Journal of paediatrics and child health最新文献

{"title":"Risk Stratification for Complications in Patients Hospitalized With Community-Acquired Pneumonia.","authors":"Işın Senem Köşker Çapar, Tuğçe Tural-Kara","doi":"10.1111/jpc.70407","DOIUrl":"https://doi.org/10.1111/jpc.70407","url":null,"abstract":"<p><strong>Aim: </strong>Community-acquired pneumonia (CAP) remains a major cause of morbidity in children. Although severity assessment tools are available, they are not specifically designed to predict the development of a broad spectrum of pulmonary and systemic complications. This study aimed to identify admission factors associated with complicated pneumonia (CP) in hospitalized children with CAP and to develop a practical risk scoring model for early risk stratification.</p><p><strong>Methods: </strong>Patients hospitalized with CAP were classified into two categories: uncomplicated CAP and complicated pneumonia. Independent predictors for the development of complicated pneumonia were identified.</p><p><strong>Results: </strong>Multivariate logistic regression identified the following as independent risk factors for complicated pneumonia: older age (OR: 1.011; p < 0.001), hypotension (OR: 28.083; p < 0.001), altered mental status (OR: 5.033; p = 0.024), low haemoglobin values (OR: 0.835; p = 0.015), leukopenia (OR: 3.197; p = 0.040), increased neutrophil-to-lymphocyte ratio levels (OR: 1.045; p = 0.049), hyponatremia (OR: 2.840; p < 0.001), hypoalbuminemia (OR: 6.489; p < 0.001) and increased C-reactive protein levels (OR: 1.034; p = 0.039). The scoring system demonstrated a sensitivity of 82% and a specificity of 79%.</p><p><strong>Conclusions: </strong>We identified admission characteristics associated with the development of pulmonary and systemic complications in hospitalized children with CAP and developed a complication-focused risk scoring model based on routinely available parameters. The model showed good performance within this retrospective cohort and may support early risk stratification. Prospective multicentre validation is required to confirm its generalizability and clinical utility.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839363","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":"Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.","authors":"S R Peart, R Haj-Yahya, M Nugent, O Ganbold, L Harbinson, Cheong Jly, B J Manley, C L Whitehead","doi":"10.1111/jpc.70403","DOIUrl":"https://doi.org/10.1111/jpc.70403","url":null,"abstract":"<p><strong>Background: </strong>Preterm birth rates may have been affected during the COVID-19 pandemic but the impact of this on perinatal morbidity is unknown.</p><p><strong>Aim: </strong>To review the impact of the COVID-19 pandemic on rates of preterm birth and perinatal mortality.</p><p><strong>Methods: </strong>Medline, Embase, and online pre-prints were searched from Jan 2020 to Oct 2022. Case-control, cohort studies and reports comparing rates of preterm birth, stillbirth and neonatal death before and during the COVID-19 pandemic period were included. The pooled odds ratio (OR) for preterm birth, stillbirth and neonatal death was calculated using a random effects model. The primary outcome was the rate of preterm birth, stillbirth and neonatal death in the pre-pandemic and pandemic periods.</p><p><strong>Results: </strong>100 studies were included. Compared with pre-pandemic periods, there was a decrease in preterm births during the pandemic period: OR 0.95 (95% CI 0.94-0.97) I² = 0.93, with the greatest reduction for births < 28 weeks' gestation in high-income countries: OR 0.92 (95% CI 0.88-0.96), I² = 0.46. There was a reduction in neonatal deaths in high-income countries: OR 0.78 (95% CI 0.64-0.95), I² = 0.4. In low- and middle-income countries the stillbirth rate increased during the pandemic compared with the pre-pandemic period: OR 1.18 (95% CI 1.02-1.36), I² = 0.86.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic was associated with a reduction in preterm births and neonatal deaths. Further research is needed to investigate the mechanisms underlying these findings. Stillbirth rates increased in low- and middle-income countries where access to healthcare may have been restricted and strategies to address this in future pandemics are warranted.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816642","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":"Alerts and Alarms-Can Electronic Medical Records Help Children and Adolescents Survive Sepsis?","authors":"Ben Driver, Franz E Babl, Daryl Cheng, Ben Gelbart, Elliot Long, Sarah McNab, Joshua Osowicki, Pauline Salib, Amanda Williams, Gabrielle M Haeusler","doi":"10.1111/jpc.70412","DOIUrl":"10.1111/jpc.70412","url":null,"abstract":"<p><p>Early recognition and treatment of paediatric sepsis has been shown to improve survival. Automated sepsis alerts embedded in electronic medical records (EMRs) offer real-time identification of high-risk patients and may improve timeliness of sepsis care, with possible limitations including overdiagnosis, overtreatment