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Améliorer la sécurité à vélo chez les enfants et les adolescents. 改善儿童和青少年的骑车安全。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-13 eCollection Date: 2024-08-01 DOI: 10.1093/pch/pxae036
Daniel Rosenfield, Pamela Fuselli, Suzanne Beno

Le vélo demeure une activité populaire pour les enfants et les adolescents du monde entier; elle combine le plaisir de se déplacer rapidement et de nombreux avantages pour la santé et la société. Cependant, le vélo est également associé à un risque de blessures graves et de décès. Depuis dix ans, les recherches démontrent de plus en plus que l'amélioration de la sécurité des cyclistes dépend en grande partie de l'environnement dans lequel ils se déplacent et de mesures de sécurité individuelles comme le port du casque. Pour de nombreux enfants et adolescents, la pandémie a accru les possibilités de faire du vélo et, et elle ramené l'attention du public vers des infrastructures cyclables sécuritaires, telles que des voies cyclables réservées. Le présent document de principes passe en revue les données probantes en appui à des infrastructures cyclables plus sécuritaires pour les enfants et les adolescents, de même que les bienfaits du vélo pour la santé physique et mentale. Les avantages du transport actif chez les jeunes et l'influence de l'environnement bâti sur la sécurité et l'adoption du vélo sont exposés. Un aperçu des mesures que chacun peut prendre pour améliorer la sécurité à vélo est suivi de recommandations pour les cliniciens, la communauté des cyclistes, les parents et les décideurs.

骑自行车仍然是全世界儿童和青少年喜爱的一项活动,它既能享受快速出行的乐趣,又能带来诸多健康和社会效益。然而,骑自行车也存在严重受伤和死亡的风险。在过去十年中,越来越多的研究表明,提高骑车人的安全主要取决于他们的出行环境和个人安全措施,如佩戴头盔。对许多儿童和青少年来说,大流行病增加了骑自行车的机会,也让公众重新关注安全的自行车基础设施,如专用自行车道。本立场文件回顾了支持为儿童和青少年提供更安全的自行车基础设施的证据,以及骑自行车对身心健康的益处。文件概述了积极交通对年轻人的益处,以及建筑环境对骑行安全和骑行率的影响。概述了每个人都能为改善骑车安全做些什么,然后向临床医生、骑车社区、家长和政策制定者提出了建议。
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引用次数: 0
Medicines for children: A global gift of trusted accessible information for parents. 儿童药品:为家长提供可信、可获取信息的全球礼物。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-12 eCollection Date: 2024-09-01 DOI: 10.1093/pch/pxae059
David P Tuthill, Anna Rossiter, Yincent Tse

To engender safer medication practice the Government of Canada encourages families to, "Ask your doctor about your child's medication." Medicines for Children (MFC) was established in 2006 when the U.K.'s Royal College of Paediatrics and Child Health (RCPCH), Wellchild charity, and the Neonatal and Paediatric Pharmacy Group (NPPG) listened to parents' concerns that they needed better information on children's medicines. Each one of the >200 information sheets available on the website has gone through a standardized, audited development. When launched in 2009 there were 10,500 hits by 7000 unique users which has grown to 4.5 million hits from 3.6 million individuals in 2022. Although the UK has the largest number of users; its worldwide importance is demonstrated by the fact that there are 430,000 users in Canada. For parents of a child who needs to take medicines safely, MFC provides high-quality, reliable family-centred information accessible 24/7 across the globe.

