Lisa Daniels, Barry J. Taylor, Jillian J. Haszard, Justine Camp, Karen L. Magrath, Zoe K. Tipa, Victoria Bryant, Sheree J. Gibb
Aim
New Zealand's post-neonatal mortality rate has remained steady at around 1.4 per 1000 live births since 2015, with Sudden Unexpected Death in Infancy (SUDI) accounting for approximately 60% of these deaths. Safe sleep guidelines are a key element of SUDI prevention but there is limited information on how these guidelines are applied in New Zealand homes. This work aims to examine safe sleep practices among New Zealand infants and explore variations based on demographic, infant and family characteristics.
Methods
This cross-sectional observational study used electronic health data for 45 969 New Zealand infants at approximately 6 weeks of age. Data came from ‘Well Child/Tamariki Ora’ visits conducted in 2023 by Whānau Āwhina Plunket, a provider of free health assessment and parenting support services for almost 80% of families in New Zealand. ‘Safer sleep space’ was defined as the exclusive use of recommended spaces (e.g., bassinet, cot, Pēpi-Pod or wahakura) and ‘safer sleep position’ referred to the supine (back) sleep position.
Results
Most infants were placed in safe sleep spaces (89% day, 93% night) and positions (95% day, 96% night). The prevalence of safe sleep practices varied between regions, ethnic groups and sociodemographic groups. Higher prevalences of safe sleep practices were seen with lower socioeconomic deprivation, adequate housing, non-smoking and employed caregivers, and caregivers with greater knowledge of health and support services.
Conclusions
There was a high prevalence of safe sleep practices with significant variations between sociodemographic, regional and ethnic groups, providing opportunities for targeted interventions to improve infant sleep safety.
{"title":"Early Infant Sleep Environments: An Observational Study of New Zealand Electronic Health Data","authors":"Lisa Daniels, Barry J. Taylor, Jillian J. Haszard, Justine Camp, Karen L. Magrath, Zoe K. Tipa, Victoria Bryant, Sheree J. Gibb","doi":"10.1111/jpc.70245","DOIUrl":"10.1111/jpc.70245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>New Zealand's post-neonatal mortality rate has remained steady at around 1.4 per 1000 live births since 2015, with Sudden Unexpected Death in Infancy (SUDI) accounting for approximately 60% of these deaths. Safe sleep guidelines are a key element of SUDI prevention but there is limited information on how these guidelines are applied in New Zealand homes. This work aims to examine safe sleep practices among New Zealand infants and explore variations based on demographic, infant and family characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional observational study used electronic health data for 45 969 New Zealand infants at approximately 6 weeks of age. Data came from ‘Well Child/Tamariki Ora’ visits conducted in 2023 by Whānau Āwhina Plunket, a provider of free health assessment and parenting support services for almost 80% of families in New Zealand. ‘Safer sleep space’ was defined as the exclusive use of recommended spaces (e.g., bassinet, cot, Pēpi-Pod or wahakura) and ‘safer sleep position’ referred to the supine (back) sleep position.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most infants were placed in safe sleep spaces (89% day, 93% night) and positions (95% day, 96% night). The prevalence of safe sleep practices varied between regions, ethnic groups and sociodemographic groups. Higher prevalences of safe sleep practices were seen with lower socioeconomic deprivation, adequate housing, non-smoking and employed caregivers, and caregivers with greater knowledge of health and support services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was a high prevalence of safe sleep practices with significant variations between sociodemographic, regional and ethnic groups, providing opportunities for targeted interventions to improve infant sleep safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 2","pages":"171-180"},"PeriodicalIF":1.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604642","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}
Celia Dewell, Denise L Chan, Vanessa Sarkozy, Eleanor Farley, Jacqueline Russell, David Mowat, Sean E Kennedy, Clara W T Chung
Tuberous sclerosis complex (TSC) is a multi-system autosomal dominant condition associated with disease-causing variants in either of the TSC1 or TSC2 genes. It can be associated with variable benign tumours (hamartomas) in different organs, most notably the brain, kidneys, skin and heart with different ages of onset. Affected children may have early-onset epilepsy, refractory epilepsy, varying degrees of developmental disability, ranging from normal cognition and learning difficulties to moderate-severe intellectual disability, neurodevelopmental disorders and mental health disorders. Multidisciplinary TSC-specific clinical care is recommended. A precision medicine (mechanistic target of rapamycin (mTOR) inhibitors) aimed at the early treatment of epilepsy and TSC-specific therapy for tumours can reduce the burden of the disease and improve clinical outcomes. We describe a multidisciplinary model of care for TSC, with an emphasis on the early detection and diagnosis of TSC and active surveillance/management of electrical seizures and clinical seizures. This review article will cover the following: clinical presentation and diagnosis of TSC, its genetic basis, the role of genetic counselling, pre-seizure surveillance of infants and TSC-specific (neurological, neurodevelopmental, renal, dermatological and pulmonary) management guidelines throughout life.
