Lancet Child & Adolescent Health最新文献

{"title":"Correction to Lancet Child Adolesc Health 2025; 9: 325–36","authors":"","doi":"10.1016/S2352-4642(25)00135-X","DOIUrl":"10.1016/S2352-4642(25)00135-X","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Page e14"},"PeriodicalIF":19.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946754","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":"Predicting paediatric pneumonia severity in the emergency department: a multinational prospective cohort study of the Pediatric Emergency Research Network","authors":"Todd A Florin MD ,&nbsp;Prof Daniel J Tancredi PhD ,&nbsp;Lilliam Ambroggio PhD ,&nbsp;Prof Franz E Babl MD ,&nbsp;Prof Stuart R Dalziel PhD ,&nbsp;Michelle Eckerle MD ,&nbsp;Prof Santiago Mintegi PhD ,&nbsp;Prof Mark I Neuman MD ,&nbsp;Prof Amy C Plint MD ,&nbsp;Norma-Jean Simon MPH ,&nbsp;Prof Nathan Kuppermann MD","doi":"10.1016/S2352-4642(25)00094-X","DOIUrl":"10.1016/S2352-4642(25)00094-X","url":null,"abstract":"<div><h3>Background</h3><div>Risk stratification tools for paediatric community-acquired pneumonia (CAP) in well-resourced settings are scarce. We prospectively developed models to predict CAP severity within a multinational cohort of paediatric emergency departments (EDs). Our primary objective was to develop a risk prediction model to discriminate between mild CAP and moderate or severe CAP to assist clinicians in determining the need for hospitalisation.</div></div><div><h3>Methods</h3><div>This prospective cohort study was conducted from Feb 6, 2019, to June 30, 2021, at 73 EDs in 14 countries. Children aged 3 months to &lt;14 years with clinical diagnoses of CAP were included. Children were excluded if they were recently hospitalised or had a chronic complex condition (eg, immunodeficiency). The primary outcome was severity, defined as mild (CAP treated in the outpatient setting or hospitalisation &lt;24 h with no use of oxygen or intravenous fluids during that time), moderate (hospitalisation &lt;24 h with oxygen or fluids, or hospitalisation ≥24 h regardless of interventions but without an outcome qualifying as severe CAP), or severe (chest drainage, intensive care unit admission &gt;24 h, positive-pressure ventilation, septic shock, vasoactive infusions, extracorporeal membrane oxygenation, or death) occurring within 7 days of the ED visit. Models were developed using logistic regression with bootstrap validation.</div></div><div><h3>Findings</h3><div>Of 2222 children in the overall study population (1103 [49·7%] female, 1119 [50·3%] male; median age 3 years [IQR 1–5]), 1290 (58·1%) had mild CAP, 812 (36·5%) moderate, and 120 (5·4%) severe. Primary analyses were performed in 1901 patients with complete data: 1011 (53·2%) mild, 772 (40·6%) moderate, and 118 (6·2%) severe CAP. Congestion or rhinorrhoea was negatively associated with moderate or severe CAP (adjusted odds ratio 0·59 [95% CI 0·46–0·76]), while abdominal pain (1·52 [1·17–1·97]), refusal to drink (1·57 [1·24–2·00]), antibiotics before ED visit (1·64 [1·29–2·10]), chest retractions (2·86 [2·24–3·65]), respiratory rate above the 95th percentile for age (1·63 [1·29–2·06]), heart rate above the 95th percentile for age (1·64 [1·27–2·12]), and hypoxaemia (oxygen saturation 90–92%, 3·24 [2·46–4·27]; &lt;90%, 13·39 [8·64–20·73]) were positively associated. The model accurately discriminated between mild CAP and moderate or severe CAP (c-statistic 0·82 [95% CI 0·80–0·84]). Similar results were found in those with radiographic CAP, with decreased breath sounds and multifocal opacities on radiography as additional predictors (c-statistic 0·82 [0·80–0·85]).</div></div><div><h3>Interpretation</h3><div>We developed accurate, pragmatic severity risk prediction models among children with CAP. After future external validation, these models have the potential to provide individualised risk assessments that can be incorporated into clinical judgement in well-resourced health systems to improve man","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Pages 383-392"},"PeriodicalIF":19.