为了提高用药安全,加拿大政府鼓励家庭 "向医生询问孩子的用药情况"。英国皇家儿科和儿童健康学院 (RCPCH)、Wellchild 慈善机构以及新生儿和儿科药学组 (NPPG) 倾听了家长们关于他们需要更好的儿童用药信息的关切后,于 2006 年成立了儿童用药 (MFC)。网站上提供的 200 多份信息表中的每一份都经过了标准化的审核开发。2009 年推出时,有 7000 名独立用户点击了 10500 次,到 2022 年,点击量已从 360 万人次增至 450 万人次。虽然英国的用户数量最多,但加拿大的用户数量也达到了 43 万,由此可见该网站在全球范围内的重要性。对于需要安全服药的孩子的父母来说,MFC 提供以家庭为中心的高质量、可靠信息,可在全球范围内全天候访问。
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引用次数: 0
Unintended consequences of a night float system in Paediatric Residency 儿科住院医师夜间流动制度的意外后果
IF 1.9 4区 医学 Q2 PEDIATRICS Pub Date : 2024-09-11 DOI: 10.1093/pch/pxae046
Ali Al Maawali, Allan Puran, Susanna Talarico, Zia Bismilla
Objectives Many residency programs implement ‘night float’ (NF) systems as alternatives to a traditional 24-h call model in an attempt to comply with duty-hour regulations. Research evaluating NF systems has focused primarily on the perspective of the resident with respect to fatigue and quality of life. Understanding the broader consequences of NF models from both trainee and faculty points of view is essential to creating effective and sustainable systems to comply with duty-hour regulations while maximizing patient care, education, and quality of life (QoL). Methods This study used qualitative thematic analysis situated in a constructivist paradigm to explore the experience of an NF system by residents and faculty. Semi-structured interviews were conducted with 15 trainees and 3 faculty members at a large academic pediatric hospital to understand their perceptions of an NF call structure compared to the traditional 24-h call schedule. Results Three themes were identified: (i) Implications for resident; (ii) Implications for patient and family; and (iii) Implications for curriculum. Eight sub-themes were identified, highlighting both intended and unintended consequences of the NF system. Conclusions The NF system resulted in the intended outcomes of decreased fatigue and improved continuity of patient care. Unintended outcomes also occurred, however, including negative effects on assessment and feedback, lack of integration of competencies, and mixed results on resident quality of life. These areas require special attention when designing and implementing NF systems.
目的 许多住院医师培训项目都实施了 "夜间浮动"(NF)系统,以替代传统的 24 小时呼叫模式,试图遵守值班时间规定。对 NF 系统的评估研究主要集中在住院医师对疲劳和生活质量的看法上。从受训者和教师的角度了解 NF 模式的广泛影响,对于创建有效且可持续的系统以遵守值班时间规定,同时最大限度地提高患者护理、教育和生活质量(QoL)至关重要。方法 本研究采用建构主义范式下的定性主题分析法,探讨住院医师和教职员工对 NF 系统的体验。研究人员对一家大型儿科学术医院的 15 名学员和 3 名教员进行了半结构式访谈,以了解他们对 NF 呼叫结构与传统 24 小时呼叫计划相比的看法。结果 确定了三个主题:(i) 对住院医师的影响;(ii) 对患者和家属的影响;(iii) 对课程的影响。确定了八个次主题,突出强调了 NF 系统的预期和意外后果。结论 NF 系统产生了预期结果,即减少疲劳和改善病人护理的连续性。然而,意外结果也有出现,包括对评估和反馈的负面影响、缺乏能力整合以及对住院医师生活质量的影响参差不齐。在设计和实施 NF 系统时,需要特别注意这些方面。
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引用次数: 0
Correction to: Integrating intersectionality into child health research: Key considerations. 更正:将交叉性纳入儿童健康研究:主要考虑因素。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-08-22 eCollection Date: 2024-09-01 DOI: 10.1093/pch/pxae053

[This corrects the article DOI: 10.1093/pch/pxae033.].

