Pub Date : 2025-04-01DOI: 10.1016/j.cppeds.2025.101759
Chris Bugnitz MD , Kelly C. Sandberg MD, MSc
Quality improvement is achievable in healthcare with the help of a set of tools. One such tool is the Plan-Do-Study-Act cycle, or PDSA cycle. When utilized correctly, PDSA cycles have the potential to effect meaningful change. When used incorrectly, they can defer learning and be counterproductive to quality healthcare. Appropriate use of PDSA cycles will be demonstrated using a ubiquitous challenge in ambulatory care, clinic workflow.
{"title":"Creating effective PDSA cycles","authors":"Chris Bugnitz MD , Kelly C. Sandberg MD, MSc","doi":"10.1016/j.cppeds.2025.101759","DOIUrl":"10.1016/j.cppeds.2025.101759","url":null,"abstract":"<div><div>Quality improvement<span><span> is achievable in healthcare with the help of a set of tools. One such tool is the Plan-Do-Study-Act cycle, or PDSA cycle. When utilized correctly, PDSA cycles have the potential to effect meaningful change. When used incorrectly, they can defer learning and be counterproductive to quality healthcare. Appropriate use of PDSA cycles will be demonstrated using a ubiquitous challenge in </span>ambulatory care, clinic workflow.</span></div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101759"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.cppeds.2025.101766
Beth Williams MBA, BSIE , Lisa R Jasin DNP, PhD, NNP-BC
Quality improvement in medicine is the process of changing behavior in response to experiential learning. The most referenced quality improvement methodologies include the Institute for Healthcare’s Model for Improvement, Six Sigma, and Lean. The Model for Improvement is the model focused on healthcare and frontline staff. Evidence-based practice models all begin with asking a question, which is shared with quality improvement models. Successful evidence-based practice and quality improvement organizational cultures support a questioning attitude. A quality roadmap developed using both quality improvement and evidence-based practice methodology facilitates the learning process and transition to quality improvement in clinical practice. Use of the quality roadmap framework provides an opportunity to cultivate psychological safety and a questioning attitude. Use of standardized tools, like a quality improvement roadmap in quality improvement positively affects children and their families.
{"title":"Development of a quality improvement roadmap as a tool to guide quality improvement education and methodology","authors":"Beth Williams MBA, BSIE , Lisa R Jasin DNP, PhD, NNP-BC","doi":"10.1016/j.cppeds.2025.101766","DOIUrl":"10.1016/j.cppeds.2025.101766","url":null,"abstract":"<div><div>Quality improvement in medicine is the process of changing behavior in response to experiential learning. The most referenced quality improvement<span> methodologies include the Institute for Healthcare’s Model for Improvement, Six Sigma, and Lean. The Model for Improvement is the model focused on healthcare and frontline staff. Evidence-based practice models all begin with asking a question, which is shared with quality improvement models. Successful evidence-based practice and quality improvement organizational cultures support a questioning attitude. A quality roadmap developed using both quality improvement and evidence-based practice methodology facilitates the learning process and transition to quality improvement in clinical practice. Use of the quality roadmap framework provides an opportunity to cultivate psychological safety and a questioning attitude. Use of standardized tools, like a quality improvement roadmap in quality improvement positively affects children and their families.</span></div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 4","pages":"Article 101766"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.cppeds.2025.101751
Martin Fisher MD
{"title":"Foreword: Substance use in adolescents – Alcohol, nicotine, marijuana: Old problems, new trends","authors":"Martin Fisher MD","doi":"10.1016/j.cppeds.2025.101751","DOIUrl":"10.1016/j.cppeds.2025.101751","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 3","pages":"Article 101751"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.cppeds.2025.101754
Khalida Itriyeva MD
The past 30 years in the United States have seen a shift towards increasing decriminalization and legalization of cannabis products. Despite the evolving legal landscape, adolescent cannabis use appears to have remained relatively stable, while use among young adults has increased. Cannabis-related emergency department visits, hospitalizations, and unintentional ingestions, particularly among young children, have all increased, with the availability of higher potency products such as concentrates and edibles likely playing a role. Cannabis intoxication should be suspected in youth presenting with altered mental status, somnolence, anxiety or euphoria, tachycardia, and conjunctival injection. In adolescents presenting with cyclic vomiting, cannabinoid hyperemesis syndrome should be considered. Long-term effects of heavy and frequent cannabis use in adolescents such as cognitive impairment, increased risk of psychosis, and the development of cannabis use disorder remain of particular concern as the tetrahydrocannabinol (THC) content of cannabis products has continued to increase in recent years. Ongoing surveillance to monitor trends in adolescent cannabis use, public education on the health effects of cannabis use in adolescence, and expanding access to substance use and mental health treatment will be crucial in the coming years.
