Lisa J Ewans, Kris Pierce, Eleanor Farley, Rachel Bowden, Carolyn Shalhoub, Elizabeth Emma Palmer
Paediatricians strive to deliver best practice care for their patients. However, when they encounter a child with one of the over 8000 rare diseases, a majority (> 70%) of which have a genetic cause, it is challenging to find clinical guidelines and point-of-care resources to support their practice. This article provides a framework for a collaborative management approach for rare diseases. It draws on the team's experience in delivering multidisciplinary clinics for ultra-rare conditions, running a rare disease registry and undiagnosed disease programme, and in founding a rare disease patient advocacy group for SCN2A-related conditions. This article signposts useful resources to facilitate paediatricians in delivering 'wraparound' rare disease care that is comprehensive, holistic and child and family-centred. These include Australia's first National Recommendations for Rare Disease Health Care and the RARE (Rare Awareness Rare Education) portal led by the national peak body for people living with a rare disease, Rare Voices Australia. Six key approaches are suggested that paediatricians can incorporate into their clinical practice to deliver high quality care for each child and young person with a rare disease. This includes strategies to support a timely diagnosis, including accessing undiagnosed disease programmes and linking children, young people and their caregivers with peers, patient advocacy groups and rare disease registries to reduce isolation and uncertainty. As less than 5% of rare diseases are currently amenable to a targeted therapy, it also suggests resources and approaches to facilitate access to and shared decision-making about research and novel advanced therapeutics.
{"title":"I've Never Heard of This! An Approach to Child and Family-Centred Care for Children and Young People With Rare Diseases.","authors":"Lisa J Ewans, Kris Pierce, Eleanor Farley, Rachel Bowden, Carolyn Shalhoub, Elizabeth Emma Palmer","doi":"10.1111/jpc.70267","DOIUrl":"https://doi.org/10.1111/jpc.70267","url":null,"abstract":"<p><p>Paediatricians strive to deliver best practice care for their patients. However, when they encounter a child with one of the over 8000 rare diseases, a majority (> 70%) of which have a genetic cause, it is challenging to find clinical guidelines and point-of-care resources to support their practice. This article provides a framework for a collaborative management approach for rare diseases. It draws on the team's experience in delivering multidisciplinary clinics for ultra-rare conditions, running a rare disease registry and undiagnosed disease programme, and in founding a rare disease patient advocacy group for SCN2A-related conditions. This article signposts useful resources to facilitate paediatricians in delivering 'wraparound' rare disease care that is comprehensive, holistic and child and family-centred. These include Australia's first National Recommendations for Rare Disease Health Care and the RARE (Rare Awareness Rare Education) portal led by the national peak body for people living with a rare disease, Rare Voices Australia. Six key approaches are suggested that paediatricians can incorporate into their clinical practice to deliver high quality care for each child and young person with a rare disease. This includes strategies to support a timely diagnosis, including accessing undiagnosed disease programmes and linking children, young people and their caregivers with peers, patient advocacy groups and rare disease registries to reduce isolation and uncertainty. As less than 5% of rare diseases are currently amenable to a targeted therapy, it also suggests resources and approaches to facilitate access to and shared decision-making about research and novel advanced therapeutics.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Portable swimming pools present a child drowning risk; however, evidence on parental and caregiver knowledge, risk perceptions, and safety practices about these products remains limited.
Methods
We conducted a cross-sectional survey of a representative sample of Australian parents and caregivers of children aged 0–5 years who owned a portable pool. Safety practices examined included pool fencing, active supervision, and emptying and storing the pool immediately after use. Descriptive statistics, non-parametric significance tests, and t-tests (comparing portable pools with in-ground pools) were used to assess knowledge, risk perceptions, and safety practices.
Results
Among 214 respondents, the majority correctly identified supervision (76%; χ2 = 56.54; p < 0.001) and emptying and storing practices (89%; χ2 = 131.89; p < 0.001) as key prevention strategies. In contrast, only 26% demonstrated knowledge of legal fencing requirements (χ2 = 50.54; p < 0.001). Risk perceptions were significantly lower for portable pools compared with in-ground pools. Only 19% reported their portable pool was fenced.
Conclusion
While self-reported supervision and storage practices were high, compliance with fencing requirements, the most effective drowning prevention strategy, was markedly low. Stronger action is needed to promote fencing compliance and confront misconceptions about the safety of shallow portable pools.
