Pediatric Reports

Purpose: Higher health literacy is associated with better health behaviors and better overall well-being; however, the contribution of relational and socio-economic factors to this association remains insufficiently explored. The present study aimed to examine the relationships between health literacy, well-being, social support, and stress among adolescents. In particular, the mediating roles of social support (family, peers, and teachers) and stress in the association between health literacy and well-being were analyzed. Participants and Methods: Data were drawn from the 2022 wave of the Health Behaviour in School-aged Children (HBSC) study, an international survey conducted every four years in collaboration with the World Health Organization (WHO) and implemented according to a standardized protocol. The sample comprised 7643 students from the 6th, 8th, 10th, and 12th grades of Portuguese public schools. Of the participants, 53.9% were female, and the mean age was 15.05 years (SD = 2.36). Gender-based comparisons indicated statistically significant differences for all study variables, with the exception of health literacy. Results: Mediation analysis reveals an effect of health literacy on well-being. After the inclusion of the mediating variables, the direct effect of health literacy on lack of well-being remained negative. All four mediators showed statistically significant indirect effects, accounting for the difference between the total and direct effects. These findings indicate that the association between health literacy and lack of well-being was partially mediated by family support, peer support, relationships with teachers, and stress. Health literacy influenced lack of well-being both directly and indirectly through these mediating pathways, with stress emerging as the strongest indirect contributor. Conclusions: The findings support an ecological interpretation of health literacy and well-being, as these constructs are embedded within multiple interacting systems. Individual adolescent characteristics, such as gender, age, and stress management, are interconnected with interpersonal contexts, including relationships with family members, peers, and teachers. In addition, adolescents’ socio-economic circumstances appear to play a relevant role in shaping both health literacy and perceptions of well-being.

Background: Pediatric lymphomas comprise a heterogeneous group of malignancies with substantial variation in their clinical presentation. In Mexico, detailed case-based characterization remains limited. This study summarizes the demographic and clinical characteristics of pediatric lymphomas diagnosed at a national referral center over an 11-year period. Methods: We conducted a retrospective review of lymphoma cases in children aged 0–17 years diagnosed at the Children’s Hospital of Mexico between 2004 and 2014. Cases were classified according to the ICCC-3 system and further described by histopathological subtype, age group, sex, and clinical outcomes. Results: Hodgkin lymphoma (HL) was the most frequent diagnosis, followed by non-Hodgkin lymphoma (NHL). Among HL cases, nodular sclerosis and mixed cellularity predominated, particularly in school-age children and adolescents. Within NHL, precursor T-cell lymphoma represented the largest subgroup, whereas mature B-cell lymphomas, such as diffuse large B-cell lymphoma, were less common than typically reported in high-income settings. Burkitt lymphoma occurred mainly among younger children. HL showed high survival, while some NHL subtypes exhibited poorer outcomes. Conclusions: This large hospital-based case series provides characterization of pediatric lymphomas in a major Mexican referral center. While HL subtype patterns resembled global trends, the predominance of precursor T-cell lymphomas within NHL contrasts with observations from high-income regions. These findings highlight the value of institutional case registries and the need for more comprehensive outcome reporting in future studies.

Background/Objectives: High-quality pediatric emergency care requires timely access, effective communication, privacy, pain management, comfort, and child- and family-centered practices; however, implementation may be constrained by several barriers. The aim of the study was to evaluate the quality of pediatric emergency care as perceived by healthcare professionals, with emphasis on child-centered care and variations based on workplace and professional characteristics. Methods: A cross-sectional survey was performed in the emergency departments in two tertiary public pediatric hospitals in Athens, Greece. A study-developed 14-item Quality of Care Assessment Scale with paired ratings of agreement with quality principles and implementation in practice was completed by 162 professionals (122 doctors, 24 nurses, 16 assistant nurses). Independent items evaluated perceived barriers, overall assessments (0–100), and information provided to parents/children (5-point Likert scale). Inferential tests and descriptive statistics were also used (p < 0.05). Results: There was a significant degree of agreement with quality principles, but there was a constant lack of implementation (principle–practice gap). The primary perceived weakness was waiting times; child-friendly settings and privacy during examinations and information-giving were also lacking. Internal consistency ranged from good to acceptable (implementation α = 0.800; agreement α = 0.711). Children were most frequently rated as “moderately informed” (48.1%), while parents were most frequently rated as “quite informed” (50.0%). Compared to the organization of care (mean 60.85), perceived safety was higher (mean 73.27). Perceptions varied by age, educational level, profession, department, shift rotations, and hospital. The main barriers were workload (30.2%), poor coordination (34.0%), and lack of resources (46.9%). Conclusions: Health professionals seem to perceive that consistent delivery of child-centered care is impaired by organizational and structural limitations. Reducing the standards-to-practice gap requires targeted system-level interventions that focus on staffing, care organization, environment, and professional support.