{"title":"Diagnosis and Management of Children With Tuberous Sclerosis Complex.","authors":"Celia Dewell, Denise L Chan, Vanessa Sarkozy, Eleanor Farley, Jacqueline Russell, David Mowat, Sean E Kennedy, Clara W T Chung","doi":"10.1111/jpc.70243","DOIUrl":"https://doi.org/10.1111/jpc.70243","url":null,"abstract":"<p><p>Tuberous sclerosis complex (TSC) is a multi-system autosomal dominant condition associated with disease-causing variants in either of the TSC1 or TSC2 genes. It can be associated with variable benign tumours (hamartomas) in different organs, most notably the brain, kidneys, skin and heart with different ages of onset. Affected children may have early-onset epilepsy, refractory epilepsy, varying degrees of developmental disability, ranging from normal cognition and learning difficulties to moderate-severe intellectual disability, neurodevelopmental disorders and mental health disorders. Multidisciplinary TSC-specific clinical care is recommended. A precision medicine (mechanistic target of rapamycin (mTOR) inhibitors) aimed at the early treatment of epilepsy and TSC-specific therapy for tumours can reduce the burden of the disease and improve clinical outcomes. We describe a multidisciplinary model of care for TSC, with an emphasis on the early detection and diagnosis of TSC and active surveillance/management of electrical seizures and clinical seizures. This review article will cover the following: clinical presentation and diagnosis of TSC, its genetic basis, the role of genetic counselling, pre-seizure surveillance of infants and TSC-specific (neurological, neurodevelopmental, renal, dermatological and pulmonary) management guidelines throughout life.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573918","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}
Yasmin Luu, Helena Teede, Melanie Gibson, Alexia Peña
<p>Polycystic ovary syndrome (PCOS) is a common endocrine condition. Adolescent PCOS diagnostic criteria include the combination of menstrual irregularities and hyperandrogenism [<span>1, 2</span>]. Polycystic ovarian morphology is not part of the adolescent diagnostic criteria [<span>3</span>]; therefore, the name of the condition is likely to be confusing. Women with PCOS report the condition's name is confusing [<span>4</span>], however, no studies have investigated adolescents' views. We aimed to investigate adolescents' perspectives on the name ‘PCOS’.</p><p>Cross-sectional questionnaire-based study including adolescent girls aged between 12 and 19 years who have been diagnosed with PCOS by a medical practitioner were eligible to participate. Adolescents were recruited from paediatric clinics at the Women's and Children's Hospital (WCH) in Adelaide and through Australian/United Kingdom-based PCOS support organisations [<span>5</span>]. One part of the questionnaire investigated adolescents' views on the name ‘PCOS’ (using a 5-point Likert scale) and the name's importance to different stakeholders. This study was part of a broader study, with 11 questions relevant to this substudy compared to the full 32-question survey.</p><p>The study was approved by the WCH Research Ethics Committee (HREC/17/WCHN/15). Informed written consent and/or assent were obtained from all participants who completed the questionnaire during their clinic visit and from their parents/guardians if participants were younger than 18 years. For participants who completed the online questionnaire, completion of the online survey was taken as consent to participate in the study as per the introduction page of the survey.</p><p>Statistical analysis was performed with Stata software version 14.0 (StataCorp), and categorical data are presented as counts and proportions.</p><p>Eighty adolescents completed the full questionnaire (mean ± SD age 16.7 ± 1.8 years, menarche 12.2 ± 1.5 years). Most adolescents had been diagnosed with PCOS 2 years prior to completing the questionnaire (<i>n</i> = 62, 78%), lived in metropolitan areas (<i>n</i> = 53, 66%), and in Australia (<i>n</i> = 70, 88%).</p><p>There were diverse opinions among adolescents about whether the name can be confusing (30 [38%] disagreed/strongly disagreed, 21 [26%] were neutral, and 29 [36%] agreed/strongly agreed). More than half of adolescents (<i>n</i> = 41, 51%) agreed/strongly agreed that the name should stay the same, whilst 26 (33%) neither disagreed nor agreed, and 13 (16%) disagreed/strongly disagreed. Nearly half of adolescents were neutral about whether the name ‘PCOS’ should be changed to reflect the range of symptoms (<i>n</i> = 33, 41%), and almost half felt that increased education about PCOS and a name change are both needed (<i>n</i> = 37, 46%). Sixty-six (83%) adolescents agreed/strongly agreed that increased education about PCOS would be more effective than a name change (Figure 1).</p><p>Over half o
