Lancet Child & Adolescent Health最新文献

{"title":"Adolescents in phase 3 HIV clinical trials","authors":"Caroline Foster , Theodore Ruel , Deborah Ford , Rebecca M Turner , Moherndran Archary , Pablo Rojo , Diana Gibb , Penta-IMPAACT","doi":"10.1016/S2352-4642(25)00221-4","DOIUrl":"10.1016/S2352-4642(25)00221-4","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 10","pages":"Pages 691-693"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognising context and power in youth mental health","authors":"The Lancet Child & Adolescent Health","doi":"10.1016/S2352-4642(25)00216-0","DOIUrl":"10.1016/S2352-4642(25)00216-0","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Page 613"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the policy and implementation gaps in paediatric hepatitis C care","authors":"Farihah Malik , Giuseppe Indolfi","doi":"10.1016/S2352-4642(25)00186-5","DOIUrl":"10.1016/S2352-4642(25)00186-5","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 617-618"},"PeriodicalIF":15.5,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bivalent prefusion F vaccination in pregnancy and respiratory syncytial virus hospitalisation in infants in the UK: results of a multicentre, test-negative, case-control study","authors":"Thomas C Williams PhD ,&nbsp;Robin Marlow PhD ,&nbsp;Prof Steve Cunningham PhD ,&nbsp;Simon B Drysdale PhD ,&nbsp;Helen E Groves MB BCh BAO PhD ,&nbsp;Samantha Hunt BSc ,&nbsp;Dalia Iskander PhD ,&nbsp;Xinxue Liu PhD ,&nbsp;Mark D Lyttle MBChB ,&nbsp;Chengetai D Mpamhanga MSc ,&nbsp;Shaun O'Hagan MB BCh BAO ,&nbsp;Thomas Waterfield PhD ,&nbsp;Damian Roland PhD","doi":"10.1016/S2352-4642(25)00155-5","DOIUrl":"10.1016/S2352-4642(25)00155-5","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections (ALRI) in infants younger than 6 months globally. A maternal bivalent RSV prefusion F (RSVpreF) vaccine was introduced to the UK in late summer in 2024 (August 12 in Scotland and September 1 in England), with all pregnant women at 28 weeks or more of gestation eligible for vaccination. We aimed to understand RSVpreF vaccine effectiveness in a real-world setting.</div></div><div><h3>Methods</h3><div>We conducted a multicentre, test-negative, case-control study to analyse the vaccine effectiveness of maternal RSVpreF vaccination against the primary outcome of hospitalisation (ie, admission to hospital) for RSV-associated ALRI in infants. Patient and public involvement from a group of parents informed the study protocol design. Included patients were infants with ALRI born after Aug 12, 2024 (Scotland), and Sept 1, 2024 (England), and therefore had mothers eligible for maternal vaccination, who were admitted to 30 hospital sites across the UK from Sept 30, 2024, to Jan 20, 2025, and tested for RSV. Infants were followed up until hospital discharge or death as an inpatient. Primary vaccine effectiveness of maternal RSVpreF vaccination against RSV-associated hospitalisation was calculated with the use of a conditional logistic regression adjusted by site, calendar month of hospital attendance for the infant, age, preterm birth, and sex.</div></div><div><h3>Findings</h3><div>We included 537 mother–infant pairs, in whom there were 391 RSV-positive infant cases (median age 1·63 months [IQR 0·94–2·26]) and 146 RSV-negative infant controls (1·41 months [0·77–2·03]). Of 537 recruited infants, 297 (55%) were male and 240 (45%) were female. Ethnicity data were available for 533 mothers, of whom 434 (81%) self-identified as White. The mothers of 73 (19%) RSV-positive cases and 60 (41%) RSV-negative controls had received RSVpreF vaccine before delivery. The adjusted effectiveness of maternal RSVpreF vaccination for preventing infant hospitalisation was 58% (95% CI 28–75) for infants whose mothers were vaccinated at any time before delivery and 72% (48–85) for infants whose mothers were vaccinated more than 14 days before delivery (39 [11%] of 357 RSV-positive cases <em>vs</em> 43 [33%] of 129 RSV-negative controls).</div></div><div><h3>Interpretation</h3><div>In the real-world setting of the first season of vaccine implementation in England and Scotland, maternal RSVpreF vaccination was effective and equivalent to trial settings in reducing the risk of hospitalisation in infants with RSV-associated ALRI.</div></div><div><h3>Funding</h3><div>National Institute for Health and Care Research, The Wellcome Trust, and Imperial College London.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 655-662"},"PeriodicalIF":15.