{"title":"Adolescents and cannabis in the 21st century","authors":"Khalida Itriyeva MD","doi":"10.1016/j.cppeds.2025.101754","DOIUrl":"10.1016/j.cppeds.2025.101754","url":null,"abstract":"<div><div><span><span><span>The past 30 years in the United States have seen a shift towards increasing decriminalization and legalization of cannabis products. Despite the evolving legal landscape, adolescent cannabis use appears to have remained relatively stable, while use among young adults has increased. Cannabis-related </span>emergency department<span> visits, hospitalizations, and unintentional ingestions<span>, particularly among young children, have all increased, with the availability of higher potency products such as concentrates and edibles likely playing a role. Cannabis intoxication should be suspected in youth presenting with altered mental status, </span></span></span>somnolence<span>, anxiety or euphoria, </span></span>tachycardia<span><span>, and conjunctival injection<span>. In adolescents presenting with cyclic vomiting, cannabinoid hyperemesis syndrome should be considered. Long-term effects of heavy and frequent cannabis use in adolescents such as </span></span>cognitive impairment<span>, increased risk of psychosis, and the development of cannabis use disorder remain of particular concern as the tetrahydrocannabinol<span><span> (THC) content of cannabis products has continued to increase in recent years. Ongoing surveillance to monitor trends in adolescent cannabis use, public education on the health effects of cannabis use in adolescence, and expanding access to substance use and mental </span>health treatment will be crucial in the coming years.</span></span></span></div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 3","pages":"Article 101754"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.cppeds.2025.101752
Arnikka Rubia , Ariel Tassy Nunez
Alcohol use and abuse among children and adolescents remains an ongoing and significant concern in our society—one that has persisted for decades. Despite the rise in popularity of other illicit substances, alcohol continues to be a major and consistent contributor to negative health and social outcomes. As such, it is essential that physicians and other healthcare providers caring for young people be proactive. This includes routinely screening for alcohol use, providing appropriate anticipatory guidance, and referring patients for treatment when alcohol use disorder is identified.
{"title":"Alcohol use in adolescents","authors":"Arnikka Rubia , Ariel Tassy Nunez","doi":"10.1016/j.cppeds.2025.101752","DOIUrl":"10.1016/j.cppeds.2025.101752","url":null,"abstract":"<div><div><span>Alcohol use and abuse among children and adolescents remains an ongoing and significant concern in our society—one that has persisted for decades. Despite the rise in popularity of other illicit substances, alcohol continues to be a major and consistent contributor to negative health and social outcomes. As such, it is essential that physicians and other healthcare providers caring for young people be proactive. This includes routinely screening for alcohol use, providing appropriate anticipatory guidance, and referring patients for treatment when </span>alcohol use disorder is identified.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 3","pages":"Article 101752"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/S1538-5442(25)00046-X
{"title":"Editorial Board Page","authors":"","doi":"10.1016/S1538-5442(25)00046-X","DOIUrl":"10.1016/S1538-5442(25)00046-X","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 3","pages":"Article 101772"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.cppeds.2025.101753
Sara Haque MD , Nadia Saldanha MD
While traditional cigarette use has been on the decline among adolescents, other products, including e-cigarettes and oral nicotine have seen an uptick in use among this age group. These products have been marketed to younger age groups, with social media playing a role. E-cigarettes and oral nicotine have negative physical and health effects, despite e-cigarettes in particular being marketed as a safer alternative to traditional cigarettes. Awareness of these products, their health effects, and how to help with cessation is necessary for all providers taking care of adolescents.
