bims-cliped 2026-08-16 papers

bims-cliped

Biomed News

on Clinical pediatrics

Issue of 2026–08–16
27 papers selected by
Alyssa M. Portwood, Akron’s Children

Recent trends and structural patterns in NIH pediatric research funding, 2015-2024.
Recommendations for Prevention and Control of Influenza in Children, 2026-2027: Policy Statement.
Current and Desired Behavioral Health Resources for Children: A Survey of Illinois Emergency Departments.
Seizure Action Plans Beyond the Neurology Clinic: What Emergency, School, and Primary Care Teams Need to Know for Children With Epilepsy.
A quality improvement initiative to optimize diagnostic and antimicrobial stewardship of ventilator-associated tracheitis in the pediatric intensive care unit.
Effect of appropriate restraint use on pediatric injury outcomes in motor vehicle crashes from US Trauma Quality Program data.
Opioid Use in Children.
Improving Screening for Adolescent Substance Use and Mental Health in Primary Care.
Recent threats to hospital medicine research careers, implications, and proposed solutions.
Early recognition and bundle-based management of pediatric sepsis in the emergency department: a narrative review.
Injury prevention content in social media posts by Children's hospitals: a missed opportunity for education and advocacy.
Factors Associated With Likelihood of Experiencing a Pediatric Safety Event in the Inpatient Setting.
A National survey of pediatric surgical care coverage models to outlying neonatal intensive care units.
Effectiveness of Oseltamivir in Hospitalized Children With Laboratory-Confirmed Influenza, 2014-2023.
From Mewing to Peptides: Looksmaxxing as an Emerging Pediatric Concern.
Primary Ciliary Dyskinesia: A Suggested Pathway to Transition From Pediatric to Adult Care.
Hospital Type and Clinical Outcomes for Pediatric Lower-Extremity Open Fracture: Implications for Child Health Services Organizations.
Multimodal strategies for alleviating postoperative pain in children: a narrative review on research progress and evidence-based practice.
Increasing Rate of Pott's Puffy Tumor Hospitalizations Among US Children.
Partnering with trans and gender diverse youth in healthcare research: considerations for safe and meaningful engagement.
Colorado Asthma-Friendly Schools: An On-ramp to Implementation Science.
What Resources Are Available for Parents Online? A Readability, Quality, and Source Evaluation of Website and AI-Generated Content on Inherited Pediatric Orthopaedic Conditions.
Describing the Infrastructure of Breastfeeding and Lactation Medicine Divisions and Centers Established Within U.S. Health Systems.
The role of the advanced practice provider in pediatric urology: A census of the pediatric urology nurses and specialists (PUNS).
Nursing interventions to improve peripheral intravenous catheter outcomes in pediatric patients: A systematic review and meta-analysis.
Beyond Intervention: A Scoping Review of Parent Engagement in Parent-Implemented Intervention for Autistic Children.
Injury Severity and Near-Absent Helmet Use in NTDB-Eligible Pediatric E-Scooter Trauma: A Single-Center Descriptive Series.

Pediatr Res. 2026 Aug 13.

Recent trends and structural patterns in NIH pediatric research funding, 2015-2024.

Christopher B Forrest, Lauren J Koenigsberg, David C Schwebel, Alexander G Bassuk, Phyllis A Dennery, Glenn Flores, Kristy O Murray, Udara Perera, Frederick P Rivara, Leah C Kottyan.

BACKGROUND: National Institutes of Health (NIH) pediatric research funding has persistently lagged behind children's share of the US population and disease burden. This study examined trends in NIH pediatric research expenditures, funding distribution across NIH components, and classification accuracy of the NIH Research, Condition, and Disease Categorization (RCDC)'s system for identifying pediatric research.
METHODS: We conducted a repeated cross-sectional analysis of RCDC, NIH Office of Budget, and NIH RePORTER data from fiscal years (FY) 2015-2024. Expenditures were inflation-adjusted using the Biomedical Research and Development Price Index (BRDPI). A stratified random audit of 200 RCDC Pediatric-category projects assessed classification accuracy.
RESULTS: NIH research expenditures grew 62% nominally (FY2015: $28.5 billion; FY2024: $46.1 billion), but only 26% in inflation-adjusted dollars. Pediatric research consistently comprised approximately 13% of NIH nonadministrative expenditures, despite children <18 years-old constituting 22% of the US population. Five institutes accounted for 57% of pediatric research expenditures. The audit identified a 6% misclassification rate, clustering around maternal health studies lacking pediatric outcomes.
CONCLUSION: NIH pediatric research funding remained proportionally stagnant, rising passively with the NIH budget rather than reflecting deliberate prioritization. Strengthening pediatric and life-course research may require more coordinated trans-NIH prioritization.
IMPACT: In nominal dollars, pediatric research funding at the NIH rose from $3.5 billion in FY2015 to $6.2 billion in FY2024; however, adjusted for inflation, the level of funding plateaued from FY2020 to FY2024. As a proportion of NIH nonadministrative expenditures, pediatric research accounted for approximately 13% across FY2015-FY2024. Although NICHD devoted 58-60% of its research funding to pediatric studies, it accounted for just 17% of all pediatric research funding. Every NIH component funded some amount of pediatric research, but the NIH lacks a coordinated trans-NIH strategy for pediatric research prioritization and oversight.

DOI: https://doi.org/10.1038/s41390-026-05379-5
Pediatrics. 2026 Aug 10.

Recommendations for Prevention and Control of Influenza in Children, 2026-2027: Policy Statement.

Committee on Infectious Diseases

This statement updates recommendations of the American Academy of Pediatrics (AAP) for use of influenza vaccines and antiviral medications in prevention and treatment of influenza in children during the 2026-2027 influenza season. A review of evidence supporting these recommendations is in the accompanying technical report (https://doi.org/10.1542/peds.2026-078779). The AAP recommends annual influenza vaccination of all children without medical contraindications starting at 6 months of age. Influenza vaccination is an important strategy for protecting children and the broader community as well as reducing the overall burden of respiratory illnesses when other viruses are cocirculating. Any licensed influenza vaccine appropriate for age and health status can be administered, as soon as possible in the season, without preference for one product or formulation. Antiviral treatment of influenza may reduce the duration of symptoms; reduce complications, including hospitalization and death; and potentially reduce transmission. The AAP recommends antiviral treatment for children with suspected or confirmed influenza who are hospitalized or have severe or progressive disease. In ambulatory settings, antiviral treatment should be offered to children who are at high risk of complications from influenza, including those with chronic medical conditions and immunocompromised patients. In all these situations, antiviral treatment should be started as soon as possible regardless of duration of illness or receipt of influenza vaccine. Antiviral treatment is an option in the ambulatory setting for all children with suspected or confirmed influenza. Antiviral chemoprophylaxis is an option in certain individuals, especially exposed children who are asymptomatic and are at high risk for influenza complications but have not yet been immunized or, if immunized, those who are not expected to mount an effective immune response.

