Academic Pediatrics最新文献

{"title":"Meeting the Moment, Dreaming Better: The Future of Children in Immigrant Families.","authors":"Anik Patel, Alan Shapiro, Julie M Linton","doi":"10.1016/j.acap.2026.103435","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103435","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103435"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient interventions addressing the social determinants of health for children and their families: a scoping review.","authors":"Justine Cohen-Silver, Iryna Artyukh, Giulia Puinean, Kimberly M Walker, Jose M Navarro, Elizabeth M Wooster, Andrew D Pinto","doi":"10.1016/j.acap.2026.103480","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103480","url":null,"abstract":"<p><strong>Background: </strong>The social and economic environments in which children grow shape their immediate and long-term health. Many families navigate fragmented health and social care services, leaving critical needs unmet. Integrating social care within outpatient healthcare settings may improve continuity of care.</p><p><strong>Objectives: </strong>This scoping review summarizes the evidence on outpatient social care interventions for children ages 0-13 and/or their families, focusing on support for at least one social determinant of health (SDOH), including housing, transportation, and food insecurity, low income, unemployment, education, early literacy, and social isolation.</p><p><strong>Data sources and eligibility criteria: </strong>We searched eight databases through July 2025, including Medline, Embase, and CINAHL. Eligible studies examined outpatient interventions addressing at least one SDOH and were published in English from 2013 onward.</p><p><strong>Synthesis methods: </strong>Dual screening and data extraction were performed, and findings were synthesized narratively.</p><p><strong>Results: </strong>38 studies were included. Most were quantitative, non-randomized, conducted in the US, and based in pediatric clinics or federally qualified health centers. Interventions were organized using three models of health and social care integration: community partnerships (n=29), screening and intervening (n=21), and co-localization (n=9). Benefits included improved home literacy environments and parent-child interactions; higher program enrollment and adherence to well-visits and vaccinations; and better detection of social needs using universal screening.</p><p><strong>Limitations: </strong>Evidence was mostly US-based and limited to children 13 years or younger, restricting generalizability.</p><p><strong>Conclusions and implications: </strong>Outpatient social care interventions show promise in strengthening outcomes for children and families. Integrating multiple models may help bridge gaps across systems.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103480"},"PeriodicalIF":2.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older Adult Perceptions and Practices Regarding Medication Use and Storage.","authors":"Jennifer Lind Lyles, Devin I Freeman, Maribeth C Lovegrove, Nimalie D Stone","doi":"10.1016/j.acap.2026.103476","DOIUrl":"10.1016/j.acap.2026.103476","url":null,"abstract":"<p><strong>Objective: </strong>Approximately 35,000 young children are brought to US emergency departments annually due to unintentional medication exposures. A 2017 study examining the circumstances surrounding these exposures found that grandparents' medications were involved in 30.7% of prescription and 7.8% of over-the-counter exposures. Therefore, survey data were analyzed to better understand older adult perceptions and practices regarding medication use and storage to help inform interventions to promote safe medication storage behaviors.</p><p><strong>Methods: </strong>Data were collected from February 22-27, 2024, through an online, \"PN View Generation\" survey of older adults aged 60-78 years.</p><p><strong>Results: </strong>Among 986 older adult respondents, 20.8% reported frequent interaction and 79.2% reported infrequent/no interaction with young children. Overall, most respondents (90.8%) reported taking at least one medication/supplement every day. Respondents most commonly reported keeping household medications in a cabinet (56.5%), on a table/desk (30.3%), and on a countertop (20.7%). Nearly half of all older adult respondents (48.5%) reported that they transfer medications from their original bottles to other containers like daily pill organizers/pill boxes. Among respondents who wanted to hear safe medication storage messages (N=769), the most frequently identified locations where they preferred to see/hear messages were at pharmacies (72.7%) and doctors' offices (66.5%).</p><p><strong>Conclusions: </strong>Behaviors that could put young children at risk for unintentional medication exposures were commonly reported. Educational efforts to reach older adults, especially in healthcare settings, and packaging/storage innovations designed to increase the likelihood that adults keep medications/supplements within child-resistant containers may be necessary to promote safe storage behaviors when spending time with young children.