Journal of pediatrics. Clinical practice最新文献

{"title":"Short Self-Assessment Questionnaire for Parents with Young Children on Caregiver Strengths and Strains: Development and Psychometric Properties of the Balance Scale.","authors":"Anneloes M Beekman, Anton Schreuder, Japke C R de Ru, Henk F van Stel, Ingrid I E Staal","doi":"10.1016/j.jpedcp.2026.200201","DOIUrl":"10.1016/j.jpedcp.2026.200201","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate reliability and validity of the Balance Scale to measure the (im)balance between caregiver strengths and strains from parents' perspectives and identify parents who struggle with balancing the care and upbringing of their children.</p><p><strong>Study design: </strong>Literature and focus groups with parents were used to develop a short questionnaire called the Balance Scale. The final Balance Scale was determined after testing through a think-aloud procedure. The internal consistency and criterion validity of the Balance Scale were evaluated using a cross-sectional design. The new Balance Scale and the validated Structured Problem Analyses Raising Kids (SPARK) were offered to parents of children at the age of 5 years during preventive youth health care visits.</p><p><strong>Results: </strong>Five themes-experience in parenting, support, relationship and agreement with partner, complicating family factors, and adaptability-and 8 questions were included in the Balance Scale, which took approximately 2 minutes to fill out and showed good internal consistency (Cronbach's alpha = 0.722). Both the Balance Scale and the SPARK were available from 1226 parents. The Balance Scale was negatively correlated with the SPARK assessments for parents' concerns (correlation coefficient = -0.28; <i>P</i> < .001) and their need for support (-0.22; <i>P</i> < .001). The relative risk of increased or high risk according to SPARK was 0.84 for each Balance Scale point increment.</p><p><strong>Conclusions: </strong>The Balance Scale is a reliable, valid, and compact instrument, enabling parents and professionals to quickly gain insight into parents' perceived (im)balance between their caregiver strengths and strains.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"20 ","pages":"200201"},"PeriodicalIF":0.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477686","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":"Sex Differences in Concussion Rates among Middle School Sex-comparable Sports.","authors":"Samantha L Hacherl, Daniel C Herman, Joel R Martin, Patricia M Kelshaw, Sanja Avramovic, Shane V Caswell","doi":"10.1016/j.jpedcp.2026.200200","DOIUrl":"10.1016/j.jpedcp.2026.200200","url":null,"abstract":"<p><strong>Objective: </strong>To investigate sex differences in sports-related concussion (SRC) rates among early adolescents participating in sex-comparable middle school (MS) sports.</p><p><strong>Study design: </strong>This prospective epidemiological study was conducted as part of the Advancing Health Care Initiatives for Underserved Students project in Virginia from 2015 to 2022. Athletic trainers collected injury and athlete exposure (AE) data from athletes MS athletes participating in sex-comparable sports, including baseball/softball, basketball, soccer, and track and field. Outcomes included SRC injury rates (IR)/1000 AE, IR ratios (IRRs) for overall sex and event-type differences (competition vs practice), and injury proportion ratios for injury mechanisms.</p><p><strong>Results: </strong>A total of 11,213 athletes (girls, n = 5647; boys, n = 5566) contributed 329,269 AEs, during which 97 SRCs were diagnosed (0.29/1000 AE). Girls were more than twice as likely as boys to sustain an SRC overall (IRR, 2.26). In 3 of the 4 sex-comparable MS sports, girls had higher SRC rates in competition and practice than boys: softball/baseball (competition/practice IRR, 4.19/2.35), basketball (3.77/2.74), and soccer (1.75/4.92). No sex differences were observed in track and field or in the proportional distribution of SRC mechanisms.</p><p><strong>Conclusions: </strong>Among early adolescents participating in sex-comparable MS sports, girls were more than twice as likely as boys to sustain a SRC. The magnitude of the sex difference in SRC rates observed among MS athletes exceeded that previously reported in high school and collegiate populations. These findings demonstrate that sex-based differences in SRC risk are evident by early adolescence and highlight the need for developmentally appropriate, female-specific concussion prevention and clinical care strategies.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"20 ","pages":"200200"},"PeriodicalIF":0.