National surveillance of severe microcephaly in Australia.

IntroductionAustralian and international clinical practice guidelines are available for common paediatric conditions. Yet there is evidence that there are substantial variations between the guidelines, recommendations (appropriate care) and the care...

IntroductionFrequent asthma attacks in children result in unscheduled hospital presentations. Patient centered care coordination can reduce asthma hospital presentations. In 2016, The Sydney Children's Hospitals Network launched the Asthma Follow up Integrated Care Initiative with the aim to reduce pediatric asthma emergency department (ED) presentations by 50% through developing and testing an integrated model of care led by care coordinators (CCs).MethodsThe integrated model of care was developed by a multidisciplinary team at Sydney Children's Hospital Randwick (SCH,R) and implemented in two phases: Phase I and Phase II. Children aged 2–16 years who presented ≥4 times to the ED of the SCH,R in the preceding 12 months were enrolled in Phase I and those who had ≥4 ED presentations and ≥1 hospital admissions with asthma attack were enrolled in Phase II. Phase I included a suite of interventions delivered by CCs including encouraging parents/carers to schedule follow-up visits with GP post-discharge, ensuring parents/carers are provided with standard asthma resource pack, offering referrals to asthma education sessions, sending a letter to the child's GP advising of the child's recent hospital presentation and coordinating asthma education webinar for GPs. In addition, in Phase II CCs sent text messages to parents/carers reminding them to follow-up with the child's GP. We compared the change in ED visits and hospital admissions at baseline (6 months pre-enrolment) and at 6-and 12-months post-enrolment in the program.ResultsDuring December 2016-January 2021, 160 children (99 in Phase I and 61 in Phase II) were enrolled. Compared to baseline at 6- and 12-months post-enrolment, the proportion of children requiring ≥1 asthma ED presentations reduced by 43 and 61% in Phase I and 41 and 66% in Phase II. Similarly, the proportion of children requiring ≥1 asthma hospital admissions at 6- and 12-months post-enrolment reduced by 40 and 47% in Phase I and 62 and 69% in Phase II.ConclusionOur results support that care coordinator led integrated model of asthma care which enables integration of acute and primary care services and provides families with asthma resources and education can reduce asthma hospital presentations in children.

Cough augmentation techniques are taught by health-care providers to improve secretion clearance and to help prevent respiratory infections in children with neuromuscular disease. There is some evidence of the effectiveness of a manually assisted cough when applied by health-care providers. However, it is unknown whether parents and caregivers may also be effective in applying manually assisted cough. The aim of this study was to evaluate whether parents and caregivers are effective at applying a manually assisted cough to a child with neuromuscular disease after being taught by a health-care provider. For this prospective cohort study, children and their parents or caregivers were recruited from neuromuscular clinics in the Sydney Children's Hospitals Network. Cough peak flow was the outcome measure for the strength of the child's cough. Children were eligible to participate if their unassisted cough peak flow at baseline was <270 L/min. Parents and caregivers were taught a manually assisted cough by a physiotherapist before being measured. The cough peak flow was measured in the following order: (1) during an unassisted cough as baseline, (2) during a manually assisted cough performed by a physiotherapist, (3) during a manually assisted cough performed by a parent or caregiver, and (4) during an unassisted cough after intervention. Twenty-eight children (24 boys, 4 girls; mean ± SD age, 12 ± 3 y) completed the study. No clinically or statistically significant changes were found in the cough peak flow after the application of a manually assisted cough by parents or caregivers (95% CI -11 to 11 L/min) or by physiotherapists (95% CI -6 to 14 L/min). Parents and caregivers and health-care providers were ineffective at increasing cough peak flow in children with neuromuscular weakness when applying a manually assisted cough. A single training session was insufficient for a parent or caregiver to be able to apply a manually assisted cough effectively on his or her child with neuromuscular weakness. Further research is warranted to guide recommendations on how best to equip parents and caregivers with the skills to help manage children with neuromuscular disease.

To explore the lived experiences of pain in children and young people with cerebral palsy (CP). Participants were recruited from the Sydney Children's Hospitals Network and the New South Wales/Australian Capital Territory CP Registers. Inclusion criteria were as follows: CP; aged 9 to 17 years; current/past experience of pain; fluent in English; no greater than mild intellectual disability. Purposive sampling ensured representation across age, motor subtypes, and Gross Motor Function Classification System (GMFCS) levels. Semi-structured face-to-face interviews were conducted. Data were analysed following an interpretative phenomenological approach. Ten participants (three male) were included (mean age 14y 5mo, SD 2y), GMFCS levels I (n=4), II (n=3), III (n=2), and IV (n=1). Analysis led to three superordinate themes: (1) Everybody's experience of pain is different; (2) When the pain is winning; (3) 'I know how to deal with it'. Pain contributors and locations varied between children. Pain intruded on school, physical activity, and psychosocial functioning. Children described personalized strategies used to deal with pain. In this study, children self-reported highly individualized pain experiences which interfered with their daily life and psychosocial well-being. There is a need for improvement in pain assessment and a personalized approach to pain management.

