Paediatrics & child health最新文献

{"title":"Optimizing paediatric specialist referrals for short stature in an era of multiple growth hormone indications.","authors":"Preetha Krishnamoorthy, Nancy Gagné, Rose Girgis, Seth Marks, Zoraida Saoudi, Ian Zenlea, Susan Kirsch","doi":"10.1093/pch/pxae025","DOIUrl":"https://doi.org/10.1093/pch/pxae025","url":null,"abstract":"<p><p>The assessment of growth during infancy and childhood is an essential component of paediatric medicine, as atypical growth may point to the existence of an underlying health condition. To reduce morbidity, it is vital that treatment for growth disorders is provided in a timely fashion. However, although there are guidelines regarding referral criteria for short stature in Europe and the USA, there are no such guidelines in Canada. To address this, a series of consultations and workshops with paediatricians, paediatric endocrinologists, family physicians and nurses were held, with the aim of developing a consensus-based set of recommendations for children in Canada showing atypical growth and to identify red flags for children who might benefit from early referral. To achieve this, a referral algorithm and referral form for primary care providers were developed to ensure timely and appropriate referrals, and transmission of the most relevant details to the secondary care consultant.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 5","pages":"306-310"},"PeriodicalIF":1.8,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292882","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":"Recognizing and responding to children with suspected exposure to intimate partner violence between caregivers","authors":"Melissa Kimber, Jill McTavish, Michelle Shouldice, Michelle G K Ward, Harriet L MacMillan","doi":"10.1093/pch/pxad079","DOIUrl":"https://doi.org/10.1093/pch/pxad079","url":null,"abstract":"Children’s exposure to intimate partner violence (CEIPV) between parents and other caregivers accounts for nearly half of all cases investigated and substantiated by child welfare authorities in Canada. The emotional, physical, and behavioural impairments associated with CEIPV are similar to effects of other forms of child maltreatment. The identification of children and youth who have been exposed to intimate partner violence (IPV) can be challenging due to the non-specific behaviours sometimes associated with such exposure, and the stigma and secrecy that often characterize IPV. Also, responding safely to children and youth with suspected CEIPV can be complicated by the need to consider the safety and well-being of a non-offending caregiver. This position statement presents an evidence-informed approach developed by the Violence, Evidence, Guidance, Action (VEGA) Project for the safe recognition and response to children and youth who are suspected of being exposed to IPV.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"27 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141194222","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":"Savoir détecter l’exposition des enfants à la violence entre partenaires intimes, qu’elle soit présumée ou divulguée, et savoir intervenir","authors":"Melissa Kimber, Jill McTavish, Michelle Shouldice, Michelle G K Ward, Harriet L MacMillan","doi":"10.1093/pch/pxad080","DOIUrl":"https://doi.org/10.1093/pch/pxad080","url":null,"abstract":"Résumé L’exposition des enfants à la violence entre partenaires intimes (EEVPI), qu’il s’agisse des parents ou d’autres proches, représente près de la moitié de tous les cas qui font l’objet d’une enquête et sont corroborés par les services de protection de l’enfance du Canada. Les atteintes affectives, physiques et comportementales associées à l’EEVPI sont semblables aux effets d’autres formes de maltraitance envers les enfants. Il peut être difficile d’établir quels enfants et adolescents sont exposés à la violence entre partenaires intimes (VPI) en raison des comportements non spécifiques parfois associés à une telle exposition, de même que de la stigmatisation et du secret entourant souvent ce type de violence. Par ailleurs, une intervention en toute sécurité auprès des enfants et des adolescents chez qui on présume une exposition à la VPI peut être compliquée par la nécessité d’également tenir compte de la sécurité et du bien-être d’un proche non contrevenant. Le présent document de principes propose une approche fondée sur des données probantes mise au point par le projet VEGA (Violence, Evidence, Guidance, Action ou violence, données probantes, conseils, action) pour détecter l’exposition des enfants et des adolescents à la VPI et intervenir en toute sécurité auprès d’eux.