BMC Pediatrics最新文献

{"title":"Comparative effects of inspiratory and expiratory muscle training on diaphragm adaptations and respiratory function in adolescent athletes: a randomized-controlled study.","authors":"Zeliha Celik, Gurkan Demirtas, Nevin A Guzel, Halit Nahit Sendur, Muserrefe Nur Keles, Nihan Karatas, Nurdan Kokturk","doi":"10.1186/s12887-026-07817-z","DOIUrl":"10.1186/s12887-026-07817-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the comparative effects of Inspiratory and Expiratory Muscle Training (IMT and EMST) on diaphragm thickness and stiffness, and respiratory muscle performance in adolescent athletes.</p><p><strong>Methods: </strong>In this randomized controlled study, 26 adolescent female volleyball players were randomly assigned to the IMT and EMST groups. Both interventions were performed for 4 weeks, 5 days per week, twice daily. Diaphragm thickness and stiffness, pulmonary function, maximal inspiratory and expiratory pressure (MIP, MEP), and respiratory muscle endurance (Tmax) were evaluated at baseline and post-intervention.</p><p><strong>Results: </strong>Significant time effects were observed for diaphragm thickness during inspiration and expiration and for MIP and MEP (all p < 0.001). However, no significant group × time interactions were detected (p > 0.05). A significant time effect was observed for PEF% (p = 0.022), while no significant group × time interaction was detected for pulmonary function parameters (p > 0.05). Diaphragm stiffness and Tmax did not change significantly over time, and no significant group × time interactions were detected (p > 0.05).</p><p><strong>Discussion: </strong>Improvements in diaphragm thickness and respiratory muscle strength were observed in both the IMT and EMST groups in adolescent athletes. Respiratory muscle training added to regular sports training may be associated with structural and strength adaptations in adolescent athletes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT06759779, Registered 6 January 2025. Retrospectively registered.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179406","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":"Laboratory correlates of observation and hospitalization decisions in children with acute gastroenteritis: an exploratory association study.","authors":"Mehmet Cengiz","doi":"10.1186/s12887-026-07783-6","DOIUrl":"10.1186/s12887-026-07783-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine, in children with acute gastroenteritis (AGE), the association between laboratory (and available clinical) findings and the real-world clinician decision to place a child under observation or to admit. The study is explicitly exploratory and association-based, not a prediction model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Single-centre retrospective analysis of 226 children aged 0-18 years (April 2024-March 2026). Disposition was classified hierarchically (outpatient discharge / observation only / hospitalization). Laboratory tests were obtained at clinician discretion at presentation, at intravenous cannulation and before fluids. Group comparisons used Mann-Whitney U with Benjamini-Hochberg FDR across 11 parameters; three-group comparisons used Kruskal-Wallis with Dunn post-hoc. NLR and PLR were assessed as exploratory composites. Logistic models reported adjusted ORs with VIF; discrimination was summarised by ROC AUC with bootstrap optimism correction. Analyses restricted to the tested subgroup (Python 3; SciPy/statsmodels).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Laboratory testing was obtained in 43% of outpatients versus 98% of observation/hospitalization patients, indicating highly differential, clinician-directed (informative) missingness. Compared with outpatients, children escalated to observation or hospitalization had lower lymphocyte counts and higher neutrophil counts and urea (all FDR p &lt; 0.05). Across the three groups, lower lymphocyte count separated outpatients from escalated patients (H = 20.1, p &lt; 0.001) but did not distinguish observation from admission. In the composite multivariable model, lower lymphocyte count was the strongest correlate (adjOR 0.575, 95% CI 0.419-0.789; p = 0.001). Adding lymphocyte count to available clinical variables (fever, vomiting, measured temperature) was associated with improved model fit within the tested subgroup (likelihood-ratio p &lt; 0.001; apparent AUC 0.75→0.81). As a secondary exploratory observation, the neutrophil-to-lymphocyte ratio showed the numerically highest single-marker discrimination (AUC 0.78, 95% CI 0.68-0.86), though its bootstrap confidence interval overlapped substantially with those of lymphocyte and neutrophil counts. The multivariable escalation model had an optimism-corrected c-statistic of 0.77 (apparent 0.82). No parameter survived FDR correction for the hospitalization-specific outcome. Rotavirus positivity was associated with admission (OR 2.74; p = 0.015).