Paediatrics & child health最新文献

{"title":"Development of a medical chart extraction tool to identify children with medical complexity in the Maritime Provinces of Canada.","authors":"Janet Curran, Holly McCulloch, Sydney Breneol, Sarah King, Jordan Sheriko, Jacklynn Pidduck, Deborah Balsor, Julie Clegg, Shauna Best, Stacy Burgess, Sam Stewart, Mari Somerville, Sandra Magalhaes, Catie Johnson, Simonne Collins, Mary-Ann Standing","doi":"10.1093/pch/pxae058","DOIUrl":"https://doi.org/10.1093/pch/pxae058","url":null,"abstract":"<p><strong>Objectives: </strong>Children with medical complexity (CMC) are a population in need of policy and practice reform within the Canadian healthcare system. They are generally characterized as sharing four predominant characteristics: (1) one or more complex chronic condition(s), (2) functional limitations, (3) high health resources use, and (4) family-identified needs. There is currently no standard method to identify the CMC population in Canada. The aim of this research was to establish a clear method to select the best way to identify this population. This was done by developing a medical chart extraction tool specific to the Maritimes' population of CMC.</p><p><strong>Methods: </strong>This study was conducted in the Canadian Maritimes. The work was conducted in two phases; first, a consensus meeting was held to develop a Maritime-specific conceptual definition with a multidisciplinary group of experts. Second, a smaller expert team used the Maritime-specific definition to co-design a medical chart extraction tool. Ethical approval for this project was granted by IWK Health.</p><p><strong>Results: </strong>The consensus meeting involved a total of 57 relevant stakeholders from all three Maritime provinces. The definition developed through consensus included four constructs (functional limitations, chronic disease, health care use, and family-identified needs) and 12 descriptors (2 to 5 per construct). The medical chart extraction tool queried 22 items and 84 sub-items.</p><p><strong>Conclusions: </strong>The consensus process developed a strong and comprehensive medical chart extraction tool that can be applied to select the best-fit method for identifying CMC at a population level.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"235-243"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775940","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":"Radiographic reporting in adolescent idiopathic scoliosis: Is there a discrepancy comparing radiologists' reports and surgeons' assessments?","authors":"Kara Sidhu, Marina Rosa Filezio, Vishwajeet Singh, Manjot Birk, David Parsons","doi":"10.1093/pch/pxae113","DOIUrl":"10.1093/pch/pxae113","url":null,"abstract":"<p><strong>Objectives: </strong>Cobb angle is a standard method for quantification of scoliosis in adolescent idiopathic scoliosis to guide treatment decisions. Precise and timely curve detection can ensure early referrals, amenable for bracing. Radiology reports serve as a guiding tool for family physicians to expedite specialist referrals. Therefore, accurate and reliable measurement of Cobb angle at the community level is crucial. This retrospective study investigated the agreement in Cobb angle measurement between radiologists and spine surgeons.</p><p><strong>Methods: </strong>Eighty radiographic reports (Cobb angle, Risser stage, and end vertebrae selection) completed by radiologists and spine surgeons were compared. To assess interrater reliability, interclass correlation coefficients (ICC) with 95% confidence intervals (CIs) were computed. ICC < 0.70, 0.70 to 0.79, 0.80 to 89, and 0.9 to 0.99 were considered poor, fair, good, and excellent reliability, respectively. All radiographs were assessed for quality.</p><p><strong>Results: </strong>The agreement between spine surgeons and radiologists was poor (ICC = 0.65, 95% CI: 0.13 to 0.97). The agreement between spine surgeons and community radiologists was poor (ICC = 0.45, 95% CI: 0.17 to 0.66). Risser stage was not reported in 56 of the 80 reports. ICC between spine surgeons and radiologists for the Risser stage was poor (ICC = 0.625, 95% CI: 0.325 to 0.794). For end vertebrae identification, there was absolute agreement of end vertebrae identification in 23 of the 80 scans.</p><p><strong>Conclusions: </strong>This study demonstrated a significant disagreement in scoliosis measurement between radiologists and spine surgeons, which significantly impacts appropriateness of referrals. Methods to improve triaging using allied health professional (i.e., nurse practitioners) may help ensure that patients presenting with scoliosis are referred in a timely manner.