Maktab education serves many purposes. It provides the substantive knowledge thought to be compulsory for Muslim pupils. Its functional role is to enable them, through varied learning processes, to embody elements of their faith and live as Muslims. Hitherto, systematic attention to curricula in primary maktab education has been rare. This ground-breaking research makes an original contribution to this under-researched area. It examines three curricula operative in the British context. In part, it presents findings on the structural and organizational features, aims and objectives of learning, pedagogical snippets and the taught content. However, the focus is on discerning matters related to the conception of social justice by addressing questions such as what Muslim children are taught about justice and injustice from a vertical and horizontal plane. Documentary thematic and descriptive analysis will be applied to simplify the content, identify patterns, determine contexts, and gain a better understanding of these teachings. The findings suggest that these curricula instil prosocial values ostensibly at the micro-level and, to some degree, at the macro level.
ABSTRACT IMPACT: To identify potential facilitators and barriers to a successful transition in care. OBJECTIVES/GOALS: Improvements in care for children with sickle cell disease (SCD) have increased survival into adulthood. However, mortality rates are increasing in young adults. One of the challenges is providing appropriate care during transition from pediatric to adult care. The goal is to identify facilitators and barriers to a successful transition in care. METHODS/STUDY POPULATION: The UAB SCD Center serves a large area of Alabama. The pediatric program is in Birmingham and has outreach clinics in three other cities. The adult program only has one clinic located in Birmingham. With IRB approval, we performed a retrospective chart review of individuals with SCD (all genotypes) aged 18-24 (as of 1/31/2019) who were seen at least twice prior to age 18 (in pediatrics) and have confirmed SCD. Charts were reviewed for demographics, genotype, last known insurance, SCD therapy, clinic location, and transition status. Analyses were undertaken to determine predictors of successful transition (defined as coming to an appointment with an adult hematologist) and unsuccessful transition (defined as lost to follow-up (LTFU) without transfer of care). RESULTS/ANTICIPATED RESULTS: There were 544 individuals meeting inclusion criteria. Of this group, 234 were LTFU, 189 transitioned, 36 moved, and 15 died. Seventy patients are still under pediatric care and were excluded. Sixty-eight percent of patients that transitioned had their last pediatric visit in Birmingham, compared to only 32% of those that transitioned from outreach sites (p<.01). Patients were more likely to successfully transition if they had sickle cell anemia (HbSS or HbSß0) (p<.01) and if they were receiving hydroxyurea or chronic transfusion therapy (p<.01). DISCUSSION/SIGNIFICANCE OF FINDINGS: Geography, genotype, and SCD therapy are potential drivers for transition. Genotype in pediatrics likely confers disease severity, suggesting patients with worse SCD may be more likely to successfully transition. Novel strategies are needed to improve transition of care for patients outside of Birmingham and those with less severe disease.
Background and objective Family-integrated care (FIC), grounded in the principles of family-centered care (FCC), has become an important approach for supporting children and families during pediatric intensive care. Although post-intensive care syndrome in pediatrics (PICS-p) provides one important rationale for family engagement, the scope of FIC extends beyond PICS-p to include bedside participation, communication, shared decision-making, rehabilitation, psychosocial support, and transition planning. This narrative review aims to synthesize current applications, reported benefits, implementation barriers, and future priorities for FIC in the pediatric intensive care unit (PICU). Methods We conducted a narrative review of literature on FIC/FCC in pediatric critical care. Searches were performed in PubMed/MEDLINE, CINAHL, Embase, Web of Science, and the Cochrane Library, with emphasis on contemporary literature from 2015 to April 2026 and inclusion of selected foundational papers when conceptually necessary. Eligible evidence included observational, qualitative, mixed-methods, quality-improvement, pre-post, interventional, guideline, and review literature relevant to family participation in PICU care. Key content and findings The review identifies several recurring themes: the transition from restricted visitation to partnership-based care; practical family participation in routine care, communication, shared decision-making, rehabilitation, and end-of-life contexts; patient- and family-centered outcomes; structural, cultural, linguistic, and resource-related barriers; and the role of interdisciplinary teams, institutional policy, staff education, and digital tools in supporting implementation. Conclusions Current evidence suggests that FIC may improve family experience, communication, parental confidence, and selected psychosocial outcomes, while its effects on long-term child outcomes and PICS-p require further pediatric-specific evaluation. Future work should prioritize clearer definitions, standardized implementation models, inclusive study designs, and pragmatic outcome measures that reflect both child and family priorities.