[此处更正了文章 DOI:10.1093/pch/pxae033]。
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引用次数: 0
Precision of point of care glucose metre measurements in the context of neonatal hypoglycemia. 新生儿低血糖护理点血糖仪测量的精确度。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-08-20 eCollection Date: 2024-09-01 DOI: 10.1093/pch/pxae049
Julie L V Shaw, Saranya Arnoldo, Sukhbir Kaur, Michael J Knauer, Felix Leung, Heather Paul, Vinita Thakur, Davor Brinc
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引用次数: 0
Patient-reported outcome measures for paediatric gender-affirming care: A systematic review 儿科性别确认护理的患者报告结果测量:系统回顾
IF 1.9 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-25 DOI: 10.1093/pch/pxae019
Liam Jackman, Cynthia Chan, Chloë Jacklin, Eve Deck, Ann C Lee, Melissa Stepney, Conrad Harrison, Abhilash Jain, Jeremy Rodrigues, Rakhshan Kamran
Objectives Patient needs must be comprehensively measured to offer paediatric gender-affirming care in line with clinical standards. Patient-reported outcome measures (PROMs) are self-report tools that measure outcomes deemed to be of importance to patients. PROMs may assess a single outcome or multiple outcomes simultaneously, such as symptoms, functional ability, and quality of life. This study aims to identify PROMs for paediatric gender-affirming care. Methods This systematic review is PRISMA-compliant and was prospectively registered on PROSPERO (CRD42023461959). Six databases were searched: PubMed, Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science from inception to December 16, 2022. Articles meeting the following criteria were included: 1) Original article; 2) Administers a formally-developed PROM; 3) Focuses on gender-affirming care; and 4) Focuses on paediatric populations. Screening and data extraction occurred independently and in duplicate. Data extracted include study/demographic information, and details of PROM used. Results In total, 20 articles were included, representing a total of 5793 paediatric patients undergoing gender-affirming care. Most studies (13, 65%) focused on hormonal gender-affirming care. A total of 38 different PROMs for paediatric gender-affirming care were identified, ranging from 4 to 120 items each (mean 23 items; median 14 items). Most PROMs (n = 22) measured psychological functioning, with eight PROMs measuring quality of life, and three PROMs measuring gender-related concepts (i.e., gender dysphoria/euphoria). Commonly used PROMs include the Utrecht Gender Dysphoria Scale (n = 4; 20%), Body Image Scale (n = 5;25%), and Youth Self-Report (n = 8; 40%). Conclusions A total of 38 PROMs were identified measuring a range of concepts for paediatric gender-affirming care.
目标 必须全面衡量患者的需求,以提供符合临床标准的儿科性别确认护理。患者报告结果测量(PROMs)是一种自我报告工具,用于测量患者认为重要的结果。PROM可评估单一结果或同时评估多种结果,如症状、功能能力和生活质量。本研究旨在确定儿科性别确认护理的 PROM。方法 本系统性综述符合 PRISMA 标准,并在 PROSPERO 上进行了前瞻性注册(CRD42023461959)。检索了六个数据库:PubMed、Embase、MEDLINE、PsycINFO、CINAHL 和 Web of Science。符合以下标准的文章均被纳入:1) 原创文章;2) 采用正式开发的 PROM;3) 关注性别确认护理;4) 关注儿科人群。筛选和数据提取独立进行,一式两份。提取的数据包括研究/人口统计学信息以及所用 PROM 的详细信息。结果 共纳入 20 篇文章,代表了 5793 名接受性别确认护理的儿科患者。大多数研究(13 项,占 65%)侧重于荷尔蒙性别确认护理。研究共发现了 38 种不同的儿科性别确认护理 PROM,每种 PROM 的项目从 4 到 120 项不等(平均 23 项;中位数 14 项)。大多数 PROM(n = 22)测量的是心理功能,其中 8 个 PROM 测量的是生活质量,3 个 PROM 测量的是与性别相关的概念(即性别焦虑症/欣快症)。常用的 PROM 包括乌得勒支性别焦虑量表(n = 4;20%)、身体形象量表(n = 5;25%)和青少年自我报告(n = 8;40%)。结论 共确定了 38 份 PROM,用于测量儿科性别确认护理的一系列概念。
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引用次数: 0
Research capacity and limitations in Canadian paediatric emergency departments: An observational study on biomarker discovery 加拿大儿科急诊部门的研究能力和局限性:生物标记物发现观察研究
IF 1.9 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-25 DOI: 10.1093/pch/pxae023
Elena Mitevska, Beata Mickiewicz, Leslie Boisvert, Christine Bon, Redjana Carciumaru, Ramona Cook, Tyrus Crawford, Joan Dietz, Melanie Doyle, Angela Y Hui, Karly Stillwell, Adriana Trajtman, Darcy Beer, Maala Bhatt, William Craig, Eleanor Fitzpatrick, Jocelyn Gravel, April Kam, Ahmed Mater, Anne Moffat, Naveen Poonai, Vikram Sabhaney, Graham C Thompson
Background Paediatric research is essential to acquire effective diagnoses and treatment for children, but it has historically been under-prioritized. The PRIMED study aimed to characterize the bio-profiles of children with appendicitis and investigate their use as a clinical prediction tool. We evaluated the clinical research capacity of several Canadian paediatric emergency departments (EDs) and described both the challenges experienced in the implementation of the PRIMED study and the strategies which were used to improve local research capacity. Methods Eleven paediatric EDs across Canada provided basic demographic and administrative data along with laboratory- and human-resource availability during the PRIMED study enrollment. Data were summarized using descriptive statistics. Results Fewer than half of the study sites (5/11, 45%) had access to a laboratory that would process research samples 24 hours per day. Four study sites (36%) only enrolled patients during business hours (8:00–17:00). There was no nighttime coverage for patient enrollment and sample collection. Only three study sites (27%) had enrollment hours that captured over 75% of the potential study participants. Over half of the study sites (6/11, 55%) developed novel processes to enable study success, for example, creating graduate student on-call schedules and hiring bioscience-trained site coordinators to process samples. Interpretation Despite site-specific efforts to overcome resource barriers, the gap in clinical research capacity at academic paediatric EDs remains a significant concern. University research institutes and paediatric hospitals should invest in infrastructure and human resources to increase after-hours research capacity to optimize child health and wellness outcomes.
背景 儿科研究对儿童获得有效的诊断和治疗至关重要,但儿科研究历来未得到足够重视。PRIMED 研究旨在描述阑尾炎患儿的生物特征,并将其用作临床预测工具。我们评估了加拿大几家儿科急诊室(EDs)的临床研究能力,并介绍了在实施 PRIMED 研究过程中遇到的挑战以及为提高当地研究能力而采取的策略。方法 加拿大的 11 家儿科急诊室提供了基本的人口和管理数据,以及在 PRIMED 研究注册期间实验室和人力资源的可用性。数据采用描述性统计方法进行总结。结果 只有不到一半的研究机构(5/11,45%)拥有每天 24 小时处理研究样本的实验室。有四个研究机构(36%)只在上班时间(8:00-17:00)接收病人。夜间没有患者登记和样本采集服务。只有 3 个研究机构(27%)的登记时间能满足 75% 以上潜在研究参与者的需求。半数以上的研究机构(6/11,55%)制定了新的流程,以确保研究的成功,例如,制定研究生值班时间表和聘用经过生物科学培训的机构协调员来处理样本。释义 尽管各研究机构努力克服资源障碍,但学术儿科急诊室在临床研究能力方面的差距仍是一个重大问题。大学研究机构和儿科医院应投资基础设施和人力资源,提高下班后的研究能力,以优化儿童健康和保健成果。
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引用次数: 0
Les soins peau-à-peau chez les nourrissons à terme et prématurés. 为足月儿和早产儿提供皮肤护理。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-22 eCollection Date: 2024-07-01 DOI: 10.1093/pch/pxae014
Gabriel Altit, Danica Hamilton, Karel O'Brien

