Academic Pediatrics最新文献

{"title":"Mentorship that Matters: Cultivating the Next Generation of Academic Pediatricians.","authors":"Joseph L Wright, Courtney A Gilliam, Aisha N Barber","doi":"10.1016/j.acap.2026.103438","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103438","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103438"},"PeriodicalIF":2.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892776","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":"Care Delivery Redesign for Children with Chronic Conditions: A Call to Embrace the Reality of Children's Needs.","authors":"Christopher J Stille, Kristina Malik, Amy J Houtrow, Dennis Z Kuo","doi":"10.1016/j.acap.2026.103433","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103433","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103433"},"PeriodicalIF":2.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892785","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":"Housing and health: Evidence to act now to improve the health of children and families.","authors":"Kathryn M Leifheit, Taylor M Mobley, Daria Murosko, Noelia Lugo, Megan Sandel","doi":"10.1016/j.acap.2026.103424","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103424","url":null,"abstract":"<p><p>Extensive, high-quality evidence has demonstrated the importance of housing as a fundamental determinant of child health and development. At the same time, housing has become more unaffordable in the US, such that one in three children lives in unaffordable housing, more children are at risk of eviction and homelessness, housing quality has not improved meaningfully, and wide disparities exist in neighborhood access to socioeconomic opportunity. This narrative review chronicles the impacts of housing on children's health via four pillars: affordability, stability, quality and safety, and neighborhood conditions. We 1) provide an overview of evidence linking each of these housing pillars to child health outcomes and 2) describe effective interventions to reinforce the housing pillar and promote health. Based on this evidence, we urge pediatricians to intervene and advocate at multiple levels in order to advance housing and health for children and families. This review aims to serve as a reference for pediatricians seeking to implement evidence-based housing interventions, across individual, clinical, systems, and policy levels.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103424"},"PeriodicalIF":2.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892799","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":"Reducing Intergenerational Poverty.","authors":"Nicholas J Ainsworth, Greg J Duncan","doi":"10.1016/j.acap.2026.103423","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103423","url":null,"abstract":"<p><p>How can the United States reduce the number of children in our country who, after growing up in families with incomes below the poverty line, remain poor as adults? This article summarizes key conclusions of a 2024 report issued by the Committee of the National Academies of Sciences, Engineering, and Medicine on Policies and Programs to Reduce Intergenerational Poverty. The committee sought to identify evidence-based policies and programs directed at low-income children, their families, or their neighborhoods that could reduce children's chances of remaining low-income as adults. The committee found direct evidence of success in affecting correlates of adult poverty (e.g., low educational attainment and earnings, poor health) for more than two dozen programs and policies addressing health; education; income and parental employment; housing; and crime. Because we concentrate on interventions focused on child health, we include a brief discussion of the importance of the involvement of health care professionals in implementing policy changes resulting from the passage of the One Big Beautiful Bill Act (OBBB Act).</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103423"},"PeriodicalIF":2.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892921","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":"The Challenge to American Childhood.","authors":"Lisa Jo Chamberlain, Olanrewaju O Falusi, Paul H Wise","doi":"10.1016/j.acap.2026.103434","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103434","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103434"},"PeriodicalIF":2.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892864","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":"Impact of Eat, Sleep, Console Versus Finnegan Neonatal Abstinence Scoring System on Neonatal Outcomes: A Meta-Analysis","authors":"Lianhao Qu BHSc,&nbsp;Avery Rhind BHSc,&nbsp;Sabrina Sefton BHSc,&nbsp;Seth Ybema BHSc,&nbsp;Medha Goyal MD, RCPSC (SEAP),&nbsp;Rizwana Ashraf MD,&nbsp;Margaret Secord-Gilbert,&nbsp;Michael Wong PhD,&nbsp;Rohan D’Souza Dr, MD, PhD, FRCOG","doi":"10.1016/j.acap.2026.103378","DOIUrl":"10.1016/j.acap.2026.103378","url":null,"abstract":"<div><h3>Background</h3><div>There are limited high-quality syntheses supporting the use of Eat, Sleep, Console (ESC) approach over Finnegan Neonatal Abstinence Scoring System (FNASS) for Neonatal abstinence syndrome (NAS).</div></div><div><h3>Objective</h3><div>To compare outcomes with ESC versus FNASS</div></div><div><h3>Data Sources</h3><div>Medline, EMBASE, PsycINFO, Web of Science, and CINAHL until March 2025</div></div><div><h3>Study Eligibility Criteria</h3><div>English-language articles comparing outcomes with ESC and FNASS.