IntroductionThis article presents an overview of a prospective randomised controlled non-inferiority study designed to evaluate the safety and effectiveness of non-operative management (NOM) with operative management in children with acute...

The Providing Enhanced Access to Child Health Services (PEACH) initiative at the Sydney Children’s Hospitals Network (SCHN) aims to reduce inequity in healthcare access and outcomes for priority population children and young people (including Aboriginal and/or Torres Strait Islander, culturally and linguistically diverse, from refugee or asylum seeker backgrounds, living in out-of-home care or recipients of the National Disability Insurance Scheme). Central to PEACH is active children and caregivers engagement through co-design, recognising the importance of understanding their experiences to facilitate enhanced healthcare provision. This qualitative study explored the experiences of priority population children and caregivers at SCHN before the implementation of PEACH initiatives, with the aim of identifying strengths, limitations, and recommendations for enhancing healthcare services tailored to priority population needs. Guided by an experience-based co-design methodology, 28 qualitative semi-structured interviews were carried out with a total of 38 participants from priority population group(s) who had accessed care at SCHN. The data were analysed via inductive thematic analysis. The findings are presented through the lens of the concept of identity, delineated into personal and social identity. Personal identity is related to person before problem and demography, while social identity is linked to cultural responsiveness. Participants emphasised both the significance of social identities in health service design, and the importance of an individualised approach that recognises and respects their unique personal identities within the broader social context. This research advocates for a person-centred approach to healthcare delivery that recognises and responds to the dynamic interconnected relationship between personal and social identities.

For 30 years the Australian Paediatric Surveillance Unit (APSU) has conducted national surveillance of rare communicable diseases and rare complications of communicable diseases. In this report, we describe the results of thirteen such studies surveyed by the APSU in 2022, including reported case numbers and incidence estimates, demographics, clinical features, management and short-term outcomes. Conditions described are: acute flaccid paralysis (AFP); congenital cytomegalovirus (cCMV); neonatal and infant herpes simplex virus (HSV) infection; perinatal exposure to human immunodeficiency virus (HIV) and paediatric HIV infection; severe complications of influenza; juvenile-onset recurrent respiratory papillomatosis (JoRRP); congenital rubella infection/syndrome; congenital varicella syndrome (CVS) and neonatal varicella infection (NVI); and the new conditions dengue; Q fever; and severe acute hepatitis. In 2022, cases of severe complications of influenza were reported to the APSU for the first time since 2019. This likely reflects the easing of government-mandated restrictions imposed in 2020-2021 to curb the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the re-emergence of a range of infectious diseases. As previously, AFP surveillance by the APSU contributed to Australia achieving a minimum target incidence of one AFP case per 105 children aged less than 15 years. Cases of JoRRP and NVI were reported in 2022. This indicates potential gaps in human papillomavirus (HPV) and varicella vaccination coverage respectively, especially in high-risk groups such as young migrant and refugee women of childbearing age from countries without universal vaccination programs. Paediatric HIV case numbers resulting from mother-to-child-transmission (MTCT) of HIV remain low in Australia due to use of effective intervention strategies. However, there has been an increase in the number of imported cases of HIV in children (mainly perinatally-acquired) from countries with a high HIV prevalence. Without effective vaccines, there has been no decline in the incidence of congenital CMV and neonatal HSV, indicating the importance of early identification and management to reduce morbidity and mortality. The first cases of dengue, Q fever and severe acute hepatitis were received by APSU in 2022, including two cases of acute hepatitis in which aetiology has not been confirmed to date. The APSU has an important ongoing role in monitoring rare childhood infections.

The Australian Paediatric Surveillance Unit (APSU), through active surveillance, collects information on the epidemiology of rare or uncommon childhood conditions. This research resource allows paediatricians to collaborate at State, national and international levels. The APSU sends a monthly report card to all (currently 971) paediatricians in Australia, who in turn indicate whether or not they have seen a patient in the last month with any of the conditions listed (98% response rate in 1999). Study investigators, notified by the APSU of positive case reports, obtain demographic and clinical data on the patient from the reporting doctor by postal questionnaire (90% response rate in 1999). Since 1993, the APSU has monitored 27 conditions, including conditions that are vaccine-preventable, otherwise infectious, genetic, congenital and non-communicable. Information collected is disseminated to paediatricians and other health professionals via an annual report, newsletters and publications and is made available to the International Network of Paediatric Surveillance Units. Information provided by the APSU has raised awareness among paediatricians of rare and uncommon childhood conditions, and has been used by health authorities for planning of prevention and intervention strategies and allocation of health resources.