Les soins peau-à-peau (SPP) sont un aspect important des soins au parent et au nourrisson pendant la période néonatale et la première enfance. Ils doivent être entrepris immédiatement après la naissance et faire partie des soins standards dans tous les milieux, y compris à la maison. Selon de solides données probantes, les SPP ont un effet positif sur l'allaitement et l'alimentation par du lait humain, tant chez les nourrissons à terme que prématurés, de même que sur la mortalité, la stabilité cardiorespiratoire et la thermorégulation. Les SPP réduisent la douleur et le stress chez les nourrissons, accroissent l'attachement entre le parent et son nourrisson et ont des effets bénéfiques sur le neurodéveloppement de l'enfant ainsi que sur la santé mentale des parents. Le caractère sécuritaire et la faisabilité des SPP sont établis chez les nourrissons à terme et prématurés, et ces soins sont recommandés dans le cadre d'une pratique exemplaire auprès de tous les nourrissons. Les avantages des SPP sont supérieurs aux risques dans la plupart des situations, et malgré les défis qui y sont associés, les dispensateurs de soins devraient adopter des protocoles et prévoir des adaptations pour s'assurer que les SPP soient une expérience positive et sécuritaire pour le parent, la famille, le nourrisson et l'équipe soignante. Le présent document de principes s'adresse à toutes les familles, telles qu'elles se définissent et se déterminent elles-mêmes, et tiennent compte de l'importance de personnaliser la communication, le langage et la terminologie en matière de santé pour que l'équipe soignante réponde aux besoins particuliers de la famille.

皮肤护理(SSC)是新生儿期和婴儿期父母和婴儿护理的一个重要方面。它应在婴儿出生后立即开始,并成为包括家庭在内的所有环境中标准护理的一部分。有确凿证据表明,PPS 对足月儿和早产儿的母乳喂养和人奶喂养,以及死亡率、心肺功能稳定性和体温调节都有积极影响。PPS 可减轻婴儿的疼痛和压力,增加父母与婴儿之间的依恋,并对婴儿的神经发育和父母的心理健康产生有益的影响。在足月儿和早产儿中,PPS 的安全性和可行性已得到证实,并被推荐为所有婴儿的最佳做法。在大多数情况下,PPH 的益处大于风险,尽管存在相关的挑战,但护理人员仍应采用规程并进行调整,以确保 PPH 对父母、家庭、婴儿和医疗团队来说都是一次积极而安全的经历。本立场文件面向所有家庭,因为他们定义并决定自己,并认识到个性化健康沟通、语言和术语的重要性,以确保医疗团队满足家庭的独特需求。
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引用次数: 0
Le développement sain de l'enfant par le jeu risqué extérieur : un équilibre à trouver avec la prévention des blessures. 通过有风险的户外游戏促进儿童健康成长:在预防伤害之间取得平衡。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-22 eCollection Date: 2024-07-01 DOI: 10.1093/pch/pxae017
Emilie Beaulieu, Suzanne Beno

