INTRODUCTION The relationship between housing instability and e-cigarette and traditional tobacco use, particularly for sexual minority students, has received little attention. This study investigates the association between housing instability, e-cigarettes, and traditional tobacco use in sexual minorities and heterosexual adolescents. METHODS We used 2021 and 2023 Youth Risk Behavior Survey data

OBJECTIVE Sexual and gender minority (SGM) people account for up to 40% of youth experiencing homelessness. SGM youth experiencing homelessness report a higher likelihood of engaging in behavior that puts them at risk of acquiring HIV. To address this increased risk, it is necessary to identify difference in awareness and use of HIV pre-exposure prophylaxis (PrEP) among SGM youth experiencing homelessness

BACKGROUND Neary 70 million people in the United States live in households where English is not the primary language. Language barriers cause significant challenges to health care use among non-English-speaking populations. We compared the use of preventive care among English, Spanish, and non-English-non-Spanish (NENS) speaking households. METHODS A retrospective analysis of the nationally representative

OBJECTIVE To explore the psychosocial experiences of African American families affected by childhood cancer. METHODS A qualitative investigation was conducted using grounded theory methods. Data collection consisted of in-depth semistructured interviews of purposively sampled participants. Eligible participants were English-speaking parents who self-identified as African American and whose children

BACKGROUND AND OBJECTIVE Adultification is the process by which children, particularly Black girls, are perceived and treated as more mature or adult-like than their peers, often resulting in the denial of their childhood experiences and the imposition of adult expectations. This study seeks to explore the impact of adultification on Black girls' identity formation and the overall well-being of Black

BACKGROUND AND OBJECTIVE Youth overdose deaths have remained elevated in recent years as the illicit drug supply has become increasingly contaminated with fentanyl and other synthetics. There is a need to better understand fatal drug combinations and how trends have changed over time and across sociodemographic groups in this age group. METHODS We used the National Vital Statistics System's multiple

BACKGROUND AND OBJECTIVES Use of flavored oral nicotine products (ONPs), including nicotine pouches and other ONPs (eg, gums and lozenges) is increasing among adolescents who use e-cigarettes (ie, vape). It is unknown whether ONP use is associated with vaping behaviors. METHODS We used data from 6 semiannual waves of a prospective cohort of Southern California adolescents (2021-2024). Among participants

OBJECTIVE Determine the prevalence of advancing and graduating residents with concerns as well as attesting readiness to the American Board of Pediatrics for residents not deemed ready at graduation among pediatric program directors. METHODS Surveys were sent to pediatric program directors from July to September 2024 to explore their experiences of graduating residents for whom they had concerns, graduating

CONTEXT Various medical and social factors are associated with adverse neurodevelopment in children born very preterm. Analyses accounting for confounders involving representative samples are essential to quantify the effects of different factors. OBJECTIVE We aimed to systematically review the effects of various risk factors on neurodevelopmental impairment (NDI) at 18 to 36 months of age in children

Metabolic acidosis and hyperlactatemia are known complications of acute metformin toxicity. However, acute cardiac complications are less well described. A 13-year-old female presented following a 150-g metformin ingestion. She developed severe metabolic acidosis, hyperlactatemia, and acute kidney injury requiring intubation and continuous renal replacement therapy. Despite rapid correction of her

Menstrual poverty occurs when inadequate access to menstrual hygiene education or financial hardship creates difficulties in sufficiently accessing menstrual hygiene products, which results in adverse outcomes for emotional well-being, school attendance, and health autonomy. The American Academy of Pediatrics recently endorsed a position statement to eliminate menstrual poverty in adolescents and young

BACKGROUND AND OBJECTIVE The specialty of neonatology faces significant and growing challenges related to patient safety, physician well-being, and workforce sustainability that highlight the necessity for innovative work models. Our objective was to develop consensus recommendations to improve neonatologist staffing practices in the United States. METHODS We used a modified Delphi process with 32

Determining whether a discharge plan is safe relies on both objective and subjective evaluations. These safety determinations are often made with the goal of having children reintegrated into their community. In the case of pediatric mechanical ventilation via tracheostomy, the stakes for discharge home are high given potential morbidity and mortality risk if there are insufficient services in place

BACKGROUND AND OBJECTIVES The prescription of stimulant medications for young people with attention-deficit/hyperactivity disorder is common and increasing. Concerns have been raised about potentially psychotogenic effects of stimulants, and previous observational research has documented an increased risk of psychotic experiences in young people prescribed stimulants. Our aim was to estimate the causal

BACKGROUND AND OBJECTIVES Current training models do not adequately prepare pediatricians to care for children with medical complexity (CMC) as part of a team. Narrative medicine may foster mutual understanding between clinicians and families with colearning as a foundation for collaborative care. In this study, we implemented family-led interprofessional narrative medicine training and explored participants'

