Paediatrics & child health最新文献

{"title":"Medical assistance in dying in pediatrics: a retrospective case study of clinical interactions and implications for team training.","authors":"Marta Martisella, Marc-Antoine Marquis, Audrey Stypulkowski, Antoine Payot, Claude Julie Bourque, Marie-Eve Bouthillier","doi":"10.1093/pch/pxag016","DOIUrl":"10.1093/pch/pxag016","url":null,"abstract":"<p><strong>Objectives: </strong>In Canada, medical assistance in dying (MAiD) has been a legal end-of-life (EOL) option since 2016. Although minors are not legally eligible, pediatric palliative care (PPC) teams can be involved in MAiD-related discussions initiated by patients or parents. However, little is known about how these discussions unfold in pediatrics. This study sought to describe the structure and content of these interactions, with the aim of developing a typology and clinical vignettes to support the preparation and training of pediatric healthcare professionals.</p><p><strong>Methods: </strong>We conducted a retrospective and descriptive case study within a single PPC service in a Canadian pediatric academic tertiary hospital. Data were collected from patient's charts (September 2013 to August 2023), including patient demographics, clinical characteristics, palliative care involvement, MAiD-related discussions and EOL details (<i>N</i> = 11). Descriptive statistics, as well as thematic and comprehensive analyses were used.</p><p><strong>Results: </strong>We identified 11 cases of documented MAiD-related interactions involving patients aged <1 to 18 years. Most interactions were initiated by patients' parents (73%; <i>n</i> = 8), and some by patients themselves (27%; <i>n</i> = 3). We identified three types of MAiD-related interactions: implicit (<i>n</i> = 2), explicit exploratory (<i>n</i> = 5) and explicit direct (<i>n</i> = 4). Based on this typology, we co-developed six clinical vignettes to illustrate these scenarios.</p><p><strong>Conclusion: </strong>Although rare, MAiD-related interactions in pediatric settings are complex and high-stakes, underscoring the need for enhanced training of pediatric healthcare professionals. The proposed typology and vignettes provide a framework to support reflective ethical practice and enhance pediatric teams' preparedness for EOL beyond the specific clinical and legal context of our study.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 4","pages":"367-376"},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212108","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 multifocal alopecia in a young girl.","authors":"Dibyendu Bikash Bhanja, Loknath Ghoshal","doi":"10.1093/pch/pxag028","DOIUrl":"https://doi.org/10.1093/pch/pxag028","url":null,"abstract":"","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 4","pages":"291-292"},"PeriodicalIF":2.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212098","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":"Supporting Canadian youth in conflict with the law: a call to action for child health professionals.","authors":"Jennifer Mooney, Khadijah Gafoor, Amy Gajaria, Elizabeth S Barnert, Matthew Carwana","doi":"10.1093/pch/pxag004","DOIUrl":"10.1093/pch/pxag004","url":null,"abstract":"<p><p>Youth in conflict with the law are an underrecognized population, with unique and complex healthcare needs. The majority live in the community under supervision, rather than in locked facilities, yet still experience significant health challenges and service gaps. In this commentary and call-to-action, we provide paediatric healthcare providers with an overview of the Canadian Youth Criminal Justice Act and what is known about the epidemiology and health needs of Canadian youth in conflict with the law. We also share results of an environmental scan conducted at the 2025 Canadian Paediatric Society Annual Conference, which suggests that paediatric providers consider supporting healthcare for this population as a priority but lack training or familiarity. We identify action items to help improve care for this population, including development of further education and partnering with youth with lived experience. We hope to create awareness and build momentum in support of this marginalized population.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 5","pages":"423-426"},"PeriodicalIF":2.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606107","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":"Patient and caregiver perspectives on feeding tube transitions: a qualitative interview study.","authors":"Raman Chawla, Lara Montgomery, Lyndsay Mackay, Sharron Spicer, Justine Turner, Tammie Dewan","doi":"10.1093/pch/pxag003","DOIUrl":"https://doi.org/10.1093/pch/pxag003","url":null,"abstract":"<p><strong>Objectives: </strong>Enteral feeding provides nutrition for children with paediatric feeding disorders. Different types of tubes are used depending on the duration of enteral feeding and whether gastric or jejunal feeds are better tolerated. Many children move from one type of tube to another; these are important transitions in the health journey of a child. This study aimed to gain a thorough understanding of the patient and caregiver perspectives and experiences during enteral feeding transitions.