Journal of paediatrics and child health最新文献

{"title":"Peripheral Blood Eosinophil Count as a Predictor of Corticosteroid Resistance in Paediatric Asthma: A Prospective Observational Study.","authors":"Shravya S Rao, Karthik Subrahmanya, Vishwas Kadambila","doi":"10.1111/jpc.70532","DOIUrl":"10.1111/jpc.70532","url":null,"abstract":"<p><strong>Background: </strong>Asthma is one of the most common chronic inflammatory disorders in children and remains a major cause of morbidity worldwide. Although inhaled corticosteroids (ICS) are the cornerstone of long-term asthma management, a considerable proportion of paediatric patients exhibit reduced responsiveness to corticosteroid therapy, resulting in persistent symptoms, frequent exacerbations, impaired quality of life and increased healthcare utilization. Early identification of children at risk of corticosteroid resistance may facilitate individualized treatment strategies. Peripheral blood eosinophil count is an inexpensive and readily available biomarker of type-2 airway inflammation and has been proposed as a predictor of asthma severity and therapeutic response.</p><p><strong>Objectives: </strong>To evaluate the association between peripheral blood eosinophil count and corticosteroid resistance in children with bronchial asthma and to determine whether eosinophil count can serve as a practical biomarker for predicting corticosteroid responsiveness.</p><p><strong>Methods: </strong>A prospective observational study was conducted among 100 children aged 5-15 years with physician-diagnosed bronchial asthma attending the Department of Paediatrics, Siddaganga Medical College and Research Institute, Tumakuru, India, between January and December 2025. Clinical characteristics, asthma severity, treatment history and absolute eosinophil count (AEC) were recorded. Patients were classified as corticosteroid-responsive or corticosteroid-resistant according to predefined clinical response criteria following adequate corticosteroid therapy. Continuous variables were compared using the independent-samples t test, while categorical variables were analysed using the chi-square test. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and a p value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Among the 100 enrolled children, 68 (68%) were classified as corticosteroid responsive and 32 (32%) as corticosteroid resistant. The mean absolute eosinophil count was significantly higher among corticosteroid-resistant children than corticosteroid-responsive children (596 ± 210 vs. 328 ± 142 cells/μL; mean difference 268 cells/μL; 95% CI: 189-347; p < 0.001). Eosinophilia (AEC ≥ 500 cells/μL) was present in 68.8% of corticosteroid-resistant patients compared with 26.5% of corticosteroid-responsive patients. Elevated eosinophil counts were associated with significantly increased odds of corticosteroid resistance (OR 6.1; 95% CI: 2.5-14.8; p < 0.001).</p><p><strong>Conclusions: </strong>Peripheral blood eosinophil count is significantly associated with corticosteroid resistance in paediatric asthma. As an inexpensive and widely available laboratory parameter, eosinophil count may assist clinicians in identifying children at increased risk of poor corticosteroid responsiveness and severe disease, thereb","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":"2003-2011"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818791","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":"Use of Telehealth Technology in the Delivery of Community Health Services for Children and Young People in New Zealand. A Scoping Review.","authors":"S Williams, J Gardiner, T W Barbarich-Unasa, J Blamires","doi":"10.1111/jpc.70616","DOIUrl":"https://doi.org/10.1111/jpc.70616","url":null,"abstract":"<p><strong>Aim: </strong>To explore what is known about the use of telehealth for delivering community health services to children and young people in New Zealand, this review will map the existing evidence and identify key characteristics, gaps, and opportunities to support equitable service delivery.</p><p><strong>Methods: </strong>A scoping review was conducted following Arksey and O'Malley's framework, enhanced by Joanna Briggs Institute recommendations. A systematic search was performed across MEDLINE, SCOPUS, and CINAHL databases, supplemented by grey literature searching. Included studies focused on children and young people up to 24 years, involved telehealth interventions, and were conducted in New Zealand primary care or community settings. Two reviewers independently screened records and extracted data. The Mixed Methods Appraisal Tool was used for quality appraisal. Findings were synthesised thematically.</p><p><strong>Results: </strong>Twelve studies were included from 259 initial records. Three main themes emerged: enablers, barriers, and acceptability/feasibility. Enablers included improved healthcare access, reduced time and travel costs, enhanced care coordination, and strong therapeutic relationships. Barriers encompassed limited access to devices and reliable internet, privacy concerns, and perceived loss of care quality. Telehealth was generally acceptable and feasible across various paediatric services, though effectiveness varied by consultation type. Evidence specifically addressing Māori children and young people was notably limited.