{"title":"Caregiver Perspectives on the Outcomes of a Multidisciplinary Developmental Assessment Service for Rural and Remote Children With Complex Needs and Adverse Childhood Experiences: A Mixed-Methods Study.","authors":"Leda Sivak, Marcel Zimmet, Blake Dear, Rosemary Evans, Jacqueline Emery, Allison Waters, Elizabeth J Elliott","doi":"10.1016/j.pedhc.2026.07.011","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.07.011","url":null,"abstract":"<p><strong>Introduction: </strong>This study describes the psychosocial complexity of rural and remote children and families who accessed a multidisciplinary developmental assessment service in New South Wales, Australia, as well as caregiver perspectives regarding service impact and outcome.</p><p><strong>Methods: </strong>This parallel convergent mixed-methods study involved thematic analysis of semi-structured interviews (n = 8) and descriptive analysis of cross-sectional survey responses (n = 154) with caregivers of children involved in a multidisciplinary pediatric developmental assessment service for rural and remote Australian children.</p><p><strong>Results: </strong>Survey respondents reported high rates of Adverse Childhood Experiences (ACEs) and related life events, including caregiver mental health issues (61%) and children's experiences of community violence (35%) and discrimination (31%). Interviewees highlighted the importance of diagnosis for understanding their child's behavior.</p><p><strong>Discussion: </strong>Rural and remote children in Australia experience alarming rates of ACEs, financial and other psychosocial stresses. Responsive, family-centered, multidisciplinary diagnostic services are perceived by caregivers as impactful.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892770","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":"Why Screening Matters in Pediatric Primary Care: Adolescent Suicide Risk from a 2023 Youth Risk Behavior Survey.","authors":"Ashley E Barber, Yu Jin Kang, Regena Spratling","doi":"10.1016/j.pedhc.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.08.001","url":null,"abstract":"<p><strong>Introduction: </strong>Suicide is the second leading cause of death among the adolescent patient population with limited evidence supporting routine suicide screening. This study sought to assess adolescent suicidal ideation, suicide attempts, and mental wellbeing to inform evidence-based universal suicide screening practice.</p><p><strong>Method: </strong>A secondary data analysis of the 2023 Youth Risk Behavior Survey was conducted. Descriptive statistics and ordinal logistic regression were performed, using SPSS v.29, with a significance level of 0.05.</p><p><strong>Results: </strong>The majority of participants were male (50.3%), over 16 years-old (61.3%), and White (49.2%). Compared with participants always reporting poor mental health without suicidal ideation, those with suicidal ideation and better mental health had significantly higher odds of more suicidal attempts (always good: OR = 19.14, 95% CI = 11.69-31.33; sometimes good: OR = 17.68, 95% CI = 13.53-23.09, p < .001).</p><p><strong>Conclusions: </strong>Consideration of universal suicide screening among adolescents may be warranted; however, the significance of the findings requires further examination.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892832","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}
Juan Boriosi, Christina Bryndzia, Megan Peters, Nick Barrowman, Mei Han, Peggy Dorr
{"title":"Advanced Practice Provider Procedural Sedation Practice and Outcomes: A Report From the Pediatric Sedation Research Consortium.","authors":"Juan Boriosi, Christina Bryndzia, Megan Peters, Nick Barrowman, Mei Han, Peggy Dorr","doi":"10.1016/j.pedhc.2026.07.006","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.07.006","url":null,"abstract":"<p><strong>Introduction: </strong>The objective was to describe the current practice of pediatric procedural sedation outside the operating room (OR) by advanced practice providers using data from the Pediatric Sedation Research Consortium (PSRC).