Elizabethkingia species often exhibit extensive antibiotic resistance and result in high morbidity and mortality, yet no systematic reviews exist that thoroughly characterize and quantify concerns for infected infants and children. We performed a review of literature and identified an initial 902 articles; 96 articles reporting 283 pediatric cases met our inclusion criteria and were subsequently reviewed. Case reports spanned 28 countries and ranged from 1944 to 2017. Neonatal meningitis remains the most common presentation of this organism in children, along with a range of other clinical manifestations. The majority of reported cases occurred as isolated cases, rather than within outbreaks. Mortality was high but has decreased in recent years, although neurologic sequelae among survivors remains concerning. Child outcomes can be improved through effective prevention measures and early identification and treatment of infected patients.

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1407 children from birth through age 6 in the “Alli Kiru” program (2011–2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth (dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for being underweight (Adjusted Odds Ratio (AOR): 1.27; 95% CI: 1.02–1.54) and decreased odds for being overweight (AOR: 0.76; 95% CI: 0.58–0.97). This relationship was most pronounced among 3–6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions.

Objectives: The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. Methods: We analyzed data from the National Pediatric Readiness Project, a nationally representative cross-sectional survey of US EDs. Nurse managers reported whether their hospitals had a policy to care for children with social/mental health concerns (n = 3612). We calculated prevalence estimates, prevalence ratios (PRs), and confidence intervals (CIs) for regional and ED characteristics (eg, rurality and types of personnel) by whether EDs had a pediatric mental health care policy. Results: Overall, 46.2% (n = 1668/3612) of EDs had a pediatric mental health care policy. Emergency departments located in remote areas were 60% less likely to have such a policy compared with EDs in urban areas (PR, 0.4; CI, 0.3–0.5). Emergency department characteristics associated with having a pediatric mental health care policy included having a policy to transfer children with social/mental health concerns (PR, 5.4; CI, 4.7–6.2), having a policy to address maltreatment (PR, 3.4; CI, 2.6–4.4), and having nurse and physician pediatric emergency care coordinators (PR, 1.6; CI, 1.5–1.8). Conclusions: Lower prevalence of pediatric mental health policies in rural EDs is concerning considering EDs are often the first point of contact for pediatric patients. This work highlights the importance of pediatric emergency care coordinators in fostering ED capacity to meet children's mental health needs.

Background: Exclusionary discipline (ED) has long been an educational equity concern, but its relationship with student health and protective factors is less understood.Methods: Using population‐based public school student data (N = 82,216), we examined associations between past‐month ED and positive depression and anxiety screening instrument results. We also assessed whether each of 9 potential protective factors moderated the ED‐mental health relationship by testing interaction effects.Results: Over 1 in 10 youth experienced past‐month ED, with variation by sex, gender identity, special education status, poverty, region, race/ethnicity, and adverse childhood experiences. Net of sociodemographic factors, youth who experienced ED had higher likelihood for current depression (adjusted odds ratio [AOR]: 1.64, 95% confidence interval [CI]: 1.55, 1.73) and anxiety (AOR: 1.49, 95% CI: 1.41, 1.58) symptoms. Significant associations were robust across 5 racial/ethnic groups, except for anxiety among American Indian/Alaska Native youth. Individual, interpersonal, and school‐level protective factors appeared to mitigate depression and anxiety regardless of disciplinary experience.Implications for School Health Policy, Practice, and Equity: Our findings document ED disproportionality and possible ramifications for emotional well‐being.Conclusions: In concert with structural efforts to reduce reliance on ED, strategies that bolster protective factors may support youth already impacted by ED and/or mental health problems.