Children-Basel最新文献

{"title":"Severe Diabetic Ketoacidosis in Children with Type 1 Diabetes: Ongoing Challenges in Care.","authors":"Simone Foti Randazzese, Mariarosaria La Rocca, Bruno Bombaci, Alessandra Di Pisa, Elèna Giliberto, Teresa Inturri, Daniel Militi, Fortunato Lombardo, Eloisa Gitto, Giuseppina Salzano, Stefano Passanisi","doi":"10.3390/children12010110","DOIUrl":"10.3390/children12010110","url":null,"abstract":"<p><p>Diabetic ketoacidosis is the most common acute complication in children and adolescents with type 1 diabetes, and contributes significantly to morbidity, mortality, and healthcare burden. This review aims to explore the multifaceted aspects of severe diabetic ketoacidosis in pediatric age, including its epidemiology, pathogenesis, risk factors, complications and emphasizing advances in prevention strategies. Incidence rates vary due to influences from geographic, socioeconomic, cultural and demographic factors. Pathogenesis is linked to insulin deficiency and an excess of counter-regulatory hormones, which disrupt glucose, protein, and lipid metabolism, causing hyperglycemia, ketosis, acidosis, dehydration, and electrolyte imbalances. According to the International Society for Pediatric and Adolescent Diabetes guidelines, severe diabetic ketoacidosis is characterized by a pH < 7.1 or bicarbonate < 5 mmol/L. This condition can lead to a wide range of life-threatening complications, including cerebral edema that represents the leading cause of death. Several prevention strategies, including awareness campaigns, early diagnosis of diabetes, regular monitoring and management, effective insulin therapy, education, access to healthcare and technological assistance, may contribute to reduce the risk of severe diabetic ketoacidosis episodes in children and adolescents.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic Presentation of Children with Joint Hypermobility: Preclinical Signs.","authors":"Mateus Marino Lamari, Neuseli Marino Lamari, Michael Peres de Medeiros, Gerardo Maria de Araújo Filho, Adriana Barbosa Santos, Matheus Gomes Giacomini, Vitor Roberto Pugliesi Marques, Eny Maria Goloni-Bertollo, Érika Cristina Pavarino","doi":"10.3390/children12010109","DOIUrl":"10.3390/children12010109","url":null,"abstract":"<p><strong>Introduction: </strong>Joint hypermobility (JH) is mobility beyond the normal range of motion. JH can be an isolated finding or a characteristic of a syndrome. Characteristics related to the sitting position with atypical body positions, such as sitting in splits (S), with the foot on the head (F), in W (W), in a concave shape (C), episodes of dislocations, and subluxations, suggest impacts on body mechanics since childhood, with damage to the conformation of the joints.</p><p><strong>Objectives: </strong>Identify preclinical signs of JH, in addition to Beighton Score (BS), through signs that are easily recognized early by pediatricians and family members to avoid possible joint deformities in the future.</p><p><strong>Methods: </strong>The medical records of 124 children (59.7% girls) between one and nine years old were analyzed. JH was assessed using the BS, a history of luxations/subluxations, and the concave (C), \"W\", \"splits\" (S), and foot (F) on head sitting positions.</p><p><strong>Results: </strong>The concave sitting position was the most common, followed by W, F, and S in decreasing order. A total of 52.4% of the children had BS > 6, with a higher prevalence among girls (60.8%) compared to boys (40.0%); a difference statistically significant (<i>p</i> = 0.024, Fisher's exact test). Thirty-two patients (27.4%) had luxations/subluxations with the higher scores.</p><p><strong>Conclusions: </strong>Sitting in S, F, W, and C positions are preclinical phenotypic characteristics of JH, easily identified by pediatricians and family members to prevent possible joint deformities. BS ≥ 6 is more frequently observed in all positions. The majority of the total sample has BS > 6, with a significant female gender influence. Among those with a history of occasional joint dislocations and subluxations, half of them have the highest BS scores.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>MTHFR</i> Gene Polymorphisms and Cancer Risk in Children and Adolescents: A Systematic Review and Meta-Analysis.","authors":"Savvas Kolanis, Eleni P Kotanidou, Vasiliki Rengina Tsinopoulou, Elisavet Georgiou, Emmanuel Hatzipantelis, Liana Fidani, Assimina Galli-Tsinopoulou","doi":"10.3390/children12010108","DOIUrl":"10.3390/children12010108","url":null,"abstract":"<p><p><b>Background/Objectives:</b><i>MTHFR</i> gene polymorphisms (677C>T and 1298A>C) correlate with various types of cancer across all age groups; however, a small number of studies have included solely children and adolescents. The aim of this systematic review and meta-analysis was to present and synthesize all the available evidence on the association between <i>MTHFR</i> gene polymorphisms and the incidence of all types of cancer in children and adolescences. <b>Methods:</b> After a systematic search of all of the