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Among children who underwent laboratory testing for AGE, lower lymphocyte count was the marker most consistently associated with the clinician's decision to escalate care, with higher NLR a secondary exploratory signal. Because these same laboratory values informed the disposition decision (incorporation bias) and testing was selective, findings describe associations with real-world management within the tested subgroup and are hypothesis-generating rat","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191204","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":"Cardiac changes in children with post-streptococcal glomerulonephritis: a prospective observational study.","authors":"Sherin Khamis Hussein, Moaz Yasser Darwish, Sara I Abo Elnour","doi":"10.1186/s12887-026-07396-z","DOIUrl":"https://doi.org/10.1186/s12887-026-07396-z","url":null,"abstract":"<p><strong>Background: </strong>Acute poststreptococcal glomerulonephritis (PSGN) is the most common type of glomerulonephritis which may involve multiple organs, including the heart. This study aimed to explore cardiac status of children with PSGN and track progression of any cardiac impairment using a comprehensive multimodal assessment approach.</p><p><strong>Methods: </strong>This observational study included 41 patients with PSGN (1-12 years) who underwent clinical, laboratory, electrocardiography, echocardiography and tissue Doppler assessment between January 2024 and April 2025 at Fayoum University Hospitals. Patients were followed up for 12 weeks after the diagnosis was established.</p><p><strong>Results: </strong>Prolonged QTc was reported in 13 cases (median=431ms), showing a significant negative correlation with ejection fraction (EF) (r=-0.40, P = 0.009) and fractional shortening (FS) (r=-0.38, P = 0.01) and a positive correlation with estimated systolic pulmonary artery pressure (ESPAP) (r = 0.36, P = 0.02). Ten patients (24.4%) had mild mitral regurgitation, and one (2.4%) had moderate regurgitation. At follow-up, cases showed a significant decrease in interventricular septum thickness (IVS), left ventricular end-diastolic diameter (LVEDD), and ESPAP with P = 0.003, 0.01, and 0.001, respectively. Thirty patients had high right ventricular myocardial performance index (MPI), and 17 had high left ventricular MPI at diagnosis. Significant decrease was observed in isovolumetric contraction time (IVCT) (RV: P = 0.03, LV P = 0.01) and MPI (P < 0.001 for both ventricles).</p><p><strong>Conclusion: </strong>Transient subclinical functional cardiac changes were evident in pediatric patients with PSGN. These transient changes may impose significant clinically relevant risks, particularly in the acute phase of the disease. Selected patients in appropriate clinical contexts may benefit from advanced cardiac investigations. QTc prolongation may warrant attention as an initial assessment tool of myocardial status, while myocardial performance index can be considered as an advanced measure. However, both tools should be interpreted with caution and within the relevant clinical context since they are subjected to various confounders.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104235","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":"Parental needs and experiences with e-Health applications in chronic pediatric care - a scoping review.","authors":"Helena Grüter, Anna Loeffler, Lisa Stähler, Irem Gönen, Jenny Prüfe, Freia De Bock, Claudia R Pischke","doi":"10.1186/s12887-026-07737-y","DOIUrl":"10.1186/s12887-026-07737-y","url":null,"abstract":"<p><strong>Background: </strong>The number of children and adolescents living with a chronic condition is steadily increasing. These conditions often place a considerable burden on affected individuals and their families. E-Health applications have the potential to support families by providing accessible resources and personalized tools for disease management. This scoping review aims to synthesize the specific needs and experiences that parents of children with chronic conditions across different diagnosis categories express in relation to e-Health applications.