Depression in children with abdominal pain in the emergency department.

Objective: This cross-sectional study examined depression and associated impairment in youth presenting to a pediatric emergency department (PED) with abdominal pain.

Methods: Participants were 11-17 years old, presenting to a PED with idiopathic abdominal pain. Participants completed demographics, pain, pain-related impairment, and depression surveys.

Revitalizing Musculoskeletal Healthcare: A Strategic Approach to Value-Based Care.

Background: Value-based care (VBC) emphasizes patient outcomes over service volume, representing a significant shift in health care delivery. Musculoskeletal (MSK) health care, with over $300 billion in annual expenditures, has lagged behind other specialties in adopting VBC. Key barriers include misaligned incentives and fragmented care delivery.

Basics of Orthopaedic Commercial and Government Bundling.

Background: The health care system is transitioning from fee-for-service models to value-based care frameworks, with bundled payments emerging as a promising approach to improve cost efficiency and patient outcomes. Bundled payments consolidate costs for multiple services into a single payment for specific treatments or conditions. This study reviews the development and implementation of bundling models in orthopaedics, comparing government and commercial approaches and discussing their benefits and challenges.

Practical Implications of Value-Based Care in the Setting of Ambulatory Surgery Centers.

Background: Ambulatory surgery centers (ASCs) are increasingly replacing traditional hospital settings for orthopaedic procedures, driven by advancements in surgical techniques, anesthesia, and enhanced recovery protocols. These innovations enable complex procedures to be performed safely in outpatient settings. ASCs align with value-based care (VBC) principles by offering cost-effective, high-quality, and patient-centered care.

Experiences and barriers with home bladder manometry in the pediatric neurogenic bladder population: A qualitative study.

Background: Patients with neurogenic bladder are at risk of developing renal deterioration secondary to increased intravesical pressures. To date, urodynamics is the gold standard test to properly assess bladder dynamics. Home bladder manometry is a low-cost and simple method to evaluate bladder pressures and volumes during clean intermittent catheterization (CIC).

Psychosocial dimensions of pain disparities in youth diagnosed with unspecified abdominal pain in an emergency department.

Diagnosis ambiguity, paired with pain care inequities experienced by marginalized groups may increase risk for ongoing pain and impairment in children diagnosed with unspecified abdominal pain in the pediatric emergency department (PED). This cross-sectional study examined psychological, caregiver, cultural, and socio-ecological factors associated with pain-related impairment in an ethnically and socioeconomically diverse population diagnosed with unspecified abdominal pain in a PED. The sample included 111 children 8-17 years old (59.

Pain Disparities Attributed to Linguistic Minoritization in Health Care Settings.

There is a paucity of understanding about how language influences pain communication and outcomes for families who speak languages other than English in the United States. This is of great importance because 21.6% (68 million) of the population speak a language other than English, with 8% (25 million) of the population speaking English "less than very well.

Auricular laser acupuncture as an adjunct for parental anxiety management during children's surgery: A randomized-controlled study.

Background: Pediatric surgery is associated with high levels of anxiety for both children and parents/caregivers. To mitigate anxiety, auricular acupuncture has shown its potential in the perioperative setting. Accordingly, our team developed a wearable prototype auricular laser acupuncture system, AcuHealth V1.

Neighborhood Socioeconomic Context Predicts Pediatric Asthma Exacerbation.

Causes of asthma exacerbation in children have been studied extensively at the individual level, but contributions of neighborhood-level factors are less explored. We test which distinctive residential characteristics produce variation in uncontrolled asthma among pediatric patients. We extracted electronic medical record data from pediatric patients living in Southern California and used multilevel modeling techniques to isolate which neighborhood characteristics drive inequitable asthma control.

The role of positive affect in asthma control and symptom severity in adolescents.