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103476"},"PeriodicalIF":2.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Risk Identification: Adherence to a Pediatric Suicide Prevention Pathway in Primary Care.","authors":"Alexandra Huttle, Mangala Rajan, Nicole E Kelly, Luz Jimenez, Cori M Green","doi":"10.1016/j.acap.2026.103469","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103469","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate adherence to a structured suicide prevention pathway in pediatric primary care and characterize management practices following suicide risk assessment.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of well-child visits among adolescents aged 12-21 years at an urban academic pediatric clinic from 2022-2024. The pathway incorporated the Patient Health Questionnaire-9 Modified for Adolescents (PHQ-A) for suicide risk identification and the Columbia-Suicide Severity Rating Scale (C-SSRS) for risk assessment. Electronic health record (EHR) data assessed adherence to pathway components, and supplemental chart review characterized management practices, including safety planning and emergency department referral. Multivariable regression examined patient-, provider-, and system-level factors associated with adherence.</p><p><strong>Results: </strong>Among 3440 visits, the PHQ-A was completed in 84.8%. Suicide risk was identified in 8.6%, and 57.8% received a C-SSRS. When an EHR alert was triggered, 79% completed the C-SSRS compared with 11% without an alert (p < 0.001). Older adolescents were less likely to receive a C-SSRS assessment (aRR=0.93; 95% CI: 0.89-0.97). Among adolescents with low or moderate C-SSRS risk levels, 20.8% had documentation of a complete six-step collaborative safety plan. Manual chart review identified additional suicide-related management practices beyond the adherence metric, including partial safety planning, behavioral health involvement, referral to mental health services, and ongoing mental health treatment.</p><p><strong>Conclusions: </strong>Suicide prevention pathways can support identification, assessment, and management of suicide risk in pediatric primary care. EHR-based decision support may improve adherence. Defining evidence-based components of pediatric suicide prevention remains critical.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103469"},"PeriodicalIF":2.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Child Opportunity Index domains with emergency department disposition: analysis of a statewide sample.","authors":"Christina R Rojas, Samaa Kemal, Megan Attridge, Michelle L Macy, Sriram Ramgopal","doi":"10.1016/j.acap.2026.103470","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103470","url":null,"abstract":"<p><strong>Objective: </strong>The Child Opportunity Index (COI) is a composite measure designed to describe children's neighborhood resources and conditions, comprised of three domains: education, health & environment, and social & economic. We evaluated the association of COI, and its domains, with emergency department (ED) disposition.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of all statewide ED encounters for pediatric patients (<18 years) in 2023. We developed multivariable logistic regression models to evaluate the association of COI and its domains with ED admissions and transfers. Models were adjusted for insurance status, race and ethnicity, age, diagnosis, medical complexity, and hospital type.</p><p><strong>Results: </strong>There were 838,408 ED encounters in our sample; among these, 26,579 (3.2%) were admitted to the hospital and 18,130 (2.2%) were transferred. There was a U-shaped association between admission/transfer with COI and each of the three COI domains. When analyzed by diagnosis group, associations between COI and ED disposition varied, with low and high measures positively associated with this outcome. The social and economic domain demonstrated the best relative model fit in most models.</p><p><strong>Conclusions: </strong>Patients with both the lowest and highest COI experience higher odds of ED admission and/or transfer; this distribution was also noted for analyses incorporating the three domains of COI. The social and economic domain was the most consistent predictor. Understanding how differing aspects of the COI are associated with pediatric outcomes can improve interpretation of the index, clarify which domains are most meaningful, and support its more precise use in pediatric health research and risk assessment.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103470"},"PeriodicalIF":2.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continued Effort Needed to Increase Metric Dosing of Oral Liquid Medications.","authors":"Leah D Kaye, Ian M Paul","doi":"10.1016/j.acap.2026.103485","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103485","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103485"},"PeriodicalIF":2.