{"title":"Cross-Sectional Study on Adolescents' Views on Changing the Name of Polycystic Ovary Syndrome: The Importance of Education on the Condition","authors":"Yasmin Luu, Helena Teede, Melanie Gibson, Alexia Peña","doi":"10.1111/jpc.70225","DOIUrl":"10.1111/jpc.70225","url":null,"abstract":"<p>Polycystic ovary syndrome (PCOS) is a common endocrine condition. Adolescent PCOS diagnostic criteria include the combination of menstrual irregularities and hyperandrogenism [<span>1, 2</span>]. Polycystic ovarian morphology is not part of the adolescent diagnostic criteria [<span>3</span>]; therefore, the name of the condition is likely to be confusing. Women with PCOS report the condition's name is confusing [<span>4</span>], however, no studies have investigated adolescents' views. We aimed to investigate adolescents' perspectives on the name ‘PCOS’.</p><p>Cross-sectional questionnaire-based study including adolescent girls aged between 12 and 19 years who have been diagnosed with PCOS by a medical practitioner were eligible to participate. Adolescents were recruited from paediatric clinics at the Women's and Children's Hospital (WCH) in Adelaide and through Australian/United Kingdom-based PCOS support organisations [<span>5</span>]. One part of the questionnaire investigated adolescents' views on the name ‘PCOS’ (using a 5-point Likert scale) and the name's importance to different stakeholders. This study was part of a broader study, with 11 questions relevant to this substudy compared to the full 32-question survey.</p><p>The study was approved by the WCH Research Ethics Committee (HREC/17/WCHN/15). Informed written consent and/or assent were obtained from all participants who completed the questionnaire during their clinic visit and from their parents/guardians if participants were younger than 18 years. For participants who completed the online questionnaire, completion of the online survey was taken as consent to participate in the study as per the introduction page of the survey.</p><p>Statistical analysis was performed with Stata software version 14.0 (StataCorp), and categorical data are presented as counts and proportions.</p><p>Eighty adolescents completed the full questionnaire (mean ± SD age 16.7 ± 1.8 years, menarche 12.2 ± 1.5 years). Most adolescents had been diagnosed with PCOS 2 years prior to completing the questionnaire (<i>n</i> = 62, 78%), lived in metropolitan areas (<i>n</i> = 53, 66%), and in Australia (<i>n</i> = 70, 88%).</p><p>There were diverse opinions among adolescents about whether the name can be confusing (30 [38%] disagreed/strongly disagreed, 21 [26%] were neutral, and 29 [36%] agreed/strongly agreed). More than half of adolescents (<i>n</i> = 41, 51%) agreed/strongly agreed that the name should stay the same, whilst 26 (33%) neither disagreed nor agreed, and 13 (16%) disagreed/strongly disagreed. Nearly half of adolescents were neutral about whether the name ‘PCOS’ should be changed to reflect the range of symptoms (<i>n</i> = 33, 41%), and almost half felt that increased education about PCOS and a name change are both needed (<i>n</i> = 37, 46%). Sixty-six (83%) adolescents agreed/strongly agreed that increased education about PCOS would be more effective than a name change (Figure 1).</p><p>Over half o","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 1","pages":"143-145"},"PeriodicalIF":1.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564157","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}
Belinda Dawson-McClaren, Melissa Martyn, Emma Weisz, Rigan Tytherleigh, Justine Elliott, Heather Renton, Natasha J. Brown, Michael Fahey, Clara Gaff
<div> <section> <h3> Background</h3> <p>Despite the potential benefits of genomic testing for children with unique body features and/or developmental differences, these tests are underutilised by paediatricians.</p> </section> <section> <h3> Aim</h3> <p>To co-design, implement and evaluate interventions to support paediatricians in overcoming barriers to requesting funded genomic tests.</p> </section> <section> <h3> Methods</h3> <p>A mixed-methods approach was taken. Co-design workshops with paediatricians, parents and genetic health professionals informed the development of multi-modal interventions. Evaluation, guided by the RE-AIM framework: data were surveys, website analytics, test request audits and interviews.