目的：便携式游泳池存在儿童溺水风险；然而，关于父母和照顾者对这些产品的知识、风险认知和安全实践的证据仍然有限。方法：我们对拥有便携式游泳池的0-5岁儿童的澳大利亚父母和照顾者的代表性样本进行了横断面调查。检查的安全措施包括游泳池围栏，积极监督，以及在使用后立即清空和储存游泳池。描述性统计、非参数显著性检验和t检验（将便携式水池与地下水池进行比较）用于评估知识、风险认知和安全实践。结果：在214名受访者中，大多数人正确识别了监督（76%）；χ2 = 56.54; p 2 = 131.89; p 2 = 50.54； p结论：尽管自我报告的监督和储存做法很高，但对围栏要求的遵守程度明显较低，围栏是最有效的溺水预防策略。需要采取更强有力的行动来促进围栏的遵守，并消除对浅便携式游泳池安全性的误解。
{"title":"Drowning Prevention in Portable Swimming Pools: A Cross-Sectional Survey of Parental Knowledge, Risk Perceptions, and Safety Practices","authors":"Amy E. Peden, Kyra Hamilton","doi":"10.1111/jpc.70257","DOIUrl":"10.1111/jpc.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Portable swimming pools present a child drowning risk; however, evidence on parental and caregiver knowledge, risk perceptions, and safety practices about these products remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional survey of a representative sample of Australian parents and caregivers of children aged 0–5 years who owned a portable pool. Safety practices examined included pool fencing, active supervision, and emptying and storing the pool immediately after use. Descriptive statistics, non-parametric significance tests, and <i>t</i>-tests (comparing portable pools with in-ground pools) were used to assess knowledge, risk perceptions, and safety practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 214 respondents, the majority correctly identified supervision (76%; <i>χ</i>\u0000 <sup>2</sup> = 56.54; <i>p</i> < 0.001) and emptying and storing practices (89%; <i>χ</i>\u0000 <sup>2</sup> = 131.89; <i>p</i> < 0.001) as key prevention strategies. In contrast, only 26% demonstrated knowledge of legal fencing requirements (<i>χ</i>\u0000 <sup>2</sup> = 50.54; <i>p</i> < 0.001). Risk perceptions were significantly lower for portable pools compared with in-ground pools. Only 19% reported their portable pool was fenced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While self-reported supervision and storage practices were high, compliance with fencing requirements, the most effective drowning prevention strategy, was markedly low. Stronger action is needed to promote fencing compliance and confront misconceptions about the safety of shallow portable pools.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"267-272"},"PeriodicalIF":1.4,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neha Sharma, Shukla Das, Kirti Nirmal, Ravi Sachan, Praveen Kumar Singh, Arshad Jawed, Sajad Ahmad Dar
Aims
Neonatal septicemia is a life-threatening condition with high mortality, and its early diagnosis remains a major challenge. Rapid and reliable biomarkers are essential for timely management. Presepsin, a soluble CD14 subtype, has emerged as a promising early sepsis marker, though evidence in neonates is scarce. This study evaluated its diagnostic and prognostic performance in suspected neonatal sepsis, covering bacterial and fungal infections.
Methods
An analytical cross-sectional study was conducted in the NICU of a tertiary hospital from May 2023 to November 2024. Eighty-eight neonates with clinically suspected sepsis were enrolled. Blood samples were collected for culture, C-reactive protein (CRP) measured by semiquantitative latex agglutination and Presepsin measured by ELISA. Diagnostic performance was assessed via receiver operating characteristic analysis, and associations with clinical features, birth weight, and outcomes were evaluated.
Results
Blood cultures were positive in 57 (64.8%) neonates, including 39 bacterial and 18 fungal cases. Presepsin levels were significantly higher in culture-proven sepsis (1208.5 ± 319.4 pg/mL) than probable sepsis (828.9 ± 235.5 pg/mL, p < 0.001). ROC analysis identified a cutoff of 906.6 pg/mL, yielding 90% sensitivity, 88% specificity, and 84% diagnostic accuracy. Presepsin levels rose faster than CRP, enabling earlier detection. Higher levels were noted in fungal sepsis (1441.4 ± 357.5 pg/mL) and in neonates with poor outcomes, correlating with longer hospital stays.
Conclusions
Presepsin is a rapid, reliable biomarker for early diagnosis and prognosis of neonatal sepsis, including fungal infections. Its use alongside clinical assessment can support timely therapeutic decisions, reduce hospital stay, and improve survival in high-risk neonates.