and alert fatigue. It is currently unclear whether automated alerts improve clinical outcomes in paediatric sepsis. We conducted a systematic review and narrative synthesis of studies evaluating clinical outcomes (mortality, PICU admission rate, length of stay), process measures (time to fluids/antibiotics, bundle adherence), and balancing measures (hospitalisation rate, antibiotic use) after implementation of EMR-based automated sepsis alerts in patients under 18 years of age. Twelve studies met inclusion criteria. Automated alerts were associated with improvements in process measures, notably reduced time to antibiotics (4/6 studies) and fluids (2/5 studies). Mortality was reduced in one study of PICU patients (29.9% vs. 17.4%, p = 0.011), and a trend towards reduced PICU admissions was observed. No significant impact on hospital or PICU length of stay was noted. Alerts did not increase hospital admission rates or antibiotic usage. Automated sepsis alerts may improve time to fluids and antibiotics in paediatric sepsis. While inconsistently reported, alerts were not found to increase hospital admission rates or antibiotic use. The impact on clinical outcomes, particularly mortality, remains uncertain. High quality randomised studies are needed to define their role in improving paediatric sepsis outcomes.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816520","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":"Bongkrekic Acid: A Rare but Potentially Deadly Foodborne Toxin and Its Relevance in Australia.","authors":"Caius Martin, Noel Cranswick","doi":"10.1111/jpc.70416","DOIUrl":"https://doi.org/10.1111/jpc.70416","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816660","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":"Normal Does Not Mean Nothing Happened: Interpreting Medical Findings in Child Sexual Abuse.","authors":"Habib Bhurawala","doi":"10.1111/jpc.70406","DOIUrl":"https://doi.org/10.1111/jpc.70406","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774417","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":"Gender Dysphoria in Adolescents With Heritable Disorders of Connective Tissue: A Case Series.","authors":"Jessica E Herrmann, Claudia Algaze, Megan Wu, Elif Seda Selamet Tierney","doi":"10.1111/jpc.70410","DOIUrl":"https://doi.org/10.1111/jpc.70410","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816621","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":"Cholestasis in Infants With Vein of Galen Malformation.","authors":"Jody Heffernan, Darren B Orbach, Brian T Kalish","doi":"10.1111/jpc.70411","DOIUrl":"https://doi.org/10.1111/jpc.70411","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774360","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":"Exploring a Single Music Therapy Session to Reduce 22q11.2 Deletion Syndrome Child and Adolescent's Outpatient Clinic-Related Anxiety.","authors":"Mary C Broughton, Emma Bunzli, Susan Pagel, Lisa Burgess, Erin Davis, Karen Elliott, Vinita Prasad, Helen S Heussler","doi":"10.1111/jpc.70397","DOIUrl":"https://doi.org/10.1111/jpc.70397","url":null,"abstract":"<p><strong>Aim: </strong>This study explored whether a single music therapy session could reduce 22q11.2 deletion syndrome (DS) children and adolescents' clinic-related anxiety when visiting the hospital outpatient clinic for health appointments.</p><p><strong>Methods: </strong>The research employed a within-subjects, single-session, intervention design. The effect of the 30-min music therapy session on children and adolescents' (henceforth children) anxiety was assessed at baseline and the end of the session. A triangulated approach examined children's anxiety through parent and child self-report questionnaires, electrocardiograph (heart rate) and observational behavioural measures.</p><p><strong>Results: </strong>Children's self-reported anxiety was low and did not significantly change pre-post session, while parent/caregiver perceptions of their child's anxiety significantly decreased. Significant reduction in the frequency of anxious eye-gaze behavior and face and bodily expressions, and an increase in non-anxious behaviours and expressions were observed pre-post the session. Heart rate did not significantly decrease pre-post the music therapy session. Up to a week after the session, parents/caregivers reported a pronounced change in their child's overall anxiety after the session and a substantial improvement in their usual overall clinic experience that day.</p><p><strong>Conclusion: </strong>The findings from parent/caregiver reports and behavioural observations suggest that the music therapy session regulated the children's clinic-related anxiety, with parents/caregivers perceiving benefits extending post-session. However, these findings did not neatly align with children's self-reported anxiety and heart rate data, possibly reflecting characteristics of the population and measurement challenges. Active engagement in musical experiences with a skilled facilitator, such as a music therapist, might offer a safe and potentially inexpensive non-pharmacological approach to reducing hospital clinic-related anxiety in 22q11.2 (DS) children and adolescents, and enhance the clinic experience.