</p> </section> <section> <h3> Results</h3> <p>The multi-modal intervention was a website, genetic expert consultation service and teaching clinic. Implementation of the intervention was supported by awareness-raising activities. Evaluation showed the website was accessed by 222 paediatricians in the first 12 months. Survey responses (T1, 1-month post-access: 11/218, 5%; T2, 3-months post-access: 14/218, 6%) indicated that confidence in knowledge-based areas increased and remained elevated 3 months after website access; skill-based confidence was also elevated but not sustained. The genetic expert consultation service, though accessed less than anticipated, provided valued support. The teaching clinic in metropolitan Melbourne offered experiential learning opportunities aimed at skill development. The clinic had 62 appointments with 39 patients. Thirteen paediatricians attended the clinic for experiential learning and 9 set learning goals. During the intervention period, requests for funded genomic tests by paediatricians increased by 227% compared to pre-intervention. Qualitative data (interviews with 12 paediatricians and 4 genetic experts) revealed paediatricians gained practical skills and confidence to assess child eligibility, discuss testing with parents and complete test requests.</p> </section> <section> <h3> Conclusions</h3> <p>The interventions helped increase paediatrician confidence and skills, highlighting the importance of combining knowledge transfer with experiential learning to support comprehensive practice change. These results offer a foundation for ongoing efforts to support wider, more equitable use of genomic tests. Long-term evaluation would further assess the impact on paediatrician practice. The study demonstr
{"title":"Exomes in Paediatrics: Co-Design and Implementation of Interventions to Support Paediatricians to Provide Genomic Care","authors":"Belinda Dawson-McClaren, Melissa Martyn, Emma Weisz, Rigan Tytherleigh, Justine Elliott, Heather Renton, Natasha J. Brown, Michael Fahey, Clara Gaff","doi":"10.1111/jpc.70237","DOIUrl":"10.1111/jpc.70237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the potential benefits of genomic testing for children with unique body features and/or developmental differences, these tests are underutilised by paediatricians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To co-design, implement and evaluate interventions to support paediatricians in overcoming barriers to requesting funded genomic tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed-methods approach was taken. Co-design workshops with paediatricians, parents and genetic health professionals informed the development of multi-modal interventions. Evaluation, guided by the RE-AIM framework: data were surveys, website analytics, test request audits and interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The multi-modal intervention was a website, genetic expert consultation service and teaching clinic. Implementation of the intervention was supported by awareness-raising activities. Evaluation showed the website was accessed by 222 paediatricians in the first 12 months. Survey responses (T1, 1-month post-access: 11/218, 5%; T2, 3-months post-access: 14/218, 6%) indicated that confidence in knowledge-based areas increased and remained elevated 3 months after website access; skill-based confidence was also elevated but not sustained. The genetic expert consultation service, though accessed less than anticipated, provided valued support. The teaching clinic in metropolitan Melbourne offered experiential learning opportunities aimed at skill development. The clinic had 62 appointments with 39 patients. Thirteen paediatricians attended the clinic for experiential learning and 9 set learning goals. During the intervention period, requests for funded genomic tests by paediatricians increased by 227% compared to pre-intervention. Qualitative data (interviews with 12 paediatricians and 4 genetic experts) revealed paediatricians gained practical skills and confidence to assess child eligibility, discuss testing with parents and complete test requests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The interventions helped increase paediatrician confidence and skills, highlighting the importance of combining knowledge transfer with experiential learning to support comprehensive practice change. These results offer a foundation for ongoing efforts to support wider, more equitable use of genomic tests. Long-term evaluation would further assess the impact on paediatrician practice. The study demonstr","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 1","pages":"97-105"},"PeriodicalIF":1.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70237","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557114","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}
Haofeng Guan, Xiaocha Liang, Yuanhao Liang, Fang Yang
Objectives
To evaluate the trends in mortality for early- and late-onset neonatal sepsis, as well as the attributable risk factors at global, regional and national levels from 1990 to 2021. Early-onset sepsis occurs within 0–6 days after birth, whereas, late-onset sepsis occurs between 7 and 27 days of life.
