Journal of Pediatrics最新文献

{"title":"A Randomized Controlled Trial of Commercially Available Virtual Reality for Intravenous Cannulation-Related Distress in Children","authors":"Samina Ali MD ,&nbsp;Summer Hudson MD ,&nbsp;Manasi Rajagopal MBT ,&nbsp;Jennifer N. Stinson RN, PhD ,&nbsp;Katie Gourlay MD ,&nbsp;Keon Ma MD ,&nbsp;Patricia Candelaria RN, BScN ,&nbsp;Ben Vandermeer MSc ,&nbsp;Bailey Felkar CCLS ,&nbsp;Kurt Schreiner MPM ,&nbsp;Amanda Proctor BA ,&nbsp;Lisa Hartling PhD","doi":"10.1016/j.jpeds.2025.114803","DOIUrl":"10.1016/j.jpeds.2025.114803","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether commercially available virtual reality (VR)-based distraction reduces distress when added to standard of care (SOC) for children undergoing intravenous insertion (IVI) in the pediatric emergency department.</div></div><div><h3>Study design</h3><div>Children aged 6-17 years requiring IVI were recruited for a two-arm randomized controlled trial. The primary outcome was child distress, measured using the Observational Scale of Behavioral Distress–Revised (score range 0-23.5). Secondary outcomes included children's procedural pain (verbal Numerical Rating Scale, score range 0-10) and fear (Children's Fear Scale, score range 0-4).</div></div><div><h3>Results</h3><div>Mean (SD) children age was 11.1 years (2.9) and 54% (45/82) were female. Mean (SD) preprocedural Observational Scale of Behavioral Distress–Revised scores were similarly low in both the VR [0.39 (0.70)] and SOC arms [0.18 (0.49)] (<em>P</em> = .16). Use of VR during IVI was not associated with lower mean (SD) total procedural distress [1.1 (1.5)] vs SOC [0.7 (1.4)] (<em>P</em> = .08), mean (SD) procedural pain intensity [3.0 (2.9)] vs SOC [2.1 (2.3)] (<em>P</em> = .14), or mean (SD) Children's Fear Scale score [0.97 (1.33)] vs SOC [0.97 (1.15)]. Technical issues with the VR equipment were reported in 26% (10/39) of cases.</div></div><div><h3>Conclusions</h3><div>VR distraction therapy employing commercially available software was not associated with reduction in procedural distress, pain or fear, above that provided with SOC, for children undergoing IVI in the pediatric emergency department. Given no differences and frequency of technical issues, other forms of distraction may be more appropriate in this setting.</div></div><div><h3>Trial registration</h3><div>Clinicaltrials.gov Identifier: NCT04291404.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114803"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental Disabilities Are Associated with Higher Unmet Social Needs in Children","authors":"Alexandra L. Falkenberg BS ,&nbsp;Samantha R. Levano MPH ,&nbsp;Miya Lemberg BS ,&nbsp;Kevin P. Fiori MD, MPH, MS ,&nbsp;Rosa Seijo MD ,&nbsp;Maria Valicenti-Mcdermott MD, MS","doi":"10.1016/j.jpeds.2025.114809","DOIUrl":"10.1016/j.jpeds.2025.114809","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the likelihood of self-reporting at least one health-related social need (HRSN) for pediatric patients with developmental disabilities (DD) compared with pediatric primary care (PC) patients.</div></div><div><h3>Study design</h3><div>This cross-sectional study was conducted in a large urban health system in the Bronx, New York, between May 2023 and August 2024. We identified a cohort of patients ≤21 years old with DD (n = 1420), at an urban center that specializes in serving children with DD, who completed a standardized HRSN screener to assess housing insecurity, housing quality, utility needs, food insecurity, health care transportation needs, health care cost needs, child or adult care needs, and legal needs. We also identified a cohort of pediatric PC patients who completed the HRSN screener at 1 of 14 outpatient PC practices (n = 32 143). We completed a retrospective analysis using electronic health record data. Multivariable logistic regressions were conducted to estimate the likelihood of self-reporting at least 1 HRSN in regard to a patient's DD status, while adjusting for sociodemographic characteristics.</div></div><div><h3>Results</h3><div>Approximately 30.0% (n = 426) of DD patients self-reported at least 1 HRSN compared with 12.6% (n = 4064) of PC patients. In the multivariable analysis, DD patients demonstrated 2.49 (2.20, 2.82) greater odds of having at least 1 HRSN compared with PC patients.