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Target trial emulation in paediatric research: how can causal effects be estimated from observational data?","authors":"Cal H Robinson MD ,&nbsp;Eddy Fan MD PhD ,&nbsp;Sonia M Grandi PhD ,&nbsp;Martin Urner MD PhD ,&nbsp;Prof Rulan S Parekh MD MS","doi":"10.1016/S2352-4642(25)00131-2","DOIUrl":"10.1016/S2352-4642(25)00131-2","url":null,"abstract":"<div><div>Conducting randomised controlled trials (RCTs) in rare paediatric diseases is often impractical or prohibitively expensive. Observational data from longitudinal cohort studies, disease registries, and population-based databases exist for children and adolescents, but standard observational analyses are typically limited by bias. Target trial emulation methods can improve the quality of observational analysis, address common sources of bias, and help fill evidence gaps in paediatric clinical practice. Applying target trial emulation methods in paediatric research creates unique opportunities, but also poses specific challenges. Tailored approaches are needed to address issues with small sample size, treatment-effect heterogeneity, longitudinal follow-up, and missing data. This Review aims to outline key concepts, such as what causal inference and target trial emulation are, justify the use of target trial emulation methods in paediatric observational research, discuss approaches to emulating key elements of an RCT protocol, and highlight unique paediatric applications of target trial emulation.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 663-672"},"PeriodicalIF":15.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of ethnicity and deprivation to paediatric critical care outcomes in the UK, 2008–21: a national retrospective cohort study","authors":"Hannah K Mitchell BMBS MSc ,&nbsp;Sarah E Seaton PhD ,&nbsp;Khurram Mustafa MBBS ,&nbsp;Gareth A L Jones MBChB ,&nbsp;Hannah Buckley MSc ,&nbsp;Peter Davis MBChB ,&nbsp;Christopher Leahy PhD ,&nbsp;Prof Richard G Feltbower PhD ,&nbsp;Prof Padmanabhan Ramnarayan MBBS MD","doi":"10.1016/S2352-4642(25)00156-7","DOIUrl":"10.1016/S2352-4642(25)00156-7","url":null,"abstract":"<div><h3>Background</h3><div>Evidence from UK paediatric intensive care units (PICUs) demonstrates increased incidence of admission among children of Asian and Black ethnicity and children residing in more deprived areas. We aimed to investigate whether mortality in PICU is associated with ethnicity and child poverty.</div></div><div><h3>Methods</h3><div>This national cohort study included children aged 0–15 years who were admitted to PICUs in the UK between Jan 1, 2008, and Dec 31, 2021. Participating PICUs were affiliated with and reported outcome data to the Paediatric Intensive Care Audit Network (PICANet), from which we extracted data for this analysis. Key exposures were ethnicity, categorised as Asian, Black, Multiple, Other, and White, and area-level deprivation at the time of admission, quantified with the Children in Low-Income Families measure of an area's proportion of children living in families with income less than 60% of the median income and receiving out-of-work benefits or tax credits. The primary outcome was mortality during PICU stay. Mixed-effects logistic regression clustered by admitting PICU centre and individual patient was used to examine the association between key exposures and mortality during PICU stay for all admissions and then separately for planned and unplanned admissions.</div></div><div><h3>Findings</h3><div>This analysis included 245 099 admissions for 163 163 children during the study period, during which 102 990 (63·1%) had unplanned PICU admissions. 15 017 (9·2%) admissions were for children of Asian ethnicity, 7244 (4·4%) for children of Black ethnicity, 4514 (2·8%) for children of multiple ethnicities, 3831 (2·4%) for children of other ethnicities, and 100 241 (61·4%) for children of White ethnicity. Ethnicity data were missing for 32 316 (19·8%) of admissions. Observed PICU mortality across planned and unplanned admissions was 3·7% (9056 deaths per 245 099 admissions). Crude PICU mortality was highest among Asian children (1336 [5·1%; 95% CI 4·9–5·5] deaths per 26 022 admissions) and lowest among White children (4960 [3·2%; 3·1–3·3] deaths per 154 041 admissions), indicating a higher relative odds of PICU mortality among Asian children than White children for all admission types (odds ratio [OR] 1·52 [95% CI 1·42–1·62]). Odds of PICU mortality did not differ between children of Black and White ethnicity (OR 1·04; 95% CI 0·93–1·15). Children of multiple ethnicities (OR 1·23 [95% CI 1·08–1·39]) and other ethnicities (1·20 [1·05–1·38]) showed increased odds of PICU mortality relative to White children. PICU mortality ranged from 1025 (3·1%; 95% CI 2·9–3·3) deaths per 33 331 admissions for children in the least deprived quintile to 2432 (4·2%; 4·0–4·4) deaths per 58 110 admissions among children in the most deprived quintile, demonstrating an association between PICU mortality and area-level child poverty (OR 1·13 [95% CI 1·03–1·23]).