Le jeu libre est essentiel pour le développement de l'enfant, de même que pour sa santé physique, mentale et sociale. Les occasions de se livrer au jeu libre extérieur, et au jeu risqué en particulier, ont considérablement diminué ces dernières années, en partie parce que les mesures de sécurité ont visé à prévenir toutes les blessures liées aux jeux plutôt que seulement les blessures graves et fatales. Le jeu risqué désigne des formes passionnantes et stimulantes de jeu libre dont l'issue est incertaine et qui comportent une possibilité de blessure physique. Les promoteurs du jeu risqué distinguent le « risque » du « danger » et aspirent à recadrer la perception du risque pour qu'il devienne une occasion d'évaluer une situation et de favoriser le développement personnel. Dans le présent document de principes, les auteures soupèsent le fardeau des blessures liées au jeu par rapport aux données probantes en appui au jeu risqué, notamment les avantages, les risques et les nuances, qui peuvent varier en fonction de l'étape de développement de l'enfant, de ses aptitudes et du contexte social et médical. Elles proposent des approches pour promouvoir des échanges ouverts et constructifs avec les familles et les organisations. Les pédiatres sont invités à percevoir le jeu risqué extérieur comme un moyen de contribuer à prévenir et à gérer des problèmes de santé courants tels que l'obésité, l'anxiété et les problèmes de comportement.

自由游戏对儿童的发展以及身体、心理和社会健康至关重要。近年来,户外自由游戏,尤其是冒险游戏的机会大大减少,部分原因是安全措施的重点是预防所有与游戏相关的伤害,而不仅仅是严重和致命的伤害。危险游戏指的是令人兴奋和具有挑战性的自由游戏形式,其结果是不确定的,并且有 可能造成身体伤害。冒险游戏的支持者将 "风险 "和 "危险 "区分开来,并希望重塑对风险的认识,使其成为评估情境和促进个人发展的机会。在这份立场文件中,作者权衡了与赌博相关的伤害负担和支持冒险赌博的证据,包括益处、风险和细微差别,这些可能因儿童的发育阶段、能力、社会和医疗环境而异。他们提出了促进与家庭和组织进行公开和建设性讨论的方法。请儿科医生将有风险的户外游戏视为帮助预防和管理肥胖、焦虑和行为问题等常见健康问题的一种方式。
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引用次数: 0
Healthy childhood development through outdoor risky play: Navigating the balance with injury prevention. 通过户外冒险游戏促进儿童健康成长:平衡与预防伤害之间的关系。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-22 eCollection Date: 2024-07-01 DOI: 10.1093/pch/pxae016
Emilie Beaulieu, Suzanne Beno

Free play is essential for children's development and for their physical, mental, and social health. Opportunities to engage in outdoor free play-and risky play in particular-have declined significantly in recent years, in part because safety measures have sought to prevent all play-related injuries rather than focusing on serious and fatal injuries. Risky play is defined by thrilling and exciting forms of free play that involve uncertainty of outcome and a possibility of physical injury. Proponents of risky play differentiate "risk" from "hazard" and seek to reframe perceived risk as an opportunity for situational evaluation and personal development. This statement weighs the burden of play-related injuries alongside the evidence in favour of risky play, including its benefits, risks, and nuances, which can vary depending on a child's developmental stage, ability, and social and medical context. Approaches are offered to promote open, constructive discussions with families and organizations. Paediatricians are encouraged to think of outdoor risky play as one way to help prevent and manage common health problems such as obesity, anxiety, and behavioural issues.

自由游戏对儿童的发展及其身体、心理和社会健康至关重要。近年来,参与户外自由游戏--尤其是危险游戏--的机会大幅减少,部分原因是安全措施旨在预防所有与游戏相关的伤害,而不是关注严重和致命的伤害。危险游戏的定义是惊险刺激的自由游戏形式,涉及结果的不确定性和身体受伤的可能 性。冒险游戏的支持者将 "风险 "与 "危险 "区分开来,并试图将感知到的风险重塑为情境评估和个人发展的机会。本陈述权衡了游戏相关伤害的负担和支持冒险游戏的证据,包括其益处、风险和细微差别, 这些都会因儿童的发展阶段、能力、社会和医疗背景而异。我们提供了促进与家庭和组织进行开放式、建设性讨论的方法。鼓励儿科医生将户外冒险游戏视为帮助预防和管理肥胖、焦虑和行为问题等常见健康问题的一种方法。
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引用次数: 0
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Paediatrics & child health
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