 12 to 21 years in Baltimore, Maryland (n = 339), collected from August 2022 to July 2023. Multivariable ordinary least squares regressions were conducted to (1) examine associations between \"the talk\" and anticipatory stress of police brutality among a sample of Black youth in Baltimore and (2) examine the associations between messages in \"the talk\" and anticipatory stress of police brutality among youth who received \"the talk.\"</p><p><strong>Results: </strong>Findings indicate that having \"the talk\" was associated with lower anticipatory stress of police brutality. Moreover, among youth who received \"the talk,\" certain messages from parents during \"the talk\" were associated with significant increases in anticipatory stress of police brutality compared with other messages.</p><p><strong>Conclusions: </strong>Findings underscore the need for a nuanced understanding of \"the talk's\" broader implications on youth well-being and may be used to expand opportunities for youth to encounter affirmative racial socialization messages.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}