Lancet Child & Adolescent Health最新文献

{"title":"Timeliness and value of individual participant data meta-analyses in paediatric tuberculosis research","authors":"Ben J Marais , Mikaela Coleman , Leyla Larsson , Katharina Kranzer","doi":"10.1016/S2352-4642(24)00357-2","DOIUrl":"10.1016/S2352-4642(24)00357-2","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Pages 78-79"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043934","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":"Evaluating care quality and appropriateness when promoting health-care seeking for children","authors":"Man Lui Chan , Kwok Ying Chan , Anthea Wan Hung Chan","doi":"10.1016/S2352-4642(24)00327-4","DOIUrl":"10.1016/S2352-4642(24)00327-4","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Page e1"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043980","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":"Political will to tackle childhood violence in Latin America","authors":"Udani Samarasekera","doi":"10.1016/S2352-4642(24)00338-9","DOIUrl":"10.1016/S2352-4642(24)00338-9","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Pages 85-86"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043933","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":"Admission to acute medical wards for mental health concerns among children and young people in England from 2012 to 2022: a cohort study","authors":"Joseph L Ward PhD ,&nbsp;Adriana Vázquez-Vázquez PhD ,&nbsp;Kirsty Phillips MSc ,&nbsp;Kate Settle BSc ,&nbsp;Hanifa Pilvar PhD ,&nbsp;Prof Francesca Cornaglia PhD ,&nbsp;Prof Faith Gibson PhD ,&nbsp;Prof Dasha Nicholls MD Res ,&nbsp;Prof Damian Roland PhD ,&nbsp;Gabrielle Mathews MBBS ,&nbsp;Prof Helen Roberts DPhil ,&nbsp;Prof Russell M Viner PhD ,&nbsp;Lee D Hudson PhD","doi":"10.1016/S2352-4642(24)00333-X","DOIUrl":"10.1016/S2352-4642(24)00333-X","url":null,"abstract":"<div><h3>Background</h3><div>There are challenges in providing high quality care for children and young people who are admitted to acute medical wards for mental health concerns. Although there is concern that these admissions are increasing, national data describing these patterns are scarce. We aimed to describe trends in these admissions in England over a 10-year period, and to identify factors associated with repeat admission and length of stay.</div></div><div><h3>Methods</h3><div>In this cohort study we used data on all admissions to medical wards in England among children and young people aged 5–18 years from April 1, 2012, to March 31, 2022. We classified admissions for mental health concerns using the Global Burden of Disease Study cause hierarchy. We described national trends in admissions for mental health concerns over time by sex, age, ethnicity, and index of multiple deprivation quintile. We examined associations between sociodemographic and clinical factors and odds of the admission lasting more than 1 week, as well as hazard ratios of repeat admissions, using mixed-effects models.</div></div><div><h3>Findings</h3><div>We identified 342 511 admissions for any cause in children and young people aged 5–18 years in 2021–22 in England, of which 39 925 (11·7%) were for mental health concerns. 21 337 (53·4%) admissions for mental health concerns were due to self-harm. Between 2012–13 and 2021–22, annual admissions for mental health concerns increased from 24 198 to 39 925 (65·0% increase), whereas all-cause admissions increased from 311 067 to 342 511 (10·1% increase). Increases were particularly steep in females aged 11–15 years, rising from 9091 to 19 349 (112·8% increase), and for eating disorders, rising from 478 to 2938 (514·6% increase). In 2021–22, 3130 (7·8%) admissions for mental health concerns lasted longer than 1 week, compared with 12 044 (3·5%) all-cause admissions. Of 239 541 children and young people who were admitted for mental health concerns between 2012–13 and 2021–22, 32 107 (13·4%) had a repeat admission within 6 months. The odds of long-stay admission and hazard ratios for being readmitted were significantly higher for children and young people aged 11–15 years, those who were female, those from less deprived areas, and those with eating disorders than among other groups.</div></div><div><h3>Interpretation</h3><div>We found large increases in the number of children and young people admitted to acute medical wards for mental health concerns over a 10-year period. Further work is needed to understand factors driving these trends and how to improve care for children and young people with mental health concerns admitted to medical wards.</div></div><div><h3>Funding</h3><div>National Institute for Health and Care Research</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Pages 112-120"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of children and adolescents with multidrug-resistant and rifampicin-resistant tuberculosis and their association with treatment outcomes: a systematic review and individual participant data meta-analysis","authors":"Anthony J Garcia-Prats MD ,&nbsp;Maria Garcia-Cremades PhD ,&nbsp;Vivian Cox MD ,&nbsp;Tamara Kredo PhD ,&nbsp;Rory Dunbar PhD ,&nbsp;Prof H Simon Schaaf PhD ,&nbsp;Prof James A Seddon PhD ,&nbsp;Jennifer Furin MD ,&nbsp;Jay Achar MBBS ,&nbsp;Kendra Radke PhD ,&nbsp;Tina Sachs MSc ,&nbsp;Amanzhan Abubakirov MD ,&nbsp;Saman Ahmed MPH ,&nbsp;Onno W Akkerman PhD ,&nbsp;Nadia Abdulkareem Al Ani MSc ,&nbsp;Farhana Amanullah MD ,&nbsp;Nafees Ahmad PhD ,&nbsp;Laura F Anderson PhD ,&nbsp;Meseret Asfaw MD ,&nbsp;Funeka Bango MPH ,&nbsp;Prof Anneke Hesseling PhD","doi":"10.1016/S2352-4642(24)00330-4","DOIUrl":"10.1016/S2352-4642(24)00330-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;There are few data on the treatment of children and adolescents with multidrug-resistant (MDR) or rifampicin-resistant (RR) tuberculosis, especially with more recently available drugs and regimens. We aimed to describe the clinical and treatment characteristics and their associations with treatment outcomes in this susceptible population.