The Lancet. Child & adolescent health最新文献_第2页

Health service use of young people after mental health admission far from home: a retrospective cohort study in England. 离家很远的青少年心理健康入院后的卫生服务使用情况：英国的一项回顾性队列研究。

The Lancet. Child & adolescent health Pub Date : 2026-09-17 DOI: 10.1016/S2352-4642(26)00187-2

Josephine Holland, Kapil Sayal, Amelia Jewell, Craig Colling, Johnny Downs

{"title":"Health service use of young people after mental health admission far from home: a retrospective cohort study in England.","authors":"Josephine Holland, Kapil Sayal, Amelia Jewell, Craig Colling, Johnny Downs","doi":"10.1016/S2352-4642(26)00187-2","DOIUrl":"https://doi.org/10.1016/S2352-4642(26)00187-2","url":null,"abstract":"Background: Severe mental illness requiring inpatient admission is associated with poorer mental health and physical and social outcomes. Out-of-area admissions persist in child and adolescent mental health services (CAMHS) but are associated with longer length of stay and increased family burden. However, their association with future health service use is unknown. Using linked mental health and national health-care data, we examined patterns of health service use up to 60 months following out-of-area psychiatric admission versus within-area psychiatric admission in young people younger than 18 years.Methods: The Maudsley Clinical Record Interactive Search (CRIS) database was used to identify all young people (aged <18 years) who had at least one mental health-related admission between Jan 1, 2009, and Dec 31, 2023, to South London and Maudsley NHS Foundation Trust in England. Admission was categorised as out of area (>50 miles [80 km or 60 min away from home address) or within area. Linkage to the Hospital Episode Statistics enabled analysis of health service use (emergency department presentations, and general hospital admissions for non-mental health-related or mental health-related reasons) in the 1 month, 12 months, and 60 months after discharge. Cox regression was used to investigate associations between admission out of area and subsequent health service use, adjusting for demographic, clinical, and admission characteristics.Findings: The outcomes of 2287 young people were analysed (median age at index admission 16·3 years [IQR 15·3-17·3]; 1435 [63%] were female, 827 [36%] were male, and 21 [1%] identified as other). Of those with relevant data, 852 were admitted out of area and 1423 were admitted within area. Out-of-area admission was associated with subsequent emergency department presentation (adjusted hazard ratio [HR] 1·13 [95% CI 1·001-1·26]) and non-mental health-related general hospital admissions at 60 months (1·12 [1·0001-1·26]) despite adjusting for demographic, clinical, and admission characteristics. However, there was no association with mental health-related general hospital admissions at 60 months (adjusted HR 1·02 [95% CI 0·91-1·15]). Other factors such as ethnicity, diagnosis, previous hospital presentations, and being in the care of the state were also associated with presentations to emergency departments and general hospital admissions.Interpretation: Admission out of area to a CAMHS ward is associated with increased likelihood of non-mental-health general hospital and emergency department use in the 60 months after discharge, raising important service planning needs in both physical and mental health care.Funding: Royal College of Psychiatrists.","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Opportunities for advancing paediatric medical device access: regulatory frameworks in the EU and USA. 推进儿科医疗器械准入的机会：欧盟和美国的监管框架。

The Lancet. Child & adolescent health Pub Date : 2026-09-08 DOI: 10.1016/S2352-4642(26)00195-1

Mira C Hasner, Iris P van Mullem, Faith C Robertson, Florence T Bourgeois, R Mark Richardson, Marike L D Broekman

{"title":"Opportunities for advancing paediatric medical device access: regulatory frameworks in the EU and USA.","authors":"Mira C Hasner, Iris P van Mullem, Faith C Robertson, Florence T Bourgeois, R Mark Richardson, Marike L D Broekman","doi":"10.1016/S2352-4642(26)00195-1","DOIUrl":"https://doi.org/10.1016/S2352-4642(26)00195-1","url":null,"abstract":"Paediatric medical device development lags substantially behind that for adults, creating inequities in access to age-appropriate care. Current regulatory frameworks ensure patient safety but impose structural barriers to device availability. In this Health Policy, we analyse decentralised EU and centralised US regulatory approaches to identify opportunities for reform. A scoping review and analysis of 40 paediatric-specific stakeholder responses to the European Commission's 2024 targeted consultation on the impact of the Medical Device Regulation and the In Vitro Diagnostic Devices Regulation revealed major shortcomings. In the EU, 29 (73%) of 40 stakeholders cited device availability problems, 22 (55%) need for regulatory reform, and 19 (48%) certification barriers, despite emerging paediatric-specific incentives. The USA's centralised oversight, facilitative regulatory pathways, and dedicated federal funding have supported paediatric medical device development more actively than in the EU; however, evidence and surveillance gaps persist. Both systems generate insufficient paediatric data, sustaining off-label use without robust evidence. Reform targeted to each system's shortcomings should prioritise proportionate evidence requirements, dedicated paediatric pathways, targeted funding, expert ethics oversight, and international data sharing to advance safe and equitable paediatric medical device access.","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The pathogenic illusion of youth incarceration: a call for abolition medicine in Europe 青少年监禁的致病幻觉：欧洲废除医学的呼吁

