Pediatric Annals最新文献

As we better understand how to deliver the most effective medical simulation, the applications and indications are growing. One way to extend the impact of these tools and methods is for community education and empowerment. Developing mobile simulation units with the intent to reach health care and community settings is a way to add value to a costly but worthy endeavor. Here we focus on developing bundles of medical simulation for pediatric populations and their families, including curricular objectives, considerations for psychological safety, and operations. [Pediatr Ann. 2024;53(11):e420-e424.].

Bacterial meningitis is a devastating disease with significant morbidity and mortality, especially in neonates and young infants. The overall incidence of meningitis has decreased with focused screening, public health interventions, and vaccination, but the disease remains a significant concern in high-risk groups. In this review, we provide an update on bacterial meningitis in children younger than age 60 days, including epidemiology, clinical presentation, diagnostic approaches, treatment, and prognosis. [Pediatr Ann. 2024;53(11):e425-e432.].

Health care educators may enhance learning with thoughtful incorporation of game elements. Gamification has shown success across various fields in medical education. It has demonstrated deeper engagement by leveraging both intrinsic and extrinsic motivational factors. While beneficial, gamification requires thoughtful implementation to increase active learning and avoid potential negative effects, such as unhealthy competition. Serious games integrate learning objectives directly within their framework, making the educational experience an intrinsic part of gameplay. These games are specifically designed to enhance knowledge and skills while promoting decision making, teamwork, and communication. The immersive nature of serious games requires players to actively engage and apply their knowledge to solve complex problems. Serious games and simulation represent transformative educational approaches that not only enhance learning and retention but also develop essential competencies crucial for health care professionals. These strategies, when combined with effective debriefing, provide a robust framework to enrich education and training in health care. [Pediatr Ann. 2024;53(11):e401-e407.].

Simulation-based education (SBE) has revolutionized health care training by enhancing skills and addressing systemic issues. This article explores how SBE can bridge the gap between recognizing health care disparities and implementing actionable steps to address them. The immersive nature of SBE, combined with structured debriefing, sets the foundation for a "brave space" that fosters critical discussions on crucial topics, such as health equity. SBE enables health care professionals to develop cultural humility, confront biases, and practice upstander skills. This approach not only addresses hidden curricula but also integrates equity into clinical practice through practical scenarios and community engagement. Despite the potential benefits, challenges such as unintentional harm and the need for thoughtful implementation persist. To maximize effectiveness, SBE initiatives must be aligned with organizational goals and include interdisciplinary team commitment. Ongoing research and robust evaluation are essential to measure SBE's impact on health equity and patient outcomes. [Pediatr Ann. 2024;53(11):e414-e419.].

Health care education is a cornerstone of clinical excellence, ensuring the highest level of readiness to achieve high-quality and safe care. Integrating simulation into health care systems can provide a modality to address educational, quality, and safety goals. Simulation is a methodology used to immerse individuals, teams, and medical systems into clinical scenarios or environments. Through facilitation and debriefing, the immersive experience can be used to provide vital education, develop optimal health care practices, and identify prospects for improvement. Simulation provides an opportunity to blend the needs of continuing multiprofessional education while addressing quality and safety goals, and ultimately, promoting a positive safety culture. Applied comprehensively, simulation for systems integration can both promote the transformation of the health care system into a learning organization, as well as translate to improved health care outcomes. [Pediatr Ann. 2024;53(11):e408-e413.].

This article focuses on the advancements made in diagnostic techniques and drug interventions of acute hematogenous osteomyelitis. A diagnosis necessitates a combination of factors, including inflammatory markers and imaging findings, as well as the collection of specimens for culture when feasible. Subsequently, treatment should be based on epidemiology, mechanisms of resistance, and susceptibility findings. A brief course of intravenous (IV) antibiotics, followed by oral antibiotics, may be employed for uncomplicated infections if there is improvement in the clinical condition and a decline in C-reactive protein levels. However, for complex infections caused by methicillin-resistant Staphylococcus aureus, prolonged administration of IV antibiotics is recommended, along with surgical intervention if necessary. [Pediatr Ann. 2024;53(10):e392-e395.].

The 2023 American Academy of Pediatrics' "Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity (Obesity CPG)" is a comprehensive document that addresses the evaluation and treatment of pediatric obesity. Much attention has been focused on the use of medications and surgery to treat severe obesity, but the document also thoroughly reviews the evaluation of obesity and its comorbidities through key action statements and consensus recommendations. The majority of these evaluation guidelines are well within the scope of the general pediatrician and an understanding of and implementation of them can lead to improved obesity care in the primary care setting. The goal of this article is to guide the reader in the evaluation of obesity and its comorbidities in the primary care setting through a chronic disease model lens as a basis for all future care. [Pediatr Ann. 2024;53(10):e378-e385.].

Factors affecting caregiver health and wellbeing, such as trauma and stress, can have significant negative impact on parenting behaviors and on subsequent child physical and mental health. Trauma-informed positive parenting (TIPP) is an effective tool that acknowledges and addresses a family's unique journey and needs, while promoting both nurturing caregiver-child interactions and appropriate limit setting. Primary care practices are in unique positions to provide such interventions, due to their long-standing and trusted involvement with families. Therefore, we propose that TIPP can feasibly be incorporated into the pediatric primary care setting to support overall family health and well-being. [Pediatr Ann. 2024;53(10):e360-e365.].