Current Problems in Pediatric and Adolescent Health Care最新文献

{"title":"Evidence-based practice recommendations for infection prevention in pediatric sickle cell patients: Interventions for the primary care provider.","authors":"Elizabeth K Webb, Amanda A Cavness, William C Owen","doi":"10.1016/j.cppeds.2025.101763","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101763","url":null,"abstract":"<p><p>In this article, we provide pediatric primary care providers (PCPs) with evidence-based recommendations to reduce the risk of life-threatening bacterial infections in pediatric patients with sickle cell disease (SCD). Standard practice guidelines for SCD comprehensive care are lacking in comparison to other chronic diseases. There is a need for continued advocacy for quality healthcare for patients with SCD, including updated standard-of-care guidelines. As a result of these concerning inequities, PCPs and specialty providers are forced to reference and compare recommendations across several different health organizations to identify the best practice. PCPs should feel empowered to follow augmented immunization schedules in pediatric patients with SCD. Immunizations and proper antibiotics can be lifesaving against invasive meningococcal and pneumococcal infections. We outline opportunities for improving quality of care in pediatric patients with SCD for PCPs in the community.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101763"},"PeriodicalIF":3.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreword-advancing quality improvement Part I.","authors":"John M Pascoe","doi":"10.1016/j.cppeds.2025.101755","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101755","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101755"},"PeriodicalIF":3.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Quality Improvement.","authors":"Grant Turek, Kelly C Sandberg","doi":"10.1016/j.cppeds.2025.101756","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101756","url":null,"abstract":"<p><p>The introduction of Artificial Intelligence (AI) into the field of medicine be met with hesitation. AI s already showing promise in specific aspects of care and research. Under the guiding hand of clinicians and researchers these new tools can elevate the quality of many different aspects of care. AI tools can benefit the patient, clinician, and quality improver. Embracing and cultivating the work of AI emphasizes the human capabilities of the physician leading to improved clinical care and enhance quality improvement.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101756"},"PeriodicalIF":3.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data Transparency in Healthcare Quality Improvement.","authors":"Brian Weimerskirch, Carrie Baker","doi":"10.1016/j.cppeds.2025.101758","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101758","url":null,"abstract":"<p><p>In recent years, the American healthcare system has seen a rapid transition to electronic health records (EHR) and a significant accumulation of digital healthcare information.¹^,² Having accurate data are key for quality improvement efforts. Unfortunately, a lack of standardization and limited access to stored data have created barriers to its use.³ The principles of data transparency include making the source and validation methods of the data clearly evident as well as ensuring equitable, easy, and timely access to the data. Data transparency can help utilize this digital transformation to support quality improvement efforts and create an effective learning health system.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101758"},"PeriodicalIF":3.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the public's knowledge, attitudes, and practice intersect with scientific evidence about fluoride.","authors":"Christine Till, Jana El-Sabbagh, Carly Goodman, Mikel Subiza-Pérez, Meaghan Hall","doi":"10.1016/j.cppeds.2025.101768","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101768","url":null,"abstract":"<p><p>For over 75 years, community water fluoridation has been implemented as a public health strategy to reduce dental caries. While early studies suggested dramatic reductions in dental caries, recent evidence indicates that the benefits of community water fluoridation are more modest. Concurrently, concerns have grown over rising rates of enamel fluorosis and possible links between fluoride intake and lowered intelligence in children and thyroid hormone disruption, even at exposure levels found in fluoridated regions. This first part of this paper discusses the historical context and current scientific evidence on the effectiveness of community water fluoridation and safety of systemic fluoride. The second part presents findings from a fluoride survey conducted with 8011 adults in Canada and the U.S. The survey assessed knowledge about fluoride, public perceptions of the risks and benefits of community water fluoridation, and fluoride use with young children. Overall, 60 % of respondents correctly identified why fluoride is added to drinking water. Knowledge of community water fluoridation was higher among older, more educated, and White participants. Among those familiar with community water fluoridation, 51 % expressed support, 27 % opposed it, and 25 % were neutral. Support was primarily driven by confidence in its safety and benefits, while opposition was driven by safety concerns and perceived violations of personal freedom. Trust in public health officials was higher among supporters (87 %) compared with non-supporters of community water fluoridation (52.1 %). When presented with hypothetical risk-benefit scenarios, participants consistently prioritized the prevention of potential health risks, such as reduced IQ, over the relatively modest dental benefit of preventing one cavity. The survey also revealed that most parents report using more fluoride toothpaste for young children than recommended, suggesting a gap in adherence to safe fluoride use guidelines. Our findings highlight mixed public views on community water fluoridation and knowledge gaps surrounding fluoride toothpaste use with children, underscoring the need for clear, evidence-based communication about fluoride exposures.