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"21 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193858","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":"Care for children and youth with cerebral palsy (GMFCS levels III to V)","authors":"Scott McLeod, Amber Makino, Anne Kawamura","doi":"10.1093/pch/pxae003","DOIUrl":"https://doi.org/10.1093/pch/pxae003","url":null,"abstract":"Cerebral palsy (CP) is the most common physical disability in Canadian children. The comprehensive care of ambulatory children with CP functioning at Gross Motor Function Classification System (GMFCS) level I and II was covered in a previous practice point. This companion document focuses on the care of children with CP functioning at GMFCS levels III to V. Children functioning at GMFCS level III and IV mobilize using devices such as a walker, canes, or powered mobility, while those functioning at GMFCS level V require assisted mobility, such as a manual wheelchair. An overview of key concepts in early detection, rehabilitation services, and therapeutic options for children with CP at these levels is provided, along with practical resources to assist health surveillance for paediatricians caring for this population.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"27 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141194167","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":"Les soins aux enfants et aux adolescents ayant la paralysie cérébrale (aux niveaux III à V du GMFCS)","authors":"Scott McLeod, Amber Makino, Anne Kawamura","doi":"10.1093/pch/pxae004","DOIUrl":"https://doi.org/10.1093/pch/pxae004","url":null,"abstract":"Résumé La paralysie cérébrale (PC) est l’incapacité physique la plus fréquente chez les enfants canadiens. Les soins complets des enfants ayant la PC, qui sont capables de marcher et qui fonctionnent aux niveaux I et II du système de classification de la fonction motrice globale (GMFCS) sont déjà exposés dans un point de pratique. Le présent document complémentaire traite des soins aux enfants ayant la PC qui fonctionnent aux niveaux III à V du GMFCS. Ceux qui fonctionnent aux niveaux III et IV du GMFCS utilisent des dispositifs d’assistance comme des déambulateurs, des cannes ou des aides à la mobilité motorisées, tandis que ceux qui fonctionnent au niveau V du GMFCS ont besoin d’assistance à la mobilité comme un fauteuil roulant manuel. Le présent document contient un aperçu des principaux concepts relatifs à la détection précoce, aux services de réadaptation et aux possibilités de traitement pour les enfants présentant ces niveaux de PC, conjointement avec des ressources pratiques pour contribuer à la surveillance de la santé assurée par les pédiatres qui s’occupent de cette population.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"38 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193862","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":"Childhood dyslipidemia: Clinician management practices in the primary care setting","authors":"Katherine N Tom, Alicia M Polack, Natasha D De Silva, Jonathan P Wong, Charles D G Keown-Stoneman, Jonathon L Maguire, Catherine S Birken, Peter D Wong","doi":"10.1093/pch/pxae018","DOIUrl":"https://doi.org/10.1093/pch/pxae018","url":null,"abstract":"Objectives To describe clinician management practices for childhood dyslipidemia in the community setting. Methods A descriptive study was conducted for children aged 2 to 10 years with dyslipidemia as defined by the National Cholesterol Education Program Expert Panel on Cholesterol in Children criteria. A convenience sample of participants from the TARGet Kids! cohort study (Toronto, Canada) was used. Trained research assistants reviewed participant medical records to document clinician management practices of abnormal lipid levels. The study outcome was the proportion of clinicians engaging in each management practice. Descriptive statistics were completed, reporting the proportion of clinician engagement in management practices. Results All 768 children were seen by primary paediatric care providers after lipid levels identified dyslipidemia. Medical history regarding lifestyle behaviours and cardiovascular risk factors were frequently obtained (n = 565, 73.6%). Physicians rarely informed families about abnormal lipid levels (n = 11, 1.43%). Management plans for abnormal lipid levels were rarely documented (n = 4, 0.5%). Clinicians did not refer to paediatric lipid specialists or initiate statin therapy. Conclusions Paediatric care providers rarely identified and initiated early management for abnormal lipid levels. Our results may inform the need for improved knowledge translation of the recently published Canadian clinical practice update for the detection and management of childhood dyslipidemia.