</p><p><strong>Methods: </strong>This qualitative study included semi-structured interviews of 16 individuals, including 14 caregivers and 2 youth with feeding tubes from 2 tertiary care centres. Interviews were conducted exploring the following key topics: (1) child and family context; (2) experience transitioning to a different enteral feeding tube; and (3) goals and expectations before and during tube transitions. Data were analysed using inductive thematic analysis.</p><p><strong>Results: </strong>The following themes were identified: (1) The decision-making process for tube transitions requires family involvement and advocacy; (2) The tube transition itself must be supported by adequate preparation and training; and (3) Children and caregivers have their own hopes and expectations for tube transitions. To supplement these themes, a table of youth/caregiver identified benefits and challenges for nasogastric versus surgical tubes was created.</p><p><strong>Conclusion: </strong>Feeding tube transitions are important transition points for children, youth, and families. Integrating their perspectives is critical to optimal decision-making, management, and training around feeding tube transitions. Deliberate shared decision-making would optimize the transition process by individualizing the timing, education and expectations.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 4","pages":"347-353"},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212080","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":"La prise en charge de la dilatation des voies urinaires en période anténatale : un point de pratique clinique pour les prestataires de soins néonatals.","authors":"Laura Betcherman, Charushree Prasad, Matt Harding, Robert L Myette, Peter Wong, Priya Saini","doi":"10.1093/pch/pxag008","DOIUrl":"https://doi.org/10.1093/pch/pxag008","url":null,"abstract":"<p><p>La dilatation des voies urinaires en période anténatale est un scénario clinique courant en pédiatrie. En raison des diverses lignes directrices, de la variabilité des pratiques et des comptes rendus hétérogènes des échographies, il est difficile de savoir quels nouveau-nés auront besoin d'un suivi et à quel moment effectuer l'imagerie postnatale ainsi que de déterminer s'il est nécessaire d'administrer une prophylaxie antibiotique. Tant les échographies anténatales que postnatales devraient être utilisées pour évaluer le diamètre antéropostérieur du pyélon rénal et la présence de manifestations complexes. Les indications d'imagerie supplémentaire, de prophylaxies antibiotiques et de consultation en surspécialité en dépendent. Les données probantes en appui à l'utilisation d'une prophylaxie antibiotique sont limitées, mais cette utilisation peut être envisagée dans un modèle de prise de décision commune avec la famille des patients dont les manifestations cliniques sont complexes et dont la mesure du diamètre antéropostérieur du pyélon rénal est élevée. Le présent point de pratique intègre les lignes directrices déjà connues aux données probantes exemplaires pour créer un cheminement clinique afin de prendre en charge la dilatation des voies urinaires en période anténatale.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 4","pages":"414-419"},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212168","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":"Management of antenatal urinary tract dilation-a clinical practice point for neonatal care providers.","authors":"Laura Betcherman, Charushree Prasad, Matt Harding, Robert L Myette, Peter Wong, Priya Saini","doi":"10.1093/pch/pxag007","DOIUrl":"10.1093/pch/pxag007","url":null,"abstract":"<p><p>Antenatal urinary tract dilation (UTD) is a common clinical scenario for paediatricians. Differing guidelines, practice variability, and inconsistent reporting of ultrasound findings make it challenging to identify infants requiring follow-up, time postnatal imaging, and determine the need for antibiotic prophylaxis. Both antenatal and postnatal ultrasounds should assess the anterior-posterior renal pelvic diameter (APD) and for the presence of any complex features. Indication for additional scans, prophylactic antibiotics, and subspecialty involvement are based on these findings. The evidence for use of prophylactic antibiotics is limited but may be considered in a shared decision-making model with the family for patients with complex features or increased APD measurement. This practice point integrates existing guidelines and best evidence to provide a clinical pathway for managing antenatal UTD.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 4","pages":"409-419"},"PeriodicalIF":2.