DOI: https://doi.org/10.1542/peds.2026-078778
J Am Coll Emerg Physicians Open. 2026 Aug;7(4): 100446

Current and Desired Behavioral Health Resources for Children: A Survey of Illinois Emergency Departments.

Jennifer A Hoffmann, Kendall Arslanian, Cindy Durr, Jennifer Monti, Suhanee Mitragotri, Stephanie Atella, Ashley A Foster.

   Objectives: In the context of rising emergency department (ED) visits by children for behavioral health (BH) concerns, our objective was to understand current and desired resources for the care of children presenting to Illinois EDs with BH concerns.
Methods: We surveyed nurse pediatric emergency care coordinators (PECCs) and nurse managers working in Illinois EDs participating in the Pediatric Facility Recognition Program from March 15 to June 30, 2025. We assessed ED characteristics, pediatric BH care practices, and current and desired BH resources.
Results: Among 101 eligible EDs, 65 (64%) responded. Respondents included nurse PECCs (77%), nurse managers (17%), and nurses serving in both roles (6%). Most EDs (60%) were in hospitals without a pediatric inpatient unit, 22% were in critical access hospitals, and 67% had <4999 annual pediatric ED visits. On-site mental health professionals and telemental health services were available in 56% and 44% of EDs, respectively. Universal suicide risk screening was reported in 88% of EDs, most frequently using the Columbia-Suicide Severity Rating Scale Screen Version (87%) and starting at age 8 (36%). Among EDs, 56% reported always or often providing all elements of safety planning. Frequently desired resources included activity kits (82%) and a portal to view pediatric psychiatric inpatient bed availability (73%). High priority resources included a mechanism to escalate difficult cases (23%) and increased access to mental health professionals in the ED (23%).
Conclusion: Survey findings inform opportunities to standardize and improve pediatric BH emergency care through the development and dissemination of desired resources.

Keywords:  adolescent; child; emergency service; hospital; mental health

DOI:  https://doi.org/10.1016/j.acepjo.2026.100446
J Child Neurol. 2026 Aug 11. 8830738261472511

Seizure Action Plans Beyond the Neurology Clinic: What Emergency, School, and Primary Care Teams Need to Know for Children With Epilepsy.

Matthew Chase Lustig.

  Most seizures in children with epilepsy occur outside the neurology clinic. Seizure action plans (SAPs) are designed to extend the neurologist's management plan into these settings. Early SAPs primarily targeted caregivers, while current plans target not only caregivers but also teachers, other medical providers, and anyone else who may be able to intervene on behalf of these children. Some studies suggest that SAPs can improve caregiver knowledge, comfort, and confidence with rescue medication administration. However, evidence that SAPs reduce emergency department use or affect other downstream outcomes is less consistent. This topical review summarizes evidence from the past decade on pediatric SAPs across home, school, emergency medical services, emergency departments, primary care, and residential or long-term care settings.

Keywords:  antiseizure drugs; epilepsy; pediatric

DOI:  https://doi.org/10.1177/08830738261472511
Infect Control Hosp Epidemiol. 2026 Aug 11. 1-8

A quality improvement initiative to optimize diagnostic and antimicrobial stewardship of ventilator-associated tracheitis in the pediatric intensive care unit.

Evin Feldman, Aidan Doona, Denise Iacono, Jesse Honig, Anupama Subramony, Todd Sweberg, Mundeep K Kainth.

OBJECTIVE: To reduce frequency of endotracheal aspirate culture (EAC) collection and decrease antibiotic days of therapy (DOT) for ventilator-associated tracheitis (VAT).
DESIGN: Quality improvement intervention.
SETTING: Tertiary-care pediatric intensive care unit (PICU).
PATIENTS: Admitted to the PICU with an endotracheal tube (ETT) or tracheostomy.
INTERVENTIONS: A clinical decision-support tool was implemented to provide clinical criteria for culture collection and microbiologic criteria for diagnosis, and to reduce treatment duration to 3 days. Key stakeholders were engaged, a nurse champion was identified, and a protocol was implemented. Culture rates (overall and serially repeated) and antibiotic DOT for VAT, each per 100 ETT/tracheostomy days, were analyzed. The proportion of VAT episodes treated for 3 days was also evaluated. Balancing measures included PICU mortality, ventilator-associated events, ventilator days, and length of stay. Statistical process control methods were used to analyze the data.
RESULTS: Across 1072 EACs sent and 213 VAT cases diagnosed, interventions led to a 23% reduction in monthly cultures (9.2 to 7.1 per 100 ETT/tracheostomy days) and a 53% reduction in serial culture use (1.5 to 0.7 per 100 ETT/tracheostomy days). There was a 53% reduction in monthly antibiotic DOT for VAT (10.8 to 5.1 per 100 ETT/tracheostomy days) and a 13-fold increase in the proportion of 3-day antibiotic prescriptions (5 to 65%). There was no increase in mortality, ventilator-associated events, ventilator days, or length of stay.
CONCLUSIONS: Standardized VAT guidelines in critically ill children can safely and effectively decrease culture and antibiotic use.

DOI: https://doi.org/10.1017/ice.2026.10522
Traffic Inj Prev. 2026 Aug 12. 1-12

Effect of appropriate restraint use on pediatric injury outcomes in motor vehicle crashes from US Trauma Quality Program data.

Gretchen H Baker, Angela L Harden, Mary E Cole, Julie A Mansfield.

   OBJECTIVE: Use of appropriate child restraint systems (CRS) based on a child's age and size is important to reduce the risk of injury in motor vehicle crashes (MVCs). The aim of this work was to assess the influence of appropriate versus inappropriate restraint use on pediatric injury outcomes in MVCs using the US Trauma Quality Programs Participant Use File (TQP PUF).
METHODS: Trauma registry data were obtained for TQP PUF admission years 2018-2022, and individuals 1-13 years involved in MVCs were identified using ICD-10 external cause of injury codes. Use of an appropriate versus inappropriate restraint was defined using the child's age, height, and weight in addition to the Child Restraint and Protective Devices variables. Ranges of appropriate child age, height, and weight for each restraint type (rear-facing CRS, forward-facing CRS, booster, seat belt only, or unrestrained) were defined using current best-practice recommendations from the American Academy of Pediatrics and typical CRS product allowable age, height, and weight ranges. Abbreviated Injury Scale (AIS) outcomes were used to identify maximum AIS (MAIS) 3+ (serious to maximal) versus 1-2 (minor to moderate) outcomes for the whole body and individual body regions. Logistic regression was used to evaluate relationships between age and use of appropriate restraints, and odds ratios were used to compare injury outcomes between use of appropriate versus inappropriate restraints.
RESULTS: 39,993 occupants admitted to trauma centers between 1 and 13 yr were evaluated. Overall, 39.10% of children were unrestrained and an additional 18.73% utilized an inappropriate restraint type, and this varied by age. For children 1-7 yr, the odds of utilizing an inappropriate versus appropriate restraint type increased by 1.46 times with each 1-year increase in age, increasing from 6.29% at 1 yr to 39.36% at 7 yr. 40.5% of occupants sustained MAIS 3+ injuries, and unrestrained children had 1.56 (95% CI [1.49, 1.64]) times increased odds to sustain MAIS 3+ versus MAIS 1-2 injuries compared to use of appropriate restraints. Head injuries were the most frequently injured body region (46.0% of all discrete injuries); however, the relative proportion of head injuries compared to other body regions decreased with age. Odds of sustaining a MAIS 3+ versus MAIS 1-2 injury were higher when unrestrained compared to appropriate restraint use when considering injuries to the head (OR = 1.33, 95% CI [1.25, 1.42]), thorax (OR = 1.71, 95% CI [1.56,1.86]), abdomen (OR = 1.52, 95% CI [1.37, 1.68]), spine (OR = 1.54, 95% CI [1.25, 1.90]), and extremities (OR = 1.87, 95% CI [1.73, 2.01]).
CONCLUSIONS: The odds ratios for sustaining a MAIS 3+ versus 1-2 injury when unrestrained compared to appropriate restraints confirm the importance of utilizing appropriate restraint types based on a child's age and size. Continued efforts to increase appropriate restraint use for children, especially between 4-10 yr, would be beneficial.