</div></div><div><h3>Interpretation</h3><div>Variation in PICU mortality ","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 646-654"},"PeriodicalIF":15.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Child Adolesc Health 2025; 9: 497–507","authors":"","doi":"10.1016/S2352-4642(25)00192-0","DOIUrl":"10.1016/S2352-4642(25)00192-0","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 8","pages":"Page e16"},"PeriodicalIF":19.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Child Adolesc Health 2025; 9: 404–12","authors":"","doi":"10.1016/S2352-4642(25)00191-9","DOIUrl":"10.1016/S2352-4642(25)00191-9","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 8","pages":"Page e16"},"PeriodicalIF":19.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My ultimate goal: reducing heat stress in schools","authors":"Matea Cañizares","doi":"10.1016/S2352-4642(25)00188-9","DOIUrl":"10.1016/S2352-4642(25)00188-9","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 8","pages":"Page 529"},"PeriodicalIF":19.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric extracorporeal membrane oxygenation use by social determinants: a multicentre retrospective cohort study","authors":"Faraz Alizadeh MD ,&nbsp;Kimberlee Gauvreau ScD ,&nbsp;Jessica A Barreto MD ,&nbsp;Matt Hall PhD ,&nbsp;Emily Bucholz MD PhD ,&nbsp;Meena Nathan MD ,&nbsp;Prof Jane W Newburger MD ,&nbsp;Sally Vitali MD ,&nbsp;Prof Ravi R Thiagarajan MBBS ,&nbsp;Titus Chan MD ,&nbsp;Katie M Moynihan MBBS","doi":"10.1016/S2352-4642(25)00134-8","DOIUrl":"10.1016/S2352-4642(25)00134-8","url":null,"abstract":"<div><h3>Background</h3><div>Social determinants of health have upstream effects on health-care access and decision making to influence outcomes. We aimed to study the use of extracorporeal membrane oxygenation (ECMO) in children according to social determinants of health.</div></div><div><h3>Methods</h3><div>This retrospective, multicentre cohort study used data from 47 children's hospitals in the USA that contributed to the Pediatric Health Information System. Children (aged &lt;18 years) admitted to an intensive care unit in one of the study hospitals between Oct 1, 2015, and March 31, 2021, with extreme or major mortality risk and cardiac or respiratory diagnoses, were eligible for the study. Social determinants of health considered were Child Opportunity Index (COI; a multidimensional metric of neighbourhood conditions), race, ethnicity, type of health insurance, distance from home to hospital, and hospital region. We calculated relative risk ratios (RRR) using multivariable multinomial regression models to compare the outcome of ECMO use according to three categories: patients who received ECMO, patients who survived without ECMO, and patients who died without ECMO (ie, those who might have benefited from ECMO).</div></div><div><h3>Findings</h3><div>Of 829 445 children admitted to paediatric intensive care units during the study period, 309 937 (37·4%) met the inclusion criteria and were included in the study. 288 717 (93·2%) of 309 937 patients survived without ECMO, 12 542 (4·0%) died without ECMO, and 8678 (2·8%) received ECMO. Patients who received ECMO were younger and more likely to have a cardiac diagnosis than those who died without ECMO. A 5% greater adjusted risk of dying without ECMO (adjusted RRR [aRRR] 1·05 [95% CI 1·01–1·09]) was seen for every 10-point decrease in COI score. A greater risk of dying without ECMO than of receiving ECMO was observed in patients of Asian (aRRR 1·36 [95% CI 1·04–1·78]) or other (1·54 [1·09–2·18]) race, Hispanic ethnicity (1·70 [1·31–2·22]), and with public health insurance (1·33 [1·16–1·52]). The risk of dying without ECMO differed by distance from hospital (aRRR per 50 miles increase 0·98 [95% CI 0·96–0·99]), whereas patients in hospitals in the south (2·34 [1·02–5·38]) and west (3·74 [1·44–9·67]) had a greater risk of dying without ECMO than those in the midwest; only those in the west also had a greater risk of survival without ECMO (3·72 [1·40–9·90]).</div></div><div><h3>Interpretation</h3><div>There are disparities in ECMO use according to social determinants of health, with lower use among children from under-resourced neighbourhoods, from minoritised racial and ethnic backgrounds, and those with public health insurance. Interventions to promote equitable ECMO use can be derived using health equity frameworks.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 8","pages":"Pages 565-577"},"PeriodicalIF":19.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}