Paediatrics & child health最新文献

{"title":"Noise pollution and its overlooked impact on child and adolescent health.","authors":"Tamsin Holland Brown, Sunny Betty Brown","doi":"10.1093/pch/pxaf119","DOIUrl":"https://doi.org/10.1093/pch/pxaf119","url":null,"abstract":"<p><p>Noise exposure is rising across modern childhood, yet its effects remain underestimated in paediatric practice. This article synthesizes evidence showing that noise pollution impairs development, learning, and hearing, contributing to lifelong inequality. Children, with developing auditory and cognitive networks, are uniquely vulnerable. By reframing noise as a modifiable determinant of health, we highlight opportunities for paediatricians to influence safer listening, improve classroom and clinical soundscapes, and champion policies that protect young ears and minds. Creating child-centred soundscapes is both urgently needed and entirely achievable.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 2","pages":"91-94"},"PeriodicalIF":2.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444260","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":"Predictors of clinically significant underlying etiologies in children presenting with torticollis.","authors":"Matan Shemer, Shai Noyman, Ayelet Rimon, Neta Cohen","doi":"10.1093/pch/pxaf113","DOIUrl":"https://doi.org/10.1093/pch/pxaf113","url":null,"abstract":"<p><strong>Background: </strong>Torticollis is a common presentation in paediatric emergency departments (PEDs), usually benign but sometimes the first sign of serious pathology.</p><p><strong>Methods: </strong>We retrospectively reviewed children <18 years presenting with torticollis to the PED at Tel Aviv Sourasky Medical Center (2018 through 2023). The primary outcome was a clinically significant underlying condition: (1) infectious aetiology, (2) head, neck, or cervical spine tumour or (3) atlantoaxial rotatory fixation (AARF) requiring intervention.</p><p><strong>Results: </strong>Among 352 children (median age 4.8 years; 52% male), 59 (17%) had a clinically significant diagnosis: infectious causes (35/59 [59%]), AARF (18/59 [30%]) and tumours (6/59 [10%]). Infectious cases were younger (<i>P</i> = 0.03), more likely to be febrile (<i>P</i> < 0.001), and had higher C-reactive protein levels (<i>P</i> < 0.001). AARF was associated with older age (<i>P</i> = 0.002), prolonged symptoms (<i>P</i> < 0.001), midline tenderness (<i>P</i> = 0.002) and restricted motion (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>One in six children with torticollis had a serious underlying condition, supporting a structured, symptom-guided diagnostic approach.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 2","pages":"111-119"},"PeriodicalIF":2.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444521","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":"Navigating treatment dilemmas in severe paediatric IDA: A case report.","authors":"Rachel Fagen, Rachel Howard, Matthew Speckert","doi":"10.1093/pch/pxaf091","DOIUrl":"https://doi.org/10.1093/pch/pxaf091","url":null,"abstract":"<p><p>Iron deficiency anemia (IDA) is a leading cause of anemia worldwide, often managed with oral iron. Severe paediatric cases, however, raise uncertainty about when to use packed red blood cell (pRBC) transfusion versus intravenous (IV) iron. We report a 16-year-old male with autism spectrum disorder and severe nutritional IDA (hemoglobin 31 g/L) who presented with tachycardia and hypotension but no acute decompensation. Although transfusion was discussed, the patient declined, and he was managed with IV iron followed by oral supplementation. Hemoglobin recovery was brisk, rising by 13 g/L within 5 days, but functional recovery was slow, taking 6 months. This case highlights the therapeutic dilemma in adolescents with chronic severe IDA who may meet criteria for transfusion yet remain clinically stable. IV iron offers a viable alternative in this setting, but paediatric guidelines are needed to better define transfusion thresholds and the role of IV iron.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 2","pages":"95-97"},"PeriodicalIF":2.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444298","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":"Medical Monkeys: A pilot community initiative providing educational crocheted monkeys with assistive devices to the Children's Hospital of Eastern Ontario.","authors":"Maya Morcos, Bassam Jeryous Fares, Angela Li, Amir-Ali Golrokhian-Sani","doi":"10.1093/pch/pxaf124","DOIUrl":"https://doi.org/10.1093/pch/pxaf124","url":null,"abstract":"<p><p>Medical play is a powerful tool for engaging pediatric patients in understanding their health conditions, fostering autonomy, and improving therapeutic outcomes. The \"Medical Monkeys\" initiative introduces crocheted monkey toys equipped with 3D-printed assistive devices to represent various medical conditions and disabilities. These toys aim to promote psychoeducation, reduce anxiety, and