</div></div><div><h3>Conclusions</h3><div>Health systems should consider developing workflows that identify and address HRSNs for pediatric patients with DD. Further research is needed to understand the factors contributing to the increased HRSN prevalence observed in patients with DD.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114809"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Correlates of Insomnia Symptoms in Young Children with Autism Spectrum Disorder.","authors":"Megan L Wenzell, Stormi L Pulver, Lawrence Scahill, Taylor Davidson, Sandhya Rajagopal, Scott Gillespie, Tracy Huang, Stephanie Griggs, Camdyn Roark, Megha Patil, Manav Patel, William G Sharp","doi":"10.1016/j.jpeds.2025.114812","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114812","url":null,"abstract":"<p><strong>Objective: </strong>To examine clinical correlates of insomnia symptoms in children with autism spectrum disorder (ASD) ascertained from a general outpatient autism clinic.</p><p><strong>Study design: </strong>This analysis included 103 children with ASD (mean age=5.8+2.2 years; range 2-10, 77.7% male). A multidisciplinary team assessed medical and psychosocial histories using parent ratings from the Pediatric Autism Insomnia Rating Scale (PAIRS), Aberrant Behavior Checklist (ABC), Brief Autism Mealtime Behavior Inventory (BAMBI), and the PedsQL and Family Functioning Surveys. Height and weight were collected. Children in the current sample with scores on the PAIRS > 22 were compared with those with a mean PAIRS score < 22. Univariable and multivariable logistic regression modeling was used to evaluate clinical correlates with insomnia symptoms > 22. Best subset selection approach identified the most important predictors.</p><p><strong>Results: </strong>The PAIRS mean was 18.39 + 14.54 (range 0 to 58); 33% scored > 22. After adjusting for confounders, disruptive mealtime behaviors (p < .001), parent HRQoL and family functioning (p<.001 to .001), ABC subscales (p<.001 to .022), and dietary supplements (p=.019) were significantly associated with PAIRS > 22. There were no group differences in height, weight, constipation, or demographics. Best subset modeling showed ABC Hyperactivity/Noncompliance, dietary supplements, and mealtime behaviors as the most significant predictors (ROC = 0.842, χ²(df) = 32.84 (3), χ²Diff. = 4.80, p<0.001).</p><p><strong>Conclusions: </strong>The PAIRS appears useful for characterizing the nature and severity of current insomnia symptoms in autistic children.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114812"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Hearing-Targeted and Universal Newborn Screening on the Observed Birth Prevalence of Congenital Cytomegalovirus Infection","authors":"Colin Kunzweiler PhD ,&nbsp;Raymond C. Stetson MD, MS ,&nbsp;Robert M. Jacobson MD ,&nbsp;Jennifer L. St Sauver PhD ,&nbsp;Yan Li PhD ,&nbsp;Ruoxiang Jiang BS ,&nbsp;Adva Gadoth PhD ,&nbsp;Laura Hendrix MSc ,&nbsp;John Diaz-Decaro PhD","doi":"10.1016/j.jpeds.2025.114811","DOIUrl":"10.1016/j.jpeds.2025.114811","url":null,"abstract":"<div><div>This retrospective study estimated the birth prevalence of congenital cytomegalovirus (cCMV) in southeastern Minnesota, US. The birth prevalence was about 3 times and about 18 times greater following implementation of hearing-targeted and universal newborn cCMV screening, respectively. Most infants born with cCMV will not be identified in the absence of systematic newborn screening programs.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114811"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Surgical Drooling Treatment in Individuals with Neurodevelopmental Disabilities: A Retrospective Cohort Study","authors":"Daan W.A. van den Nieuwenhof MD ,&nbsp;Esther J.P.C. van Bergen MD ,&nbsp;Corrie E. Erasmus MD, PhD ,&nbsp;Corinne P.A. Delsing MD, PhD ,&nbsp;Karen van Hulst MD, PhD ,&nbsp;Stijn Bekkers MD, PhD ,&nbsp;Frank J.A. van den Hoogen MD, PhD","doi":"10.1016/j.jpeds.2025.114807","DOIUrl":"10.1016/j.jpeds.2025.114807","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the long-term treatment outcomes of submandibular duct relocation (SMDR), submandibular gland excision (SMGE), and submandibular duct ligation (SDL) for the treatment of anterior drooling in individuals with neurodevelopmental disabilities.