Neonatal brachial plexus palsy (NBPP) is caused by injury to the C5 to T1 nerve roots, which are responsible for both sensory and motor functions in the upper limbs. Importantly, NBPP is not always linked to delivery-related trauma. We present the case of a 16-day-old neonate who was evaluated in the emergency department for fever, lethargy, and skin pallor. In the context of an infection, the infant

BACKGROUND AND OBJECTIVES Pediatric medical device (PMD) development lags behind device development for adults. We sought to identify infrastructure elements that support the conduct of PMD clinical trials (PMD-CTs). METHODS We conducted a multistage modified Delphi process with 25 panelists who were experts on different aspects of PMD-CTs to identify and rate the importance of infrastructure elements

BACKGROUND/OBJECTIVES Celiac disease (CD) is underdiagnosed and thus untreated in many cases. Untreated CD may be associated with severe health complications, increased morbidity and mortality, and considerable burdens to health care systems. Our objectives were to prospectively assess whether implementation of case finding in young children at the Dutch Preventive Youth Health Care Centers (YHCCs)

BACKGROUND AND OBJECTIVES In 2023, the Advisory Committee on Immunization Practices recommended either Abrysvo, a vaccine administered during pregnancy, or nirsevimab, a monoclonal antibody administered to infants after birth, to protect infants from respiratory syncytial virus (RSV). Our objective was to assess the proportion of infants immunized against RSV through antenatal RSV vaccination or receipt

BACKGROUND AND OBJECTIVES Pediatric arterial ischemic stroke (AIS) is an important cause of morbidity and mortality that requires early recognition to benefit from hyperacute therapies. We sought to improve timely diagnosis of AIS through an interdisciplinary stroke response protocol. METHODS A quality improvement initiative was implemented at our pediatric hospital emergency department from November

BACKGROUND AND OBJECTIVES Medicaid eligibility determinations paused during the COVID-19 pandemic but resumed in April 2023. We evaluated whether this "Medicaid unwinding" disrupted chronic medication therapy in young patients. METHODS This study was a difference-in-differences analysis of the 2017-2023 IQVIA Longitudinal Prescription Database (92% of US pharmacies). Analyses included Medicaid-insured

BACKGROUND Anaphylaxis is life-threatening and requires immediate treatment with injectable epinephrine. Among the 20 million children attending US summer camps yearly, 2.5% (approximately 500 000) have immunoglobulin E (IgE)-mediated food allergies and fewer than half bring their epinephrine to camp. OBJECTIVE We aimed to investigate the cost-effectiveness of stock epinephrine in US summer camps.

OBJECTIVE Unplanned extubation (UE) is a significant cause of harm for pediatric patients. Hospitals working with a quality improvement collaborative, Solutions for Patient Safety, tested and developed a UE bundle that demonstrated significant UE reduction after implementation. The objective of this study was to spread the UE bundle to a large number of children's hospitals using workgroups to facilitate

Firearm injuries are the leading cause of death among U.S children and teens.(1) Decreasing firearm access by storing firearms locked and unloaded has the potential to decrease deaths in this population,(2) thus clinical, community, and policy initiatives have focused on improving home firearm storage.(3-10) However, the risk to children and teens extends beyond their own homes - studies of unintentional

BACKGROUND AND OBJECTIVES The Phoenix criteria for pediatric sepsis and septic shock have recently been proposed for worldwide application. The Phoenix sepsis criteria are based on organ dysfunction scoring. Although many screening tools exist, their performance in predicting Phoenix outcomes is not known. We hypothesized that the quick Pediatric Septic Shock Screening Score (qPS4) would demonstrate

BACKGROUND AND OBJECTIVES Although national recommendations advise antivirals for all hospitalized children with influenza, this recommendation is not supported by high-quality evidence like a randomized clinical trial, and recent data suggest nonadherence to guidelines. Our objective was to describe clinician treatment preferences for oseltamivir in hospitalized children. METHODS This cross-sectional

CONTEXT The US Advisory Committee on Immunization Practices states a contraindication for live attenuated influenza vaccine (LAIV) use in children aged 2 to 4 years with asthma or recurrent wheeze plus a precaution, defined as defer vaccine use, in those aged >5 years with asthma. OBJECTIVE We assessed the certainty of evidence on the safety of LAIV vs inactivated influenza vaccine (IIV) or no vaccine

For more than 60 years, the United States Agency for International Development (USAID) has been a major funder of efforts to improve maternal and child health (MCH) across many low- and middle-income countries (LMICs). From 2000 to 2022, the global under-five mortality rate declined from 76 to 37 deaths per 1000 live births.1. Though this progress stemmed from the cumulative efforts of many organizations

