Journal of paediatrics and child health最新文献

{"title":"Paediatric Care in a Combined Trauma Centre - A Retrospective Cohort Study Examining Major Trauma Processes and Outcomes.","authors":"Daniel Pasquale Cinelli, Raksheel Chand, Joel D'Souza, Andrew McCombie, Jonathan M Wells, Laura R Joyce","doi":"10.1111/jpc.70129","DOIUrl":"https://doi.org/10.1111/jpc.70129","url":null,"abstract":"<p><strong>Aim: </strong>Priorities in the assessment and management of major trauma between paediatric and adult patients vary due to clinically relevant differences in anatomy and physiology. Christchurch Hospital is a combined trauma centre, where-in a paediatric trauma service is nested into a predominantly adult hospital, providing specialist paediatric surgical care to the South Island of New Zealand. A system analysis comparing outcomes between adult and paediatric patients was undertaken to assess this service.</p><p><strong>Methods: </strong>A retrospective analysis comparing outcomes between all paediatric and adult major trauma patients (Injury Severity score > 12) who presented to Christchurch Hospital Emergency Department (ED) between June 2016 and November 2021.</p><p><strong>Results: </strong>A total of 1594 adult (median age 51, IQR 33-67) and 77 paediatric (median age 11, IQR 7-14) patients were identified. Median time to CT was significantly shorter in paediatric patients compared to adults (83 min vs. 96 min, p = 0.05). Similarly, the ED length of stay was significantly shorter in paediatric patients (124 min vs. 282 min, p < 0.001). The paediatric and adult mortality rates were 4% and 8% respectively (p value 0.06).</p><p><strong>Conclusions: </strong>These results serve to establish baseline characteristics of our trauma service and demonstrate efficient paediatric trauma care delivery within our current nested paediatric trauma service model. Further research may help delineate clinical demand for population-specific trauma services and characterise trauma-specific interventions in the paediatric population.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626554","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":"Misaligned Attitudes and Perceptions Among Adolescents Living With Obesity, Caregivers and Healthcare Professionals: ACTION Teens Australia Survey Study.","authors":"Cathy Kwok, Nicholas Bentley, Jacqueline Curran, Natalie Lister, Helen Truby, Louise A Baur","doi":"10.1111/jpc.70146","DOIUrl":"https://doi.org/10.1111/jpc.70146","url":null,"abstract":"<p><strong>Aims: </strong>To explore perceptions, attitudes, behaviours and barriers relating to adolescent weight management in Australia.</p><p><strong>Methods: </strong>ACTION Teens was a cross-sectional, survey-based study. Adolescents with high body mass index (BMI), caregivers and healthcare professionals (HCPs) from 10 countries completed an online survey in 2021. This analysis was limited to participants in Australia. Adolescents (N = 298) were aged 12-< 18 years with BMI ≥ 95th percentile for age and sex. Caregivers (N = 276) lived with an eligible adolescent and were involved in healthcare decisions. HCPs (N = 137) had ≥ 2 years' clinical experience and saw/treated ≥ 10 adolescents with high BMI per month. Outcomes included perceptions of high BMI, weight loss (history, barriers, definition of success), weight-management information sources, and history/assessment of weight-related conversations.</p><p><strong>Results: </strong>Most adolescents believed their health was good/very good/excellent (83%) but worried about weight impacting their future health (69%). More caregivers indicated their adolescent's health was good/very good/excellent (92%). More adolescents than caregivers agreed weight loss was entirely the adolescent's responsibility (72% vs. 28%), reported a recent weight-loss attempt by the adolescent (52% vs. 21%) and believed initiating weight-related discussions with HCPs was the adolescent's responsibility (62% vs. 51%). Only 42% of adolescents had recently discussed weight with an HCP; although 66% of this subset trusted their HCP's advice, the adolescents reported both positive (73%) and negative (44%) feelings following discussions.</p><p><strong>Conclusions: </strong>To improve adolescent obesity care in Australia, improved communication between adolescents and caregivers/HCPs is needed. We recommend HCPs raise the topic of weight with adolescents in a sensitive manner.</p><p><strong>Clinicaltrials: </strong>gov identifier: NCT05013359.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626553","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":"The Longitudinal Impact of a Peer Support Program on Adolescents Experiencing Chronic Illness.","authors":"Emma Anderson, Rebecca Powers, Ken C Pang, Harry Lengelsen-Brown, Cate Rayner","doi":"10.1111/jpc.70139","DOIUrl":"https://doi.org/10.1111/jpc.70139","url":null,"abstract":"<p><strong>Aims: </strong>The Chronic Illness Peer Support (ChIPS) program is a peer support group for adolescents with chronic illness (CI) at The Royal Children's Hospital, Melbourne. The program provides psychosocial support through connection to peers with shared experience. This quantitative study aimed to evaluate the longitudinal impact of ChIPS participation on measures of belonging, social support, life satisfaction, and self-efficacy.