BMJ Paediatrics Open最新文献

{"title":"Neurodevelopmental disorders at Chris Hani Baragwanath Academic Hospital: a 4-year retrospective database review.","authors":"Sarah Jane Lowick, Sibongile Mbatha","doi":"10.1136/bmjpo-2025-003373","DOIUrl":"https://doi.org/10.1136/bmjpo-2025-003373","url":null,"abstract":"<p><strong>Background: </strong>Developmental paediatrics is a growing field both globally and locally with increasing demand for medical and educational resources.</p><p><strong>Methods: </strong>This retrospective, developmental database review is a baseline description of the Chris Hani Baragwanath Academic Hospital neurodevelopmental clinic population, and the service offered over the past 4 years. The population comprises all patients seen at the clinic from May 2020 to December 2024. Outcomes measured were total patient numbers, demographic, clinical and management variables.</p><p><strong>Results: </strong>The cohort comprised 1877 patients. An increase in total patient numbers was observed over the past 4 years. The ratio of male to female patients was 3:1. Median age at referral was 48.8 months with an average waiting period of 12 months. The median, mean and age range at first visit were 60, 66 and 5-192 months, respectively. Autism was diagnosed in 37.1%, non-syndromic intellectual disability in 16.6%, a confirmed genetic diagnosis in 11.8% and a 'likely genetic disorder' in 18% of patients. 98 different genetic conditions were identified. Comorbidity included cerebral palsy (11.4%), epilepsy (16.1%), hearing (5.2%) and visual impairment (5.5%). Associated behavioural disorders occurred in 52.8% of patients, predominantly attention deficit hyperactivity disorder (ADHD) (30%). At least one medication was prescribed in 58.2% of children. Over 40% of children were either at home or at crèche; 14.0% were attending mainstream school; 10.5% an autism school; 26.3% a special needs school. Of the 841 (44.8%) children in supported schooling, 47.8% were placed after 7 years of age.</p><p><strong>Conclusions: </strong>This study provides insights into the regional burden and clinical presentation of neurodevelopmental disorders. Trends in this region reflect broader global patterns, with increasing numbers of children presenting with complex conditions. Greater resources are needed for earlier diagnosis and therapy, access to all tiers of genetic testing and upscaling of inclusive and special needs education.</p><p><strong>Trial registration number: </strong>NHRD GP_202510_105.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969156","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":"Correction for '<i>Hospitalisations for chronic conditions among care experienced and general population children and young people: evidence from the Children's Health in Care in Scotland (CHiCS) cohort study, 1990-2016'</i>.","authors":"","doi":"10.1136/bmjpo-2024-002705corr1","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002705corr1","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963654","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":"Parents' divorce and early child development: a population-based study in China.","authors":"Le Kang, Ruoyu Yin, Yuhao Deng, Yunting Zhang, Jin Zhao, Yingquan Song, Fan Jiang, Chunling Lu","doi":"10.1136/bmjpo-2024-003200","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-003200","url":null,"abstract":"<p><strong>Background: </strong>The divorce rate has increased globally and in China. Literature from developed countries and few developing countries has shown the negative impact of parental divorce on children's health and development. This cross-sectional study aimed to examine the association between parental divorce and early childhood development (ECD) in China.</p><p><strong>Method: </strong>This study used data collected from four provinces in China and reported by parents or other caregivers of 62 899 children, aged 3-5 years old, in 2017 and 2018. We constructed three types of ECD outcomes: (1) overall score of the early Human Capability Index (eHCI), (2) score of each domain of the eHCI, and (3) a dichotomous variable indicating a child developmentally on track, defined by ranking above the 20th percentile of overall eHCI scores in the corresponding age group in the pooled dataset. To understand the link between parental divorce and ECD outcomes, we used the propensity score matching method to match children from divorced families to those from intact families. We applied generalised linear regression models in data analysis using both the full sample and matched sample.</p><p><strong>Results: </strong>A total of 3.8% (N=2409) of young children came from divorced families. Children whose parents divorced had significantly lower overall eHCI scores (OR: 0.95, 95% CI 0.92 to 0.98) and lower odds of being developmentally on track (OR: 0.79, 95% CI 0.71 to 0.89), compared with their counterparts after matching. Statistically significant differences were observed in nearly all of nine domains of eHCI, especially for physical health, reading and social and emotional skills. Subgroup analyses showed more prominent associations in Shanghai.</p><p><strong>Conclusion: </strong>Children from divorced families showed slower early sociopsychological and physical development than their peers. Efforts are needed to help this vulnerable group minimise the differences.