Abstract Background Significant variation exists in the duration of antibiotic therapy for children in ambulatory care settings. Understanding drivers of variation for common conditions such as community-acquired pneumonia (CAP) and urinary tract infection (UTI) is important to informing antimicrobial stewardship interventions. Methods A retrospective observational study was conducted of patients with CAP and UTI seen in outpatient clinics or discharged from the emergency room (ER) of a tertiary care children’s hospital network from 2016 – 2019. Diagnoses CAP and UTI were identified via ICD-10 coding. Only oral medications ordered for ≥ 3 and < 28 days were included. Multivariable logistic regression was performed to identify predictors of long antibiotic duration (defined as ≥ 10 days). Potential non-clinical drivers of longer duration included race, ethnicity, sex, primary language, and insurance status. Results A total of 2,104 prescriptions for CAP from 442 prescribers and 1,070 prescriptions for UTI from 314 prescribers were included. Antibiotic durations were ≥ 10 days in 59.9% and 47.6% of prescriptions for CAP and UTI, respectively. Long duration of therapy was more common in children discharged from the ER when compared to clinics for both CAP (OR 1.795, 95% CI: 1.107 - 2.929), and UTI (OR 5.149, 95% CI: 1.933 - 16.373). The proportion of patients with long duration of therapy increased with younger age for both diagnoses and decreased overall in the final year of the study. Race, gender, ethnicity, and primary language were not associated with prolonged duration of therapy. However, patients with Medicaid insurance were more likely to receive long duration of therapy for CAP (OR 1.337, 95% CI: 1.062 - 1.682) and UTI (1.654, 95%, CI: 1.181 - 2.325). Conclusion In pediatric patients in ambulatory care settings, younger age, care in the ER, and being insured through Medicaid were independently associated with prolonged duration of therapy for both UTI and CAP. Disclosures All Authors: No reported disclosures
OBJECTIVES/GOALS: Designed sampling from databases (DSD) methods have been used to cross-check electronic medical records for errors, structure study design, and, we hypothesize, can be used to make data collection for surgical quality metrics more efficient, particularly within national databases. We plan to apply statistical and DSD methods to accomplish the following aims: Identify the most important elements in managing post-operative pain Identify the most informative procedure or population-based targets to focus collection of additional, labor-intense detail surrounding adequacy of pain control (i.e., Patient Reported Outcome Measures (PROMs)). METHODS/STUDY POPULATION: Our study population includes all children, ages 1-18 years, captured in the National Surgical Quality Improvement Project-Pediatric (NSQIP-P) from 2019 to 2021. We plan to apply statistical (regression modeling) and DSD methods to accomplish the aims listed above. RESULTS/ANTICIPATED RESULTS: For Aim 1, we expect to identify patient, procedure, and perioperative pain management practices that influence postoperative pain. For Aim 2, we will focus on outcomes such as PROMs that are challenging to obtain. By applying DSD methods, we will identify specific procedure and/or population-based cohorts to capture PROMs and decrease data collection burdens, while maintaining power, as the project is scaled nationally to all of NSQIP-P. DISCUSSION/SIGNIFICANCE OF IMPACT: Data from this study will inform expansion of NSQIP-P to collect novel outcomes of clinical and societal importance without prohibitively increasing data collection burden.
