Pediatrics最新文献

{"title":"The State of Pediatric Concurrent Hospice Care in the United States.","authors":"Meaghann S Weaver,Steven M Smith,Christy Torkildson,Deborah Fisher,Betsy Hawley,Alix Ware,Holly Davis,Conrad S P Williams,Lisa C Lindley","doi":"10.1542/peds.2025-071610","DOIUrl":"https://doi.org/10.1542/peds.2025-071610","url":null,"abstract":"The Patient Protection and Affordable Care Act (ACA) required all state Medicaid programs to pay for both curative and hospice services for children and adolescents. The purpose of this Special Article report is to quantify and describe the use of concurrent care for children, including a depiction of the barriers and benefits according to community-based hospice organizations in the United States. A total of 295 hospice organizations from 50 states and Washington, DC responded to the National Alliance for Care at Home call for engagement. Almost three-quarters of responding organizations admit children under concurrent care. An average of 38% (median 10%) of admitted pediatric patients are cared for under concurrent care. There was a notable lack of uptake of diverse reimbursement models relevant to concurrent care. Definitions of concurrent care focused on location of care and access to ongoing treatments without defining services. Responses tended toward an emphasis on regulatory/compliance language rather than goals of care or partnership focus. Challenges and barriers to concurrent care were quantitatively and qualitatively described as confusion, complexities, lack of consistency, cumbersomeness, and poor cross-partner communication. Policy and reimbursement model clarification is warranted to improve the potential benefits of this coverage for children and their families. As the ACA is currently at risk of discontinuation and Medicaid is at risk of decreased funding, the pediatric community should leverage advocacy for improved concurrent care coverage approaches that are clear, consistent, and compassionately attuned to the needs of children and their families.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"28 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756229","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":"Advocating for a 3-Pronged Approach to Treating PANS.","authors":"Gail A Bernstein,Jenny Wilson,Lauren Breithaupt","doi":"10.1542/peds.2025-071886b","DOIUrl":"https://doi.org/10.1542/peds.2025-071886b","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"13 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720336","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":"Another Perspective: Should We Swab for Group A Streptococcus?","authors":"Ellen R Wald,Mark S Pasternack","doi":"10.1542/peds.2025-071886a","DOIUrl":"https://doi.org/10.1542/peds.2025-071886a","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"37 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720339","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":"Disparities During Family-Centered Rounds for Families Using Languages Other Than English.","authors":"Judith S Pelpola,Christina R Rojas,Erin Abu-Rish Blakeney,Jonathan S Farkas,Jennifer L Everhart,Angela L Fan,Sonia Garcia,Dionne Graham,Tyler M Johnson,Yuko Kajiwara,Erin Knoebel,Kheyandra D Lewis,Nandini Mallick,Peggy Markle,Eileen M Romano,Erin Shaughnessy,Jennifer D Baird,Sharon Calaman,Nancy D Spector,Christopher P Landrigan,Alisa Khan","doi":"10.1542/peds.2024-070285","DOIUrl":"https://doi.org/10.1542/peds.2024-070285","url":null,"abstract":"BACKGROUND/OBJECTIVEPatient- and family-centered rounds (PFCR) have become a pediatric standard of care. However, rounds experiences of families using languages other than English (LOE)-particularly languages other than English or Spanish (LOES; eg, Arabic)-receive less focus. We aimed to identify differences in PFCR communication and engagement by language.METHODSWe analyzed postintervention data from a 21-center structured PFCR study, assessing communication practices, quality, and family and nurse engagement during PFCR. Logistic regression adjusted by site compared PFCR between families using (1) LOE vs English, (2) Spanish vs English, and (3) LOES vs English.RESULTSAmong 3051 PFCR encounters, 348 (11.4%) involved LOE (Spanish = 260; LOES = 85). Interpretation was not used in 7.2%, 5.8%, and 9.4% of encounters using LOE, Spanish, and LOES, respectively. PFCR in the following groups had lower adjusted odds (adjusted odds ratio [95% CI]) for the following domains: (1) LOE vs English: including providing verbal patient summaries (0.66 [0.46-0.95]), explaining diagnoses and differentials (0.62 [0.44-0.88]), family engagement (0.34 [0.20-0.57]), nursing inclusion (0.75 [0.60-0.93]), and nursing engagement (0.69 [0.52-0.90]). (2) Spanish vs English: diagnoses/differentials being explained (0.56 [0.37-0.85]), family engagement (0.35 [0.18-0.67]), nursing inclusion (0.77 [0.59-1.00]), and nursing engagement (0.68 [0.52-0.89]). (3) LOES vs English: families sharing concerns (0.66 [0.47-0.93]), family engagement (0.30 [0.16-0.54]), and nursing inclusion (0.74 [0.55-0.99]).CONCLUSIONEven after implementing a PFCR intervention, families using LOE-especially LOES-experienced significant disparities in communication and engagement. Future approaches to improving PFCR should emphasize language access and promote nurse and family engagement for families using LOE, particularly LOES.