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953997","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":"Joint parental stimulation and early childhood development in 26 sub-Saharan African countries.","authors":"Hyejun Chi, Yun-Jung Eom, Joshua Jeong, Hwa-Young Lee, Rockli Kim","doi":"10.1136/bmjpo-2024-003091","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-003091","url":null,"abstract":"<p><strong>Background: </strong>Engagement in stimulation activities by both parents can have synergistic effects on early childhood development (ECD). While the role of maternal stimulation is well known, the association with paternal stimulation remains underexplored and inconsistent. The current study aimed to assess the distribution of different combinations of maternal and paternal stimulation and explore their associations with ECD in the context of sub-Saharan Africa (SSA).</p><p><strong>Methods: </strong>Using the Multiple Indicator Cluster Surveys and Demographic and Health Surveys from 26 SSA countries, we included 69 637 children aged 3-4 years in the analysis. The standardised ECD z-score was constructed using the ECD index. We estimated three-level linear regressions to assess its association with parental engagement in stimulation activities which was classified into four categories: mother low, father low (fewer than four activities); mother high, father low; father high, mother low; mother high, father high. Stratification analyses were conducted to examine whether the association differs by socioeconomic, geographic and learning-related variables.</p><p><strong>Results: </strong>Only 4% of parents provided high stimulation jointly (both high), which was associated with higher ECD z-score compared with both parents providing low stimulation (both low), after adjusting for covariates (b=0.04, 95% CI=0.01, 0.08). The association between joint parental stimulation and ECD was greater for children from wealthier households compared with their poorer counterparts (interaction p=0.012).</p><p><strong>Conclusions: </strong>Children showed better developmental status when both parents jointly provided high stimulation. Policies and interventions should target both mothers and fathers, and transform traditional norms about parenting to achieve the most optimal development outcomes of children.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978670","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":"Children's and adolescents' negative internet experiences and the association with quality of life and behavioural difficulties: a cross-sectional study.","authors":"Deborah Prkno, Nico Grafe, Marian S Schulz, Wieland Kiess, Tanja Poulain","doi":"10.1136/bmjpo-2024-003135","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-003135","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have assessed cyberbullying victimisation and perpetration in children. However, the internet poses risks beyond cyberbullying. This study explores the prevalence of eight different negative online experiences and their associations with sociodemographic characteristics, media use, behavioural difficulties and quality of life in children and adolescents.</p><p><strong>Methods: </strong>The sample included 622 participants aged 10-17 years who provided information on negative internet experiences (exclusion, financial loss, disturbing content, hurtful comments, tracking, misuse of personal data, threat, other harmful experiences), media use, symptoms of problematic smartphone use (PSU) (Smartphone Addiction Proneness Scale), behavioural difficulties (Strengths and Difficulties Questionnaire), quality of life (KIDSCREEN-27 Health-Related Quality of Life Questionnaire for Children and Young People and their Parents) and sociodemographic characteristics (age, sex, type of school, maternal education, family income). Poisson regressions were performed to evaluate associations.</p><p><strong>Results: </strong>Negative internet experiences were prevalent in 31% of participants. Individual factors (older age, female sex, family income), media usage characteristics (high media use, PSU symptoms) and mental health factors (poor quality of life, behavioural difficulties) were associated with a higher frequency of self-reported negative internet experiences. In contrast, type of school and maternal education were not significantly associated with negative internet experiences.</p><p><strong>Conclusion: </strong>Our study indicates that negative internet experiences are highly prevalent in adolescents, particularly those struggling with mental health issues. This underlines the importance of preventive measures. Longitudinal studies are needed to disentangle the potential interdependence of mental health and negative internet experiences.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961992","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":"How young people experienced long covid services: a qualitative analysis.","authors":"Olivia Lauryn Taylor, Georgia Treneman-Evans, Madeleine Riley, Jo Bond-Kendall, Katharine Claire Pike","doi":"10.1136/bmjpo-2024-003206","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-003206","url":null,"abstract":"<p><p>ΒACKGROUND: After the COVID-19 pandemic, children and young people (CYP) with long covid were managed in specialist clinics. However, there is limited research on how CYP who accessed long covid clinics experienced them.</p><p><strong>Methods: </strong>We aimed to evaluate how acceptable paediatric long covid services were to patients. Semi-structured qualitative interviews with 13 paediatric patients were used to understand the experiences of patients with long covid. Recruited participants were aged 11-17 years old, had a long covid diagnosis, and accessed specialist paediatric service in the Southwest of England from June 2022 to September 2023. Clinicians working in the long covid clinics identified CYP who were eligible and asked their consent to be contacted by a member of the study team. All participants who consented to be involved in the study were sampled. Thematic analysis was used to extract codes and themes from the data.