</p><p><strong>Methods: </strong>This review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and the PRISMA-ScR reporting guidelines. A systematic search of the literature published between January 2010 and February 2025 was carried out in the Web of Science and Ovid databases, including Ovid MEDLINE and APA PsycInfo. The initial search identified 1,173 articles, of which 39 underwent data analysis via narrative synthesis.</p><p><strong>Results: </strong>A broad spectrum of needs and experiences was identified regarding e-Health applications intended to support parents of children with chronic conditions. Across conditions, such as autism, diabetes, asthma, congenital heart disease, and obesity, recurring themes emerged. Parents consistently emphasized the need for accessible and user-friendly interfaces, reliable and comprehensible health information, and tools to support care coordination and communication with healthcare professionals. Social support and psychological resources provided via e-Health applications were also valued, while concerns regarding data privacy persisted. Experiences with e-Health applications were generally positive, particularly for mobile apps, web-based platforms, and video conferencing, which improved monitoring, empowerment, and access to care. However, parents also reported barriers, including technical difficulties, limited customization, and fear of reduced personal contact with providers. Needs and experiences were frequently repeated across different modalities and conditions, suggesting common priorities for digital health design. Evidence on needs along the care trajectory was limited, with early and long-term phases better represented than transitional periods.</p><p><strong>Conclusion: </strong>Parents of children with chronic conditions articulate broad, cross-cutting needs for e-Health applications that go beyond diagnosis-specific management. From their perspective, effective tools should integrate accessible design, reliable information, coordination features, social support, and ensure data protection. Research gaps remain regarding transitional care phases and the dynamic evolution of needs over time.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058516","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":"Temporal profile of serum orexin-A in neonatal hypoxic-ischemic encephalopathy: a prospective longitudinal study.","authors":"Pınar Gençpınar, Gunce Basarir, Atilla Ersen, Defne Engür, Nihal Olgaç Dündar, Hüseyin Üstün, Melike Kefeli Demirel, Fatma Ceren Sarıoğlu, Banu İşbilen Başok","doi":"10.1186/s12887-026-07727-0","DOIUrl":"10.1186/s12887-026-07727-0","url":null,"abstract":"<p><strong>Background: </strong>No serum biomarker has yet been validated for clinical use in neonatal hypoxic-ischemic encephalopathy (HIE). Orexin-A is a hypothalamic neuropeptide that has demonstrated neuroprotective effects in experimental models of cerebral hypoxia-ischemia. We aimed to describe the early temporal profile of serum orexin-A in neonates with HIE, to compare its longitudinal change according to therapeutic hypothermia (TH) exposure, and to examine its relationship with clinical severity, electrophysiological findings and brain imaging.</p><p><strong>Methods: </strong>This prospective longitudinal observational study enrolled 41 neonates born at ≥ 36 weeks' gestation in whom HIE was diagnosed within the first 6 postnatal hours. Serum orexin-A was measured at 6-12 h and at 72-96 h after birth. Longitudinal changes were compared between neonates who received TH and those managed without TH, and were examined against clinical severity, amplitude-integrated and video electroencephalography (EEG), brain magnetic resonance imaging (MRI) and routine metabolic indices.</p><p><strong>Results: </strong>Twenty-two neonates received TH and 19 were managed without TH. Orexin-A concentrations did not differ between groups at either time point (6-12 h, p = 0.078; 72-96 h, p = 0.082). The within-subject change from 6-12 h to 72-96 h did differ, with relative preservation under TH and a decline without it (median + 31.2 vs. -54.5 pg/mL; p = 0.002), and more neonates in the TH group had a higher value at the second measurement (p = 0.012). Orexin-A fell significantly over time in the normothermia group (p = 0.005). The change also differed by amplitude-integrated EEG background (p = 0.010), although abnormal tracings were almost confined to the TH group. Neither concentration nor change was related to video EEG findings, MRI abnormality or metabolic indices. Higher 72-96 h concentrations tracked clinical severity only in outlier-sensitive analyses.