Introduction: We test the effects of positive affect and its arousal subscale components of calm, wellbeing, and vigor on asthma control and symptom severity in adolescents with moderate to severe asthma. Additionally, we test whether positive affect (and its arousal components) moderate how stress impacts asthma control and symptom severity.

Methods: Adolescents with asthma (N = 66, ages 12-17) completed brief surveys 4 times a day for 7 days reporting on their positive affect, stress, and asthma symptom severity and conducted a morning peak expiratory flow assessment each day.

Adults With Spina Bifida Fare Worse Than Young Adults: A Systemic Vulnerability in Urinary Tract Infection-Related Hospital Care.

Purpose: We aim to estimate the odds of UTI-related hospital care in spina bifida (SB) patients aged 18 to 25 years as compared with patients with SB in adolescence (11-17 years) or adulthood (26-35 years). We hypothesize that patients with SB in the typical transitional age, 18 to 25 years, will have higher odds of UTI-related hospital care as compared to adolescent SB patients or adult SB patients.

Materials And Methods: Using Cerner Real-World Data, we performed a retrospective cohort analysis comparing SB patients to age- and gender-matched controls.

Paediatric laceration repair in the emergency department: post-discharge pain and maladaptive behavioural changes.

Background: Paediatric laceration repair procedures are common in the ED; however, post-discharge recovery remains understudied. Perioperative research demonstrates that children exhibit maladaptive behavioural changes following stressful and painful medical procedures. This study examined post-discharge recovery following paediatric laceration repair in the ED.

The intersection of pediatric anesthesiology and social determinants of health.

Purpose Of Review: There is increasing evidence of racial and ethnic disparities in pediatric perioperative care, which indicates a need to identify factors driving disparities. Social determinants of health (SDOH) play a fundamental role in pediatric health and are recognized as key underlying mechanisms of healthcare inequities. This article summarizes recent research exploring the influence of SDOH on pediatric perioperative outcomes.

Predictors of parental anxiety in a paediatric emergency department.

Background: Children experience significant anxiety in the paediatric ED. Although research from preoperative and primary care samples indicates that parents experience anxiety surrounding their children's medical procedures, less is known about parental anxiety and factors that contribute to higher parental anxiety in the ED. This study aimed to assess parental anxiety in families presenting to a paediatric ED with a variety of presenting concerns and examine demographic and psychological factors associated with parental anxiety.

Does Liposomal Bupivacaine Injectable Suspension Peripheral Nerve Block Further Aid in Decreasing At-home Narcotic Utilization in Children and Adolescents After Anterior Cruciate Ligament Reconstruction.

Background: Opioid misuse and addiction among children and adolescents is an increasingly concerning problem. This study sought to determine whether liposomal bupivacaine injectable suspension admixture administered as a single-shot adductor canal peripheral nerve block (SPNB+BL) would decrease utilization of at-home opioid analgesics after anterior cruciate ligament reconstruction (ACLR) in adolescents compared with single-shot peripheral nerve block with bupivacaine (SPNB+B) alone.

Methods: Consecutive ACLR patients with or without meniscal surgery by a single surgeon were enrolled.

Neighborhood disadvantage and pediatric inpatient opioid prescription patterns.

Background: To explore the role of children's residential environment on opioid prescribing patterns in a predominantly Latinx sample.

Methods: We connected geocoded data from electronic medical records in a diverse sample of pediatric patients to neighborhood environments constructed using latent profile modeling techniques. We then estimated a series of multilevel models to determine whether opioid prescribing patterns vary by residential context.

Impact of COVID-19 pandemic on pediatric healthcare burnout in acute care: a longitudinal study.

Background: COVID-19 pandemic introduced significant challenges that may have exacerbated healthcare worker (HCW) burnout. To date, assessments of burnout during COVID-19 pandemic have been cross-sectional, limiting our understanding of changes in burnout. This longitudinal study assessed change across time in pediatric HCW burnout during the COVID-19 pandemic and whether demographic and psychological factors were associated with changes in burnout.