Methods
Data on deaths from early- and late-onset neonatal sepsis, as well as the proportion attributable to risk factors, was sourced from the Global Burden of Disease Study (GBD) 2021. Temporal trends in mortality rates were assessed using estimated annual percentage changes.
Results
In 2021, global deaths from early- and late-onset neonatal sepsis totalled 136 040 and 70 411, respectively, corresponding to mortality rates of 5549.9 and 965.3 per 100 000 population. Both early- and late-onset neonatal sepsis mortality declined from 1990 to 2021, with a more pronounced reduction in late-onset sepsis. However, total deaths increased in low-SDI regions, driven by early-onset sepsis. The highest mortality rates were observed in Sub-Saharan Africa, particularly in Western and Eastern Sub-Saharan Africa. In 2021, short gestation (gestational age < 38 weeks) and low birth weight (< 2500 g) were responsible for 29.6% and 66.3% of neonatal sepsis deaths globally. Mortality rates showed an inverse correlation with SDI, with higher-SDI regions experiencing faster reductions in mortality.
Conclusions
Neonatal sepsis remains a major global health challenge, particularly in low-SDI regions. Interventions targeting preterm birth, low birth weight and healthcare infrastructure are urgently needed.
{"title":"Global Trends in Neonatal Sepsis Mortality and Attributable Risk Factors From 1990 to 2021","authors":"Haofeng Guan, Xiaocha Liang, Yuanhao Liang, Fang Yang","doi":"10.1111/jpc.70241","DOIUrl":"10.1111/jpc.70241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the trends in mortality for early- and late-onset neonatal sepsis, as well as the attributable risk factors at global, regional and national levels from 1990 to 2021. Early-onset sepsis occurs within 0–6 days after birth, whereas, late-onset sepsis occurs between 7 and 27 days of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on deaths from early- and late-onset neonatal sepsis, as well as the proportion attributable to risk factors, was sourced from the Global Burden of Disease Study (GBD) 2021. Temporal trends in mortality rates were assessed using estimated annual percentage changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, global deaths from early- and late-onset neonatal sepsis totalled 136 040 and 70 411, respectively, corresponding to mortality rates of 5549.9 and 965.3 per 100 000 population. Both early- and late-onset neonatal sepsis mortality declined from 1990 to 2021, with a more pronounced reduction in late-onset sepsis. However, total deaths increased in low-SDI regions, driven by early-onset sepsis. The highest mortality rates were observed in Sub-Saharan Africa, particularly in Western and Eastern Sub-Saharan Africa. In 2021, short gestation (gestational age < 38 weeks) and low birth weight (< 2500 g) were responsible for 29.6% and 66.3% of neonatal sepsis deaths globally. Mortality rates showed an inverse correlation with SDI, with higher-SDI regions experiencing faster reductions in mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Neonatal sepsis remains a major global health challenge, particularly in low-SDI regions. Interventions targeting preterm birth, low birth weight and healthcare infrastructure are urgently needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 1","pages":"106-117"},"PeriodicalIF":1.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557145","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}
Oesophageal atresia and tracheoesophageal fistula (OA/TOF) is a neonatal congenital condition usually repaired within the first days of life. Children with OA/TOF frequently experience long-term aerodigestive tract difficulties, requiring ongoing multidisciplinary care from a variety of different specialties and allied health services. Our aim was to determine the benefit of a coordinated multidisciplinary Aerodigestive follow up clinic for patients with OA/TOF.
Methods
We conducted a retrospective cohort study of all patients who underwent OA/TOF repair at Starship Hospital between 2008 and 2022. Follow up data was collected from Paediatric Surgery, Paediatric Otorhinolaryngology (ORL), Gastroenterology, Respiratory, Dietetics and Speech Language Therapy (SLT), and was categorised according to clinics, investigations and operative visits.
Results
Ninety three patients were identified as having OA/TOF repairs during the study timeframe, and 79 were included in the analysis. The median length of hospital stay from birth to discharge was 27 days. During the first year of life, patients had an average of 5.8 clinic visits (range 0–33), 0.8 diagnostic investigations (range 0–4), and 1.9 operative procedures (range 0–17). The mean age at the end of the follow up period was 6.45 years. 19% of included patients had a rural address, indicating greater difficulty in accessing care due to location.
