Journal of paediatrics and child health最新文献

{"title":"Te Maatai Manawa a Whaanau: Maaori and Pacific People's Experiences of Echocardiography in Rheumatic Fever Health Care in Auckland, New Zealand","authors":"Anneka Anderson,&nbsp;Monleigh Muliaumasealii,&nbsp;Tira Phillipson-Puna,&nbsp;Rachel Webb,&nbsp;Nigel Wilson,&nbsp;Shannon Leilua,&nbsp;Kim Arrowsmith,&nbsp;Rachel Brown,&nbsp;Florina Chan-Mow,&nbsp;Adam Dennison","doi":"10.1111/jpc.70509","DOIUrl":"10.1111/jpc.70509","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This research aimed to gain an understanding of rheumatic fever related echocardiography experiences from Indigenous Maaori and Pacific children, adolescents and their whaanau (family members) in the Counties Manukau region of Aotearoa New Zealand to improve these services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The study used qualitative Indigenous Kaupapa Maaori consistent and Kakala methodologies. The research was based in the Counties Manukau region of Auckland, New Zealand. Data was collected through interviews with Maaori and Pacific children and adolescents with rheumatic fever or rheumatic heart disease who had recently had echocardiograms and their whaanau. Data was analysed using a general inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen Participants Were Included in the Study. Four Themes Were Identified in the General Inductive Analysis: (1) Communication; (2) Engagement; (3) Access; (4) Kaiaawhina.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By identifying barriers and facilitators of echocardiography services for rheumatic fever, this research provided knowledge and insights that can assist in developing child, adolescent and whaanau-focused models of care that have the potential to improve patient experience and echocardiography services in Aotearoa New Zealand.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1676-1681"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549413","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":"Hypomagnesemia as a Predictor of Noninvasive Respiratory Support in Children With Acute Obstructive Lower Airway Disease: A Retrospective PICU Cohort Study","authors":"Kıvanç Terzi,&nbsp;Fatma Gül Ersan","doi":"10.1111/jpc.70506","DOIUrl":"10.1111/jpc.70506","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Acute obstructive lower airway disease (AOLAD) is a common cause of paediatric respiratory distress, yet early predictors of escalation beyond low-flow oxygen are limited. We aimed to identify admission factors associated with the need for noninvasive respiratory support (NRS; HFNC and/or nasal CPAP/BiPAP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective observational study conducted in a tertiary paediatric intensive care unit in Türkiye (January 2020 and January 2025) including children aged 1 month to 5 years with AOLAD; pneumonia and asthma were excluded. Demographics, admission vital signs, laboratory values (including serum magnesium) and chest imaging findings were abstracted from electronic records. Univariable analyses reported crude associations, and multivariable logistic regression included prespecified clinically relevant covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 338 children (median age 11 months), 172 (50.9%) received NRS. In multivariable analysis, hypomagnesemia (OR 6.56; 95% CI 3.28–13.12), tachypnea (OR 2.40; 95% CI 1.29–4.46), acidosis (OR 2.01; 95% CI 1.15–3.54) and younger age (OR 0.98 per month; 95% CI 0.96–0.99) were independently associated with NRS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hypomagnesemia is a readily measurable marker associated with NRS requirement in paediatric AOLAD and may complement bedside assessment. Serum magnesium should be considered in the admission workup of patients with AOLAD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1663-1668"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497699","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":"A Checklist-Based Approach to Complex Hypospadias: Surgical, Genetic and Endocrine Insights From a Multidisciplinary Model","authors":"Bandar Alsahn,&nbsp;Amit Nagpure,&nbsp;Claire Sharpin,&nbsp;Grahame Smith,&nbsp;Sarah A. Sandaradura,&nbsp;Ann M. Maguire,&nbsp;Kristen Neville,&nbsp;Sarah Giutronich,&nbsp;Shubha Srinivasan,&nbsp;Aniruddh Deshpande","doi":"10.1111/jpc.70498","DOIUrl":"10.1111/jpc.70498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Complex hypospadias (CH) is a challenging congenital anomaly that requires comprehensive surgical, genetic and endocrine evaluation. This study evaluates the implementation of a pre-operative clinical checklist to standardise care and streamline a multidisciplinary team (MDT) approach to CH management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort analysis was conducted on 50 children with CH managed at two tertiary paediatric hospitals between 2016 and 2024. A structured pre-operative checklist was introduced in 2021 to standardise genetic, endocrine and anatomical evaluations and to facilitate asynchronous MDT review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 50 children evaluated (median age 18 months; median GMS score 11), 35 were managed after the checklist's introduction. The checklist enabled 77% (27/35) of these patients to bypass a full, synchronous MDT discussion. Clinical assessments revealed renal anomalies in 11% and proteinuria in 19%. Testing identified suboptimal testosterone responses in 4% and pathogenic genetic variants in 