3,423 results match your criteria: "Sydney Children's Hospital.[Affiliation]"

Longitudinal study of the manifestations and mechanisms of technology-related prescribing errors in pediatrics.

J Am Med Inform Assoc

January 2025

Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.

Objectives: To examine changes in technology-related errors (TREs), their manifestations and underlying mechanisms at 3 time points after the implementation of computerized provider order entry (CPOE) in an electronic health record; and evaluate the clinical decision support (CDS) available to mitigate the TREs at 5-years post-CPOE.

Materials And Methods: Prescribing errors (n = 1315) of moderate, major, or serious potential harm identified through review of 35 322 orders at 3 time points (immediately, 1-year, and 4-years post-CPOE) were assessed to identify TREs at a tertiary pediatric hospital. TREs were coded using the Technology-Related Error Mechanism classification.

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HLA donor specific antibodies (DSA) are implicated in antibody-mediated rejection (AMR), graft dysfunction and failure in kidney transplant (KT) recipients. Non-HLA antibodies including angiotensin II type 1 receptor (AT1R) may also play a role in AMR, impact graft function and survival. Data is limited in paediatric KT cohorts.

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A growing number of genes have been identified in individuals with cerebral palsy (CP); however, many of these studies have poor compliance with the cerebral palsy clinical description. This systematic review aimed to assess the quality of the cerebral palsy clinical description/phenotype in cerebral palsy genetic studies published between 2010 and 2024 and report clinically relevant genes based on the quality of the cerebral palsy phenotype. An expert panel developed 6 criteria to review the reported cerebral palsy phenotype/description for each included study.

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Antecedent and persistent symptoms in COVID-19 and other respiratory illnesses: Insights from prospectively collected data in the BRACE trial.

J Infect

November 2024

Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Infectious Diseases, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia. Electronic address:

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Article Synopsis
  • Community perception of vaccine safety significantly affects vaccine uptake, prompting a study on how current monitoring practices could be improved.
  • Researchers utilized causal directed acyclic graphs (DAGs) and Bayesian posterior predictive analysis (PPA) to identify biological and behavioral factors impacting post-vaccination survey data.
  • The study revealed that the severity of adverse reactions and healthcare-seeking behaviors influence survey participation, potentially leading to false signal detection when reactions are infrequent but have strong behavioral effects.
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This study aimed to increase our understanding of cardiac activity abnormalities in Prader-Willi Syndrome (PWS) and the relationship between cardiac activity, PWS behaviours thought to be associated with cardiac vagal tone and endogenous oxytocin and vasopressin levels. We compared cardiac activity (respiratory sinus arrhythmia (RSA), low-frequency heart rate variability (LF-HRV), heart period) in 30 adolescents and adults with PWS to 30 typically developing age-matched controls. RSA, LF-HRV, and heart period were lower in individuals with PWS than in the control group.

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  • The study aimed to examine the causes of vaginal bleeding and discharge in prepubescent girls and assessed the effectiveness of vaginoscopy for diagnosis.
  • Conducted over 14 years in two pediatric hospitals in Sydney, the study involved 104 girls who underwent a total of 120 vaginoscopy procedures.
  • Results showed that vaginoscopy provided a positive diagnosis in 43.3% of cases, with common causes including foreign bodies and vulvovaginitis, highlighting its significance in confirming diagnoses and ruling out malignancies.
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Background: Children with cancer or cancer-like disease risk treatment-related isolation, which can negatively impact their peer relationships and social competencies and exacerbate their loneliness. During the COVID-19 pandemic, increased online socialization became the new normal imposed by national isolation guidelines. To adhere to the treatment-related isolation guidelines, children with cancer were offered online classmate "ambassador" visits during hospitalization.

