Journal of paediatrics and child health最新文献

{"title":"Including Parents in Clinical Ethics Case Consultation","authors":"Carolyn Johnston,&nbsp;Katherine Moore,&nbsp;Giuliana Fuscaldo,&nbsp;Aahana Dudani","doi":"10.1111/jpc.70051","DOIUrl":"10.1111/jpc.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Parents have legal and moral authority in healthcare decision making regarding their minor children. However, parents are not routinely involved in ethics case consultation meetings in paediatric settings. Clinical ethics services in paediatric hospitals in Australia have not yet debated the moral justification for parental involvement, nor the practicalities of doing so. This paper reports on a quality assurance project evaluating an Australian paediatric Clinical Ethics Response Group (CERG) to identify whether any changes to the service could improve clinical ethics support. Parental involvement in CERG ethics case consultations was one strand of the interviews, and this paper reports on this strand only.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews (<i>n</i> = 12) were conducted over Zoom or Microsoft Teams with members of a paediatric CERG and clinicians who had referred cases to the CERG, exploring their views on parental involvement in ethics case consultations and the optimal process for doing so. Transcripts were manually coded and analysed using Inductive Content Analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The unanimous view of a small cohort is that, as a minimum, parents should be offered the opportunity to provide information to ethics case deliberations, whether by letter or attendance at a meeting, yet the best process for doing so remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Debate and consideration of the underlying premise of parental involvement and various processes for doing so is an important step in developing best practice in Australian paediatric ethics case consultation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"935-940"},"PeriodicalIF":1.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997898","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 Importance of Long-Term and Multi-Agency Follow-Up for Children Born Premature","authors":"Alison Davie-Gray,&nbsp;Patricia Champion","doi":"10.1111/jpc.70056","DOIUrl":"https://doi.org/10.1111/jpc.70056","url":null,"abstract":"&lt;p&gt;This brief communication introduces a new position paper, ‘Prematurity in Aotearoa New Zealand’, for professionals about the effects on our pēpē (babies) and tamariki (children) of having been born early. It was commissioned by the Champion Foundation in Ōtautahi Christchurch. The authors, Drs Patricia Champion and Alison Davie-Gray, provide a comprehensive summary of recent multi-disciplinary research in the field. The paper can be downloaded at no cost from the Champion Centre website—https://www.championcentre.org.nz/resources-for-professionals.html. Prematurity is an area of expertise for neonatal specialists, but the effects of prematurity are now well-established as having possible or probable lifelong impacts for those born early and their whānau (families). The Champion Centre, which runs a longstanding, follow-up and early intervention programme for babies and pre-schoolers born premature, recognises the need for accessible, evidence-based information for non-specialist professionals working with children beyond their pre-school years in health, education and social services. The report, which is clinically informed and based on an extensive review of the international literature, synthesises the silos of research evidence about prematurity as it relates to developmental science, which has not been previously provided in an international context.&lt;/p&gt;&lt;p&gt;Around 7% of children born in Aotearoa New Zealand are born premature. International evidence suggests that a preterm birth may result in vulnerabilities and differences for the developing brain, as well as other organs, which in turn may affect learning, health and wellbeing throughout childhood and beyond [&lt;span&gt;1&lt;/span&gt;]. The research shows that children and adults who were born early are most likely to experience ongoing effects, especially (but not only) if they were born very early, with children being born under 32 weeks being most at risk (around 1%–2% of the population); and particularly if they are growing up with families who have additional social, health, mental health or economic challenges [&lt;span&gt;2&lt;/span&gt;]. Research is clear that effects on the brain may not emerge until tamariki are at pre-school age or beyond, by which stage, children in New Zealand will not generally be followed up by specialist health-care providers.&lt;/p&gt;&lt;p&gt;Research highlights in particular the vulnerability of emerging self-regulation skills for children born premature. Self-regulation skills are now regarded as key building blocks for positive developmental outcomes. When children have difficulty acquiring these skills, it can have long-term effects on learning, attention, behaviour and emotional well-being. Parents can, however, make an important contribution to the self-regulatory skill capacity of their children. The report makes the case for the availability of early intervention with tamariki and their whānau, to understand and establish these foundational skills. Evidence suggests these skills ","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"820-821"},"PeriodicalIF":1.