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380481","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":"A Roadmap to Improved Quality Outcomes in Neonates Exposed to Illegally Manufactured Fentanyl.","authors":"Cristiane G Lin, Christine Wade, Becky Micetic, Pooja Rangan, Natalie Wade, Vrinda Arora","doi":"10.1016/j.jpedcp.2025.200190","DOIUrl":"10.1016/j.jpedcp.2025.200190","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of neonatal opioid withdrawal syndrome (NOWS) has dramatically increased, and illegally manufactured fentanyl may be a significant contributor. The optimal treatment approach for an infant experiencing severe withdrawal from fentanyl is unknown. Our aim was to decrease the mean length of stay (LOS) by 20% over 19 months for infants with NOWS by implementing a transitional phase before establishing our modified Eat, Sleep, Console (ESC) model of care.</p><p><strong>Study design: </strong>A multidisciplinary team used quality improvement methodology to improve treatment of NOWS in 2 phases, each adapted to fentanyl's complex pharmacology. Beginning May 2023, a hybrid Finnegan/ESC protocol was implemented to address hospital barriers for a year before initiating full ESC management. Data were collected on infants >35 weeks of gestational age admitted to a level III neonatal intensive care unit. Primary metrics included LOS and total days/doses of morphine. Rates of apnea and naloxone were used as balancing measures. The LOS was plotted on a statistical process control chart and the data were summarized with descriptive statistics.</p><p><strong>Results: </strong>Outcomes were analyzed for 217 infants. The aim was exceeded with a mean LOS reduction of 29% (hybrid) and 49% (ESC). On average, decreased morphine days (22.5, 11.2, 6.9, <i>P</i> < .001) and doses (162, 63, 14, <i>P</i> < .001) also were observed. No significant apnea occurred, nor was naloxone used.</p><p><strong>Conclusions: </strong>This quality improvement project provides a successful fentanyl-adapted ESC model that may be adopted to decrease postnatal morphine usage and LOS.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"18 ","pages":"200190"},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914575","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":"Parent and Physician Global Assessment Discordance in Juvenile Arthritis: The Role of Pain Coping Strategies.","authors":"Maria Backström, Anna Halttu, Maarit Tarkiainen, Ella Lehtinen, Sirja Sard, Paula Keskitalo, Kati Markula-Patjas, Katariina Rebane, Kristiina Aalto, Terhi Remes-Pakarinen, Johanna Kärki, Maiju Hietanen, Heini Pohjankoski, Katja Korkatti, Emmi Kosonen, Eliisa Löyttyniemi, Merja Malin, Liisa Kröger, Paula Vähäsalo","doi":"10.1016/j.jpedcp.2025.200186","DOIUrl":"10.1016/j.jpedcp.2025.200186","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the factors underlying the discordance in physicians', patients', and caregivers' perceptions of disease state in patients with juvenile idiopathic arthritis and their caregivers in a prospective observational study.</p><p><strong>Study design: </strong>We invited all children in 8 centers in Finland from November 2021 to March 2024 presenting with newly confirmed or suspected juvenile idiopathic arthritis and the accompanying parents to participate. Children older than 8.0 years and all the parents completed the patient and parent proxy pain and global assessment of wellbeing at 0 and 3 months and the pain coping scale at 3 months after diagnosis. The discordance between patient or parent global assessment and physician global assessment of disease activity was determined by subtracting the physician global from the patient or parent global assessment. The factors explaining discordance between the global assessments, were evaluated by a multivariable linear model.</p><p><strong>Results: </strong>In the study, 186 families participated. A positive or negative discordance of 30 mm or greater was seen in 17% of the children and 11% of the caregivers. In the children, the lower the active joint count (AJC) (<i>P</i> = .006) and the greater the pain assessment (<i>P</i> < .001), the greater the discordance between patient and physician global assessment. In parents, the lower the AJC (<i>P</i> < .001) and the higher the parent proxy pain assessment (<i>P</i> < .001) and catastrophizing score (<i>P</i> < .005), the greater the discordance between parent and physician global assessment.</p><p><strong>Conclusion: </strong>The discordance between parent's and physician's global assessment is greater among parents who use catastrophizing as a pain coping strategy.