Aim To understand the meanings attributed by mothers of children with cerebral palsy (CP) to their experiences of school inclusion. Method This was an exploratory, qualitative study guided by the theoretical framework of symbolic interactionism. Participants included 15 Brazilian women, all literate and over 18 years of age, who were mothers of 18 children with CP-including cases of multiple births, aged between 2 and under 19 years. Participants were recruited using snowball sampling. Data were collected through remote interviews guided by a semi-structured script and analysed using thematic content analysis. The study complied with all national and international ethical standards. Results Three themes emerged: (1) between desire and insecurity: uncertainties and possibilities of school inclusion; (2) inclusion in progress: navigating barriers, facilitators and maternal struggles; and (3) school inclusion: reflections on the ideal and the reality experienced by children and their mothers. Mothers assigned ambivalent meanings to school: on the one hand, a space for potential development and social interaction; on the other, an environment marked by structural and attitudinal limitations that compromise effective inclusion. Narratives of resilience, maternal advocacy and collaborative partnerships also emerged. Conclusion From the interactions of mothers with their children, the school and the socio-political context, meanings were constructed that symbolize school inclusion as a challenging process, permeated by barriers, few facilitators and ambivalence in the guarantee of this right. Recognizing this scenario may inform the adaptation of public policies and school practices, strengthening care for children with disabilities and their families.
Abstract Background/Aims Chilblain-like lesions (perniosis) have been reported frequently during COVID-19 pandemic in children and adolescents with no history of exposure to cold temperatures or underlying autoimmune conditions. Patients with these skin changes reported mild COVID-19 symptoms or previous contact with confirmed COVID-19 cases before they became symptomatic. In the majority of cases, a causal relationship between SARS-CoV-2 infection and chilblain-like lesion has not been proven. Methods Retrospective review of patients with chilblain-like lesions, possibly secondary to SARS-CoV-2 infection, presenting to a tertiary Adolescent Rheumatology service between January and August 2021. Results We identified five, male, adolescent patients (mean age, 16 years old) who presented with new onset of chilblain-like lesions affecting fingers, toes and heels in December 2020, which coincided with the peak of second wave of COVID-19 infection. One month prior to skin changes occurrence, 3 out of 5 patients experienced mild respiratory COVID-19-like symptoms and the rest of the patients were asymptomatic but were in contact with COVID-19 positive cases following outbreaks in schools. 1 of 3 symptomatic patients had a positive COVID-19 PCR test prior to skin manifestations. 2 out of 4 patients with heel lesions had deep, full thickness skin loss heel ulcers and 2 of 5 patients had superficially ulcerated lesions on a finger and toes, respectively, resulting in inability to attend school. None of the patients had any other symptoms or signs to suggest an underlying autoimmune connective tissue disorder. Demographics, clinical features and serological data are summarised in Table 1. One patient underwent a biopsy of heel ulcer which was histologically consistent with perniosis. In two patients (40%) chilblain like lesions resolved spontaneously within 2 months. Three patients (60%), with progressive ulcerated lesions, required various combinations of treatments with aspirin, calcium channel blockers (nifedipine), topical or oral steroids and hydroxychloroquine with complete resolution of symptoms within 6 months. Conclusion Chilblain-like lesions, including heel involvement associated with mildly symptomatic COVID-19 infection, have been reported before. Our mini-case series raises awareness of ulcerating chilblain like lesions possibly secondary to COVID-19 in adolescent patients, which require early recognition and instigation of treatment leading to better patient’s outcomes. P167 Table 1 Demographics, clinical, laboratory findings of patientsCaseAgeLesion locationCOVID-19 symptomsSARS-CoV-2 PCR / SARS-CoV-2 AbAutoimmune profile/ complement levelsTreatment/ skin symptoms resolution (months)116Fingers, toes, heelsNoNA/ NegativeANA positive (1:80) ENA negative anti-dsDNA normal, C3, C4 normalAspirin, prednisolone, nifedipine, hydroxychloroquine /6216fingers heels, toesNoNA/ NegativeANA negativePrednisolone, nifedipine/6318Toes, heelsrespiratoryPositive/NAANA negativeNil/1416Fingers, toesrespiratoryNegative/ NegativeANA positive (1:320) ENA negative anti- dsDNA normal C3, C4 normalNil/2516Fingers, toes, heelsrespiratoryNA/ NegativeANA negativenifedipine/6 NA: not available, PCR: polymerase chain reaction, SARS-CoV-2: severe acute respiratory syndrome coronavirus 2 Disclosure N. Gak: None. V. Choida: None. M. Leandro: None. D. Sen: None. C. Ciurtin: None. C. Fisher: None.