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774423","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":"Placebo in Paediatric Clinical Trials: Systematic Literature Review and Framework-Based Synthesis.","authors":"Georgia Parry, Artur Abelian, Chloe C E Williams, Lydia E Roberts, Megan Athersmith, Louise Oni","doi":"10.1111/jpc.70399","DOIUrl":"https://doi.org/10.1111/jpc.70399","url":null,"abstract":"<p><strong>Introduction: </strong>Placebo-controlled trials can provide strong evidence on safety and efficacy, but their ethical acceptability in paediatric research is contested because children have limited decisional capacity and placebo use may entail withholding effective therapy.</p><p><strong>Objective: </strong>To identify the ethical and methodological conditions under which placebo controls are acceptable in paediatric clinical trials, using a systematic review of the literature and regulatory guidance.</p><p><strong>Methods: </strong>We searched Medline, Scopus and Embase for sources addressing the ethics, acceptability or regulation of placebo use in paediatric trials. We extracted study characteristics and ethical arguments, mapped them to beneficence, non-maleficence, autonomy and justice, and then synthesised findings using Emanuel, Wendler and Grady's seven requirements for ethical clinical research. We also obtained expert guidance from UK, USA and European regulators.</p><p><strong>Results: </strong>We included 51 sources spanning neonatal research, disease-specific paediatric contexts, parental perspectives and general ethics/regulatory discussions. Placebo was generally considered acceptable when methodologically necessary and scientifically sound, when no proven effective therapy was withheld (or any withholding carried minimal incremental risk), and when safeguards such as rescue therapy, early escape, and close monitoring were in place. Common emphases included limits on non-beneficial risk in children, assent and parental permission, and fair participant selection.</p><p><strong>Conclusion: </strong>Placebo use in paediatric trials is acceptable only under constrained conditions centred on scientific necessity, minimising harm from withholding therapy, robust safeguards and appropriate permission/assent processes. Further work should translate these conditions into disease-specific, operational guidance.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774440","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":"Strategies and Tools to Aid the Transition Between Paediatric and Adult Health Services for Young Adults With Neurodevelopmental Conditions: A Scoping Review.","authors":"Yattheesh Thanalingam, Lisa Hamm, Jin Russell, Colette Muir, Fiona Langridge","doi":"10.1111/jpc.70398","DOIUrl":"https://doi.org/10.1111/jpc.70398","url":null,"abstract":"<p><strong>Introduction: </strong>The global rise in neurodevelopmental conditions (NDD), alongside increased life expectancy for affected individuals, underscores the critical importance of effective transition from paediatric to adult healthcare. The transition between paediatrics and adults is an important stage to consider for emotional, psychosocial and psychological development. This scoping review aimed to summarise published literature on current tools and strategies designed to support the transition of young adults with NDD.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using MEDLINE, Embase, and PsychInfo via the OVID platform. Studies were included if they described interventions that facilitated the transition of young adults with NDD from child- to adult-centred health services. Screening and data extraction were performed independently by two reviewers per published study. Findings were synthesized using descriptive statistics and thematic analysis.</p><p><strong>Results: </strong>Out of 1876 records, 61 studies met inclusion criteria, the majority originating from the USA (66%). Five key intervention types emerged: education (62%), facilitation of paperwork (59%), transition clinics (57%), transition coordinators (33%), and clinical guidelines (7%). Only 38% of studies incorporated young people in the design of interventions, and only 8% addressed cultural considerations. Implementation was reported in 59% of studies, with 57% providing outcome evaluations; however, heterogeneity in measures limited assessment of efficacy.</p><p><strong>Conclusion: </strong>This scoping review highlights while tools and strategies exist, future efforts should focus on culturally informed, youth-centred approaches underpinned by consistent outcome measures. A holistic, relationship-based model-engaging families, young people, and health professionals-is essential for successful and sustainable transitions in care.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774434","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}