available data, original case-control studies involving children or adolescents with a confirmed diagnosis of any type of cancer and a molecular genetic test of <i>MTHFR</i> gene polymorphisms were included. <b>Results:</b> A total of 53 original studies in children and adolescents with cancer were included in the systematic review. Among these, 40 studies reviewed children and adolescents with Acute Lymphoblastic Leukemia (ALL), 4 those with Acute Myeloblastic Leukemia (AML), 8 those with central nervous system (CNS) tumors and 3 those with other types of cancer. Children and adolescents with ALL had less frequent T allele sequences (CT and TT variations) of the 677C>T polymorphism compared to a healthy population (OR: 0.85; CI: 0.80-0.91; <i>p</i> < 0.00001). Concerning the 1298A>C polymorphism, the C allele sequences (AC and CC) did not present a statistically significant difference in frequency compared to a healthy population (OR: 1.01; CI: 0.95-1.08; <i>p</i> = 0.69). <b>Conclusions:</b> Children and adolescents with ALL appeared to have the T allele sequences of the 677C>T polymorphism of the <i>MTHFR</i> gene less frequently compared to a healthy population.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Thyroid-Stimulating Hormone Reference Intervals in Multi-Ethnics Population.","authors":"Hery Priyanto, Fauqa Arinil Aulia, Hartono Kahar, Muhammad Faizi, Ferdy Royland Marpaung, Aryati Aryati","doi":"10.3390/children12010104","DOIUrl":"10.3390/children12010104","url":null,"abstract":"<p><p>(1) Background: This study is designed to establish thyroid-stimulating hormone (TSH) reference intervals tailored to different neonatal age groups and Indonesian local populations. (2) Methods: Dried blood spot neonatal TSH values, from 1 January 2022 to 31 December 2023, were used to establish the neonatal TSH reference intervals partitioned by sex, gestational age, and ethnic group at different neonatal ages. (3) Results: A significant difference in the reference intervals value was observed in sex, gestational ages, and parental ethnicity groups in different neonatal age subgroups (<i>p</i> < 0.05). Male reference intervals were significantly higher than those of females at all neonatal ages. Late and post-term gestational age categories reference intervals were higher than early and full-term. Among the ethnic groups, Madurese had a higher upper limit TSH reference interval. (4) Conclusions: Our neonatal TSH reference intervals were needed to provide a reference adapted to the local population of Indonesia.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes of Adolescents Toward Addictive Substances: Hope and Self-Control as Protective Factors.","authors":"Serkan Cengiz, Mehmet Emin Turan, Eyüp Çelik","doi":"10.3390/children12010106","DOIUrl":"10.3390/children12010106","url":null,"abstract":"<p><p><b>Background</b>: Experiences of ostracism may be related to attitudes toward substance abuse. However, the protective factors underlying this relationship are still unclear. Therefore, based on the Need-threat and Self-control theory, we aimed to test a model in which self-control and hope mediate the relationship between ostracism and attitudes toward addictive substances. <b>Methods</b>: In this model, we highlighted risk factors (ostracism) and protective factors (self-control and hope). This study was a cross-sectional data analysis of 787 students (52.50% boys, 47.50% girls; M<i>_age</i> = 15.69, SD = 1.12). <b>Results:</b> The results revealed that ostracism was positively associated with attitudes toward addictive substances, and evidence was provided that this relationship was mediated by hope and self-control. Ultimately, the research highlights the link between ostracism and attitudes toward addictive substances, identifying hope and self-control as mediators. <b>Conclusions</b>: This study highlights individual risk and protective factors related to attitudes toward addictive substances and offers new perspectives on ways to prevent and reduce adolescents' positive attitudes toward substance use. School counselors and educators should help students strengthen skills such as hope and self-control to prevent them from developing positive attitudes toward substance use in the future.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Tech Neck: A Pilot Study Using a Self-Developed Questionnaire on Symptoms, Posture, and Preventive Measures.","authors":"Brigitte Osser, Csongor Toth, Carmen Delia Nistor-Cseppento, Gyongyi Osser, Caius Calin Miuța, Iosif Ilia, Diana Carina Iovanovici, Cristina Aur, Laura Ioana Bondar","doi":"10.3390/children12010102","DOIUrl":"10.3390/children12010102","url":null,"abstract":"<p><strong>Background/objectives: </strong>Musculoskeletal symptoms, such as neck pain, back pain, and eye strain, are prevalent in modern work environments, particularly among individuals engaged in prolonged sitting and repetitive tasks. This study aimed to explore the prevalence of these symptoms and the impact of ergonomic tool usage, break frequency, posture awareness, and proactive measures on symptom intensity and daily functioning.