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908988","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":"Developing a Transition Tool for Young Adults With Neurodevelopmental Conditions","authors":"Yattheesh Thanalingam,&nbsp;Fiona Catherine Langridge,&nbsp;Jin Russell,&nbsp;Anita Johansen,&nbsp;Rachel Howlett,&nbsp;Colette Muir","doi":"10.1111/jpc.70054","DOIUrl":"10.1111/jpc.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transition from paediatric to adult healthcare is a challenging time for young adults with neurodevelopmental conditions (NDC). The fragmentation and deficits in health, social and disability systems, and the increasing numbers of people with NDC, mean a more guided transition focusing on health independence is needed. This study aimed to develop a holistic transition tool and identify areas for improvement in transition services based on the consensus of experts involved with the care of children with NDC in Aotearoa, New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilising the Delphi method, two rounds (Round One: open-ended, Round Two: Likert scale) of online questionnaires involving 61 panellists (healthcare professionals, educators and caregivers) reviewed areas for improvement in transition services and ideas for a transition tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In Round One, Delphi participants identified seven themes related to transition services, including processes, resources, professionals, governance and culture; and 10 themes related to components of the tool, including communication, healthcare management, rights, activities, supports and community connectedness, whānau/family, culture, mental and spiritual health and sexual health. In Round Two, 94% of the ideas for transition services items reached consensus (26% with strong consensus [&gt; 95%]). All the components of the transition tool reached consensus, and 62% of items reached strong consensus (&gt; 95%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides direction on key domains related to transition services and a framework for a transition tool for young adults with NDC in Aotearoa, New Zealand. Its inclusion of domains related to culture, mental and spiritual health, rights for young adults, family involvement and community connectedness is a first step in developing a holistic approach to support a successful transition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"941-956"},"PeriodicalIF":1.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026412","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":"Medicinal Cannabis for Emotional and Behavioural Symptoms: Parent and Physician Perspectives","authors":"Corey Driscoll,&nbsp;Kaitlyn Taylor,&nbsp;Cecilia Moore,&nbsp;Chidambaram Prakash,&nbsp;Daryl Efron","doi":"10.1111/jpc.70048","DOIUrl":"10.1111/jpc.70048","url":null,"abstract":"<p>In recent years there has been increasing interest in the use of medicinal cannabis (MC) to treat neurodevelopmental and mental health disorders in children and adolescents; however, evidence for its efficacy and safety remains limited. There are several ongoing paediatric trials of MC in autism spectrum disorder (ASD), intellectual disability (ID), fragile X syndrome, and early psychosis [<span>1</span>]. Despite the lack of evidence regarding its benefits and safety, parents of children with these problems are increasingly asking their health care providers about using MC for their children [<span>2</span>]. However, physicians appear to be relatively uninformed about MC [<span>3</span>]. Parents are therefore using social media to learn about product choice, dosing, and concomitant medications [<span>4</span>].</p><p>In order to investigate the knowledge, attitudes, and experience regarding MC for children with developmental, emotional, and/or behavioural symptoms, we developed two anonymous web-based surveys: one for parents and the other for clinicians.</p><p>Of the 543 parents (92% female) who responded, (282) 52% reported believing MC is safer than other medications because it is natural, 315 (58%) thought it might be helpful, and 462 (85%) indicated they would be comfortable giving MC to their child. 186 (34%) had sought information about MC for their child, primarily from social media, and 100 (19%) had discussed MC as an option with their doctor. Of those who had discussed MC with their doctor, 58 (58%) felt that their doctor did not know the risks and benefits of using MC, and only 23 (23%) felt they received the information they wanted. Having a child with ASD or ID, or a personal history of cannabis use, was predictive of parents requesting MC. Of the 32 (6%) parents whose children were using MC, 19 (59%) were using non-prescribed MC and 8 (25%) had not informed their doctor of the use.