{"title":"Diagnostic and Prognostic Evaluation of Presepsin Levels in Neonatal Septicemia: A Hospital-Based Study","authors":"Neha Sharma, Shukla Das, Kirti Nirmal, Ravi Sachan, Praveen Kumar Singh, Arshad Jawed, Sajad Ahmad Dar","doi":"10.1111/jpc.70272","DOIUrl":"10.1111/jpc.70272","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Neonatal septicemia is a life-threatening condition with high mortality, and its early diagnosis remains a major challenge. Rapid and reliable biomarkers are essential for timely management. Presepsin, a soluble CD14 subtype, has emerged as a promising early sepsis marker, though evidence in neonates is scarce. This study evaluated its diagnostic and prognostic performance in suspected neonatal sepsis, covering bacterial and fungal infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An analytical cross-sectional study was conducted in the NICU of a tertiary hospital from May 2023 to November 2024. Eighty-eight neonates with clinically suspected sepsis were enrolled. Blood samples were collected for culture, C-reactive protein (CRP) measured by semiquantitative latex agglutination and Presepsin measured by ELISA. Diagnostic performance was assessed via receiver operating characteristic analysis, and associations with clinical features, birth weight, and outcomes were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Blood cultures were positive in 57 (64.8%) neonates, including 39 bacterial and 18 fungal cases. Presepsin levels were significantly higher in culture-proven sepsis (1208.5 ± 319.4 pg/mL) than probable sepsis (828.9 ± 235.5 pg/mL, <i>p</i> < 0.001). ROC analysis identified a cutoff of 906.6 pg/mL, yielding 90% sensitivity, 88% specificity, and 84% diagnostic accuracy. Presepsin levels rose faster than CRP, enabling earlier detection. Higher levels were noted in fungal sepsis (1441.4 ± 357.5 pg/mL) and in neonates with poor outcomes, correlating with longer hospital stays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Presepsin is a rapid, reliable biomarker for early diagnosis and prognosis of neonatal sepsis, including fungal infections. Its use alongside clinical assessment can support timely therapeutic decisions, reduce hospital stay, and improve survival in high-risk neonates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"261-266"},"PeriodicalIF":1.4,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jasmina Felsinger, Sharon L. O'Brien, Stuart R. Dalziel, Donna Franklin, Shane George, Lauren Shumack, Simon S. Craig, Paediatric Research in Emergency Departments International Collaborative (PREDICT) and the Children's Inpatient Research Collaboration of Australia and New Zealand (CIRCAN)
Aims
To describe the current clinical practices relating to nasal high-flow therapy (NHF) therapy for infants with bronchiolitis across Australia and New Zealand, with a focus on describing the approach to non-hypoxic infants.
Methods
Voluntary online questionnaire distributed to Emergency Department and inpatient unit staff affiliated with the Paediatric Research in Emergency Departments International Collaborative (PREDICT) and Children's Inpatient Research Collaboration of Australia and New Zealand (CIRCAN) networks. The survey explored clinicians' general approach to NHF and included six clinical scenarios to assess self-reported practice patterns.
Results
A total of 704 clinicians (386 physicians and 318 nurses) from 42 healthcare services across Australia and New Zealand responded. For non-hypoxic infants with moderate illness, 55% of nursing staff would commence NHF, compared with 24% of doctors (p < 0.001). For hypoxic infants with moderate illness, 70% of nurses compared with 34% of doctors reported initiating NHF (p < 0.001). Nurses were more likely than doctors to consider moderate work of breathing, and worsening tachypnoea (not meeting emergency response criteria), as indications to initiate NHF for non-hypoxic infants, whereas doctors more frequently cited critical work of breathing and apnoea. Key therapeutic objectives of NHF identified were ‘reduced work of breathing’ (96%) and ‘reduced tachypnoea’ (80%).
Conclusions
Substantial variability exists in the clinical application of NHF therapy for infants with bronchiolitis, particularly in cases of moderate illness without hypoxia. Clearer clinical guidelines and better evidence for NHF in non-hypoxic infants may reduce this variability.