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 5","pages":"390-394"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016037","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":"Training and usage of language interpretation services among health care providers in a large Canadian pediatric centre.","authors":"Nicholas Brochez, Bonnieca Islam, Qaasim Mian, Karen L Forbes","doi":"10.1093/pch/pxae110","DOIUrl":"10.1093/pch/pxae110","url":null,"abstract":"<p><strong>Objectives: </strong>Canada has a diverse population and one of the highest immigration rates in the world. Non-English or French language preference populations face barriers accessing health care, which leads to increased rates of adverse events. Adequate training of health care providers (HCPs) with language interpretation services (LIS) and having accessible LIS are crucial to improve the quality of patient care. We sought to identify HCPs' prior training, and use of and attitudes toward LIS in a Canadian tertiary pediatric centre.</p><p><strong>Methods: </strong>An electronic survey was developed and distributed to a diverse group of pediatric HCPs at the Stollery Children's Hospital in Edmonton, Alberta between October 2022 and February 2023. Survey completion was anonymous and voluntary. Descriptive statistics were used for quantitative data and thematic analysis for free text responses.</p><p><strong>Results: </strong>Three hundred forty-five HCPs accessed the survey and 281 (81%) completed it. Fifty-three percent of respondents encountered a pediatric non-English or French language preference patient/family once weekly or more and 51.5% reported no previous training in the use of LIS in patient care. In-person interpreters were perceived as the most effective LIS modality. Barriers to using LIS included: inability to access desired modality and/or language; insufficient time; and lack of comfort in effective usage.</p><p><strong>Conclusions: </strong>HCPs perceive LIS as integral to patient care and convenient to use, yet most report no prior training. This study identifies multiple barriers to using LIS and suggested improvements include enhancing LIS accessibility, reliability, and LIS education. These results will help inform local LIS initiatives and resource allocation.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 3","pages":"176-183"},"PeriodicalIF":1.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541795","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":"Maternal smoking during pregnancy and blood lead levels in US children aged 1-15 years: associations modified by age and race.","authors":"Ian Alexander Sellars, Jian Zhang, Gunnar Preston Rogers, Yudan Wei","doi":"10.1093/pch/pxae112","DOIUrl":"https://doi.org/10.1093/pch/pxae112","url":null,"abstract":"<p><strong>Objectives: </strong>Tobacco smoke is an important source of lead exposure. Maternal smoking during pregnancy likely transfers lead from the mother to the child, contributing to increased lead exposure in developing children. The present study aims to examine the association between maternal smoking during pregnancy and blood lead levels (BLL) in children.</p><p><strong>Methods: </strong>A total of 18,946 US children aged 1-15 years in the 1999-2016 National Health and Nutrition Examination Survey were included. We defined children with elevated BLL if BLL ≥ 3.5 µg/dL. We estimated odds ratios (ORs) of elevated BLL in children born to mothers who smoked versus nonsmoking mothers.</p><p><strong>Results: </strong>A decreasing trend in the prevalence of elevated BLL occurred between 1999 and 2016. After adjustment for the trend and other covariates, children whose mothers smoked during pregnancy had significantly increased odds of having elevated BLL (OR = 1.60; 95% confidence interval [CI] 1.25-2.06) compared to children of nonsmoking mothers. The stratified analyses revealed a significant association existed in children aged 1-5 years (OR = 1.88 [95% CI 1.32-2.68]) and aged 6-10 years (OR = 1.79 [1.07-2.98]), but not in youths (11-15 years, OR = 0.72 [0.37-1.40]). Being born to smoking mothers was found to be associated with high odds of elevated BLL in White (1.93 [1.35-2.77]) and Black children (2.03 [1.43-2.87]), but with low odds in Hispanic children (0.46 [0.23-0.92]).</p><p><strong>Conclusions: </strong>The study demonstrates age- and race-specific associations between maternal smoking during pregnancy and BLL among US children. Maternal smoking contributes to lead exposure in early life. Culturally appropriate interventions are needed to further reduce BLL in the pediatric population.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"296-304"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775966","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":"Safety and health care utilization following COVID-19 vaccination (BNT162b2) among children and youth with juvenile idiopathic arthritis and inflammatory bowel disease: A population-based study.","authors":"Jennifer J Y Lee, Sasha Bernatsky, Eric I Benchimol, Jeffrey C Kwong, Qing Li, Rae S M Yeung, Jessica Widdifield","doi":"10.1093/pch/pxae101","DOIUrl":"https://doi.org/10.1093/pch/pxae101","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate among Ontario children and youth (<16 years old) with juvenile idiopathic arthritis (JIA) or inflammatory bowel disease (IBD), whether COVID-19 vaccines (Monovalent BNT162b2) were associated with adverse events of special interest (AESI) or health care utilization.