Keywords:  Child restraint systems; appropriate restraint; injury risk; motor vehicle crashes

DOI:  https://doi.org/10.1080/15389588.2026.2709029
J Pediatr Pharmacol Ther. 2026 Aug;31(4): 560-565

Opioid Use in Children.

Kelly L Matson, Peter N Johnson, Evan R Horton.

  Limited guidance on opioid use exists in the pediatric population, causing medication safety concerns for pain management in children and adolescents. Opioid misuse and opioid use disorder continue to greatly affect adolescents and young adults in the United States, furthering the apprehension of their use. The Pediatric Pharmacy Association (PPA) recommends that pharmacists contribute their knowledge to pain management in children, including discussing the appropriate use of non-opioid alternatives for pain and when to recommend co-prescribing naloxone. The PPA also supports the review of electronic prescription drug monitoring programs before opioid prescribing and dispensing by both prescribers and pharmacists, respectively. Education by pharmacists of children and their families regarding proper administration, storage, and disposal, as well as the awareness of opioid misuse and use disorder among adolescents and young adults, is key to prevention. If opioid use disorder is diagnosed, PPA encourages improved access among adolescents to evidence-based medications, including methadone, buprenorphine, and naltrexone. Furthermore, pharmacists should assist with, or in some settings perform, screening and referral to evidence-based treatments.

Keywords:  misuse; opioid; opioid-related disorder; opioid-related disorders/prevention and control; pediatrics; pharmacist

DOI:  https://doi.org/10.5863/JPPT-25-00157
Am J Med Qual. 2026 Aug 12.

Improving Screening for Adolescent Substance Use and Mental Health in Primary Care.

Ulfat Shaikh, Anna B Correa, Jennifer Monti, Maria H Rahmandar, Cheryl Courtlandt.

BACKGROUND: Mental health and substance use can coexist and worsen outcomes for youth. The goals of the Transformative and Evidence-based Approaches to Mental Health and Substance Use Screening (TEAMSS) quality improvement virtual learning collaborative were to enhance the implementation of screening and follow-up practices for adolescent substance use and mental health issues in primary care.
METHODS: TEAMSS engaged 160 clinicians at 27 pediatric primary care clinics in 18 states. Interventions focused on enhancing clinical processes related to screening, brief intervention, and follow-up for substance use, depression, anxiety, and suicide risk. The learning collaborative model was adapted for a virtual environment with learning sessions and action periods of shorter duration interspersed with individualized coaching.
RESULTS: Clinics standardized processes for screening and intervention, incorporated use of validated screening tools, increased the use of electronic health records and mobile devices in screening, engaged interprofessional team members, identified community resources, and increased clinician and staff knowledge of evidence-based guidelines and quality improvement methods. Substance use screening significantly increased from 35% to 75%. Follow-up of adolescents with positive substance use screening increased from 69% to 86%. Depression screening increased from 82% to 90%, anxiety screening increased from 32% to 69%, and suicide risk screening increased from 18% to 41%.
CONCLUSIONS: TEAMSS significantly improved care for substance use, depression, anxiety, and suicide risk for adolescents at participating primary care clinics. Adapting a learning collaborative approach to a virtual setting requires close attention to maintaining engagement with clinical care teams, especially those in busy primary care clinics.

DOI: https://doi.org/10.1097/JMQ.0000000000000337
J Hosp Med. 2026 Aug 12.

Recent threats to hospital medicine research careers, implications, and proposed solutions.

Sunitha V Kaiser, Kavita Parikh, Jeffrey L Schnipper.

Hospitalist researchers are facing many new threats to their careers due to changes in the funding environment. To overcome these challenges and ensure our researcher pipeline, academic institutions will need to invest in and support investigators most at risk, senior investigators will need to provide increased support to mentees and advocate for resources, and all investigators will need to diversify their funding portfolios.

DOI: https://doi.org/10.1002/jhm.70422
Transl Pediatr. 2026 Jul 31. 15(7): 290

Early recognition and bundle-based management of pediatric sepsis in the emergency department: a narrative review.

Shanshan Gu, Lijun Guan, Yiyao Bao.

   Background and Objective: Pediatric sepsis is a high-stakes, time-sensitive emergency, yet early recognition in the emergency department (ED) remains inconsistent because presenting features are heterogeneous, early signs are nonspecific, and implementation capacity varies across hospitals. At the same time, evidence for bundle-based care has expanded, but important clinical questions remain regarding which recognition approaches are most reliable in frontline ED settings, which bundle elements are best supported, and why pathway uptake remains uneven. This narrative review was undertaken to address these questions and to clarify current evidence gaps relevant to pediatric emergency practice.
Methods: This structured narrative review searched PubMed on March 15, 2026 for studies published from January 1, 2010 through March 15, 2026 using terms related to pediatric sepsis, emergency care, screening, early recognition, sepsis bundles, biomarkers, quality improvement, and digital decision support. We focused on ED-relevant studies addressing recognition strategies, bundle implementation, nursing or workflow processes, and emerging technologies. Titles and abstracts were screened against predefined inclusion and exclusion criteria, and the final literature set was synthesized thematically into recognition, management, implementation, and future-direction domains. No language filter was planned at search design, but the review was limited to studies with accessible English full-text data for analysis.
Key Content and Findings: Current evidence supports a layered ED recognition model that combines clinical assessment with structured screening, targeted biomarkers, and workflow-integrated digital support rather than reliance on any single tool. Evidence is strongest for bundle pathways improving process outcomes such as time to antibiotics, pathway activation, and compliance with first-hour care targets. By contrast, evidence for direct mortality benefit, stand-alone biomarker superiority, and routine use of artificial intelligence (AI)-enabled systems remains promising but inconsistent because studies are heterogeneous in definitions, populations, and implementation context. The literature also shows that success in general ED practice depends heavily on pediatric readiness, nursing-led escalation, local workflow design, and multidisciplinary coordination.
Conclusions: Pediatric sepsis care in the ED should be organized around rapid recognition plus measurable, context-adapted bundle delivery. The clearest evidence gaps involve external validation of recognition tools in general EDs, more explicit evaluation of individual bundle components, harmonized operational definitions and bundle metrics, and implementation studies that test how digital support and nursing workflows can improve frontline performance.

