Paediatrics & child health最新文献

{"title":"A new care pathway for the diagnosis of cerebral palsy among community pediatricians.","authors":"Olivia Scoten, Vivian Wong, Mor Cohen-Eilig, Ram A Mishaal","doi":"10.1093/pch/pxae108","DOIUrl":"10.1093/pch/pxae108","url":null,"abstract":"","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"217-220"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775937","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":"Disparities in use of a virtual pediatric emergency department in Ottawa, Canada.","authors":"Habeeb Alsaeed, Maala Bhatt, Ewa Sucha, Nicholas Mitsakakis, Natalie Bresee, Melanie Bechard","doi":"10.1093/pch/pxae075","DOIUrl":"https://doi.org/10.1093/pch/pxae075","url":null,"abstract":"<p><strong>Objectives: </strong>Virtual care can facilitate access to pediatric emergency departments (EDs), but it is unclear if virtual care is equitably accessed by patients from marginalized communities. This study compares the use of a virtual pediatric ED between neighbourhoods with different levels of marginalization.</p><p><strong>Methods: </strong>This is a cross-sectional study of virtual ED visits per neighbourhood (defined by census dissemination area) within 100 km of a tertiary-care pediatric hospital in Ottawa, Ontario, from May to December 2020. Our primary outcome was incidence rate ratios (IRRs) of virtual ED visits for each quintile of the Ontario Marginalization Index's four dimensions: material deprivation, ethnic concentration, residential instability, and dependency. We conducted a negative binomial regression and adjusted for distance from the hospital.</p><p><strong>Results: </strong>There were 2920 virtual ED visits from 1076 dissemination areas. Compared to the first quintile of material deprivation (wealthier neighbourhoods), there were lower adjusted IRRs of virtual pediatric ED visits for the third (0.80, 95% confidence interval [CI] 0.68 to 0.94), fourth (0.79, 95% CI 0.67 to 0.94), and fifth (0.51, 95% CI 0.42 to 0.61) quintiles. The highest quintile of ethnic concentration (more diverse neighbourhoods) had a lower adjusted IRR compared to the lowest quintile (0.79, 95% CI 0.82 to 0.87). The adjusted IRR for the second quintile of residential instability was slightly higher than the first quintile (1.20; 95% CI 1.02 to 1.41). Adjusted IRR of visits did not vary by dependency.</p><p><strong>Conclusions: </strong>Wealthier and less ethnically diverse neighbourhoods displayed higher rates of virtual pediatric ED visits, after adjusting for distance to the hospital.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"244-249"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775941","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":"Illicit drug toxicity from opioid, stimulant or sedative use in adolescents: results of a Canadian one-time cross-sectional study.","authors":"Matthew Carwana, Eva Moore, Helia Shariati, Hasina Samji, Nicholas Chadi","doi":"10.1093/pch/pxae104","DOIUrl":"https://doi.org/10.1093/pch/pxae104","url":null,"abstract":"<p><strong>Background: </strong>Illicit drug toxicity is an escalating public health emergency. Usually framed as an adult issue, adolescents are significantly impacted. Little is currently known about the interface between Canadian paediatric physicians and adolescents experiencing severe health events from illicit drug toxicity.</p><p><strong>Objectives: </strong>(1) To determine the proportion of paediatricians in Canada who care for young people between 12 and 18 years who have managed cases of illicit drug toxicity; (2) to identify the characteristics of paediatricians that provide this care; and (3) to describe respondents' awareness of substance use-oriented services for youth in their home communities.</p><p><strong>Methods: </strong>A one-time descriptive cross-sectional study was conducted from May to June 2022. Clinicians self-reported cases of illicit drug toxicity from opioids, stimulants and sedatives for adolescents 12 to 18 years old over the preceding 24-month period. Respondents also self-reported their knowledge of substance use-focussed services for children and adolescents in their communities.</p><p><strong>Results: </strong>A total of 1027/2791 (response rate 37%) physicians completed the survey. Most respondents (<i>n</i> = 934, 91%) reported providing medical care to children and youth 12 years of age and over. 128/934 (13.7%) reported caring for at least one case of illicit drug toxicity. The majority of case reporters were general paediatricians (43%). Overall awareness of substance-related services was limited.</p><p><strong>Conclusion: </strong>A considerable proportion of respondents provided care for illicit drug toxicity over 24 months. This contrasts with a relatively low level of awareness of services for substance use in this population. Further research and education can support patients and physicians alike in the care of adolescent illicit drug toxicity.