Physical Activity and Sports Participation among Children and Adolescents with Disabilities
Approximately 25% of children in the United States participate in appropriate amounts of physical activity. That percentage is even lower for children with disabilities. Adaptive sports and physical activity opportunities are increasing in the United States. Health care providers are encouraged to discuss physical activity in the clinical setting and to help to promote physical activity for all individuals, including children with disabilities. (Source: Pediatric Clinics of North America)
Source: Pediatric Clinics of North America - March 19, 2023 Category: Pediatrics Authors: Mary E. Dubon, Stephanie Tow, Amy E. Rabatin Source Type: research
Chronic Pain in Children
Chronic pain in children is a relatively prevalent cause of functional disability. Contributing factors to this pain are best viewed through the biopsychosocial model. Although evidence is lacking for individual aspects of treatment, interdisciplinary care is considered the best treatment approach for children with chronic pain. Interdisciplinary care can include medication management with daily and as-needed medications, physical and occupational therapy focusing on function and movement, and psychological treatment with cognitive-behavioral therapy and acceptance focused treatment. In children with severe pain and disabi...
Source: Pediatric Clinics of North America - March 19, 2023 Category: Pediatrics Authors: Andrew B. Collins Source Type: research
Introduction to Limb Deficiency for the Pediatrician
Owing to the lack of trained professionals in amputee care, the pediatrician is often required to assist in the care of children with limb deficiencies. An overview of the causes and epidemiology of limb deficiency is provided, as well as an evaluation and diagnostic workup. Important considerations for surgical interventions are discussed and an introduction to prosthetic prescribing and care of the amputee is described. Common overuse syndromes and mental health issues are also reviewed. Finally, resources for funding of prosthetic devices, as well as support and education for clinicians and families are provided. (Sourc...
Source: Pediatric Clinics of North America - March 19, 2023 Category: Pediatrics Authors: Phoebe Scott-Wyard Source Type: research
Evaluation and Treatment of the Child with Acute Back Pain
Back pain is common, in up to 30% of children, increasing with age. Eighty percent is benign, mechanical type, improving within 2 weeks of conservative care. Required for those not improving is in-depth evaluation, including MRI, laboratory, and peer consultations. Spondylolysis and spondylolisthesis comprise almost 10% of pediatric back pain, often caused by lumbar hyperextension activities and treated conservatively in mos t cases. Osteoid osteomas and osteoblastomas constitute the most common benign spinal tumors in childhood. Aggressive and malignant tumors of the spine are rare but when present require tertiary care...
Source: Pediatric Clinics of North America - March 19, 2023 Category: Pediatrics Authors: Kevin P. Murphy, Cristina Sanders, Amy E. Rabatin Source Type: research
Promoting Recovery Following Birth Brachial Plexus Palsy
Neonatal brachial plexus palsies (NBPP) occur in 1.74 per 1000 live births with 20% to 30% having persistent deficits. Dysfunction can range from mild to severe and is correlated with the number of nerves involved and the degree of injury. In addition, there are several comorbidities and musculoskeletal sequelae that directly impact the overall functional development. This review addresses the nonsurgical and surgical management options and provides guidance for pediatricians on monitoring and when to refer for specialty care. (Source: Pediatric Clinics of North America)
Source: Pediatric Clinics of North America - March 19, 2023 Category: Pediatrics Authors: Marisa Osorio, Sarah Lewis, Raymond W. Tse Source Type: research
Congenital and Acquired Spinal Cord Injury and Dysfunction
Pediatric spinal cord injury and dysfunction (SCI/D) can result from atypical embryologic development or be acquired as the result of trauma, infection, autoimmune conditions, and tumors. The age of onset and causal mechanism of SCI/D has dramatic implications for function and risk of comorbidities throughout the lifespan. Optimal care of children with SCI/D is multidisciplinary and the pediatrician is a very important member of this team. This review highlights functional prognosis and important health maintenance issues to prevent complications and maximize independence. It is intended to assist the pediatrician in the c...
Source: Pediatric Clinics of North America - March 19, 2023 Category: Pediatrics Authors: Loren T. Davidson, Maya C. Evans Source Type: research
State of Vaccine Hesitancy in the United States
Although the term “vaccine hesitancy” has achieved great prominence, the extent to which US parents have reluctance, doubts, or indecision when it comes to vaccines recommended for children and how such hesitancy is manifest are unclear. A narrative review approach that placed emphasis on recent data and publishe d work is used to surface evidence and insights into the current state of US parent vaccine hesitancy. The assessment finds evidence that ∼6% to 25% of parents may be vaccine hesitant, that hesitancy is higher for influenza and HPV vaccines, and there are indications that addressing parent hesitan cy has bec...