</p><p><strong>Method: </strong>Retrospective analysis of prospectively collected cases in which the responsible provider was an advanced practice provider (pediatric nurse practitioner or physican assistant), from April 27, 2020, to July 31, 2024. Descriptive statistics, adverse events, and interventions were reported.</p><p><strong>Results: </strong>A total of 3,795 (3.6%) cases met inclusion criteria. Median patient age was 6 years (interquartile range: 2, 11) and 49% were male. Ninety-five percent of cases were American Society of Anesthesiologists (ASA) status 1-2. The most common procedure was radiologic (24%). Most procedures took place in a sedation unit (76%). The most common sedative administered was midazolam (50%). Cases with any adverse events and any critical adverse events were infrequent, 3.3%, and 0.1%, respectively. 0.4% of cases were unable to be completed.</p><p><strong>Discussion: </strong>These data demonstrate low frequency of adverse events and discontinued procedures for advanced practice provider-administered sedations.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881711","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":"\"It's Hard to Feed Them Right\": A Phenomenological Analysis of Dietary Diversity, Family Sanitation, and Food Access in Rural Indonesian Stunting Cases.","authors":"Tantut Susanto, Hanny Rasni, Emi Wuri Wuryaningsih","doi":"10.1016/j.pedhc.2026.07.010","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.07.010","url":null,"abstract":"<p><strong>Introduction: </strong>This study explores maternal perceptions of stunting, food security challenges, and child-feeding efforts in rural Indonesia, where socioeconomic constraints and traditional practices significantly impact child nutritional outcomes.</p><p><strong>Method: </strong>Utilizing a descriptive phenomenological approach, the study conducted in-depth interviews with 16 mothers of stunted toddlers to explore their daily experiences regarding food access and family sanitation, achieving data saturation.</p><p><strong>Results: </strong>Three themes emerged. First, mothers view stunting as nutritional deficiency and growth failure causing low immunity. Second, economic barriers and limited knowledge drive food insecurity, forcing reliance on cheap, low-nutrient diets instead of animal proteins. Third, mothers actively attempt food modification and utilize Posyandu for supplementary feeding, preferring face-to-face counselling.</p><p><strong>Discussion: </strong>Maternal care for stunted children is heavily hindered by poverty and low health literacy, despite active engagement with local health services. Interventions must prioritize direct nutritional education and economic empowerment to improve dietary diversity and household food security.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889154","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":"Breaking Silos in Pediatric Nurse Practitioner Education: Virtual Case Collaboration Between Primary and Acute Care Pediatric Nurse Practitioner Students.","authors":"Sally Humphrey, Andrea Sebastian","doi":"10.1016/j.pedhc.2026.07.005","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.07.005","url":null,"abstract":"<p><strong>Introduction: </strong>This article describes a virtual case study initiative to promote collaboration between Acute and Primary Care Pediatric Nurse Practitioner students. The program aimed to enhance clinical reasoning skills and clarify role differences within pediatric healthcare.</p><p><strong>Methods: </strong>Students in both Acute and Primary Care PNP programs at UTHSC CON were assigned case studies on pediatric neurological and cardiovascular issues relevant to their settings. Each student prepared a 10-minute oral presentation covering: Chief Complaint, History of Present Illness, Review of Systems, Medical/Family/Social History (if applicable), Physical Examination Findings, Differential Diagnosis, Final Diagnosis, Medical Management Plan, and Family Education or Anticipatory Guidance. Presentations were delivered virtually via Zoom to peers, faculty, and clinical experts in neurology and cardiovascular care. After each presentation, students and faculty debriefed, provided feedback, and asked questions. Students then completed a 10-question survey about their experience.