Journal of pediatrics. Clinical practice最新文献

{"title":"Parent and Family Well-Being and Associated Risk Factors as Children with Neonatal Seizures Reach Preschool and School-Age: A Longitudinal Cohort Study.","authors":"Linda S Franck, Monica E Lemmon, Lisa Grossbauer, Kamil Pawlowski, Julie S Sturza, Courtney J Wusthoff, Shavonne L Massey, Catherine J Chu, Janet S Soul, Adam L Numis, Cameron Thomas, Giulia M Benedetti, Tayyba Anwar, Madison M Berl, Jennifer C Gidley Larson, Elizabeth E Rogers, Carmen Chen, Charles E McCulloch, Hannah C Glass, Renée A Shellhaas","doi":"10.1016/j.jpedcp.2025.200149","DOIUrl":"10.1016/j.jpedcp.2025.200149","url":null,"abstract":"<p><strong>Objective: </strong>To assess parent/family well-being when children with neonatal seizures reach 3-8 years of age and examine factors associated with parent/family well-being.</p><p><strong>Methods: </strong>One parent per surviving infant in the Neonatal Seizure Registry-II was invited to complete validated surveys annually when children were between 3 and 8 years of age. Three outcomes were examined: (1) parent well-being (anxiety, depression, and quality of life); (2) parent post-traumatic stress symptoms; and (3) impact on the family. We used mixed model regression with random intercepts and guided backward elimination and included potential predictors that had bivariate associations <i>P</i> < .10 in the multivariable analyses.</p><p><strong>Results: </strong>Among 169 parents, 8%-35% experienced symptoms of anxiety, depression, or post-traumatic stress. When children were 8 years of age, about 1 in 3 parents had moderate to severe anxiety symptoms, approximately double the general population, 1 in 5 had post-traumatic stress disorder symptoms and depression symptom frequency was similar to the general population in the final models, only child social communication impairment was associated with poorer parental well-being or post-traumatic stress symptoms. Several child factors, including age at discharge from the neonatal admission, functional impairment at 24 months, social communication impairment, and receiving special services, were associated with greater impact on the family.</p><p><strong>Conclusions: </strong>Child social and functional health challenges following neonatal seizures were associated with poorer parent and family well-being across the preschool and early school years. Longitudinal screening of child social functioning, parent well-being, and family function is indicated for early detection and referral to treatment services.</p><p><strong>Trial registration: </strong>Clinical Trial Registration:NCT04337697.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"16 ","pages":"200149"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Open Notes\" in Pediatric Acute Care Cardiology: Caregiver and Provider Experiences in a Single Center.","authors":"Megan Rodts, Dana B Gal, Brittney K Hills, Elisa Marcuccio, Colleen M Pater, Samuel Hanke","doi":"10.1016/j.jpedcp.2025.200147","DOIUrl":"10.1016/j.jpedcp.2025.200147","url":null,"abstract":"<p><strong>Objective: </strong>To identify the utilization of shared medical notes, referred to as \"open notes,\" and the experience of caregivers and cardiology providers during inpatient hospitalization for congenital heart disease.</p><p><strong>Study design: </strong>Single-center, cross-sectional, survey-based study utilizing convenience sampling of patient caregivers on a pediatric acute care cardiology unit and corresponding cardiology providers. Surveys assessed demographic information, health literacy of caregivers, and experiences during inpatient hospitalization that relate to open note use. Descriptive statistics were performed.</p><p><strong>Results: </strong>Forty-five caregivers (47% of eligible) and 21 cardiology providers (100% of eligible) were enrolled. There were no demographic differences between caregivers, or their children, who were open notes vs nonopen notes users (<i>P</i> > .05). Most caregivers were aware that the notes were available (87%), yet fewer enrolled in the program to read them (71%). Most caregivers had positive experiences with the notes (85%), while cardiology providers' opinions were overall neutral or negative (65%). Cardiology providers' suggestions for improvement of open notes were frequently infeasible based on regulations required by the 21st Century Cures Act.