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"24 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193856","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":"Automatic urine cultures from catheter-obtained samples—time to implement a practice change to improve value","authors":"Inbal Kestenbom, Neta Cohen, Gidon Test, Aaron Campigotto, Michelle Science, Olivia Ostrow","doi":"10.1093/pch/pxae021","DOIUrl":"https://doi.org/10.1093/pch/pxae021","url":null,"abstract":"Objectives Urine cultures are often automatically obtained after urinary catheterization in young children, even in the absence of pyuria, to test for urinary tract infections (UTIs). Although this practice conflicts with some newer guidelines, it is frequently followed in busy emergency departments (EDs) to minimize the need for a repeat invasive procedure. To assess the implications of this longstanding practice, we aimed to describe the frequency and characteristics of children with normal urinalysis (UA) and positive urine culture obtained via catheterization, and to describe their clinical course. Methods A single center, retrospective cohort study was performed for otherwise healthy children aged 6 to 24 months, presenting to a Pediatric ED between January and June 2019 who underwent UTI testing via a urine catheterization. The point-of-care (POC) UA and urine culture results along with any follow-up phone call documentation were reviewed and analyzed using descriptive statistics. Results Of the 818 urine cultures obtained via catheterization during the 6-month study period, 131 (16%) cultures were reported as positive. Of these positive cultures, 14 (10.7%) of the patients meeting inclusion criteria had a normal POC UA. In follow-up phone calls after the ED visit, the majority of these 14 patients were asymptomatic without any antibiotic treatment and 3 (2.3%) patients were still febrile and classified as a potentially missed UTI. Conclusions The routine practice of sending urine cultures from all catheterized urine samples in children 6 to 24 months, regardless of POC UA results, rarely detect missed UTIs. In alignment with more recent practice guidelines, this practice should be reconsidered in low-risk children seen in EDs to improve overall care quality and resource utilization.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193922","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":"Investigating the effect of virtual reality glasses during inhaler therapy use in children: A randomized clinical trial","authors":"Berker Okay, Zeynep Üze Okay","doi":"10.1093/pch/pxae020","DOIUrl":"https://doi.org/10.1093/pch/pxae020","url":null,"abstract":"Objectives Virtual reality (VR) glasses have been used in the medical field, as they are perceived to be suitable for distracting children. In this study, we aimed to compare patients who received inhaler treatment with VR glasses with those who received treatment without the aid of any device in terms of treatment compliance. Materials and Methods A prospective, randomized controlled study was conducted on pediatric patients aged 2 to 5 years requiring inhaler treatment (salbutamol), with the informed consent of their families. Participating patients who received standard care were divided into three groups via randomization: roller coaster VR group, wild dolphin VR group, and no additional device group. The patients were observed during their 15-minute inhaler treatment, and the groups were compared in terms of crying times, pre- and post-treatment physician and family questionnaire data (Face, Legs, Activity, Cry, Consolabity Scale [FLACC], Modified Yale Anxiety Scale [MYPAS], Modifiye Parents’ Pain Measure [MPMM], Wong–Baker Faces Pain Rating Scale [WBS]), and respiratory rate (RR), peripheral oxygen saturation, and heart rate value changes to determine any differences between them. Results Post-treatment questionnaire scores, RR, crying duration, and efficacy of treatment exhibited significant differences in Groups 1 and 2 compared to the control group. A significant difference was found in the post-treatment RR between groups 1 and 2, but no difference was observed in the other parameters. Conclusions Utilizing VR glasses during inhaler therapy has the potential to minimize adverse effects, such as pain, and enhance the overall comfort of the treatment environment for patients.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"36 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141194249","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":"Reference gender-specific neonatal size at birth growth curves for singleton and twin neonates from North India.","authors":"Ambalakkuthan Murugesan, Sushma Nangia, Arvind Saili","doi":"10.1093/pch/pxae011","DOIUrl":"10.1093/pch/pxae011","url":null,"abstract":"<p><strong>Objectives: </strong>To construct reference growth curves for the preterm population from North India and compare it with global charts.