15% (7/46), with genetic testing directly influencing clinical decision-making in three patients. Among the 38 patients who underwent index surgical repair, 32% required revision surgery. Short-term surgical reintervention was driven by anatomical complexity rather than by underlying genetic or endocrine abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementing a pre-operative checklist for the CH streamlines the MDT review process, we hypothesise reduces the risk of missing important investigations, and supports a more structured approach to informed surgical consent. While genetic and endocrine findings are crucial for diagnosis, anatomical severity remains the primary predictor of early surgical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1706-1711"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592300","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":"Does a Monetary Incentive Increase the Response to Maternal and Child Health Questionnaires?-Evidence From the GEMS Follow Up Study.","authors":"Jake Fuyala, Phyllis Ohene-Agyei, Caroline A Crowther, Greg Gamble, Oluwatoyin Oladimeji, Deborah Samuel, Jane E Harding","doi":"10.1111/jpc.70597","DOIUrl":"https://doi.org/10.1111/jpc.70597","url":null,"abstract":"<p><strong>Aim: </strong>High participation is important for longitudinal studies to reduce bias. We evaluated whether a small monetary incentive (gift or 'koha' in Māori) increased consent and questionnaire completion rates, and decreased time to consent in the GEMS Follow-up Study.</p><p><strong>Methods: </strong>We conducted a before and after comparison during follow-up at 4.5 years of the GEMS randomised trial of diagnostic thresholds for gestational diabetes. Participants were invited to consent and complete health questionnaires for themselves and their child. The intervention (koha) was a NZ$25 supermarket voucher. Consent and questionnaire completions were compared between Koha and No Koha groups using Chi-square. Times to these outcomes were compared using survival analysis.</p><p><strong>Results: </strong>The Koha (n = 838) and No Koha groups (n = 368) had similar baseline characteristics. Consent rates were similar in Koha and No Koha groups for mothers (72.8% vs. 70.4%, p = 0.390) and children (69.1 vs. 69.0%, p = 0.980). Questionnaire completion was also similar for mothers (71.6 vs. 68.2%, p = 0.234) and for children (67.6% vs. 66.6%, p = 0.711), although the Koha group were more likely to complete the full child questionnaire (p = 0.019). Median times to maternal and child consent were also similar between groups for those who consented (24 vs. 24 days and 23 vs. 22 days), but survival analysis showed time to consent was reduced in the Koha group for mothers (p < 0.001) and children (p = 0.001). Findings did not vary by maternal ethnicity.</p><p><strong>Conclusions: </strong>Introduction of a small monetary incentive (koha) did not increase consent or questionnaire completion rates, but was associated with reduced time to consent.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069908","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":"A Randomised Open-Label Comparison of Dexamphetamine and Methylphenidate in Children With Attention Deficit Hyperactivity Disorder (ADHD): Symptom Response, Adherence and Weight Impact Over 12 Months","authors":"Alison Poulton,&nbsp;Sharon Ng,&nbsp;Hoang Cuc Do,&nbsp;Vincent Chau,&nbsp;Jessica Simons,&nbsp;Isabella Nilsson,&nbsp;Yilin Zhang,&nbsp;Stephanie Ng,&nbsp;Rosa Dyson,&nbsp;Habib Bhurawala","doi":"10.1111/jpc.70487","DOIUrl":"10.1111/jpc.70487","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Stimulant medications dexamphetamine and methylphenidate are well-established for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), but few studies directly compare their efficacy. We aimed to compare the therapeutic and adverse effects of immediate-release formulations of dexamphetamine and methylphenidate during the initial treatment of children with ADHD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This open-label study was conducted in public and private specialist paediatric clinics in New South Wales, Australia, between 2016 and 2020. One hundred stimulant-naïve children and adolescents with DSM-5-confirmed ADHD were randomised 1:1 to dexamphetamine or methylphenidate. ADHD diagnosis was based on detailed clinical assessment supported by parent and teacher DSM-5-based ratings. Dose titration followed a standardised 4-week weight-based protocol monitored with weekly school-based IOWA Conners ratings, after which dose adjustment or switching was made as clinically indicated. Participants were followed for 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study participants (mean age 9.08 [SD 2.87] years; range 4.5–16.4 years; 73% male) showed significant ADHD symptom improvement on either medication at all time periods (<i>p</i> = 0.001), with no significant between-group difference on repeated-measures ANOVA. At 12 months, 62 participants remained on their allocated medication, with no apparent preference between methylphenidate and dexamphetamine (34/50 [68%] vs. 28/50 [56%], <i>p</i> = 0.15). Both medications were associated with weight loss which was greater on dexamphetamine at 3 months (−1.44 [SD 2.42] kg vs. −0.31 [SD 0.97] kg; <i>p</i> = 0.005).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stimulant medications dexamphetamine and methylphenidate appear comparable in short-term symptom response and 12-month persistence after initial randomised allocation, but dexamphetamine may be associated with greater weight loss.