</p><p><strong>Results: </strong>Student feedback from the post-activity survey was limited (n=4) but revealed consistent themes. Students valued examining the same diagnosis in different clinical contexts, especially comparing acute presentations in primary care and transitions to the emergency department. They appreciated exposure to diverse clinical perspectives, real-world cases, and involvement of specialty nurse practitioners.</p><p><strong>Discussion: </strong>Through interactive case presentations, faculty-led discussions, and structured feedback, the initiative deepened students' understanding of care transitions across settings. It also fostered advanced diagnostic reasoning and collaborative skills essential for interdisciplinary practice. The project was well received, highlighting the value of case-based learning in competency-based education.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881705","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}
Htu Lum MPH, Kaung Myat Soe MPH, Wor Mi Thi DrPH, Kyaw Min Htike DrPH, Roshan Kumar Mahato DrPH
{"title":"Childhood Malnutrition and its Predictors: A Comparative Cross-Sectional Study on Stunting and Wasting in Under-Five Children Along the Myanmar–China Border","authors":"Htu Lum MPH, Kaung Myat Soe MPH, Wor Mi Thi DrPH, Kyaw Min Htike DrPH, Roshan Kumar Mahato DrPH","doi":"10.1016/j.pedhc.2026.03.005","DOIUrl":"10.1016/j.pedhc.2026.03.005","url":null,"abstract":"<div><h3>Background</h3><div>In Myanmar, malnutrition is particularly severe in underserved areas such as the Myanmar–China border, where data are scarce.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted from April 2024 to March 2025 in selected townships of Kachin State among children aged 6–59 months. Bivariate and multivariable logistic regression analyses were used to identify associated factors under <em>p</em> < .05.</div></div><div><h3>Results</h3><div>Of the total 518 respondents, stunting was observed in 26.25% (95% confidence interval [CI]: 22.64–30.23) and wasting in 20.66% (95% CI: 17.38–24.37). Stunting was associated with high birth order (adjusted odds ratio [AOR]: 2.07; 95% CI: 1.15–3.71), inadequate antenatal care (AOR: 2.53; 95% CI: 1.37–4.69), and unsafe wastewater disposal (AOR: 1.67; 95% CI: 1.08–2.61). Similarly, wasting was associated to low birth order (AOR: 2.77; 95% CI: 1.02–7.52), early complementary feeding (AOR: 3.36; 95% CI: 1.64–6.88), and improper garbage disposal practices (AOR: 3.26; 95% CI: 2.02–5.27).</div></div><div><h3>Conclusion</h3><div>Stunting and wasting are influenced by demographic, maternal, environmental, and feeding factors. Targeted interventions are essential.</div></div>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 5","pages":"Pages 678-689"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787672","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}
Asma A. Taha PhD, CPNP, PC/AC, PCNC-BC, FAAN (Professor, Pediatric Nurse Practitioner), Sarah F. Sahl RDN, LDN (Assistant Professor, Registered Dietitian), Julia R. Farrell P-OTD, OTR/L, IBCLC (Assistant Professor, Occupational Therapist), Amber Wright DNP, CPNP-PC, PMHS, CENP (Assistant Professor, Pediatric Nurse Practitioner), Kelsey Frazier MA, CCC-SLP (Instructor, Speech Pathologist), Sylvia Doan MBBS (Assistant Professor, Medical Director, Feeding Clinic)
{"title":"Beyond “Picky Eating”: Identification, Screening, and Referral for Pediatric Feeding Disorders in Primary Care","authors":"Asma A. Taha PhD, CPNP, PC/AC, PCNC-BC, FAAN (Professor, Pediatric Nurse Practitioner), Sarah F. Sahl RDN, LDN (Assistant Professor, Registered Dietitian), Julia R. Farrell P-OTD, OTR/L, IBCLC (Assistant Professor, Occupational Therapist), Amber Wright DNP, CPNP-PC, PMHS, CENP (Assistant Professor, Pediatric Nurse Practitioner), Kelsey Frazier MA, CCC-SLP (Instructor, Speech Pathologist), Sylvia Doan MBBS (Assistant Professor, Medical Director, Feeding Clinic)","doi":"10.1016/j.pedhc.2026.05.011","DOIUrl":"10.1016/j.pedhc.2026.05.011","url":null,"abstract":"<div><div>Pediatric feeding disorders (PFDs) affect 1 in 37 children under age 5 in the United States, representing