Journal of Pediatric Health Care最新文献

Introduction: Children diagnosed with Autism Spectrum Disorder (ASD) more commonly experience feeding difficulty than their neurotypical (NT) peers, although less is known about how the feeding behaviors present during infancy.

Methods: Twenty-four mothers participated in interviews exploring their experiences feeding their autistic and NT children during the first year of life and the context behind feeding practices that may also contribute to feeding difficulty in autistic children during infancy.

Results: Thematic analysis identified four main themes: (1) bottle feeding and cup behaviors, (2) challenges in complementary food introduction, (3) continuing difficulty with complementary feeding, and (4) bottle feeding and complementary feeding in the NT sibling.

Conclusions: Infant feeding behaviors during bottle feeding and complementary feeding may be indicative of early signs of ASD, including repetitive and restrictive interests, social communication differences, and sensory sensitivities.

Introduction: Concerning the growing prevalence of hypertriglyceridemia in pediatrics, further investigation into their use in children is warranted. This study aimed to evaluate the efficacy and safety of fenofibrate compared to omega-3 in pediatric hypertriglyceridemia.

Methods: This open-label, parallel-group randomized controlled trial was performed in 17 Shahrivar Hospital in Rasht, Iran, from January to June 2023. This included individuals aged 8 to 18 with TG levels >400 mg/dL or >250 mg/dL unresponsive to diet and exercise. Patients (N = 30) were randomly assigned to receive either fenofibrate (100 mg daily) or omega-3 (1,000 mg twice daily) for 12 weeks.

Results: Fenofibrate treatment significantly lowered triglyceride (TG), Low-density lipoprotein-cholesterol (LDL-C), and total cholesterol levels compared to omega-3 (p = .014, p < .001, and p < .001, respectively). The omega-3 group exhibited an upward trend in high-density lipoprotein-cholesterol (HDL-C) levels (p = .004), and intergroup differences were statistically significant (p = .038).

Discussion: Fenofibrate appeared to be a safe and effective candidate for TG lowering in pediatrics with hypertriglyceridemia, though further clinical research is recommended.

This case study describes a school-age child who developed orbital cellulitis following an upper respiratory infection. Orbital cellulitis is an infection of the orbital space, typically caused by an extension of an infection in the sinuses. While complications of upper respiratory infections are rare, they can be serious, and advanced practice nurses need to be alert for signs and symptoms that may indicate a complication.

Pediatric-focused advanced practice registered nurses (APRNs) frequently move from expert bedside positions to graduate education and, ultimately, faculty roles. These transitions require navigating significant identity shifts, developing new competencies, and adapting to unique institutional expectations. This article examines the critical transition points from clinician-to-graduate student to practitioner-to-educator, highlighting key barriers, important facilitators, and core competency domains. Practical tools, including a competency table and a transition checklist, support both individuals and institutions in creating clearer pathways into academic roles and fortifying the pediatric nursing education pipeline.

Hypoparathyroidism is a rare disorder that presents with a low total serum or ionized calcium, characterized by insufficient release of parathyroid hormone (PTH) from the parathyroid glands to maintain serum calcium. Patients with hypoparathyroidism may present with acute symptoms of muscle cramps, paresthesia, numbness, tetany, muscle pain in the calves, and carpopedal spasms. This case study reports an 11-year-old girl with 3 weeks of bilateral, painful leg, occasional leg paresthesia, and fatigue. Initial investigations in the emergency department revealed an elevated creatinine kinase of 995 U/L and low total calcium of <1.25 mmol/L. On further workup, she was found to have a low ionized calcium of 0.56 mmol/L, hyperphosphatemia of 2.03 mmol/L, and inappropriately low PTH of <0.5 pmol/L. Interestingly, Chvostek's sign was negative, and her neuromuscular physical exam was normal. Her ECG, however, displayed normal sinus rhythm with a prolonged QT interval. She was treated with intravenous calcium gluconate as she had an acute gastroenteritis concurrently, then transitioned to oral active vitamin D (alfacalcidol) and oral calcium and discharged home. Genetic testing for inherited causes of hypoparathyroidism were found to be negative and the diagnosis of idiopathic hypoparathyroidism was made. In children with acute myalgias or unexplained creatinine kinase elevation, calcium and PTH should be measured. Early recognition and correction of hypocalcemia can prevent long term complications such as irreversible basal ganglia calcifications, papilledema, lenticular cataracts, and cardiac complication.

