Journal of paediatrics and child health最新文献

{"title":"A Blood Pressure Check for Every Child","authors":"Anke Raaijmakers, David T. Selewski","doi":"10.1111/jpc.70541","DOIUrl":"10.1111/jpc.70541","url":null,"abstract":"<p>Hypertension is among the most important modifiable risk factors for chronic kidney and cardiovascular disease and premature death worldwide, and its roots often begin in childhood [<span>1-3</span>]. A life-course perspective makes clear that identifying elevated blood pressure (BP) early creates a window for intervention to alter adverse cardiovascular and renal trajectories before damage accrues. Childhood BP is no longer just a surrogate. It is increasingly linked to clinical events in adulthood, strengthening the imperative to measure it routinely in children and intervene to improve outcomes. In an era of rising paediatric obesity and widening health inequities, the question is no longer whether we should screen, but how we can systematically embed BP measurement into everyday child health care [<span>4</span>]. The development of such a robust screening strategy will allow for early identification of children at risk to allow for early intervention to improve outcomes.</p><p>The rising prevalence of hypertension in children and adolescents tracks closely with increasing rates of obesity. In Australia, these trends are evident across the population, with a disproportionately higher prevalence among Aboriginal and Torres Strait Islander children and adolescents, consistent with the marked excess of early cardiac and kidney events seen in young Aboriginal and Torres Strait Islander adults [<span>5-7</span>]. Despite this, Australia has lacked a unified, practical guideline for identifying and managing hypertension in those under 18 years. International guidelines may not fully reflect Australia's unique demographics, healthcare access patterns and limited preventative mechanisms once children start school. In this issue of the Journal of Paediatrics and Child Health, this gap was addressed with the new Australian Hypertension guideline [<span>8</span>]. It is endorsed by major national bodies including the National Heart Foundation of Australia, Hypertension Australia, the Royal Australasian College of Physicians and the national kidney and obesity societies [<span>8</span>].</p><p>Given the silent nature of paediatric hypertension and the feasibility of accurate measurement with appropriate cuffs and technique, routine BP screening should be incorporated into standard child health encounters: well baby/infant checks in high-risk populations, preschool and school health checks and GP/paediatrician visits. Embedding BP measurement into these touchpoints creates repeated opportunities to detect elevated readings early, confirm them over time and initiate timely lifestyle and, when needed, pharmacologic management. This is especially important in a system where preventative follow-up can become fragmented after school entry.</p><p>Routine measurement must be done correctly: the child should be seated and calm, with the right cuff size (bladder width > 40% of arm circumference and length covering 80%–100% of the circumference), and the arm ","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1820-1821"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764200","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":"Retinopathy of Prematurity Is Associated With Reduced Thalamic Volume and Impaired Neurodevelopment. A Cohort Study","authors":"Jose Uberos,&nbsp;Marta Carrasco-Solis,&nbsp;Carolina Laynez-Rubio,&nbsp;Ana Nieto-Ruiz,&nbsp;Aida Ruiz-López,&nbsp;Francisco Contreras-Chova,&nbsp;Elizabeth Fernández-Marin,&nbsp;Ana Campos-Martínez,&nbsp;Jose Luis García-Serrano","doi":"10.1111/jpc.70536","DOIUrl":"10.1111/jpc.70536","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Retinopathy of prematurity (ROP) is a neurovascular disorder that may affect not only the retina but also the brain structures involved in visual processing. The relationship between ROP severity and the volumetric development of these regions remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 157 children aged 6–16 years, born preterm (24–36 weeks gestational age), were assessed. Perinatal data and comorbidities were collected. Brain MRI (3 T) data were analysed using FreeSurfer to obtain the volumes of the thalamus, fusiform gyrus, cuneus, lingual gyrus, lateral occipital gyrus, optic chiasm and calcarine sulcus. Cognitive performance was evaluated using the WISC-V. Multivariate regression analyses were adjusted for significant perinatal variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The children with severe ROP had significantly smaller bilateral thalamic volumes (left Th: 6665 ± 672 mm³ vs. 7492 ± 820 mm³; <i>p</i> &lt; 0.005) and a reduced right fusiform gyrus volume (<i>p</i> = 0.041) compared with those without ROP or only mildly affected. Severe ROP was also associated with lower full-scale IQ scores and reduced verbal comprehension, visuospatial reasoning, and working memory indices (<i>p</i> &lt; 0.008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Severe ROP is associated with reduced thalamic and fusiform gyrus volumes as well as with lower cognitive performance, suggesting that ROP reflects a broader neurovascular disruption affecting central visual pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1931-1941"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70536","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706926","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":"Enhancing Parents' Experiences of Paediatric Genomic Testing in Usual Outpatient Care: Insights From a Multi-Perspective Qualitative Study","authors":"Erin Crellin,&nbsp;Melissa Martyn,&nbsp;Selima Ymer,&nbsp;Maya Pinn,&nbsp;Emma Weisz,&nbsp;Clara