Exploring the role of the rock climbing Treadwall as a novel therapy tool in physical rehabilitation.

Background: Rock climbing offers numerous health benefits, but accessibility and safety concerns limit its therapeutic use, especially for individuals with disabilities. No prior studies have explored the potential benefits of integrating the Treadwall, a rotating climbing wall with improved accessibility and safety, into rehabilitation protocols.

Objective: To evaluate the safety and feasibility of implementing a Treadwall climbing intervention as a novel therapy tool for children with hemiplegic cerebral palsy.

On the prevalence and magnitude of resurgence during delay-and-denial tolerance teaching.

Resurgence is the recurrence of target behavior (e.g., challenging behavior) during a worsening of reinforcement conditions (e.

Assessments of working group effectiveness in the planning of the New Jersey Kids Study: An applied mixed-methods study on the science of team science.

Introduction: The New Jersey Kids Study (NJKS) is a transdisciplinary statewide initiative to understand influences on child health, development, and disease. We conducted a mixed-methods study of project planning teams to investigate team effectiveness and relationships between team dynamics and quality of deliverables.

Methods: Ten theme-based working groups (WGs) (e.

The application of quality improvement concepts, strategies, and tools to enhance participation in clinical trials among Latino families.

Underrepresentation of people from racial and ethnic minoritized groups in clinical trials threatens external validity of clinical and translational science, diminishes uptake of innovations into practice, and restricts access to the potential benefits of participation. Despite efforts to increase diversity in clinical trials, children and adults from Latino backgrounds remain underrepresented. Quality improvement concepts, strategies, and tools demonstrate promise in enhancing recruitment and enrollment in clinical trials.

Resistance is reality: findings from the first Ukrainian cumulative antibiogram.

Background: Antimicrobial resistance is a global health threat resulting in significant morbidity and mortality worldwide. Until recently, in Ukraine, cumulative antibiograms (CuAbgms) have never been available.

Objectives: To describe the first CuAbgm developed in Ukraine.

Teaching trainees to implement functional communication training with multiple schedules: An evaluation of training effects and durability.

We evaluated the effects of behavioral skills training on improving participant implementation of functional communication training with multiple schedules when working with a confederate. Behavioral skills training produced mastery-level responding for all six participants who required training, providing the first empirically supported training for this functional communication training approach. Next, we assessed durability during training challenges with (a) procedural changes to the original protocol, (b) a novel confederate with different discriminative stimuli and reinforcers, and (c) relapsed confederate destructive behavior.

Saudi consensus guidance for the diagnosis and management of inflammatory bowel disease in children and adolescents.

The management of inflammatory bowel disease (IBD) in children and adolescents is challenging. Clear evidence-based guidelines are required for this population. This article provides recommendations for managing IBD in Saudi children and adolescents aged 6-19 years, developed by the Saudi Ministry of Health in collaboration with the Saudi Society of Clinical Pharmacy and the Saudi Gastroenterology Association.

CffDNA screening for Niemann-pick disease, type C1: a case series.

Cell-free fetal DNA (cffDNA) screening is a valuable tool in clinical practice for detecting chromosomal abnormalities and autosomal dominant (AD) conditions. This study introduces a novel proof-of-concept assay designed for autosomal recessive (AR) cffDNA screening, focusing on cases involving the NPC1 gene. We aim to illustrate the significant benefits of AR cffDNA screening in managing high-risk pregnancies, specifically where biallelic pathogenic variants in NPC1 cause Niemann-Pick disease, type C1 (NPC), a disorder marked by progressive neurodegeneration.

Toward More Equitable Care: A Closer Look at Autism Clinic Intake Practices and Paperwork.

Objective: To describe intake requirements among autism clinics and to assess how well intake paperwork aligns with national standards for enhancing language and literacy accessibility.

Methods: This was a survey of 126 autism clinics in the Children's Hospital Association, assessing intake processes and intake paperwork readability conducted between November 2021 and August 2022. Descriptive analyses characterized intake requirements and paperwork components.

Patterns and unique features of infantile cholestasis among Arabs.

Background: Most of the literature on infantile cholestasis (IC) originated from Caucasian and Asian populations. The differential diagnosis of IC is very broad, and identification of etiology is challenging to clinicians because the list includes many entities with overlapping clinical, biochemical, and histological features. Thus, a structured, stepwise diagnostic approach is required to help early recognition and prompt evaluation and management of treatable causes of cholestasis.

Parents' Perspectives on Early Relational Health: A Qualitative Study.

Objective: The American Academy of Pediatrics endorses a paradigm shift toward promoting early relational health (ERH) in pediatrics. Pediatric clinicians have a unique opportunity to promote ERH, yet little work has sought parents' perspectives on how clinicians can do so effectively. We sought to understand diverse parents' perspectives on ERH and the role of pediatric clinicians in supporting it.

Knowledge, attitude, and practice toward pediatric vitamin D deficiency among parents.

Objective: To investigate the knowledge, attitude, and practice (KAP) towards pediatric vitamin D deficiency (VitD) among parents and explore the risk factors of their knowledge, attitude, and practice.

Methods: This cross-sectional study enrolled parents in our Hospital between November 2022 and January 2023.

Results: A total of 621 valid questionnaires were collected in this study.

