"You need to be supported": An integrative review of nurses' experiences after death in neonatal and paediatric intensive care.

Background: The death of a child can have a profound impact on critical care nurses, shaping their professional practice and personal lives in diverse, enduring ways. Whilst end-of-life care is recognised as a core component of critical care nursing practice and a research priority, evidence about nurses' experiences after death in neonatal and paediatric intensive care is poorly understood.

Research Question: What is the experience of the nurse after death of a patient in neonatal and/or paediatric intensive care?

Method: Following registration with Open Science Framework, an integrative review of the empirical literature was undertaken.

Lung Point of Care Ultrasound (POCUS) in Cardiorespiratory Physiotherapy and Respiratory Therapy Practices: Current Status and Future Directions.

Lung Point of Care Ultrasound (POCUS) strongly influences physiotherapy and respiratory therapy clinical decision-making in the intensive care unit (ICU). The uptake of Lung POCUS training by physiotherapists and respiratory therapists is low in some countries, often due to many barriers to its implementation. The safe and appropriate integration of Lung POCUS into physiotherapy and respiratory therapy clinical practice may be achieved by various means.

Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital.

Background: Rapid Response Systems are hospital-wide patient-focused systems aiming to improve recognition of acute deterioration in patients and trigger a rapid response aimed at preventing potentially avoidable adverse events such as cardiac arrest and death. In 1994, the Royal Children's Hospital in Brisbane, Australia, was one of the first institutions to adopt a paediatric rapid response system (RRS). The purpose of this study was to investigate the impacts of both introduction of a paediatric RRS and increasing RRS activations (MET dose) on hospital mortality.

Compassionate access to virus-specific T cells for adoptive immunotherapy over 15 years.

Adoptive T-cell immunotherapy holds great promise for the treatment of viral complications in immunocompromised patients resistant to standard anti-viral strategies. We present a retrospective analysis of 78 patients from 19 hospitals across Australia and New Zealand, treated over the last 15 years with "off-the-shelf" allogeneic T cells directed to a combination of Epstein-Barr virus (EBV), cytomegalovirus (CMV), BK polyomavirus (BKV), John Cunningham virus (JCV) and/or adenovirus (AdV) under the Australian Therapeutic Goods Administration's Special Access Scheme. Most patients had severe post-transplant viral complications, including drug-resistant end-organ CMV disease, BKV-associated haemorrhagic cystitis and EBV-driven post-transplant lymphoproliferative disorder.

Treatment regimens and glycaemic outcomes in more than 100 000 children with type 1 diabetes (2013-22): a longitudinal analysis of data from paediatric diabetes registries.

Background: Advances in paediatric type 1 diabetes management and increased use of diabetes technology have led to improvements in glycaemia, reduced risk of severe hypoglycaemia, and improved quality of life. Since 1993, progressively lower HbA targets have been set. The aim of this study was to perform a longitudinal analysis of HbA, treatment regimens, and acute complications between 2013 and 2022 using data from eight national and one international paediatric diabetes registries.

RANZCP Position Statement 46: A missed opportunity to provide sophisticated guidance on asylum seeker and refugee policy.

Objective: To stimulate discussion on how the RANZCP can contribute more constructively to the debate over Australia's immigration policies.

Conclusions: Updated in March 2024, RANZCP Position Statement 46, titled: 'The provision of mental health services for asylum seekers and refugees', continues the College's advocacy for a compassionate stance towards asylum seekers and refugees on the grounds of preventing or improving their mental health. College statements over the last decade have raised concerns about policies that are designed to deter boat arrivals; and recently, have endorsed the High Court's NZYQ decision to mandate community release of detained non-Australian citizens deemed to have failed 'the character test' under the .

Hyperlactataemia Following Crystalloid Cardiopulmonary Bypass Priming in Paediatric Cardiac Surgery-Benign or Malignant? A Retrospective Study.

Background: Various mechanisms leading to early hyperlactataemia post-cardiac surgery have been postulated. Specifically, in the paediatric population, benign early hyperlactataemia may be associated with crystalloid priming in the cardiopulmonary bypass circuit. The aim of this study was to review paediatric patients who had crystalloid prime and assess their outcomes.

The potential effects of climate change on non-cystic fibrosis bronchiectasis in children.