Conclusion
Our results highlight the significant and diverse follow up care that OA/TOF patients require following repair, and the benefit of a multidisciplinary Aerodigestive follow up clinic. A review of data following the establishment of a multidisciplinary clinic at Starship Hospital is planned.
{"title":"Aerodigestive Clinic: Multidisciplinary Follow Up for Oesophageal Atresia and Tracheoesophageal Fistula Patients","authors":"Annabel Kate Noakes, James Hamill, Edward Toll","doi":"10.1111/jpc.70238","DOIUrl":"10.1111/jpc.70238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Oesophageal atresia and tracheoesophageal fistula (OA/TOF) is a neonatal congenital condition usually repaired within the first days of life. Children with OA/TOF frequently experience long-term aerodigestive tract difficulties, requiring ongoing multidisciplinary care from a variety of different specialties and allied health services. Our aim was to determine the benefit of a coordinated multidisciplinary Aerodigestive follow up clinic for patients with OA/TOF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study of all patients who underwent OA/TOF repair at Starship Hospital between 2008 and 2022. Follow up data was collected from Paediatric Surgery, Paediatric Otorhinolaryngology (ORL), Gastroenterology, Respiratory, Dietetics and Speech Language Therapy (SLT), and was categorised according to clinics, investigations and operative visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety three patients were identified as having OA/TOF repairs during the study timeframe, and 79 were included in the analysis. The median length of hospital stay from birth to discharge was 27 days. During the first year of life, patients had an average of 5.8 clinic visits (range 0–33), 0.8 diagnostic investigations (range 0–4), and 1.9 operative procedures (range 0–17). The mean age at the end of the follow up period was 6.45 years. 19% of included patients had a rural address, indicating greater difficulty in accessing care due to location.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results highlight the significant and diverse follow up care that OA/TOF patients require following repair, and the benefit of a multidisciplinary Aerodigestive follow up clinic. A review of data following the establishment of a multidisciplinary clinic at Starship Hospital is planned.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 1","pages":"84-89"},"PeriodicalIF":1.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549662","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}
Andrea Eid, Mohamad El Haj, Ahmed Moustafa, Diana Malaeb, Fouad Sakr, Mariam Dabbous, Sami El Khatib, Souheil Hallit, Sahar Obeid, Feten Fekih-Romdhane
Background
Chronic pain is frequently experienced by adolescents, affecting their psychological health and frequently lasting into adulthood. Increased pain sensitivity has been connected to a number of sleep disorders, including nightmare distress. However, the underlying mechanisms of this relationship remain unclear. In this study, adolescents' perceptions of pain intensity and nightmare distress are examined in connection to the mediating effects of stress, anxiety and depression.
Methods
A cross-sectional study was conducted with 600 Lebanese adolescents (mean age = 15.94 years) recruited through random and snowball sampling. Participants completed validated Arabic versions of the Nightmare Distress Questionnaire (NDQ-AV), the Depression, Anxiety and Stress Scales for Youth (DASS-Youth-12) and a self-reported pain intensity scale.
Results
The results showed that depression and anxiety fully mediated the association between nightmare distress and perceived pain intensity. Higher nightmare distress was significantly associated with higher depression (β = 0.04; p < 0.001) and anxiety (β = 0.05; p < 0.001), whereas higher depression (β = 0.19; p < 0.001) and anxiety (β = 0.17; p < 0.001) were significantly associated with higher pain intensity. Finally, nightmare distress was significantly and directly associated with higher pain in both models.
Conclusion
The study emphasises the psychological connections between nightmare distress and pain perception in adolescents. Findings suggest that addressing depression and anxiety in adolescents suffering from nightmare distress may be essential to improving pain management.
