Pediatrics最新文献

{"title":"Development and Evaluation of an Advocacy Curriculum for Pediatric Emergency Medicine Fellows.","authors":"Megan M Attridge,Kristen M Kester,Samaa Kemal,Selina Varma Thomas,Karen Mangold,Jennifer A Hoffmann","doi":"10.1542/peds.2024-067564","DOIUrl":"https://doi.org/10.1542/peds.2024-067564","url":null,"abstract":"Advocacy is a key skill for pediatric emergency medicine (PEM) physicians; however, advocacy education is not a PEM fellowship program requirement, and literature describing the design, implementation, or evaluation of PEM advocacy curricula have not been published. We aimed to develop, implement, and evaluate a curriculum to teach core advocacy concepts to PEM fellows that builds on advocacy training in residency. An advocacy curriculum for PEM fellows, informed by a needs assessment, was implemented at an urban academic children's hospital during the 2021 to 2022 academic year. Eight fellows participated in the curriculum, which consisted of didactic and work group sessions integrated into the fellows' educational conference. PEM fellows were surveyed before and after 1 year of curriculum participation to assess advocacy attitudes, knowledge, skills, and participation in advocacy activities. After the curriculum, most fellows agreed or strongly agreed they had the skills to conduct specific advocacy activities, and fellows reported participating in a range of advocacy activities including use of social media for advocacy, legislative advocacy, and speaking with community partners. Fellows completed mentored longitudinal advocacy projects focused on firearm injury prevention, increasing underrepresented minority student exposure to health careers, and understanding caregiver hesitancies regarding the COVID-19 vaccine. This curriculum may serve as a model for integration of advocacy education into PEM and other pediatric subspecialty fellowships.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"9 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836537","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":"Increasing Incidence of Neonatal HSV in the United States: A Public Health Challenge.","authors":"Sanjay Mahant,David W Kimberlin","doi":"10.1542/peds.2024-070052","DOIUrl":"https://doi.org/10.1542/peds.2024-070052","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831685","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":"What's Old Is New Again: Measles.","authors":"Caitlin Naureckas Li,Sheldon L Kaplan,Kathryn M Edwards,Gary S Marshall,Sarah Parker,C Mary Healy","doi":"10.1542/peds.2025-071332","DOIUrl":"https://doi.org/10.1542/peds.2025-071332","url":null,"abstract":"Measles is resurging in the United States fueled by decreasing vaccination rates and rising vaccine hesitancy. Clinicians are confronted with a highly infectious vaccine-preventable disease that is unfamiliar to them since, as a result of routine childhood vaccination with measles, mumps, and rubella (MMR) vaccine, measles was declared non-endemic in the U.S. in 2000 and many pediatricians have never seen a case. In this article, we provide an update on measles presentation, clinical course, and outcomes by reviewing the literature and sharing the expertise of senior pediatric infectious disease physicians with experience in caring for children infected with measles. Measles typically presents with a recognizable clinical picture, allowing providers to appropriately triage cases, make the diagnosis, and implement infection control practices to mitigate transmission. Measles is associated with complications, including frequent pulmonary infections and central nervous system involvement which may result in morbidity and mortality. Since treatment options for measles are limited, prevention through vaccination and contact tracing are the mainstays in controlling measles outbreaks. Given the high infectivity of this virus, health care providers are an essential first line of defense for communities. Providers can protect children through advocacy for vaccination including effective communication techniques to educate parents and caregivers about measles infection and the benefits of vaccination. They can also maintain a high clinical index of suspicion so that appropriate infection prevention strategies are rapidly implemented when appropriate.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822765","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":"Cord Blood Treatment for Children With Cerebral Palsy: Individual Participant Data Meta-Analysis.","authors":"Megan Finch-Edmondson,Madison C B Paton,Annabel Webb,Mahmoud Reza Ashrafi,Remy K Blatch-Williams,Charles S Cox,Kylie Crompton,Alexandra R Griffin,MinYoung Kim,Steven Kosmach,Joanne Kurtzberg,Masoumeh Nouri,Mi Ri Suh,Jessica Sun,Morteza Zarrabi,Iona Novak","doi":"10.1542/peds.2024-068999","DOIUrl":"https://doi.org/10.1542/peds.2024-068999","url":null,"abstract":"CONTEXTUmbilical cord blood (UCB) is a novel treatment for cerebral palsy (CP), with trials indicating UCB can improve gross motor function. However, heterogeneity has limited the ability to interpret findings.OBJECTIVEAssess the safety and efficacy of UCB for improving gross motor function in children with CP, including exploring cell dose effect and responder subgroups.DATA SOURCESIndividual participant data from published reports and registered trials identified via systematic searches.STUDY SELECTIONStudies administering UCB to individuals with CP collecting Gross Motor Function Measure (GMFM) scores.DATA EXTRACTIONA 1-stage individual participant data meta-analysis was conducted in R to obtain the pooled effect of UCB and cell