Climate change may have devastating effects on the pathogenesis of non-cystic fibrosis bronchiectasis in children since it affects the biological cycle of the respiratory pathogens and alters the human respiratory defense mechanisms. Bronchiectasis in children has been identified as an emerging global epidemic that has attracted the attention of the medical community over recent years. Pediatric pulmonologists should be aware of the consequences of climate change on children with bronchiectasis and plan strategies to ameliorate these effects.

Outcomes after hospital discharge in children requiring post-cardiotomy extracorporeal membrane oxygenation: A binational retrospective cohort study.

Objectives: To describe longer-term survival and morbidity outcomes after hospital discharge in a binational cohort of children who required extracorporeal membrane oxygenation after cardiac surgery.

Methods: This was a retrospective cohort study from the Australia and New Zealand Congenital Outcomes Registry for Surgery database. All patients younger than 18 years of age (n = 12,290) undergoing pediatric cardiac surgical procedures between January 1, 2013, and December 31, 2021, who required post-cardiotomy extracorporeal membrane oxygenation in the same admission were included.

Neurodevelopmental follow-up care pathways and processes for children with congenital heart disease in Australia.

Background: International consensus exists for neurodevelopmental follow-up care of children with congenital heart disease (CHD) to support timely intervention for developmental delays. Yet, documentation of how this care is implemented in Australia is lacking. This study aimed to identify, categorise, and understand care pathways and services supporting neurodevelopmental follow-up of Australian children with CHD.

Management of detected syphilis in pregnancy adheres to guideline recommendations, but the crisis of congenital syphilis persists.

Background: Infectious syphilis among women of reproductive age continues to rise in many countries including Australia, with a resultant increase in congenital syphilis. In response, new guidelines for management of syphilis in pregnancy were published in Queensland, Australia in 2018.

Aims: This study evaluates the management of women diagnosed with syphilis in pregnancy in South-East Queensland (SEQ) after release of this guideline.

A contemporary analysis of the Australian clinical and genetic landscape of spinal muscular atrophy: a registry based study.

Background: New paradigms of diagnosis and treatment have changed the neurodegenerative trajectory for individuals with spinal muscular atrophy (SMA). Registries are a critical tool to provide real-world data on treatment patterns, their effects and health care provision within this evolving paradigm of care. This study aimed to evaluate the phenotypic and genotypic landscape, treatment patterns and health impact of SMA in Australia through the national registry.

Second Opinion Seeking in Paediatric Oncology: Motivations and Predictors.

Introduction: This study investigated the prevalence, methods and factors leading carers of childhood cancer patients to seek second opinions.

Methods: A prospective, questionnaire-based study was conducted among families attending oncology clinics at Sydney Children's Hospital, Randwick. Participants were asked whether they had sought a second opinion for their child and if so, their motivations.

Impact of time to antibiotics on clinical outcome in paediatric febrile neutropenia: a target trial emulation of 1685 episodes.

Background: Prompt antibiotic administration for febrile neutropenia (FN) is standard of care, and targets of time to antibiotics (TTA) <60 min are common. We sought to determine the effect of TTA ≥60 versus <60 min on adverse outcomes (intensive care unit (ICU) admission or death) in children with cancer and FN. Effect modification by a decision rule that predicts infection (AUS-rule) and bacteraemia were also investigated.

Upregulation versus loss of function of NTRK2 in 44 affected individuals leads to 2 distinct neurodevelopmental disorders.

Purpose: Heterozygous pathogenic variants in NTRK2 (HGNC: 8032) have been associated with global developmental delay. However, only scattered cases have been described in small or general studies. The aim of our work was to consolidate our understanding of NTRK2-related disorders and to delineate the clinical presentation.

Perceptions of service providers on available care for paediatric feeding disorder: A survey study.

Aim: This study aimed to describe current strengths and gaps in services for children with feeding needs in Southeast Queensland, Australia from the perspective of key professionals involved in service design and provision.

Methods: A web-based survey was distributed to health professionals involved in providing services to children with feeding needs, staff who triaged/managed referrals, and/or service team leaders in Southeast Queensland.

Results: There were 79 responses to the survey, with 61 of these responses included in the analysis.

Caregiver experiences of oral feeding in infants on long-term high flow nasal cannula support.

Purpose: Navigating the feeding journey of medically complex infants on long-term high flow nasal cannula support can be challenging for caregivers, especially given inconsistencies in clinical practice for oral feeding on high flow nasal cannula support. The aim of this study was to explore the perspectives of caregivers who have experienced this journey, to inform best practice care.

Method: This study used a generic qualitative inquiry approach.