</p><p><strong>Methods: </strong>This prospective study enrolled preterm neonates (23 to 36 weeks) from July 2018 to August 2019 after excluding stillbirths and those with congenital malformations. Anthropometry was performed within 18 hours of birth. Gestation age was assessed by the best estimate of a combination of the last menstrual period, antenatal first-trimester ultrasound, and Expanded New Ballard Score (ENBS). Centile curves were constructed for both genders for twins and singleton neonates separately using the GAMLSS method using R software.</p><p><strong>Results: </strong>During the study period, of the 14,908 births, 3253 (21.8%) were born preterm. After excluding malformations and stillbirths, 2976 preterm neonates were eligible, out of which anthropometry within 18 hours was done for 2719 neonates. Data was analyzed for 2290 singleton and 414 twin preterm neonates. Smoothed reference growth curves were constructed for all anthropometric parameters for both genders for singleton as well as twin neonates. Indian preterm infants were smaller compared to international standards. The proportion of small for gestational age (SGA) neonates was 23.1% (Fenton's charts) but only 10.9% when the data from the newly constructed chart was used. The concordance with international standards was better for very preterm neonates <32 weeks than moderate and late preterm neonates (32 to 36 weeks).</p><p><strong>Conclusions: </strong>The reference charts derived from the present study can be used for the North Indian preterm population. The use of western growth charts tends to overestimate the incidence of SGA.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 6","pages":"367-373"},"PeriodicalIF":1.8,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625638","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":"Canadian developmental pediatrics workforce survey.","authors":"Scott A McLeod, Sabrina Eliason, Melanie Penner, Elizabeth Mickelson, Ana Marello, Darcy Fehlings","doi":"10.1093/pch/pxae012","DOIUrl":"10.1093/pch/pxae012","url":null,"abstract":"<p><strong>Background: </strong>Neurodevelopmental conditions are common, and many of these conditions benefit from specialized developmental assessments or services from a developmental pediatric clinic. There is limited data about the supply of developmental pediatric subspecialists and limited knowledge about the sustainability of the current workforce providing this care in Canada.</p><p><strong>Objectives: </strong>To understand the current Canadian developmental pediatric workforce, we conducted a survey to determine: (1) The demographic profile of developmental pediatric professionals who comprise the current workforce and their career plans; (2) The challenges and trends to inform future resource planning; and (3) Opportunities for innovative provision of developmental care in pediatrics.</p><p><strong>Design/methods: </strong>A 31-item questionnaire was cross-sectionally distributed to practicing developmental pediatricians in Canada. The Royal College of Physicians and Surgeons and Canadian Pediatric Society Section of Developmental Pediatrics assisted with the distribution of the survey to its membership. Results were analyzed with descriptive statistics.</p><p><strong>Results: </strong>A total of 145 participants completed the study (91% response). Forty-six percent (n = 65) of the participants had >20 years of experience. Within the next 3 to 5 years, 23% (n = 32) of respondents' plan to retire completely from practice. Trends influencing the present workload of developmental pediatricians included: (1) requirements for translation services (endorsed by 70% of respondents); (2) coordination issues with multidisciplinary assessments (endorsed by 64%); and (3) the influence of government funding resources for specific neurodevelopmental disorders (endorsed by 32%).</p><p><strong>Conclusions: </strong>Addressing issues affecting developmental pediatrician workload and increasing the developmental pediatric workforce will be vital to address current needs. The viability of specialized developmental care in Canada will rely on recruitment and identifying barriers that inhibit trainees and physicians from choosing to practice in the field of developmental pediatrics.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 8","pages":"501-506"},"PeriodicalIF":1.8,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483815","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}