Pediatrics最新文献

Gabriel is an adolescent with a disability who uses an Augmentative and Alternative Communication (AAC) device to communicate. Previously reliant on blinking for "yes" and pouting by sticking his lips out for "no," he now engages with his therapists using eye-tracking technology for his communication. This article highlights how the interdisciplinary team has been working collaboratively with Gabriel and his family to integrate AAC into his daily life, illustrating both the challenges and benefits of this approach.

The International Liaison Committee on Resuscitation continually reviews new, peer-reviewed cardiopulmonary resuscitation science and publishes comprehensive reviews every 5 years. The Neonatal Life Support chapter of the 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations addresses all published resuscitation evidence reviewed by the Neonatal Life Support Task Force science experts since 2020. This summary addresses 40 questions on population, intervention, comparator, and outcomes, addressing all parts of the Neonatal Resuscitation Algorithm. The summary includes 4 new systematic reviews, 2 new scoping reviews, and evidence updates for other topics. Members of the Neonatal Life Support Task Force have assessed, discussed, and debated the quality of the evidence on the basis of Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task force are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task force lists priority knowledge gaps for further research. Key Words: AHA Scientific Statements • cardiopulmonary resuscitation • ILCOR • infant • neonatal resuscitation.

This case study uses a hospital family safety reporting intervention, coproduced with key partners, with the aim to garner lessons for developing complex, hospital-based interventions. Health equity, communication science, health literacy, and organizational behavior principles were utilized to develop a family safety reporting intervention consisting of a family safety reporting tool, staff and family education, and a process for reviewing and sharing family reports with unit and hospital leaders. We evaluated intervention training rates and hospital impact (comparing family-reported safety incidents received by the hospital through voluntary incident reports at baseline to incidents received through voluntary incident reports and after the intervention). Additionally, we analyzed field notes and minutes to describe lessons learned from applying these principles in complex, hospital-based interventions. We trained 208 families, 149 nurses, 42 resident physicians, and 7 attending physicians in the intervention. After implementing the intervention, the frequency of families from whom the hospital documented safety concerns increased from an average of 0.4 per month at baseline to 4.4 per month after the intervention. Four key lessons emerged: (1) Build deep and regular partnerships across all intervention key partners, including initial skeptics. (2) Tailor the intervention message to each audience. (3) Embrace flexibility and a growth mindset when weighing suggestions and adapting interventions. (4) Equity is an investment, not a checkbox. We conclude that health equity, communication science, health literacy, and organizational behavior can inform inclusive, effective, complex hospital-based interventions but require deep partnerships, tailored messaging, flexibility, a growth mindset, and a commitment to equity.

Background and objectives: Childhood obesity has remained persistently high in the United States. This study aimed to (1) assess changes in obesity prevalence and (2) examine the associations of ultra-processed food (UPF) intake and physical activity (PA) patterns with obesity, by obesity severity, before and during the COVID-19 pandemic among US 2- to 19-year-olds.

Methods: A serial cross-sectional analysis using the National Health and Nutrition Examination Survey compared data from before (2017 to March 2020) and during (August 2021 to August 2023) the COVID-19 pandemic. Obesity was determined using body-mass-index-for-age percentiles: class I obesity (≥95th percentile to <120% of the 95th percentile), class II (≥120% to <140%), and class III (≥140% of the 95th percentile). UPF intake was assessed via 24-hour dietary recalls. Participants self-reported the number of days/week they engaged in moderate to vigorous PA. Survey logistic regression models assessed the odds of increasing obesity severity by UPF intake and PA, age, sex, race, ethnicity, and household income.

Results: Analysis included 4756 participants in the pre-pandemic period and 2501 in the pandemic period. Obesity prevalence was 21.2% pre-pandemic (N = 1072) and 22.6% during the pandemic (N = 694; P = .30). Mean %UPF intake decreased from 66.0% to 62.7% (P < .01). Before the pandemic, adjusted analysis showed youth with higher PA days had lower odds of class II obesity (odds ratio [OR] = 0.86, 95% CI: 0.76-0.97) and overall obesity (OR = 0.91, 95% CI: 0.85-0.97), with a protective effect across class I and III that did not reach significance. During the pandemic, meeting PA guidelines was also protective against overall obesity (OR = 0.86, 95% CI: 0.76-0.99). Although no significant predictors of obesity by class emerged during the pandemic, protective nonsignificant effects of PA were also observed.

Conclusions: Obesity prevalence trended up from before to during the pandemic, and PA was associated with obesity, whereas no distinct associations of UPF and increasing obesity severity emerged.

Objective: To describe demographics and explore outcomes of newborns impacted by glucose-6-phosphate dehydrogenase (G6PD) deficiency in our health system during the first year of universal screening following the 2022 New York State mandate.

Methods: In this retrospective review, clinical data were compared across infants with normal, intermediate, and deficient G6PD enzyme levels. Categorical variables were analyzed using χ2 tests. Continuous variables were compared using Kruskal-Wallis and Mann-Whitney U tests. To ascertain whether all G6PD-deficient infants would have been captured by a risk factor-based approach, demographic data were reviewed.

Results: The study cohort comprised 5470 infants. The prevalence of G6PD deficiency and intermediate status were 1.7% and 2.4%, respectively, with 2.9% of male infants testing deficient. G6PD-deficient infants had higher bilirubin levels and were more likely to require phototherapy during birth hospitalization (P < .001) and be readmitted for phototherapy (P = .04) compared with G6PD-sufficient infants. Thirteen percent of infants with G6PD deficiency had parents who identified as "white" and "Ashkenazi Jewish." Twenty-two percent of G6PD-deficient newborns had parents who identified as "Puerto Rican" or "Dominican." Risk factor-based screening would have missed 44% of affected newborns prior to hospital discharge.

Conclusions: G6PD-deficient newborns are more likely to require phototherapy than G6PD-sufficient infants. Exchange transfusion and bilirubin-induced neurotoxicity are rare, likely due to protocolized bilirubin management. Our findings suggest that infants will be missed by risk factor-based screening such as that recommended by New York State.

The International Liaison Committee on Resuscitation conducts continuous review of new peer-reviewed published cardiopulmonary resuscitation science and publishes annual summaries. More comprehensive reviews are published every 5 years. The Pediatric Life Support Task Force chapter of the 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations addresses all published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Pediatric Life Support Task Force members in the past year, as well as brief summaries of topics reviewed since 2020, to provide a more comprehensive update. In total, 39 questions related to pre-arrest, intra-arrest, and postarrest resuscitation phases of pediatric cardiac arrest are included, including systematic reviews, scoping reviews, and evidence updates. Members of the task force assessed, discussed, and debated the quality of evidence, based on Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into deliberations of the task force are provided in the Justification and Evidence-to-Decision Framework Highlights sections. The task force has also listed priority knowledge gaps for further research. Key Words: AHA Scientific Statements • cardiac arrest • cardiopulmonary arrest • cardiopulmonary resuscitation • children • ILCOR • pediatrics • resuscitation.