CONTEXT Hypothermia after very preterm birth, typically defined as a temperature less than 36 °C, is variably linked to neonatal mortality and morbidities. OBJECTIVE To examine the association between admission hypothermia and adverse outcomes in very preterm infants with a gestational age (GA) of less than 32 weeks. DATA SOURCES CENTRAL, MEDLINE, and Embase from inception to February 18, 2024. STUDY

A few studies have reported immunoglobulin A nephropathy (IgAN) complications in pediatric patients with Crohn disease (CD). Additionally, reports of severe atopic dermatitis (AD) complicating CD with IgAN are rare. In this case report, we review the case of a 10-year-old boy with CD later complicated by IgAN and severe AD at various time points. In his treatment course, he required multiple concurrent

When I was seven, my eldest brother, Sammy, was diagnosed with subacute sclerosing panencephalitis (SSPE) - a sequela of measles infection. He rapidly deteriorated into a vegetative state. Looking back, the bulk of my childhood consisted of mixing nasogastric feeds for him and assisting with his physical therapy alongside my grandfather to prevent worsening contractures. It was extremely traumatic

BACKGROUND Cancer is the leading cause of death by disease among US children. While previous studies have examined the impact of poverty on pediatric cancer outcomes, most relied on single time point measures, which may not capture the long-term, systemic effects of poverty. Persistent poverty, defined as having 20% or more of an area's population below the poverty level for 30 years, represents a

BACKGROUND AND OBJECTIVES Pediatric HCV cases have increased in the United States. Guidelines recommend beginning treatment of HCV for children as young as 3 years old. However, no studies have evaluated pediatric linkage to HCV care and direct-acting antiviral (DAA) uptake on a national level. This study aims to characterize the HCV care cascade among a national cohort of children with HCV. METHODS

A healthy 13-year-old boy who resides in rural Vermont presented after witnessed, generalized seizure-like activity for approximately 2 minutes. He had been well until the development of right inguinal pain and rash 2 weeks before presentation, which had progressed to a 5-cm irregular, red, tender, and raised area that was unresponsive to 5 days of cephalexin. At the time of presentation, he was afebrile

CONTEXT Our understanding of the benefits of breastfeeding and the consumption of human milk for specific infant outcomes and the magnitude of those benefits continues to evolve. OBJECTIVE Review the evidence on the association between breastfeeding and child health outcomes. DATA SOURCES Systematic literature searches in MEDLINE, Embase and CINAHL for English-language articles published from 2006

With growing reports of severe presentations in children, increasing our genetic understanding of pulmonary alveolar microlithiasis (PAM) is crucial. We describe a 6-month-old infant presenting with bronchiolitis, with deterioration due to disseminated Pseudomonas infection, with novel homozygosity of a variant in SLC34A2, and with pulmonary calcospherites on postmortem analysis, in keeping with PAM

BACKGROUND AND OBJECTIVES New regulations require hospitals to screen patients for health-related social needs (HRSNs). Neighborhood indices, like the Child Opportunity Index (COI), may help identify families at risk of experiencing HRSNs and inform targeting of health system-based resources and support. However, it is unknown how well the neighborhood-level COI predicts household-level HRSNs. METHODS

CONTEXT The proportion of US adolescents experiencing mental health or substance use disorders continues to rise. Pediatricians are expected to deliver evidence-based screening and counseling, but multiple barriers impede implementation. OBJECTIVE This systematic review assessed the effectiveness of implementation strategies-activities to enhance implementation, service, and health outcomes-to support

There are many barriers to the identification and treatment of behavioral, mental health, and substance abuse problems in primary care, including but not limited to lack of time, confidence, and resources.1,2 The American Academy of Pediatrics has developed outstanding guidelines and tools to address these challenges.3,4 In this issue of Pediatrics, Patel and colleagues report on a robust systematic

OBJECTIVE The objective of this initiative was to increase the proportion of infants born in participating hospitals receiving the benefits of delayed cord clamping (DCC) for at least 60 seconds to a minimum of 90% for each facility. METHODS In January 2022, a quality improvement (QI) initiative was launched across 5 pilot hospitals, later expanding to 22 additional hospitals in May 2022. The goal

Advocacy is a key skill for pediatric emergency medicine (PEM) physicians; however, advocacy education is not a PEM fellowship program requirement, and literature describing the design, implementation, or evaluation of PEM advocacy curricula have not been published. We aimed to develop, implement, and evaluate a curriculum to teach core advocacy concepts to PEM fellows that builds on advocacy training

CONTEXT Umbilical cord blood (UCB) is a novel treatment for cerebral palsy (CP), with trials indicating UCB can improve gross motor function. However, heterogeneity has limited the ability to interpret findings. OBJECTIVE Assess the safety and efficacy of UCB for improving gross motor function in children with CP, including exploring cell dose effect and responder subgroups. DATA SOURCES Individual