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  • First Nations peoples have a higher risk of getting sick from diseases that vaccines can prevent, partly because they face challenges in healthcare and social issues.
  • During the COVID-19 pandemic, some First Nations people were hesitant to get vaccinated due to past unfair treatment and misinformation.
  • To tackle vaccine hesitancy, researchers studied various strategies in countries like Australia, the USA, Canada, and Guatemala, highlighting the importance of working closely with communities and understanding their needs to improve vaccination rates.
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Background: Advances in our understanding of the genetic basis of childhood cancer, including primary central nervous system cancers, are improving the diagnosis, treatment, and clinical management of pediatric patients. To effectively translate scientific breakthroughs into enhanced clinical care, it is essential we understand and learn from the experiences of patients, families, and health professionals.

Methods: This report summarizes findings from 4 Australian psychosocial substudies exploring the perspectives of patients, parents, clinicians, and scientists participating in research related to childhood cancer genetics.

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  • Pediatric long COVID is still not fully understood, and this study aimed to explore its impact on children and adolescents following the 2021 Delta variant outbreak in Australia.
  • Out of 11,864 surveyed parents, 17.6% responded, with 11.7% of children reporting ongoing symptoms or functional impairment; only a small fraction were classified as having Long COVID.
  • The findings suggest that while most children recover within 12 weeks, a notable minority may experience long-term symptoms, highlighting the need for further attention and research on risk factors like age and previous health issues.
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Objectives: The use of analytic rubrics in assessing and grading students' performance has become more prominent among instructors due to its reliability and validity in ensuring consistency in student evaluation. However, there is limited evidence demonstrating the consistency of examiner judgments between analytic marking rubrics and holistic marking rubrics.

Methods: Therefore, we aimed to compare the consistency of marks given using holistic marking methods and analytic rubrics at an Australian university by analyzing the mean mark differences and number of adjudications between two rubric types as well as the inter-rater reliability between two assessors.

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Systematic Review of the Efficacy and Safety of RSV-Specific Monoclonal Antibodies and Antivirals in Development.

Rev Med Virol

September 2024

Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, Australia.

Article Synopsis
  • Respiratory syncytial virus (RSV) is a major cause of respiratory infections worldwide, prompting the development of vaccines and treatments, particularly for older adults and infants.
  • A systematic review of clinical trials since 2000 identified numerous monoclonal antibodies (mAbs) and antiviral (AV) therapies, revealing promising results for mAbs like nirsevimab and clesrovimab, while AV options like EDP-938 and AK0529 showed early effectiveness.
  • Overall, advancements in vaccines, mAbs, and AV therapies are crucial for reducing the health impact of RSV in the future.
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Background: A collaborative approach is critical in inclusive research and should incorporate taking time to build relationships with co-researchers based on trust and shared understanding. Involvement can often be seen as tokenistic and in order to avoid this, it is important to provide opportunities for people to exercise choice throughout the research process.

Main Body: The current paper outlines learnings from a co-researcher training process for young people with disabilities to identify the ways in which meaningful choice can be facilitated with this group.

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Barriers to access of precision guided therapies for children with high-risk cancer.

Pediatr Blood Cancer

November 2024

School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.

Introduction: Accessing compassionate access schemes to obtain novel therapeutic agents for children with hard-to-treat cancers can be fraught with challenges such as regulatory barriers and limited resources. This study aimed to explore clinician perspectives on the barriers, impacts and ethical considerations of accessing novel therapeutic agents within the context of a paediatric oncology precision medicine trial.

Methods: We gathered data from 37 semi-structured interviews with paediatric oncologists participating in the PRecISion Medicine for Children with Cancer (PRISM) study, a precision medicine clinical trial in Australia.

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Perinatal risk factors of renal outcome in former extremely low birth weight neonates.

Eur J Pediatr

November 2024

Department of Paediatric Nephrology, Sydney Children's Hospital Randwick, Sydney Children's Hospital Network, Randwick, NSW, Australia.

Unlabelled: Former Extremely Low Birthweight (ELBW) neonates suffer from adverse renal and cardiovascular outcomes later in life. Less is known about additional perinatal risk factors for these adverse outcomes which we have investigated in this study. We compared renal outcome between ELBW children and controls, to find perinatal risk factors for poorer renal outcome and to unveil associations between kidney function and blood pressure.

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How to deliver effective paediatric simulation based education.