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"320-326"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775961","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":"Follow-up needs after paediatric critical care: A survey.","authors":"Oliver Venettacci, Nazanine Gholami, Elaine Gilfoyle, Christopher Parshuram, Christina Maratta","doi":"10.1093/pch/pxaf001","DOIUrl":"10.1093/pch/pxaf001","url":null,"abstract":"<p><strong>Objectives: </strong>This survey aims to describe the perceived needs for follow-up, and the actual follow-up received, by caregivers of Paediatric Intensive Care Unit (PICU) survivors. It explores PICU survivors' existing healthcare usage, primary care and specialist follow-up, and return to school and work for patients and their caregivers, respectively.</p><p><strong>Methods: </strong>A cross-sectional survey of patients surviving their PICU admission at a quaternary care children's hospital. Patients admitted less than 24 hours or who were not expected to survive were excluded. Descriptive statistics were used to describe characteristics and responses, and Likert scale responses were summarized.</p><p><strong>Results: </strong>Of the 139 patients consented, 62 (45%) completed the survey. Among children who attended school/daycare, 34% had not returned within 3 months of PICU discharge and 23% of those children returning to school required a new specialized education plan. Among employed caregivers, 38% had missed more than 1 month of employment. After discharge, 39% of patients had follow-up scheduled with a hospital specialist and 53% had new allied health follow-up. Of the respondents, 59% agreed or strongly agreed that follow-up after PICU would be beneficial for their child, and 84% agreed or strongly agreed that they would attend an in-person PICU follow-up appointment.</p><p><strong>Conclusions: </strong>This survey demonstrates a perceived need for follow-up among some caregivers of PICU survivors, an ongoing reliance on healthcare services, and school absenteeism following PICU admission. Further work is required to better delineate the ideal timing and format of follow-up, as well as the population most likely to benefit.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 5","pages":"395-401"},"PeriodicalIF":2.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016105","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":"Competency-based training for paediatric residents caring for children with medical complexity.","authors":"Catherine Diskin, Naomi Gryfe Saperia, Erin Brandon, Victor Do, Julie Johnstone, Nathalie Major, Ramsay MacNay, Eyal Cohen, Julia Orkin, Kathleen Huth","doi":"10.1093/pch/pxae099","DOIUrl":"https://doi.org/10.1093/pch/pxae099","url":null,"abstract":"<p><p>Children with medical complexity (CMC) are characterized by medical fragility, multisystem disease involvement, and medical technology use. Due to the complexities of care needs, CMC requires a tailored approach to care relying on intensive care coordination and consideration of the family and caregiver experience. With increasing access to medical technology and technological innovation that has improved, the prevalence of CMC is increasing. Postgraduate paediatric training needs to equip trainees to care for this population of children, including complex chronic disease management, medical technology use, health maintenance, care coordination, and optimizing family and child quality of life and well-being. Competency-based education in paediatric postgraduate training should embed principles in the care of CMC throughout training. Equipping future paediatricians with enhanced capacity to care for CMC and their families, including the ability to perform core clinical activities, would improve physician, patient, and family experience and care outcomes for this population.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"199-202"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775939","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":"Every child matters: An imperative paediatric healthcare movement.","authors":"Emily R Kacer, Patricia Farrugia","doi":"10.1093/pch/pxae065","DOIUrl":"https://doi.org/10.1093/pch/pxae065","url":null,"abstract":"<p><p>Guided by the 2015 Truth and Reconciliation Commission Report, this paper examines the legacy of colonialism in Canada and its continued detrimental effects on the health of First Nations, Inuit, and Métis children. Supporting Call to Action 24, which emphasizes the importance of Indigenous health and histories within medical training, the \"Every Child Matters\" social movement can inform the domains of education, patient care, non-Indigenous advocacy, and Indigenous inclusion, drawing attention to the negative impacts of Canadian institutions, including residential schools, on Indigenous peoples. This paper argues that \"Every Child Matters\" can provide a novel conceptual framework within which non-Indigenous paediatric health practitioners may engage in self-reflection, practise cultural humility, and deliver trauma-informed care with the aim of decolonizing their practices and supporting equitable healthcare for Indigenous children. Additionally, this proposed framework can support efforts toward reconciliation, providing opportunities for meaningful partnerships with Indigenous patients, families, and colleagues.