</p><p><strong>Conclusions: </strong>Open notes in inpatient subspecialty pediatrics yields a novel opportunity for caregivers to engage positively and actively with the care team. Cardiology providers may value how positively caregivers view open notes as a method of receiving medical information and interacting with the care team. Cardiology providers may also benefit from further education on the new legislation in the 21st Century Cures Act.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"16 ","pages":"200147"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Outcomes from Childhood into Adulthood: Prevalence of Social Needs in Pediatric Cardiology.","authors":"Hemen Muleta, Kevin P Fiori","doi":"10.1016/j.jpedcp.2025.200148","DOIUrl":"10.1016/j.jpedcp.2025.200148","url":null,"abstract":"","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"16 ","pages":"200148"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: Trends of Congenital Syphilis among Neonates in Canada 2012-2023.","authors":"Chantal R M Nelson, Annalise Ferro, Katarzyna Naczk, Ari Bitnun, Deborah Money, Micheal Narvey, Genevieve Gravel, Joanna Merckx, Michiel Van den Hof, Heather Scott, Leah Thorp, Elisabeth McClymont, Prakesh S Shah","doi":"10.1016/j.jpedcp.2025.200146","DOIUrl":"10.1016/j.jpedcp.2025.200146","url":null,"abstract":"<p><p>In Canada, incidence of congenital syphilis significantly increased from 2018 to 2023. Supporting enhanced public health preventive interventions such as early screening and treatment, particularly for younger women in lower socioeconomic strata and those with a history of addictive substance use, may reduce congenital syphilis.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"16 ","pages":"200146"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Bronchopulmonary Sequestration in Congenital Diaphragmatic Hernia: Is Frequency Increasing or Are We Better at Diagnosis?","authors":"Michelle J Yang, Christian C Yost, Martha Monson, Paula J Woodward, Anne M Kennedy, Stephen J Fenton, Katie W Russell, Janice L B Byrne, Bradley A Yoder","doi":"10.1016/j.jpedcp.2025.200141","DOIUrl":"10.1016/j.jpedcp.2025.200141","url":null,"abstract":"<p><strong>Objective: </strong>To assess the incidence and clinical outcomes of neonates with congenital diaphragmatic hernia with patients with concurrent bronchopulmonary sequestration (CDH + BPS).</p><p><strong>Study design: </strong>In this retrospective cohort study, we compared BPS diagnoses in patients with CDH across 4 epochs (2002-2008, 2009-2015, 2016-2019, 2020-2023) to assess incidence and outcomes of neonates with CDH + BPS. Because of marked epoch differences in key outcomes, we only compared extracorporeal membrane oxygenation use and survival for CDH + BPS and CDH alone across the final 2 epochs using multinominal regression analysis.</p><p><strong>Results: </strong>Among 383 neonates with CDH, we concurrently diagnosed 15 (3.9%) with BPS. Consistent with increasing fetal CDH diagnoses (56% in 2002-2008 vs 74% in 2020-2023; <i>P</i> < .05) and fetal magnetic resonance imaging (0% in 2002-2008 vs 92% in 2020-2023; <i>P</i> < .001), CDH + BPS rates increased from 1.9% across the first 3 epochs to 13.2% in the 2020-2023 epoch (<i>P</i> < .001). There were no differences in other anomalies, repair rates, thoracic liver, or defect size. From 2016 onward, all 10 neonates diagnosed with CDH + BPS survived without extracorporeal membrane oxygenation. CDH + BPS neonates had larger defects and increased rates of nonprimary repair. After we controlled for defect size, neonates with CDH + BPS had greater rates of vasodilator therapy for postoperative pulmonary hypertension (56% vs 23%; <i>P</i> < .05). However, there were no differences in home discharge on pulmonary vasodilator medications or oxygen.</p><p><strong>Conclusion: </strong>Incidence of CDH + BPS diagnoses increased over time with an increased need of inpatient vasodilatory therapy. Additional studies with enhanced imaging analyses and intraoperative assessment are needed to better define the incidence and potential impact of concurrent BPS on CDH morbidities and outcomes.