Keywords:  Pediatric sepsis; artificial intelligence (AI); early recognition; emergency department; nursing care

DOI:  https://doi.org/10.21037/tp-2026-0358
Inj Epidemiol. 2026 Aug 14. pii: 55. [Epub ahead of print]13(Suppl 1):

Injury prevention content in social media posts by Children's hospitals: a missed opportunity for education and advocacy.

Maneesha Agarwal, Jacqueline B Gluck, Zoe Fischman, Harleigh J Markowitz, Morgan Cantor, Zoë Teicher, Kristyn Jeffries, Wendy J Pomerantz.

   BACKGROUND: Preventable injuries are the leading cause of pediatric death. Most healthcare organizations and the general public engage in social media (SoMe) to disseminate and consume health-related information. It is unknown how frequently pediatric hospitals leverage their SoMe platforms to educate on injury prevention (IP) topics. We sought to better characterize SoMe messaging and IP content by children's hospitals.
METHODS: This was a retrospective cross-sectional study of US children's hospitals' primary SoMe Facebook, Twitter/X, and Instagram accounts. Included hospitals were associated with Injury Free Coalition for Kids (IFCK), a current or past Centers for Disease Control and Prevention Injury Control and Research Center, a level I pediatric trauma center, or a pediatric surgery fellowship. Accounts established after 1/1/23 or covering adult health topics were excluded. Abstractors reviewed all available posts from 2023; posts were dichotomized into IP vs. non-IP content, with further subcategorization based on injury mechanisms and other topics covered. Descriptive statistics and frequencies with ranges were calculated. Chi-square analyses were used for comparisons between groups.
RESULTS: Of 82 unique hospitals with eligible SoMe accounts, all used Facebook and 69 (84.1%) used all 3 SoMe platforms. Of the 55,339 posts, 3,863 (7.0%) posts covered IP. Among IP posts, the most frequently covered specific topics were mental health/suicide, poisonings, and child passenger safety. Most non-IP posts were focused on general publicity/goodwill; other frequently covered medical categories were cardiac conditions, cancer, and neonatal diseases. Hospital affiliation with a pediatric surgery fellowship (X2 = 93.79; p<.001) and IFCK (X2 = 4.56; p=.03) were associated with more IP content. More affiliations with IP-oriented organizations were also associated with more IP content (X2 = 119.8; p<.001).
CONCLUSION: Although children's hospitals have large SoMe followings, IP is rarely discussed. While ties to IP-oriented organizations improve coverage of IP content, this represents a critical missed opportunity to address the leading causes of pediatric deaths.

Keywords:  Facebook; Injury prevention; Instagram; Social media; Twitter

DOI:  https://doi.org/10.1186/s40621-026-00705-1
J Patient Saf. 2026 Aug 12.

Factors Associated With Likelihood of Experiencing a Pediatric Safety Event in the Inpatient Setting.

Senayit Demie, Jennifer Lee, Katharine Cunnane, Sarah Rosselli, Anjile An, Joy Howell, Erika Abramson, Snezana Nena Osorio.

   OBJECTIVE: Adult studies show that persons marginalized by race/ethnicity, preferred language, and public insurance experience higher rates of hospital harm. This study examined the association between patient race/ethnicity, preferred language, insurance type, and safety events among hospitalized pediatric patients.
METHODS: This retrospective observational study analyzed safety event reports from 2 tertiary children's hospitals (2020-2022). Patients ≤18 years admitted to neonatal intensive care, pediatric intensive care, and inpatient units were included. Demographics were obtained from the electronic health record, and safety events from the voluntary reporting system. Patients were matched by age, sex, and unit to reduce confounding. Descriptive statistics and multivariable logistic regression were used to assess the independent effect of demographic factors on the occurrence of safety events.
RESULTS: Among 4112 unique patients, 370 (9%) experienced a reported safety event. Medication errors comprised 76% of events. After matching, there were no statistically significant differences in the likelihood of experiencing a safety event by race/ethnicity or primary language. However, patients with public insurance had higher odds of experiencing a safety event than those with private insurance (OR=1.51; 95% CI: 1.04-2.20).
CONCLUSION: Public insurance type remains a significant factor in a patient's likelihood of experiencing a safety event during hospitalization. While previous studies have identified race/ethnicity and primary language as contributing factors, we observed no such associations in our analysis. Further research is warranted to explore the underlying structural drivers of this health inequity.

Keywords:  health disparities; health equity; inpatient care; insurance status; patient safety; pediatric hospital medicine; preferred language; race and ethnicity; social determinants of health; voluntary safety reporting

DOI:  https://doi.org/10.1097/PTS.0000000000001578
J Pediatr Surg. 2026 Aug 13. pii: S0022-3468(26)00463-X. [Epub ahead of print] 163381

A National survey of pediatric surgical care coverage models to outlying neonatal intensive care units.

American Academy of Pediatrics Section on Surgery, Delivery of Surgical Care Committee

   BACKGROUND: The delivery of pediatric surgical care to newborns varies based on neonatal intensive care unit (NICU) coverage. We aimed to describe the current national coverage landscape and assess pediatric surgeons' perspectives on the optimal management of infants at outlying NICUs.
METHODS: The AAP Delivery of Surgical Care Committee administered a web-based survey to pediatric surgery division chiefs at Children's Hospital Association practices. Responses were analyzed using appropriate nonparametric and categorical statistical tests, with significance set at p<0.05.
RESULTS: Fifty-two division chiefs responded (28.9%); 26 (50% reporting covering one or more outlying NICUs. Of these outlying NICUS, 76% were Level III. Just over half (51%) had no affiliation with the surgeons' primary hospital. Case volumes were low, with only 5 NICUs (15%) performing more than 25 operations annually. Factors influencing decisions to operate at outlying NICUs included rapport with neonatologists, NICU level designation, transfer capability, and availability of pediatric anesthesiology. The capacity of outlying NICUs to care for infants with index surgical diagnoses varied based on specific diagnosis. Over half of respondents endorsed transfer to the primary center as the optimal location for care for all procedures except gastrostomy tube placement and central venous access.
CONCLUSION: Half of surveyed pediatric surgery groups provide coverage to one or more outlying NICUs despite low reported case volumes. A clear disconnect exists between pediatric surgeons' views on location for optimal care and sites of current care provision. These findings underscore the need for regionalized strategies to optimize surgical care of these infants.