</div></div><div><h3>Appraisal and Synthesis Methods</h3><div>Random effects meta-analysis to calculate risk ratios (RR), absolute risk reduction (ARR), and mean difference (MD) with 95% confidence intervals (95%CI) and certainty of evidence (CoE) using the GRADE approach.</div></div><div><h3>Results</h3><div>We identified 30 observational studies and 1 randomized controlled trial (RCT). Based on meta-analysis of observational studies, ESC may be associated with reduced need for pharmacological treatment [n=6098; RR 0.51, 95%CI, 0.41–0.63, ARR 23.9%, low CoE]. ESC may also be associated (very low CoE) with shorter length of hospital stay [n=5841, MD −4.33; 95%CI −5.66 to −2.99], fewer neonatal intensive care unit admissions [n=2112; RR 0.69, 95%CI 0.51–0.93, ARR 10.1%], decreased hospital costs [n=546; MD −13,341, 95%CI −15,993 to −10,690], shorter duration of pharmacological treatment [n=3021; MD −4.97 days, 95%CI −5.68 to −4.26] and higher 30-day readmission risk [n=3390; RR 1.43, 95%CI 1.02–1.99, ARR 1.2%].</div></div><div><h3>Limitations</h3><div>Risk-of-bias; Heterogeneity in outcomes; low-to-very-low CoE.</div></div><div><h3>Conclusions</h3><div>Based on low CoE largely from observational studies, ESC may reduce treatment duration, hospital stay, and hospital costs. Well-powered RCTs assessing a range of patient important outcomes are required to confirm the optimal assessment approach for NAS outcomes.</div></div><div><h3>Systematic Review Registration</h3><div>PROSPERO CRD42024530639.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"26 7","pages":"Article 103378"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370767","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":"HIGH-IMPACT LECTURES: How to Create Lectures That Engage Your Audience Through Problem-Centered Learning","authors":"Savarra Mantzor MD, PhD,&nbsp;Betty Ansong-Assoku MD,&nbsp;Elizabeth Reed Hanson MD,&nbsp;On Behalf of the Association of Pediatric Program Directors Faculty and Professional Development Task Force","doi":"10.1016/j.acap.2026.103382","DOIUrl":"10.1016/j.acap.2026.103382","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"26 7","pages":"Article 103382"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370831","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":"Smart Inhaler Randomized Controlled Trial for Improving Inhaler Technique in Adolescents With Intellectual and Developmental Disabilities and Asthma","authors":"Sophia Park MD,&nbsp;Alexis Deavenport-Saman DrPH, MPH,&nbsp;My H. Vu MS,&nbsp;Ramon Durazo-Arvizu PhD,&nbsp;Hyunbin Park MD,&nbsp;Jeanne Delgado MD, MPH,&nbsp;Christine B. Mirzaian MD, MPH, IBCLC,&nbsp;Caitlin Sayegh PhD,&nbsp;Naydelli Mendoza MPH,&nbsp;Jasmine Osumo MPH, PTA, CBIS,&nbsp;Megan Enciso MPH,&nbsp;Aneli Torres MPH,&nbsp;Larry Yin MD, MSPH","doi":"10.1016/j.acap.2026.103387","DOIUrl":"10.1016/j.acap.2026.103387","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility, acceptability, and usability of a real-time feedback smart inhaler for adolescents with intellectual and developmental disabilities (IDD) and asthma; assess preliminary efficacy in improving metered-dose inhaler (MDI) technique; and explore device-measured proficiency and lung function in the full cohort, alongside a predefined autism subgroup analysis.</div></div><div><h3>Methods</h3><div>We conducted a single-center, single-blind, pilot randomized controlled trial involving 28 adolescents (aged 10–17 years) with IDD and asthma. Participants were randomized 1:1 to an intervention group using smart inhalers with audiovisual feedback for 8 weeks, or a control group receiving standard asthma education. Primary outcomes were parent- and adolescent-reported feasibility, acceptability, and usability. The secondary outcome was observer-rated inhaler proficiency. Exploratory outcomes were full-cohort device-measured inhaler proficiency and lung function (FEV₁ and PEF), alongside a predefined autism subgroup analysis.</div></div><div><h3>Results</h3><div>The intervention was feasible, acceptable, and usable, yielding high parent and adolescent motivation and satisfaction. The intervention group demonstrated significantly greater improvement in observer-rated Inhaler Proficiency Scale scores from baseline to week 8 compared to the control group (mean difference 1.5 points; 95% CI: 0.4–2.6; <em>P</em> = .02). Exploratory outcomes showed no significant between-group differences in lung function or device-measured proficiency. However, the autism subgroup exhibited inhaler technique improvements consistent with the broader cohort.</div></div><div><h3>Conclusions</h3><div>Smart inhalers are feasible, acceptable, and usable for adolescents with IDD, and are associated with significant improvement in observer-rated inhaler technique when combined with standard clinical education. Given the inherent challenges of spirometry in this population, future studies should incorporate effort-independent clinical assessment measures.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"26 7","pages":"Article 103387"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406769","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":"Promoting Early Relational Health in Primary Care: A Scoping Review of Interventions and Evidence Gaps","authors":"Sarah Behrens PhD,&nbsp;Stephen Lauer PhD, MD,&nbsp;Brenda J. Salley PhD","doi":"10.1016/j.acap.2026.103418","DOIUrl":"10.1016/j.acap.2026.103418","url":null,"abstract":"<div><h3>Background</h3><div>Early relational health – the quality of caregiver–child interactions – is foundational for socio-emotional development and long-term wellbeing. The American Academy of Pediatrics has called for a paradigm shift toward relationship-centered care in pediatric primary care, yet a gap remains between this vision and real-world implementation.