</p><p>One hundred twenty-nine physicians (89% paediatricians, 5% paediatric trainees) responded. Ninety-five (74%) physicians had been asked about MC by parents, and 60 (47%) had managed patients whose parents have said that they have given unregulated MC to their children. Although 77 (60%) reported they believed MC was a legitimate medical therapy, 104 (81%) felt that they did not have adequate knowledge to discuss MC with parents. Only 4 (3%) had prescribed MC.</p><p>To our knowledge, this is the first survey of parents and paediatric physicians regarding the use of MC in children with emotional and behavioural symptoms. Our findings demonstrate that there is high parental interest in the use of MC; however, physicians are unprepared for discussions with parents about this. As new evidence emerges from clinical trials, physicians should receive ongoing education on the appropriate use of MC in children.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"996-997"},"PeriodicalIF":1.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803263","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":"Evaluating Primitive Reflexes in Early Childhood as a Potential Biomarker for Developmental Disabilities","authors":"Gerry Leisman,&nbsp;Robert Melillo","doi":"10.1111/jpc.70053","DOIUrl":"10.1111/jpc.70053","url":null,"abstract":"<p>We aim to understand better the significance of retained primitive reflexes (RPRs) and examine the effect of RPRs in children, adolescents, and adults, focusing on autism spectrum disorder (ASD) and other neurodevelopmental conditions, as well as examine a basis for future treatment alternatives. We included a history section to better recognise the way that the scientific and medical communities have studied and understood the importance of RPRs. We review findings indicating that aspects of these disorders are related to the presence of functional disconnectivities related to a cortical maturational effect on neuronal networks. Cortical maturational delay within specific networks may lead to enhanced growth and maturation in other networks, resulting in asynchronous development and inconsistency in functional skills. There has been reported an overconnectivity of short-range, more immature connections and an underconnectivity of long-range, more mature connectivities. We review the relationship between motor and cognitive impairments and RPRs. A crucial conclusion will be that inhibiting these RPRs is representative of treatment targets.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"846-851"},"PeriodicalIF":1.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803324","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":"Late Nutrition and Negative Outcomes in a Brazilian Paediatric Intensive Care Unit: A Retrospective Cohort","authors":"Arnildo Linck Júnior,&nbsp;Flávia Lopes Gabani,&nbsp;Edmarlon Girotto,&nbsp;Ana Maria Rigo Silva,&nbsp;Selma Maffei de Andrade","doi":"10.1111/jpc.70049","DOIUrl":"10.1111/jpc.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To analyse the association between late initiation of enteral nutrition and negative outcomes in the Paediatric Intensive Care Unit (PICU) in Brazil.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This was a retrospective cohort study with data from the medical records of children hospitalised between 2012 and 2017. The independent variable was late initiation of enteral nutrition (&gt; 24 h after admission). The outcomes analysed included longer length of stay in the PICU and hospital, incidence of healthcare-related infections (HAIs), and death. Poisson regression models with robust variance were adjusted for potentially confounding variables by presenting relative risks (RR) and 95% confidence intervals (95% CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analysed 840 hospitalizations: 311 (37.0%) with delayed initiation of nutrition, 252 (30.0%) with a diagnosis of HAIs, and 93 deaths (11.1%). After all adjustments, late initiation of enteral nutrition was associated with longer lengths of stay in the PICU (RR: 1.41; 95% CI: 1.01–1.30), hospital stay (RR: 1.22; 95% CI: 1.06–1.41), and higher HAI incidence (RR: 1.40; 95% CI: 1.14–1.73). The association with mortality was no longer significant after adjusting for the admission severity indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results indicate that late initiation of nutrition can lead to longer PICU and hospital stays and a higher incidence of HAIs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"926-934"},"PeriodicalIF":1.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788624","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":"Recent Advances in the Diagnosis and Treatment of Paediatric Endocrine Disorders","authors":"Lara E. Graves,&nbsp;Benjamin Wheeler","doi":"10.1111/jpc.70047","DOIUrl":"10.1111/jpc.70047","url":null,"abstract":"&lt;p&gt;The discovery, synthesis and administration of hormones revolutionised the medical management of endocrine disorders in the first half of the 20th century. Kocher revolutionised thyroid surgery in the late 1800s and early 1900s [&lt;span&gt;1&lt;/span&gt;], Banting and Best are credited with the synthesis of insulin in 1920 [&lt;span&gt;2, 3&lt;/span&gt;], and steroids were first administered to patients with congenital adrenal hyperplasia (known as adrenogenital syndrome at the time) in the 1950s [&lt;span&gt;4, 5&lt;/span&gt;]. Nobel Prizes were awarded for these and other discoveries that furthered endocrinology knowledge and treatment [&lt;span&gt;6&lt;/span&gt;]. Although these hormonal replacements were life-saving, clearly further advancements are required to truly manage these conditions.