</p><p><strong>Methods: </strong>Participants who commenced the ChIPS program from April 2019 to May 2024 were invited to complete questionnaires containing validated measures (Sense of Belonging scale, Multidimensional Scale of Perceived Social Support, Life Satisfaction Scale, General Self-Efficacy Scale, and Self-Efficacy to Manage Disease in General Scale). Surveys were completed at four time points over a two-year period: pre and post completing the introductory program, then at two further time points 12 and 24 months later.</p><p><strong>Results: </strong>Participants demonstrated a high sense of belonging to the program. Life satisfaction scores remained relatively stable despite the expected reduction in these across adolescence. Perceived social support scores also remained stable. Participation in ChIPS was associated with increasing self-efficacy in general and in the management of CI over time.</p><p><strong>Conclusions: </strong>The ChIPS program is valuable for adolescents experiencing CI, and provides a sense of belonging for young people who are at risk of social isolation.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626575","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":"Variability in Home Oxygen Therapy Practices for Bronchopulmonary Dysplasia in Japan: A Questionnaire Survey.","authors":"Ryo Ogawa, Masaki Hasebe, Tomohiko Nakamura, Fumihiko Namba","doi":"10.1111/jpc.70150","DOIUrl":"https://doi.org/10.1111/jpc.70150","url":null,"abstract":"<p><strong>Aim: </strong>To examine variations in home oxygen therapy (HOT) initiation and management practices for bronchopulmonary dysplasia (BPD) among perinatal medical centres in Japan.</p><p><strong>Methods: </strong>A questionnaire survey was distributed to 112 perinatal medical centres in Japan from September to October 2023. Responses were collected from supervising neonatologists at each centre.</p><p><strong>Results: </strong>The response rate was 91.1% (102/112). All centres utilised percutaneous oxygen saturation (SpO₂) levels as a criterion for initiating HOT, with thresholds ranging from 90% to 95%; the most common threshold was 95% (37%). However, 17% of centres lacked defined threshold criteria. Only 35% had standards for the duration or frequency of subthreshold SpO₂ levels; 11% initiated HOT when SpO₂ fell below the threshold for ≥ 10% of the time. Pulmonary hypertension assessments were performed before discharge at 83% of facilities but continued post-discharge in only 30%. Home pulse oximetry monitoring was implemented at 84% of centres, primarily for discontinuing HOT (95%) and detecting respiratory deterioration (90%). For discontinuation, 66% used a threshold of ≥ 95%, but 69% lacked criteria for duration or frequency. Additionally, 67% relied on family-reported SpO₂ data, with only 14% analysing oximeter data.</p><p><strong>Conclusions: </strong>Significant variability exists in HOT practices among Japanese perinatal centres. These findings emphasise the need for standardised, evidence-based guidelines to enhance the management and outcomes of infants with BPD.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626576","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":"Growth, Feeding and Nutrition in Rett Syndrome: Retrospective Audit of Twenty Years' Experience From an Australian Multidisciplinary Management Clinic.","authors":"Susan Thompson, Toni Bird, Gloria Tzannes, Carolyn Ellaway","doi":"10.1111/jpc.70123","DOIUrl":"https://doi.org/10.1111/jpc.70123","url":null,"abstract":"<p><strong>Aim: </strong>This study reviewed the nutritional status, feeding skills, safety, and management of patients with Rett syndrome during childhood and adolescence.</p><p><strong>Method: </strong>Retrospective chart review of 103 females with classical Rett syndrome, aged ≤ 18 years, attending a Rett syndrome Multidisciplinary Management clinic in a tertiary hospital from 2000 to 2019.</p><p><strong>Results: </strong>Over multiple clinic visits the cohort was significantly (p < 0.0001) shorter and of lower weight (p < 0.0001) on standard CDC growth charts but not on Rett syndrome specific growth charts. Body mass index Z score was not significantly different on either chart but at first visit both mean and median were <0 (range -5.39 to +3.44) (p = 0.002) on standard charts. Nutritional issues included inadequate energy, fibre, calcium and iron intake. Participants tolerated food textures ranging from puree to regular diet, and fluids ranging from unmodified to modified. Compensatory strategies for drinking, chewing and swallowing difficulties were frequent. Six percent had a documented episode of aspiration pneumonia. Twenty-four percent had gastrostomy placement with 64% of these continuing oral intake or tastes at last visit.</p><p><strong>Conclusions: </strong>Growth and weight gain in this cohort of females with Rett syndrome supports the pattern observed in other Rett syndrome cohorts. Given the risk of inadequate nutrition, and that optimal nutritional status is undefined in Rett syndrome, there is a need for individualised ongoing clinical assessment of nutritional status and feeding, with a multidisciplinary approach. Oropharyngeal dysphagia and compensatory feeding strategies were common, with feeding safety requiring close monitoring. The burden of assisted feeding was high.