dose effect on GMFM using linear mixed models. Responder subgroups were also investigated.RESULTSFour hundred ninety-eight participant data records were obtained from 11 studies. Main analysis of 170 participants treated with UCB and 171 controls demonstrated UCB increased mean GMFM-66 score compared with controls by 1.36 points at 6 months (95% CI, 0.41-2.32; P = .005) and 1.42 at 12 months (95% CI, 0.31-2.52; P = .012). Mean GMFM-66 effect size increased with increasing cell dose at 3 (P < .001) and 12 months (P = .047). CP severity and baseline age were associated with GMFM-66 effect size. The rate of serious adverse events was similar between groups.LIMITATIONSHeterogeneity across variables and time points, reducing subanalysis power.CONCLUSIONSUCB is safe and provides benefit for improving gross motor function in some children with CP, with higher doses associated with increased effect size. Younger participants (aged approximately <5 years) with milder CP showed increased benefit. Findings will help design future trials with precision.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"25 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822472","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":"Cord Blood Treatment for Children With Cerebral Palsy.","authors":"Peter Rosenbaum,Robert Palisano","doi":"10.1542/peds.2024-070467","DOIUrl":"https://doi.org/10.1542/peds.2024-070467","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"60 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822471","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":"Reducing Disparities in Nonaccidental Trauma Evaluations in Emergency Departments.","authors":"Arianne L Baker,Robert H Rosen,Jessica K Creedon,Celeste R Wilson,Wee-Jhong Chua,Lois K Lee","doi":"10.1542/peds.2024-067809","DOIUrl":"https://doi.org/10.1542/peds.2024-067809","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"108 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819061","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":"Well-Child and Hematology Visit Adherence Among Youth With Sickle Cell Disease.","authors":"Huey-Fen Chen,Laura Chavez,Susan Creary","doi":"10.1542/peds.2024-069448","DOIUrl":"https://doi.org/10.1542/peds.2024-069448","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"39 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819059","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 Need to Standardize the Diagnosis of Cerebral Palsy.","authors":"Bhooma R Aravamuthan, Michael C Fahey, Darcy L Fehlings, Iona Novak, Michael C Kruer","doi":"10.1542/peds.2024-069666","DOIUrl":"https://doi.org/10.1542/peds.2024-069666","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811991","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":"How to Build a Better Doctor.","authors":"Hilary M Haftel","doi":"10.1542/peds.2025-070654","DOIUrl":"https://doi.org/10.1542/peds.2025-070654","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811989","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":"Graduating Residents' Readiness for Unsupervised Practice.","authors":"Daniel J Schumacher, Catherine Michelson, Ariel Winn, Duncan Henry, Meghan O'Connor, Su-Ting T Li, Robyn J Blair, Maria Velazquez-Campbell, Margaret J Kihlstrom, Emily Borman-Shoap, Keith Ponitz, Joselyn Salvador-Sison, Benjamin Kinnear, David A Turner, Abigail Martini, Heather L Burrows, Rita Patel, Lauren M Newhall, Rachel Osborn, Mia Mallory, Johannah M Scheurer, Matthew Grant, Ross E Myers, Elena C Griego, Svetlana Kravtchenko, Shivika Jain, Thao Vu, Alan Schwartz","doi":"10.1542/peds.2024-070307","DOIUrl":"https://doi.org/10.1542/peds.2024-070307","url":null,"abstract":"<p><p></p><p><strong>Objective: </strong>This study sought to determine whether graduating residents were deemed ready for unsupervised practice for each of the 17 general pediatrics entrustable professional activities (EPAs).</p><p><strong>Methods: </strong>At the end of the 2021-22, 2022-23, and 2023-24 academic years, the authors collected entrustment-supervision levels assigned by clinical competency committees for graduating residents from pediatric and medicine/pediatrics residency training programs to determine readiness for unsupervised practice at the time of graduation. They did this for each of the general pediatrics EPAs and examined the levels reported to determine the proportion of residents ready for unsupervised practice on each EPA and on all EPAs. They compared rates of readiness by academic year using a mixed-effects logistic regression model.</p><p><strong>Results: </strong>Across all EPAs, 33 190 total entrustment-supervision levels were reported for 2276 graduating pediatrics residents, and 2607 entrustment-supervision levels were reported for 168 graduating medicine/pediatrics residents. There were no EPAs in which programs reported more than 89% of residents as ready for unsupervised practice at the time of graduation. Only 31.3% of graduating residents with observations on all EPAs (414/1322) were deemed ready for unsupervised practice for all EPAs. Graduating medicine/pediatrics residents were more likely than pediatrics residents to be deemed ready for all EPAs (P = .002). Across study years, the rates of readiness at graduation for all EPAs rose from 18.0% to 38.5% (linear contrast P < .001).</p><p><strong>Conclusion: </strong>While there are reasons beyond actual resident readiness that may contribute, this study highlights a gap in readiness for unsupervised practice at the time of graduation.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811986","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}