The Lancet. Child & adolescent health Pub Date : 2026-09-01 DOI: 10.1016/s2352-4642(26)00223-3

Nicola Cocco,Emma Plugge,Edoardo Corsi Decenti,Fadi Meroueh,Lara Tavoschi,Michele Umbrello,Valentina Burzio,Camilla Ponti,Babak Moazen,Marie Claire Van Hout

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Neurological effects of encapsulated dexamethasone sodium phosphate in children aged 6–9 years with ataxia telangiectasia (NEAT): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial 包裹性地塞米松磷酸钠对6-9岁儿童共济失调毛细血管扩张症（NEAT）的神经系统影响：一项多中心、随机、双盲、安慰剂对照的3期试验

The Lancet. Child & adolescent health Pub Date : 2026-08-14 DOI: 10.1016/s2352-4642(26)00125-2

Sam Russo, Stefan Zielen, Barbara Pietrucha, Jordis Trischler, Susan Perlman, Daniel Zielonka, Maria del Mar Garcia Romero, Winnie Ip, Asbjørg Stray-Pedersen, Malene Landbo Børresen, David Gomez-Andres, Samantha Lissauer, Jana Pachlopnik-Schmid, Konstantinos Karampatsas, Steve Wu, Francesco Pisani, Howard Lederman, Raffaele Badolato, Jan Kern, Oliver Kornmann, Helena Donath, William P Whitehouse, Mary Kay Koenig, Hassan Abolhassani, Caralee Schaefer, Maureen Roden, Dirk Thye, Alex Smith, Biljana Horn, Andrew Prayle

引用次数: 0

Urban informal settlements: an overlooked context for adolescent digital safety 城市非正规住区：青少年数字安全被忽视的背景

The Lancet. Child & adolescent health Pub Date : 2026-08-04 DOI: 10.1016/s2352-4642(26)00199-9

Sakshi Ghai, Mario Schmidt

引用次数: 0

Calling for a strategic shift in drug development for childhood cancers. 呼吁对儿童癌症药物开发进行战略转变。

The Lancet. Child & adolescent health Pub Date : 2026-07-20 DOI: 10.1016/s2352-4642(26)00183-5

Nicholas Bird,Nicole Scobie,Vickie Buenger,Martha Donoghue,Dominik Karres

引用次数: 0

The roles of paediatric emergency physicians and intensivists in disaster responses. 儿科急诊医师和重症监护医师在灾害应对中的作用。

The Lancet. Child & adolescent health Pub Date : 2024-09-01 Epub Date: 2024-07-29 DOI: 10.1016/S2352-4642(24)00198-6

Özlem Teksam, Oksan Derinoz Guleryuz, Oğuz Dursun, Aykut Caglar, Ayse Berna Anil, Tanıl Kendirli, Riza Dincer Yildizdas

引用次数: 0

Monitoring change from residential housing care to family-based care for children. 监测儿童从寄宿照料向家庭照料的转变。

The Lancet. Child & adolescent health Pub Date : 2024-08-01 Epub Date: 2024-05-14 DOI: 10.1016/S2352-4642(24)00102-0

Marian J Bakermans-Kranenburg, Marinus H van IJzendoorn

引用次数: 0

Lipoprotein apheresis and long-term cardiovascular health: a real answer for children with HoFH? 脂蛋白分离与长期心血管健康：HoFH 儿童的真正答案？

The Lancet. Child & adolescent health Pub Date : 2024-07-01 Epub Date: 2024-05-14 DOI: 10.1016/S2352-4642(24)00105-6