Keywords:  access to care; neonatal surgical care; regionalization

DOI:  https://doi.org/10.1016/j.jpedsurg.2026.163381
JAMA Pediatr. 2026 Aug 10.

Effectiveness of Oseltamivir in Hospitalized Children With Laboratory-Confirmed Influenza, 2014-2023.

Kacie Rytlewski, Angela Dunn, Alissa O'Halloran, Jennifer Habeck, Isaac Armistead, Nisha B Alden, Darpun Sachdev, Pam Daily Kirley, James Meek, Kimberly Yousey-Hindes, Satoshi Kamidani, Kyle P Openo, Patricia A Ryan, Maya Monroe, Sue Kim, Elizabeth Urlaub, Ruth Lynfield, Melissa McMahon, Chad B Smelser, Yomei Shaw, Grant Barney, Jemma V Rowlands, Brenda Tesini, Christina Felsen, Krista Lung, Melissa Sutton, Ann Thomas, H Keipp Talbot, William Schaffner, Andrea George, Holly Staten, Jessica R Cataldi, Samuel R Dominguez, Catherine H Bozio, Suchitra Rao.

Importance: National organizations recommend antiviral treatment for hospitalized children with influenza; however, use in this setting has recently declined. Studies of oseltamivir effectiveness in children are limited by misclassification bias, unknown symptom onset date, and incomplete capture of antiviral use prior to admission.
Objective: To assess the association between oseltamivir receipt and intensive care unit (ICU) admission and hospital length of stay (LOS) among pediatric influenza-associated hospitalizations.
Design, Setting, and Participants: This cohort study used data that were obtained from the Influenza Hospitalization Surveillance Network (FluSurv-NET), which conducts US population-based surveillance for laboratory-confirmed influenza hospitalizations for all ages across 13 states. The study data include seasons 2014 to 2015 through 2022 to 2023, excluding 2020 to 2021. Participants included children aged younger than 18 years who were hospitalized with laboratory-confirmed influenza and for whom a respiratory symptom onset date was available. These data were analyzed from October 2024 through May 2026.
Exposures: Oseltamivir receipt as a time-dependent exposure.
Main Outcome(s) and Measure(s): The primary outcome was time from symptom onset to ICU admission. Secondary outcome was time from admission to discharge (LOS). Adjusted Cox proportional hazard models (aHR) with oseltamivir receipt as a time-dependent exposure were used.
Results: After exclusions, 6044 influenza cases were included in the primary ICU analysis, of whom 4240 (70.2%) received oseltamivir, and 7103 cases were included in the secondary LOS analysis, of whom 5746 (80.9%) received oseltamivir. In the ICU analysis, the median (IQR) age was 3 (1-7) years, 3382 (56%) were male and 3721 (44%) were female, and 2937 (49%) had 1 or more medical comorbidity-the most common of which was asthma in 1547 children (26%). In adjusted models, compared with untreated children, oseltamivir treatment reduced the hazard of ICU admission (aHR, 0.69; 95% CI, 0.60-0.80) and shortened LOS (analyzed as hazard of hospital discharge; aHR, 1.13; 95% CI, 1.06-1.21).
Conclusions and Relevance: In this cohort of children hospitalized with influenza, oseltamivir treatment was significantly associated with a reduced risk of ICU admission by 31% and decreased hospital LOS. These findings demonstrate the benefits of oseltamivir receipt and support current national recommendations for oseltamivir treatment as soon as possible in children hospitalized with suspected or laboratory-confirmed influenza.

DOI: https://doi.org/10.1001/jamapediatrics.2026.3376
Pediatrics. 2026 Aug 12. pii: e2026077705. [Epub ahead of print]

From Mewing to Peptides: Looksmaxxing as an Emerging Pediatric Concern.

Joseph Mekhail, Caroline Howard, Ruth Milanaik.

DOI: https://doi.org/10.1542/peds.2026-077705
Pediatr Pulmonol. 2026 Aug;61(8): e71780

Primary Ciliary Dyskinesia: A Suggested Pathway to Transition From Pediatric to Adult Care.

Abel De Castro, Melanie Sue Collins, Raksha Jain, Jennifer B Walsh, Juliana Alba-Suárez, Yadira M Rivera-Sánchez.

Primary ciliary dyskinesia (PCD) is a rare, genetically heterogeneous disorder characterized by motile ciliary dysfunction that impairs mucociliary clearance. Symptoms of PCD can include unexplained neonatal respiratory issues, chronic sino-otopulmonary symptoms, recurrent infections, bronchiectasis, and subfertility. It is expected that the number of adult patients with PCD is four times higher than the number of pediatric patients. There are no established guidelines for transitioning individuals with PCD from pediatric to adult clinics. Although the exact prevalence is difficult to determine, it is estimated that up to 13% of adults with non-CF bronchiectasis have PCD. The Six Core Elements of Health Care Transition, developed by Got Transition, funded by the National Alliance to Advance Adolescent Health, and endorsed by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians, can serve as a framework for transitioning PCD patients to adult care. Programs implementing the Six Core Elements have significantly reduced care dropouts during adolescence and early adulthood and increased engagement in care in early adulthood. PCD has been the subject of growing research aimed at improving diagnostic methods, treatments, and awareness, leading to earlier and more accurate diagnoses in both children and adults. Additionally, more adult PCD centers are seeking accreditation from the PCD Foundation and collaborating with pediatric centers to ensure continuity of care. Although many chronic diseases, such as cystic fibrosis (CF), inflammatory bowel disease (IBD), and, more recently, sickle cell disease, have established transition guidelines, PCD presents unique challenges that affect the transition process, as discussed in this work. We outline a pathway for transitioning pediatric patients with PCD to adult care.

DOI: https://doi.org/10.1002/ppul.71780
J Pediatr Health Care. 2026 Aug 13. pii: S0891-5245(26)00224-5. [Epub ahead of print]

Hospital Type and Clinical Outcomes for Pediatric Lower-Extremity Open Fracture: Implications for Child Health Services Organizations.

Keri M Spitler, Andrea Krzyzaniak, Kevin Kuhn, Alexandra S Rooney, Margaret N Mericle, Romeo C Ignacio, Rasheed I Ahmad, Brad Culotta, Michael J Krzyzaniak, Vishal Bansal, Michael J Sise.

   OBJECTIVES: Evaluate associations between hospital type and clinical outcomes for pediatric lower-extremity open fractures.
METHODS: Retrospective study of children ≤17 years with lower-extremity open fractures using HCAI (2016-2021). Fractures were categorized as Type I/II or III. Hospitals were categorized as exclusively children's hospitals (ECH), other hospitals with pediatric surgeon coverage (WPS), or without (NPS). Outcomes included time to surgery, length of stay (LOS), discharge disposition, and complications. Multivariate models evaluated associations between hospital type and outcomes.
RESULTS: Among 1,118 admissions, 324 (29%) were treated at ECH, 445 (40%) at WPS, and 349 (31%) at NPS. ECH patients had a shorter time to surgery (p = .02), had shorter LOS (p < .001), and were more frequently discharged home (p < .001). Complication rates were similar. Multivariable regression showed WPS and NPS had lower odds of routine home discharge while WPS had longer LOS for isolated fractures.
CONCLUSION: ECH provide more efficient care for pediatric lower-extremity open fractures while maintaining comparable complication rates.