a common yet frequently underrecognized condition in primary care. In 2019, a multidisciplinary expert panel established the first consensus definition of PFD, creating a standardized four-domain framework (medical, nutritional, feeding skill, and psychosocial) that has transformed clinical assessment and management. A recent 2025 consensus further clarified the relationship between PFD and avoidant/restrictive food intake disorder (ARFID), providing guidance on diagnostic overlap and differentiation. This continuing education article provides pediatric healthcare providers with current, evidence-based knowledge to screen, identify, and make appropriate referrals for children with PFDs. The article reviews the consensus definitions, epidemiology, validated screening tools, differential diagnosis, risk factors, assessment strategies, and referral guidelines. A case-based example illustrates the application of the four-domain framework in clinical practice. With appropriate early identification and intervention, most children with feeding difficulties can achieve improved nutritional status, oral-motor development, and positive mealtime experiences.</div></div>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 5","pages":"Pages 770-781"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856406","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":"Editorial Board Page","authors":"","doi":"10.1016/S0891-5245(26)00235-X","DOIUrl":"10.1016/S0891-5245(26)00235-X","url":null,"abstract":"","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 5","pages":"Pages A5-A6"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856439","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":"Fenofibrate vs. Omega-3 in Pediatric Hypertriglyceridemia: A Randomized Controlled Trial","authors":"Setila Dalili MD, Shahin Koohmanaee MD, Afagh Hassanzadeh Rad PhD, Parnian Nemati Pharm D, Habibeh Mashayekhi-sardoo PhD, Reza Bayat MSc, Maryam Shahrokhi Pharm D, PhD","doi":"10.1016/j.pedhc.2025.12.021","DOIUrl":"10.1016/j.pedhc.2025.12.021","url":null,"abstract":"<div><h3>Introduction</h3><div>Concerning the growing prevalence of hypertriglyceridemia in pediatrics, further investigation into their use in children is warranted. This study aimed to evaluate the efficacy and safety of fenofibrate compared to omega-3 in pediatric hypertriglyceridemia.</div></div><div><h3>Methods</h3><div>This open-label, parallel-group randomized controlled trial was performed in 17 Shahrivar Hospital in Rasht, Iran, from January to June 2023. This included individuals aged 8 to 18 with TG levels >400 mg/dL or >250 mg/dL unresponsive to diet and exercise. Patients (N = 30) were randomly assigned to receive either fenofibrate (100 mg daily) or omega-3 (1,000 mg twice daily) for 12 weeks.</div></div><div><h3>Results</h3><div>Fenofibrate treatment significantly lowered triglyceride (TG), Low-density lipoprotein-cholesterol (LDL-C), and total cholesterol levels compared to omega-3 (<em>p</em> = .014, <em>p</em> < .001, and <em>p</em> < .001, respectively). The omega-3 group exhibited an upward trend in high-density lipoprotein-cholesterol (HDL-C) levels (<em>p</em> = .004), and intergroup differences were statistically significant (<em>p</em> = .038).</div></div><div><h3>Discussion</h3><div>Fenofibrate appeared to be a safe and effective candidate for TG lowering in pediatrics with hypertriglyceridemia, though further clinical research is recommended.</div></div>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 5","pages":"Pages e207-e214"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120902","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}
Nutrena H. Tate PhD, MBA, APRN, CPNP-PC, NEA-BC, FADLN
{"title":"ACTIVATE: Igniting Engagement, Leadership, and the Future of Pediatric-Focused Advanced Practice Nursing","authors":"Nutrena H. Tate PhD, MBA, APRN, CPNP-PC, NEA-BC, FADLN","doi":"10.1016/j.pedhc.2026.06.008","DOIUrl":"10.1016/j.pedhc.2026.06.008","url":null,"abstract":"","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 5","pages":"Pages 641-642"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856172","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}