Gaff,&nbsp;Belinda Dawson-McClaren","doi":"10.1111/jpc.70538","DOIUrl":"10.1111/jpc.70538","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this research was to explore what makes (or would make) for good genomic care delivered wholly or in part by paediatricians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An interpretive description, qualitative study with parents of children offered genomic testing as an outpatient for a condition other than cancer; general and subspecialist paediatricians; nurses; and genetic counsellors. Data were primarily collected retrospectively and analysed using inductive content analysis. Interpretation was enriched by the involvement of parent and paediatrician project advisors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five parents and 20 health professionals participated. Most parents had received a genetic diagnosis for a child presenting with neurodevelopmental delay and/or epilepsy. Key aspects of good genomic care identified included: adopting a slow, multi-appointment approach to discussing genomic testing in certain instances; letting families know what to expect; signposting to information and psychosocial support services when disclosing results; communicating next steps; and adopting a team approach to aid sense-making. Paediatricians were not expected to do everything, with ongoing roles for genetic experts described. At different stages of the testing process, paediatricians existing and ongoing relationships with families were identified as an asset in helping promote good experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Genomic testing in usual paediatric outpatient care can be delivered well, with this research yielding practical guidance for paediatricians. Ongoing evaluation as models of care evolve will support the delivery of high-quality genomic care that best meets families' needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1959-1970"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794506","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":"Screen Use, Child Development and Family Involvement in Children Aged 2–7 Years: A Systematic Review","authors":"Mónica Gomariz-Martínez,&nbsp;Pedro Gil-Madrona,&nbsp;Luisa Losada-Puente","doi":"10.1111/jpc.70533","DOIUrl":"10.1111/jpc.70533","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to explore the effects of screen time on the development of children and the mediating role of families, following the PRISMA method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Searches were conducted in Web of Science, Scopus and ERIC databases between 2020 and 2025. Eighteen articles met inclusion criteria: participants aged 2–7 years; specified screen time duration; reported associations with child development; and examination of family-related factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nearly 62% of studies reported screen use exceeding recommended limits. Socio-emotional development was the most frequently examined domain, followed by cognitive, language and motor/physical domains. Excessive screen time was associated with poorer attention and working memory, hyperactivity and impulsivity symptoms, language comprehension and production deficits, emotional regulation difficulties and reduced family interactions. Parental modelling, supervision, joint viewing, educational content use and shared reading emerged as moderating factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Overall, children's digital device use was influenced by family practices and educational use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1921-1930"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70533","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706934","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":"Optimising Asparaginase Use and Managing Hypersensitivity in Australasia—A Clinical Practice Guideline From the Australian and New Zealand Children's Haematology/Oncology Group","authors":"Matthew J. O'Connor,&nbsp;Michelle Martin,&nbsp;Sarah M. Trinder,&nbsp;Draga Barbaric,&nbsp;Diane Hanna,&nbsp;Chow Y. Lai,&nbsp;Michael P. Osborn,&nbsp;Tim Prestige,&nbsp;Bryony Ross,&nbsp;Leanne Super,&nbsp;Thomas Walwyn,&nbsp;Stacie S. Wang,&nbsp;Andrew Wood,&nbsp;Andrew S. Moore,&nbsp;Rishi S. Kotecha,&nbsp;Siobhan Cross","doi":"10.1111/jpc.70531","DOIUrl":"10.1111/jpc.70531","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Asparaginase is a critical component of modern multi-agent chemotherapy regimens for paediatric acute lymphoblastic leukaemia and lymphoblastic lymphoma, with inadequate exposure leading to inferior patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop a clinical practice guideline for the use of asparaginase products in the Australasian context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This clinical practice guideline was developed following consultation and a review of the available published data and is designed to standardise treatment across the region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This paper reports the position of the Australian and New Zealand Children's Haematology/Oncology Group (ANZCHOG) on key areas including established and new asparaginase products and their use in Australasia, monitoring and interpretation of serum asparaginase activity, care in the setting of hypersensitivity and management of suboptimal asparagine depletion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This clinical practice guideline will assist clinicians in the Australasian region who provide care to children, adolescents and young adults receiving asparaginase therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1913-1920"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70531","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701604","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":"High-Flow