</p><p><strong>Conclusions: </strong>Telehealth shows promise for improving access to paediatric community health services in New Zealand but risks exacerbating digital inequities. Future telehealth development must prioritise digital inclusion, cultural responsiveness, and co-creation alongside Māori and other populations experiencing inequities to ensure equitable healthcare access for all New Zealand children.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111123","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":"Leveraging Bioinformatic Strategies to Advance Care of Children With Urinary Tract Infections.","authors":"Xin Wang, Rishil H Patel, Qiushi Li, Christina B Ching, Laura Schwartz, Juan de Dios Ruiz- Rosado, John David Spencer, Brian Becknell","doi":"10.1111/jpc.70607","DOIUrl":"https://doi.org/10.1111/jpc.70607","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) are among the most common bacterial infections and pose a significant global health challenge in children. UTIs can cause a range of conditions from cystitis and pyelonephritis to bacteraemia. Current methods for diagnosing UTI lack adequate sensitivity and specificity and are time-consuming, driving demand for improved approaches. Although most UTIs resolve with antibiotic therapy, some children develop recurrent UTIs due to multidrug-resistant organisms and progressive chronic kidney disease. Currently, there are no reliable methods to identify which children are at risk for adverse outcomes, representing a critical gap in paediatric UTI management. This review explores how bioinformatic approaches can offer a comprehensive framework to harness scientific discoveries and meet clinical challenges posed by paediatric UTI. Recent advances in high-throughput sequencing and proteomics have generated extensive datasets, enabling detailed analysis of microbial and host responses during UTI. We summarize how computational and multi-omics approaches, including metagenomics, bulk and single-cell transcriptomics, proteomics, epigenetics and integrative frameworks, have deepened our understanding of UTI pathogenesis and the foundational determinants of a successful host response. We consider the collective potential of these discoveries and technologies to transform future UTI management.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075111","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":"Hyperammonaemia in Neonatal Transport: A Retrospective Statewide Review of Neonates Retrieved With Elevated Ammonia.","authors":"Jessica Sabljak, Michael Stewart, Gregory Woodhead, Rosalynn Pszczola","doi":"10.1111/jpc.70619","DOIUrl":"https://doi.org/10.1111/jpc.70619","url":null,"abstract":"<p><strong>Aims: </strong>To characterise the aetiology, retrieval characteristics and outcomes of neonatal hyperammonaemia in a statewide neonatal retrieval service.</p><p><strong>Methods: </strong>Retrospective chart review of all neonates (aged ≤ 8 weeks) retrieved by the statewide Paediatric Infant Perinatal Emergency Retrieval (PIPER) service to the Royal Children's Hospital (RCH), Melbourne, Australia, between April 2016 and February 2025, with a pre-transport plasma ammonia > 100 μmol/L.</p><p><strong>Results: </strong>Twenty-one neonates met inclusion criteria. Median gestation was 38 weeks (IQR: 38-39) and median age at retrieval referral was 59 h (IQR: 48-84). A confirmed inborn error of metabolism (IEM) was identified in 16 of 21 neonates (76%), with urea cycle disorders accounting for 12 of the 16 confirmed IEMs (75%). Twelve patients (57%) required continuous veno-venous haemofiltration (CVVHF). Compared with those managed without haemofiltration, the CVVHF group had higher peak ammonia (median 854 vs. 378 μmol/L) and a higher rate of confirmed IEM (92% vs. 56%). Twelve retrievals (57%) were classified as time-critical, and metabolic medication was administered during transport in nine cases (43%). Median time from decision to retrieve to team dispatch was 20 min (IQR: 13-26) and to specialist hospital arrival 152 min (IQR: 97-229). Seventeen neonates (81%) survived to hospital discharge.</p><p><strong>Conclusions: </strong>Neonatal hyperammonaemia requiring retrieval is predominantly caused by an IEM and frequently requires CVVHF, with low occurrence of spurious elevation. These findings support early retrieval to a quaternary centre with haemofiltration capability and provide benchmarking data for retrieval services managing this rare, high-acuity condition.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075087","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":"Predictive Modelling in Neonatal Acute Kidney Injury: Emerging Approaches.","authors":"Dermot Wildes, Lisa Corley, Atif Awan, Catherine Quinlan, Michael A Boyle","doi":"10.1111/jpc.70604","DOIUrl":"https://doi.org/10.1111/jpc.70604","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081131","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":"Effect of a Novel Mediterranean-Style Diet (MIND-DASE) on Behavioural and Developmental Outcomes in Children With Autism Spectrum Disorder: A Propensity Score-Matched Analysis.","authors":"Hanim Seyma Topuz, Mehmet Eren Kurnaz, Eyup Sabri Keles, Atilla Ersen, Hasan Onal","doi":"10.1111/jpc.70606","DOIUrl":"https://doi.org/10.1111/jpc.70606","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the efficacy of the MIND-DASE (Mediterranean-style Intervention for Neuro-Developmental Diversity and Autism Symptom Evaluation) nutritional model in children with autism spectrum disorder (ASD). We hypothesized that increasing dietary diversity acts as a clinical catalyst for rapid behavioural improvement.