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101768"},"PeriodicalIF":3.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a quality improvement roadmap as a tool to guide quality improvement education and methodology.","authors":"Beth Williams, Lisa R Jasin","doi":"10.1016/j.cppeds.2025.101766","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101766","url":null,"abstract":"<p><p>Quality improvement in medicine is the process of changing behavior in response to experiential learning. The most referenced quality improvement methodologies include the Institute for Healthcare's Model for Improvement, Six Sigma, and Lean. The Model for Improvement is the model focused on healthcare and frontline staff. Evidence-based practice models all begin with asking a question, which is shared with quality improvement models. Successful evidence-based practice and quality improvement organizational cultures support a questioning attitude. A quality roadmap developed using both quality improvement and evidence-based practice methodology facilitates the learning process and transition to quality improvement in clinical practice. Use of the quality roadmap framework provides an opportunity to cultivate psychological safety and a questioning attitude. Use of standardized tools, like a quality improvement roadmap in quality improvement positively affects children and their families.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101766"},"PeriodicalIF":3.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating effective PDSA cycles.","authors":"Chris Bugnitz, Kelly C Sandberg","doi":"10.1016/j.cppeds.2025.101759","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101759","url":null,"abstract":"<p><p>Quality improvement is achievable in healthcare with the help of a set of tools. One such tool is the Plan-Do-Study-Act cycle, or PDSA cycle. When utilized correctly, PDSA cycles have the potential to effect meaningful change. When used incorrectly, they can defer learning and be counterproductive to quality healthcare. Appropriate use of PDSA cycles will be demonstrated using a ubiquitous challenge in ambulatory care, clinic workflow.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101759"},"PeriodicalIF":3.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol use in adolescents.","authors":"Arnikka Rubia, Ariel Tassy Nunez","doi":"10.1016/j.cppeds.2025.101752","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101752","url":null,"abstract":"<p><p>Alcohol use and abuse among children and adolescents remains an ongoing and significant concern in our society-one that has persisted for decades. Despite the rise in popularity of other illicit substances, alcohol continues to be a major and consistent contributor to negative health and social outcomes. As such, it is essential that physicians and other healthcare providers caring for young people be proactive. This includes routinely screening for alcohol use, providing appropriate anticipatory guidance, and referring patients for treatment when alcohol use disorder is identified.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101752"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustaining improvement gains.","authors":"Mellissa Mahabee, Maddie VanDorpe, Samantha Neumeier","doi":"10.1016/j.cppeds.2025.101757","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101757","url":null,"abstract":"<p><p>A \"system\" as described by W. Edwards Deming, the father of the quality movement, is a set of interdependent components - structures, people, and processes - working together towards a common purpose.¹ Within health systems, the primary intent and common purpose is to promote, restore, and maintain health by focusing on safety, effectiveness, and efficiency. For these reasons, many organizations devote substantial time and resources to build their improvement capability, but these hard-earned improvements fade as the focus changes to other priorities and workers revert to the old system of doing things. To counter this, many health systems are incorporating methods that ensure initiatives continue to help patients in the short term but also become embedded in the system to help future patients. The Institute for Healthcare (IHI) in their 2016 White Paper suggests that the key to sustaining improvements in systems is to \"focus on the daily work of frontline managers, supported by a high-performance management system (HPMS) that prescribes standard tasks and responsibilities for these managers at all levels of the organization.\"² Both these factors are interconnected. An HPMS can be categorized into several areas; quality management, quality control, quality improvement, and a culture of high performance. As a practical example, this paper describes how the IHI framework can be employed to achieve sustainability for quality improvements, using an example of improving problem list utilization at discharge for patients.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101757"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyzing the CBC for common pediatric hematologic disorders in primary care.","authors":"Charlotte McCrary, Eric J Lowe","doi":"10.1016/j.cppeds.2025.101761","DOIUrl":"https://doi.org/10.1016/j.cppeds.2025.101761","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101761"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}