</p><p><strong>Methods: </strong>Using health administrative databases, all children/youth with JIA or IBD who received at least one vaccine were identified from November 2020 to December 2021 with follow-up until August 31, 2022. Self-controlled case series analyses were used to determine the relative incidence rates (RIR) of events in any 3-week period [AESI, Emergency Department (ED) visits, hospitalizations] and in any 1-month period [specialist visits] post-vaccine compared to control periods.</p><p><strong>Results: </strong>We studied 1629 JIA and 1050 IBD patients. In the JIA cohort, the median age at vaccination was 12.0 years [Interquartile range (IQR): 10.0 to 14.0], and the median disease duration was 4.3 years (IQR: 2.0 to 7.5). By December 2021, 67.1% (n = 1093) received two doses and 24.1% (n = 393) received three doses. In the IBD cohort, the median age at vaccination was 13.0 (IQR: 11.0 to 14.0) with a median disease duration of 2.4 years (IQR: 1.1 to 4.8). Fifty-four percent (n = 565) received two doses and 36.3% (n = 381) received three doses. During risk periods, AESI was rarely reported. Relative to control periods, JIA and IBD patients demonstrated similar rates of hospitalizations [JIA: RIR: 0.76 (95% confidence interval [CI]: 0.25 to 2.33), IBD: RIR: 0.64 (95% CI: 0.29 to 1.41)], ED visits [JIA: RIR: 1.11 (95% CI: 0.77 to 1.59), IBD: RIR: 0.93 (95% CI: 0.61 to 1.43)], and specialist visits [JIA: RIR: 1.06 (95% CI: 0.89 to 1.26), IBD: RIR: 0.56 (95% CI: 0.22 to 1.43)].</p><p><strong>Conclusions: </strong>Overall, this study demonstrates the safety of the BNT162b2 vaccine in children/youths with JIA and IBD, with no associated increase in AESI or health care use.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 4","pages":"305-311"},"PeriodicalIF":2.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775970","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":"Incidence and severity of paediatric sledding injuries during the COVID-19 pandemic.","authors":"Domenic F Alaimo, Nishita T Sharif, Redjana Carciumaru, Stephanie C Scott, April J Kam","doi":"10.1093/pch/pxae098","DOIUrl":"10.1093/pch/pxae098","url":null,"abstract":"<p><strong>Objectives: </strong>During the coronavirus disease 2019 (COVID-19) pandemic, we observed an increase in sledding injuries resulting in paediatric emergency department (PED) visits. We sought to describe the potential impact of the pandemic on the incidence and severity of sledding injuries in children.</p><p><strong>Methods: </strong>We conducted a descriptive, retrospective cohort study of children with sledding injuries presenting to the PED in a tertiary care centre. We compared injuries occurring before and after the start of the pandemic, using March 11, 2020 as a cut-off. Children aged 0 to 17 years presenting with sledding injuries were eligible for inclusion. We compared monthly visit counts of sledding injuries, demographics, site and type of injury, disposition, surgical intervention, return visits, and length of inpatient admissions.</p><p><strong>Results: </strong>In total, 243 visits for sledding injuries were analysed. There were 13 presentations in 2018, 31 in 2019, 30 in 2020, 105 in 2021, and 64 in 2022. The mean age was 8.6 years (standard deviation 3.7), with 53.5% of injuries occurring in males. Head injuries and sprains/strains were the most common site and type of injury, respectively (n = 103, 41.4%). There was a significant increase in the number of sledding injuries between pre-COVID-19 and COVID-19 years (P = 0.048). There were no significant differences in demographic and injury characteristics.</p><p><strong>Conclusions: </strong>We identified a significant increase in PED visits for sledding injuries during the pandemic. Examining epidemiological trends of sledding injuries can facilitate advocacy for improved communication of injury prevention recommendations in the event of future infectious disease outbreaks.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 3","pages":"171-175"},"PeriodicalIF":1.