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Australian New Zealand Clinical Trials Registry number: ACTRN12616000569404</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1621-1629"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405116","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":"Continuous Glucose Monitoring in Children and Adolescents With Type 2 Diabetes: A Narrative Review","authors":"Cate O'Brien,&nbsp;Kairavi Sethi,&nbsp;Alexia Peña","doi":"10.1111/jpc.70525","DOIUrl":"10.1111/jpc.70525","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Continuous glucose monitoring (CGM) has well-established benefits in Type 1 diabetes; however, evidence in paediatric Type 2 diabetes (T2D) remains limited, and CGM is not currently publicly funded for this group in Australia. This review aimed to evaluate the impact of CGM use in adolescents with T2D.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of Ovid Medline, Embase, CINAHL and Emcare was conducted for studies published from database inception to 18 November 2025 that evaluated CGM use in children and adolescents with T2D. Outcomes included glycaemic measures (HbA1c and time in range [TIR]), patient-reported benefits and barriers and psychological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1019 manuscripts identified, eight studies met inclusion criteria. Study designs were longitudinal or cross-sectional, with relatively small sample sizes (7–41 participants). Five studies assessed HbA1c and TIR, two demonstrating short-term improvements that were not consistently sustained over time. Reported benefits included improved lifestyle behaviours, greater ease of diabetes management and increased frequency of glucose monitoring. Common barriers were sensor adhesion issues, connectivity challenges and concerns regarding wearability. Psychological outcomes were variable across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CGM use in children and adolescents with T2D is associated with transient improvements in glycaemic control and perceived benefits in daily diabetes management; however, technical and usability barriers limit sustained effectiveness. Structured education for children and families is essential to overcome these barriers and optimise long-term outcomes. Current evidence supports consideration of CGM funding for children and adolescents with T2D in Australia, alongside implementation of education programs to maximise benefit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1595-1604"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669777","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":"Development of Multidisciplinary Consensus-Informed Guidance for the Management of Paediatric Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis Among Clinicians From Australasian Tertiary Referral Hospitals","authors":"Patrick David Mahar,&nbsp;Thomas Lee,&nbsp;David Orchard,&nbsp;Amy Gray,&nbsp;Laura Scardamaglia,&nbsp;Susan Robertson,&nbsp;Monique Bertinetti,&nbsp;Warwick Teague,&nbsp;Danielle Nizzero,&nbsp;Claire Grills,&nbsp;Ryan Toholka,&nbsp;Danni Bao,&nbsp;Julian Kelly,&nbsp;Joanne Grindlay,&nbsp;Thomas Rozen,&nbsp;Mark Oliver,&nbsp;Nicole Alexander,&nbsp;Ashan Fernando,&nbsp;Anu Matthew,&nbsp;Kiri Chan,&nbsp;Sonia R. Grover,&nbsp;Emma McDonald,&nbsp;Li-Chuen Wong,&nbsp;Marius Rademaker,&nbsp;Diana Purvis,&nbsp;Katherine Dear,&nbsp;Stephanie Weston,&nbsp;Vanessa Morgan,&nbsp;Anne Halbert,&nbsp;Orli Wargon,&nbsp;Gayle Fischer,&nbsp;Erin Mewton,&nbsp;Emma King","doi":"10.1111/jpc.70435","DOIUrl":"10.1111/jpc.70435","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Paediatric Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a rare, severe mucocutaneous reaction requiring coordinated multidisciplinary care. Existing guidelines provide evidence-based recommendations, but implementation across tertiary paediatric hospitals requires practical consensus on local resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To develop and evaluate multidisciplinary consensus-informed practical clinical guidance for assessment and management of paediatric SJS/TEN among clinicians from Australasian tertiary referral hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A draft guidance document was developed after review of SJS/TEN guidelines, systematic reviews and other relevant literature. Clinicians from one tertiary paediatric centre (Group A) and other Australian and New Zealand tertiary centres (Group B) completed a 130-item questionnaire. Continuous items were scored on a 1–9 Likert scale. Categorical items addressed referral urgency and whether investigations should be routine, reasonable but not routine, or not ordered. Quantitative responses and free-text comments informed revision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two multidisciplinary clinicians from the internal centre and nine clinicians from eight external centres participated. Agreement was high for history, examination, supportive care, multidisciplinary involvement, discharge planning and follow-up. Uncertainty remained regarding fluid requirements compared with burns patients, the scope of initial investigations and systemic immunomodulatory therapy. The guidance was revised to emphasise individualised fluid management, directed differential diagnosis and testing, and case-by-case systemic therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This practical multidisciplinary