Patrik Laiho, Sauli Palmu, Eero Lauhkonen, Matti Korppi, Paula Heikkilä
Aim
To compare high-flow oxygen therapy (HFOT) with continuous positive airway pressure (CPAP) in children with bronchiolitis aged < 24 months, using treatment failure, length of stay (LOS) in the paediatric intensive care unit (PICU), and adverse events as outcomes.
Methods
Systematic literature search was conducted using PubMed and Scopus until March 13, 2024. Data from prospective and retrospective studies comparing HFOT to CPAP were incorporated in the random-effects meta-analysis model. The results for treatment failure were presented as risk ratios (RRs) with 95% confidence intervals (95% CIs), and those for LOS in the PICU as mean differences (MD) with 95% CIs.
Results
Eight studies fulfilled the inclusion criteria, and one study was found by manual search. Treatment failure was less often associated with CPAP than with HFOT (RR: 0.65; 95% CI: 0.51–0.81). Instead, LOS in the PICU did not differ (standardised MD: −0.10; 95% CI: −0.27 to 0.06). Adverse events were minor being associated more often with CPAP.
Conclusion
Both HFOT and CPAP were safe for treating bronchiolitis, but CPAP showed a lower risk of treatment failure. Our results can be generalized to those treated in the PICU.
{"title":"High-Flow Oxygen Therapy vs. Continuous Positive Airway Pressure in Hospitalised Bronchiolitis: A Meta-Analysis","authors":"Patrik Laiho, Sauli Palmu, Eero Lauhkonen, Matti Korppi, Paula Heikkilä","doi":"10.1111/apa.70396","DOIUrl":"10.1111/apa.70396","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare high-flow oxygen therapy (HFOT) with continuous positive airway pressure (CPAP) in children with bronchiolitis aged < 24 months, using treatment failure, length of stay (LOS) in the paediatric intensive care unit (PICU), and adverse events as outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic literature search was conducted using PubMed and Scopus until March 13, 2024. Data from prospective and retrospective studies comparing HFOT to CPAP were incorporated in the random-effects meta-analysis model. The results for treatment failure were presented as risk ratios (RRs) with 95% confidence intervals (95% CIs), and those for LOS in the PICU as mean differences (MD) with 95% CIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies fulfilled the inclusion criteria, and one study was found by manual search. Treatment failure was less often associated with CPAP than with HFOT (RR: 0.65; 95% CI: 0.51–0.81). Instead, LOS in the PICU did not differ (standardised MD: −0.10; 95% CI: −0.27 to 0.06). Adverse events were minor being associated more often with CPAP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both HFOT and CPAP were safe for treating bronchiolitis, but CPAP showed a lower risk of treatment failure. Our results can be generalized to those treated in the PICU.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"527-535"},"PeriodicalIF":2.1,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70396","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656471","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":"EBNEO Commentary: Association Between Early Fortification and Body Composition in Very Preterm Infants","authors":"Kaitlin Hannan, Kera McNelis","doi":"10.1111/apa.70389","DOIUrl":"10.1111/apa.70389","url":null,"abstract":"<p>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"750-751"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656553","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}
Aim: Bacterial meningitis, including meningococcal meningitis, poses a significant global health threat for children. This study aimed to identify the key reasons why parents accepted meningococcal vaccines. It also wanted to promote wider meningococcal vaccination efforts.
Methods: A cross-sectional study was conducted with the parents of children who visited a university hospital's paediatric outpatient clinic in Turkey between 20 August 2015 and 30 May 2016. The parents provided sociodemographic information and responded to a questionnaire about the meningococcal conjugate vaccination (MCV), based on the Health Belief Model.
Results: The parents of 302 children (52.3% girls), with a mean age of 6.77 ± 4.77, participated in the study. Mothers accounted for 80.1%. Sociodemographic factors, including the parents' education and the mother's occupation, were significant factors in accepting the vaccine. So were recognizing the severity of the disease and the perceived susceptibility and risks. Vaccine uptake also increased if the parents received concise and timely information from doctors. However, some parents were uncomfortable with the number of injections their children would receive and larger families were also a barrier.
