Journal of Pediatric Health Care最新文献

This methods-focused article advocates for a paradigm shift in pediatric research by engaging youth, emerging adults, and families as full partners across all stages of the research process-from design and data collection to authorship and dissemination. Rooted in the "Nothing About Us, Without Us" ethos and aligned with the Patient-Centered Outcomes Research Institute framework, this model promotes authentic, sustained engagement with those most affected. Developmentally attuned, co-produced inquiry reframes youth and families not as passive participants, but as knowledge contributors whose lived experience drives relevance, ethics, and impact. This approach embeds equity, co-learning, and shared decision-making throughout pediatric research. Practical guidance is offered for ethically engaging communities, co-designing studies, navigating human subjects' protection and authorship considerations, and using participatory methods. By centering lived experience from the outset, this framework produces findings that are more actionable and inclusive, advancing Patient-Centered Outcomes Research Institute's national mission to generate meaningful, patient-centered clinical effectiveness research.

Global health challenges transcend national boundaries, requiring nurse practitioners (NPs) to extend practice beyond traditional local contexts. This paper examines contemporary issues in global health in the context of historical foundations and the lasting effects of colonialism. Contemporary issues include pandemics, climate change, antimicrobial resistance, workforce migration, and armed conflict, all of which can influence local NP practice. For each of those areas, we identify actions that NPs can take on the level of practice and policy to address those issues. More broadly, we recommend three priority areas for NP engagement: (1) integrating global health competencies and ethical international experiences into education; (2) providing culturally appropriate, trauma-informed care for diverse populations; and (3) advocating for equitable immigration policies and international health funding. By adopting a global health perspective, and making use of decolonizing approaches to international partnerships, NPs can enhance care for immigrant and refugee populations, address climate change, collaborate with international colleagues, and promote health equity and social justice.

Introduction: The COVID-19 pandemic has led to a rise in mental health issues among adolescents. School-based health centers (SBHCs) aim to improve access to health care, including mental health services.

Methods: This study examines the degree to which schools provide mental health programming and the role of SBHCs in particular, guided by the Whole School, Whole Community, Whole Child model. Data from the 2022 School Health Profiles Principal Questionnaire were analyzed for this study.

Results: Schools with SBHCs offered more mental health services than those without. Specifically, schools with an SBHC provided significantly more universal mental health promotion, trauma-informed practices, prosocial skills training, confidential mental health screenings, and small groups for specific issues. The largest difference was observed in the availability of cognitive behavioral therapy groups.

Discussion: Ongoing discussions are necessary to understand how to best meet student needs and the role of providers in school settings.

Introduction: This study examined cardiovascular disease (CVD)-related emergency department (ED) visits among children aged 0-17 years using data from the 2017-2021 National Emergency Department Sample (NEDS).

Methods: CVD-related primary diagnoses were classified at ED admissions into 14 clinically meaningful primary diagnosis categories. Unweighted counts, weighted counts, percentages, and rankings were stratified by diagnosis categories, sex, and age group.

Results: Among 126,376 pediatric ED visits for CVD-related primary diagnoses, the most common diagnoses were cardiac arrhythmias (48,279 ED visits; 38.2%, 95% confidence interval [CI] [36.6%, 39.8%]), essential hypertension (17,767; 14.1%, 95% CI [13.3%, 14.8%]), and congenital heart disease (14,488; 11.5%, 95% CI [10.0%, 12.9%]). Males had more CVD-related ED visits than females. Children under 5 years primarily presented with congenital heart disease and cardiac arrhythmia, while children aged 5 years and older presented with cardiac arrhythmias and essential hypertension.

Discussion: These findings highlight the need for targeted CVD management strategies in pediatric emergency care.

The pediatric nurse practitioner (NP) profession currently faces obstacles imposed by financial, systematic, political and population issues. Many of the obstacles may be overcome as pediatric NPs apply competencies obtained in their Doctor of Nursing Practice (DNP) preparation. Key competencies of the DNP education enhance pediatric NPs for critical roles in leadership, health policy engagement, quality improvement initiatives, development of nurse-led models of care and scholarship. This article provides a resounding call to all pediatric NPs to obtain the value-added knowledge and skills of the DNP to strengthen the profession and create a positive impact on the health and well-being of children.

Introduction: Sleep problem treatments are commonly used by families raising children with developmental disabilities (DD). However, intervention targets often build exclusively on parent reports which can include inherent biases or missing information. To inform sleep intervention targets in this population, the present study explored using videosomnography-a video-based sleep assessment method.

Methods: This qualitative descriptive study observed nine school-aged children (M age = 10 years, majority African American boys) with DD for 7-consecutive nights. Videos captured sleep-wake behaviors, caregiver-child interactions, and environmental factors. Thematic analysis identified themes/intervention targets.

Results: Three themes emerged: (1) "children are active and awake when they should be asleep"; (2) "mothers engaged in various caregiving and nighttime activities," including co-sleeping; and (3) "poor sleep hygiene and environment," which did not meet clinical recommendations.

Discussion: Videosomnography provided unique insights into sleep behaviors, nighttime parenting, and sleep environments, highlighting intervention targets to improve sleep in children with DD.

Introduction: Kawasaki disease (KD) is associated with long-term cardiovascular risks, raising concerns about future obesity. However, robust longitudinal data on body mass index (BMI) are lacking. This study investigated long-term BMI trajectories from childhood to early adolescence in children with a history of KD.

Method: We conducted a secondary analysis of 19,642 children from a nationwide Japanese birth cohort, followed for 13 years. The exposure was parent-reported hospitalization for KD between 6 and 18 months of age. The outcome was membership in distinct BMI z-score trajectory groups identified using group-based multivariate trajectory modeling.

Results: Three distinct BMI z-score trajectories were identified ("Stable," "High-Decreasing," and "Low-Increasing"). After multivariable adjustment, a history of KD was not associated with membership in any trajectory group for either males or females.

Conclusions: A history of KD in infancy was not associated with alterations in long-term BMI trajectories through early adolescence.