</div></div><div><h3>Study design</h3><div>A retrospective cohort study was conducted with patients from the Netherlands who received surgery for drooling. All participants received follow-up after 8 and 32 weeks. A questionnaire was completed at least 1 year postsurgery for long-term follow-up. Visual analog scale (VAS) for drooling was the primary outcome. Secondary outcomes included the Drooling Quotient and the Drooling Severity and Frequency Scale. Repeated measures ANOVA was employed to assess the outcomes within and between each type of surgery.</div></div><div><h3>Results</h3><div>A total of 255 patients who visited the Saliva Control Clinic between 2000 and 2021 were included in this study. For the VAS at long-term follow-up, a mean reduction was observed of 44.9 points for SMDR (<em>P</em> &lt; .001), 27.2 for SMGE (<em>P</em> &lt; .001), and 25.4 for SDL (<em>P</em> &lt; .001). VAS increased by within-surgery difference at long-term compared with 32 weeks for SMGE (8.6, <em>P</em> = .036) and SDL (8.5, <em>P</em> = .047), but not for SMDR (2.9, <em>P</em> = .46). When comparing the three types of surgery, the outcomes after SMDR remained stable in the long term, while the VAS increased for SMGE (mean difference 18.9, <em>P</em> = .011) and SDL (mean difference 18.5, <em>P</em> = .013).</div></div><div><h3>Conclusions</h3><div>VAS for drooling, Drooling Quotient, and Drooling Severity Frequency Scale decreased after all surgical procedures. SMDR showed superior outcomes over SMGE and SDL in the long term. Our data suggest partial recurrence of drooling after SDL and SMGE.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114807"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational Programming to Prevent Violence in Schools in the United States: An Analysis of School Health Profiles","authors":"Chloe Gao BHSc ,&nbsp;Donald Szlosek MS ,&nbsp;Anthony Zhong MA ,&nbsp;Scott E. Hadland MD, MPH, MS ,&nbsp;Sarah S. Benes EdD, MPH, CHES","doi":"10.1016/j.jpeds.2025.114805","DOIUrl":"10.1016/j.jpeds.2025.114805","url":null,"abstract":"<div><div>This repeated, cross-sectional study examined trends in the availability of school-based programming to prevent violence in middle and high schools across the United States from 2008 to 2020. Overall, violence prevention programming increased in respondent schools throughout the study period. However, important gaps remain, with lingering state-level disparities.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114805"},"PeriodicalIF":3.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobilizing Pediatric Subspecialists to Inform Regulation: A Five-Step Case Study to Reduce Consumption of Added Sugars.","authors":"Jang Lee, Eimaan Anwar, Alison Clayshulte, Lisa J Chamberlain, Janine Bruce, Noelle Ebel, Christina Hecht, Adrienne Lazaro, Shweta S Namjoshi, Anisha I Patel","doi":"10.1016/j.jpeds.2025.114808","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114808","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114808"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to: A Clinical Tool to Relate Youth Risk Factors to Adult Cardiovascular Events and Type 2 Diabetes: The i3C Consortium J. Pediatr. 2025 Jan;276:114277.","authors":"Jessica Haley, Jessica G Woo, David R Jacobs, Lydia Bazzano, Stephen Daniels, Terry Dwyer, Markus Juonala, Olli Raitakari, Alan Sinaiko, Julia Steinberger, Alison Venn, Kara M Whitaker, Elaine M Urbina","doi":"10.1016/j.jpeds.2025.114782","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114782","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114782"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Children's Active Play in Nature via Primary Care","authors":"Georgia M. Griffin MD ,&nbsp;Liv Ellerton BA ,&nbsp;Marnie F. Hazlehurst PhD ,&nbsp;Kirsten Senturia PhD ,&nbsp;Emily Kroshus ScD, MPH ,&nbsp;Danette Glassy MD ,&nbsp;Edna Maddalena MA ,&nbsp;Kimberly Garrett MPH ,&nbsp;Pooja Tandon MD, MPH","doi":"10.1016/j.jpeds.2025.114810","DOIUrl":"10.1016/j.jpeds.2025.114810","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the feasibility, acceptability, and utility of Project Nature (PN), an intervention during well-child checks, to promote children's active play in nature from the perspectives of parents and clinic staff.