Journal of paediatrics and child health最新文献

Aim: Use of social media platforms such as TikTok within the adolescent population is widespread. Harnessing its accessibility and prevalence provides health professionals an opportunity to disseminate positive, evidence-based health information. However, infiltrating this domain brings challenges such as countering abundant misinformation and understanding the target audience. Creating successful short-form videos for social media is a nuanced skill. University health students produced videos focusing on common adolescent issues for a health-promoting TikTok channel. The aim of this study was to explore secondary school student perceptions of these videos.

Methods: A mixed methods evaluation was undertaken using surveys and focus group interviews. Teachers from participating secondary schools recruited parents and students via the school online communication system. Descriptive statistics from survey responses were used to analyse demographics and scale responses. A uses and gratification lens was used for inductive content analysis of qualitative data.

Results: Participant students were predominantly from Year 9 (age 14-15 years), 161/212 (76%). The median score for enjoyment and positive learnings from videos was 5/10 and for likelihood of sharing videos was 3/10. Three themes emerged from the qualitative data: (1) mixed perceptions of video content with a preference for health not disease, (2) engagement driven by entertainment and 3) social media platforms for enjoyment versus education.

Conclusions: Social media platforms are an accessible source of health information for adolescents. Health professionals have an opportunity to provide evidence-based health information and combat misinformation. Creating effective and targeted video content can increase the positive impact on adolescent audiences.

Background: Paediatric patients requiring a medical discharge generally have to wait for daytime ward rounds before leaving hospital. This can lead to unnecessary discharge delays spanning hours, with impacts on hospital capacity and patient satisfaction.

Aims: To assess the impact of an early-morning discharge project on discharge by time of day, family satisfaction, and staff experience.

Methods: A novel approach ("Sunrise Discharges") was trialled and audited at a tertiary children's hospital, whereby appropriate patients were discharged by night medical staff prior to morning handover. The Sunrise Discharge project was piloted in the General Paediatric department for 3 months starting from 1 August 2024, with prior communication to clinical staff through multiple channels. Analysis of patient discharge time trends was performed to assess the impact of this initiative. In addition, "Plan, Do, Study, Act" quality improvement cycles were implemented throughout the 3-month audit period utilising feedback from staff surveys, a parent experience survey, and chart reviews to improve this process.

Results: The implementation of Sunrise Discharges resulted in a nearly seven-fold increase in the percentage of total general paediatric discharges prior to 09:00 a.m. (0.65%-4.46%, p < 0.0001) when compared to the 3 months prior. Parent feedback on the project was positive. Staff provided helpful feedback which guided project improvement and notably, night staff did not feel this added unmanageable workload to their shifts.

Conclusion: The Sunrise Discharge project significantly improved discharge by time of day, with positive family experience of the process. With further refinement, it holds potential for hospital-wide implementation and broader use in other paediatric centres.

Aim: To define preschool wheeze profiles to 4-years, identify their early life associations, and impact on wheeze risk at 9-years.

Methods: A latent class analysis of eight wheeze responses (1 month-4 years) and two severity markers (respiratory presentation to emergency department and wheeze with shortness of breath) using data from a pre-birth prospective cohort study. Relative risk ratios (RRR) with 95% confidence intervals were calculated using multinomial logistic regression to examine associations between early life risk factors and wheeze at 9-years.

Results: Four distinct preschool wheeze profiles were identified: "never/infrequent" with minimal wheeze (n = 538), "early persistent" wheeze from 3 months to 4 years (n = 83), "transient" from 6 to 18 months (n = 263) and "late-onset" from 18 months to 4 years (n = 148). Relative to "never/infrequent", maternal asthma history was associated with increased risk of all adverse wheeze profiles, the highest for "early persistent" wheeze [RRR 5.06; 2.96-8.67]. Breastfeeding at 6 months decreased the risk of "early persistent" wheeze [RRR 0.53; 0.31-0.90] and at 12 months protected against all adverse wheeze profiles. Eczema, food allergy, aeroallergen and food sensitisation all increased the risk of "early persistent" and "late-onset" wheeze. "Early persistent" [RRR 7.25; 3.92-13.42] and "late-onset" [RRR 3.93; 2.24-6.89] wheeze profiles were associated with increased risk of wheeze at 9-years.

Conclusions: Early life exposures and atopy measures had distinct associations with data-derived preschool wheeze profiles. Maternal asthma and the absence of breastfeeding emerged as unifying risk factors. Investigation of the underlying mechanistic pathways is required to inform novel primary prevention strategies.

Background: Children with Duchenne Muscular Dystrophy (DMD) often experience impairments in trunk control and balance, which may negatively impact their functional abilities. This study aimed to investigate the relationships between trunk control, balance and functional skills in ambulatory children with DMD.

Methods: Thirty-two ambulatory boys with DMD aged 5-12 years (mean age: 8.59 ± 2.14 years) participated in the study. Assessments included the Trunk Control Measurement Scale (TCMS), Paediatric Functional Reach Test (PFRT), Timed-Up-and-Go Test (TUG) and Paediatric Evaluation of Disability Inventory (PEDI).