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618675","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":"WITHDRAWAL: A Mother Describes her Child's Experience with Juvenile Arthritis.","authors":"","doi":"10.1111/jpc.70125","DOIUrl":"https://doi.org/10.1111/jpc.70125","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608622","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":"Turner Syndrome.","authors":"Ken L Wan, Emma L Brown, Raj Krishnaswamy, Peter A Kaub","doi":"10.1111/jpc.70132","DOIUrl":"https://doi.org/10.1111/jpc.70132","url":null,"abstract":"<p><p>Turner syndrome (TS) is a sex chromosome disorder affecting phenotypic females who have one intact X chromosome and a completely or partially missing second sex chromosome. It was first described approximately a century ago by Seresevskij, Ullrich and Turner. However, the cytogenetic basis of TS was only reported by Ford in 1959 following Tjio and Levan's optimisation of chromosome visualisation. TS karyotypes include classic monosomy X (40%-50%); monosomy X mosaicism (3%-25%); isochromosome X (10%-18%); ring X (10%-16%); mosaicism for monosomy X and a normal or structurally abnormal Y chromosome (6%-12%); deletion Xp (< 5%) and unbalanced X-autosome translocation (< 2%). While parental age does not affect the complete loss of one X chromosome, the paternal X chromosome is absent in three-quarters of patients with TS. Clinically, detecting the parental origin of the remaining X chromosome is not currently useful in routine TS care. Recurrence risk is low for phenotypically normal parents with a child diagnosed with TS. Pregnancy loss is the outcome for the majority (~99%) of TS cases; however, prenatal ultrasound findings for foetuses with TS may include abnormalities like cystic hygroma and hydrops. Postnatal phenotype for patients with TS includes short stature, delayed puberty, ovarian dysgenesis, hypergonadotropic hypogonadism, infertility, cardiac defects, endocrine, metabolic and autoimmune disorders. This review aims to outline clinical indications for testing, describe test methodologies, provide genetic test result examples that highlight complex TS karyotype diagnoses, summarise clinical management options and discuss the phenomenon of 'normal' sex chromosome loss with advancing age.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608621","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":"Markers of Metabolic Bone Disease in Extremely Preterm and Very Low Birth Weight Infants: A Four-Part Cohort Study Spanning Changes in Clinical Approach.","authors":"Ilana Levene, Mar Moreno, Brian Shine, Amish Chinoy, Raja Padidela, Zoltan Molnar","doi":"10.1111/jpc.70137","DOIUrl":"https://doi.org/10.1111/jpc.70137","url":null,"abstract":"<p><strong>Aim: </strong>Analyse the association of markers of metabolic bone disease of prematurity (MBDP) with different clinical approaches to MBDP prevention and management.</p><p><strong>Methods: </strong>Four-part cohort study in a tertiary neonatal unit between 2015 and 2023. Eligible infants were born under 28 weeks' postmenstrual age or under 1.5 kg birthweight. Four 1-year periods were included. Baseline cohort received routinely unfortified breastmilk and universal phosphate supplementation. Second cohort received routine breastmilk fortification and universal phosphate supplementation. Third cohort received routine breastmilk fortification and parathyroid hormone (PTH) monitoring with targeted calcium/phosphate supplementation. In the fourth cohort, the PTH threshold for supplementation was increased.</p><p><strong>Results: </strong>About 329 infants were included. The highest ALP concentration increased between cohort 1 and 2 (median 466 IU/L; IQR 332-581, median 529 IU/L; IQR 439-809) and remained stable in cohort 3 and 4 (median 570 IU/L; IQR 412-850, median 665 IU/L; IQR 480-868). There was no change in the incidence of osteopenic bone fractures (1/72, 0/84, 0/85, 1/88) or osteopenia on clinical radiographs (4/72, 4/84, 4/85, 7/88). Multivariable analysis identified lower 25-hydroxyvitamin D, lower birthweight and higher birth gestation as the variables independently associated with higher ALP concentration. Multivariable analysis identified lower 25-hydroxyvitamin D, lower ionised calcium, lower birthweight and maternal ethnic minority background as the variables independently associated with higher PTH concentration.</p><p><strong>Conclusions: </strong>There was no improvement in markers of MBDP with routine fortification of breastmilk or the use of PTH-targeted mineral supplementation. This may be due to the high level of 25-hydroxyvitamin D deficiency in this cohort, as lower 25-hydroxyvitamin D was associated with higher PTH and ALP.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608620","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":"Wide Spectrum of Disease Manifestations in Siblings With Primary Ciliary Dyskinesia Carrying DNAJB13 Mutations: A Case Study.","authors":"Randy Suryadinata, Ophir Bar-On, Paul Martinello, Meghan McKinnon, Philip Robinson","doi":"10.1111/jpc.70149","DOIUrl":"https://doi.org/10.1111/jpc.70149","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600823","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":"Collagenous Gastritis-A Rare Cause of Iron Deficiency Anaemia.","authors":"Manuel Lima Ferreira, Joana Carvalho Queirós, Inês Mazeda, Ana Gisela Oliveira, Emília Costa, Xiaogang Wen, Rosa Lima","doi":"10.1111/jpc.70152","DOIUrl":"https://doi.org/10.1111/jpc.70152","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600822","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}