Medical Journal of AustraliaVolume 2, Issue 26 p. 1169-1172 Original Article EFFECTS OF THE ANTIMALARIAL DRUGS PROGUANIL AND CHLOROQUINE ON HEAT TOLERANCE F. A. Beasley, F. A. Beasley Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsTechnical Officer.Search for more papers by this authorG. M. Budd M.D., B.S., G. M. Budd M.D., B.S. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsLecturer in Environmental Health.Search for more papers by this authorG. M. Galvin B.Sc., G. M. Galvin B.Sc. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsCaptain, R.A.A.M.C.Search for more papers by this authorK. E. Hicks M.B., B.S., K. E. Hicks M.B., B.S. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsMedical Officer.Search for more papers by this authorR. K. Macpherson M.Sc., M.D., B.S., M.R.A.C.P., R. K. Macpherson M.Sc., M.D., B.S., M.R.A.C.P. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsProfessor of Environmental Health.Search for more papers by this authorJ. A. Welch H.S.E., A.S.T.C., A.M.I.E., J. A. Welch H.S.E., A.S.T.C., A.M.I.E. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsScientific Officer.Search for more papers by this author F. A. Beasley, F. A. Beasley Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsTechnical Officer.Search for more papers by this authorG. M. Budd M.D., B.S., G. M. Budd M.D., B.S. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsLecturer in Environmental Health.Search for more papers by this authorG. M. Galvin B.Sc., G. M. Galvin B.Sc. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsCaptain, R.A.A.M.C.Search for more papers by this authorK. E. Hicks M.B., B.S., K. E. Hicks M.B., B.S. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsMedical Officer.Search for more papers by this authorR. K. Macpherson M.Sc., M.D., B.S., M.R.A.C.P., R. K. Macpherson M.Sc., M.D., B.S., M.R.A.C.P. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsProfessor of Environmental Health.Search for more papers by this authorJ. A. Welch H.S.E., A.S.T.C., A.M.I.E., J. A. Welch H.S.E., A.S.T.C., A.M.I.E. Department of Environmental Health, School of Public Health and Tropical Medicine, University of Sydney, and 1 Malaria Research Laboratory, Royal Australian Army Medical CorpsScientific Officer.Search for more papers by this author First published: 01 December 1968 https://doi.org/10.5694/j.1326-5377.1968.tb83503.x AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume2, Issue26December 1968Pages 1169-1172 RelatedInformation

The Australian Paediatric Surveillance Unit (APSU) conducts national active surveillance of rare diseases of childhood, including infectious and vaccine preventable diseases, genetic disorders, childhood injuries and mental health conditions. Studies of communicable and vaccine-preventable diseases are supported by the Australian Government Department of Health and Ageing through its communicable diseases program. This report is a summary of surveillance results for communicable and/or vaccine preventable diseases studied through the APSU in 2005.

This thesis explores the intersections of ubiquitous technologies, embedded democracies,&#13;\nand bright green futures and how that is resolved in a user interface design for a citizen centric&#13;\nmobile phone application.&#13;\nMy main question of enquiry is: How can I connect citizens to their local environment through&#13;\nhuman interface design on a mobile platform? The Politics of Nature by Bruno Latour&#13;\nproposes;&#13;\n‘An end to the old dichotomy between nature and society... of a collective, a&#13;\ncommunity incorporating humans and non humans and building on the&#13;\nexperiences of the sciences as they are actually practiced.’ (Latour, 2004, p.&#13;\n186-206).&#13;\nDesign research throughout this thesis explores the intersections of urban health, human&#13;\ninterface design, captology, mobile and sensor technology and citizen science while proposing&#13;\nan interactive mobile application for local and national governments to engage with an&#13;\nincreasingly urban and technological savvy agora.&#13;\nThe aim of the accompanying mobile application prototype titled Tune In, Share Out (TISO),&#13;\ngives access to air and water quality information coupled with a mobile air quality sensor&#13;\ndevice which enables urban citizens to directly participate in the concept of the quantified self&#13;\n(Fawkes, 2010) by monitoring their pollution paths, while sharing this information through their&#13;\nrespective social networks within a mobile mapping platform.&#13;\nConcurrently this project contributes air quality information to aid citizens, scientists and city&#13;\nplanners to make more informed and sustainable decisions within their local environment and&#13;\nagora.&#13;\nBenefits of this application include citizen and environmental interaction and awareness, the&#13;\nability for local government and citizens to enhance their tacit and embodied knowledge of&#13;\nrespective groups and individual’s, enabling greater understanding of each others perspective,&#13;\nwhile offering a channel of participation to an otherwise silent segment of society.