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948789","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":"Empowering young voices in clinical research: co-creation of an educational video to support informed assent","authors":"Anne E M Kamphuis,&nbsp;Lungile P Jafta,&nbsp;Tom G Jacobs,&nbsp;Penta Youth Trials Board","doi":"10.1016/S2352-4642(25)00138-5","DOIUrl":"10.1016/S2352-4642(25)00138-5","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Pages 369-370"},"PeriodicalIF":19.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948936","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":"Keeping families stable, secure, and together","authors":"The Lancet Child & Adolescent Health","doi":"10.1016/S2352-4642(25)00137-3","DOIUrl":"10.1016/S2352-4642(25)00137-3","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Page 361"},"PeriodicalIF":19.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948787","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":"Advancing severity grading for risk-differentiated paediatric pneumonia care","authors":"Chris A Rees ,&nbsp;Yasir B Nisar ,&nbsp;Quique Bassat ,&nbsp;Ziyaad Dangor","doi":"10.1016/S2352-4642(25)00125-7","DOIUrl":"10.1016/S2352-4642(25)00125-7","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Pages 362-363"},"PeriodicalIF":19.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948788","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":"Real-world effectiveness of nirsevimab against respiratory syncytial virus disease in infants: a systematic review and meta-analysis","authors":"Dewan Md Sumsuzzman PhD ,&nbsp;Zhen Wang PhD ,&nbsp;Joanne M Langley MD ,&nbsp;Seyed M Moghadas PhD","doi":"10.1016/S2352-4642(25)00093-8","DOIUrl":"10.1016/S2352-4642(25)00093-8","url":null,"abstract":"<div><h3>Background</h3><div>Nirsevimab was approved in 2023, and implemented in all-infant immunisation programmes in several high-income countries to prevent lower respiratory tract infection (LRTI) caused by respiratory syncytial virus (RSV). Knowledge of real-world effectiveness of broad nirsevimab programmes is crucial to validate the benefits observed in clinical trials and guide immunisation policy. We assessed the real-world effectiveness of nirsevimab in populations where infant immunisation programmes were introduced.</div></div><div><h3>Methods</h3><div>For this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science, Scopus, Global Health, and medRxiv from Jan 1, 2023, to Feb 25, 2025, to identify observational studies of immunisation programmes for infants aged 2 years or younger in routine clinical practice reporting original data for the real-world effectiveness of nirsevimab. The primary analysis focused on infants aged 12 months or younger. Pooled analyses were done with inverse-variance random-effects models for RSV-related hospital admissions, intensive care unit (ICU) admissions, and RSV-related LRTI incidence. For length of hospital stay, we used a restricted maximum likelihood random-effects model to estimate the weighted mean difference (WMD) in days between the nirsevimab and control groups. This study is registered with PROSPERO (CRD42024628782).</div></div><div><h3>Findings</h3><div>We identified and screened 1238 records, of which 32 cohort and case-control studies from five countries (France, Italy, Luxembourg, Spain, and the USA) were included in the systematic review and 27 of them were included in the meta-analysis. Nirsevimab was associated with a lower odds of RSV-related hospitalisation (odds ratio 0·17; 95% CI 0·12–0·23; <em>I</em>²=85·8%), a lower odds of ICU admission (0·19; 0·12–0·29; 55·6%), and a lower odds of LRTI incidence (0·25; 0·19–0·33; 35·1%) in infants aged 0–12 months. However, length of hospital stay did not differ between the nirsevimab and control groups (WMD 0·01; 95% CI –0·63 to 0·65; <em>I</em>²=62·3%).</div></div><div><h3>Interpretation</h3><div>Our findings indicate that the benefits of nirsevimab observed in clinical trials are also evident in real-world settings, effectively reducing the burden of RSV disease in infants and, consequently, health-care use.</div></div><div><h3>Funding</h3><div>Natural Sciences and Engineering Research Council of Canada and the Canadian Immunization Research Network.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Pages 393-403"},"PeriodicalIF":19.