</p><p><strong>Conclusions: </strong>Serum orexin-A followed different early trajectories in neonates managed with and without hypothermia, and the clinical signal lay in the direction of change rather than in any single concentration. Because treatment allocation was inseparable from disease severity, these trajectories cannot be attributed to cooling itself. Orexin-A behaves as a marker of functional state rather than of tissue injury, and serial sampling in larger, severity-matched cohorts with neurodevelopmental follow-up is required before any clinical role can be defined.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135111","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":"Preliminary exploration of tissue oxygen saturation index using near-infrared spectroscopy in two infants of neonatal catheter-associated venous thrombosis.","authors":"Haihong Zhu, Yun Ling, Xiaoying Dong, Feixiang Luo, Jihua Zhu","doi":"10.1186/s12887-026-07711-8","DOIUrl":"10.1186/s12887-026-07711-8","url":null,"abstract":"<p><strong>Background: </strong>Near-infrared spectroscopy (NIRS) is commonly used for monitoring oxygen saturation in brain and abdominal tissues, while reports on the monitoring of local tissue oxygen saturation in limbs are very limited. This study observed the changes in limb tissue oxygen saturation index (TOI) in two infants of catheter-related venous thrombosis (CRT) and preliminarily investigated their correlation.</p><p><strong>Case presentation: </strong>This study involved two infants who experienced limb catheterization complicated by venous thrombosis. NIRS was employed for the continuous monitoring of TOI prior to, during, and subsequent to urokinase thrombolysis. The safe TOI range was established at 58%-68% ±2; a reduction above 20% from baseline signified an anomaly. Changes in skin color and temperature of the affected limb were simultaneously observed, and the thrombolytic effect was comprehensively assessed using vascular ultrasound. Infant 1 was diagnosed with right iliac vein thrombosis; after 144 h of thrombolytic therapy, the TOI of the affected lower limb returned to the normal range, with no abnormalities in limb skin temperature or circumference. Infant 2 involved axillary vein thrombosis near the subclavian vein; following 17 h of combined thrombolysis and anticoagulation therapy, TOI values in both upper limbs became balanced, and ultrasound follow-up revealed no residual thrombus, indicating restored venous patency.</p><p><strong>Conclusions: </strong>NIRS-monitored limb tissue oxygen saturation index can indicate the local venous filling status, which may facilitate the assessment of thrombolytic efficacy and the surveillance of thrombus formation.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058513","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":"Establishing preliminary normative reference values for oral motor skills in typically developing Egyptian children using oral placement therapy tools.","authors":"Rehab Abd Elhafeez Zaytoun, Aisha Fawzy Abdel Hady, Mohamed Eid Farag, Rasha Abdelrahman Alasheery, Manar Mohsen Gomaa, Sameh Mahmoud Amin","doi":"10.1186/s12887-026-07555-2","DOIUrl":"10.1186/s12887-026-07555-2","url":null,"abstract":"<p><strong>Introduction: </strong>Oral motor skills are essential for normal feeding and speech development. Impairments in these functions may adversely affect a child's growth, communication abilities, and overall quality of life. Accurate and standardized assessment of oral motor function is therefore critical for early diagnosis and intervention. However, many currently available assessment tools lack adequate objectivity and standardization.</p><p><strong>Aim: </strong>This study aimed to evaluate oral motor function in typically developing Egyptian children aged 2-6 years using Oral Placement Therapy (OPT) tool hierarchies and to establish normative reference values for clinical use.</p><p><strong>Subjects and methods: </strong>A cross-sectional study was conducted on 275 typically developing children randomly selected from nurseries in Fayoum, Egypt. Participants were categorized into 6-month age intervals across the 2-6-year age range. Oral motor skills were assessed using OPT tool hierarchies, including bite blocks, bite tubes, horn hierarchies, straw hierarchies, and bubble-blowing tasks.</p><p><strong>Results: </strong>Oral motor performance demonstrated an overall age-related progression across most assessment domains. Children younger than 42 months consistently achieved lower scores, whereas children older than 66 months achieved the highest scores across most OPT tool hierarchies. Significant differences were observed among age groups in measures of jaw stability, jaw strength, lip function, and oral airflow control.