Conclusion: Factors that affected parents' acceptance of the MCV included sociodemographic factors, awareness of the severity of the disease and perceived susceptibility and risks.
{"title":"Parents Who Accepted the Meningococcal Conjugate Vaccine Were More Aware of the Severity of the Disease and Risks.","authors":"Ozge Yendur, Zuhal Gundogdu","doi":"10.1111/apa.70398","DOIUrl":"https://doi.org/10.1111/apa.70398","url":null,"abstract":"<p><strong>Aim: </strong>Bacterial meningitis, including meningococcal meningitis, poses a significant global health threat for children. This study aimed to identify the key reasons why parents accepted meningococcal vaccines. It also wanted to promote wider meningococcal vaccination efforts.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with the parents of children who visited a university hospital's paediatric outpatient clinic in Turkey between 20 August 2015 and 30 May 2016. The parents provided sociodemographic information and responded to a questionnaire about the meningococcal conjugate vaccination (MCV), based on the Health Belief Model.</p><p><strong>Results: </strong>The parents of 302 children (52.3% girls), with a mean age of 6.77 ± 4.77, participated in the study. Mothers accounted for 80.1%. Sociodemographic factors, including the parents' education and the mother's occupation, were significant factors in accepting the vaccine. So were recognizing the severity of the disease and the perceived susceptibility and risks. Vaccine uptake also increased if the parents received concise and timely information from doctors. However, some parents were uncomfortable with the number of injections their children would receive and larger families were also a barrier.</p><p><strong>Conclusion: </strong>Factors that affected parents' acceptance of the MCV included sociodemographic factors, awareness of the severity of the disease and perceived susceptibility and risks.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650191","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}
J. Anderberg, P. Carlsson, M. Lundgren, H. Elding Larsson, A. Carlsson
Aim
We aimed to investigate if the incidence of type 1 diabetes increased in children during the SARS-CoV-2 pandemic and whether SARS-CoV-2 antibodies were more frequently present at diagnosis compared with healthy individuals. We also examined whether clinical characteristics and coexisting autoimmunity differed between SARS-CoV-2 antibody positive and negative individuals.
Methods
This retrospective, longitudinal observational study included children aged 0–17 years diagnosed with type 1 diabetes between 01 January 2018 and 31 December 2023 at Skåne University Hospital, Sweden. Blood samples were analysed for SARS-CoV-2 antibodies and islet autoantibodies and compared to analyses of healthy children from the same period. Clinical characteristics and thyroid autoimmunity at onset were collected from medical records.
Results
The incidence of type 1 diabetes increased from 40/100.000 (pre-pandemic) to 53/100.000 (pandemic). Children diagnosed with type 1 diabetes more likely tested positive for SARS-CoV-2 nucleocapsid protein (NCP) antibodies compared to healthy children. The SARS-CoV-2-NCP positive group had a higher prevalence of thyroid autoimmunity compared to the SARS-CoV-2-NCP negative group.
Conclusion
The incidence of type 1 diabetes increased during the SARS-CoV-2 pandemic, with a possible connection to COVID-19. Interestingly, children positive for SARS-CoV-2 antibodies at type 1 diabetes diagnosis had a higher likelihood of thyroid autoimmunity compared to children negative for SARS-CoV-2 antibodies.