Journal of Clinical PeriodontologyVolume 50, Issue S25 p. 4-4 INVITED EDITORIAL Editorial: Core outcome sets and measures for clinical trials in implant dentistry Lisa Heitz-Mayfield, Corresponding Author Lisa Heitz-Mayfield [email protected] orcid.org/0000-0001-5755-8265 International Research Collaborative, Oral Health and Equity, School of Human Anatomy and Biology, The University of Western Australia, Crawley, WA, Australia Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The university of Sydney, Sydney, NSW, Australia Correspondence Panos N. Papapanou, Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, 630 W 168th Street, PH-7E-110, New York, NY 10032, USA. Email: [email protected] Lisa Heitz-Mayfield, International Research Collaborative, Oral Health and Equity, School of Human Anatomy and Biology, The University of Western Australia, Crawley, WA, Australia. Email: [email protected]Search for more papers by this authorPanos N. Papapanou, Corresponding Author Panos N. Papapanou [email protected] orcid.org/0000-0002-6538-3618 Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA Correspondence Panos N. Papapanou, Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, 630 W 168th Street, PH-7E-110, New York, NY 10032, USA. Email: [email protected] Lisa Heitz-Mayfield, International Research Collaborative, Oral Health and Equity, School of Human Anatomy and Biology, The University of Western Australia, Crawley, WA, Australia. Email: [email protected]Search for more papers by this author Lisa Heitz-Mayfield, Corresponding Author Lisa Heitz-Mayfield [email protected] orcid.org/0000-0001-5755-8265 International Research Collaborative, Oral Health and Equity, School of Human Anatomy and Biology, The University of Western Australia, Crawley, WA, Australia Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The university of Sydney, Sydney, NSW, Australia Correspondence Panos N. Papapanou, Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, 630 W 168th Street, PH-7E-110, New York, NY 10032, USA. Email: [email protected] Lisa Heitz-Mayfield, International Research Collaborative, Oral Health and Equity, School of Human Anatomy and Biology, The University of Western Australia, Crawley, WA, Australia. Email: [email protected]Search for more papers by this authorPanos N. Papapanou, Corresponding Author Panos N. Papapanou [email protected] orcid.org/0000-0002-6538-3618 Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA Correspondence Panos N. Papapanou, Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, 630 W 168th Street, PH-7E-110, New York, NY 10032, USA. Email: [email protected] Lisa Heitz-Mayfield, International Research Collaborative, Oral Health and Equity, School of Human Anatomy and Biology, The University of Western Australia, Crawley, WA, Australia. Email: [email protected]Search for more papers by this author First published: 26 May 2023 https://doi.org/10.1111/jcpe.13810 This manuscript was simultaneously and jointly published in the Journal of Clinical Periodontology and Clinical Oral Implants Research Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume50, IssueS25Supplement: The Implant Dentistry Core Outcome Set and Measurement (ID‐COSM) International Consensus ReportMay 2023Pages 4-4 RelatedInformation

This annual report provides an update on the surveillance conducted by the Australian Paediatric Surveillance Unit (APSU) during the period January to December 2017. Nine communicable diseases and complications were under surveillance by APSU in 2017. This report highlights key findings from studies on: acute flaccid paralysis (AFP); congenital cytomegalovirus (cCMV) infection, neonatal herpes simplex virus (HSV) infection, perinatal exposure to human immunodeficiency virus (HIV) and paediatric HIV infection, juvenile onset recurrent respiratory papillomatosis (JoRRP), severe complications of influenza (undertaken during the influenza season June to September 2017), microcephaly, which is monitored in relation to the emergence of Zika virus infection, congenital rubella infection and congenital varicella syndrome and neonatal varicella infection.

The Australian Paediatric Surveillance Unit (APSU) conducts national active surveillance of rare diseases of childhood, including infectious and vaccine preventable diseases, genetic disorders, childhood injuries and mental health conditions. The study of communicable and vaccine preventable diseases is supported in part by the Australian Government Department of Health and Ageing through its communicable diseases program. This report is a summary of surveillance results for communicable and/or vaccine preventable diseases studied through the APSU in 2006

This report provides an update on the surveillance conducted by the Australian Paediatric Surveillance Unit (APSU) during the period 1 January to 31 December 2012. The APSU, now in its 20th year of operation, continues to facilitate national active surveillance of uncommon communicable diseases of childhood. In 2012, the APSU conducted national surveillance for acute flaccid paralysis (AFP), congenital cytomegalovirus (cCMV), congenital rubella, perinatal exposure to HIV and HIV infection, neonatal herpes simplex virus (HSV) infection, congenital and neonatal varicella, severe complications of varicella and juvenile onset recurrent respiratory papillomatosis (JoRRP). Surveillance for the severe complications of influenza was undertaken during the influenza season June to September.