enhance emotional resilience in children with visible disabilities who may be otherwise under-represented. Feedback from healthcare professionals and families highlights their therapeutic value in preparing children for medical procedures and supporting emotional well-being. Community support has enabled significant growth and scalability. Future directions include research to assess the impact and broader implementation across pediatric care settings. Additionally, we hope to further promote inclusion and support by providing toys to siblings and peers of pediatric patients, fostering empathy and understanding. This initiative demonstrates how inclusive therapeutic play can be a meaningful, community-driven tool to support pediatric patients and their families.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 2","pages":"75-78"},"PeriodicalIF":2.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444218","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":"Towards a healthier Canada: Transforming the community-based consultant paediatric workforce.","authors":"Brett Schrewe","doi":"10.1093/pch/pxaf134","DOIUrl":"https://doi.org/10.1093/pch/pxaf134","url":null,"abstract":"<p><p>Health care is a public good and social right in Canada. Yet, the paediatric workforce is increasingly strained, jeopardizing timely and readily available health care access for Canadian children and youth. While there have been welcome funding interventions to support efforts of dedicated paediatric centres, the significant amount of paediatric health care provided in the myriad contexts comprising the community has received less attention. This Commentary examines the current state of the community-based consultant paediatric (CBCP) workforce, highlighting a lack of comprehensive data and raising questions about the utility of current training models. In turn, it argues for strategies that lay the groundwork to improve data collection, centre voices of CBCPs and patients in policies and practices, and better support CBCPs in ways that may lead to a sustainable consultant paediatric workforce equitably distributed and effectively trained to deliver the kinds of health care that Canada's children need from coast to coast to coast.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 2","pages":"79-83"},"PeriodicalIF":2.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444494","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":"Culturally informed developmental pediatric care: A qualitative study.","authors":"Scott A McLeod, Michelle Huie, Kaitlyn Francois","doi":"10.1093/pch/pxaf112","DOIUrl":"10.1093/pch/pxaf112","url":null,"abstract":"<p><strong>Objectives: </strong>Paediatricians deliver developmental care through surveillance, diagnosis, management, and advocacy. Although developmental concerns are among the most common reasons for paediatric visits, care in this area is complex, intersecting medical, mental health, and educational systems. Increasing international migration, persistent health inequities, and diverse cultural concepts of child development require paediatricians to build skills for culturally informed care. However, there is limited research describing how paediatricians perceive and navigate cultural factors when providing developmental care, and how current training and systems support or hinder this. This qualitative study explored paediatricians' perceptions of providing culturally informed developmental care to diverse populations.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with paediatricians who primarily provide developmental care, to understand perceived challenges, opportunities, and educational needs. Thematic analysis of transcribed interviews used both inductive and deductive approaches.</p><p><strong>Results: </strong>Eighteen interviews yielded three major themes. First, <i>cultural translation</i> encompassed language barriers, use of interpreters, and trust-building within physician-family relationships. Second, <i>inequity</i> described systemic barriers faced by diverse families, power imbalances in healthcare, and the pandemic's amplification of inequities. Third, <i>educational opportunities</i> highlighted the value of reflective practice, immersive experiences in diverse settings, and building communities of practice to strengthen cultural competence.</p><p><strong>Conclusion: </strong>Paediatricians described unique aspects of developmental care that may benefit from practice changes and curriculum reform. Enhanced training in interpreter use, multicultural health brokers, and care coordination teams is recommended. Peer mentorship from diverse colleagues may reduce stereotypes and broaden perspectives. Infrastructure to monitor and close culturally based health gaps is a critical priority for developmental paediatrics in Canada.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 1","pages":"63-68"},"PeriodicalIF":2.