No one really plans to have multiple sclerosis: Transition readiness and quality of life in paediatric multiple sclerosis.

Aim: We sought to explore the experiences and perceptions of the quality of life of adolescents with pediatric-onset multiple sclerosis and assess their readiness for academic, employment and/or health care-related transitions.

Background: Adolescents with pediatric-onset multiple sclerosis face unique challenges in managing a chronic illness while navigating future scholastic, social and occupational goals. We conducted a qualitative study with in-depth, semi-structured interviews from July 2017 to March 2019.

Experiences of patients, parents, and healthcare professionals in the process of transitioning from hospital to community after inpatient pediatric rehabilitation among children with special health care needs.

Purpose: Children with Special Health Care Needs (CSHCN) may experience disruptions in education due to extended hospitalizations. The purpose of this study was to describe how CSHCN experience educational supports during inpatient rehabilitation and identify the ongoing challenges when planning to return to school.

Materials And Methods: Semi-structured focus groups were conducted with parents ( = 12), former patients ( = 20), and rehabilitation professionals ( = 8).

Middle Eastern Expert Opinion: Strategies for Successful Antifungal Stewardship Program Implementation in Invasive Fungal Infections.

In recent years, global public health efforts have increasingly emphasized the critical role of antimicrobial stewardship (AMS) in improving outcomes, reducing costs, and combating the growing threat of antimicrobial resistance. However, antifungal stewardship (AFS) has remained relatively overlooked despite the staggering impact of invasive fungal infections (IFIs). This burden is particularly pronounced in hospitals worldwide, with the Middle East facing significant unmet needs.

Trends in C reactive protein testing: a retrospective cohort study in paediatric ambulatory care settings.

Objectives: This study aims to investigate C reactive protein (CRP) testing practices in paediatric ambulatory care across British primary care and accident and emergency (A&E) departments.

Design, Setting, Participants: This retrospective cohort study included children <18 years old having ≥1 CRP test at primary care or A&E departments in Oxfordshire between 2007 and 2021.

Outcomes: We estimated the frequency and annual changes in CRP testing in both settings and evaluated referral and admission patterns based on CRP levels: low (<20 mg/L), intermediate or high (≥80 mg/L).

Screening Options in Autism Telediagnosis: Examination of TAP, M-CHAT-R, and DCI Concordance and Predictive Value in a Telediagnostic Model.

Tele-assessment of autism in early childhood has increased. However, it is unclear how autism screening tools (M-CHAT-R, DCI) function as part of tele-assessment and relate to a commonly used tele-assessment instrument, the TAP. 361 families from a clinically referred sample of children (mean age: 27.

Eosinophilic esophagitis: Current concepts in diagnosis and management.

Eosinophilic esophagitis is an antigen-mediated chronic inflammatory disorder that has risen in incidence and prevalence over the past 2 decades. The clinical presentation is variable and consists of mainly esophageal symptoms such as dysphagia, heartburn, food impaction, and vomiting. Current management relies on dietary elimination, proton-pump inhibitors, and topical corticosteroids with different response rates and relapses after treatment discontinuation.

Resurgence of destructive behavior following decreases in alternative reinforcement: A prospective analysis.

Basic and retrospective translational research has shown that the magnitude of resurgence is determined by the size of the decrease in alternative reinforcement, with larger decreases producing more resurgence. However, this finding has not been evaluated prospectively with a clinical population. In Experiment 1, five participants experienced a fixed progression of reinforcement schedule-thinning steps during treatment of their destructive behavior.

Scoping Review: Digital Mental Health Interventions for Children and Adolescents Affected by War.

Objective: More than 200 million children and adolescents live in countries affected by violent conflict, are likely to have complex mental health needs, and struggle to access traditional mental health services. Digital mental health interventions have the potential to overcome some of the barriers in accessing mental health support. We performed a scoping review to map existing digital mental health interventions relevant for children and adolescents affected by war, to examine the strength of the evidence base, and to inform the development of future interventions.

Infected pulmonary hydatid cyst: A challenging diagnosis.

Echinococcosis is a parasitic infection that is distributed worldwide. Its clinical presentation depends on the size and location of the cyst. A 7-year-old was found with a superimposed infected pulmonary hydatid cyst that was initially misdiagnosed as complicated pneumonia.

Design and Implementation of an Opt-Out, End-to-End, Preemptive Testing Program for Patients Planned for a Systemic Fluoropyrimidine.

Purpose: Several allelic variants of the gene encoding dihydropyrimidine dehydrogenase (DPD) are associated with impaired metabolism of the systemic fluoropyrimidine fluorouracil (5FU) and its oral prodrug, capecitabine, which elevates the risk for severe toxicity. Following a patient death related to capecitabine toxicity in which DPD deficiency was suspected, a multidisciplinary advisory panel was convened to develop an institution-wide approach to future patients planned for a systemic fluoropyrimidine.

Methods: The panel selected an opt-out testing strategy which focused on developing reliable processes to collect and report test results and targeted education.

A demonstration of incorporating discriminative stimuli into an AAC device during functional communication training.

Functional communication training (FCT) is an effective intervention for teaching communication responses and reducing challenging behavior. One limitation of FCT is that frequent reinforcement may be impractical or impossible in many situations. Recently, Mitteer et al.