{"title":"The Relationship Between Nightmare Distress and Perceived Pain Intensity in Adolescents: The Role of Depression, Anxiety and Stress as Mediators","authors":"Andrea Eid, Mohamad El Haj, Ahmed Moustafa, Diana Malaeb, Fouad Sakr, Mariam Dabbous, Sami El Khatib, Souheil Hallit, Sahar Obeid, Feten Fekih-Romdhane","doi":"10.1111/jpc.70240","DOIUrl":"10.1111/jpc.70240","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic pain is frequently experienced by adolescents, affecting their psychological health and frequently lasting into adulthood. Increased pain sensitivity has been connected to a number of sleep disorders, including nightmare distress. However, the underlying mechanisms of this relationship remain unclear. In this study, adolescents' perceptions of pain intensity and nightmare distress are examined in connection to the mediating effects of stress, anxiety and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted with 600 Lebanese adolescents (mean age = 15.94 years) recruited through random and snowball sampling. Participants completed validated Arabic versions of the Nightmare Distress Questionnaire (NDQ-AV), the Depression, Anxiety and Stress Scales for Youth (DASS-Youth-12) and a self-reported pain intensity scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed that depression and anxiety fully mediated the association between nightmare distress and perceived pain intensity. Higher nightmare distress was significantly associated with higher depression (<i>β</i> = 0.04; <i>p</i> < 0.001) and anxiety (<i>β</i> = 0.05; <i>p</i> < 0.001), whereas higher depression (<i>β</i> = 0.19; <i>p</i> < 0.001) and anxiety (<i>β</i> = 0.17; <i>p</i> < 0.001) were significantly associated with higher pain intensity. Finally, nightmare distress was significantly and directly associated with higher pain in both models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study emphasises the psychological connections between nightmare distress and pain perception in adolescents. Findings suggest that addressing depression and anxiety in adolescents suffering from nightmare distress may be essential to improving pain management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 1","pages":"90-96"},"PeriodicalIF":1.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549688","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}
{"title":"Avoiding Pitfalls in Paediatric Trauma: The Importance of Systematic Physical Examination","authors":"Soya Yamaguchi, Kazuki Iio, Masakazu Kinoshita","doi":"10.1111/jpc.70234","DOIUrl":"10.1111/jpc.70234","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 1","pages":"135-137"},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541118","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}
R. A. Hibbert, D. R. Cheng, A. McMinn, N. W. Crawford, S. Tosif
Aim
Human Metapneumovirus (hMPV) is a common cause of hospitalisation in children; yet there are currently no preventative licensed vaccines or specific treatments available. Our aim was to describe the clinical profile and seasonality of hospitalised children with hMPV, and to highlight those at higher risk of severe disease.
Methods
We conducted a retrospective audit at a single quaternary centre, The Royal Children's Hospital Melbourne, Australia. Clinical and epidemiological data were extracted from the electronic medical record for any child (0–18 years) with a positive respiratory Polymerase Chain Reaction (PCR) test for hMPV between May 2016 and December 2023 (study duration 7.5 years).
Results
A total of 1296 children who tested positive for hMPV between May 2016 and December 2023 were included in our study. Children aged < 2 years made up 50% of the cohort (n = 648). Seasonality reflected a consistent end-of-winter rise in case numbers, except during the COVID-19 pandemic when there were no reported cases of hMPV but a spike in case numbers the following year. Of those admitted, 41.2% had a comorbidity such as prematurity, cerebral palsy or malignancy. Children with comorbidities were more likely to have a longer duration of hospital stay with a median of 3 days (IQR 1–7) compared with 1 day (IQR 0–3) and be admitted to the Intensive Care Unit (ICU) (16.1% compared with 6.7%). Three children died within 30 days of returning a positive PCR, all of whom had an underlying malignancy.
Conclusions
Our study describes the impact of hMPV on hospitalisation at a quaternary centre. Younger children, particularly those aged < 2 years, and those with comorbidities were at a higher risk of ICU admission. Prevention strategies are needed to protect children from hMPV infection.