&lt;/p&gt;&lt;p&gt;Here we present a collection of narrative reviews on recent advances in paediatric endocrinology, including the management of paediatric thyroid cancer, screening for type 1 diabetes and the use of burosumab in X-linked hypophosphataemic rickets.&lt;/p&gt;&lt;p&gt;The management of paediatric thyroid cancer has traditionally relied on extrapolation from adult data, but childhood disease behaves differently from adult thyroid cancer. Paediatric differentiated thyroid cancers are more widely metastatic at diagnosis than adults; however, the mortality rate is much lower. The first guideline for the management of paediatric thyroid cancer was published by the American Thyroid Association in 2015 [&lt;span&gt;7&lt;/span&gt;]. Vanderniet et al.'s review focuses on developments in the understanding and management of paediatric thyroid cancer since the publication of this guideline [&lt;span&gt;8&lt;/span&gt;]. Important conclusions are drawn, including the importance of paediatric-specific data, optimal sonographic and cytological diagnostics, use of advanced genomic techniques to prognosticate and make management decisions, consideration of familial cancer syndromes and that management recommendations are rapidly evolving due to the accumulation of new knowledge. Furthermore, interdisciplinary input is required for optimal management of this rare condition and may include paediatric endocrinologists, surgeons, oncologists, geneticists, pathologists, radiologists and nuclear medicine physicians. As we enter the age of advanced therapeutics, there are new targeted molecular therapies available for some forms of paediatric thyroid cancer that can reduce the burden of traditional treatment such as radioactive iodine.&lt;/p&gt;&lt;p&gt;Approximately 30% of children and adolescents present with diabetic ketoacidosis (DKA) at the diagnosis of type 1 diabetes [&lt;span&gt;9&lt;/span&gt;]. There are potential long-term consequences of DKA, in addition to the acute metabolic decompensation. Clinical type 1 diabetes mellitus is defined as a random plasma glucose level ≥ 11.1 mmol/L or a fasting plasma glucose of ≥ 7.0 mmol/L, which signifies irreversible damage to the insulin-producing beta cells. However, it is now well recognised that the onset of beta cell autoimmu","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"664-665"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772010","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 Burden of Paediatric Supracondylar Humeral Fractures Admitted Within a Health Region in New Zealand","authors":"Evangeline Liddicoat,&nbsp;Sheena Moosa,&nbsp;Alastair Smith,&nbsp;Grant Christey","doi":"10.1111/jpc.70045","DOIUrl":"10.1111/jpc.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Supracondylar humeral fractures (SCHF) comprise the majority of all paediatric elbow injuries and most require surgical intervention. This study determines the incidence and outcomes of SCHF in children of all injury severities admitted to hospital over 10 years in a health region of Aotearoa New Zealand (AoNZ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Retrospective data from Te Manawa Taki (TMT) Trauma Registry was extracted for all paediatric trauma hospitalisations (aged 0–14 years) with SCHF from 1 January 2012 to 31 December 2022. Patients with SCHF were identified using the International Classification of Disease-10 primary cause codes. Demographic and injury characteristics with hospital costs were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Paediatric SCHF (<i>n</i> = 1563) incidence was 73.7/100 000 (CI 61.5–85.8). Majority (62.8%) were aged 5–9 years with an incidence rate of 131.5/100 000 (CI 104.2–158.8). They were 6.6 and 2.0 times more frequently hospitalised than 10–14 and 0–4 year olds. The most common place for injury was home (40.9%) followed by school, other institution and public administrative area (32.5%). Falls accounted for 91.7% of injuries with most (52.4%) occurring at a height of less than 1 m. The majority (76.2%) of patients spent 1 day in hospital and over three quarters had operative management. Estimated hospital costs were $9 842 587 total with an average cost of $6354 per admission. There was no significant difference in annual incidence over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Paediatric SCHF is a significant issue in AoNZ, particularly in those aged 5–9 years. There is a clear need for injury prevention interventions in the home and school to minimise falls and reduce healthcare costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"919-925"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764221","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":"Paediatric Emergency Department Mental Health and Behavioural Presentations in Australia Before and After the Onset of the COVID-19 Pandemic: Retrospective Observational Study","authors":"Jackson Newberry-Dupe,&nbsp;Glenn Melvin,&nbsp;Kylie King,&nbsp;Marietta John White,&nbsp;Vicki Anderson,&nbsp;Franz E. Babl,&nbsp;Meredith L. Borland,&nbsp;Stuart R. Dalziel,&nbsp;Harriet Hiscock,&nbsp;Bruce J. Tonge,&nbsp;Paul Buntine,&nbsp;Brooke Charters,&nbsp;Megan Hamilton,&nbsp;Amit Kochar,&nbsp;Alastair Meyer,&nbsp;Viet Tran,&nbsp;Emogene Aldridge,&nbsp;Giles Barrington,&nbsp;Liam Hackett,&nbsp;Nicole Lowry,&nbsp;Joseph Miller,&nbsp;Sebastian Wrobel,&nbsp;Rohan Borschmann,&nbsp;Simon Craig","doi":"10.1111/jpc.70046","DOIUrl":"10.1111/jpc.