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pain research and marginalized children in the emergency setting: a scoping review.","authors":"Elise Kammerer, Samina Ali, Calveen Basi, Patricia Candelaria, Jaspreet K Khangura, Lexyn Iliscupidez, Zoe Zelyck, Sarah E Elliott, Liz Dennett, Tehseen Ladha, Shannon D Scott, Lisa Hartling, Peak Equity In Pain Research Group","doi":"10.1016/j.acap.2026.103478","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103478","url":null,"abstract":"<p><strong>Background: </strong>Pediatric pain is prevalent in emergency departments (EDs). Marginalized children are disproportionately affected by disparities in pain care.</p><p><strong>Objectives: </strong>This scoping review maps the extent and nature of the literature concerning the pain care of marginalized children in the ED.</p><p><strong>Data sources: </strong>We searched MEDLINE, PsycINFO, CINAHL, Web of Science, iPortal, Native Health Database, and CENTRAL.</p><p><strong>Study eligibility criteria: </strong>Studies published between 2013 and 2025.</p><p><strong>Participants and interventions: </strong>Children/youth with pain or undergoing painful procedures in US or Canadian EDs; populations defined by at least one PROGRESS-Plus factor, an internationally recognized framework to identify characteristics that may be associated with inequities in healthcare.</p><p><strong>Study appraisal and synthesis methods: </strong>De-duplicated results from searching were screened in two stages by two reviewers in Covidence, with disagreements resolved through consensus, or a third reviewer. Data were charted using standard forms in Microsoft Excel. We extracted all PROGRESS-Plus criteria quantified in the studies.</p><p><strong>Results: </strong>From 3,056 identified records, we included 33 studies, all conducted in the US. Most (31/33) were retrospective studies. Child age was reported in all studies, race/ethnicity in 97% (32/33), and gender/sex in 94% (31/33). All studies concerned presenting pain; none explored procedural pain.</p><p><strong>Limitations: </strong>We only searched for literature conducted in Canada and the US and did not include studies documenting general care inequities.</p><p><strong>Conclusions and implications of key findings: </strong>Current research on marginalized children's pain in the ED is dominated by retrospective American studies using administrative data that focus on racial/ethnic disparities.</p><p><strong>Scoping review registration number: </strong>10.1371/journal.pone.0296518.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103478"},"PeriodicalIF":2.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth and Parent Perspectives on Patient-Centered Outcomes for a Pediatric Hospital-Based Violence Intervention Program.","authors":"Anthony Oddo, Kevin Rak, Leonardo Barrera, Leslie Helmcamp, Sheila Hickey, Britinia Johnson, Karen Sheehan, Samaa Kemal","doi":"10.1016/j.acap.2026.103473","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103473","url":null,"abstract":"<p><strong>Background: </strong>Hospital-based violence intervention programs (HVIPs) aim to interrupt cycles of violence and support recovery among youth exposed to interpersonal violence. However, HVIP evaluations often rely on deficit-oriented outcomes (i.e., reinjury, mortality, criminal justice system involvement) that may not reflect priorities of youth and families.</p><p><strong>Objective: </strong>To determine youth and parent perspectives on patient-centered outcomes, needs, and priorities following violent injury.</p><p><strong>Methods: </strong>Focus groups were conducted with youth and parents connected to community-based organizations (CBOs) collaborating with a pediatric HVIP. Focus group participants were engaged as community proxies for HVIP participants given their affiliation with CBOs serving violence-affected communities and their relevant experiences with violence and/or service systems. Focus groups explored definitions of health and success, barriers to healing, and priorities for recovery. Transcripts were analyzed using thematic analysis and consensus-based coding.</p><p><strong>Results: </strong>Three focus groups were conducted with a total of 17 participants (12 youth, 5 parents). Five major themes emerged: (1) holistic definitions of health and success; (2) emotional communication and processing during recovery following violent injury; (3) systemic and structural barriers to recovery; (4) social circles as key determinants in healing; (5) the role of trust in recovery. Regarding patient-centered outcome priorities, youth emphasized goal-planning, mental health and social needs, while parents highlighted mental health, mentorship, and repeat injury.</p><p><strong>Conclusions: </strong>Youth and parents prioritize outcomes that extend beyond traditional HVIP metrics. Incorporating patient-centered outcomes into program evaluation may better capture meaningful recovery and improve trauma-informed design of HVIPs.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103473"},"PeriodicalIF":2.