Safe water is essential for children to comply with healthy beverage consumption recommendations. Tap water generates varying degrees of concern, including safety, health, taste, and so on. Perceptions of water quality may influence other beverages consumed, such as sugar-sweetened beverages (SSBs). To assess the association between tap water perceptions and SSB and juice consumption, parents of 4- to 6-year-old children completed surveys. The associations between tap water concerns and SSB and juice consumption were separately assessed via chi-square tests and multinomial logit models (adjusted for child sex, household income, and parent anxiety). Children (N = 221) were racially and socioeconomically diverse. One-quarter (27%) of parents expressed some concern about tap water; their children had higher risk of consuming SSB 3+ times a day (relative risk ratio [RRR] = 6.7; 95% CI = 1.4-33.1) and sometimes consuming SSB (RRR = 3.4, 95% CI = 1.1-10.8) compared with those without concerns. In conclusion, tap water concerns may contribute to increased SSB consumption among young children.

We evaluated the appropriateness of cefdinir prescribing in an integrated health care system. We performed a cross-sectional analysis of cefdinir prescribing for children aged 0 to 17 years old from 2005 to 2020 with acute otitis media, sinusitis, streptococcal pharyngitis, community-acquired pneumonia, urinary tract infection, and viral respiratory tract infections. The percentage of potentially inappropriate prescriptions was compared by location, provider specialty, and provider type using the chi-square test. A total of 93 748 cefdinir prescriptions were prescribed to pediatric patients, with 53 642 (57%) deemed as potentially inappropriate. Encounters in emergency and urgent care settings were more likely than ambulatory settings to be associated with inappropriate prescribing of cefdinir (P < .001). Non-pediatric-trained providers were responsible for 46.8% of the potentially inappropriate cefdinir prescriptions and were more likely to prescribe potentially inappropriate cefdinir prescriptions compared with pediatric-trained providers (P < .001). Advanced practice providers were more likely than physician providers to prescribe potentially inappropriate cefdinir prescriptions (P < .001).

This poem captures the transformative journey of pregnancy, from the initial shock of discovery on an ordinary day to a profound shift in identity. It celebrates the simultaneous birth of a child and a mother, honoring the courage required to navigate the wait through doubt and hope.

Bright Futures Parent and Patient Handouts from the American Academy of Pediatrics are widely used after pediatric well-child visits, yet their content has not been systematically evaluated. We assessed all fourth-edition handouts using standard readability formulas for readability and the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) for understandability and actionability. Patient Handouts averaged a 4th-grade level (ages 7-8), 5th-grade level (ages 9-10), and 6th- to 7th-grade level (age 11+). Parent Handouts ranged from about 5th to nearly 7th grade. The PEMAT-P scores across all 23 handouts showed high understandability (92.3%) but lower actionability (60%). Overall, Bright Futures Handouts appear readable and understandable, supporting their use in pediatric practice, although opportunities remain to improve actionability. When clinicians create or evaluate patient education materials, attention to plain language, straightforward delivery, visual aids, and checklists helps improve readability, understandability, and actionability. These strategies may support more effective patient education and promote pediatric health outcomes.

Necrotizing enterocolitis (NEC) has emerged over the past 25 years as the most common gastrointestinal emergency in neonatal intensive care units (NICUs) worldwide. Despite significant improvements in survival among premature and low-birth-weight (LBW) neonates due to advances in neonatal intensive care, the incidence of NEC remains persistently high, largely because of the physiological vulnerability associated with LBW and prematurity. The purpose of this study was to assess the incidence and identify predictors of NEC among LBW newborns in South Ethiopia. A hospital-based prospective cohort study was conducted among 627 LBW neonates in public hospitals in southern Ethiopia from December 2, 2020, to December 1, 2021. Data were coded and entered into Epi-data version 4.4.2.1 and exported to STATA version 17 for analysis. Weibull regression analysis was employed after assessing model fitness. Adjusted hazard ratio (AHR) with 95% confidence interval (CI) was calculated, and variables with a P value < .05 were considered statistically significant. The incidence rate of NEC among LBW neonates was 11.7 per 1000 child-day observations (95% CI: 8.95-15.26). Maternal age (25-35 years) (AHR = 2.45 [95% CI: 1.16-5.15]) and advanced maternal age (>35 years) (AHR = 3.68 [95% CI: 1.33-10.19]) were significantly associated with an increased risk of NEC. Other independent predictors of NEC included preeclampsia (AHR = 2.49 [95% CI: 1.18-5.31]), oligohydramnios (AHR = 9.80 [95% CI: 1.11-86.89]), intraventricular hemorrhage (IVH) (AHR = 7.56 [95% CI: 1.58-36.21]), neonatal jaundice (AHR = 2.03 [95% CI: 1.09-3.81]), dehydration (DHN) (AHR = 10.75 [95% CI: 2.33-49.63]), formula feeding (AHR = 4.71 [95% CI: 1.86-11.95]) and not initiated feeding early (AHR = 9.36 [95% CI: 4.17-20.98]]). This study revealed a high incidence rate of NEC among LBW neonates. To mitigate the burden of NEC among LBW neonates, targeted interventions aimed at preventing and effectively managing pregnancy-related complications, particularly preeclampsia and oligohydramnios, should be strengthened. In addition, early diagnosis and prompt treatment of neonatal conditions, including intraventricular hemorrhage, jaundice, and dehydration, are critical to decrease NEC. Promoting breastfeeding and encouraging early initiation of feeding are also key strategies for the effective prevention of NEC.