{"title":"Increased Incidence of Type 1 Diabetes and Co-Existing Thyroid Autoimmunity During the COVID-19 Pandemic in Sweden","authors":"J. Anderberg, P. Carlsson, M. Lundgren, H. Elding Larsson, A. Carlsson","doi":"10.1111/apa.70388","DOIUrl":"10.1111/apa.70388","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We aimed to investigate if the incidence of type 1 diabetes increased in children during the SARS-CoV-2 pandemic and whether SARS-CoV-2 antibodies were more frequently present at diagnosis compared with healthy individuals. We also examined whether clinical characteristics and coexisting autoimmunity differed between SARS-CoV-2 antibody positive and negative individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective, longitudinal observational study included children aged 0–17 years diagnosed with type 1 diabetes between 01 January 2018 and 31 December 2023 at Skåne University Hospital, Sweden. Blood samples were analysed for SARS-CoV-2 antibodies and islet autoantibodies and compared to analyses of healthy children from the same period. Clinical characteristics and thyroid autoimmunity at onset were collected from medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of type 1 diabetes increased from 40/100.000 (pre-pandemic) to 53/100.000 (pandemic). Children diagnosed with type 1 diabetes more likely tested positive for SARS-CoV-2 nucleocapsid protein (NCP) antibodies compared to healthy children. The SARS-CoV-2-NCP positive group had a higher prevalence of thyroid autoimmunity compared to the SARS-CoV-2-NCP negative group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The incidence of type 1 diabetes increased during the SARS-CoV-2 pandemic, with a possible connection to COVID-19. Interestingly, children positive for SARS-CoV-2 antibodies at type 1 diabetes diagnosis had a higher likelihood of thyroid autoimmunity compared to children negative for SARS-CoV-2 antibodies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"713-723"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650197","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}
Ester Del Vescovo, Simonetta Costa, Simona Fattore, Chiara Piscitelli, Monica Fusco, Sara Rossin, Giovanni Vento, Giovanna Maragliano
Aim
This study evaluated if oral support with techniques to support the infant's jaw to promote sucking could improve the exclusive breastfeeding rate in full-term infants born small-for-gestational-age (SGA).
Methods
This was an observational study with a prospective cohort and a historical control. SGA infants born in 2023–2024 who received oral support were compared to those born in 2020–2021 who did not. The primary outcome was the exclusive breastfeeding rate at 7–10 days of life. Secondary outcomes were the exclusive breastfeeding rate at discharge, the maximum weight loss, the time to regain birthweight, the occurrence of transient and/or persistent hypoglycaemia and the length of hospitalisation.
Results
We analysed 146 infants: 73 received oral support and 73 did not. Infants who received oral support had an exclusive breastfeeding rate when returning to the hospital at day 7–10 that was significantly higher than infants who did not (54.8% vs. 37.0%, p = 0.03). Exclusive breastfeeding at discharge, at a median (interquartile range) age of 3 (2–4) days, was similar between groups. No differences were found in the secondary outcomes.
Conclusion
Oral support appeared useful in promoting exclusive breastfeeding in full-term SGA infants. Further research could assess if the intervention maintained exclusive breastfeeding over time.