Keywords:  Children’s hospitals; Pediatric open fractures; fracture fixation methods; health care utilization; lower-extremity fractures; pediatric trauma care

DOI:  https://doi.org/10.1016/j.pedhc.2026.07.002
Transl Pediatr. 2026 Jul 31. 15(7): 291

Multimodal strategies for alleviating postoperative pain in children: a narrative review on research progress and evidence-based practice.

Liang Du, Xiaoqian Ma, Hangyan Zhao.

   Background and Objective: Postoperative pain is a prevalent and clinically important issue in pediatric surgery. Poor pain control can hinder recovery, increase distress, and lead to negative short- and long-term outcomes. Due to developmental, physiological and behavioral differences between children and adults, pediatric pain management needs tailored strategies. This review aims to summarize recent evidence on multimodal pediatric postoperative pain management.
Methods: A narrative review was conducted to synthesize updated evidence on multimodal analgesic approaches for children undergoing surgery. Literature from 2010 to 2025 was retrieved from PubMed using keywords: pediatric postoperative pain, multimodal analgesia, opioid-sparing care, non-pharmacologic intervention, family-centered care, evidence-based practice and digital health. The review was prepared in accordance with the Narrative Review reporting checklist.
Key Content and Findings: Evidence supports non-opioid basic analgesics, regional techniques and standardized perioperative pathways for better pain control and less opioid use. Non-pharmacological and theory-guided interventions [distraction, virtual reality (VR), family engagement, caring nursing] further enhance pain relief and recovery. Future trends focus on implementable models integrating standardized assessment, individualized multimodal therapy, family participation and digital follow-up.
Conclusions: Effective pediatric postoperative pain management relies on multidisciplinary cooperation throughout the perioperative period. Family‑centered multimodal strategies with ongoing pain monitoring are essential to reduce opioid‑related side‑effects and facilitate children's holistic recovery.

Keywords:  Pediatric postoperative pain; family-centered care; multimodal analgesia; non-pharmacologic intervention; opioid-sparing care

DOI:  https://doi.org/10.21037/tp-2026-0363
Hosp Pediatr. 2026 Aug 14. pii: e2025009198. [Epub ahead of print]

Increasing Rate of Pott's Puffy Tumor Hospitalizations Among US Children.

Anne K Jackson, Qing Duan, Kelly Patterson, Janet Zahner, James Gray, Katherine A Auger, Patrick W Brady, Matthew J Molloy.

BACKGROUND: Pott's puffy tumor is a rare complication of sinusitis characterized by osteomyelitis of the frontal bone with subperiosteal abscess, often with intracranial sequelae. Although complications of sinusitis increased after the pandemic, it is unclear whether rates of Pott's puffy tumor increased.
OBJECTIVE: To investigate the rate of Pott's puffy tumor hospitalizations in US children and assess trends in clinical characteristics during 2017-2025.
METHODS: We performed a cross-sectional epidemiological study using Epic Cosmos. We included hospitalizations of pediatric patients (aged 0-21 years) at continuously contributing US hospitals during 2017-2025 with a Pott's puffy tumor diagnosis and receipt of systemic antibiotics. We calculated annual Pott's puffy tumor hospitalization rates per 100 000 hospitalizations. We identified patient-level demographic and clinical characteristics and compared these between 2017-2019 and 2022-2025.
RESULTS: We identified 601 pediatric patients hospitalized for Pott's puffy tumor during 2017-2025 from 170 hospitals. The hospitalization rate increased from 2.8 per 100 000 hospitalizations in 2017 to 6.0 in 2025. The median age was 12 years, the median length of stay was 7 days, and 33% of patients received care in the intensive care unit, which was similar across time periods. The proportion of patients who underwent surgical procedures increased from 37% in 2017-2019 to 60% in 2022-2025 (P < .001).
CONCLUSION: Our findings suggest that, although still a rare diagnosis, Pott's puffy tumor hospitalizations among children have increased, with an increase in surgical intervention. Further investigation into the incidence and the cause of observed increases is warranted.

DOI: https://doi.org/10.1542/hpeds.2025-009198
J Clin Epidemiol. 2026 Aug 14. pii: S0895-4356(26)00342-2. [Epub ahead of print] 112466

Partnering with trans and gender diverse youth in healthcare research: considerations for safe and meaningful engagement.

Kira London-Nadeau, Charlie Rioux, Nikk Raun, Philémon Julien, Nicholas Chadi.

   BACKGROUND AND OBJECTIVES: When pursuing participatory methods with youth, healthcare research teams may have the opportunity to create partnerships with transgender and gender diverse youth (TGDY). While these partnerships are crucial to ensure the voices of TGDY are included throughout health domains, research teams must ensure this marginalized population is safely and meaningfully included. It is therefore important for research teams to be aware of key pitfalls that contribute to the marginalization of TGDY in healthcare and research, and certain strategies to counteract these pitfalls.
METHODS: Using our lived and learned expertise, this commentary seeks to support research teams wishing to conduct participatory research that includes TGDY.
RESULTS: We present an overview of the mechanisms through which TGDY are marginalized throughout healthcare and research, providing context around the sociocultural ostracization, institutional erasure, and epistemic injustice this group faces. Considering these issues, we provide suggested approaches to ensure partnerships with TGDY are safe and meaningful.
CONCLUSION: Including TGDY voices throughout healthcare research is key to counteract the marginalization this group faces. Through safe and meaningful partnership, research teams across healthcare fields can contribute to this work.

Keywords:  Gender diverse; Healthcare research; Participatory methods; Transgender; Youth engagement; Youth participatory research

DOI:  https://doi.org/10.1016/j.jclinepi.2026.112466
J Allergy Clin Immunol Pract. 2026 Aug 10. pii: S2213-2198(26)00640-9. [Epub ahead of print]

Colorado Asthma-Friendly Schools: An On-ramp to Implementation Science.

Stanley J Szefler, Melanie Gleason, Arthur McFarlane, Christy Haas-Howard, Ana Kim, Heather De Keyser.

  Schools are a key point of intervention for child health. Children spend most of their days in school, and school nurses are well trained in the acute management of many childhood chronic diseases. The approach to asthma has changed significantly over time, with updates to inhaled corticosteroid use, the use of single inhalers for both relievers and controllers, and the increasing use of asthma biologics for managing severe asthma. Asthma specialists can play an important role in providing timely updates for school nurses about ongoing changes in overall asthma management. The purpose of this review is to summarize the evolution of our urban-centered school-based asthma program to one that has expanded into many school districts across Colorado, including rural communities, by applying principles of implementation science. We will share steps that we took to grow and scale this program as well as lessons learned during dissemination to additional school districts in Colorado. An effective school nurse-clinician interaction sets up a strong infrastructure for identifying children and adolescents who are not receiving optimal chronic disease care. Such efforts can leverage existing partnerships between schools and the healthcare system to improve the network of care for children with poorly controlled asthma.