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106650","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":"Ramblings from the editor on vaccine hesitancy.","authors":"Joan L Robinson","doi":"10.1093/pch/pxaf118","DOIUrl":"https://doi.org/10.1093/pch/pxaf118","url":null,"abstract":"","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 8","pages":"657-659"},"PeriodicalIF":2.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12718043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805155","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":"Response to the Letter to the Editor-Appealing abstracts: ChatGPT or outside advice?","authors":"Jocelyn Gravel","doi":"10.1093/pch/pxaf096","DOIUrl":"10.1093/pch/pxaf096","url":null,"abstract":"","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 8","pages":"664"},"PeriodicalIF":2.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12718045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805181","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":"Congenital nasolacrimal duct obstruction outcomes.","authors":"Abbie C Lai, Anubhav Garg, Kourosh Sabri, Santa Heede","doi":"10.1093/pch/pxaf114","DOIUrl":"10.1093/pch/pxaf114","url":null,"abstract":"<p><strong>Objective: </strong>To characterize children with congenital nasolacrimal duct obstruction (NLDO) seen by a pediatric ophthalmologist in terms of initiation of tear duct massage and need for lacrimal duct probing.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Participants: </strong>All children with a diagnosis of congenital NLDO managed by one pediatric ophthalmologist (SH) at a tertiary pediatric center (McMaster Children's Hospital, Hamilton, Ontario, Canada).</p><p><strong>Methods: </strong>Charts were reviewed to determine the percentage of patients requiring nasolacrimal duct probing. Secondary outcomes were percentage of patients who had tear duct massage, accurate or inaccurate, initiated by the referring provider.</p><p><strong>Results: </strong>Overall, 113 patients with a mean age of 1.8 ± 1.5 years at presentation were included, and 55 (48.7%) were male. Most patients (83.2%) were referred by a primary care provider (family physician or pediatrician) and the remainder by optometrists (13.3%) or ophthalmologists (3.5%). Accurate tear duct massage was initiated by referring providers in 23% of cases. Ultimately, 44.2% of cases required probing, and 4.4% were still pending follow-up at time of data collection. Of children who learned accurate massage technique, 56% avoided surgical intervention, even when proper massage is introduced after 12 months of age.</p><p><strong>Conclusion: </strong>Most patients referred to pediatric ophthalmology for congenital NLDO did not have an appropriate trial of tear duct massage before referral, and less than half of patients required probing after appropriate massage was initiated. Educating primary care providers and optometrists on proper initiation of tear duct massage may reduce the volume of congenital NLDO referrals to pediatric ophthalmology, a subspecialty with limited physicians and long wait times.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 1","pages":"69-72"},"PeriodicalIF":2.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106639","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":"Evaluation of an interprofessional school-based health centre: A multimethods study.","authors":"Susan Tang, Kathleen Morgan, Jessy Gatete, Mary Hendrickson, Hugues Plourde, Noa Hitterman, Reina Remman, David Estok, Geoffrey Dougherty, Matthew Donlan, David D'Arienzo","doi":"10.1093/pch/pxaf123","DOIUrl":"https://doi.org/10.1093/pch/pxaf123","url":null,"abstract":"<p><strong>Objectives: </strong>School-based health centres (SBHCs) aim to improve access to care, especially among socially vulnerable children. Interprofessional SBHCs are emerging, though their evaluations remain limited. We evaluated an interprofessional SBHC in a low-income community.</p><p><strong>Methods: </strong>The evaluation of the SBHCs was guided by the RE-AIM framework. The multimethods design included (i) a document analysis and (ii) a retrospective chart review of SBHC patients from September 2021 to May 2024.</p><p><strong>Results: </strong>The SBHC team comprised of paediatricians, a dietitian, occupational therapist, speech language pathologist, and a nurse working alongside school staff and community providers. After 98 clinic half-days, 760 appointments were scheduled across 153 patients, with a nonattendance rate of 12%. Care needs extended beyond preventative medicine for 80% of children, with mental health conditions being the most common diagnoses.</p><p><strong>Conclusion: </strong>This evaluation demonstrates that interprofessional SBHCs are feasible and offer a scalable model for addressing the complex health needs of socially vulnerable children.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 2","pages":"136-141"},"PeriodicalIF":2.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443925","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}