Interim Federal Health Program: Survey of use of supplemental benefits by paediatric health care providers.

Objectives: The Interim Federal Health Program (IFHP) provides temporary healthcare coverage to refugees and refugee claimants. Previous research demonstrates that paediatric healthcare providers poorly utilize the IFHP, with low registration rates and limited understanding of the program. The objective of this study was to examine paediatric provider use of IFHP-covered supplemental benefits, and their experience with trying to access these benefits.

Interim Federal Health Program: Survey of access and utilization by paediatric health care providers.

Background: The Interim Federal Health Program (IFHP) provides health care coverage to refugees and refugee claimants, yet remains underused by providers. The objective of this study was to assess Canadian paediatricians' current understanding and utilization of the IFHP, and perceived barriers to utilization.

Methods: A one-time survey was administered via the Canadian Paediatric Surveillance Program in February 2020.

Exploring Stakeholder Service Navigation Needs for Children with Developmental and Mental Health Diagnoses.

Objective: Service navigation programs are necessary for children with neurodevelopmental and/or mental health diagnoses to facilitate access to specialized therapies, social services, and community programs, especially those who are socially and economically marginalized. Few studies have included diverse stakeholders in the development and implementation of such programs in resource-limited settings. In this qualitative formative study, we aimed to explore stakeholder experiences after the implementation of a pilot service navigation program in resource-limited settings and identify the perceived elements of an effective service navigator, to develop a revised service navigation program for this patient population.

Patient navigators: Mapping the route toward accessibility in health care.

Children and youth with developmental and mental health conditions require a wide range of clinical supports and social services to improve their quality of life. However, few children and youth are currently able to adequately access these clinical, community and social services, and newcomers or those living in poverty are even further disadvantaged. Patient navigator programs can bridge this gap by facilitating connections to social services, supporting family coping strategies and advocating for patient clinical services.

Breastfeeding by Women Living With Human Immunodeficiency Virus in a Resource-Rich Setting: A Case Series of Maternal and Infant Management and Outcomes.

The reduction in human immunodeficiency virus (HIV) transmission through breastmilk with maternal combination antiretroviral therapy (cART) has led many pregnant women living with HIV and healthcare providers to question exclusive formula feeding in resource-rich settings. Here, we describe cART prophylaxis in 3 breastfed infants whose mothers had sustained virologic suppression; all 3 of these infants remained uninfected.

Supporting the developmental health of refugee children and youth.

The Canadian Government has announced that over 50,000 refugees from the Middle East will be resettled in Canada by 2018. More than one-third of these refugees are expected to be children. The Canadian Paediatric Society has called for the Canadian government to prepare for the influx of these children.

We need psychologists!

Paediatricians are more likely than ever to encounter patients with mental health problems on a daily basis. There is a need for investment in proven treatments, such as psychology-based interventions, for children identified with mental health disorders. There are four main arguments supporting the engagement of psychologists for children with mental health problems: there is clear evidence that psychological interventions can effectively treat a wide range of mental health disorders; many parents and children are more open to exploring psychological therapies rather than medication for mental health problems; psychologists are trained and licensed to perform psychoeducational assessments, which can provide invaluable information about a child's learning profile, attention problems and overall intelligence; and behaviour problems in children can be prevented or improved through parent-based interventions.

Housing and sexual health among street-involved youth.

Street-involved youth (SIY) carry a disproportionate burden of sexually transmitted diseases (STD). Studies among adults suggest that improving housing stability may be an effective primary prevention strategy for improving sexual health. Housing options available to SIY offer varying degrees of stability and adult supervision.

Acute neurological findings in a national cohort of neonates with severe neonatal hyperbilirubinemia.

Objective: To describe and compare infants with severe hyperbilirubinemia, who presented with and without abnormal neurological findings and to identify associated risk factors.

Study Design: Data on infants with severe hyperbilirubinemia (>425 μmol l(-1) and/or received exchange transfusion) were collected prospectively through the Canadian Paediatric Surveillance Program (CPSP) from 2002 to 2004. Cases were categorized into two groups on the basis of information provided by the reporting physician: neurologically normal or abnormal.

Immigrant health and the children and youth of Canada: are we doing enough?