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720099","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":"Medical vs Nonmedical Immunization Exemptions for Child Care and School Attendance: Policy Statement.","authors":"Jesse M Hackell,Kyle Brothers,Sara Bode,Lisa M Costello,Lisa M Kafer,Sean T O'Leary, , , , ","doi":"10.1542/peds.2025-072714","DOIUrl":"https://doi.org/10.1542/peds.2025-072714","url":null,"abstract":"Routine childhood immunizations against infectious diseases are an integral part of our public health infrastructure. They provide direct protection to the immunized individual and indirect protection to children and adults unable to be immunized by reducing spread of vaccine-preventable diseases in the community. All 50 states, the District of Columbia, and Puerto Rico have regulations requiring proof of immunization as a condition for child care and school attendance as a public health strategy to protect children in these settings and to secondarily serve as a mechanism to promote timely immunization of children by their caregivers. Although all states and the District of Columbia have mechanisms to exempt school attendees from specific immunizations for medical reasons, the majority also have a heterogeneous collection of regulations and laws that allow nonmedical reasons for exemption. The American Academy of Pediatrics (AAP) supports certification of immunization to attend child care and school as a sound means of providing a safe environment for attendees and employees of these settings. The AAP also supports medically indicated exemptions to specific immunizations as determined for each individual child. The AAP advocates for the elimination of nonmedical exemptions from immunizations as contrary to optimal individual and public health.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"90 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720098","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":"Recommendations for Prevention and Control of Influenza in Children, 2025-2026: Technical Report.","authors":"","doi":"10.1542/peds.2025-073622","DOIUrl":"https://doi.org/10.1542/peds.2025-073622","url":null,"abstract":"<p><p>This technical report accompanies the recommendations of the American Academy of Pediatrics for the routine use of influenza vaccine and antiviral medications in the prevention and treatment of influenza in children during the 2025-2026 influenza season. The rationale for the American Academy of Pediatrics recommendation for annual influenza vaccination of all children without medical contraindications starting at 6 months of age is provided. Influenza vaccination is an important strategy for protecting children and the broader community against influenza. This technical report summarizes recent influenza seasons, morbidity and mortality in children, vaccine effectiveness, and vaccination coverage and provides detailed guidance on vaccine storage, administration, and implementation. The report also provides a brief background on inactivated (non-live) and live attenuated influenza vaccines, available vaccines for the 2025-2026 influenza season, vaccination during pregnancy and breastfeeding, diagnostic testing for influenza, and antiviral medications for treatment and chemoprophylaxis. Strategies to promote vaccine uptake are emphasized.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732751","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":"Recommendations for Prevention and Control of Influenza in Children, 2025-2026: Policy Statement.","authors":"","doi":"10.1542/peds.2025-073620","DOIUrl":"https://doi.org/10.1542/peds.2025-073620","url":null,"abstract":"<p><p>This statement updates the recommendations of the American Academy of Pediatrics (AAP) for the use of influenza vaccines and antiviral medications in the prevention and treatment of influenza in children during the 2025-2026 influenza season. A review of the evidence supporting these recommendations is in the accompanying technical report (https://doi.org/10.1542/peds.2025-073622). The AAP recommends annual influenza vaccination of all children without medical contraindications starting at 6 months of age. Influenza vaccination is an important strategy for protecting children and the broader community as well as reducing the overall burden of respiratory illnesses when other viruses are cocirculating. Any licensed influenza vaccine appropriate for age and health status can be administered, as soon as possible in the season, without preference for one product or formulation. Antiviral treatment of influenza is recommended for children with suspected or confirmed influenza who are hospitalized or have severe or progressive disease or have underlying conditions that increase their risk of complications of influenza. In this situation, antiviral treatment should be started as soon as possible regardless of duration of illness. Antiviral treatment is an option in the outpatient setting for other children with suspected or confirmed influenza in some circumstances. Antiviral chemoprophylaxis is an option in certain individuals, especially exposed children who are asymptomatic and are at high risk for influenza complications but have not yet been immunized or those who are not expected to mount an effective immune response.