{"title":"Nasal High-Flow Therapy for Infants With Bronchiolitis Across Australia and New Zealand: A PREDICT and CIRCAN Clinician Survey","authors":"Jasmina Felsinger, Sharon L. O'Brien, Stuart R. Dalziel, Donna Franklin, Shane George, Lauren Shumack, Simon S. Craig, Paediatric Research in Emergency Departments International Collaborative (PREDICT) and the Children's Inpatient Research Collaboration of Australia and New Zealand (CIRCAN)","doi":"10.1111/jpc.70270","DOIUrl":"10.1111/jpc.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To describe the current clinical practices relating to nasal high-flow therapy (NHF) therapy for infants with bronchiolitis across Australia and New Zealand, with a focus on describing the approach to non-hypoxic infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Voluntary online questionnaire distributed to Emergency Department and inpatient unit staff affiliated with the Paediatric Research in Emergency Departments International Collaborative (PREDICT) and Children's Inpatient Research Collaboration of Australia and New Zealand (CIRCAN) networks. The survey explored clinicians' general approach to NHF and included six clinical scenarios to assess self-reported practice patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 704 clinicians (386 physicians and 318 nurses) from 42 healthcare services across Australia and New Zealand responded. For non-hypoxic infants with moderate illness, 55% of nursing staff would commence NHF, compared with 24% of doctors (<i>p</i> < 0.001). For hypoxic infants with moderate illness, 70% of nurses compared with 34% of doctors reported initiating NHF (<i>p</i> < 0.001). Nurses were more likely than doctors to consider moderate work of breathing, and worsening tachypnoea (not meeting emergency response criteria), as indications to initiate NHF for non-hypoxic infants, whereas doctors more frequently cited critical work of breathing and apnoea. Key therapeutic objectives of NHF identified were ‘reduced work of breathing’ (96%) and ‘reduced tachypnoea’ (80%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Substantial variability exists in the clinical application of NHF therapy for infants with bronchiolitis, particularly in cases of moderate illness without hypoxia. Clearer clinical guidelines and better evidence for NHF in non-hypoxic infants may reduce this variability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"252-260"},"PeriodicalIF":1.4,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To describe the age- and problem-related characteristics of children referred for discussion at a multidisciplinary child abuse and neglect meeting as part of the Safer Kids Project ‘SKiP’ at Royal Prince Alfred Hospital. Second, to compare the initial period of program establishment in 2021 with the 2022 period once the program was embedded, in terms of actions and outcomes prompted by SKiP.
Methods
A retrospective descriptive and comparative audit was performed for two 12-week periods of data from the SKiP meetings from May to September 2021 (inaugural roll-out of the SKiP model) and May to September 2022 (the same period 1 year later after the model was embedded). N = 1382 cases were included.
Results
Pre-verbal children (aged 0–2 years) and teenagers (aged 11–16 years) showed an overrepresentation in cases requiring further action post multidisciplinary meeting. Comparison of initial versus embedded periods suggested improvements in the assessment and management of children while they were in the Emergency Department and several reductions in additional child protection measures required post multidisciplinary meeting, with an implication these actions were increasingly being performed in real time.
Conclusion
A multi-modal, multidisciplinary child protection model of care can be effective at improving child protection assessment in the Emergency Department and staff effectiveness at recognising and actioning cases concerning child maltreatment.
{"title":"The Safer Kids Project (SKiP): A Descriptive and Evaluative Audit of an Interdepartmental Multidisciplinary Child Maltreatment Model of Care for Paediatric Emergency Department Presentations","authors":"Philippa Edwards, Rheannwynn Sneesby, Greg Fairbrother, Nadia Husain, John Cass-Verco, Elayne Forbes, Christy Norwood","doi":"10.1111/jpc.70265","DOIUrl":"10.1111/jpc.70265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the age- and problem-related characteristics of children referred for discussion at a multidisciplinary child abuse and neglect meeting as part of the Safer Kids Project ‘SKiP’ at Royal Prince Alfred Hospital. Second, to compare the initial period of program establishment in 2021 with the 2022 period once the program was embedded, in terms of actions and outcomes prompted by SKiP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective descriptive and comparative audit was performed for two 12-week periods of data from the SKiP meetings from May to September 2021 (inaugural roll-out of the SKiP model) and May to September 2022 (the same period 1 year later after the model was embedded). <i>N</i> = 1382 cases were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pre-verbal children (aged 0–2 years) and teenagers (aged 11–16 years) showed an overrepresentation in cases requiring further action post multidisciplinary meeting. Comparison of initial versus embedded periods suggested improvements in the assessment and management of children while they were in the Emergency Department and several reductions in additional child protection measures required post multidisciplinary meeting, with an implication these actions were increasingly being performed in real time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A multi-modal, multidisciplinary child protection model of care can be effective at improving child protection assessment in the Emergency Department and staff effectiveness at recognising and actioning cases concerning child maltreatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"242-251"},"PeriodicalIF":1.4,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chee Sean Tan, Gehan Roberts, William Garvey, Elise D'Abaco, Anita D'Aprano
Aim
Clinical supervision plays an important role in the success of Competency Based Medical Education. This study aims to explore the Victorian Training Programme Community Child Health (VTPCCH) supervisory practices from the perspectives of trainees and supervisors.