</div></div><div><h3>Study design</h3><div>Six primary care clinics in Washinton State implemented PN, including anticipatory guidance from a clinician, a nature-based toy, and written/internet based family resources, during well-child checks for 1-10 year olds. We conducted quantitative surveys of different groups of parents before (control group, n = 154) and after (intervention group, n = 131) the implementation of PN at each clinic. We analyzed differences between the 2 groups using chi-square and Mann–Whitney U tests. Postintervention, we conducted qualitative interviews with 11 clinic staff members about implementation, coded the data, and conducted thematic analysis.</div></div><div><h3>Results</h3><div>The proportion of parents reporting that their child's clinician encouraged daily outdoor time was higher postintervention than the control group (85% vs 54%, <em>P</em> = .02). A higher proportion of parents in the intervention compared with the control group reported that the clinician encouraged daily physical activity (86% vs 71%, <em>P</em> = .09). Families generally reported strong satisfaction with all the intervention components. Clinic staff felt PN facilitated conversation around active outdoor play and believed that PN was feasible within their existing workflows.</div></div><div><h3>Conclusions</h3><div>PN is a feasible and acceptable approach for supporting children's active play in nature via primary care clinics. These results provide a foundation for a larger evaluation assessing the impact of PN on families' physical activity and nature-based experiences.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114810"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Remote Patient Monitoring on Neonatal Intensive Care Unit Patients Discharged with Nasogastric Tube Feeding","authors":"Rebecca D. Henkel MD ,&nbsp;Kristin Melton MD ,&nbsp;Tanya Cahill MD ,&nbsp;Melissa House MD ,&nbsp;Julisa Muñoz ,&nbsp;Christa Tabacaru MD ,&nbsp;Chunyan Liu MS ,&nbsp;Shelley R. Ehrlich MD, ScD, MPH ,&nbsp;Heather C. Kaplan MD, MSCE","doi":"10.1016/j.jpeds.2025.114802","DOIUrl":"10.1016/j.jpeds.2025.114802","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether discharge with remote patient monitoring (RPM) is associated with improved outcomes among infants discharged from the neonatal intensive care unit with a nasogastric tube (NGT).</div></div><div><h3>Study design</h3><div>This was a retrospective cohort study of infants discharged with an NGT from the Cincinnati Children's Hospital Medical Center neonatal intensive care unit from 2015 to 2022. Infants were divided into pre-RPM and RPM cohorts. Differences in clinical characteristics, weight at follow-up, and unplanned health care utilization were evaluated using multivariable generalized linear regression models.</div></div><div><h3>Results</h3><div>There were 385 eligible patients (n = 139 pre-RPM, n = 246 RPM). Infants discharged with RPM had higher rates of prematurity. The RPM group was discharged at an earlier postmenstrual age (43.00 vs 44.12 weeks, <em>P</em> = .0102) and had more favorable change in weight z-score at follow-up (0.21 [0.03, 0.4] at 3 months, 0.34 [0.09, 0.58)] at 6 months). The risk of unplanned admissions or emergency department visits was 53% lower in the RPM group than in the pre-RPM group (risk ratio = 0.47 [0.28, 0.79]).</div></div><div><h3>Conclusions</h3><div>Patients discharged with an NGT plus RPM were discharged at earlier postmenstrual age, had more favorable growth trajectory, and had fewer unplanned health care encounters, indicating that discharge with NGT feeds with RPM appears to be safer and more effective than discharge with NGT feeds without RPM.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114802"},"PeriodicalIF":3.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}