Journal of Pediatric Health Care最新文献

Introduction: This study investigates the impact of different feeding methods (direct breastfeeding, expressed milk feeding, formula feeding) on the infant microbiota at 6 weeks of age.

Methods: A total of 217 healthy infants stool samples were collected from Hong Kong between August 2018 and December 2019.

Results: Various microbial taxa, including the genera Enterobacter and Raoultella were identified in the expressed breast milk feeding group. The richness and composition of the major bacterial phyla showed similar abundance between direct breastfeeding and expressed breast milk.

Discussion: These findings suggests that these bacteria may have colonized the milk during expression or could be introduced from other external sources. The mode of breastfeeding did not significantly alter microbiota parameters in the infant gut at 6 weeks.

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare but potentially life-threatening cause of upper airway obstruction in infants. It was first described in 1988 and 1989 in the radiology and otolaryngology literature. Congenital airway obstruction affects up to 1 in 5,000 infants, and many of these obstructions result from choanal atresia. CNPAS is estimated to occur 1 in 25,000 live births. This case report describes a neonate with acute respiratory distress and obstructive breathing pattern relieved by opening her oral airway and maintained with the McGovern nipple decreasing ventilator days during hospitalization with viral bronchiolitis.

Neuroglial cysts are rare congenital cysts that seldom require surgical treatment. This case highlights a rare instance when a neurolglial cyst caused acute hydrocephalus in a 10-year old boy. Originally diagnosed and managed as pediatric-onset migraines, the patient presented to the emergency department with nausea, vomiting, and ataxia without clear pathology on neuroradiology. The neurosurgical team took him to the operating room based on his clinical picture and history and the cyst was discovered there. The pathology was benign, and he has had a complete resolution of symptoms.

In pediatric primary care, incorporation of existing practice tools into screening for adverse childhood experiences (ACEs) may reduce screening barriers, promoting timely intervention on negative health impacts from childhood trauma. One such screening tool is the Bright Futures Previsit Questionnaire (PVQ). To evaluate the extent to which the PVQ may be used to screen for ACEs, this research aimed to map items related to ACEs from adolescent PVQs against adverse events historically identified as conventional and expanded ACEs. The adolescent PVQs mapped effectively to nine ACEs: adverse neighborhood experiences, bullying, emotional neglect, friend or family substance misuse, household safety, intimate partner violence, interpersonal violence, physical neglect, and sexual abuse. Universal ACE screening can be conducted using adolescent PVQs; however, issues remain regarding the reliability and validity of using the PVQs to identify ACEs, and some ACEs are not effectively assessed using adolescent PVQs.

Introduction: The purpose of this quantitative study was to consider factors that may negatively impact glycemic levels in Black and White children 8-12 years old with a diagnosis of type 1 diabetes mellitus.

Method: Perceived stress, diabetes distress, morning and afternoon salivary cortisol, inflammatory biomarkers, and hemoglobin A1c (HbA1c) were measured in this quantitative, cross-sectional phase of a larger, mixed methods study. Thirty-four children and their parents completed self-report surveys, and children provided blood and salivary samples, to examine effect sizes of relationships among variables of interest.

Results: Most children did not meet ADA recommendations for HbA1c. HbA1c was higher in Black children. Medium-to-large effects were noted between perceived stress and HbA1c. Cortisol and IL-8 may mediate the relationship between perceived stress and HbA1c in children.

Discussion: Understanding causes of elevated glycemic levels in children, especially from low-income and underrepresented populations, may help tailor diabetes management interventions to improve health outcomes.

Background: Immigrants, asylum seekers, and refugees live with extreme stress, consistent vulnerability, and life-long health consequences. Children in these populations face an increased risk of poor mental health because of adverse childhood experiences (ACEs).

Aim: To implement an ACE screening questionnaire for all migrant children aged < 19 years in a community shelter.

Method: The Model for Improvement.

Intervention: The Pediatric ACEs and Related Life Events Screener was implemented over 10 weeks in a community shelter.

Results: All children screened had at least 1 ACE. Initiation of screening led to the recognition of adverse experiences, thus allowing for mental health support and referrals to mental health specialists.

Conclusions: This quality improvement project supports screening for ACEs in migrant children to uncover potential mental health concerns and provide targeted support, recognizing the long-term effects of trauma on their well-being.

Childcare and early educational programs provide children with the opportunities to learn and develop social skills prior to being introduced into the academic system. Suspension and expulsion from childcare and early education programs occur in high numbers and can cause life-long detrimental effects for children. Federal and state legislation has made advances over the years, but further development and implementation of universal policies are needed in order to reduce the number of young children being suspended and expelled. Pediatric nurse practitioners have a unique role in screening, identifying, and intervening when children are at risk or have experienced exclusionary discipline tracts.

Background: Sexually transmitted infections (STIs) affect 20 million adolescents and young adults in the United States annually.

Local problem: In a pediatric outpatient sickle cell disease clinic in the southeastern United States, 16% (43/272) of patients aged 16-24 years had a documented sexual health history, and 12% (4/77) completed STI screenings. The clinic aimed to increase sexual health assessment, STI screenings, diagnosis, and treatment.

Methods: Using process redesign, a standardized sexual health and STI screening process at routine visits was implemented to increase the completion of sexual health histories and STI screening.

Results: Sexual health history collection rates increased from 16% (43/272) pre-intervention to 92% (107/116) pos-tintervention. The rate of STI testing offered increased from 12% (5/43) preintervention to 100% (116/116) postintervention. The STI testing rates increased 22.5% from 40% (2/5) pre-intervention to 49% (20/41) post-intervention.

Conclusions: Evidence-based standardized interventions can successfully be used to assist in sexual health documentation and STI screening.

Introduction: This study explored the understanding and experiences related to health among Dominican American adolescents in an urban setting in the northeastern United States.

Method: A qualitative descriptive study was conducted, applying thematic analysis to focus group interview data from 23 students.

Results: Five themes emerged: (1) Health is All About Healthy Eating, (2) Sugarcoating, (3) Dynamics Affecting Adherence, (4) Dominican Cultural Influences on Health, and (5) Toll of the Immigrant Life.

Discussion: Cultural expectations, particularly deference to family members, substantially impact health care providers' interactions with Dominican American adolescents. Limited communication hinders discussion on topics like healthy eating and mental health. Parental reliance on home remedies over seeking professional care adds another layer of complexity. This study establishes a foundational understanding of Dominican American adolescents' health experiences, highlighting areas where pediatric nurse practitioners can target interventions to support Dominican American adolescents' health journeys.