Journal of Pediatric Health Care最新文献

Trauma-informed care (TIC) is an essential holistic framework for pediatric-focused advanced practice registered nurses (APRNs) to understand, recognize, and respond to children and families who have experienced trauma while resisting re-traumatization. TIC allows APRNs to engage with children with an understanding of how trauma impacts well-being. Universal adoption of TIC is prudent; it assumes all patients experience some degree of trauma and disclosure is limited. The National Association of Pediatric Nurse Practitioners Partners for Vulnerable Youth published an evidence-based TIC toolkit online for pediatric-focused ARPNs as a clinical guide for TIC application. This article reviews toolkit elements and demonstrates practical application of TIC.

Introduction: Online child sexual abuse (CSA) involves sharing abusive images, sexual communications, and forming pedophilic networks, leading to both short- and long-term psychiatric issues for victims. The present study aimed to identify risk factors for penetrative online CSA.

Method: Analysis of medical records from 1,501 cases at a child advocacy center in Turkey identified 221 cases of online CSA, categorized into penetrative and nonpenetrative groups.

Results: Among 1,501 cases, 19.2% involved online CSA. Victims' mean age was 14.50 ± 1.65 years; perpetrators averaged 23.00 ± 9.60 years. Most victims were girls (92.3%) and had dropped out of school (79.2%). Instagram was the most common platform (71.5%). Higher rates of sexting, risky behaviors, and threats of exposure were seen in the penetrative group. Predictors included the victim's age, sexting, running away, and threats of exposure.

Discussion: Key differences between penetrative and nonpenetrative online CSA underscore the need for targeted prevention and intervention.

Acute myelogenous leukemia (AML) represents nearly 40% of all cancers affecting the adolescent and young adult (AYA) population. Although overall survival has improved, cure rates for AYAs lag behind younger leukemia patients. The primary care provider (PCP), including the college health provider, is a crucial member of the medical team for children and AYA cancer survivors. In the college setting, the PCP plays a key role in close monitoring for relapse and late effects. This case highlights the presentation of a college student to their university's health center for complaints later found to be due to relapsed leukemia. The PCP must distinguish the unique needs of AYA cancer survivors to provide early recognition and referral to treatment for concerns.

Pediatric firearm violence is the number one cause of death in all children and a threat that must be addressed. Applying a harm reduction framework to this growing crisis recognizes that firearms exist and incorporates evidence-based practice actionable strategies for pediatric-focused Advanced Practice Registered Nurses (APRNs) to follow to address this public health crisis. This harm reduction framework encompasses several strategies, including an understanding of the physical and mental health care impact that pediatric firearm violence has on survivors, as well as recognizing the inherent health inequities associated with it. This framework also includes strategies to implement firearm safety education at the community level, discusses key laws and policies that pediatric-focused APRNs can advocate for to effect change, and raises awareness of accessible resources and funding for pediatric-focused APRNs to utilize.

Our hypothetical case study depicts the experience of a newly arrived refugee child, a 10-year-old refugee from war-torn Kyiv, Ukraine. She presented with symptoms of anxiety-related physical complaints following displacement and relocation to the United States. This case study illustrates the care provided by a pediatric nurse practitioner. A multidisciplinary approach was used to address her psychosomatic symptoms, mental health, malnutrition, immunization status, and social integration challenges.

Pediatric cases of metabolic dysfunction-associated fatty liver disease (MASLD, formerly termed non-alcoholic fatty liver disease (NAFLD) are a troubling new outcome of the pediatric obesity epidemic. Advising patients and families with this condition is challenging considering the nutrition needed to sustain developmentally appropriate growth in youth. Describing risk factors, comorbidities, management, and referrals for MASLD could improve surveillance and outcomes for this condition. MASLD is commonly seen with other comorbidities such as dyslipidemia, obstructive sleep apnea, type 2 diabetes, hypothyroidism, anxiety, and depression. Considerations of epigenetics, diabetes, and adverse childhood experiences will be explored as additional underlying contributors to MASLD. Screening patients for this condition in conjunction with other comorbidities is essential to preventing the progression to non-alcoholic steatohepatitis (NASH) and cirrhosis, as well as lowering the risk for hepatocellular carcinoma. This fraternal twin case report describes pertinent diagnostics, recommendations for referrals, follow-up consultations, and red flags for more advanced liver disease.