</p><p><strong>Conclusion: </strong>OPT tool hierarchies provide a feasible and practical method for assessing oral motor function in typically developing Egyptian children. The preliminary reference data generated in this study may serve as a useful clinical guide for the early identification and management of oral motor disorders. However, multi-center validation and comprehensive psychometric evaluation are warranted before these data can be adopted as standardized clinical benchmarks.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001237","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":"Knee proprioception in children with spastic cerebral palsy: an observational study.","authors":"Annika Ericson, Åsa Bartonek, Israel Luis, Marie Eriksson, Cecilia Lidbeck","doi":"10.1186/s12887-026-07652-2","DOIUrl":"10.1186/s12887-026-07652-2","url":null,"abstract":"<p><strong>Background: </strong>Proprioception, the sense of body position and movement, is vital for motor control but has been sparsely explored in children with cerebral palsy (CP), particularly in the lower extremities. This study explored proprioception as the capacity to reproduce and maintain a knee flexion angle in children with CP.</p><p><strong>Methods: </strong>Fifty-seven children aged 6-18 years with spastic CP; 20 unilateral (USCP), and 37 bilateral (BSCP), at Gross Motor Function Classification System (GMFCS) I-IV, and 42 typically developing (TD) children participated. Three-dimensional motion analysis was used to capture knee movements during a joint position sense test performed in sitting with occluded vision. The test consisted of (i) the criterion angle (CA) trial; the leg was passively elevated to a knee flexion angle of 45 degrees (CA) by an examiner and the position was maintained by the child, and (ii) the reproduced angle (RA) trial; the angle was actively reproduced (RA) and maintained by the child. Joint position sense errors were evaluated as the difference between CA and RA. The children's capacity to maintain the leg position was measured as the difference in knee angles, fluctuations (root mean square error) and drift (linear regression). Data were analysed with non-parametric statistics.</p><p><strong>Results: </strong>Joint position sense errors were greater in the USCP-group than the BSCP-group (p = 0.037), with a more extended knee in the USCP-group (p = 0.012). When maintaining the passively positioned knee angle for 2.5 s, the CP-group compared to the TD-group, showed increased knee flexion and greater movement fluctuations (p = 0.006). Within-group analysis showed increased knee flexion at the passively assumed position (CA vs. maintained for 2.5 s) compared to at the actively assumed position (RA vs. maintained for 2.5 s) in the BSCP-group (p = 0.015) and the GMFCS II-group (p = 0.028). The BSCP-group also showed increased drift over time towards knee flexion when the leg was passively compared to actively positioned (p = 0.040).</p><p><strong>Conclusions: </strong>The results reveal a divergence in proprioceptive function: while the USCP-group had greater difficulty than the BSCP-group in reproducing a knee angle, the BSCP-group demonstrated greater difficulty in maintaining the knee position during passive positioning of the lower limb.</p><p><strong>Trial registration: </strong>This study was observational and was therefore not registered as a clinical trial.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982305","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":"Bidirectional pathways to suicide: how parent-child interactions shape adolescent depression and suicidality in China.","authors":"Yan Han, Rongying Sun, Yan Tang, Chunhong Wei","doi":"10.1186/s12887-026-07402-4","DOIUrl":"10.1186/s12887-026-07402-4","url":null,"abstract":"<p><strong>Background: </strong>Adolescent suicide, largely driven by depression, is a critical public health crisis in China, with depression affecting over 70% of cases and demonstrating recurrence rates exceeding 80% within one year. While parent-child interactions significantly influence suicidal trajectories, existing research has predominantly examined unidirectional perspectives, neglecting the complex bidirectional dynamics between adolescents and their caregivers.</p><p><strong>Methods: </strong>This qualitative study used purposive sampling to recruit 12 adolescent-parent dyads (N = 24) from a tertiary hospital in China. Adolescents met the ICD-10 criteria for depression, had recent suicide attempts, and were aged 11-18 years. Parents were the primary caregivers. Semi-structured interviews explored the bidirectional physical, emotional, and cognitive impacts of depression. Data were analyzed using Colaizzi's phenomenological method, grounded in family systems theory and stress contagion models, with rigorous quality controls including member checking, triangulation, and negative case analysis.