Methods
Nine peadiatric trainees enrolled in the VTPCCH who were based at the Royal Children's Hospital Melbourne and 15 supervising consultants were recruited in this study. Questionnaires were designed according to the roles of trainee and supervisor, exploring their experiences related to clinical supervision in the VTPCCH. Mixed quantitative and qualitative analyses were conducted.
Results
Sixteen responded (seven trainees and nine supervisors). Quantitative analysis revealed that respondents were highly satisfied with the overall training programme and quality of clinical supervision (median = 5.0 [trainee], 4.0 [supervisor], p > 0.05). Learning opportunity, especially the overall learning experience was valued, (median = 5.0 vs. 4.0 [supervisor], p = 0.03). Trainees were less satisfied with the opportunity to discuss patients and accessibility to supervision (median = 3.0, 4 [supervisor], p > 0.05) while supervisors perceived lower level of satisfaction pertaining to workload monitoring and extent of support they could provide in meeting the training requirements (median = 3.0, 4.0 [trainee], p > 0.05). Higher level of burnout was rated by trainee (median = 4.0, 3.0 [supervisor], p > 0.05). Access to supervision, heavy workload, inconsistent practices, lack of clarity and valuable educational opportunities are factors impacting participants' perceived satisfaction with the clinical supervision.
Conclusions
Our findings indicate learning opportunity as the valued factor while suggesting gaps around access to supervisors, heavy workload, inconsistent and lack of clarity in practices as areas for improvement. Recommendations are being implemented with the 2025 cohort of paediatric trainees.
目的：临床督导对能力本位医学教育的成功与否起着至关重要的作用。本研究旨在从受训人员和督导人员的角度探讨维州社区儿童健康培训项目（VTPCCH）的督导实践。方法：本研究招募了9名来自墨尔本皇家儿童医院的VTPCCH的儿科实习生和15名指导顾问。根据实习医生和督导医生的角色设计问卷，探讨实习医生和督导医生在临床督导方面的经验。进行了定量和定性混合分析。结果：回复16人（学员7人，主管9人）。定量分析显示，受访者对整体培训计划和临床督导质量高度满意（中位数= 5.0[学员]，4.0[主管]，p > 0.05）。学习机会，特别是整体学习经验被重视，（中位数= 5.0 vs. 4.0 [supervisor], p = 0.03）。受训者对讨论患者和获得监督的机会不太满意（中位数= 3.0,4 [supervisor], p > 0.05），而主管对工作量监测和他们在满足培训要求方面可以提供的支持程度的满意度较低（中位数= 3.0,4.0 [trainee], p > 0.05）。受训者的职业倦怠程度较高（中位数为4.0，中位数为3.0,p < 0.05）。获得监督、繁重的工作量、不一致的实践、缺乏清晰度和宝贵的教育机会是影响参与者对临床监督的感知满意度的因素。结论：我们的研究结果表明，学习机会是有价值的因素，而与主管接触的差距、繁重的工作量、不一致和缺乏透明度的实践是需要改进的领域。目前正在对2025年儿科受训人员队列实施各项建议。
{"title":"Understanding the Experience of Clinical Supervision in Community Child Health: A Mixed-Methods Cross Sectional Study","authors":"Chee Sean Tan, Gehan Roberts, William Garvey, Elise D'Abaco, Anita D'Aprano","doi":"10.1111/jpc.70266","DOIUrl":"10.1111/jpc.70266","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Clinical supervision plays an important role in the success of Competency Based Medical Education. This study aims to explore the Victorian Training Programme Community Child Health (VTPCCH) supervisory practices from the perspectives of trainees and supervisors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine peadiatric trainees enrolled in the VTPCCH who were based at the Royal Children's Hospital Melbourne and 15 supervising consultants were recruited in this study. Questionnaires were designed according to the roles of trainee and supervisor, exploring their experiences related to clinical supervision in the VTPCCH. Mixed quantitative and qualitative analyses were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen responded (seven trainees and nine supervisors). Quantitative analysis revealed that respondents were highly satisfied with the overall training programme and quality of clinical supervision (median = 5.0 [trainee], 4.0 [supervisor], <i>p</i> > 0.05). Learning opportunity, especially the overall learning experience was valued, (median = 5.0 vs. 4.0 [supervisor], <i>p</i> = 0.03). Trainees were less satisfied with the opportunity to discuss patients and accessibility to supervision (median = 3.0, 4 [supervisor], <i>p</i> > 0.05) while supervisors perceived lower level of satisfaction pertaining to workload monitoring and extent of support they could provide in meeting the training requirements (median = 3.0, 4.0 [trainee], <i>p</i> > 0.05). Higher level of burnout was rated by trainee (median = 4.0, 3.0 [supervisor], <i>p</i> > 0.05). Access to supervision, heavy workload, inconsistent practices, lack of clarity and valuable educational opportunities are factors impacting participants' perceived satisfaction with the clinical supervision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings indicate learning opportunity as the valued factor while suggesting gaps around access to supervisors, heavy workload, inconsistent and lack of clarity in practices as areas for improvement. Recommendations are being implemented with the 2025 cohort of paediatric trainees.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"233-241"},"PeriodicalIF":1.4,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Penny Pei Lee Kee, Asiyath Rasheed, Martin Kluckow, Niranjan Thomas, Arun Sett
Aim
The Australian and New Zealand model for neonatal point of care ultrasound (POCUS) training was developed in 2009 and is the first of such certification available internationally. Despite this, there has only been a modest increase in the number of certified POCUS clinicians in the last 10 years. Little is known about the accessibility to training. To address this knowledge gap, we conducted a binational survey of the neonatal clinicians.