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"195-198"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775958","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":"Impacting the physical activity confidence of children with medical conditions or disabilities: A randomized controlled trial.","authors":"Hana Alazem, Jenna Yaraskavitch, Angelica Blais, Anna M McCormick, Jane Lougheed, Christine Lamontagne, Kristian B Goulet, Anne Tsampalieros, Leanne M Ward, Sherri Lynne Katz, Marie-Eve Robinson, Lesleigh S Abbott, Thomas A Kovesi, John J Reisman, Daniela Pohl, Richard J Webster, Patricia E Longmuir","doi":"10.1093/pch/pxae085","DOIUrl":"https://doi.org/10.1093/pch/pxae085","url":null,"abstract":"<p><strong>Objectives: </strong>Youth with medical conditions or disabilities (MCD) seldom achieve healthy physical activity recommendations. Barriers include a perceived lack of competence, fear of pain/symptom exacerbation, or physical function changes. A 12-week intervention targeting physical activity confidence was evaluated among youth with MCD.</p><p><strong>Methods: </strong>This three-arm randomized controlled trial (in-person/virtual/control) enrolled youth (8 to 18 years) requiring ongoing medical care from tertiary paediatric clinics. Readiness Ruler (motivation ≥4/10, confidence ≤8/10) determined eligibility. Blinded assessments (0, 3, and 6 months) were total motivation/confidence (Canadian Assessment of Physical Literacy), physical activity (7-day accelerometry), screen time, and sleep behaviours. Intervention (2 h × 12 weeks, in-person or virtual) combined game/sport skills with activity participation and education.</p><p><strong>Results: </strong>Sixty-three youth (of 111 randomized) with baseline total motivation/confidence below recommended levels among 31 children and 32 adolescents (51% male, mean age 13.1 ± 3.0 years). In a model adjusted for age and baseline confidence, activity confidence at 3 months was higher among in-person intervention participants compared with control participants (beta = 1.7 [95% Confidence Interval (CI): 0.3, 3.1], P = 0.02). Higher confidence was associated with higher physical activity (r = 0.30; P = 0.01) and decreased sedentary time (r = 0.74; P < 0.001).</p><p><strong>Conclusions: </strong>Youth who were confident were more likely to engage in physical activity. The in-person intervention increased participants' activity confidence. The limited impact of the virtual format suggests that implementing new skills with peers is critically important for enhancing activity confidence. Further research is required to evaluate whether confidence gains could be sustained beyond the study intervention, would longitudinally increase activity participation over time, or would transfer to other activity settings.</p><p><strong>Clinical trial registration: </strong>The study was registered at ClinicalTrials.gov (NCT04106154).</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"257-267"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775962","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":"Long-term cardiovascular outcomes and mortality following Kawasaki disease: A systematic review and meta-analysis.","authors":"Francis Lao, Cal H Robinson, Dorota Borovsky, Joycelyne Ewusie, Karen Beattie, Michelle Batthish","doi":"10.1093/pch/pxaf003","DOIUrl":"10.1093/pch/pxaf003","url":null,"abstract":"<p><strong>Objectives: </strong>To determine if children with Kawasaki disease (KD) are at an increased long-term risk of cardiovascular disease and mortality.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was performed. A systematic search of MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science databases was performed through 2022. English-language publications, patients 0 to 18 years at KD diagnosis, minimum follow-up >1 year, and ≥10 patients included. Of 5072 articles, 181 were included. Cardiovascular events and mortality were extracted and pooled for analysis. Meta-analyses and meta-regression analyses were performed. The primary outcome of interest was the incidence of specific cardiovascular events (composite of myocardial infarction, heart failure or cardiac arrest) and all-cause mortality. Secondary outcomes included the incidence of occlusive coronary events, myocardial infarction, heart failure, cardiac arrest, non-coronary artery bypass grafting (CABG) coronary revascularization procedures, and CABG.</p><p><strong>Results: </strong>Cardiovascular events occurred in 0.85% of children during study follow-up. The incidence rate of cardiovascular events was 370 per 100,000 person-years. Mortality occurred in 0.24% of children during study follow-up. The incidence rate of mortality was 117 per 100,000 person-years.