Results: Self-care scores on the PEDI were significantly correlated with TCMS-selective movement control (r = 0.424, p = 0.016) and PFRT (r = 0.566, p = 0.001). Mobility scores were correlated with TCMS-static sitting balance (r = 0.512, p = 0.003), selective movement control (r = 0.518, p = 0.002), dynamic reaching (r = 0.664, p < 0.001), PFRT (r = 0.350, p = 0.049) and TUG (r = -0.600, p < 0.001). No significant correlations were found between PEDI-social function scores and trunk control or balance measures (p > 0.05).

Conclusions: The findings suggest that trunk control and balance are important contributors to functional performance, particularly in self-care and mobility domains, in ambulatory children with DMD.

Trial registration: ClinicalTrials.gov identifier: NCT06379906.

Introduction: Child mortality is a critical global health indicator, reflecting a nation's development and healthcare quality. Despite significant progress in reducing child mortality globally, Somalia continues to experience high rates, particularly among infants and young children, due to preventable and treatable conditions. Malnutrition, birth complications and infectious diseases are the leading causes of death.

Objective: To assess and analyse the trends in pediatric mortality over the past 2 years at a national referral hospital in Mogadishu, Somalia.

Methods: This retrospective cross-sectional study, conducted in the pediatric Department of Banadir Hospital in Mogadishu, Somalia, reviewed records of 1513 pediatric deaths during the study period, of which 70 were excluded due to incomplete records, leaving 1443 cases that met the inclusion criteria for analysis.

Results: The overall pediatric mortality rate during the study period was 5.3%. Male children accounted for 56.5% of deaths, whereas females represented 43.5%. Infants under 1 year were disproportionately affected, contributing to most deaths. The primary causes of death were severe acute malnutrition (29.04%), birth asphyxia (10.33%) and preterm (13.65%). The majority of deaths occurred within the first 24 h after admission and between 2 and 5 days of hospitalisation. Significant associations were found between the age of the child and the cause of death (χ² = 537.485, p < 0.001). Additionally, there were significant associations between the year of death and the age of the child (χ² = 17.669, p < 0.001), as well as the number of deaths in children per year (χ² = 89.057, p < 0.001).

Conclusions: The leading cause of pediatric death was SAM, followed by prematurity and birth asphyxia. Most deaths occurred within the first 24 h of hospital admission. Nationwide, multi-centre studies and interventions are highly recommended.

Background: In Cambodia, emergency rooms (ERs) often serve as the primary access point for paediatric care, reflecting limited outpatient capacity and health system constraints.

Methods: A retrospective descriptive analysis of presentations at Angkor Hospital for Children between 2012 and 2021 was conducted. Diagnoses were harmonised using ICD-10 definitions. The primary cohort included all eligible presentations, while a secondary cohort excluded patients aged outside the hospital age range, procedural-only visits, unclassifiable diagnoses, and referrals. Analyses focused on the 10 most common diagnostic groups in the secondary cohort. Seasonal and rural-urban patterns were assessed using risk ratios.

Results: A total of 60 310 patients with 87 977 visits were included in the primary cohort and 43 170 patients with 62 148 visits in the secondary cohort. More boys (57%) than girls (43%) accounted for ER presentations, and approximately 40% of patients were aged 1-5 years. Respiratory-related diseases were the most frequent diagnostic group, followed by infectious and parasitic diseases. Visits peaked during the rainy season, with dengue showing strong rainy season predominance (RR ≈ 5.9). Rural children accounted for 56% and showed a higher relative likelihood of dengue, influenza and pneumonia, and haemolytic anaemias, whereas chronic respiratory diseases and toxic substance exposures were more frequent among urban children. Most presentations resulted in discharge home, and mortality was low (0.09%).

Conclusion: ER utilisation in Cambodia reflects both acute illness burden and broader health system access patterns. The findings highlight the need for seasonally responsive preparedness, strengthened rural outreach, and integrated acute care planning in resource-limited settings.

Aim: In April 2024 nirsevimab, a long-acting respiratory syncytial virus (RSV)-specific monoclonal antibody, was made available free of charge to all newborn infants in Queensland. We aimed to explore the community-level impact of a nirsevimab-based prevention program on RSV detection percentages among infants aged ≤ 3 months in Queensland, Australia.

Methods: A retrospective analysis of January 2022-December 2024 laboratory data from a Queensland network. Weekly percentages of RSV-positive tests among infants aged ≤ 3 months (eligible group for nirsevimab) were compared with children aged 24-35 months (ineligible group) after nirsevimab introduction in mid-April 2024, and with comparable age data from 2022 to 2023.

Results: Overall, 20 956 RSV polymerase chain reaction tests for both age groups were performed during the study period (2022: 5593; 2023: 4910; 2024: 10 453). Following nirsevimab introduction, the percentage of RSV positive tests declined from 16.0% (370/2316) to 5.8% (51/876) among eligible infants (aged ≤ 3 months), compared to 18.6% (1879/10 098) to 14.6% (1117/7666) among ineligible children (aged 24-35 months). Difference-in-differences analysis showed an absolute risk difference of -6.9 percentage points (95% confidence interval: -13.2 to -4.1, p = 0.03).

Conclusions: We present the first real-world community-based evidence on the impact of nirsevimab upon RSV detection percentages in infants aged ≤ 3 months in Queensland, Australia. The nirsevimab-based prevention program may be contributing to a substantial decline in RSV detection percentages among young infants in the community.