Upper gastrointestinal involvement beyond the duodenum in pediatric celiac disease (CD) remains undercharacterized. We conducted a single-center retrospective analysis of children who underwent esophagogastroduodenoscopy, comparing CD cases with non-CD controls. Biopsies were graded using the modified Marsh-Oberhuber and Sydney systems; Helicobacter pylori was assessed by histology and rapid urease testing. Outcomes were esophagitis, gastritis subtypes, H pylori infection, peptic ulcers, and, in CD, associations with Marsh stage. Among 996 procedures, 260 (26.1%) had CD. Gastritis was common in both groups, with chronic active gastritis most frequent. Chronic lymphocytic gastritis was more prevalent in CD (P < .05), while H pylori infection was lower (39.6% vs 50.3%; P < .05). Peptic ulcers were more frequent in CD, predominantly in the duodenal bulb (P < .001). Esophagitis showed an inverse relationship with Marsh stage (P < .05). These findings delineate distinct upper gastrointestinal features in pediatric CD and may support a more comprehensive evaluation of the upper gastrointestinal tract during diagnostic endoscopy.

This study evaluated CXC motif chemokine 5 (CXCL5) and C-C motif chemokine ligand 20 (CCL20) as predictors of azithromycin failure in pediatric Mycoplasma pneumoniae pneumonia (MPP). Procalcitonin (PCT), CXCL5, CCL20, interleukin-6 (IL-6), and C-reactive protein (CRP) were assayed in 318 patients and 100 controls. Favorable outcome was symptomatic remission with >50% radiological absorption; poor outcome was persistent/worsening symptoms, no radiological absorption or progression, or complications requiring additional intervention. Patients were stratified by 7-day outcomes (poor, n = 62; favorable, n = 256). Multivariable logistic regression and receiver operating characteristic analysis showed prolonged fever, higher clinical pulmonary infection score (CPIS), and elevated PCT, lactate dehydrogenase, CXCL5, and CCL20 predicted poor prognosis (P < .05). Procalcitonin, CXCL5, and CCL20 area under the curve (AUC) were 0.755, 0.714, and 0.745, respectively; combined AUC was 0.863. Pretreatment CXCL5 and CCL20 positively correlated with CPIS, IL-6, and CRP (P < .05). CXCL5 and CCL20 are robust additive biomarkers for azithromycin-refractory MPP.

There are many problems that mothers who take care of disabled children experience, and when mothers cannot cope with these problems, they suffer greatly. This study aimed to examine the relationship between life satisfaction, psychological resilience, and burnout in mothers of disabled children. The research is descriptive in a cross-sectional type. The Parents Burnout Scale, The Satisfaction With Life Scale, and The Resilience Scale for Adults were used to collect data in the study. In total, 79.9% of the children were receiving rehabilitation training, 56.5% could not attend school, 49.5% had mental disabilities, and 36.7% had second-degree disabilities. The total mean score of the Parent Burnout Scale was 161.95 ± 32.55. A negative relationship was detected between the total mean score of the parental burnout scale and the satisfaction with life scale, the psychological resilience scale (r = -0.61, P < .05, r = -0.26, P < .05). Mothers' burnout status was interpreted as moderate. A relationship was detected between burnout, life satisfaction, and psychological resilience. It was suggested that nurses should work to produce more detailed solutions to solve the problems of disabled children.

Windshield surveys (WS) have been used to teach about social determinants of health (SDOH) through direct observation of communities. Limited information exists about how pediatric residency programs design and implement WS; therefore, the authors created a survey to understand their use. Twenty-one percent (61/290) of pediatric residency programs responded and 42 report using WS. Most require completion during first year of training (19/33). Learning objectives for the WS included themes on barriers to health, understanding resources and community characteristics. Resident assessment involved discussion with faculty (15/33), reflective writing (3/33), faculty review of WS (1/33), or a combination of these (8/33). To evaluate the curriculum, discussion (17/33), formal evaluations (7/33), or both (3/33) were used. Experiential activities like WS can teach about communities and SDOH, however, no standardization of methods or evaluation exist. Further research is needed on effective learner assessment and curriculum evaluation methods for residency programs wanting to implement WS.

To assess the feasibility of an electronic nose (e-nose) for volatile organic compounds (VOCs) to classify respiratory diseases and establish a protocol for use. We analysed exhaled air samples with Cyranose 320 nose from 67 children (14 healthy, 34 asthmatics and 19 other respiratory diseases) (mean age 11.4 years). Three samples were collected for each patient. We used machine learning models to generate an algorithm to classify children according to disease. There were significant differences in 30/32 sensors between plastic and tedlar bags. The Cronbach alpha was <0.5 in all cases, so that the consistency of the measurements was low. An analysis was performed to distinguish between healthy and asthmatics, P < .05 in 27/32 sensors. The algorithm predicted asthma disease with high sensitivity (over 99%) and accuracy (over 96%). The negative and positive predictive values were over 90%. The e-nose seems a valuable tool for screening asthma disease in the paediatric population in clinical practice.