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Aim: Nosocomial infections (NIs) and multidrug resistant (MDR) pathogens are an important paediatric healthcare issue. In vulnerable patients such as children with life-limiting conditions, MDR infections can be life-threatening. Additionally, these children have a significantly increased risk for colonisation with MDR pathogens. Therefore, it is vital to prevent new colonisations with MDR pathogens in this vulnerable patient group. However, little is known about colonisation with MDR pathogens and NIs in inpatient units for paediatric palliative care (PPC). The aim of this study was to investigate the prevalence of colonisation with MDR pathogens and the incidence of NIs in a PPC unit.Methods: Evaluation of surveillance data of a PPC unit. All patients admitted to a PPC unit from 1 April 2012 to 31 March 2013 were screened for MDR pathogens upon admission. Patients who exhibited clinical signs of an infection during their inpatient stay were screened again. Results: During the study period, 198 cases were admitted to the unit. Those cases represent 118 patients. 18% of the patients were colonised with MDR pathogens. The most common MDR pathogens were (8.1%) and (8.1%). In addition, 58% of patients with tracheostomy had MDR pathogens in their tracheal secretions. The incidence density of NIs was 0.99 per 1000 inpatient treatment days with no NI caused by MDR pathogens.Conclusion: Due to a high prevalence, it is reasonable to screen PPC patients for MDR pathogen colonisation before or during admission. Special attention must be given to patients with tracheostomy. Our results provide preliminary evidence that participation in social activities in a PPC unit for patients colonised with MDR pathogens is safe if hygiene concepts are applied.

Background/Objectives: The use of digital media, and especially social media, has been increasing over recent years. Previous research has reported a negative impact of media use on headaches; however, most of these studies are cross-sectional. Therefore, we conducted a longitudinal study to explore the relationship between different types of media usage (watching videos, gaming, and social media) and headache frequency and headache intensity over time. Methods: School-aged children from five German schools completed five assessments between 2017 and 2018. In total, N = 575 (72.9% female; Mage = 13.3, SDage = 1.86) children and adolescents reporting consistent headaches across all assessments were analyzed. Multilevel linear modeling was used to assess the relationships between media use and headache frequency and intensity over time. Results: There were only minor associations between media use and headache intensity or frequency. Notably, only high social media usage was linked with worse headache intensity (t(1989) = 4.109, p < 0.001). Conclusions: The impact of media use on headaches seems to be less harmful than previous research might suggest. We believe that increased time spent consuming media should not be considered a risk factor for pain conditions but rather a helpful resource for pain management. [ABSTRACT FROM AUTHOR]

Background/Objectives: Patients with life-limiting conditions (LLCs) often suffer from restlessness, spasticity, pain, and seizures. Dronabinol (DRB) may have a relieving effect; however, data on the effectiveness of DRB in children with LLCs are limited to outpatients. The aim of this study was to assess the efficacy and safety of DRB. Methods: Retrospective analysis of inpatients. Results: From 2011 to 2021, 1219 patients were admitted. Of these, 63 patients (63.5% male, age: 10.4 (SD = 6.3) years) were treated with DRB; 96.8% had a neurological disease, and 26 patients were started on DRB (group A), while 37 were admitted with existing DRB (group B). The effective doses were 0.21 (SD = 0.11) in group A and 0.48 (SD = 0.5) mg/kg/BW/day in group B (p = 0.01). Subjective response rates to DRB in both groups (good/moderate effect) were 9.5%/38.1% for spasticity and 1.6%/25.4% for restlessness. However, no reduction in seizures, restlessness, or demand medication was observed in 24 h protocols when patients started DRB in group A. Three patients experienced severe side effects (e.g., respiratory depression). Other side effects included fatigue (22.2%) and behavioral problems (14.3%). Conclusions: Subjective positive effects could not be confirmed by more objective data. Side effects can be severe. Thus, DRB should be started in a well-monitored setting and only with clear indications. [ABSTRACT FROM AUTHOR]

Background: Abdominal pain is a common and often debilitating issue for children and adolescents. In many cases, it is not caused by a specific somatic condition but rather emerges from a complex interplay of bio-psycho-social factors, leading to functional abdominal pain (FAP). Given the complex nature of FAP, understanding its origins and how to effectively manage this condition is crucial. Until now, however, no questionnaire exists that targets knowledge in this specific domain. To address this, the Abdominal Pain Knowledge Questionnaire (A-PKQ) was developed. Methods: Two versions were created (one for children and one for parents) and tested in four gastroenterology clinics and one specialized pain clinic in Germany between November 2021 and February 2024. Children between 8 and 17 years of age (N = 128) and their accompanying parents (N = 131) participated in the study. Rasch analysis was used to test the performance of both versions of the questionnaire. Results: The original questionnaires exhibited good model and item fit. Subsequently, both questionnaires were refined to improve usability, resulting in final versions containing 10 items each. These final versions also demonstrated good model and item fit, with items assessing a variety of relevant domains. Conclusion: The A-PKQ is an important contribution to improving assessment in clinical trials focused on pediatric functional abdominal pain. [ABSTRACT FROM AUTHOR]

Chronic pain in the vulnerable phase of emerging adulthood is associated with severe life impairments. The current healthcare system has no suitable treatments for young people. A new multimodal inpatient and app-supported treatment for young people with chronic pain counteracts this. The study examines the effectiveness of this new treatment. Our mixed-methods design combined qualitative and quantitative evaluations. The sample comprised N = 44 patients (18–25 years) who took part in the new treatment. The quantitative data showed a reduced degree of pain severity, pain-related and emotional impairments, and an improved quality of life. The qualitative data showed that several components of the new treatment were particularly important to the young adults: individuality and taking the patient seriously, group therapy with peers, individual therapies (psychological, medical), life counselling, and sports. Results support the individual and objective success of a new inpatient pain treatment applied during emerging adulthood. [ABSTRACT FROM AUTHOR]

Objectives: Anxiety and depression are internalizing mental disorders often commencing in childhood and manifesting in adolescence. The Revised Anxiety and Depression Scale (RCADS) is an internationally widely used standardized diagnostic tool, but the German version has only been validated in a pediatric chronic pain sample; normative data are not available. The aim of this study is to test its reliability (internal consistency) and validity (factorial, convergent, known‐groups) in a representative German school sample and to provide norm data. Methods: Data were collected from N = 1562 German schoolchildren (Mage = 12.2; SDage = 2.33; range 8–17 years; 52.4% girls). Results: Cronbach's α ranged from 0.73 to 0.96 for the total and the six subscales (five anxiety and one depression). Confirmatory factor analysis showed the 6‐factor model had acceptable to good model fit with CFI = 0.93, TLI = 0.93, RMSEA = 0.05, SRMR = 0.05, which was better than 1‐ and 2‐factor models. The (sub)scales correlated moderate to high negatively with health‐related quality of life (−0.31 ≤ τ ≤ −0.51; p < 0.001) and positively with functional impairment (0.31 ≤ τ ≤ 0.48; p < 0.001). Mean scores of anxiety and depression scales were significantly higher in girls and partly in adolescents. Conclusion: Findings provide support for the good psychometric properties of the German RCADS in a community sample. [ABSTRACT FROM AUTHOR]