</p><p><strong>Methods: </strong>In this propensity score-matched retrospective cohort study (N = 188), children in the diet group (n = 94) were matched 1:1 with non-compliant controls (n = 94) based on age, gender and baseline symptom severity (ATEC/ABC). Behavioural and developmental outcomes were assessed at baseline, 6 and 12 months.</p><p><strong>Results: </strong>At 6 months, the MIND-DASE group demonstrated a significantly more rapid reduction in Aberrant Behavior Checklist (ABC) total scores compared to controls (-18.4 ± 21.7 vs. -3.6 ± 16.2; p < 0.0001). Significant superiority was observed across all ABC subscales, including irritability (p = 0.0001) and hyperactivity (p = 0.0001). While both groups showed significant developmental progress in ATEC scores by the 12-month mark, the dietary intervention induced a markedly earlier clinical response in behavioural symptoms within the first 6 months.</p><p><strong>Conclusion: </strong>The MIND-DASE model induces a rapid and significant improvement in aberrant behaviours. While long-term standard care eventually leads to developmental gains, the nutritional intervention serves as a critical catalyst, accelerating clinical improvement in the early stages of treatment.</p><p><strong>Trial registration: </strong>This study was registered at ClinicalTrials.gov identifier: NCT06662916.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075133","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":"Anterior Drooling Versus Posterior Drooling: A Comparative Analysis.","authors":"Kaitlin Duell, Eric Levi, Will Alexander, David Chong, Monica S Cooper","doi":"10.1111/jpc.70602","DOIUrl":"https://doi.org/10.1111/jpc.70602","url":null,"abstract":"<p><strong>Aims: </strong>To examine the patient population of a tertiary Interdisciplinary Saliva Control Clinic, describe management pathways and identify patients suitable for primary care.</p><p><strong>Methods: </strong>Retrospective single-centre cohort study in a tertiary hospital reviewing patients referred to the Saliva Control Clinic over a 5-year period.</p><p><strong>Results: </strong>Of 361 referrals, 289 patients were seen. Age at referral ranged from 4 months to 18 years, 8 months (median 4 years, 9 months). Most referrals were from General Paediatricians (163, 58.2%). Severe neurological impairment was the most common primary diagnosis (106, 36.7%). Anterior drooling alone was present in 233 patients (83.5%), with 46 (16.5%) having posterior involvement. Prior to clinic, the most common prior intervention was medication (103, 36.1%). Many children, mostly typically developing, required no treatment (71, 24.6%). Common interventions were medications (138, 47.8%), saliva-specific surgery (74, 25.6%) and botulinum toxin (62, 21.5%). Saliva-specific surgery was more likely in patients with posterior drooling (31, 67.4%) than anterior alone (40, 17.2%).</p><p><strong>Conclusion: </strong>Management of drooling depends on saliva flow and patient phenotype. Typically developing children usually require only reassurance. Anterior drooling in young children can be managed in primary care, while posterior drooling in children with neurodevelopmental disabilities should be prioritised for specialist care.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081106","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":"Factors Impacting Laxative Use in Children and Adolescents With Epidermolysis Bullosa: Single Centre Retrospective Study","authors":"Isabella Cotton,&nbsp;Natalie Yerlett,&nbsp;Pablo Lopez Balboa,&nbsp;Gabriella Petrof,&nbsp;Sumaiya Alauddin,&nbsp;Maria Bageta,&nbsp;Anna E. Martinez,&nbsp;Graeme O'Connor","doi":"10.1111/jpc.70497","DOIUrl":"10.1111/jpc.70497","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Epidermolysis bullosa (EB) is characterised by chronic cutaneous wounds and gastrointestinal complications, including constipation. Aim to identify factors that impacted stool frequency and laxative use in paediatric patients with severe subtypes of EB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective data collection on demographics, type of EB, total fibre intake (food, enteral formula and supplements), probiotic supplementation, laxative use, iron supplementation, opioid-based pain medication, stool consistency and frequency using the Bristol Stool Chart.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data collected on 37 patients. The mean total fibre intake was 16.67 g/day (10.67 SD). Twenty-seven of 37 (73%) children were on macrogol osmotic laxatives. Children who were taking fibre supplementation were also more likely to be on macrogol compared to children not taking fibre supplementation (<i>p</i> = 0.047). No significant association was found between total fibre intake g/day or fibre reference nutrient intake (%) on stool consistency, <i>r</i> = −0.04 and <i>r</i> = −0.3, respectively. Children taking iron supplements were more likely to take macrogol compared to children not on iron supplements. Eight of 37 patients were on regular probiotics, but there was not a significant reduction in the need for macrogol osmotic laxatives compared to children not taking probiotics (<i>χ</i>² 0.025, <i>p</i>-value 0.87).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients who were on fibre supplementation were also more likely to take laxatives. Patients on iron supplements had a greater reliance on laxatives than those patients not taking iron supplements, further demonstrating the impact iron has within the intestines. The potential benefits of probiotics in the management of constipation may be suppressed in children with EB due to regular antibiotic administration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1700-1705"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592278","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":"Factors Associated With High Pain Scores During Paediatric Peripherous Intravenous Cannulation Insertion: A Secondary Analysis of a Prospective Cohort Study in Children","authors":"Amy L. Sweeny,&nbsp;Shane George,&nbsp;Clayton Lam,&nbsp;Bianca Goucher,&nbsp;Stuart Watkins,&nbsp;Lucy Dunstan,&nbsp;Peter J. Snelling","doi":"10.1111/jpc.70493","DOIUrl":"10.1111/jpc.70493","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>PIVC insertion can be a painful procedure, but limited research focuses on contributors and alleviators of pain. This study aimed to determine participant, proceduralist, and/or situational factors associated with a high pain score in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a secondary analysis of a previously published single-centre prospective observational study conducted over 28 consecutive days. Research assistants observed PIVC insertion attempts for children aged under 16 years and recorded data relating to the patient, proceduralist, and event. Pain scores during each attempt were determined observationally using the Faces Pain Score Revised (FPS-R) scale, which ranges 0–10. A score of 7–10 was categorised as high pain. Multivariable logistic regression modelling was performed to identify factors associated with a high pain score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 198 attempts for 130 participants were evaluated. About half of the children were male (<i>n</i> = 64, 49.2%) and median age was 5.7 years (2.0–11.0). Fifty-five children (42.3%) had high pain scores during PIVC insertion. Factors that independently increased the likelihood of a high pain score during PIVC insertion were younger age Odds ratio, 95% confidence interval (OR [95% CI]) = 0.83 [0.72–0.95], three or more attempts (OR 17.3 [1.8–163.8]), history of negative PIVC experience (7.0 [1.4–36.1]), a combative child (10.7 [2.3–50.3]), and antecubital fossa site as first attempt (3.37 [1.07–10.66]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High pain during PIVC insertion is common and associated with repeated attempts. Optimising the first attempt—and employing strategies shown to mitigate pain are recommended, particularly in younger children and/or those with prior negative experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1712-1722"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604297","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":"A Data-Driven Approach Towards Understanding the Volume and Complexity of Young Adults With Chronic Medical Conditions Transitioning to Adult Healthcare: A Cross-Sectional Study","authors":"Mary White,&nbsp;Ameer Lambrias,&nbsp;Evelyn Culnane,&nbsp;Alice Voskoboynik","doi":"10.1111/jpc.70508","DOIUrl":"10.1111/jpc.70508","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To describe the volume, complexity, referral patterns and pre-transition supports provided to a cohort of adolescents/young adults (AYAs) transitioning to adult healthcare services from a tertiary paediatric centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross-sectional retrospective review of AYAs aged ≥ 17 years who attended their <i>final</i> paediatric clinic review 1 January 2017–31 December 2018 with one or more of the most common chronic medical conditions or who attended the most frequently attended medical clinics at The Royal Children's Hospital, Melbourne.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 592 AYA (female = 283, 47.8%) met the inclusion criteria, with a mean (SD) age at the final RCH clinic of 18.6 (1.1) years. Of these, 115 (19.43%) were discharged to primary care, 44 (7.43%) disengaged from RCH prior to formal transition 44 (7.43%) and 3 (1.85%) died prior to completion of the transition process. Of the 430 AYA who were referred for ongoing specialist care, 384 (89.3%) were expected to be reviewed within the public system. Pre-transition support was accessed by 106/430 (24.65%) where 83 (19.3%) received standardised support. Higher representation in those who received coordinated care (<i>n</i> = 23, 5.35%) was seen in those; with ≥ 2 ongoing conditions, from regional postcodes, requiring interpreter assistance, with documented intellectual disability; and specific conditions such as epilepsy, inflammatory bowel disease and cerebral palsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Referral patterns and the nature of transition support at our institution are clinician/department dependent and therefore access may not be equitable between or even within condition groups. These data provide a platform from which robust post-transition outcome data and policy can be generated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1669-1675"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549401","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}