Nasal Cannula Use for Respiratory Support Outside the Paediatric Intensive Care Unit in Children Over 1 Year: A Narrative Review","authors":"Eimear O'Connell,&nbsp;Des W. Cox","doi":"10.1111/jpc.70572","DOIUrl":"10.1111/jpc.70572","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>High-flow nasal cannula (HFNC) therapy is increasingly used outside paediatric intensive care units (PICUs) for children with acute respiratory distress, despite limited evidence beyond bronchiolitis and neonatal populations. No existing review has synthesised evidence in children over 1 year without bronchiolitis managed in emergency department and ward settings. This narrative review aims to address this gap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Scopus and Medline (OVID) were searched to October 2025 for studies of HFNC in children aged over 12 months with acute respiratory distress, managed in emergency department or ward settings and compared with conventional oxygen therapy or non-invasive ventilation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies (six randomised trials, one pilot RCT, one observational cohort) were included, covering asthma, pneumonia and mixed hypoxaemic respiratory failure. Small trials showed early physiological improvement without consistent benefit in length of stay or PICU admission. Flow rates were highly variable, with several studies delivering flow below thresholds considered necessary for a true high-flow effect. The largest trial reported longer hospital stay and higher PICU admission with early HFNC use compared to conventional oxygen therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, while HFNC appears safe and well tolerated, current evidence does not support routine first-line use outside the PICU in children over 1 year. More prospective research is urgently needed to identify which populations will benefit from HFNC use. Until such data is available, HFNC should be implemented with clear institutional guidelines, defined escalation criteria and close clinical monitoring.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1873-1880"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891754","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":"Hypermanganesemia in Children With Liver and Portosystemic Circulation Disorders: A Systematic Review","authors":"Helena J. Kim,&nbsp;Susan M. Siew,&nbsp;Ji Hyun Moon,&nbsp;Tracey A. Williams,&nbsp;S. Murthy Chennapragada,&nbsp;Gordon Thomas,&nbsp;Shekeeb S. Mohammad","doi":"10.1111/jpc.70523","DOIUrl":"10.1111/jpc.70523","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Children with chronic liver disease and portosystemic circulation disorders may have long-term neurocognitive problems. Hypermanganesemia, reported in this group, could be a contributor. This systematic review aimed to characterise liver and portosystemic circulation disorders associated with hypermanganesemia and reported neurocognitive outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE, PubMed and Embase were systematically searched from inception to February 2023. Study quality and risk of bias were assessed using the Joanna Briggs Institute (JBI) critical appraisal tools and the Navigation Guide framework, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen studies (<i>n</i> = 103 patients) were included. Seventy of 103 had evidence of hypermanganesemia—47/78 with chronic liver disease and 23/25 with portosystemic shunts without liver disease. Among these, 40/70 had elevated manganese levels, 60/70 had characteristic MRI changes and 30/70 had both. Manganese levels and MRI abnormalities normalised in most cases following definitive treatment of chronic liver disease and portosystemic shunting. Neurocognitive outcomes were inconsistently reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Portosystemic shunting is likely an important risk factor for hypermanganesemia in children with liver and portosystemic circulation disorders. Substantial gaps and biases limit firm conclusions about its independent contribution to neurocognitive outcomes, highlighting the need for a structured framework including shunt status, biochemical markers including manganese and longitudinal neurocognitive profiling.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1848-1858"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673827","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":"The Performance of the STRONGkids Nutrition Screening Tool Following Nurse Training in a Tertiary Care Setting","authors":"Punthita Ngamboriruk,&nbsp;Oraporn Dumrongwongsiri,&nbsp;Phanphen Phoonlapdacha","doi":"10.1111/jpc.70515","DOIUrl":"10.1111/jpc.70515","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The low sensitivity of STRONGkids, a nutrition risk screening tool, was observed during its implementation in patient care services at a tertiary care hospital. The screening process improvement was performed to enhance its effectiveness. This study aimed to evaluate the validity and inter-rater reliability of the screening tool after the improvement process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional study that collected baseline characteristics and clinical data from medical records. STRONGkids score and risk classification were recorded by ward nurses. Concurrent validity was assessed with respect to nutritional status, including undernutrition (BMI Z-score &lt; −2), stunting (height-for-age Z-score &lt; −2), and overall malnutrition (including both undernutrition and stunting). Nutrition risk screening was repeated by a nutrition nurse to determine inter-rater reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study enrolled 1419 paediatric admissions. Undernutrition, stunting, and overall malnutrition were observed in 13%, 17%, and 27.6% of