Methods
An online questionnaire was distributed through the Australian and New Zealand Neonatal Network (ANZNN) mailing list in May 2024. The network consists of all 32 NICUs in Australia and New Zealand, and the distribution list includes neonatologists and trainees registered with the network.
Results
A total of 132/283 (47%) responses were received. Sixty-seven percent were from neonatologists, and the remainder were trainees. 33% had completed POCUS training, 23% were enrolled, 17% did not complete training and 27% were not enrolled. Forty-three percent worked in a NICU where POCUS service was available 24/7, and the rest were available ad hoc (43%), or during business hours only (12%); 2% worked in a NICU with no POCUS service. The main barriers include a lack of protected teaching time (73%), POCUS supervisors (52%) and a formal curriculum (40%). Seventy-two percent felt POCUS training should be included in the neonatal specialist training curriculum.
Conclusion
Neonatal clinicians recognise the importance of POCUS training and its benefits for patient care. However, there are significant barriers limiting access to training. The results of this survey may help inform curriculum design and educational strategies that can lead to wider implementation of training and integration of POCUS into clinical care.
{"title":"Barriers and Enablers in Accessing Neonatal Point of Care Ultrasound Training in Australia and New Zealand: A Survey of Neonatal Clinicians","authors":"Penny Pei Lee Kee, Asiyath Rasheed, Martin Kluckow, Niranjan Thomas, Arun Sett","doi":"10.1111/jpc.70259","DOIUrl":"10.1111/jpc.70259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The Australian and New Zealand model for neonatal point of care ultrasound (POCUS) training was developed in 2009 and is the first of such certification available internationally. Despite this, there has only been a modest increase in the number of certified POCUS clinicians in the last 10 years. Little is known about the accessibility to training. To address this knowledge gap, we conducted a binational survey of the neonatal clinicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online questionnaire was distributed through the Australian and New Zealand Neonatal Network (ANZNN) mailing list in May 2024. The network consists of all 32 NICUs in Australia and New Zealand, and the distribution list includes neonatologists and trainees registered with the network.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 132/283 (47%) responses were received. Sixty-seven percent were from neonatologists, and the remainder were trainees. 33% had completed POCUS training, 23% were enrolled, 17% did not complete training and 27% were not enrolled. Forty-three percent worked in a NICU where POCUS service was available 24/7, and the rest were available ad hoc (43%), or during business hours only (12%); 2% worked in a NICU with no POCUS service. The main barriers include a lack of protected teaching time (73%), POCUS supervisors (52%) and a formal curriculum (40%). Seventy-two percent felt POCUS training should be included in the neonatal specialist training curriculum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Neonatal clinicians recognise the importance of POCUS training and its benefits for patient care. However, there are significant barriers limiting access to training. The results of this survey may help inform curriculum design and educational strategies that can lead to wider implementation of training and integration of POCUS into clinical care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"224-232"},"PeriodicalIF":1.4,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marco Gabrielli, Caterina Cocchi, Silvia Fazio, Daniele Vanz, Alessandro Roncoli, Andrew Tenore, Roberto Dall'Amico, Egidio Barbi
<p>Paediatric emergency departments are increasingly reporting a significant rise in visits for neuropsychiatric concerns. Although not always severe, these presentations often involve acute episodes of agitation, anxiety, behavioural dysregulation, self-injurious behaviour, or suicidal ideation that require prompt assessment and intervention. Many children and adolescents presenting with these symptoms have predisposing conditions such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), or other behavioural disorders and their episodes are frequently exacerbated by external factors [<span>1-3</span>]. It is important to emphasise, however, that in psychiatry a diagnosis is fundamentally one of exclusion: organic causes must always be considered and ruled out, as timely recognition and treatment of an underlying medical condition can result in complete recovery.</p><p>An 11-year-old female, previously healthy and without relevant past medical history, presented to the Paediatric Emergency Department with acute abdominal pain, marked hyperventilation with polypnea and increased respiratory effort. According to parental report, the patient had experienced two isolated episodes of non-bloody vomiting the previous evening. Oral intake of food and fluids had been preserved. The medical history revealed a 4-month period of psychological distress following the death of her paternal grandmother, with whom she had a close emotional bond. Since that event, she had been undergoing private psychological counselling for anxiety symptoms and had been advised to participate in a residential summer camp programme. On the morning of admission, she was evaluated by her primary care paediatrician for agitation. A behavioural origin was initially considered, and the patient received diazepam, but her symptoms did not improve. Over the preceding 2 months, the patient had experienced an unintentional weight loss of approximately 4–5 kg, initially attributed to the emotional stress. In the weeks leading up to presentation, her parents had also observed polydipsia, polyuria and two episodes of nocturia.