Journal of paediatrics and child health最新文献

Background: Artificial intelligence (AI) systems hold great promise in improving medical care and health problems.

Aim: We aimed to evaluate the answers by asking the most frequently asked questions to ChatGPT for the prediction and treatment of fever, which is a major problem in children.

Methods: The 50 questions most frequently asked about fever in children were determined, and we asked them to ChatGPT. We evaluated the responses using the quality and readability scales.

Results: While ChatGPT demonstrated good quality in its responses, the readability scale and the Patient Education Material Evaluation Tool (PEMAT) scale used with materials appearing on the site were also found to be successful. Among the scales in which we evaluated ChatGPT responses, a weak positive relationship was found between Gunning Fog (GFOG) and Simple Measure of Gobbledygook (SMOG) scores (r = 0.379) and a significant and positive relationship was found between FGL and SMOG scores (r = 0.899).

Conclusion: This study sheds light on the quality and readability of information regarding the presentation of AI tools, such as ChatGPT, regarding fever, a common complaint in children. We determined that the answers to the most frequently asked questions about fire were high-quality, reliable, easy to read and understandable.

Aim: Hospitalisation rates for paediatric bone and joint infection (BJI) in New Zealand (NZ) are among the highest globally. This study aims to quantify hospitalisation costs of BJI in 2018-2019.

Methods: National hospitalisation data from the NZ Ministry of Health was used to describe costs associated with all paediatric hospitalisations coded for osteomyelitis or septic arthritis in those aged <16 years. Data included age, ethnic group, area level deprivation, diagnosis-related-group coding, admission length and cost-weight. Readmissions up to 24 months following the initial encounter were analysed for associated costs.

Results: More than ten million dollars was spent on hospitalisation for paediatric BJI over the study period (NZ$10 819 474). There were 869 primary hospitalisations and 229 related readmissions. Median length of stay was 7.4 days (95% confidence interval 6.8-7.9). Re-admission costs were NZ$1 196 640 within 24 months following diagnosis. Higher median hospitalisation costs occurred for children residing in the most deprived versus least deprived neighbourhoods (NZ$12 126 vs. NZ$9010, P < 0.01). NZ Māori compared with non-Māori children had longer length of stay (8.4 vs. 6.3 days, P = 0.04), more complex and severe illnesses (53% vs. 17%, P < 0.01), and higher median hospitalisation costs (NZ$11 796 vs. NZ$9581, P = 0.03).

Conclusions: Direct BJI hospitalisation costs in 2018-2019 were NZ$10 819 474 with 11% of costs due to re-admission. Direct hospitalisation costs for paediatric BJI in NZ vary by deprivation and ethnic group. Illness complexity of paediatric BJI varies by ethnic group. Interventions are needed to reduce incidence and severity of these debilitating infections.

Aim: Creating an overview of the existing literature about peer support in paediatrics, with a focus on children with chronic diseases.

Methods: An online search was conducted in MEDLINE and Web of Science. English, Dutch or French articles published between 1 January 2000 and 10 May 2023 were included, based on title and abstract.

Results: In this review, 47 articles were included, identifying following themes: Health-Related Quality of Life (n = 8), peer support for parents/siblings (n = 6), social environment (n = 2), and peer support programme for children (n = 31) subdivided in: general concept (n = 13), online (n = 11), camps (n = 6), and development of a peer support programme (n = 1). Peer support aims to improve disease-related knowledge, coping, and management of the disease, as well as creating a positive mindset and decreasing the disease burden. There is no consensus regarding which peer group design was superior.

Conclusions: Peer groups aim to increase knowledge and psychological adaptation, and decrease physical symptoms and side effects. It is desired to start the peer mentor programme within 1 year after diagnosis or during a critical incident. Further investigation needs to determine the optimal age to start these groups and the format (online or in-person). Communication between mentors and their mentees was crucial in the succeeding of the programme, as well as creating a safe environment to share experiences. Even though research is still needed concerning peer-to-peer support for children, there is already a lot known about similar programmes for parents of children with chronic diseases.

Aim: Clinical registries are an important research tool to enhance our understanding of vision loss in the Australian paediatric population. We aim to provide an update on the epidemiology of visual impairment among Western Australian children using registry data analysis, and to highlight the challenges of registry data collection.