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Glen J. Nowak, Michael A. Cacciatore Source Type: research
Human Papillomavirus Vaccine Hesitancy in the United States
Although the US Advisory Committee on Immunization Practices recommends vaccinating adolescents against the human papillomavirus (HPV) to prevent HPV-associated cancers, vaccine initiation and completion rates are suboptimal. Parental and provider hesitancy contributes significantly to low HPV vaccine uptake. This review describes sources of HPV vaccine hesitancy using a World Health Organization framework that categorizes determinants of vaccine hesitancy as follows: contextual factors (historical, sociocultural, environmental, or political factors), individual and group factors (personal perception or influences of the s...
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Daisy Y. Morales-Campos, Gregory D. Zimet, Jessica A. Kahn Source Type: research
Influenza Vaccine Hesitancy
Influenza vaccination rates in children are suboptimal. One underlying reason is influenza vaccine hesitancy. Tools such as the Parent Attitudes about Childhood Vaccines survey and the Vaccine Hesitancy Scale can be used to measure influenza vaccine hesitancy. The adapted Increasing Vaccination Model from Brewer and colleagues can help identify factors that influence influenza vaccine hesitancy, motivation, and uptake. Several strategies can be used to address influenza vaccine hesitancy, which we discuss further in this review. (Source: Pediatric Clinics of North America)
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Ashley B. Stephens, Annika M. Hofstetter, Melissa S. Stockwell Source Type: research
Maternal Vaccination and Vaccine Hesitancy
The American College of Obstetrics and Gynecology recommends influenza vaccine annually, Tdap with each pregnancy, and COVID-19 vaccine for those not previously vaccinated or who are due for boosters. The influenza and COVID-19 vaccines are safe during pregnancy and are effective in reducing morbidity in both the pregnant person and infant. The Tdap vaccine is given primarily to protect the newborn from pertussis through transplacental antibody transfer. Methods to enhance vaccination rates include stocking and giving vaccines in the obstetric office, recommending eligible vaccines at each visit, and focusing on the health...
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Cynthia M. Rand, Courtney Olson-Chen Source Type: research
A Structural Lens Approach to Vaccine Hesitancy and Identity
Vaccine hesitancy is an increasing global health threat, and to improve vaccine uptake, it is critical to account for identity-based considerations including racial and ethnic, religious, and contemporary socio-political identities. Using critical consciousness to create awareness of the diverse cultural viewpoints on vaccines can help providers have conversations that are identity aware, equity-focused, and linguistically sensitive with their patients. It is necessary to collaborate with patients, families, communities, and community leaders to share information about vaccines, their safety profiles, and on how to have va...
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Jennifer D. Kusma, Leslie Walker-Harding, Maria Veronica Svetaz, Tamera Coyne-Beasley Source Type: research
Adolescents, Young Adults, and Vaccine Hesitancy
This article reviews the importance of vaccination for adolescents and young adults, the variability in uptake of different vaccines, the reasons for vaccine hesitancy for this age group, and the legal framework for consent for vaccination. One important difference between vaccine hesitancy for adolescents and hesitancy for younger children or adults is the unique developmental, clinical, ethical, and legal context in which the decision to vaccinate is made. (Source: Pediatric Clinics of North America)
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Abigail English, Amy B. Middleman Source Type: research
Using Technology to Overcome Vaccine Hesitancy
Technology holds great potential to address many vaccine hesitancy determinants and support vaccine uptake given its ability to amplify positive messages, support knowledge, and enhance providers ’ recommendations. Modalities previously implemented with variable success have included automated reminder systems, decision support for clinicians, online education programs, social media campaigns, and virtual reality curricula. Further research is needed to identify the optimal uses of technol ogy at the patient/parent and provider levels to overcome vaccine hesitancy. The most effective interventions will likely be multipro...
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Francis J. Real, Matthew W. Zackoff, Brittany L. Rosen Source Type: research
Clinician Communication to Address Vaccine Hesitancy
There are several factors that influence childhood vaccine uptake. Pediatric clinicians play a particularly influential role in parent vaccine decision-making. It is critical therefore that pediatric clinicians have a “communication toolbox”––a set of effective, evidence-based communication strategies to facilitate uptake of childhood vaccines––that they can use in conversations with parents about vaccines. In this article, recent advances in our understanding of what constitutes effective clinician v accine communication with parents are discussed. (Source: Pediatric Clinics of North America)
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Douglas J. Opel Source Type: research
Training Residents and Medical Students to Overcome Parents ’ Vaccine Hesitancy
Strong provider recommendations increase vaccine confidence. Medical students and pediatric residents, as future physicians, will play an important role in the messaging about vaccines to their parents and patients. The importance of inclusion of vaccine education and communication skills in the medical school curriculum and residency training programs must be recognized to ensure provider confidence in discussions with vaccine-hesitant parents and patients. (Source: Pediatric Clinics of North America)
Source: Pediatric Clinics of North America - February 24, 2023 Category: Pediatrics Authors: Amisha Malhotra, Patricia Whitley-Williams Source Type: research