Keywords:  asthma; asthma management; chronic disease management; community health worker; implementation science; rural health care; school health

DOI:  https://doi.org/10.1016/j.jaip.2026.07.043
J Pediatr Soc North Am. 2026 Nov;17 100420

What Resources Are Available for Parents Online? A Readability, Quality, and Source Evaluation of Website and AI-Generated Content on Inherited Pediatric Orthopaedic Conditions.

Daniel S Hayes, Elizabeth H Blank, Ryan D Muchow.

   Background: Individuals frequently consult the internet when seeking information about their health. However, patient education materials (PEMs) published online are often written above the recommended sixth-to eighth-grade reading level. The readability and quality of online resources for inherited conditions are poorly studied. Additionally, little is known about the reading level of responses from artificial intelligence (AI) models when prompted with healthcare inquiries. We aimed to assess the readability and quality of online health information encountered when searching for inherited pediatric orthopaedic conditions, including outputs from popular large language model (LLM) chatbots.
Methods: Twenty-three inherited pediatric orthopaedic conditions were queried using Google in three common search formats. First-page search results, including Google AI Overviews, were analyzed. Searches were replicated in three chatbots: Microsoft Copilot, ChatGPT, and Google Gemini. Readability was assessed using Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL).
Results: Of 706 identified webpages, 355 met inclusion criteria. Most webpages were hosted by government agencies, academic hospitals, or nonprofit organizations. Mean readability levels were high (FRE 38.2; FKGL 12.1), substantially exceeding the recommended levels for patient-facing health information. Only 18% of webpages met eighth-grade readability standards. AI-generated outputs demonstrated similar readability (FRE 36.1; FKGL 12.3). Only 2% of AI responses met eighth-grade readability recommendations. However, when the input prompt included a request to improve readability, AI models lowered average output readability by nearly six grade levels (FRE 69.0; FKGL 6.8).
Conclusions: Online information for inherited pediatric orthopaedic conditions is frequently written above recommended reading levels, and AI-generated content does not meaningfully improve accessibility unless specifically prompted to do so. Despite generally reputable website sources, limited readability and accountability highlight opportunities for orthopaedic surgeons and organizations to advocate for improved clarity, accessibility, and patient-centered communication.
Key Concepts: (1)Online patient education materials for inherited pediatric orthopaedic conditions are written at a higher reading level than the recommended 8th grade level.(2)Only 18% of websites and 2% of AI-generated responses meet the ≤8th grade readability standard.(3)Most online resources come from reputable sources (government, academic hospitals, nonprofits) but still have poor readability.(4)AI-generated health information has similar readability to websites but is significantly shorter.(5)Improving readability, accessibility, and patient-centered communication is a key opportunity for orthopaedic providers and organizations.
Level of Evidence: V.

Keywords:  Artificial intelligence; Orthopaedics; Patient education; Pediatrics; Readability

DOI:  https://doi.org/10.1016/j.jposna.2026.100420
Breastfeed Med. 2026 Aug 13. 15568253261476454

Describing the Infrastructure of Breastfeeding and Lactation Medicine Divisions and Centers Established Within U.S. Health Systems.

Deanna Nardella, Casey Rosen-Carole, Mariana Castaño Colmenares, María-Teresa Hernández-Aguilar, Meredith Young, Emily Swisher Rosa, Veronika Shabanova, Josefa L Martinez-Brockman, Katherine R Standish.

   BACKGROUND: There is a well-described need for a more coordinated, systems-based approach to breastfeeding care delivery in the United States. Although several Breastfeeding and Lactation Medicine (BFLM) Divisions, Centers, and Institutes (D/C/Is) exist within U.S. health systems, they remain poorly described. We aimed to describe the U.S. national landscape of BFLM D/C/Is and the clinical and nonclinical activities they conduct.
METHODS: We present a secondary analysis of cross-sectional survey data collected from U.S. BFLM prescribing clinicians from November 2024 to February 2025. Participants were recruited from conferences, professional listservs, and social media groups relevant to BFLM clinicians. If they reported working under a BFLM D/C/I, additional questions assessed clinical infrastructure and non-clinical activities of their D/C/I. Descriptive summaries were completed.
RESULTS: Of 138 participants in our final sample, 20 (15%) from 10 states worked under a BFLM D/C/I and thus were included in this secondary analysis. Participants were physicians (n = 14, 70.0%), midwives (2, 10.0%), and nurse practitioners (4, 20.0%) with an average of 10.5 (standard deviation 8.6) years of BFLM experience. Most (70.0%) held positions as directors. D/C/Is had existed for an average of 7.2 years and delivered outpatient (95.0%), electronic (45.0%, i.e., "e-consult"), and inpatient (35.0%) clinical consultation services for an average of 7.9, 2.1, and 5.6 years, respectively. Most provided evidence-based staff education (95.0%), oversaw system lactation services and policies (75.0%), and conducted quality improvement and research (65.0%).
CONCLUSION: Our national description of BFLM D/C/Is can inform future research and expansion of BFLM infrastructure in U.S. health systems.

Keywords:  breastfeeding medicine; capacity building; health care economics and organization; health care infrastructure; health services administration; program development

DOI:  https://doi.org/10.1177/15568253261476454
J Pediatr Urol. 2026 Jul 30. pii: S1477-5131(26)00464-X. [Epub ahead of print] 106185

The role of the advanced practice provider in pediatric urology: A census of the pediatric urology nurses and specialists (PUNS).

Maryellen S Kelly, Vivian W Williams, Mandy Rickard, Celicia Little, Azadeh Wickham.

   BACKGROUND: The prevalence of pediatric chronic conditions and demand for lower urinary tract symptom management have risen in recent decades, contributing to growing clinical demand for pediatric urology services. Meeting this demand requires a sufficient and well-supported workforce, and Advanced Practice Providers (APPs) have become an increasingly recognized component of urological care delivery. The Pediatric Urology Nurses and Specialists (PUNS) organization represents APPs in pediatric urology in the United States and Canada. This study aimed to conduct a census survey of PUNS members to better understand APP education and roles in pediatric urology.
STUDY DESIGN: This descriptive survey, developed by the PUNS research special interest group, was administered to PUNS fall meeting attendees in 2023. The electronic survey collected information on demographics, professional settings, the degree of independence in practice versus physician-supervised roles, procedures, and diagnoses managed, and engagement in research.
RESULTS: There were 112 of 300 respondents (37%), predominantly female (97.9%). 46.3% were between 31 and 40 years, followed by the 41-50 years group (27.4%), those aged 51 years and older (15.8%), and the 20-30 years (10.5%). 90% of the respondents work in urban centers, with 98.7% based in university settings or academic institutions. Respondents held advanced degrees, including a Master of Science in Nursing (MSN) (71.4%), a Doctor of Nursing Practice (DNP) (9.8%), and a Doctor of Philosophy (PhD) (1.8%). Most respondents evaluate patients independently of physicians (94.7%). 58% were involved in research through their roles, 24.1% assisted with patient recruitment and consent, another 24.1% were co-investigators, 8.9% were primary investigators, and 8.9% of respondents had published in peer-reviewed journals over the past two years.
DISCUSSION: APPs reported independently managing most pediatric urology conditions, with many also performing procedures independently. APPs are also involved with research activities to various degrees. This information can be used to improve APP utilization internationally, fully optimizing their practice scope and improving surgeon time utilization.
CONCLUSION: This survey revealed a well-educated, predominantly female membership primarily working in urban academic environments and exhibiting high clinical independence. Less than half of the membership participates in research; those who do are significantly involved across various capacities.