consensus-informed guidance supports paediatric SJS/TEN care in Australasian tertiary referral hospitals. Its contribution is the quantified consultative process and identification of consistent, variable and uncertain practice. It complements, rather than replaces, existing guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1578-1584"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138285","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":"Association Between Delivery Room Continuous Positive Airway Pressure and Neonatal Outcomes in Late Preterm and Term Infants: A Systematic Review and Meta-Analysis","authors":"Yoxin Chin,&nbsp;Maclean Hill,&nbsp;Arun Sett,&nbsp;Niranjan Thomas,&nbsp;Abdul Razak","doi":"10.1111/jpc.70516","DOIUrl":"10.1111/jpc.70516","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the effects of delivery room continuous positive airway pressure (DR-CPAP) in late preterm and term infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>Cochrane Library, Embase, Emcare and MEDLINE were searched through March 26, 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Eligibility Criteria</h3>\u0000 \u0000 <p>Observational studies and randomised clinical trials (RCTs) comparing outcomes in infants receiving DR-CPAP versus no DR-CPAP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Meta-analyses were conducted using a random-effects model to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Risk of bias was assessed per Cochrane guidelines, and certainty of evidence was graded using the GRADE framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome</h3>\u0000 \u0000 <p>Pneumothorax.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven studies (five non-randomised, two RCTs) involving 135 472 infants were included. In observational data, DR-CPAP was associated with a significant increased risk of pneumothorax (unadjusted OR: 45.79; 95% CI: 31.47–66.63; <i>moderate certainty</i>; adjusted OR: 24.18; 95% CI: 2.32–251.63; <i>moderate certainty</i>). RCTs reported no pneumothorax events in both groups, preventing meta-analytic estimation. DR-CPAP was also associated with increased use of surfactant in observational studies (OR: 5.68; 95% CI: 2.97–10.86; <i>very low certainty</i>). For neonatal intensive care unit admissions, DR-CPAP was associated with significantly higher odds in observational studies (OR: 14.56; 95% CI: 13.27–15.98; <i>moderate certainty</i>), but significantly lower odds in RCTs (OR: 0.24; 95% CI: 0.09–0.63; <i>very low certainty</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DR-CPAP was associated with potential harm in observational studies, though confounding cannot be excluded. Evidence from RCTs remains limited, and is of very low certainty. Well-designed, robust clinical studies are urgently needed to guide practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"62 9","pages":"1585-1594"},"PeriodicalIF":1.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70516","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604262","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":"Beyond Baseline BMI: Weight Trajectory as a Longitudinal Marker of Paediatric Obstructive Sleep Apnoea.","authors":"Weerapong Lilitwat","doi":"10.1111/jpc.70610","DOIUrl":"https://doi.org/10.1111/jpc.70610","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061906","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":"Risks for Childhood Bone and Joint Infection: A Case Control Study.","authors":"Sarah Hunter, John Mutu-Grigg, Haemish Crawford, Vanessa Selak, Cameron Grant","doi":"10.1111/jpc.70599","DOIUrl":"https://doi.org/10.1111/jpc.70599","url":null,"abstract":"<p><strong>Aim: </strong>Despite status as a high-income nation, New Zealand (NZ) experiences the second highest rate of childhood bone and joint infection (BJI) globally with a disproportionate burden in Māori and Pacific children. This study aims to identify potentially modifiable risk factors for childhood BJI.</p><p><strong>Methods: </strong>An age and ethnicity matched case-control design was utilised to compare acute cases of BJI with healthy controls recruited from orthopaedic fracture clinics. Cases were </= 15 years hospitalised because of acute haematogenous osteomyelitis or septic arthritis across multiple centres in the North Island of NZ. A pre-tested questionnaire was used to measure exposures including household income and crowding, healthcare access and eczema and eczema treatment.</p><p><strong>Results: </strong>Ninety-nine cases and 309 controls consented to participate. Median age for cases was 8 years. The odds of having BJI were increased by eczema diagnosis (aOR 2.6, p = 0.0001). Eczema diagnosis posed greater risk for Māori (aOR 3.8, p = 0.01) and Pacific children (3.3, p = 0.004). Children with eczema who received treatment (tablets, creams or other) did not experience greater odds of BJI (aOR 1.05, p = 0.85). Having income in the form of salary or rent was associated with reduced odds of BJI development (aOR 0.44, p = 0.02). Eczema remained independently associated with BJI after adjustment for socioeconomic factors and healthcare access (adjusted OR 2.23, 95% p = 0.02).</p><p><strong>Conclusions: </strong>This case-control study has shown up to three times higher disease risk with eczema. This risk becomes negligible when eczema is treated, which should inform public health measures to lower disease burden.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039498","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}