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a systematic review and individual participant data meta-analysis. Databases were searched from Oct 1, 2014, to March 30, 2020. To be eligible, studies must have included more than five children or adolescents (0–19 years of age) treated for microbiologically confirmed or clinically diagnosed MDR or RR tuberculosis within a defined treatment cohort, and reported on regimen composition and treatment outcomes. Abstracts were screened independently by two authors to identify potentially eligible records. Full texts were reviewed by two authors independently to identify studies meeting the eligiblity criteria. For studies meeting eligiblity criteria, anonymised individual patient data was requested and individiual level data included for analysis. The main outcome assessed was treatment outcome defined as treatment success (cure or treatment completed) versus unfavourable outcome (treatment failure or death). Multivariable logistic regression models were used to identify associations between clinical and treatment factors and treatment outcomes. This study is registered with Prospero (CRD42020187230).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;1417 studies were identified through database searching. After removing duplicates and screening for eligibility, the search identified 23 369 individual participants from 42 studies, mostly from India and South Africa. Overall, 16 825 (72·0%) were successfully treated (treatment completed or cured), 2848 died (12·2%), 722 (3·1%) had treatment failure, and 2974 (12·7%) were lost to follow-up. In primary analyses, the median age was 16 (IQR 13–18) years. Of the 17 764 (87·1%) participants with reported HIV status, 2448 (13·8%) were living with HIV. 17 707 (89·6%) had microbiologically confirmed tuberculosis. After adjusting for significant factors associated with treatment outcome, the use of two (adjusted odds ratio [OR] 1·41 [95% CI 1·09–1·82]; p=0·008) or three (2·12 [1·61–2·79]; p&lt;0·0001) WHO-classified group A drugs (bedaquiline, moxifloxacin, levofloxacin, and linezolid) compared with the use of no group A drugs at all was positively associated with treatment success.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Younger and clinically diagnosed children are underrepresented among those treated for MDR and RR tuberculosis and should be a focus for case-finding efforts. Overall treatment outcomes in our analysis were better than in adults but lower than the international targets of 90% or more individuals successfully treated. Treatment with more group A drugs was associated with better treatment ou","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Pages 100-111"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043948","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":"Dancing with dad","authors":"Sophie Cousins","doi":"10.1016/S2352-4642(25)00003-3","DOIUrl":"10.1016/S2352-4642(25)00003-3","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Page 87"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043971","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":"Patricia Young: advocating for children in humanitarian crises","authors":"Udani Samarasekera","doi":"10.1016/S2352-4642(25)00004-5","DOIUrl":"10.1016/S2352-4642(25)00004-5","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Page 88"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043989","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":"A toolbox for innovative paediatric research","authors":"The Lancet Child & Adolescent Health","doi":"10.1016/S2352-4642(25)00005-7","DOIUrl":"10.1016/S2352-4642(25)00005-7","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Page 77"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043780","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":"Adapt to survive and thrive: the time is now for adaptive platform trials for preterm birth","authors":"Prof Brett J Manley PhD ,&nbsp;Christopher J D McKinlay PhD ,&nbsp;Prof Katherine J Lee PhD ,&nbsp;Prof Katie M Groom PhD ,&nbsp;Clare L Whitehead PhD","doi":"10.1016/S2352-4642(24)00328-6","DOIUrl":"10.1016/S2352-4642(24)00328-6","url":null,"abstract":"<div><div>In this Viewpoint, we discuss the challenges facing perinatal clinical researchers, many of which are unique to this field, and how traditional two-arm randomised trials using frequentist analysis might no longer be fit for purpose for perinatology. We propose a solution: the adoption of adaptive platform trials (APTs) with Bayesian methodology to address perinatal research questions to improve outcomes of preterm birth. APTs use a master protocol as a foundation to efficiently assess multiple interventions simultaneously for a particular disease. APTs can study these interventions in a perpetual manner, with interventions allowed to enter or leave the platform on the basis of preplanned decision algorithms. In this Viewpoint, we outline the ways in which APTs can overcome some of the issues facing perinatal clinical research, and the challenges and essential requirements for the design and implementation of perinatal APTs that should be considered.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Pages 131-137"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043890","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":"Harnessing n-of-1 trials for personalised paediatric care in the era of information overload","authors":"Joyce P Samuel","doi":"10.1016/S2352-4642(24)00299-2","DOIUrl":"10.1016/S2352-4642(24)00299-2","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 2","pages":"Pages 82-84"},"PeriodicalIF":19.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043982","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}