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden Unexplained Deaths in Childhood: A Scoping Review.","authors":"Laura Gould, Caitlin Plovnick, Chidera Ubah, Joyce Campos, Orrin Devinsky","doi":"10.1016/j.acap.2026.103481","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103481","url":null,"abstract":"<p><strong>Background: </strong>Sudden unexplained death in childhood (SUDC) affects children 1-18 years whose deaths remain unexplained after thorough investigation. SUDC lacks a coordinated research strategy to clarify causes and reduce incidence.</p><p><strong>Objective: </strong>To conduct the first scoping review of the SUDC literature and characterize prevalence, study designs, key findings, knowledge gaps, and research recommendations.</p><p><strong>Data sources: </strong>PubMed, Embase, Scopus, Cochrane Library, Virtual Health Library, and ProQuest Dissertations searched through December 2025.</p><p><strong>Study eligibility criteria: </strong>Included articles comprised original research, reviews, and commentaries addressing unexplained deaths 1-18 years, with symptom onset <24 hours before death.</p><p><strong>Study appraisal and synthesis methods: </strong>Two reviewers screened studies and extracted data; a third assessed risk of bias and limitations.</p><p><strong>Results: </strong>We reviewed 101 studies published from 1951-2025, 75% after 2012. SUDC was rare, with variable prevalence and differing death-investigation practices. Most cases involved children aged 1-4 years, were unwitnessed, occurred during sleep, and found prone. Febrile seizures were reported at approximately 10-fold higher rates than expected. Older cases were less common and more heterogeneous. Genetic findings suggested possible cardiac and neurologic contributions. Autopsies usually showed mild, noncausal findings. Neuropathologic studies identified hippocampal anomalies of uncertain significance; proteomic studies found differences between explained and unexplained deaths.</p><p><strong>Limitations: </strong>Generalizability was limited by mixed populations, inconsistent terminology and investigative standards, and possible case duplication.</p><p><strong>Conclusions: </strong>SUDC research has grown but remains constrained by small datasets and methodological inconsistency.</p><p><strong>Implications of key findings: </strong>Progress will require multidisciplinary collaboration, standardized data collection, biospecimen access, and dedicated funding.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103481"},"PeriodicalIF":2.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccination during pregnancy or lactation and infant growth and health care utilization.","authors":"Elyse O Kharbanda, Jingran Cao, Gabriela Vazquez-Benitez, Kirsten Ehresmann, Elisabeth M Seburg, Malini B DeSilva, Yihe G Daida, Kimberly K Vesco, Abbey Sidebottom, Rachel Effros, Heather S Lipkind, Kristin Palmsten","doi":"10.1016/j.acap.2026.103477","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103477","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate associations between COVID-19 vaccination during pregnancy or lactation and infant growth and health care utilization.</p><p><strong>Methods: </strong>This observational study from 4 U.S. health systems included singleton pregnancies with linked live births from December 2020-September 2022; eligibility varied by exposure and outcome. COVID-19 vaccinations were identified from electronic health records, claims, and immunization information systems. Infant health care utilization was based on number of outpatient (OP) or emergency department (ED) visits while faltering weight was identified from weight-for-length percentiles. Outcomes were compared for those with and without COVID-19 vaccine exposures ≥20 weeks gestation or during lactation and within 90 days following delivery. For OP and ED visits, we calculated adjusted rate ratio (aRR) and 95% confidence intervals (CI) using negative binomial regression. For faltering weight, we calculated adjusted prevalence ratio (aPR) and 95% CIs using Poisson regression.</p><p><strong>Results: </strong>Among 7,141 eligible mother-infant dyads, aRRs for infant OP and ED visits by 6 months following COVID-19 vaccination during pregnancy were 1.03 (95% CI 0.99-1.06) and 1.03 (0.83-1.27), respectively. Among 11,921 eligible mother-infant dyads the aPR for faltering weight by 12 months following vaccination during pregnancy was 1.07 (0.89-1.28). Among 8,442 lactating mother-infant dyads, aRRs for infant OP and ED visits within 90 days of postpartum vaccination were 1.03 (0.98-1.08) and 1.05 (0.70-1.56), respectively. Among 10,181 mother-infant dyads, the aPR for faltering weight following vaccination during lactation was 0.62 (0.48-0.79).</p><p><strong>Conclusion: </strong>COVID-19 vaccination during pregnancy or lactation was not associated with adverse infant growth or health care utilization.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103477"},"PeriodicalIF":2.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}