目的：本研究评估口腔支持技术支持婴儿颌部促进吸吮是否能提高小胎龄足月婴儿的纯母乳喂养率。方法：这是一项前瞻性队列和历史对照的观察性研究。将2023-2024年出生的接受口腔支持的SGA婴儿与2020-2021年出生的未接受口腔支持的婴儿进行比较。主要结果是出生后7-10天的纯母乳喂养率。次要结局是出院时的纯母乳喂养率、最大体重减轻、恢复出生体重的时间、一过性和/或持续性低血糖的发生以及住院时间。结果：我们分析了146名婴儿：73名接受了口头支持，73名没有。接受口服支持的婴儿在第7-10天返回医院时的纯母乳喂养率显著高于未接受口服支持的婴儿（54.8% vs. 37.0%, p = 0.03）。出院时纯母乳喂养，年龄中位数（四分位数范围）为3（2-4）天，各组之间相似。次要结果没有发现差异。结论：口腔支持有助于促进SGA足月儿纯母乳喂养。进一步的研究可以评估干预是否在一段时间内保持纯母乳喂养。
{"title":"Oral Support Is Effective to Promote Exclusive Breastfeeding in Infants Born Small for Gestational Age","authors":"Ester Del Vescovo, Simonetta Costa, Simona Fattore, Chiara Piscitelli, Monica Fusco, Sara Rossin, Giovanni Vento, Giovanna Maragliano","doi":"10.1111/apa.70390","DOIUrl":"10.1111/apa.70390","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study evaluated if oral support with techniques to support the infant's jaw to promote sucking could improve the exclusive breastfeeding rate in full-term infants born small-for-gestational-age (SGA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was an observational study with a prospective cohort and a historical control. SGA infants born in 2023–2024 who received oral support were compared to those born in 2020–2021 who did not. The primary outcome was the exclusive breastfeeding rate at 7–10 days of life. Secondary outcomes were the exclusive breastfeeding rate at discharge, the maximum weight loss, the time to regain birthweight, the occurrence of transient and/or persistent hypoglycaemia and the length of hospitalisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analysed 146 infants: 73 received oral support and 73 did not. Infants who received oral support had an exclusive breastfeeding rate when returning to the hospital at day 7–10 that was significantly higher than infants who did not (54.8% vs. 37.0%, <i>p</i> = 0.03). Exclusive breastfeeding at discharge, at a median (interquartile range) age of 3 (2–4) days, was similar between groups. No differences were found in the secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Oral support appeared useful in promoting exclusive breastfeeding in full-term SGA infants. Further research could assess if the intervention maintained exclusive breastfeeding over time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"724-730"},"PeriodicalIF":2.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642922","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}
Amaia Merino-Hernández, Elena Rodríguez-Corrales, Sylvia Caballero-Martín, Cristina Ramos-Navarro, Noelia González-Pacheco, María Carmen Sánchez-Gómez de Orgaz, Manuel Sánchez-Luna
Aim
Bronchopulmonary dysplasia (BPD) is a major cause of morbidity and impaired growth in preterm infants. This study compared the incidence of grade 2–3 BPD in infants predominantly fed with mother's own milk (MOM) or pasteurised donor milk (PDM) and examined associations between nutrition and BPD severity.
Methods
Prospective single-centre study including infants < 32 weeks' gestation admitted between January 2023 and June 2024. Infants were classified by predominant feeding type (> 50% MOM or PDM) and BPD severity (no BPD/1 or BPD 2–3). Nutritional intake, feeding tolerance, fortification timing and growth were analysed.
Results
Of 158 infants, 88 (56%) received > 50% MOM and 70 (44%) > 50% PDM. BPD 2–3 occurred in 27 (17.1%) infants with no significant group difference (19% vs. 14%, p = 0.41). Feeding intolerance (44% vs. 11%, p < 0.01), delayed fortification (12.5 vs. 7.0 days, p < 0.01), and later enteral feeding (12.0 vs. 6.0 days, p < 0.01) were associated with BPD 2–3.
Conclusion
No significant difference in BPD 2–3 incidence was found between MOM and PDM groups. Feeding intolerance, delayed fortification, and slower enteral transition were independent risk factors for grade 2–3 BPD.