</p><p><strong>Methods: </strong>This cross-sectional pilot study used a self-developed questionnaire to assess the prevalence and intensity of musculoskeletal symptoms among participants aged 6-18 years. The survey collected data on ergonomic tool usage, break frequency, posture awareness, and proactive measures (such as taking breaks and seeking professional help). Symptom intensity was assessed across common musculoskeletal issues. Internal consistency was assessed using Cronbach's Alpha. Statistical analyses, including descriptive statistics, Chi-squared tests, ANOVA, and Spearman's correlation, were used to identify significant correlations and associations between variables.</p><p><strong>Results: </strong>A significant proportion of participants reported moderate to severe symptoms, including neck pain, back pain, and eye strain. Participants who used ergonomic tools reported significantly lower symptom intensity (<0.001). A positive correlation was found between fewer breaks and higher symptom intensity (r = 0.908, <i>p</i> < 0.001). Those with higher posture awareness reported lower symptom intensity (<i>p</i> < 0.001). Proactive measures, including regular breaks and ergonomic interventions, were perceived as effective strategies for managing symptoms. Increased symptom intensity was associated with reduced ability to perform daily activities (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The study highlights the significant role of ergonomic tools, posture awareness, and regular breaks in mitigating musculoskeletal symptoms. Proactive measures, including structured interventions, can effectively reduce symptom intensity and improve daily functioning. These findings suggest that workplace health strategies focusing on ergonomics and posture education are crucial for reducing the impact of musculoskeletal discomfort on employee well-being and productivity.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stressful but Not Unhappy: A Review of the Positive Aspects of Parenting a Child with Autism Spectrum Disorder.","authors":"Kenneth Curley, Robert Hughes, Yasuhiro Kotera","doi":"10.3390/children12010107","DOIUrl":"10.3390/children12010107","url":null,"abstract":"<p><p>This review aimed to identify and synthesise the evidence for the positive aspects of parenting a child with autism spectrum disorder (ASD). To date, ASD parental research has predominantly focused on the negative aspects; parents and carers are left uninformed of how to strengthen their positive mental wellbeing. Three electronic databases-PubMed, Scopus, and Web of Science -were searched for literature reporting positive aspects of parenting a child with ASD, published between January 2013 and December 2023. The PRISMA 2020 checklist was used for reporting. Two hundred and fifty-four articles were retrieved from the databases. After title/abstract screening (<i>n</i> = 213) and full-text reviews (<i>n</i> = 32), six papers were included (<i>n</i> = 6). Sixteen positive aspects of parenting a child with ASD were identified and grouped into three themes: joyful moments, journey to resilience, and social connection. These three themes are eudaimonic wellbeing constructs and often under-represented in ASD parental studies. Focusing on joyful moments, building resilience through the parenting journey, and finding support and connection with others in similar situations can support the mental wellbeing of parents and carers of children with ASD. Future research is needed to further evaluate the positive aspects of parenting a child with ASD.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of Parents' Perspective of Receiving a Developmental Diagnosis for Their Child.","authors":"Stacey D Miller, Maria Juricic, Jaimy Coates, Jeffrey N Bone, Ash Sandhu, Kishore Mulpuri, Maureen O'Donnell","doi":"10.3390/children12010105","DOIUrl":"10.3390/children12010105","url":null,"abstract":"<p><p>Receiving a diagnosis, such as cerebral palsy (CP), can have lasting impacts on caregivers and families. Previous literature has described that caregivers wish to receive a diagnosis together, without delay, in a private, direct, honest, and sympathetic way. This study aimed to understand the experience of caregivers of children with cerebral palsy (CP) or similar conditions when receiving a diagnosis for their child.: Caregivers of children and youth aged 0-18 years with CP or a similar physical condition completed a survey investigating who first provided a diagnosis, and the way it was provided. Questions were based on the pediatric SPIKES framework. Caregivers were asked how receiving a diagnosis could have been improved. Thematic analysis of qualitative data were performed.: A total of 180 surveys were completed. Mean age at diagnosis was 19.0 (SD 25.7) months. Most caregivers reported the healthcare provider was sympathetic and understanding (75%) and clear and direct (69%). Only 25% of caregivers recalled being directed to where to find information; only 37% reported being told what their child does well or is expected to do well. Thematic analysis revealed three themes: (1) less waiting, (2) more compassionate communication, and, (3) information and support to move forward: Caregivers wanted the diagnosis to be timely and provided with compassion. Requests for greater information on the diagnosis, available support, and their child's future, suggest that greater care to support families in the aftermath of receiving a diagnosis is also needed.