</div></div><div><h3>Objectives</h3><div>To map early relational health interventions implemented in pediatric primary care, summarize reported outcomes and identify implementation strategies, barriers, and facilitators.</div></div><div><h3>Data Sources</h3><div>PubMed, CINAHL, and PsycINFO were searched for studies published between 2014 and 2024, supplemented by backward citation searching.</div></div><div><h3>Study Eligibility Criteria, Participants, and Interventions</h3><div>A scoping review methodology following PRISMA-ScR guidelines was used. Data were charted and synthesized using descriptive and thematic analysis.</div></div><div><h3>Results</h3><div>Eighteen studies met inclusion criteria. Interventions were delivered in clinic, home, or hybrid settings and were commonly integrated into routine workflows. Reported outcomes included improvements in caregiver responsiveness, parenting self-efficacy, and child language and socio-emotional development. Implementation strategies included staff training, workflow integration, fidelity monitoring, and community partnerships. Key facilitators were contextual responsiveness, strong relational supports, and alignment with clinical processes. Barriers included small or homogeneous samples, reliance on parent-report outcomes, short follow-up periods, and resource constraints.</div></div><div><h3>Conclusions and Implications of Key Findings</h3><div>Early relational health interventions are feasible and show promise in pediatric primary care when embedded into routine care and adapted to context. Addressing methodological and implementation challenges is essential to advancing relationship-centered pediatric practice.</div></div><div><h3>Scoping Review Registration</h3><div>Open Science Framework (OSF), DOI: <span><span>https://doi.org/10.17605/OSF.IO/ZCGVA</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"26 7","pages":"Article 103418"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632543","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":"Safe Sleep Education Across Healthcare Settings: A Systematic Review of Delivery, Content, and Outcomes","authors":"Mary Beth Howard MD, MSc,&nbsp;Olivia A. Wilson-Lall HBSc,&nbsp;Sarah Sprauer MD,&nbsp;Stephanie K. Napolitano MD,&nbsp;Katie Lobner MLIS,&nbsp;Rachel Y. Moon MD,&nbsp;Leticia M. Ryan MD, MPH,&nbsp;Lara B. McKenzie PhD, MA, FAAHB","doi":"10.1016/j.acap.2026.103415","DOIUrl":"10.1016/j.acap.2026.103415","url":null,"abstract":"<div><h3>Background</h3><div>Sleep-related infant deaths remain a leading cause of postneonatal mortality. Healthcare systems represent critical touchpoints for delivering safe sleep education, yet delivery varies across clinical settings.</div></div><div><h3>Objectives</h3><div>To synthesize how safe sleep education is delivered across healthcare settings, evaluate its impact on caregiver knowledge and adherence, and identify gaps to inform scalable, equitable interventions.</div></div><div><h3>Data Sources</h3><div>PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Scopus, and Cochrane CENTRAL were searched from inception through July 15, 2025.</div></div><div><h3>Study Eligibility Criteria, Participants, and Interventions</h3><div>Eligible studies evaluated healthcare-delivered safe sleep education for caregivers of infants ≤12 months and reported caregiver-level outcomes.</div></div><div><h3>Study Appraisal and Synthesis Methods</h3><div>Four reviewers independently screened studies, extracted data, and assessed risk of bias using Cochrane RoB1. Due to heterogeneity in design and outcomes, findings were synthesized narratively.</div></div><div><h3>Results</h3><div>Twenty-three studies across eight countries were included. Interventions included bedside counseling, written materials, videos, quality improvement initiatives, mobile health messaging, and sleep space provision. Most studies reported improved caregiver knowledge and adherence, particularly supine positioning. Multicomponent interventions incorporating clinician modeling and post-discharge reinforcement demonstrated the most consistent improvements across behaviors.</div></div><div><h3>Limitations</h3><div>Evidence was limited by heterogeneity, reliance on self-reported outcomes, short follow-up periods, and moderate-to-high risk of bias.</div></div><div><h3>Conclusions and Implications of Key Findings</h3><div>Healthcare-delivered safe sleep education is associated with improved caregiver knowledge and behaviors, but effectiveness varies across settings. Multicomponent, system-level strategies extending beyond hospitalization may offer the most scalable approach. Future research should prioritize rigorous evaluation of equitable, implementable interventions across healthcare systems.</div></div><div><h3>Systematic Review Registration Number</h3><div>PROSPERO CRD420251050656.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"26 7","pages":"Article 103415"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609807","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}