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"18 ","pages":"200186"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914598","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":"A Brief Observation to Screen Autism in Toddlers and Predict Developmental Trajectory.","authors":"Fiona Journal, Thibaut Chataing, Michel Godel, Nada Kojovic, Kenza Latrèche, Maude Schneider, Marie Schaer","doi":"10.1016/j.jpedcp.2025.200176","DOIUrl":"10.1016/j.jpedcp.2025.200176","url":null,"abstract":"<p><strong>Objective: </strong>Autism spectrum disorder (ASD) affects approximately 1 in 31 children. Early diagnosis is crucial for optimizing outcomes through early interventions, and primary care settings need efficient tools to identify children presenting autistic features. This study explores the potential of early socio-communicative behaviors, measured by the Early Social Communication Scales, to screen for ASD in children younger than 3 years old, and predict their future cognitive development using machine learning models.</p><p><strong>Study design: </strong>This study analyzed longitudinal data from 113 children with ASD and 59 with typical development (TD), aged from 1 to 3 at baseline. Twenty-three ESCS variables were used to screen for ASD and predict cognitive development. The C5.0 decision tree algorithm was used to classify ASD vs TD, while linear regression and K-means clustering identified cognitive development patterns among autistic children. K-fold cross-validation, permutation testing, and undersampling were used for validation.</p><p><strong>Results: </strong>We distinguished between ASD and TD children with 95% accuracy, 96% sensitivity and 92% specificity. Nine behaviors contributed to distinguish ASD from TD. Behaviors that contributed most are the child's ability to initiate a turn taking and to point at desired objects. A separate model stratified children into groups with different cognitive outcome with 97% accuracy. Behavioral requests variables contributed in distinguishing extreme cognitive trajectories in autistic children.</p><p><strong>Conclusions: </strong>We provide an original decision-algorithm focusing on early socio-communicative behaviors to guide pediatricians through autism screening and cognitive development prediction.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"18 ","pages":"200176"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914615","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":"Effects of the COVID-19 Pandemic on Pediatric Hospitalizations for Life-Threatening Conditions.","authors":"Cassandra L Louis, Parthak Prodhan, Daniel B Horton, E Vincent S Faustino, Isabella Zaniletti, Clare C Brown, Simon Li","doi":"10.1016/j.jpedcp.2025.200175","DOIUrl":"10.1016/j.jpedcp.2025.200175","url":null,"abstract":"<p><p>Mitigation measures implemented during the COVID-19 pandemic led to low levels of circulating non-SARS-CoV-2 viruses, providing a unique opportunity to study trends in pediatric conditions linked to viral triggers. We identified significant reductions in first pediatric hospitalizations for acute flaccid paralysis (-96.2%), myocarditis (-79.4%), Guillain-Barré syndrome (-44.1%), and other conditions.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"17 ","pages":"200175"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133358","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":"Adults' Beliefs on Asking About Unlocked Firearms in Homes Where Children Play.","authors":"Joseph A Simonetti, Maya Haasz, Rachel L Johnson, Shelby L Bandel, Erin Wright-Kelly","doi":"10.1016/j.jpedcp.2025.200174","DOIUrl":"10.1016/j.jpedcp.2025.200174","url":null,"abstract":"<p><p>Because many firearm injuries occur outside childrens' households, the American Academy of Pediatrics recommends asking about firearms in households where children visit. Using survey data from 2023, we estimate that 85.0% (95% CI: 82.2-87.5) of Colorado adults agree that it is appropriate to ask about unlocked firearms in homes where children play.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"17 ","pages":"200174"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042862","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":"Clinical and Demographic Characteristics Associated with Type 1 Diabetes Distress in Latin American Children.","authors":"Valeria Hirschler, Amanda Benitez, Andrea Escalante Marassi, Angeles Arrigo, Eugenia Andres, Ethel Codner, Juan Pablo Rojas Godoy, Claudia Molinari, Luciana Araujo, Fabio Palacios Porta, Daniel R Witte","doi":"10.1016/j.jpedcp.2025.200173","DOIUrl":"10.1016/j.jpedcp.2025.200173","url":null,"abstract":"<p><strong>Objective: </strong>To determine the degree of diabetes-specific distress in children with type 1 diabetes mellitus (T1DM) and its association with demographic characteristics, family and educational situation indicators, glycemic control, complications, and disease duration.