Paediatr Respir Rev

September 2024

Department of Paediatric Emergency Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia; Clinical Associate Professor, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, NSW, Australia. Electronic address:

Simulation based education (SBE) is an educational tool increasingly used in the approach to the initial and ongoing education of healthcare professionals. Like all education tools, SBE needs to be used appropriately to achieve the desired outcomes. Using Cognitive Load Theory (CLT) in the instructional design of simulations is essential to maximise participant learning by reducing extraneous load and optimising intrinsic load.

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Background: Button battery (BB) exposures are common in children and can have devastating consequences. We reviewed current evidence on the complications associated with BB exposure and identified predictors of outcomes using individual patient-level data.

Data Sources: We carried out a systematic review and pooled analysis by searching MEDLINE, Embase, and Scopus up to May 19, 2023.

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From 1 January 2020 to 31 December 2021, thirty-eight institutions across Australia submitted data to the Australian Group on Antimicrobial Resistance (AGAR) from patients aged < 18 years (AGAR-Kids). Over the two years, 1,679 isolates were reported from 1,611 patients. This AGAR-Kids report aims to describe the population of children and adolescents with bacteraemia reported to AGAR and the proportion of resistant isolates.

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  • There is a significant need for clinical trials that include infants, children, and adolescents to ensure evidence-based care; this communication discusses three different trial design strategies to address this issue.
  • The three strategies include sequential, parallel, and unified adult-pediatric Bayesian adaptive designs, which allow for better integration of pediatric populations into clinical research.
  • The unified design, exemplified by the SNAP trial, utilizes Bayesian hierarchical models to share data across age groups, enhancing accuracy in assessing treatment safety and efficacy for both children and adults.
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  • Diagnostic genomic sequencing is becoming essential in nephrology, with efforts to enhance its national implementation to benefit patient outcomes.
  • A national study established 20 kidney genetics clinics across Australia from 2013 to 2022, offering genomic testing for patients with suspected monogenic kidney diseases and facilitating the collection of data on diagnostic experiences.
  • The initiative successfully integrated a multidisciplinary approach to kidney genetics, optimizing care for patients while adapting to ongoing technological advancements and preparing for broader healthcare funding for genomic testing.
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Purpose: To explore (i) the impact of unmet social needs on children with cerebral palsy and their families; (ii) enablers-, and (iii) barriers to addressing unmet social needs.

Material And Methods: Eligible participants attended or worked at one of the three Paediatric Rehabilitation Departments including: children with a diagnosis of cerebral palsy; parents/carers; and clinicians. One-on-one interviews were conducted with parents/carers and focus groups with clinicians.

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The KidGen Collaborative's Policy Implementation Workshop 2023 celebrated the 10th anniversary of Australia's first kidney genetics clinic in Brisbane. This event marked the establishment of a national network now comprising 19 kidney genetics clinics across Australia, all dedicated to providing equitable access to genomic testing for families affected by genetic kidney diseases. The workshop reflected on past progress and outlined future objectives for kidney genetics in Australia, recognising the collaborative efforts of clinical teams, researchers, and patients.

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  • Respiratory syncytial virus (RSV) is a major cause of serious respiratory infections in young children, leading to many hospitalizations, but recent treatments like nirsevimab show promise in preventing these issues.
  • Nirsevimab, a monoclonal antibody, offers protection for at least 5 months and has been shown to significantly reduce hospital stays due to RSV in clinical trials and real-world data, with effectiveness rates ranging from 62.1% to 90%.
  • Successful implementation strategies for nirsevimab include seasonal administration for infants and contingency plans for those born before RSV season; however, careful consideration of cost and logistics is necessary for widespread usage.
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Early onset medullary thyroid carcinoma, later pheochromocytomas, and nonspecific extra-endocrine features (hypermobility and persistent constipation) are part of the clinical phenotype of Multiple Endocrine Neoplasia type 2B (MEN2B). A de novo pathogenic M918T variant in the rearranged during transfection proto-oncogene is usually identified. Affected children are often seen by multiple clinicians over a long period before consideration of a diagnosis of MEN2B, with metastatic medullary thyroid carcinoma often the precipitator.

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