目的：支气管肺发育不良（BPD）是早产儿发病和生长受损的主要原因。本研究比较了主要以母乳喂养（MOM）或巴氏供体奶（PDM）喂养的婴儿2-3级BPD的发病率，并研究了营养与BPD严重程度之间的关系。方法：前瞻性单中心研究，包括50% MOM或PDM的婴儿和BPD严重程度（无BPD/1或BPD 2-3）。分析营养摄取量、摄食耐受性、强化时间和生长情况。结果：158例婴儿中，88例（56%）接受> 50% MOM治疗，70例（44%）接受> 50% PDM治疗。27例（17.1%）婴儿发生BPD 2-3，组间差异无统计学意义（19% vs. 14%, p = 0.41）。喂养不耐受（44% vs. 11%, p）结论：MOM组和PDM组BPD -3发生率无显著差异。喂养不耐受、延迟强化和较慢的肠内过渡是2-3级BPD的独立危险因素。
{"title":"Nutritional Strategies in Preterm Infants: The Role of Human Milk in Bronchopulmonary Dysplasia","authors":"Amaia Merino-Hernández, Elena Rodríguez-Corrales, Sylvia Caballero-Martín, Cristina Ramos-Navarro, Noelia González-Pacheco, María Carmen Sánchez-Gómez de Orgaz, Manuel Sánchez-Luna","doi":"10.1111/apa.70385","DOIUrl":"10.1111/apa.70385","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Bronchopulmonary dysplasia (BPD) is a major cause of morbidity and impaired growth in preterm infants. This study compared the incidence of grade 2–3 BPD in infants predominantly fed with mother's own milk (MOM) or pasteurised donor milk (PDM) and examined associations between nutrition and BPD severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective single-centre study including infants < 32 weeks' gestation admitted between January 2023 and June 2024. Infants were classified by predominant feeding type (> 50% MOM or PDM) and BPD severity (no BPD/1 or BPD 2–3). Nutritional intake, feeding tolerance, fortification timing and growth were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 158 infants, 88 (56%) received > 50% MOM and 70 (44%) > 50% PDM. BPD 2–3 occurred in 27 (17.1%) infants with no significant group difference (19% vs. 14%, <i>p</i> = 0.41). Feeding intolerance (44% vs. 11%, <i>p</i> < 0.01), delayed fortification (12.5 vs. 7.0 days, <i>p</i> < 0.01), and later enteral feeding (12.0 vs. 6.0 days, <i>p</i> < 0.01) were associated with BPD 2–3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No significant difference in BPD 2–3 incidence was found between MOM and PDM groups. Feeding intolerance, delayed fortification, and slower enteral transition were independent risk factors for grade 2–3 BPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"686-696"},"PeriodicalIF":2.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642961","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}
Mia Giertz, Annika Englund, Fanny Fernsten, Sascha Michelsen Wilk, Riitta Niinimäki, Arja Harila, Henri Aarnivala
Aim
Most children with Hodgkin lymphoma (HL) survive today, yet about 50% experience long-term complications. This study evaluated health-related quality of life (HRQoL) in survivors of childhood HL.
Methods
Two different HRQoL-instruments, the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) and Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires, were sent to all individuals aged 0–18 and diagnosed with HL in Sweden and Finland from 2005 to 2019.
Results
A total of 135 of 377 survivors responded to the survey. The mean EQ-5D-5L index was 0.933 ± 0.11 and the EuroQoL Visual Analogue Scale (EQ-VAS) score averaged 75.1 ± 17.6. Females reported lower scores than males on the EQ-5D-5L index (p = 0.007) and EQ-VAS (p = 0.022), as well as more problems within the PROMIS-domains for physical function (p = 0.016), fatigue (p < 0.001), anxiety (p < 0.001), and depression (p = 0.002). Both EQ-5D-5L index and PROMIS T-scores for all assessed domains were comparable with the general population, including differences between sexes. Our analysis indicated that an EQ-VAS cut-off of ≤ 85 effectively identified 90%, or more, of the individuals reporting problems in the PROMIS domains for fatigue, anxiety and depression.
Conclusion
Survivors of childhood HL report a good HRQoL. The EQ-VAS may serve as a useful, simple screening tool for detecting survivors in need of psychosocial interventions.