</p><p><strong>Study design: </strong>A cross-sectional study (Jan-Mar 2025) in Argentina and Chile included 143 T1DM patients (8-17 years, ≥1-year duration). Diabetes distress was measured using the Problem Areas in Diabetes (PAID) questionnaire (0-80; high distress ≥40).</p><p><strong>Results: </strong>One hundred forty-three children (53.8%; 77 females), median age 13.4 years (IQR 11.5-15.8 years), T1DM duration 4.4 y (IQR 3.3-6.6 years), hemoglobin A1c (HbA1c) 8.5%, 69.8 mmol/mol (IQR 7.4%-9.4%), were included. The median PAID score was 25 (IQR 15-42), with 28% (95% CI: 20.6-35.3) experiencing high distress (PAID ≥ 40). HbA1c was higher in children with high distress 9.00% (IQR: 8.1%-10.4%) than in moderate 8.5% (IQR: 7.5%-9.7%) or low distress 7.8% (IQR: 7.0%-8.9%). There was a higher prevalence of children living with only one parent among those with high or moderate distress (33.3%, 95% CI: 24%-34%) compared to those with low distress (9.8%, 95% CI: 2%-18%). Multiple logistic regression analysis revealed that higher HbA1c values were significantly associated with being in the high distress group (OR = 1.48; 95% CI: 1.12-1.96 per % point HbA1c), adjusted for confounding variables.</p><p><strong>Conclusions: </strong>Diabetes distress was linked to higher HbA1c in Latin American children with T1DM. This suggests that addressing diabetes distress may contribute to improved glycemic control.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"17 ","pages":"200173"},"PeriodicalIF":0.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017140","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":"Child and Parent Perspectives on Daily Functioning after Perinatal Brain Injury.","authors":"Lisanne M Baak, Corline E J Parmentier, Nienke Wagenaar, Fleur-Sophie N Buijsen, Anne A M van Wendel de Joode, Jan Willem Gorter, Manon J N L Benders, Floris Groenendaal, Linda S de Vries, Cora H Nijboer, Thomas Alderliesten, Corine Koopman-Esseboom, Cornelia H Verhage, Rian M J C Eijsermans, Niek E van der Aa, Marjolijn Ketelaar","doi":"10.1016/j.jpedcp.2025.200172","DOIUrl":"10.1016/j.jpedcp.2025.200172","url":null,"abstract":"<p><strong>Objective: </strong>Perinatal brain injury can result in long-term neurodevelopmental sequelae. To examine the most significant consequences from a patient perspective, this questionnaire study explored the strengths and difficulties in daily functioning after perinatal brain injury, by child self-report and parent-proxy report.</p><p><strong>Study design: </strong>Cross-sectional questionnaire study of participants ≥8 years of age born with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia, or with perinatal arterial ischemic stroke, and their parents. Open-ended questions regarding strengths and difficulties in daily functioning were analyzed by thematic analysis using the International Classification of Functioning, Disability and Health as coding framework.</p><p><strong>Results: </strong>Of the 102 participants (hypoxic-ischemic encephalopathy: n = 50, perinatal arterial ischemic stroke: n = 52) with a median age of 12.4 (range 8-25) years, 81% of the questionnaires (n = 83) were filled out by both participants and parents. Participants mainly reported participation in recreational activities and school-related learning abilities as strengths, while parents most frequently highlighted their child's personality traits. Difficulties were reported by 91% of participants and 76% of parents. Both parents and participants often mentioned difficulties with cognitive functioning including attention, memory, and processing speed. Furthermore, parents described social skills and movement difficulties, while participants mostly reported learning difficulties. Half of the parents reported that the difficulties significantly impacted their families' daily lives.</p><p><strong>Conclusions: </strong>Children and young adults with a history of perinatal brain injury face a variety of challenges in their everyday lives, emphasizing the importance of taking the full spectrum of sequelae into account in care, counseling, and future research.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"17 ","pages":"200172"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985330","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":"Corrigendum to Association Between Prenatal Cannabis Exposure and Child Health Care Use: A Retrospective Cohort Study in Ontario, Canada.","authors":"Gabrielle Pratt Tremblay, Arum Han, Ewa Sucha, Helen Hsu, Jessy Donelle, Daniel J Corsi","doi":"10.1016/j.jpedcp.2025.200171","DOIUrl":"https://doi.org/10.1016/j.jpedcp.2025.200171","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1016/j.jpedcp.2025.200151.].</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"17 ","pages":"200171"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240732","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}