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948790","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":"Co-design methodologies to develop mental health interventions with young people: a systematic review","authors":"Alessandra Chinsen BA ,&nbsp;Ashley Berg BA ,&nbsp;Sophie Nielsen GradDipP ,&nbsp;Kate Trewella GradDipN ,&nbsp;Tim J Cronin MPsych ,&nbsp;Carmen C Pace PhD ,&nbsp;Ken C Pang PhD ,&nbsp;Michelle A Tollit PhD","doi":"10.1016/S2352-4642(25)00063-X","DOIUrl":"10.1016/S2352-4642(25)00063-X","url":null,"abstract":"<div><div>Co-design methodologies are increasingly being used to develop mental health interventions with young people (aged 10–24 years), but the adoption of this participatory approach has been accompanied by concerns around quality, reporting, and participation. We aimed to identify and critically assess the characteristics, quality, outcomes, barriers, and facilitators of co-design methodologies used to develop mental health interventions with young people. We searched MEDLINE, PubMed, PsycINFO, SCOPUS, and Web of Science for articles published from database inception to Feb 6, 2024. We included articles describing empirical studies that used co-design in the development of a mental health intervention with young people, and identified 41 unique co-design studies. Our systematic review revealed that the use of co-design methodologies to develop mental health interventions has expanded substantially over the past 5 years. We also found that the application of co-design terms, frameworks, and methods varied across the studies, and most co-designed interventions had not been evaluated. A third of the studies evaluating the co-design process were assessed as being low quality, and two-thirds had a low degree of participation of young people in the co-design process. In the future, this area should be guided by clearer terms and frameworks, higher quality and degree of participation, and greater evaluation of co-designed programmes.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Pages 413-425"},"PeriodicalIF":19.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902989","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: 297–305","authors":"","doi":"10.1016/S2352-4642(25)00128-2","DOIUrl":"10.1016/S2352-4642(25)00128-2","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Page e14"},"PeriodicalIF":19.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946753","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: 213–15","authors":"","doi":"10.1016/S2352-4642(25)00123-3","DOIUrl":"10.1016/S2352-4642(25)00123-3","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 6","pages":"Page e14"},"PeriodicalIF":19.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849463","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":"Management of severe acute pulmonary haemorrhage in children","authors":"Alexander I Gipsman MD ,&nbsp;Lauren M C Grant MD ,&nbsp;Prof Joseph C Piccione DO ,&nbsp;Nadir Yehya MD ,&nbsp;Char Witmer MD ,&nbsp;Lisa R Young MD ,&nbsp;Antoinette Wannes Daou MD ,&nbsp;Abhay Srinivasan MD ,&nbsp;Pelton A Phinizy MD","doi":"10.1016/S2352-4642(25)00060-4","DOIUrl":"10.1016/S2352-4642(25)00060-4","url":null,"abstract":"<div><div>Pulmonary haemorrhage is a potentially life-threatening condition with a variety of causes. Quality clinical trials are insufficient in children, restricting the evidence base to observational data and adult studies. The overall management strategy should address control of symptomatic bleeding, identification of the bleeding source, and treatment of the underlying cause. Flexible bronchoscopy is an important tool used to identify the cause and site of bleeding, do interventional procedures, and directly instil medications to affected areas. Medications to control bleeding include vasoconstrictors, antifibrinolytics, and recombinant factor VIIa. Definitive treatment often requires immunomodulatory medications, bronchial artery embolisation, or surgery. In this Review, we summarise the most recent evidence pertaining to medical, interventional, and surgical treatments of pulmonary haemorrhage in children.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 5","pages":"Pages 349-360"},"PeriodicalIF":19.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833146","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}