Objectives Although close to 1 in 10 children under age 2 gain excess weight and can remain overweight throughout life, engaging parents in early preventative interventions is challenging because they may not recognize the issue of overweight in infancy. This study aimed to inform knowledge about maternal perceptions of infant obesity, to investigate topics of interest for program content and identify barriers and facilitators to parental engagement. Methods Mothers (N = 240) of 0 to 24-month-old children completed an online cross-sectional survey. Results The majority of mothers were aware that overweight can affect infants, however most considered that excess weight becomes an issue only after 2 years of age and believed that parents should be more worried about their child being underweight than overweight. Mothers were also open to participating in a parenting program, were mostly interested in program content about promoting babies' health but not feeding, and preferred advertisements for positive parenting and promoting babies' health rather than preventing infant obesity. Conclusions for practice These findings can help to develop effective strategies to enhance parental engagement and optimize parenting interventions in infant obesity prevention research.
Background High readmission rates after child and adolescent inpatient treatment point to underrecognized issues in the post-discharge period. With a shift towards early reintegration in youth mental health care, the family environment youth return to is of particular importance for post-discharge outcomes, but there is currently a knowledge gap on family-level risk and protective factors in this context. Caregiver burden may act as a crucial mechanism linking family context to youth recovery. Methods and design The ReCoVer study investigates caregivers' perspectives on family care and youth mental health following inpatient psychiatric treatment (minimum 24-hour stay) of youth aged 7-21 in Germany, Austria, and Switzerland. In a mixed-methods design, ReCoVer combines a longitudinal panel survey with semi-structured interviews. Caregivers of youth who received inpatient mental health treatment (target N = 70) will be recruited during discharge planning or follow-up sessions within one month after discharge. At baseline (T0) and after three (T1) and six (T2) months, participants will report on youth outcomes, caregiver well-being, and family processes. Primary outcomes (inpatient readmission, mental health problems) will be analyzed with regard to the contribution of caregiver burden and other family factors. Interview and survey data will be synthesized to identify burden, resources, and needs of families around their child's return to home care. Discussion Results from this study are expected to provide insights into family challenges and their associations with youth mental health in the immediate and medium-term post-discharge period. Clinical trial registration https://clinicaltrials.gov/study/NCT06865573, NCT06865573.
Background Although Constraint-Induced Movement Therapy is increasingly recommended as an evidence-based, intensive treatment for children with hemiparesis, parent perspectives are lacking. I-ACQUIRE, a multicomponent form of Constraint-Induced Movement Therapy, involves substantial parent participation. Child outcomes from the United States 15-site I-ACQUIRE phase 3 clinical trial (2019-2025), partnered with a Parent Council, are presented elsewhere. Here, we examine complementary lived-experience parent data. Methods All parents (167) of infants/toddlers with perinatal arterial ischemic stroke and hemiparesis consented to child random assignment to usual treatment (UT), moderate-dose I-ACQUIRE (3 h/d, 5 d/wk over 4 weeks), or high-dose I-ACQUIRE (6 h/d). Parents completed assessments about life- and therapy-related stress, treatment concerns, observations of child progress, and perceived therapy-related responsibilities. Results Parents of children in the I-ACQUIRE moderate-dose (56) and high-dose group (58), compared with UT (53), reported lower rates of concerns or problems that therapy did not produce clear benefits (≤4% versus 18%), child-therapist interactions (≤2% versus 24%), and parent-therapist interactions (≤2% versus 6%). I-ACQUIRE versus UT parents had higher proportions of positive feelings that therapy was useful (94%-98% versus 83%); interesting (96%-98% versus 79%), important (94%-98% versus 85%), and fun (78%-84% versus 53%); and provided comforting (72%-83% versus 47%) and relaxing benefits (28%-31% versus 17%). In all groups, similar proportions reported their role was stressful (I-ACQUIRE 26%-28%, UT 32%), difficult (I-ACQUIRE 35%-48%, UT 38%), and tiring (I-ACQUIRE 48%-52%, UT 43%). General life stress scores were mostly in the moderate-range category, similar across groups. Conclusions Parents of I-ACQUIRE children reported higher positive feelings and notably fewer concerns about lack of benefits compared with UT. Across all groups, some parents (<52%) reported treatment-related stress, difficulty, and fatigue. These findings provide new perspectives from parents' lived experiences to help families and clinicians in treatment decision-making. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03910075.