{"title":"Overall Good Quality of Life Reported by Survivors of Childhood Hodgkin Lymphoma in Sweden and Finland","authors":"Mia Giertz, Annika Englund, Fanny Fernsten, Sascha Michelsen Wilk, Riitta Niinimäki, Arja Harila, Henri Aarnivala","doi":"10.1111/apa.70386","DOIUrl":"10.1111/apa.70386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Most children with Hodgkin lymphoma (HL) survive today, yet about 50% experience long-term complications. This study evaluated health-related quality of life (HRQoL) in survivors of childhood HL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two different HRQoL-instruments, the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) and Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires, were sent to all individuals aged 0–18 and diagnosed with HL in Sweden and Finland from 2005 to 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 135 of 377 survivors responded to the survey. The mean EQ-5D-5L index was 0.933 ± 0.11 and the EuroQoL Visual Analogue Scale (EQ-VAS) score averaged 75.1 ± 17.6. Females reported lower scores than males on the EQ-5D-5L index (<i>p</i> = 0.007) and EQ-VAS (<i>p</i> = 0.022), as well as more problems within the PROMIS-domains for physical function (<i>p</i> = 0.016), fatigue (<i>p</i> < 0.001), anxiety (<i>p</i> < 0.001), and depression (<i>p</i> = 0.002). Both EQ-5D-5L index and PROMIS T-scores for all assessed domains were comparable with the general population, including differences between sexes. Our analysis indicated that an EQ-VAS cut-off of ≤ 85 effectively identified 90%, or more, of the individuals reporting problems in the PROMIS domains for fatigue, anxiety and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Survivors of childhood HL report a good HRQoL. The EQ-VAS may serve as a useful, simple screening tool for detecting survivors in need of psychosocial interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"697-705"},"PeriodicalIF":2.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643033","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}
Odile Dicky, Pierre Kuhn, Jacques Sizun, Madeleine Akrich, Charlotte Bouvard, Charlotte Tscherning, Laurence Caeymaex
Aim
Skin-to-skin contact (SSC) is a key aspect of infant- and family-centred developmental care and should be initiated as early as possible after birth. This study aimed to assess the effects of early SSC, within the first 3 days of life, compared to late SSC, from Day 4 onwards, in very preterm infants. It also explored parents' experiences of SSC.
Method
Data were collected over 10 years, from 2014 to 2024, via an online parental survey created by parent associations and the French National Neonatal Society. We analysed only responses from parents of infants born before 32 weeks' gestation.
Results
A total of 2212 responses were analysed. Findings revealed that 98% of parents who began SSC early believed it occurred at the right time, while 30% of those who started later felt it was too late. Parents who practised early SSC were more likely to report comfortable SSC during the hospital stay, with an adjusted odds ratio of 1.64 (95% confidence interval: 1.14–2.37). Key factors contributing to a positive SSC experience included support from nursing staff, a secure setting, privacy and a comfortable chair.
Conclusion
Early SSC was highly valued by parents of very preterm infants.
{"title":"Parents of Premature Infants Value Early Skin-to-Skin Care: A 10-Year Survey in France","authors":"Odile Dicky, Pierre Kuhn, Jacques Sizun, Madeleine Akrich, Charlotte Bouvard, Charlotte Tscherning, Laurence Caeymaex","doi":"10.1111/apa.70387","DOIUrl":"10.1111/apa.70387","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Skin-to-skin contact (SSC) is a key aspect of infant- and family-centred developmental care and should be initiated as early as possible after birth. This study aimed to assess the effects of early SSC, within the first 3 days of life, compared to late SSC, from Day 4 onwards, in very preterm infants. It also explored parents' experiences of SSC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data were collected over 10 years, from 2014 to 2024, via an online parental survey created by parent associations and the French National Neonatal Society. We analysed only responses from parents of infants born before 32 weeks' gestation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2212 responses were analysed. Findings revealed that 98% of parents who began SSC early believed it occurred at the right time, while 30% of those who started later felt it was too late. Parents who practised early SSC were more likely to report comfortable SSC during the hospital stay, with an adjusted odds ratio of 1.64 (95% confidence interval: 1.14–2.37). Key factors contributing to a positive SSC experience included support from nursing staff, a secure setting, privacy and a comfortable chair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Early SSC was highly valued by parents of very preterm infants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"706-712"},"PeriodicalIF":2.1,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607593","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}
Mattias Wennergren, Ann Jansson, Julie Showich Lundgren
Aim
This study aimed to compare providers' ratings of delivery and fidelity of a post-natal extended home visiting programme within Child Health Services for visits conducted in families' homes versus the clinic setting.