</p><p><strong>Conclusions: </strong>There is a low incidence of cardiovascular events and mortality following childhood KD diagnosis. Further studies are needed to better define this long-term risk.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 5","pages":"406-413"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016068","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 educational video assessing knowledge and attitudes of transgender youth on fertility preservation.","authors":"Florence Grégoire-Briard, Andie Chernoff, Ken Tang, Jenna Gale, Margaret L Lawson, Maria Kielly","doi":"10.1093/pch/pxae050","DOIUrl":"10.1093/pch/pxae050","url":null,"abstract":"<p><strong>Objectives: </strong>While gender-affirming therapy can alleviate gender dysphoria in transgender individuals, such treatments may negatively impact fertility. As such, multiple organizations have highlighted the importance of counselling and offering fertility preservation (FP) prior to the initiation of medical therapy. To supplement fertility discussions, whiteboard educational videos were created to review and provide information on FP for transgender and non-binary youths and their families. This study assessed the understandability, actionability, and readability of the FP educational videos; patient perceptions, knowledge, barriers, and interest in FP; and overall satisfaction with the videos.</p><p><strong>Methods: </strong>Participants (age 12 to 18) completed an online survey assessing their knowledge, perceptions, and overall thoughts on FP prior to watching a short educational video on FP. They were then invited to complete the survey again after watching the educational video and provide feedback on the video presented.</p><p><strong>Results: </strong>Twenty-one participants were enrolled in the study. Seventeen participants completed the pre-video survey, and 12 completed the post-video and video feedback survey (completion rate of 81.0% and 57.1%, respectively). The mean age of participants was 15.50 (SD = 1.34). In the pre-video survey, one participant (1/15; 6.7%) rated their knowledge of FP as 'very good' or 'good' (1/15; 6.7%) compared to 10 participants (10/12; 83.3%) in the post-video survey (P = 0.039). Feedback regarding the videos was overwhelmingly positive.</p><p><strong>Conclusions: </strong>Our results suggest that targeted patient education aids, such as a whiteboard educational video on FP, can be used to supplement fertility discussions with gender-diverse youth.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"229-234"},"PeriodicalIF":2.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775957","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":"Improving paediatric clinical teaching unit handover: A quality improvement project.","authors":"Samantha G Gerber, Marina S Yacob, Michael R Miller, Brianna L McKelvie","doi":"10.1093/pch/pxae052","DOIUrl":"https://doi.org/10.1093/pch/pxae052","url":null,"abstract":"<p><strong>Background: </strong>Handover is an integral part of patient care and is dependent on effective communication between physicians. Poor quality handover can lead to patient harm, with up to 75% of patients in whom there are handover failures sustaining preventable adverse events. Paediatric Clinical Teaching Unit (CTU) Morbidity and Mortality rounds identified multiple handover-related adverse events. We therefore undertook a quality improvement project to reduce handover-related adverse events and improve participant satisfaction with handover.</p><p><strong>Methods: </strong>This project was carried out in two phases at an academic tertiary care paediatric hospital in London, Ontario. Phase I involved recording any adverse events that occurred overnight. A root cause analysis with paediatric residents identified the key contributors to poor handover. Phase II implemented strategies aimed at addressing these contributors. CTU handovers were then observed using the same questionnaires as Phase I. Following Phase II, a questionnaire was sent to all paediatric residents to evaluate their perceived changes in handover.</p><p><strong>Interventions: </strong>Designating a handover room, collaborating with nurses to reduce pages during handover, changing pager messages to minimize non-emergent pages during handover, creating a handover template, and providing formal teaching to medical students and residents.</p><p><strong>Results: </strong>Implementation of the interventions resulted in a significant decrease in interruptions and background noise. There was a trend toward a reduction in adverse events from 13 in Phase I to 7 in Phase II. All residents felt that handover improved, with 16.7% stating minimal improvement, 61.1% stating some improvement, and 22.2% stating good improvement.</p><p><strong>Conclusions: </strong>Results show that the simple strategies implemented improved resident handover.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"212-216"},"PeriodicalIF":2.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775963","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}