</p><p><strong>Results: </strong>Four interconnected thematic domains emerged, revealing complex bidirectional dynamics. Bidirectional stress transmission manifested through reciprocal physical deterioration (most adolescents reported chronic fatigue, and approximately two-thirds of parents developed stress-related symptoms) and destructive psychological feedback mechanisms (all adolescents identified parental emotional states as suicidal triggers). Communication disruptions affected the majority of adolescents who ceased emotional disclosure, while most parents demonstrated limited understanding of depression. Family system destabilization included role confusion, relationship deterioration (more than half experiencing marital strain), and substantial economic burden, averaging 42,500 yuan annually, representing approximately one-third of the median household income in the study region. Systemic support deficiencies encompassed social stigma (nearly all families), healthcare delays averaging 5.3 months between symptom onset and appropriate psychiatric care, and institutional barriers to care.</p><p><strong>Conclusion: </strong>This study illuminates the cyclical and relational nature of adolescent suicidality, demonstrating how bidirectional stress transmission, communication breakdowns, and systemic barriers maintain pathological cycles. The findings support comprehensive family centered intervention models that address patient and caregiver needs while providing integrated socioeconomic support.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975777","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":"Characteristics of youth reporting suicidal ideation in an integrated youth services initiative in British Columbia, Canada (2018-2023): a retrospective cohort study.","authors":"Katherine G Hastings, Guiping Liu, Kirsten Marchand, Anne Gadermann, Jason M Sutherland, Emily Jenkins, Skye P Barbic","doi":"10.1186/s12887-026-07543-6","DOIUrl":"10.1186/s12887-026-07543-6","url":null,"abstract":"<p><strong>Background: </strong>Integrated youth services (IYS) are a growing model of care where youth can access a range of youth-friendly health and social services within a single location. Located in British Columbia (B.C.), Foundry was the first IYS initiative established in Canada. In this study, we examine service utilization patterns and characteristics of youth reporting suicidal ideation (SI) to better understand and address their care needs.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of linked health survey and service data collected at Foundry from 2018 to 2023. Descriptive statistics and bivariate analyses compared groups of youth who reported having SI within the past month vs. youth who reported never having SI at the time of their initial visit. Standardized mean differences (SMD) and p-values were calculated to identify statistically significant differences between groups. We plotted monthly proportions of overall youth reporting SI accessing Foundry over the study period and by sex/gender, sexual identity (i.e., LGBTQ+), and age group.</p><p><strong>Results: </strong>A total of 8,347 individuals were included in the analysis, of which 6,021 (72.1%) reported any lifetime history of SI and 2,975 (35.6%) reporting past-month SI. Youth with past-month SI were more likely to identify as gender diverse (13.3% of youth with SI vs. 4.9% of youth with no SI; SMD: 29.7), and LGBTQ+ youth (45.2% vs. 22.3%; SMD: 52.7). Youth with past-month SI also had higher distress scores (as measured by the Kessler Psychological Distress Scale; 36.7 vs. 27.0 mean score for past-month SI vs. never SI youth, respectively; SMD: 138.5).Youth with past-month SI had more service contact with IYS than those without SI [7.0 (SD: 16.8) vs. 11.2 (SD: 23.2) mean visits; p < 0.0001] and had accessed other mental health/substance use services in the last year (43.4% vs. 20.9%; SMD: 49.7). We found no substantial change in the overall proportion of youth reporting SI over the study period, and by subpopulations, we found a slight increase among females in the last two years.</p><p><strong>Conclusions: </strong>Many youth accessing Foundry reported having SI, indicating an important opportunity for early intervention. Our findings also shed light on health inequities of self-reported SI, particularly among gender and sexually diverse youth.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975809","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}