</p><p>At the initial evaluation, the patient was alert but demonstrated mildly slowed responsiveness. She was afebrile, with noted pallor. The patient was polypneic, with a markedly elevated respiratory rate of 50 breaths per minute, characterised by deep, laboured breathing respiration. Cardiovascular examination revealed tachycardia with 150 bpm and hypertension 150/100 mmHg. Abdominal examination elicited generalised deep tenderness, which limited completion of the POCUS assessment. Neurological examination revealed reduced responsiveness alternating with periods of wakefulness. For this reason, a capillary blood test for glucose and ketones was performed, which revealed hyperglycaemia and hyperketonaemia. Initial venous blood gas point of care investigations demonstrated severe hyperglycaemia (plasma glucose: 623 mg/dL), significant ke
{"title":"Rethinking a Case of Paediatric Agitation Through a Different Mindset","authors":"Marco Gabrielli, Caterina Cocchi, Silvia Fazio, Daniele Vanz, Alessandro Roncoli, Andrew Tenore, Roberto Dall'Amico, Egidio Barbi","doi":"10.1111/jpc.70268","DOIUrl":"10.1111/jpc.70268","url":null,"abstract":"<p>Paediatric emergency departments are increasingly reporting a significant rise in visits for neuropsychiatric concerns. Although not always severe, these presentations often involve acute episodes of agitation, anxiety, behavioural dysregulation, self-injurious behaviour, or suicidal ideation that require prompt assessment and intervention. Many children and adolescents presenting with these symptoms have predisposing conditions such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), or other behavioural disorders and their episodes are frequently exacerbated by external factors [<span>1-3</span>]. It is important to emphasise, however, that in psychiatry a diagnosis is fundamentally one of exclusion: organic causes must always be considered and ruled out, as timely recognition and treatment of an underlying medical condition can result in complete recovery.</p><p>An 11-year-old female, previously healthy and without relevant past medical history, presented to the Paediatric Emergency Department with acute abdominal pain, marked hyperventilation with polypnea and increased respiratory effort. According to parental report, the patient had experienced two isolated episodes of non-bloody vomiting the previous evening. Oral intake of food and fluids had been preserved. The medical history revealed a 4-month period of psychological distress following the death of her paternal grandmother, with whom she had a close emotional bond. Since that event, she had been undergoing private psychological counselling for anxiety symptoms and had been advised to participate in a residential summer camp programme. On the morning of admission, she was evaluated by her primary care paediatrician for agitation. A behavioural origin was initially considered, and the patient received diazepam, but her symptoms did not improve. Over the preceding 2 months, the patient had experienced an unintentional weight loss of approximately 4–5 kg, initially attributed to the emotional stress. In the weeks leading up to presentation, her parents had also observed polydipsia, polyuria and two episodes of nocturia.</p><p>At the initial evaluation, the patient was alert but demonstrated mildly slowed responsiveness. She was afebrile, with noted pallor. The patient was polypneic, with a markedly elevated respiratory rate of 50 breaths per minute, characterised by deep, laboured breathing respiration. Cardiovascular examination revealed tachycardia with 150 bpm and hypertension 150/100 mmHg. Abdominal examination elicited generalised deep tenderness, which limited completion of the POCUS assessment. Neurological examination revealed reduced responsiveness alternating with periods of wakefulness. For this reason, a capillary blood test for glucose and ketones was performed, which revealed hyperglycaemia and hyperketonaemia. Initial venous blood gas point of care investigations demonstrated severe hyperglycaemia (plasma glucose: 623 mg/dL), significant ke","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"325-327"},"PeriodicalIF":1.4,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Uncommon Presentation of Shigella flexneri Pancolitis in Paediatrics: A Case Report and Diagnostic Challenge","authors":"Mohd Ayub Ansari, Aida Kaiser, Sangita Yadav","doi":"10.1111/jpc.70264","DOIUrl":"10.1111/jpc.70264","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"305-309"},"PeriodicalIF":1.4,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dermatological consultations from paediatric emergency departments are common but often underreported. Understanding the profile and outcomes of these consultations is crucial for improving diagnostic accuracy and patient management. The aim was to retrospectively analyse paediatric patients referred from the paediatric emergency department to the dermatology clinic in a tertiary care hospital over a 5-year period, focusing on demographic characteristics, preliminary and final diagnoses, diagnostic concordance and treatment modalities.