Methods: This is a retrospective study of visual impairment and blindness registrations of children aged 0-16 years in Western Australia from 1996 to 2015. Blindness was defined as visual acuity ≤6/60 in the better-seeing eye or binocular visual field ≤20° diameter, with all other certifications labelled as visual impairment. Certificates were assessed for primary causes of vision loss by age strata and sex. Registration rate trends were analysed across three discrete registration periods.

Results: Of 11 800 certificates issued between 1996 and 2015, 728 certificates (6.2%) were issued to 710 children. Five hundred and twenty-nine (74.5%) certificates were issued for visual impairment and 181 (25.5%) for blindness. The leading cause of certification was inherited retinal disease (73, 10.3%), followed by cortical visual impairment (57, 8.0%) and albinism (56, 7.9%). The annual registration rate of visual impairment increased from 0.5 to 9.8 per 100 000 person-years across the study period, whereas blindness rates fell from 2.7 to 1.3.

Conclusions: Overall registration rates of paediatric visual impairment in Western Australia are increasing, but these trends should be interpreted with caution given the known limitations of registry data. Enhancements of the registration process could be achieved through digitisation, inclusion of patient outcome data, and incentives for greater practitioner engagement.

Aim: This scoping review aims to expansively review the reporting of Indigenous status, ethnicity, culture, language and country of birth in Australian paediatric clinical studies.

Methods: Scoping review of Australian clinical studies, including randomised controlled trials, non-randomised controlled trials, cluster randomised controlled trials and quasi-experimental studies, with paediatric participants (<18 years) or mixed adult and paediatric participants. PubMed, Cumulated Index to Nursing and Allied Health Literature and Embase databases were searched for clinical studies published 1 January 2018 to 28 November 2022.

Results: Of the 2717 studies identified in the search, 209 clinical studies were included. Overall, 131 (62.7%) clinical studies captured in this review did not report any of the variables of interest. When reported, terms used by study authors varied extensively and subsequently five study-defined categories emerged 'Indigenous status', 'race', 'race and ethnicity', 'ethnicity', or 'natural skin colour'. 'Indigenous status' was most reported (n = 37, 17.7%), followed by 'ethnicity and/or cultural background' (n = 15, 7.2%), 'race and ethnicity' (n = 4, 1.9%), race (n = 1, 0.5%) and 'natural skin colour' (n = 1, 0.5%). Furthermore, language used at home was reported in 27 studies (12.9%) and country of birth in 23 studies (11.0%).

Conclusions: This review demonstrated very low reporting of Indigenous status, ethnicity, culture, language and country of birth in Australian paediatric clinical studies. Poor reporting has raised concerns surrounding generalisability of findings from these trials in addition to equity. The recent international shift encompassing improved clinical trial reporting requirements, for ethnicity and race, require prompt establishment in the Australian clinical trial domain.

Aim: Maternal health and gestational control are crucial to improving the newborn's prognosis. This study analyses demographic and obstetric factors at the beginning of pregnancy related to neonatal health, assessing their impact on the risk of hospital admission and prematurity.

Methods: Observational retrospective study conducted in Northeast Spain with data of 9560 newborns between February 2017 and February 2022. The following have been evaluated as risk factors for hospital admission: nulliparity, multiple gestation, fertilisation techniques, foreign maternal origin, maternal age, smoking and residential location, dividing the sample according to gestational age. Hypothesis testing and logistic regression were performed.

Results: Nulliparity, fertilisation techniques and multiple gestation represent a risk factor for neonatal admission (OR 22.48, 4.04 and 3.34, respectively), especially in premature newborns <32 weeks of GA (OR: 30.71, 10.71 and 22.76, respectively). Foreign maternal origin also adds risk of admission, both in term newborns (OR 1.26; CI: 1.10-1.43) and in premature babies <32 weeks of GA (OR 1.61; CI: 1.09-2.38). Tobacco does not present a significant risk of neonatal admission. The multivariate analysis model confirms the influence of the following factors in all the studied groups: nulliparity, multiple gestation and foreign maternal origin.

Conclusions: Nulliparity and multiple pregnancies are both main risk factors for neonatal admission and premature delivery. The use of fertilisation techniques and the foreign origin of the mother significantly associate increased risk of admission and neonatal prematurity. These findings underscore the need for a comprehensive approach to prenatal care to improve neonatal prognosis and promote long-term health in risk populations.