Introduction: The evolving healthcare landscape has increased demand for Pediatric Inpatient Advanced Practice Providers (APPs). APPs working collaboratively with physicians offer a sustainable alternative care delivery model in inpatient settings. This program evaluation assessed the impact of transitioning from a physician moonlighter model to an APP-only nocturnist model at a satellite pediatric hospital, focusing on coverage gaps, patient safety, quality of care, and return on investment (ROI).

Methods: The new model provides consistent, year-round nocturnist coverage with a single APP per shift, improving handoffs and continuity. Pre- and post-implementation data were compared using run charts and linear correlation. Measures included QSRS reports, coverage gaps, transfer rates, throughput times, and ROI.

Results: Coverage gaps and related safety reports were eliminated. Financial analysis showed a 12% increase in charge capture and $178K in salary savings, totaling $300K in ROI. Transfer and throughput rates remained stable but correlated with patient volume.

Discussion: APPs offer safe, cost-effective care and a sustainable staffing model in pediatric inpatient settings.

Atypical antipsychotic medications have served as mainstays in the treatment of pediatric-onset bipolar disorder and schizophrenia and are typically prescribed by psychiatric providers. These medications also have an important role in treating specific behaviors associated with other pediatric diagnoses, including autism spectrum disorder, disruptive behavior disorders, and tic disorders. Nurse practitioners play an important role in initiating treatment in children who require these drugs and monitoring those who are already prescribed these medications by psychiatric professionals. The pharmacokinetics, pharmacodynamics, and pharmacogenomic implications for aripiprazole, olanzapine, quetiapine, and risperidone are described. This article reviews appropriate approaches to prescribing, monitoring for efficacy and side effects, and considerations when tapering or discontinuing antipsychotic medications.

Introduction: This study was conducted to explore the views of pediatric nurses on robot nurses and artificial intelligence.

Method: A qualitative research design was used in this study, and semistructured interviews were conducted with 22 nurses working in the pediatric unit between May and June 2025. The interview data were transcribed and systematically analyzed via MAXQDA software.

Results: Nurses stated that robot nurses and artificial intelligence have various advantages, such as reducing workload and malpractice and systematizing care, as well as several disadvantages, including the inability to provide individualized care, emotional inadequacy, concerns regarding parents' safety and communication, and ethical risks.

Discussion: The integration of robot nurses and artificial intelligence can increase pediatric nursing quality, reduce nurses' workload, and make care more enjoyable. However, their lack of real human touch and emotional connection raises concerns about parents' sense of safety and communication.

Introduction: Disinformation regarding childhood and adult vaccines represents a public health crisis throughout the United States. Disinformation is defined as the deliberate spreading of false information that is intentionally created and shared to mislead or manipulate people.

Professional issue: The Health and Human Services Secretary has publicly expressed doubts about vaccine safety and is well known as an antivaxxer. Pediatric Nurse Practitioners must create a strategic, proactive, cohesive, and powerful response to our Legislators to correct this problem.

Problem statement: The authors identified three problems: disinformation about vaccine safety and efficacy, problems associated with Legislators confirming individuals for leadership positions in Health and Human Services who openly oppose scientific evidence for vaccine recommendations, and concerns for the new ACIP members who refuse to evaluate vaccine safety evidence based on scientific research studies.

Recommendations: PNPs must have a strong voice addressing public health policies and speak with Legislators to protect the children and adults of our nation from contracting vaccine preventable diseases.