Methods
A retrospective quantitative study based on questionnaires (n = 3028) from child health services nurses and social workers was conducted using non-parametric tests to determine if there were any differences in professionals' perceptions of programme delivery and/or quality.
Results
The results from this study indicate significant differences in professionals' perceptions of fidelity, confidence in abilities, content coverage, alliance-building, and emotional climate between home and clinic visits, with higher ratings given in all areas for visits conducted in the home.
Conclusion
While clinic visits may offer certain logistical advantages for professionals and primary care clinics, they may not provide the optimal environment for delivering the programme with fidelity, which is necessary for achieving the desired outcomes for child health and family well-being. The findings need to be taken into consideration when making decisions about resource allocation for early childhood programmes aimed at equitable health for a more sustainable society.
{"title":"Clinic Versus Home: Nurses' and Social Workers' Perceptions of Extended Home Visits","authors":"Mattias Wennergren, Ann Jansson, Julie Showich Lundgren","doi":"10.1111/apa.70382","DOIUrl":"10.1111/apa.70382","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to compare providers' ratings of delivery and fidelity of a post-natal extended home visiting programme within Child Health Services for visits conducted in families' homes versus the clinic setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective quantitative study based on questionnaires (<i>n</i> = 3028) from child health services nurses and social workers was conducted using non-parametric tests to determine if there were any differences in professionals' perceptions of programme delivery and/or quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results from this study indicate significant differences in professionals' perceptions of fidelity, confidence in abilities, content coverage, alliance-building, and emotional climate between home and clinic visits, with higher ratings given in all areas for visits conducted in the home.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While clinic visits may offer certain logistical advantages for professionals and primary care clinics, they may not provide the optimal environment for delivering the programme with fidelity, which is necessary for achieving the desired outcomes for child health and family well-being. The findings need to be taken into consideration when making decisions about resource allocation for early childhood programmes aimed at equitable health for a more sustainable society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"679-685"},"PeriodicalIF":2.1,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607655","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}
<p>In 1963, Reynolds and Cook observed that <i>oxygen is vitally important</i> (in the treatment of acute bronchiolitis) <i>and there is little evidence that any other therapy is consistently or even occasionally useful</i> [<span>1</span>] and this still holds true more than 60 years later. In the study by Loveys et al. published in this issue [<span>2</span>] the authors address the suggestion that the macrolide antibiotic, azithromycin, may reduce the severity of the acute illness and the prevalence of subsequent respiratory symptoms. They concluded <i>‘</i>There is insufficient evidence to support the use of azithromycin as part of hospital care for infants with bronchiolitis<i>’</i>. While none of the included studies individually found evidence to support the use of macrolides, the initial meta-analysis suggested that it may have a small effect on the length of stay. However, in their sensitivity analysis, which involved removing the studies that reported longer durations of stay than the authors felt were typical for Australasia [<span>2</span>], this apparent effect disappeared.</p><p>Azithromycin joins an extensive list of potential therapies which fell by the wayside when subject to more rigorous testing. These include ‘asthma therapies’ such as β-agonists, corticosteroids, theophylline, anti-cholinergics and a leukotriene antagonist; antibiotics and antivirals and approaches to improve airways clearance including inhaled hypertonic saline and physiotherapy. Despite the evidence, adherence to guidelines is frequently poor as illustrated by the two Australasian studies in which non-macrolide antibiotics were used in 60%–70% of patients. The rationale for using a macrolide antibiotic in these studies was based on having anti-inflammatory, immunomodulatory and anti-viral effects [<span>2</span>]. Macrolides appear to have a role in downregulating neutrophilic inflammation and, as noted by Loveys et al., the airways inflammation in bronchiolitis is dominated by neutrophils. The use of azithromycin has become ubiquitous, particularly in adult respiratory medicine, largely because of its perceived anti-inflammatory effects (even though, as in these studies, it is used at doses that have antibacterial activity). The downside of using this convenient ‘magic bullet’ so widely is, of course, the fact that macrolides are extremely effective in driving antimicrobial resistance [<span>3</span>].