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The paediatric global musculoskeletal task force-'towards better MSK health for all'

Foster, Helen E. Scott, Christiaan Tiderius, Carl J. Dobbs, Matthew B.

Newcastle Univ Newcastle Upon Tyne Tyne & Wear EnglandNewcastle Univ Med Malaysia Newcastle Upon Tyne Tyne & Wear EnglandUniv Cape Town Cape Town South AfricaSkane Univ Hosp Lund SwedenWashington Univ Sch Med St Louis MO USA

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Attitudes towards varicella vaccination in parents and paediatric healthcare providers in Hungary

Huber, Annamaria Gazder, Judit Dobay, Orsolya Meszner, Zsofia Horvath, Andrea

Semmelweis Univ Inst Med Microbiol Nagyvarad Ter 4 H-1089 Budapest HungaryMunicipal Tatabanya City Hlth Visitor Serv Tatabany HungaryHeim Pal Natl Paediat Inst Budapest Hungary

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ScienceDirect Journa...

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关键词： Varicella vaccination Vaccine hesitancy Cross-sectional study Parents Healthcare providers

摘要： Background: Varicella vaccination is important in prevention of childhood infection. Aim of this cross-sectional study was to survey attitudes and determinants of support or refusal of varicella vaccination in parents and in paediatric healthcare professionals, mainly health visitors in Hungary prior to the introduction of this vaccine in National Immunization Program in 2019. Methods: Between October 2018 and February 2019, 1042 parents and 198 healthcare professionals completed a self-administered anonymous questionnaire regarding sociodemographic background, knowledge and attitudes towards varicella vaccination, and reasons for non-vaccination. Results: From the participating parents 53.3% have vaccinated at least one of their children. Vaccination rate was significantly higher in families with <3 children, living in the capital, among those who have seen complications of varicella and among parents with university degree. Most important positive determinant was recommendation of the vaccine by healthcare professionals: 77.8% of parents accepted vaccination when recommended by the paediatrician, despite the cost of the vaccine, whereas only 17.3% of parents vaccinated their children when the vaccine was not recommended by paediatrician. Most important reasons for non-vaccination was finding the vaccine unnecessary, concerns regarding side effects, and not believing in the vaccine's effectiveness. Among paediatric healthcare professionals, support rate of universal varicella vaccination was 76.3%. Support rate was higher among those who have seen complications of varicella more often and those who consider varicella a severe infection. Reasons of professionals who do not support universal varicella vaccination were similar to those of vaccine hesitant parents. Practice of intentional exposure of non-immune child to infected ones still exist. Conclusions: Educational programs are needed for parents and health visitors to address concerns regarding vaccination. Paed

Impact of Australian mandatory 'No Jab, No Pay' and 'No Jab, No Play' immunisation policies on immunisation services, parental attitudes to vaccination and vaccine uptake, in a tertiary paediatric hospital, the Royal Children's Hospital, Melbourne

Armiento, Raffaela Hoq, Monsurul Kua, Eugene Crawford, Nigel Perrett, Kirsten P. Elia, Sonja Danchin, Margie

Royal Childrens Hosp Dept Gen Med 50 Flemington Rd Parkville Vic 3052 AustraliaMurdoch Childrens Res Inst Murdoch WA AustraliaUniv Melbourne Melbourne Vic Australia

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关键词： Mandatory vaccine policies Vaccine hesitancy Vaccine refusal Childhood vaccination Australian 'No Jab' policies Specialist immunisation services

摘要： Introduction: 'No Jab, No Play' and 'No Jab, No Pay' mandatory immunisation policies were introduced in the state of Victoria and Australia-wide, respectively, in January 2016. They restrict access to childcare/kindergarten and family assistance payments respectively, for under-vaccinated children. We aimed to describe the proportion of attendees to immunisation services of a tertiary hospital, the Royal Children's Hospital Melbourne (RCH), who were motivated by the policies to discuss or catch-up vaccination. We explored the association between motivation by policies, vaccine hesitancy (VH) and intent to seek medical exemption, with vaccine-uptake. Methods: Parents/Guardians and clinicians completed surveys October 2016-May 2017 from the nurse-led immunisation Drop in Centre (DIC) or physician-led Specialist Immunisation Clinic (SIC). Vaccine-uptake was measured using the Australian Immunisation Register (AIR) at baseline, 1 and 7 months post-attendance. The association between vaccine-uptake, motivation by policies and VH was explored by logistic regression. Results: Of 607 children, 393 (65%) were from the DIC and 214 (35%) SIC. 74 (12%) parents were motivated by the policies to attend immunisation services and 19% were VH. Only 50% of VH parents planned to catch-up vaccination for enrolment to childcare/kindergarten. Seven months post-attendance there was no association between motivation by policies and full vaccination status (difference 10%, OR 0.42, CI 0.17-1.1, p 0.08). Fewer children were fully immunised at 7 months if their parents were VH (difference 18%;OR 0.24, CI 0.1-0.54, p < 0.001) or seeking medical exemption (difference 33%, OR 0.08, CI 0.01-0.6, p 0.015). Conclusion: The 'No Jab' policies motivated attendance to a tertiary immunisation service. However, children of vaccine hesitant parents and those seeking medical exemption to immunisation were less likely to be fully immunised after attendance, than at baseline. The 'No Jab' policies may not be