Ari Horton

引用次数: 0

Cardiovascular outcomes in patients with homozygous familial hypercholesterolaemia on lipoprotein apheresis initiated during childhood: long-term follow-up of an international cohort from two registries. 童年时期开始接受脂蛋白分离治疗的同型家族性高胆固醇血症患者的心血管预后：两个登记处国际队列的长期随访。

The Lancet. Child & adolescent health Pub Date : 2024-07-01 Epub Date: 2024-05-14 DOI: 10.1016/S2352-4642(24)00073-7

M Doortje Reijman, Tycho R Tromp, Barbara A Hutten, G Kees Hovingh, Dirk J Blom, Alberico L Catapano, Marina Cuchel, Eldad J Dann, Antonio Gallo, Lisa C Hudgins, Frederick J Raal, Kausik K Ray, Fouzia Sadiq, Handrean Soran, Jaap W Groothoff, Albert Wiegman, D Meeike Kusters

{"title":"Cardiovascular outcomes in patients with homozygous familial hypercholesterolaemia on lipoprotein apheresis initiated during childhood: long-term follow-up of an international cohort from two registries.","authors":"M Doortje Reijman, Tycho R Tromp, Barbara A Hutten, G Kees Hovingh, Dirk J Blom, Alberico L Catapano, Marina Cuchel, Eldad J Dann, Antonio Gallo, Lisa C Hudgins, Frederick J Raal, Kausik K Ray, Fouzia Sadiq, Handrean Soran, Jaap W Groothoff, Albert Wiegman, D Meeike Kusters","doi":"10.1016/S2352-4642(24)00073-7","DOIUrl":"10.1016/S2352-4642(24)00073-7","url":null,"abstract":"Background: Homozygous familial hypercholesterolaemia (HoFH) is a rare genetic disease characterised by extremely high plasma LDL cholesterol from birth, causing atherosclerotic cardiovascular disease at a young age. Lipoprotein apheresis in combination with lipid-lowering drugs effectively reduce LDL cholesterol, but long-term health outcomes of such treatment are unknown. We aimed to investigate the long-term cardiovascular outcomes associated with lipoprotein apheresis initiated in childhood or adolescence.Methods: In this cohort study, data were drawn from the HoFH International Clinical Collaboration (HICC) and the international registry for Children with Homozygous Hypercholesterolemia on Lipoprotein Apheresis (CHAIN). An overall cohort included patients diagnosed with HoFH aged 0-18 years who were alive and in follow-up between Jan 1, 2010, and Nov 8, 2021, and whose high plasma LDL cholesterol concentrations made them eligible for lipoprotein apheresis. To compare cardiovascular outcomes, patients who initiated lipoprotein apheresis in childhood (lipoprotein apheresis group) and patients who only received lipid-lowering drugs (pharmacotherapy-only group) were matched by sex and untreated plasma LDL cholesterol concentrations. The primary outcome was a composite of cardiovascular death, myocardial infarction, ischaemic stroke, percutaneous coronary intervention, coronary artery bypass grafting, aortic valve replacement, peripheral artery disease, carotid endarterectomy, angina pectoris, and supra-aortic or aortic stenosis (collectively referred to as atherosclerotic cardiovascular disease), for which survival analyses were performed in the matched cohort. Cox regression analyses were used to compare disease-free survival between cohorts and to calculate hazard ratio (HR) and 95% CI adjusted for sex, age at diagnosis, untreated plasma LDL cholesterol concentration, and number of lipid-lowering therapies other than lipoprotein apheresis.Findings: The overall cohort included 404 patients with a median age at diagnosis of 6·0 years (IQR 3·0-9·5) and median untreated plasma LDL cholesterol of 17·8 mmol/L (14·7-20·8). The matched cohorts included 250 patients (125 patients per group), with a median untreated LDL cholesterol of 17·2 mmol/L (14·8-19·7). Mean reduction in plasma LDL cholesterol concentrations between baseline and final follow-up was greater in the lipoprotein apheresis group (-55% [95% CI -60 to -51] vs -31% [-36 to -25]; p<0·0001). Patients in the lipoprotein apheresis group had longer atherosclerotic cardiovascular disease-free survival (adjusted HR 0·52 [95% CI 0·32-0·85]) and longer cardiovascular death-free survival (0·0301 [0·0021-0·4295]). Cardiovascular death was more common in the pharmacotherapy-only group than in the lipoprotein apheresis group (ten [8%] vs one [1%]; p=0·010), whereas median age at coronary artery bypass grafting was lower in the lipopro","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"491-499"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0