participants, respectively. STRONGkids classified 24%, 71.1%, and 4.9% of patients as having low, moderate, and high nutrition risk, respectively. Patients with high nutrition risk had significantly longer hospital stays and higher rates of hospital-acquired infections. STRONGkids demonstrated sensitivities of 82.4%–82.6% and specificities of 25%–26.5% for nutrition status. Inter-rater reliability was assessed across 320 admissions and showed excellent reliability for both the total score (<i>k</i> = 0.84; <i>p</i> &lt; 0.001) and risk categories (<i>k</i> = 0.89; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The performance of the nutrition risk screening tool may differ from that observed in research settings when used in routine clinical practice. STRONGkids demonstrates satisfactory validity and inter-rater reliability after the improvement process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1894-1900"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673897","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":"Complexity and Culturally Competent Care for Aboriginal Children Seen in a Hospital Paediatric Outpatient Clinic—A Retrospective File Review","authors":"Renata Kukuruzovic,&nbsp;Selena White,&nbsp;Sharon Mongta,&nbsp;Harriet Hiscock","doi":"10.1111/jpc.70540","DOIUrl":"10.1111/jpc.70540","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To document the health status and clinical complexity of Aboriginal children attending the Wadja Health Clinic at The Royal Children's Hospital (RCH), Melbourne and to assess the delivery of culturally competent care. To use the findings to inform service delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of 208 patient records (March 2018–March 2020) was conducted. Diagnoses and social–emotional difficulties were categorised into four domains: medical, developmental/behavioural, mental health and adverse childhood experiences (ACEs). Children with issues in ≥ 3 domains were classified as having complexity. Culturally competent care was assessed based on documentation or inference of cultural safety, relationship-based care, family-centred and strength-based care and a focus on social and emotional wellbeing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-eight percent of children met criteria for complexity. Thirty-six percent had experience with Out of Home Care (OOHC), and 80% had at least one ACE. Aboriginal Case Managers provided a median of 7 contacts per child over 2 years, while paediatricians saw children a median of 4 times. Referrals supported relationship-based care: 35% to Victorian Aboriginal Child Care Agency (VACCA) and 17.8% to an Aboriginal Community Controlled Health Organisation (ACCHO). Self-reported connection to culture and connection to cultural practices were poorly recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This Australian study documents high levels of clinical complexity in Aboriginal children attending an urban hospital clinic and demonstrates the value of embedding culturally competent care. The service response has been to strengthen an Aboriginal-led integrated multidisciplinary model of care at the hospital and could serve as a model for other hospital settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1942-1947"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760532","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 Sound Environment in the PICU: A Scoping Review Describing Sound Levels, Interventions and Patient Impacts","authors":"Janeen Bower,&nbsp;Hazel Low,&nbsp;Naomi Khan,&nbsp;Sebastian J. Corlette,&nbsp;Emma Macdonald-Laurs,&nbsp;Andrea Veysey,&nbsp;Ben Gelbart,&nbsp;Kate Masterson","doi":"10.1111/jpc.70591","DOIUrl":"10.1111/jpc.70591","url":null,"abstract":"<p>Elevated sound levels are associated with increased morbidity in adult and neonatal intensive care; however, their impact in the paediatric intensive care unit (PICU) remains poorly characterised. The aim of this scoping review was to characterise sound exposure in the PICU, including its measurement, sources, and associations with patient outcomes. MEDLINE, Embase, PsycINFO (Ovid), and PubMed were searched up to 5 November 2025 for full-text, peer-reviewed publications within the past 10 years to reflect the contemporary PICU environment. Titles, abstracts, and full texts were independently screened by two authors, and results were reported according to the PRISMA Extension for Scoping Reviews. Thirty-six publications were included. Publications were grouped into five domains: measurement of sound levels; sources of sound; patient impacts; sound reduction interventions including care bundles incorporating sound descriptions; and other. Reported sound levels varied substantially across studies, reflecting heterogeneity in measurement approaches and clinical contexts. Most studies reported sound levels above WHO recommendations, and several reported maximum levels exceeding 80 dBA. Sound sources were broadly categorised as medical equipment, human activity, and environmental factors. Links between elevated sound and clinically meaningful outcomes remain uncertain. Intervention studies were limited, often behaviour-focused, and rarely evaluated patient-centred outcomes or clinical sustainability. Current evidence suggests WHO recommended sound levels are rarely achieved. The sound environment in the PICU is multifaceted, reflecting the interaction of clinical equipment, human activity, and environmental systems. There is a need for interventional research to evaluate whether modification of the PICU sound environment meaningfully improves patient outcomes.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 10","pages":"1881-1893"},"PeriodicalIF":1.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955949","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}