Keywords:  Advanced practice provider; Nurse practitioner; Pediatric urology; Practice patterns

DOI:  https://doi.org/10.1016/j.jpurol.2026.106185
J Pediatr Nurs. 2026 Aug 14. pii: S0882-5963(26)00377-5. [Epub ahead of print]91 166-178

Nursing interventions to improve peripheral intravenous catheter outcomes in pediatric patients: A systematic review and meta-analysis.

Gözde Türkmenoğlu Küçükakça, Aylin Akça Sümengen, Tuğçe Aksan, Ahmet Kolip.

   BACKGROUND: Nursing interventions related to peripheral intravenous catheters help reduce the risks of catheter-related clinical outcomes. This study aims to evaluate the effectiveness of nursing interventions aimed at improving peripheral intravenous catheter outcomes in pediatric patients.
METHODS: A comprehensive search was conducted in CINAHL, PubMed, Scopus, Embase, MEDLINE, PsycINFO, and the Cochrane Library for studies published between 2000 and 2025. Nursing interventions included those targeting infiltration, extravasation, catheter failure, and dwell time in hospitalized pediatric patients aged 0-18. Thirteen studies were qualitatively reviewed. Seven RCTs were meta-analyzed. Data analysis used CMA v3 to calculate Hedges' g under a random effects model.
RESULTS: The systematic review findings show that nursing-based interventions have generally reduced infiltration and catheter failure rates, prolonged catheter dwell time, and improved quality of care. The pooled effect size for catheter dwell time was small and non-significant. Due to high heterogeneity, a subgroup analysis was performed, revealing that catheter duration was significantly prolonged in studies including the pediatric population, but no significant effect was observed in neonatal studies.
CONCLUSION: Nursing-based interventions, particularly fixation methods and evidence-based care packages, can improve peripheral intravenous catheter outcomes in pediatric patients. However, heterogeneity between studies, methodological limitations, and differences in outcome definitions highlight the need for separate, standardized protocols and large-scale, multicenter RCTs for pediatric and neonatal IV management.
IMPLICATIONS FOR PRACTICE: Demonstrating the potential of nursing-based interventions to improve peripheral IV catheter outcomes in pediatric patients, this contributes significantly to the development of standardized care protocols in clinical practice.

Keywords:  Catheterization, peripheral; Pediatric nursing; Quality of care

DOI:  https://doi.org/10.1016/j.pedn.2026.08.008
J Autism Dev Disord. 2026 Aug 14.

Beyond Intervention: A Scoping Review of Parent Engagement in Parent-Implemented Intervention for Autistic Children.

Cao Fang, Jun-Hong Chen, Melissa Jonson-Reid.

   PURPOSE: Parent-implemented interventions (PII) are evidence-based practices that improve developmental and functional outcomes for autistic children. However, limited attention has been given to the processes of parent engagement within PII, despite its potential to shape intervention sustainability and effectiveness. This scoping review examined how parent engagement has been incorporated and reported in parent-implemented interventions for autistic children in the United States.
METHODS: Following PRISMA-ScR guidelines, PubMed and EBSCO (nine sub-databases) were searched for peer-reviewed studies published between January 2013 and October 2023. Eligible studies were randomized controlled trials conducted in the United States, focused on autistic children, and included a parent-implemented component. Two reviewers independently screened records (94% initial agreement).
RESULTS: Forty-two articles representing 29 unique trials were synthesized. Developmental interventions primarily employed dyadic or combined training formats, while non-developmental interventions more often used parent-only approaches. Fewer than half of the trials reported structured opportunities for parental involvement in planning or problem-solving. Clinician fidelity was consistently measured, whereas parent fidelity was assessed less frequently and often without independent raters. Parent engagement was measured as an outcome in fewer than half of the trials and examined as a predictor or moderator in only a small subset, where higher engagement predicted greater child gains.
CONCLUSION: Parent engagement processes remain inconsistently reported in PII research despite their centrality to intervention delivery. Greater attention to structured involvement, standardized fidelity measures, and long-term maintenance is needed. Clinically, embedding collaborative problem-solving and sustained supports may strengthen parents' competence and enhance intervention outcomes for autistic children.

Keywords:  Autism spectrum disorder; Parent engagement; Parent training; Parent-implemented intervention; Scoping review

DOI:  https://doi.org/10.1007/s10803-026-07474-2
Am Surg. 2026 Aug 08. 31348261474182

Injury Severity and Near-Absent Helmet Use in NTDB-Eligible Pediatric E-Scooter Trauma: A Single-Center Descriptive Series.

Alexander S Mina, Victoria Cunningham, Adam M Vogel, Howard I Pryor.

  Pediatric e-scooter injuries have risen rapidly, yet single-center data describing injury severity, admission patterns, and helmet use within high-acuity trauma populations remain limited. We describe a single-center retrospective series of 31 National Trauma Data Bank (NTDB)-eligible pediatric patients treated for e-scooter-related injuries at a level-one pediatric trauma center from January 2022 to December 2024. The cohort was predominantly male (26 of 31, 83.9%). Twenty-three patients (74.2%) were admitted-substantially higher than the 5% to 15% reported in broader national cohorts and consistent with NTDB selection for significant trauma. Injuries were minor (ISS 1-9) in 23 patients (74.2%) and moderate or greater (ISS ≥10) in 8 (25.8%); all moderate-or-greater injuries were admitted, and every PICU and operative admission occurred within these higher-severity groups, although the difference from minor injuries did not reach statistical significance (Fisher exact P = 0.08). Notably, no patient was documented as wearing a helmet at the time of injury (unhelmeted 64.5%, unknown 35.5%). Within this NTDB-eligible, level-one cohort, pediatric e-scooter trauma was characterized by a high admission rate and near-absent documented helmet use, reinforcing the importance of helmet promotion and targeted injury-prevention efforts.

Keywords:  e-scooter; injury prevention; pediatric trauma

DOI:  https://doi.org/10.1177/00031348261474182