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"15 ","pages":"200141"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aligning with Obesity Guidelines: A Quality Improvement Initiative in Pediatric Primary Care.","authors":"Alicia Tucker, Richard Fagbemigun, Christina Driskill, Nia Bodrick, Kaleab Ribbiso, Abraham Ipe, Meera Krishnamoorthy, Adwoa Bamfo, Kofi Essel","doi":"10.1016/j.jpedcp.2024.200135","DOIUrl":"10.1016/j.jpedcp.2024.200135","url":null,"abstract":"<p><strong>Objective: </strong>National guidelines recommend diagnosis of obesity on the basis of body mass index starting at age 2 years and screening for specific comorbidities based on age and risk factors. A multimodal intervention was developed and quality improvement (QI) methodology was used to assess the effectiveness of different interventions on pediatric primary care clinician's adherence to evidence-based clinical guidelines.</p><p><strong>Study design: </strong>A multidisciplinary team was engaged to develop an institutional weight management and diet-related disease toolkit to standardize practice through a QI initiative. This initiative included an educational series, coaching sessions for a subset of providers, and automating electronic medical record (EMR) changes to support adherence to the clinical toolkit. We staggered the interventions to assess for behavior change related to clinical documentation and laboratory test ordering practices.</p><p><strong>Results: </strong>Baseline data showed significant differences between individual clinicians' practices. Educational initiatives increased the use of diagnostic obesity codes from a baseline of <20% to >75% of charts. Initially, <i>International Classification of Diseases</i>, <i>Tenth Revision</i>, codes for nutrition and physical activity counseling were underused and remained low despite education interventions. EMR prompts and templates led to a significant and sustained increase in coding. A statistically significant decrease in overall extraneous laboratory test collection was noted but inconsistencies in laboratory test collection persisted.</p><p><strong>Conclusions: </strong>This QI initiative aimed to standardize clinicians' behavior around EMR documentation. A multimodal intervention was able to improve documentation of weight status and counseling measures to >80% of well child check encounters. Future studies are encouraged to investigate whether these changes led to improved patient outcomes.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200135"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficulty with Dental Caries among Adolescents Who Are Underweight: A Nationwide Study.","authors":"Vinodh Bhoopathi, Paula Ortega-Verdugo, Christine Wells, Honghu Liu","doi":"10.1016/j.jpedcp.2024.200136","DOIUrl":"10.1016/j.jpedcp.2024.200136","url":null,"abstract":"<p><p>This study highlights a unique association between weight status and difficulty with dental caries among US adolescents. Being underweight was significantly associated with dental caries in adolescents aged 10-17.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200136"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth, Therapeutic Effectiveness, and Disparities in Pediatric Type 1 Diabetes: Lessons from Continuous Glucose Monitoring Use in Latin America.","authors":"Linda A DiMeglio, Adda Grimberg","doi":"10.1016/j.jpedcp.2024.200137","DOIUrl":"10.1016/j.jpedcp.2024.200137","url":null,"abstract":"","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200137"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of Prescription Opioid Disposal Bins at United States Children's Hospitals.","authors":"Rabab M Barq, Laura Houshmand, Olivia A Keane, Shadassa Ourshalimian, Lorraine I Kelley-Quon","doi":"10.1016/j.jpedcp.2024.200133","DOIUrl":"10.1016/j.jpedcp.2024.200133","url":null,"abstract":"<p><p>This descriptive study examined availability of prescription opioid disposal bins at US children's hospitals and assessed pharmacy-provided information on safe disposal. Only 44.2% reported a bin on site and among those without, advice varied. These findings highlight the need for improved prescription opioid disposal education and infrastructure at children's hospitals.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200133"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Gold is Tarnished: The Impact of Smoker's Breast Milk on Offspring Growth.","authors":"Elizabeth Yen","doi":"10.1016/j.jpedcp.2024.200132","DOIUrl":"10.1016/j.jpedcp.2024.200132","url":null,"abstract":"","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200132"},"PeriodicalIF":0.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}