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of the Radial Bow in Children: Normative Values.","authors":"Samara F Kass, Julia L Conroy, Alisa Forsberg, Rebecca S Li, Catherine C May, Natasha S McKibben, Julio J Jauregui, Raymond W Lui, Joshua M Abzug","doi":"10.3390/children12010101","DOIUrl":"10.3390/children12010101","url":null,"abstract":"<p><strong>Background: </strong>Radial bowing is necessary for forearm rotation. Fractures or deformities of the forearm that affect the radial bow may disrupt normal forearm rotation.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate the development and establish normative values for the pediatric and adolescent radial bow.</p><p><strong>Methods: </strong>A retrospective review of radiographs from children aged 0-17 years with no previous history of an upper extremity fracture or condition was performed. Patient demographics, maximal radial bow location, and depth were recorded in millimeters and as percentages of the total radial length. The proximal, middle, and distal third radial bows were measured. Means and standard deviations were utilized to establish average measurements by age group. Pearson correlation coefficients assessed the relationship between radial bowing and age.</p><p><strong>Results: </strong>A total of 505 forearm radiographs were measured. The average age of the patients was 10.0 years (SD: 5.2). The maximal radial bow location remained consistent with age, with a mean value of 61.7%. The maximal radial bow depth marginally decreased with age, with a mean value of 7.7%. The proximal, middle, and distal third maximal radial bows (measured in millimeters) increased with age.</p><p><strong>Conclusions: </strong>The maximal radial bow depth marginally decreases with increasing age, while the location of the maximal radial bow remains consistent as age increases. These measurements may be used to assess fracture reduction to ensure proper restoration of the radial bow during fracture and congenital condition treatment. Furthermore, they can aid in the detection of subtle fractures of the radius, including plastic deformations and greenstick fractures.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational Study.","authors":"Manuele Cesare, Fabio D'Agostino, Emanuele Sebastiani, Nursing And Public Health Group, Gianfranco Damiani, Antonello Cocchieri","doi":"10.3390/children12010103","DOIUrl":"10.3390/children12010103","url":null,"abstract":"<p><strong>Background/objectives: </strong>The increasing medical and nursing care complexity in hospitalized children represents a significant challenge for healthcare systems. However, the link between these two dimensions remains partially explored. This study aims to decipher the relationship between Diagnosis-Related Group (DRG) weight and nursing care complexity in hospitalized children and to identify the determinants of medical complexity.</p><p><strong>Methods: </strong>This retrospective study, conducted in an Italian university hospital, included children aged 2 to 11 years admitted to the hospital in 2022 with a minimum hospital stay of 2 days. Data were gathered from the Neonatal Pediatric Professional Assessment Instrument and the Hospital Discharge Register. DRG weight was used as an indicator of medical complexity, while the number of nursing diagnoses (NDs) documented in the first 24 h from hospital admission and the nursing actions (NAs) recorded during the patient's hospital stay were used to measure nursing care complexity. Correlation analyses were conducted to explore the associations between DRG weight, NDs, and NAs. Stepwise regression was run to identify the key determinants of medical complexity across sociodemographic, clinical, organizational, and nursing variables.</p><p><strong>Results: </strong>Among 914 patients (mean age of 6.11 ± 2.90 years), the median DRG weight was 0.6982 (IQR: 0.5522). Patients had an average of 3.89 ± 2.83 NDs and a median of 17 NAs (IQR: 8). Significant correlations were found between NDs and NAs (r_s = 0.507; <i>p</i> < 0.001), as well as between DRG weight and the frequency of NDs (r_s = 0.232; <i>p</i> < 0.001) and NAs (r_s = 0.184; <i>p</i> < 0.001). Stepwise regression indicated that the number of NAs, surgical DRG, scheduled admissions, and ND frequency were significant determinants of DRG weight (R² = 0.311; adjusted R² = 0.308; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>In children, DRG weight is also influenced by nursing care complexity, alongside clinical and organizational factors. An integrated approach is essential to enhance pediatric care and patient outcomes.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}