{"title":"Human Metapneumovirus Hospitalisation in Children: A Retrospective Audit","authors":"R. A. Hibbert, D. R. Cheng, A. McMinn, N. W. Crawford, S. Tosif","doi":"10.1111/jpc.70233","DOIUrl":"10.1111/jpc.70233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Human Metapneumovirus (hMPV) is a common cause of hospitalisation in children; yet there are currently no preventative licensed vaccines or specific treatments available. Our aim was to describe the clinical profile and seasonality of hospitalised children with hMPV, and to highlight those at higher risk of severe disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective audit at a single quaternary centre, The Royal Children's Hospital Melbourne, Australia. Clinical and epidemiological data were extracted from the electronic medical record for any child (0–18 years) with a positive respiratory Polymerase Chain Reaction (PCR) test for hMPV between May 2016 and December 2023 (study duration 7.5 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1296 children who tested positive for hMPV between May 2016 and December 2023 were included in our study. Children aged < 2 years made up 50% of the cohort (<i>n</i> = 648). Seasonality reflected a consistent end-of-winter rise in case numbers, except during the COVID-19 pandemic when there were no reported cases of hMPV but a spike in case numbers the following year. Of those admitted, 41.2% had a comorbidity such as prematurity, cerebral palsy or malignancy. Children with comorbidities were more likely to have a longer duration of hospital stay with a median of 3 days (IQR 1–7) compared with 1 day (IQR 0–3) and be admitted to the Intensive Care Unit (ICU) (16.1% compared with 6.7%). Three children died within 30 days of returning a positive PCR, all of whom had an underlying malignancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study describes the impact of hMPV on hospitalisation at a quaternary centre. Younger children, particularly those aged < 2 years, and those with comorbidities were at a higher risk of ICU admission. Prevention strategies are needed to protect children from hMPV infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 1","pages":"66-75"},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541192","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 evaluate the health and developmental concerns for children in out-of-home care in Central Australia and assess whether they received timely and comprehensive paediatric health assessments.
Methods
A retrospective audit of paediatric outpatient assessments for all children in out-of-home care in Central Australia, from 1 September 2018 to 1 May 2020. Timeliness of paediatric assessment was compared with the recommended timeframes in the National Clinical Assessment Framework.
Results
A total of 304 children, aged 0–17 years were in out-of-home care during the audit period, with 174 (57%) children seen through paediatric clinics. Ninety-five percent of children were Aboriginal and Torres Strait Islander and all children had health needs identified. Developmental concerns were most common in children over 1-year-old (70%). Sixty-three percent of school-aged children had behavioural concerns and 43% had mental health concerns identified. Foetal alcohol spectrum disorder (FASD) was diagnosed or suspected in 50%–66% of primary school-aged and younger and 43% of high school-aged children. More than 50% of primary school-aged children had diagnosed or suspected attention-deficit/hyperactivity disorder (ADHD). Nearly all children were referred for ongoing paediatric care. Less than half of the children had a comprehensive health assessment within the recommended 3 months of entry into out-of-home care.
Conclusions
Children in out-of-home care in Central Australia experience significant physical, developmental, behavioural and mental health care needs. The findings highlight significant delays in the provision of paediatric health assessments, with most children not seen within recommended timeframes. The findings from this study highlight the importance of timely and consistent access to assessments and should challenge stakeholders to prioritise service, system and policy development.
{"title":"Out-of-Home Care in Central Australia—A Retrospective Audit of Health Needs and Timeliness of Assessment Compared to the National Clinical Assessment Framework","authors":"Jade Woon, Annie Kilpatrick, Karen McLean","doi":"10.1111/jpc.70235","DOIUrl":"10.1111/jpc.70235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the health and developmental concerns for children in out-of-home care in Central Australia and assess whether they received timely and comprehensive paediatric health assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective audit of paediatric outpatient assessments for all children in out-of-home care in Central Australia, from 1 September 2018 to 1 May 2020. Timeliness of paediatric assessment was compared with the recommended timeframes in the National Clinical Assessment Framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 304 children, aged 0–17 years were in out-of-home care during the audit period, with 174 (57%) children seen through paediatric clinics. Ninety-five percent of children were Aboriginal and Torres Strait Islander and all children had health needs identified. Developmental concerns were most common in children over 1-year-old (70%). Sixty-three percent of school-aged children had behavioural concerns and 43% had mental health concerns identified. Foetal alcohol spectrum disorder (FASD) was diagnosed or suspected in 50%–66% of primary school-aged and younger and 43% of high school-aged children. More than 50% of primary school-aged children had diagnosed or suspected attention-deficit/hyperactivity disorder (ADHD). Nearly all children were referred for ongoing paediatric care. Less than half of the children had a comprehensive health assessment within the recommended 3 months of entry into out-of-home care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children in out-of-home care in Central Australia experience significant physical, developmental, behavioural and mental health care needs. The findings highlight significant delays in the provision of paediatric health assessments, with most children not seen within recommended timeframes. The findings from this study highlight the importance of timely and consistent access to assessments and should challenge stakeholders to prioritise service, system and policy development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 1","pages":"76-83"},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541147","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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