</p><p><strong>Results: </strong>Four themes were reported. Accessing specialist clinics helped CYP to feel validated; they appreciated consulting with clinicians who were knowledgeable about long covid and empathetic. CYP found comfort in knowing other CYP were experiencing long covid. CYP wanted to be proactive in their long covid management, appreciating regular appointments and the opportunity to learn about their condition. CYP desired normality, and therefore sought flexible appointment times, online appointments and reasonable adjustments. CYP found the waiting times to access long covid services were too long.</p><p><strong>Conclusions: </strong>Our results stress the importance to CYP of several features of the care received in the specialist clinics. These relate to the experiences of CYP with long covid but potentially extend to CYP with other conditions, particularly long-term and/or poorly understood conditions. The results support creating community-based support groups for CYP with long-term medical conditions, providing online flexible appointments, offering early reasonable adjustments for school and providing quicker access to specialist clinics.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967545","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":"Bridging the divide: the growing role of school-based integrated care in regional Australia.","authors":"Santuri Rungan, Corin Miller, Deborah Daley, Desmond Barton, Wilhelmina Ebbett, Sandra Mikhail, Erin Evans, Hueiming Liu","doi":"10.1136/bmjpo-2024-003245","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-003245","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973751","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":"Mainstreaming genomics in the National Health Service in England: a survey to understand preparedness and confidence among paediatricians.","authors":"Rachel Griffiths, Celine Lewis","doi":"10.1136/bmjpo-2024-003286","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-003286","url":null,"abstract":"<p><strong>Background: </strong>The National Health Service in the UK is the first national healthcare system to offer genomic sequencing for rare disease diagnosis as routine care. Non-genetic medical specialists, including paediatricians, can now request genomic testing for certain clinical indications. The primary purpose of this study was to evaluate the preparedness and confidence of paediatricians providing genomic sequencing in England. In addition, we assessed current practice, perceived utility of testing, barriers and enablers, prior genomics education and training preferences.</p><p><strong>Methods: </strong>A 26-item electronic survey for completion by paediatric specialists. Participants were recruited through national associations and a conference. Quantitative items were analysed using descriptive and inferential statistics. Open-ended question responses were analysed by qualitative content analysis.</p><p><strong>Results: </strong>157 responses were included in the analysis. Only 49.0% reported feeling prepared for mainstreaming despite 75.0% reporting they had requested testing in the past 12 months, 47.7% indicating they had returned genomic sequencing results and 67.1% feeling genomic testing was useful. Mean confidence scores were lowest for tasks including using human phenotype ontology terminology on test request forms (3.9/10), interpreting genomic test results (4.8/10), discussing complex genomic results with patients and families (4.3/10) and integrating test results into patient care (4.7/10). Significantly higher average ranked genomic confidence was identified among those who had requested testing in the last 12 months compared with those who had not (Z=5.063, p<0.001, r=0.412). The most frequent barriers to mainstreaming were lack of training and knowledge (43.3%), determining patient eligibility (28.0%), lack of time (27.4%) and confidence (25.5%). Webinars (48.4%), followed by continued professional development meetings and/or conferences (38.9%), were the preferred mode of training.</p><p><strong>Conclusions: </strong>Our data suggest that preparedness and confidence among paediatricians in genomics is currently lacking. Support from clinical genetics services, simplified referral forms and webinar training sessions could improve current practice.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973719","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":"Correction for '<i>Global, regional and national burden of retinopathy of prematurity among childhood and adolescent: a spatiotemporal analysis based on the Global Burden of Disease Study 2019'</i>.","authors":"","doi":"10.1136/bmjpo-2023-002267corr1","DOIUrl":"https://doi.org/10.1136/bmjpo-2023-002267corr1","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976378","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":"Correction for 'Unravelling the potential relationship between the climate crisis and the health of migrant children in LAC: perceptions from migrant parents and healthcare professionals in Chile<i>'</i>.","authors":"","doi":"10.1136/bmjpo-2024-002899corr1","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-002899corr1","url":null,"abstract":"","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963918","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}