{"title":"An update on nicotine use in adolescents","authors":"Sara Haque MD , Nadia Saldanha MD","doi":"10.1016/j.cppeds.2025.101753","DOIUrl":"10.1016/j.cppeds.2025.101753","url":null,"abstract":"<div><div>While traditional cigarette use has been on the decline among adolescents, other products, including e-cigarettes and oral nicotine have seen an uptick in use among this age group. These products have been marketed to younger age groups, with social media playing a role. E-cigarettes and oral nicotine have negative physical and health effects, despite e-cigarettes in particular being marketed as a safer alternative to traditional cigarettes. Awareness of these products, their health effects, and how to help with cessation is necessary for all providers taking care of adolescents.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 3","pages":"Article 101753"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/S1538-5442(25)00020-3
{"title":"Editorial Board Page","authors":"","doi":"10.1016/S1538-5442(25)00020-3","DOIUrl":"10.1016/S1538-5442(25)00020-3","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 2","pages":"Article 101746"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cppeds.2025.101733
Arthur H. Fierman M.D. (Editor-in-Chief)
{"title":"Foreword: Integrated behavioral and mental health in pediatric primary care: Challenges and solutions–Part II","authors":"Arthur H. Fierman M.D. (Editor-in-Chief)","doi":"10.1016/j.cppeds.2025.101733","DOIUrl":"10.1016/j.cppeds.2025.101733","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 2","pages":"Article 101733"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.cppeds.2025.101734
Roberta Guimaraes De Oliveira, Ian Christopher Carroll
Collaborative Care is well accepted as an evidence-based model to manage depression and anxiety in pediatric primary care. However, symptoms of attention-deficit hyperactivity disorder (ADHD), traumatic stress, and grief are common in primary care and can also be identified by pediatricians and treated within this model. Attention-deficit hyperactivity disorder (ADHD) is the most common childhood-onset neurodevelopmental disorder with a prevalence of 10.2 %.1 Trauma-spectrum disorders are another cluster of disorders that will often be seen first by the pediatrician, and, potentially, only by the pediatrician. In some urban pediatric centers, the rate of children who have been exposed to traumatic events is as high as 90 %.2 Similarly, symptoms of grief are often first identified by the pediatrician. Considering that the COVID-19 pandemic alone has claimed >760,000 parents, custodial grandparents, and other caregivers to children in the US, the number of children and teenagers affected by trauma and loss overwhelms the mental health care system's capacity. In light of the shortage of child and adolescent psychiatrists in the United States and the increased demand for mental health services, it is essential to broaden the scope of what collaborative care initiatives can accomplish in pediatrics. This paper shares insights from a collaborative care model implemented in a New York City safety net hospital center to illustrate how ADHD, traumatic stress, and grief can be identified and managed in pediatric primary care. Lastly, we will discuss the potential for collaborative care models to increase access to care for immigrant families.
{"title":"Beyond depression and anxiety in pediatric primary care: Current insights from the collaborative care model","authors":"Roberta Guimaraes De Oliveira, Ian Christopher Carroll","doi":"10.1016/j.cppeds.2025.101734","DOIUrl":"10.1016/j.cppeds.2025.101734","url":null,"abstract":"<div><div>Collaborative Care is well accepted as an evidence-based model to manage depression and anxiety in pediatric primary care. However, symptoms of attention-deficit hyperactivity disorder (ADHD), traumatic stress, and grief are common in primary care and can also be identified by pediatricians and treated within this model. Attention-deficit hyperactivity disorder (ADHD) is the most common childhood-onset neurodevelopmental disorder with a prevalence of 10.2 %.<sup>1</sup> Trauma-spectrum disorders are another cluster of disorders that will often be seen first by the pediatrician, and, potentially, only by the pediatrician. In some urban pediatric centers, the rate of children who have been exposed to traumatic events is as high as 90 %.<sup>2</sup> Similarly, symptoms of grief are often first identified by the pediatrician. Considering that the COVID-19 pandemic alone has claimed >760,000 parents, custodial grandparents, and other caregivers to children in the US, the number of children and teenagers affected by trauma and loss overwhelms the mental health care system's capacity. In light of the shortage of child and adolescent psychiatrists in the United States and the increased demand for mental health services, it is essential to broaden the scope of what collaborative care initiatives can accomplish in pediatrics. This paper shares insights from a collaborative care model implemented in a New York City safety net hospital center to illustrate how ADHD, traumatic stress, and grief can be identified and managed in pediatric primary care. Lastly, we will discuss the potential for collaborative care models to increase access to care for immigrant families.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 2","pages":"Article 101734"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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