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541789","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":"Evaluating and caring for children with a suspected learning disorder in community practice.","authors":"Justine Cohen-Silver, Meta van den Heuvel, Sloane Freeman, Jacqueline Ogilvie, Tara Chobotuk","doi":"10.1093/pch/pxae089","DOIUrl":"10.1093/pch/pxae089","url":null,"abstract":"<p><p>Learning challenges are common in school-aged children, with 5% to 10% meeting the criteria for a specific learning disorder (SLD, previously termed a 'learning disability'). Learning disorders can present in community practice settings as behaviour challenges, school avoidance, or as symptoms of a mental health problem. Concomitant issues may include a mental health disorder, a genetic, metabolic, or neurological condition, or developmental delay. This practice point offers guidance to paediatric health care professionals regarding the presentation and diagnosis of an SLD, including information on psychoeducational assessments, a medical workup for children with learning challenges, possible comorbid health issues, and points for improvement and advocacy in support of families and children with a range of learning issues.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 8","pages":"544-552"},"PeriodicalIF":1.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483817","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":"Literacy in school-aged children: A paediatric approach to advocacy and assessment.","authors":"Anne Kawamura, Angela Orsino, Scott McLeod, Mark Handley-Derry, Linda Siegel, Jocelyn Vine, Nicola Jones-Stokreef","doi":"10.1093/pch/pxae088","DOIUrl":"10.1093/pch/pxae088","url":null,"abstract":"<p><p>Literacy is a key social determinant of health that affects the daily socioemotional lives of children and their economic prospects later in life. Being able to read, write, and understand written text is essential to participating in society, achieving goals, developing knowledge, and fulfilling potential. Yet a significant proportion of adults in Canada do not have the literacy skills they need to meet and manage increasingly complex workforce demands. Paediatric care providers play a pivotal role in identifying children and families at risk for low literacy. This statement offers approaches for assessing children and counselling families to improve reading skills while advocating for their right to access evidence-based reading instruction.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 8","pages":"531-543"},"PeriodicalIF":1.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483826","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":"Musings of the editor in the last print issue of <i>Paediatrics & Child Health</i>.","authors":"Joan L Robinson","doi":"10.1093/pch/pxae096","DOIUrl":"https://doi.org/10.1093/pch/pxae096","url":null,"abstract":"","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 8","pages":"483-484"},"PeriodicalIF":1.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482674","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":"Frequency and impact of paediatric acute-onset neuropsychiatric syndrome/paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections diagnosis in Canada.","authors":"Rachel Goren, Ari Bitnun, Asif Doja, Peter J Gill, Ronald M Laxer, Deborah M Levy, Tamara Pringsheim, Paul Sandor, Eluen Ann Yeh, Colin Wilbur, Sefi Kronenberg, Michelle Shouldice","doi":"10.1093/pch/pxae092","DOIUrl":"10.1093/pch/pxae092","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to estimate the prevalence of the PANS/PANDAS diagnostic label in Canada and describe its impact on families, patients, and health care.</p><p><strong>Methods: </strong>Through the Canadian Paediatric Surveillance Program (CPSP), a monthly form was distributed to paediatricians from December 2019 to November 2021, requesting reports of children who received the diagnostic label of PANS/PANDAS between the ages of 3 and 18 years seen in the previous month. Descriptive and association statistical analyses were performed.</p><p><strong>Results: </strong>Eighty-four cases (57% female, median age of symptom onset 7.8 years interquartile range [IQR] = 5) who received the diagnostic label of PANS/PANDAS were included. Prevalence was found to be 1 in 60,155 (0.0017%). Core diagnostic criteria for PANS/PANDAS (obsessive-compulsive disorder or tics or acute food refusal) were not present in 12% of cases (10/84). Only 22% reported sudden symptom onset. Infection was associated with symptom onset or exacerbation in less than one-third of cases. The majority exhibited two or more neuropsychiatric symptoms (95%). There was significant health care utilization and symptom burden amongst cases. There was a significant difference in the certainty of diagnosis between physicians and families (P < 0.05).</p><p><strong>Conclusions: </strong>PANS/PANDAS diagnoses, while rare, significantly impact children, families, and the health care system. Diagnostic uncertainty underscores the challenges professionals and families face in accessing effective care, emphasizing the need for education and evidence-based clinical practice guidelines.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 3","pages":"157-163"},"PeriodicalIF":1.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541788","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}