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732750","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":"Anaphylaxis Definition, Clinical Support Tool.","authors":"","doi":"10.1542/peds.2025-072390","DOIUrl":"https://doi.org/10.1542/peds.2025-072390","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732749","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":"Characteristics of Children Aged 0 to 23 Months Hospitalized With Respiratory Syncytial Virus.","authors":"Dennis Wang,Huong T Pham,Shua Chai,Cora Hoover,Isaac Armistead,Breanna Kawasaki,Kimberly M Yousey-Hindes,James Meek,Lucy S Witt,Kyle P Openo,Alicia Brooks,Sarah Rojewski,Justin J Henderson,Erica Martin,Erica Mumm,Yadira Salazar-Sanchez,Yomei Paloma Shaw,Fiona Keating,Adam Rowe,Kevin Popham,Brenda L Tesini,Arilene Novak,Melissa Sutton,William Schaffner,H K Talbot,Mary Hill,Hafsa Zahid,Fiona P Havers,Monica E Patton","doi":"10.1542/peds.2024-069719","DOIUrl":"https://doi.org/10.1542/peds.2024-069719","url":null,"abstract":"BACKGROUND AND OBJECTIVESRespiratory syncytial virus (RSV) is a leading cause of hospitalization among young children. Nirsevimab is recommended for all infants younger than 8 months and children aged 8 to 19 months who are at increased risk of severe RSV entering their second RSV season. Additional data are necessary to identify children aged 8 to 19 months at increased risk for severe disease.METHODSThe Respiratory Syncytial Virus Hospitalization Surveillance Network, a population-based surveillance system, captures laboratory-confirmed RSV-associated hospitalizations in 12 states. We compared demographics and clinical characteristics of children aged 0 to 23 months by age category, and of children aged 12 to 23 months by severity (not admitted to the intensive care unit [ICU], admitted to the ICU, or with prolonged [≥3 days] ICU admission) during the 2022-2023 season using χ2 tests and logistic regression.RESULTSAmong 3659 randomly sampled hospitalized children in 2022-2023, 31.2%, 40.0%, and 28.9% were aged 0 to 2, 3 to 11, and 12 to 23 months, respectively. Compared with children aged 0 to 2 months, children 3 to 11 and 12 to 23 months were more likely to have at least 1 underlying medical condition (UMC) (3.4%, 12.6%, 23.4%, respectively; P < .05). Children aged 12 to 23 months with prolonged ICU admission were more likely to have airway abnormalities, cardiovascular disease (CVD), Down syndrome (with or without concomitant CVD), and feeding tube dependence than those without ICU admission (P < .05 for all).CONCLUSIONSUMCs were more frequently identified among hospitalized children aged 12 to 23 months compared with children 0 to 2 months; prolonged ICU admission was associated with airway abnormalities, CVD, Down syndrome, and feeding tube dependence.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"19 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701235","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":"Outpatient Therapy and Risk of Rehospitalization for Youth With Eating Disorders.","authors":"Megan E Mikhail,Kate Duggento Cordell,Amanda E Downey,Lonnie R Snowden,Erin C Accurso","doi":"10.1542/peds.2025-070797","DOIUrl":"https://doi.org/10.1542/peds.2025-070797","url":null,"abstract":"OBJECTIVEEating disorders (EDs) are serious mental illnesses that affect youth of all socioeconomic backgrounds. However, low-income, publicly insured youth with EDs face substantial barriers to adequate treatment and often experience repeated hospitalizations with significant costs to families and care systems. We examined whether increased outpatient psychotherapy following hospitalization could break these \"revolving door\" cycles of admissions.METHODSParticipants were California Medicaid enrollees aged 7 to 18 years with diagnosed EDs who were hospitalized at least once (N = 920). We used Cox proportional hazard models to examine whether the amount of outpatient therapy youth received in the 90 days after hospitalization predicted rehospitalization in the subsequent 90 days, covarying demographic characteristics, ED diagnosis, admission length and type (primarily medical/psychiatric), and amount of outpatient therapy in the 90 days preceding admission.RESULTSRelative to youth who received 0 to 3 sessions of outpatient therapy in the 90 days after hospitalization, those who received 4 to 7 sessions had significantly reduced readmission risk in the subsequent 90 days (hazard ratio [HR] = 0.46; 95% CI, 0.23-0.91; P = .026). Risk was further reduced for youth who received 8 or more sessions (nearly weekly) (HR = 0.04; 95% CI, 0.004-0.34; P = .003). Cost savings associated with 8 or more therapy sessions were estimated at nearly $70 000 per youth. However, only a small minority of the population (4.5%) received at least 8 sessions, with the modal number of sessions being zero.CONCLUSIONEven a moderate amount of outpatient therapy may substantially reduce rehospitalization in publicly insured youth with EDs, decreasing morbidity and costs.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"144 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701229","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}