</p><p>Every paediatrician knows what ‘acute bronchiolitis’ looks like when they see it, but there is no universally agreed definition. There is no definitive test for the condition, and the diagnosis is based on a cluster of signs [<span>4</span>]. The studies included in the review allow subjects to have crackles and/or wheeze as a sign of airways obstruction. Crackles are generally observed in young infants (< 6 months) and represent the snapping opening of alveolar units. Secretions in the airways and mucosal oedema are almost certainly responsible for
{"title":"Bronchiolitis (The Snotty Lung): Prevention Is Likely to Be More Helpful Than a ‘Cure’","authors":"Mark L. Everard","doi":"10.1111/apa.70384","DOIUrl":"10.1111/apa.70384","url":null,"abstract":"<p>In 1963, Reynolds and Cook observed that <i>oxygen is vitally important</i> (in the treatment of acute bronchiolitis) <i>and there is little evidence that any other therapy is consistently or even occasionally useful</i> [<span>1</span>] and this still holds true more than 60 years later. In the study by Loveys et al. published in this issue [<span>2</span>] the authors address the suggestion that the macrolide antibiotic, azithromycin, may reduce the severity of the acute illness and the prevalence of subsequent respiratory symptoms. They concluded <i>‘</i>There is insufficient evidence to support the use of azithromycin as part of hospital care for infants with bronchiolitis<i>’</i>. While none of the included studies individually found evidence to support the use of macrolides, the initial meta-analysis suggested that it may have a small effect on the length of stay. However, in their sensitivity analysis, which involved removing the studies that reported longer durations of stay than the authors felt were typical for Australasia [<span>2</span>], this apparent effect disappeared.</p><p>Azithromycin joins an extensive list of potential therapies which fell by the wayside when subject to more rigorous testing. These include ‘asthma therapies’ such as β-agonists, corticosteroids, theophylline, anti-cholinergics and a leukotriene antagonist; antibiotics and antivirals and approaches to improve airways clearance including inhaled hypertonic saline and physiotherapy. Despite the evidence, adherence to guidelines is frequently poor as illustrated by the two Australasian studies in which non-macrolide antibiotics were used in 60%–70% of patients. The rationale for using a macrolide antibiotic in these studies was based on having anti-inflammatory, immunomodulatory and anti-viral effects [<span>2</span>]. Macrolides appear to have a role in downregulating neutrophilic inflammation and, as noted by Loveys et al., the airways inflammation in bronchiolitis is dominated by neutrophils. The use of azithromycin has become ubiquitous, particularly in adult respiratory medicine, largely because of its perceived anti-inflammatory effects (even though, as in these studies, it is used at doses that have antibacterial activity). The downside of using this convenient ‘magic bullet’ so widely is, of course, the fact that macrolides are extremely effective in driving antimicrobial resistance [<span>3</span>].</p><p>Every paediatrician knows what ‘acute bronchiolitis’ looks like when they see it, but there is no universally agreed definition. There is no definitive test for the condition, and the diagnosis is based on a cluster of signs [<span>4</span>]. The studies included in the review allow subjects to have crackles and/or wheeze as a sign of airways obstruction. Crackles are generally observed in young infants (< 6 months) and represent the snapping opening of alveolar units. Secretions in the airways and mucosal oedema are almost certainly responsible for","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 3","pages":"518-520"},"PeriodicalIF":2.1,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607558","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}
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