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562552","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 call for equity-informed pediatric palliative care in Canada.","authors":"Liana Bailey, Kira Goodman","doi":"10.1093/pch/pxag010","DOIUrl":"10.1093/pch/pxag010","url":null,"abstract":"<p><p>Infants, children, and youth with serious illness, and their families continue to face inequities in access to pediatric palliative care across Canada. This paper explores what it means to take an equity-informed approach within this field and why such a shift is urgently needed. Drawing on current literature and emerging insights from practice and policy, it outlines key considerations for embedding equity principles into pediatric palliative care and calls for ongoing collaboration toward more inclusive, responsive, and just systems of care for children and families.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 4","pages":"315-318"},"PeriodicalIF":2.5,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219083","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 call to action: expanding take-home naloxone availability for paediatric patients.","authors":"Christian Singh, Avery Longmore, Lauren Morris, Yaron Finkelstein, Trisha Tulloch","doi":"10.1093/pch/pxag011","DOIUrl":"https://doi.org/10.1093/pch/pxag011","url":null,"abstract":"<p><p>The rise in opioid-related hospitalizations and deaths continues to profoundly impact Canadian children, youth, and families. Take-home naloxone (THN) programs provide an evidence informed harm reduction intervention that equips individuals with naloxone kits and overdose response training. Despite the known benefits of THN, children and youth impacted by substance use are often overlooked. Moreover, there is a critical lack of evidence informing the implementation of THN programs in pediatric settings. This commentary highlights the impact of the opioid crisis on Canadian children and youth; identifies the need for expanded youth focused harm reduction efforts and calls on stakeholders to prioritize the integration of THN initiatives into paediatric clinical settings.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 6","pages":"563-565"},"PeriodicalIF":2.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990997","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":"Atropine for the treatment of paediatric sialorrhea: a retrospective case series.","authors":"Natalie Sloof, Julie Strychowsky, Agnieszka Dzioba, Breanna A Chen","doi":"10.1093/pch/pxag017","DOIUrl":"10.1093/pch/pxag017","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective case series examined the efficacy of sublingual atropine drops for paediatric patients with sialorrhea followed at the multidisciplinary sialorrhea clinic at Children's Hospital, London Health Sciences Centre.</p><p><strong>Methods: </strong>A retrospective review of patients seen for management of sialorrhea at the multidisciplinary sialorrhea clinic between January 1, 2015 and September 30, 2023 was completed. Patient demographics, comorbidities, interventions, frequency and severity of sialorrhea, and adverse effects were recorded. Drooling frequency and severity scale (DFSS) scores were collected to examine the effectiveness of atropine sublingual drops. A descriptive analysis and Wilcox signed-rank tests were conducted to compare pre- and post-treatment DFSS scores.</p><p><strong>Results: </strong>Twenty-one patients were included in the final analysis. The median DFSS score pretreatment was 4 for frequency and 4 for severity. Post-treatment, the median DFSS score decreased to 3 for both frequency (P = 0.006) and severity (P = 0.003), representing a statistically and clinically significant change.</p><p><strong>Conclusion: </strong>Atropine sublingual drops demonstrated efficacy for decreasing both drooling frequency and severity in a paediatric patient population.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 5","pages":"462-466"},"PeriodicalIF":2.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606050","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":"Multi-strain probiotics for Canadian preterm infants: a call for action.","authors":"Belal Alshaikh, Joseph Ting, Kumar Kumaran, Horacio Osiovich, Fabiana Bacchini, Prakesh Shah, Marc Beltempo","doi":"10.1093/pch/pxag020","DOIUrl":"https://doi.org/10.1093/pch/pxag020","url":null,"abstract":"<p><p>Strong evidence demonstrates that specific multi-strain probiotics substantially reduce the incidence of necrotizing enterocolitis and all-cause mortality in preterm infants. While many high-income nations have access such preparations into routine neonatal practice, Canadian preterm infants do not currently have access to this therapy following the discontinuation of the only high-quality multi-strain probiotic previously available for this population. Consequently, Canadian preterm infants are now placed at a disadvantage, lacking access to regulated and clinically validated products. This is a significant public health concern regarding neonatal care in Canada. In this call for action, we underscore the urgent need for a coordinated national strategy to re-establish access to safe, regulated, multi-strain probiotic formulations, ensuring Canadian preterm infants are no longer denied a preventive therapy with proven benefits.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 6","pages":"566-569"},"PeriodicalIF":2.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991060","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}