Bubble Wrap PLUS – August 2025

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). 

This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

How much stress can we induce in our interns and assistants without jeopardising their performance? An interesting study in the Archives this month investigated the impact of induced stress on response and performance during simulations for residents training neonatal endotracheal intubation.

Participants were exposed to ‘high’ and ‘low’ neonatal resuscitation scenarios. Not surprisingly, high stress scenarios were associated with higher heart rates during and after the scenario and anxiety rates were also slightly higher.  Interestingly, success rate, duration, and checklist scores did not differ between high and low stress scenarios. So, although it is possible to generate a physiologic and psychologic stress response in simulations, it does not affect performance. This might be applicable to more teaching situations and an interesting avenue to further explore.

With globalisation and migration, we often see patients who speak a different language than the country and/or physician’s language. A quality improvement project published in Pediatrics investigated consistency of interpreter-mediated presence throughout hospitalisation. This is necessary to ensure equitable health care delivery. The aim was to improve the average number of interpreted encounters per patient day. They tested interventions, including provider education, increased language access devices on the unit, and in-room family language signs.

Over the course of the study, the average number of interpreted encounters per patient day increased significantly—from 1.8 to 3.2—even though the total number of encounters remained steady. This positive change suggests that greater awareness, improved training, and better access to interpreter services can meaningfully enhance communication for these families.

Prevention is key in health care – particularly for persons at risk. There are screening tools for the heart under stress (i.e. troponins), but what about the kidneys? Early detection of kidney impairment in vulnerable children might help detect those at risk. Prematurity (especially when born very preterm) has been linked to kidney dysfunction from infancy through adulthood.

A Greek group of investigators combined traditional (creatinine, etc.) and modern biomarkers (cystatin C, etc.) to estimate kidney function (glomerular filtration rate). They found that school-aged children born very preterm may begin to show early, subtle signs of kidney changes. Both cystatin C and creatinine show promise as helpful biomarkers for detecting early kidney function decline in at-risk groups.

You will find the list is broken down into four sections:

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments!