Journal of paediatrics and child health最新文献

{"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}

{"title":"Epidemiology of Children and Young People Presenting to Australian Emergency Departments for the Management of Acute Severe Behavioural Disturbance: Secondary Analysis of a Randomised Controlled Trial","authors":"Elyssia M. Bourke,&nbsp;Kate Klein,&nbsp;Chris J. Selman,&nbsp;Katherine J. Lee,&nbsp;Amit Kochar,&nbsp;Deborah Shellshear,&nbsp;Meredith L. Borland,&nbsp;Shane George,&nbsp;Shefali Jani,&nbsp;Doris Tham,&nbsp;Michael Gordon,&nbsp;Chidambaram Prakash,&nbsp;Andrew Davidson,&nbsp;Catherine L. Wilson,&nbsp;Natalie Phillips,&nbsp;Gaby Nieva,&nbsp;Jonathan C. Knott,&nbsp;Franz E. Babl,&nbsp;Simon S. Craig,&nbsp;the Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network","doi":"10.1111/jpc.70499","DOIUrl":"10.1111/jpc.70499","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the epidemiological characteristics of children and young people presenting to the emergency department (ED) with acute severe behavioural disturbance (ASBD) who were deemed to require oral sedative medication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Secondary analysis of a randomised controlled open-label multi-centre trial of oral olanzapine versus oral diazepam for the management of ASBD in children and young people aged nine to 17 years for whom epidemiological data were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 348 participants enrolled in the randomised controlled trial (RCT). The majority were female (215/348, 62%) with a mean age of 14.6 years (standard deviation 2.2). The most common pre-existing medical or mental health condition was anxiety (122/299, 35%) followed by attention deficit hyperactivity disorder and autism spectrum disorder (33% and 32%, respectively). Two-thirds of the study population (216/348, 62%) had previously attended the ED for ASBD management and 61% (212/348) reported previous intentional self-harm. Nearly three-quarters (247/348, 71%) were accessing psychiatric care in the community prior to their ED presentation. Half of the study population (178/348, 52%) presented to the ED with emergency services (e.g., ambulance, police). The median length of stay in the ED was 5.7 h (interquartile range 3.9–10.2 h) and 28% (98/348) of study participants required admission to hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For children and young people presenting to the ED with ASBD who were deemed to require oral sedative medication to assist with behavioural containment, pre-existing mental health disorders were common. There is a need for focussed management procedures for more targeted, trauma-focussed care for children and young people presenting to the ED with ASBD and for support and education in the pre-hospital setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The primary study (PEAChY-O) was registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12621001236886) prior to commencement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1630-1641"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70499","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471399","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":"Age-Specific Normative Values for the Sitting-Rising Test in Brazilian Children and Adolescents","authors":"Cíntia de Oliveira Cunha,&nbsp;Ana Luiza Righetto Greco,&nbsp;Gustavo Henrique Leite de Souza,&nbsp;Layra Alves Guimarães,&nbsp;Thailyne Bizinotto,&nbsp;Celmo Celeno Porto,&nbsp;Cibelle Kayenne Martins Roberto Formiga","doi":"10.1111/jpc.70507","DOIUrl":"10.1111/jpc.70507","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Functional assessment of children and adolescents is essential for monitoring motor development and for the prevention of deficits that may impact health and quality of life. In primary care contexts, the implementation of simple and cost-effective tests has been a pragmatic strategy, particularly in low- and middle-income countries. The sitting-rising test is noteworthy for its clinical and community relevance, although normative values for paediatric populations remain unavailable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To establish reference values for the Sitting-rising Test in children and adolescents aged 5–14 years, to investigate the influence of body mass index on functional performance, and to compare results between sexes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted with 596 schoolchildren (aged 5–14 years) assessed using the Sitting-rising Test and anthropometric measures. Reference values were defined by age-specific percentiles. The association between body mass index and performance was analysed using linear regression, and sex differences were tested with the chi-square test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sitting-rising Test performance was classified into three categories: below expected (≤ P10), adequate (&gt; P10 and ≤ P90) and above expected (&gt; P90). Body mass index accounted for 17.4% of the performance variation, indicating that greater body composition was associated with poorer test results. No significant sex differences were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides, for the first time, normative Sitting-rising Test values for children and adolescents aged 5–14 years. The findings highlight the SRT as a simple, low-cost and effective tool for early detection of functional deficits, especially in resource-limited settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1642-1647"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471359","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":"Prediction of Post-Intubation Oxygenation Using Saturation Oxygen Pressure Index in Newborns","authors":"Mariko Ishimaru,&nbsp;Masashi Zuiki,&nbsp;Eisuke Ichise,&nbsp;Kanae Hashiguchi,&nbsp;Tatsuji Hasegawa,&nbsp;Daisuke Kinoshita,&nbsp;Tomoko Iehara","doi":"10.1111/jpc.70478","DOIUrl":"10.1111/jpc.70478","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In neonatal intensive care, the management of mechanical ventilation frequently transitions from non-invasive to invasive techniques. Predicting post-intubation oxygenation status is essential before intubation. We aimed to validate the correlation between the saturation oxygen pressure index (SOPI) during non-invasive positive pressure ventilation (NPPV) and post-intubation oxygenation saturation index (OSI), and to determine the SOPI cut-off values corresponding to the OSI after initiation of invasive mechanical ventilation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a multicentre retrospective observational study. A total of 203 neonates who required synchronised intermittent mandatory ventilation after NPPV management for continuous positive airway pressure (CPAP) or bilevel positive pressure ventilation (BPPV) between April 2012 and January 2026 were enrolled. Pre-intubation SOPI and post-intubation OSI were calculated. Their correlations were analysed using Spearman's rank correlation coefficient. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of SOPI of all NPPV at OSI of 2.0, 3.0 and 4.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SOPI was positively correlated with OSI (all NPPV: <i>ρ</i> = 0.699, <i>p</i> &lt; 0.001; CPAP: <i>ρ</i> = 0.703, <i>p</i> &lt; 0.001; BPPV: <i>ρ</i> = 0.670, <i>p</i> &lt; 0.001). ROC curve analysis identified the optimal SOPI cut-off values as 1.49 (sensitivity 71.0%, specificity 86.5%) for OSI = 2.0, 2.30 (94.3%, 63.6%) for OSI = 3.0 and 2.49 (89.8%, 87.5%) for OSI = 4.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SOPI is a useful predictive marker of post-intubation oxygenation status in newborns. It may serve as a non-invasive, continuous and objective tool for clinicians to assess the oxygenation status of newborns managed with NPPV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1605-1610"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361176","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":"Australian General Practitioners' Perspectives on Childhood Obesity Management","authors":"Stephanie Lee,&nbsp;Jasveen Kaur,&nbsp;Hasnain Bhurawala,&nbsp;Gary Leong,&nbsp;Habib Bhurawala","doi":"10.1111/jpc.70500","DOIUrl":"10.1111/jpc.70500","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Childhood obesity is a public health challenge, with 26.1% of Australian children aged between 2 and 17 years classified as overweight or obese in 2022. General practitioners (GPs) are the most frequently accessed healthcare providers for children. This project aims to provide a contemporary insight into current childhood obesity management practices among Australian GPs, including perceived barriers and enablers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A 20-question survey was developed by a multidisciplinary team including a paediatric endocrinologist, GP registrar, paediatric registrar and medical student. The HealthMap database distributed the survey to registered Australian GPs using a Quality Audit Reporting System. Free-text responses were thematically analysed using Braun and Clarke's qualitative descriptive methodology. Ethics approval was granted by the Nepean Blue Mountains Local Health District Human Research Ethics Committee.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 199 responses, of which 92% (<i>n</i> = 183) were GP Fellows. Most respondents were from New South Wales (34.7%, <i>n</i> = 69) and Victoria (27.6%, <i>n</i> = 55). A majority (60.3%, <i>n</i> = 120) practised in major cities, with 18.1% (<i>n</i> = 36) based in outer regional areas. Thematic analysis identified key barriers to obesity management: difficulty engaging families, limited referral pathways for multidisciplinary care, inadequate public health interventions and underutilisation of national resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participating Australian GPs identified significant challenges in managing childhood obesity, particularly limited awareness of available resources and referral pathways. Improving the dissemination of existing services, strengthening clinical support and enhancing multidisciplinary care pathways may help support GPs in delivering effective, obesity-targeted care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1648-1662"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70500","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497482","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":"Systemic Therapy for Paediatric Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review of Current Evidence and Limitations","authors":"Samantha Ting,&nbsp;Kangjie Reuel Chua,&nbsp;Li-Chuen Wong,&nbsp;Gloria Fong","doi":"10.1111/jpc.70432","DOIUrl":"10.1111/jpc.70432","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The role of systemic therapy in paediatric Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) remains undefined. Management is primarily guided by observational data and variable practice patterns. This systematic review aims to integrate recent evidence and evaluate clinical outcomes associated with systemic therapies in paediatric SJS/TEN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, Embase and Scopus was conducted from January 1990 to February 2025. Studies were eligible if they included patients (&lt; 18 years) with SJS, SJS-TEN overlap or TEN managed with supportive care alone or systemic therapy (corticosteroids, intravenous immunoglobulin (IVIg), cyclosporin, TNF-α inhibitors or plasmapheresis). Studies without defined diagnoses or outcomes were excluded. Primary outcomes were mortality and length of hospital stay. Risk of bias was assessed using CARE guidelines for case reports and the Joanna-Briggs checklist for observational studies. Studies providing individual-level data were synthesised quantitatively, while aggregated data were described narratively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 260 studies comprising 1608 paediatric patients met inclusion criteria. Most patients received systemic therapy, most commonly corticosteroids or IVIg. Systemic therapy was not associated with a shorter length of stay or reduced mortality rate compared to supportive care alone. Treatment with cyclosporin and TNF-α inhibitors trended towards lower mortality rates, and for cyclosporin, shorter length of stay. However, these findings did not reach statistical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Evidence for systemic therapy remains limited by study heterogeneity and small sample sizes. Although emerging targeted therapies show early promise, firm conclusions regarding efficacy cannot be drawn. This highlights the need for further collaborative research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1570-1577"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963992","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":"Impact of Access to Pasteurised Donor Human Milk on Rates of Necrotising Enterocolitis in Neonatal Units in Australia: A Cohort Study","authors":"Laura D. Klein,&nbsp;Kei Lui,&nbsp;Abrar A. Chughtai,&nbsp;David A. Osborn,&nbsp;Robert Guaran,&nbsp;Andrew J. McPhee,&nbsp;Ulrike Brandenberg,&nbsp;Ian Callander,&nbsp;Lisa H. Amir,&nbsp;Christine Sulfaro,&nbsp;Richard Brown,&nbsp;David O. Irving,&nbsp;Veronica Hoad,&nbsp;Joanne Pink,&nbsp;Vanessa Clifford,&nbsp;the Australian and New Zealand Neonatal Network","doi":"10.1111/jpc.70472","DOIUrl":"10.1111/jpc.70472","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>In 2018, a pasteurised donor human milk (PDHM) service was established within Australia's national blood service, Lifeblood, and subsequently expanded to a national service. Before 2018, five milk banks operated in Australia, but most infants admitted to Australian neonatal intensive care units (NICUs) still did not have access to PDHM. This study aimed to compare infant outcomes before and after Australian NICUs had access to an assured supply of PDHM from Lifeblood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cohort study utilising Australian and New Zealand Neonatal Network data for infants born &lt; 32 weeks' gestation admitted to 15 NICUs across Australia over a 3-year period (2018–2020; <i>n</i> = 4395 infants). The primary study factor was NICU access to an assured supply of PDHM from Lifeblood. Neonatal outcomes were compared in periods with “PDHM available” versus “PDHM not available”. The primary outcome was the proportion of infants born &lt; 28 weeks' gestation who developed NEC. Secondary outcomes included duration of parenteral nutrition, retinopathy of prematurity, infection, death, length of stay, weight at discharge, and breast milk feeding at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After adjusting for confounding risks, NEC relative risk was 38% lower for infants born &lt; 28 weeks' (aRR 0.62, 95% CI 0.46–0.83) when Lifeblood PDHM was available. Weight at discharge (2828.8 vs. 2939.56 g, <i>p</i> = 0.001) was lower when PDHM was available. Breast milk feeding at discharge, infections and death were not associated with PDHM availability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Reliable access to PDHM was associated with reduced risk of NEC for infants born &lt; 28 weeks' gestation in Australian NICUs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1611-1620"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376082","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":"Investigating the Relationship Between Sensory Processing, Pain and Toe Walking Gait: A Survey Study","authors":"Jack H. Donne,&nbsp;Verity Pacey,&nbsp;Desiree Polt,&nbsp;Jennifer A. Powell,&nbsp;Michael C. Fahey,&nbsp;Cylie M. Williams","doi":"10.1111/jpc.70504","DOIUrl":"10.1111/jpc.70504","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to examine sensory processing patterns, the frequency and impact of parent-reported pain in children who toe walk across a range of diagnoses using validated caregiver-report tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online cross-sectional survey was distributed internationally between July 2024 and March 2025. Parents of children who toe walk aged 3–14 years, regardless of diagnosis, completed the Short Sensory Profile (SSP) and the Child Activity Limitations Interview-9 (CALI-9).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The survey collected responses from 176 parents of 187 children with toe walking gait. Sensory processing challenges were frequently reported, particularly in children with autism spectrum disorder (98%). Nearly half (48% of 187) of children were reported to experience pain, most frequently in the feet/ankles, lower legs, and hips/thighs. Most parents (94%) and their child's medical professional (81%) attributed their child's pain to toe walking. Parents of children experiencing pain described significantly greater limitations in activities such as sports (OR 3.10, <i>p</i> &lt; 0.001), running (OR 3.46, <i>p</i> &lt; 0.001), and social participation (OR 2.43, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sensory processing differences and pain were frequently reported among children who toe walk in this sample. Routine assessment of sensory processing and pain in clinical practice may guide targeted interventions to improve participation, function, and quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1682-1692"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579089","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 Framework for Ethical and Clinical Governance Evaluation of Innovative Medicines in Children: A Mixed Methods Study","authors":"Sonya Stacey,&nbsp;Jamie Lam,&nbsp;Fiona Gregory,&nbsp;Shakira Wild,&nbsp;Steven McTaggart,&nbsp;Helen Irving","doi":"10.1111/jpc.70501","DOIUrl":"10.1111/jpc.70501","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this project was to develop and implement a working definition and ethical framework for use of innovative medicine in contemporary Australian paediatric practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed methods research methodology was undertaken using a Delphi process to establish a definition of innovative medicines in paediatric patients. This definition was used to quantitate innovative medicines use in a retrospective quantitative review of non-formulary medications in a tertiary paediatric hospital. An existing ethical framework from the United Kingdom was adapted to supplement standard clinical governance processes in contemporary Australian paediatric practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A definition of innovative medicines and an ethical framework for their use in paediatric patients was developed after four rounds of feedback from 18 Australian paediatric experts. A total of 2906 individual patient medication approval applications were reviewed, 1447 of these were included for analysis, 120 of which were for medications not on the Australian Register of Therapeutic Goods and six applications were considered innovative using the newly developed definition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Evaluation of the use of innovative medicines in paediatric patients is essential to ensure patient safety and critical clinical governance of medication use. An adapted ethical framework for Australian practice is a valuable tool to assist clinical governance processes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1693-1699"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592295","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":"What Are the Systemic Therapeutic Options for Paediatric Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)?","authors":"Orli Wargon","doi":"10.1111/jpc.70468","DOIUrl":"10.1111/jpc.70468","url":null,"abstract":"&lt;p&gt;Although rare, the outcomes of SJS and TEN continue to be serious, with mortality rates ranging from 3% in SJS and up to 15% in TEN [&lt;span&gt;1&lt;/span&gt;]. Therapeutic options are unclear and in survivors, long-term sequelae such as ocular discomfort, nail dystrophy, and skin dyschromia are common [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The systematic review by Ting et al. is the first paediatric specific analysis since 2011. The authors assessed current evidence and limitations in the use of systemic therapies for paediatric SJS/TEN in 1608 children (84.7% treated with systemic therapies) from early 1990 to early 2025, with data coming from small sample sized case reports, case series, cohort studies and one prospective open trial. Patients on cyclosporin demonstrated the shortest median length of stay (sample size insufficient for meaningful statistical comparison). There was no significant difference in time to complete re-epithelisation between groups.&lt;/p&gt;&lt;p&gt;It highlights the lack of systemic therapeutic options for paediatric SJS/TEN, the ongoing lack of randomised controlled clinical trials, and the need for increased awareness, improvement in early recognition and a standardised approach to the management of SJS/TEN for paediatric patients.&lt;/p&gt;&lt;p&gt;There are, for examples, many variations of SJS/TEN that need to be considered. For example, Reactive Infectious Mucocutaneous Eruption (RIME) is a severe immune mediated reaction resulting in significant mucosal erosions, following a febrile respiratory infection often triggered by &lt;i&gt;Mycoplasma pneumoniae&lt;/i&gt; but also triggered by &lt;i&gt;Chlamydia pneumoniae&lt;/i&gt;, influenza B, adenovirus and COVID-19. RIME seems to usually have a better prognosis than drug induced SJS [&lt;span&gt;2&lt;/span&gt;]. Drug induced SJS/TEN which causes severe morbidity, in particular ocular complications [&lt;span&gt;3&lt;/span&gt;] and mortality, requires clinicians to have an immediate high level of suspicion and then use a validated tool (e.g., algorithm of drug causality for epidermal necrolysis) for early withdrawal of the relevant causative drug, usually an antibiotic, an anti-epileptic or a non-steroidal anti-inflammatory agent [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Systemic therapy options remain controversial with limited consensus on the use of immunomodulatory therapies including corticosteroids, intravenous immunoglobulin and cyclosporin in paediatric populations [&lt;span&gt;5&lt;/span&gt;] due to the absence of high-quality randomised controlled clinical trials.&lt;/p&gt;&lt;p&gt;TNF-alpha inhibitors (etanercept and infliximab), reported in meta-analysis of 1 RCT and mainly retrospective case series (mean age 40 years) [&lt;span&gt;6&lt;/span&gt;] suggest that early administration (with or without IVIG and corticosteroids) may be promising in severe SJS/TEN.&lt;/p&gt;&lt;p&gt;Sachdeva M et al. [&lt;span&gt;7&lt;/span&gt;] summarised outcomes of paediatric SJS/TEN cases treated with infliximab and etanercept but this systematic review was limited by small sample size and low evidence of included studies.&lt;/p&gt;&lt;p&gt;The Janus kina","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1568-1569"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218102","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}