Methods
This retrospective observational study included paediatric patients (aged 0–18 years) consulted at the dermatology clinic from the paediatric emergency department of a tertiary care centre. Data collected included demographics, triage codes, consultation response times, diagnoses, examination findings and treatments.
Results
A total of 486 patients were included, with a mean age of 95.3 ± 66.6 months. The gender distribution was 48.1% (n = 234) female and 51.9% (n = 252) male. The most frequent final diagnoses were scabies 14% (n = 68), insect bites 7.8% (n = 38) and urticaria–angioedema 7% (n = 34). Diagnostic concordance between paediatricians and dermatologists was 64.23% (n = 88 of 137 with preliminary diagnoses). Topical antibiotics 40.3% (n = 196), systemic antihistamines 27.2% (n = 132) and topical steroids 24.7% (n = 120) were the most commonly prescribed treatments. Hospitalisation was required for 1.9% (n = 9) of patients, and 4.3% (n = 21) underwent biopsy.
Conclusion
The majority of dermatology consultations from the paediatric emergency department were for non-emergent conditions. Strengthening dermatology education in paediatric training programmes and establishing specialised paediatric dermatology outpatient clinics may improve diagnostic accuracy and patient care.
{"title":"The Analysis of Dermatology Consultations From the Paediatric Emergency Department in a Tertiary Care Centre","authors":"Nurten Gozgen Atmaca, Berkay Temel, Nermin Karaosmanoglu, Sinem Ornek Ozdemir","doi":"10.1111/jpc.70255","DOIUrl":"10.1111/jpc.70255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aim</h3>\u0000 \u0000 <p>Dermatological consultations from paediatric emergency departments are common but often underreported. Understanding the profile and outcomes of these consultations is crucial for improving diagnostic accuracy and patient management. The aim was to retrospectively analyse paediatric patients referred from the paediatric emergency department to the dermatology clinic in a tertiary care hospital over a 5-year period, focusing on demographic characteristics, preliminary and final diagnoses, diagnostic concordance and treatment modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study included paediatric patients (aged 0–18 years) consulted at the dermatology clinic from the paediatric emergency department of a tertiary care centre. Data collected included demographics, triage codes, consultation response times, diagnoses, examination findings and treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 486 patients were included, with a mean age of 95.3 ± 66.6 months. The gender distribution was 48.1% (<i>n</i> = 234) female and 51.9% (<i>n</i> = 252) male. The most frequent final diagnoses were scabies 14% (<i>n</i> = 68), insect bites 7.8% (<i>n</i> = 38) and urticaria–angioedema 7% (<i>n</i> = 34). Diagnostic concordance between paediatricians and dermatologists was 64.23% (<i>n</i> = 88 of 137 with preliminary diagnoses). Topical antibiotics 40.3% (<i>n</i> = 196), systemic antihistamines 27.2% (<i>n</i> = 132) and topical steroids 24.7% (<i>n</i> = 120) were the most commonly prescribed treatments. Hospitalisation was required for 1.9% (<i>n</i> = 9) of patients, and 4.3% (<i>n</i> = 21) underwent biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The majority of dermatology consultations from the paediatric emergency department were for non-emergent conditions. Strengthening dermatology education in paediatric training programmes and establishing specialised paediatric dermatology outpatient clinics may improve diagnostic accuracy and patient care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"216-223"},"PeriodicalIF":1.4,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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