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Although child and adolescent mental health and behavioural presentations to hospital emergency departments (EDs) increased during the first 2 years of the COVID-19 pandemic (2020 and 2021), little is known about the characteristics of these presentations. We aimed to compare demographic, clinical and psychosocial profiles of paediatric presentations to Australian EDs before and after the onset of the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective observational study of 100 randomly sampled presentations by children (6–11-year-olds) and adolescents (12–17-year-olds) to 10 Australian EDs between 1 January and 31 December 2019 (pre-COVID-19) and 1 January and 31 December 2021 (COVID-19). Using a multilevel factor model, we compared the pre-COVID-19 and COVID-19 cohorts regarding demographic characteristics, diagnoses, precipitants, time-to-treatment, length of stay, and discharge disposition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The COVID-19 period was characterised by increased presentations by adolescents and girls. Compared to the pre-COVID-19 cohort, the COVID-19 cohort experienced increased median waiting times (48 and 72 min, respectively), median length of ED stay (4.7 and 5.4 h), and likelihood of admissions to the ED short stay unit (9.5% and 12.9%). Patients in the COVID-19 cohort were more likely to present with self-harm and suicidal thoughts/behaviours, eating disorders, neurodevelopmental and neurocognitive disorders, and psychosocial stressors, and less likely to have diagnoses of disruptive behaviour, impulse control, and conduct disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Young people presenting to the ED in 2021 for mental health reasons were more likely to wait longer, stay longer, have a diagnosis of intentional self-harm and/or a neurodevelopmental disorder, and report psychosocial stressors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"910-918"},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753184","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 Impact of Electronic Devices on Children's Behaviour","authors":"Najlaa Ibrahim Al-Sammak,&nbsp;Muhammad Ahmad Younis,&nbsp;Abdulrhman Akram Abdulrhman,&nbsp;Manahil Ammar Thanoon,&nbsp;Ubayda Abdulsattar Salim,&nbsp;Redhaa Muthanna Khalil,&nbsp;Hiba Thamer Muhammed","doi":"10.1111/jpc.70043","DOIUrl":"10.1111/jpc.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>One of the main advances today is the development of electronic devices and their applications. They eased human life, but adversely impacted their psych and social relationships. Children, the sensitive part of human development, become involved in these quandaries. So, this study aimed to determine the effects of these devices on childhood behaviours in Mosul/Iraq.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was applied on parents' of 1102 children whose ages range 1–15 years. They were chosen conveniently from public places in Mosul over a period of 6 months since December 2023. A self-administered questionnaires were filled by those parents taking their opinions about the benefits and drawbacks of electronic devices on their children. The latter were divided into three comparable groups according to the duration of use. The collected data were analysed by SPSS using the Goodness of Fit test for exploring the significance of comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean age of studied children was 9.3 years, half of them (50.9%) used devices for three or more years, and another half (49.3%) had three or more hours of daily use. Parents said that their children's language and educational commitments were promoted by electronic devices, but unfortunately, they significantly suffered from anger, stubbornness, aggressiveness and sleep disturbances, especially after prolonged use (<i>p</i> &lt; 0.001) for each variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although digital devices enhanced the learning abilities of children, they impacted their psych and real communication adversely. So, to protect them, children should have limited time and types of applications used in order to positively promote their wellbeing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"905-909"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730402","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}