Sitting across from me in the crowded examining room of an inner-city Toronto pediatric clinic is a mother, a child and their family friend. The mother and her three-year-old have been in Canada for almost a year, having emigrated from Vietnam (insert virtually any country of origin here) and are currently living in a multi-family dwelling in a well-known area of lower socio-economic status. The mother speaks very little English, and the family friend is attempting to act as interpreter and support person.

High-fidelity simulation in neonatal resuscitation.

Introduction: There are currently few studies describing the use of high-fidelity (hi-fi) simulation in teaching neonatal resuscitation. Traditionally, residents are certified in the neonatal resuscitation program (NRP) after successful completion of a multiple-choice written examination and demonstration of skills during a hands-on 'mega-code'. In the present study, the use of a hi-fi simulation mannequin was compared with a standard plastic mannequin when teaching the megacode portion of the NRP.

False diagnosis of renal agenesis on fetal MRI.

We report a twin pregnancy in which prenatal ultrasound revealed anhydramnios and bilateral absence of the kidneys in both fetuses. To overcome the difficulties faced in obtaining accurate information on fetal ultrasound in cases with oligohydramnios, an attempt was made to use fetal magnetic resonance imaging (MRI) to confirm the renal status. However, while the fetal MRI showed renal agenesis in both twins, postnatal follow-up revealed that one twin, which survived, had a small unilateral kidney not seen antenatally on fetal ultrasound or MRI.

Caroli's disease: prenatal diagnosis, postnatal outcome and genetic analysis.

Caroli's disease is a rare autosomal recessive condition characterized by cystic dilatation of the intrahepatic bile ducts and infantile polycystic kidney disease. We report a case with Caroli's disease detected prenatally at 33 weeks' gestation with fetal ultrasound findings of a cystic liver mass and echogenic kidneys. Postnatal investigation confirmed enlarged and echogenic kidneys with dilatation of the intrahepatic bile ducts consistent with the diagnosis of Caroli's disease.

An active ring X and haploinsufficiency of SHOX contribute to short stature, congenital anomalies, and developmental delay in a female.

We report on a female infant with short stature and mesomelic limb shortening, multiple congenital abnormalities, developmental delay, and Rieger anomaly. Cytogenetic analysis revealed a complex rearrangement of the sex chromosomes in this patient. In addition to a normal X chromosome, a derivative Y [der(Y)] chromosome composed of X and Y material and a ring X [r(X)] were present.

Pregnancy outcome post renal transplantation.

Background: The success in performing organ transplantations and prevention of rejection has resulted not only in a substantial increase in life expectancy, but also improvement in the patients' quality of life. Thus, women who underwent organ transplantation are now reaching puberty and the age of reproduction. This has presented new challenges regarding the teratogenicity and the long-term effect of immunosuppressive medications used by these patients.

Prenatal detection of cerebral lesions in a fetus with tuberous sclerosis.

We report a newborn, diagnosed prenatally with both cardiac rhabdomyomas and a brain tumor. To the best of our knowledge, this is the first report of central nervous system (CNS) lesions detected prenatally in a child with tuberous sclerosis with term follow-up. At 36 months, the child has normal growth and is developing appropriately.

School board survey of attention deficit/hyperactivity disorder: Prevalence of diagnosis and stimulant medication therapy.

Background: Attention deficit/hyperactivity disorder (ADHD), a well described, common problem affecting school-aged children, has an estimated prevalence in Ontario of 7% to 10% of boys and 3% of girls in the age range of four to 11 years. There has been a documented trend to increased use of stimulant medications in the treatment of this disorder in the United States.

Objective: To assess the prevalence of stimulant medication therapy for ADHD in three southern Ontario school boards.

Fetal bilateral subdural haemorrhages. Prenatal diagnosis and spontaneous resolution by time of delivery.

We report a patient diagnosed prenatally on routine fetal ultrasound, at 30 weeks' gestation, with subdural haemorrhage. The mother had suffered a mild abdominal trauma and had Factor XI deficiency; however, both were felt to be aetiologically insignificant. Prenatal follow-up showed a complete resolution of the haematoma and no postnatal sequelae have been noted to date.