Veganism and paediatric food allergy: two increasingly prevalent dietary issues that are challenging when co-occurring

Protudjer, Jennifer L. P. Mikkelsen, Andrea

Univ Manitoba Dept Pediat & Child Hlth Winnipeg MB CanadaGeorge & Fay Yee Ctr Healthcare Innovat Winnipeg MB CanadaChildrens Hosp Res Inst Manitoba Winnipeg MB CanadaUniv Manitoba Dept Food & Human Nutr Sci Winnipeg MB CanadaKarolinska Inst Ctr Allergy Res Stockholm SwedenPaediat Primary Hlth Care Clin Vastra Gotaland Vastra Gotaland SwedenRes & Dev Primary Hlth Care Gothenburg Region Vastra G SwedenRes & Dev Primary Hlth Care Sodra Bohuslan Region Vastra G SwedenUniv Gothenburg Sahlgrenska Acad Inst Med Dept Publ Hlth & Community Med Gothenburg Sweden

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关键词： Food allergy Nutrition Pediatrics Vegan

摘要： Vegan diets - defined as the exclusion of all foods of animal origin from the diet- are becoming popular. In recent years, the prevalence of food allergy has also increased, and disproportionately affects children. When vegan diets and food allergy co-occur, this combination can be challenging and pose risks of nutritional deficiencies, particularly during childhood. In this paper, we aim to summarise the major concerns regarding vegan diets and food allergy, review the literature on this topic, and provide some suggestions for healthcare providers, particularly dietitians and nutritionists, who work with food allergic, vegan patients and their family. When working with this patient population, a regular and complete medical nutrition history, including screening for any possible nutritional deficiencies, is warranted. Likewise, the routine tracking of serum markers (especially iodine, iron, zinc, calcium, Vitamins B12, D, B2, and A, selected n-3 fatty acids and protein, which are more abundant in animal vs. plant foods) and symptoms of co-morbid diseases, including asthma, is important, as comorbid diseases may increase energy and nutrient requirements. For infants and children, anthropometry ought to be tracked longitudinally at regular intervals to identify any deviations from the child's previous growth pattern, and to accommodate any increased requirements for growth and development. Correct diagnoses, education and allergy management must be disseminated to the family in a clear and appropriate manner. Children with allergy may have increased nutritional needs due to comorbidity. This is complicated by coincident food allergy and vegan diet as both impose diet restrictions (limiting sources of important nutrients, need for dietary variety and/or increased consumption due to reduced bioavaliability).

When my four-year-old got cancer: a retrospective on resilience in a paediatric oncology ward

Beeler, Dori-Michelle

Johns Hopkins Bloomberg Sch Publ Hlth Hlth Behav & Soc Baltimore MD 21205 USA

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关键词： Childhood cancer resilience growth care survivorship auto-ethnography

摘要： The author presents an interpersonal experience between the author and her son during childhood cancer treatment and care, illustrating the complex relationship between childhood cancer and the term 'resilience'. During treatment and care, nurses used the term 'resilience' in an apparent attempt to reassure her. However, the author found that the concept distanced her from her and her son's experience, creating emotional distress for him. She discovered that the everyday use of resilience, devoid of its research connotations, has the potential to create barriers in understanding these experiences for the patient and the caregiver. For example, this everyday use did not account for the relationship that resilience has with growth. It is not just important in terms of diagnosing a tumour, it is also important for supporting the agency of a child and the cultivation of trustworthiness. A focus on growth supports the notion of an "active resilience," a process informed by research literature to help medical staff and families develop the child patient's capability for growing into resilience throughout the survivorship experience. By neglecting this relationship with growth, resilience was found to silence the agency and voice of the author's child which added to the difficulty that she had in providing care. As more children survive cancer, a meaningful use of the term resilience can support their recovery from the adversities of treatment and a life of adverse outcomes. The ethnographic detail provides the context necessary for contributing to and unpacking the normative use of the term resilience in paediatric oncology.

历久弥新,一路辉煌,引领儿科学术发展

黄国英陈超

复旦大学附属儿科医院上海201102

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