Childhood Hospitalization Research Articles

Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study

ObjectiveTo investigate the moderating effects of socio-demographic social determinants of health (SDH) in the relationship between types of childhood hospitalisation (ie, none, injury, non-injury, injury+non-injury) and academic performance.Design, setting and...

Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK

BackgroundResearch consistently finds poorer health and educational outcomes for children who have experienced out-of-home care relative to the general population. Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care. Children receiving social services interventions often experience Adverse Childhood Experiences (ACEs), and deprivation, which are known to negatively impact outcomes. We aimed to estimate the association of different social services interventions with educational outcomes and hospital admissions, while adjusting for ACEs and deprivation.MethodsWe linked retrospective, routinely collected administrative records from health, education, and social care to create a cohort via the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK. We analysed data for children and household members (N = 30,439) across four different groups: [1] no social care intervention; [2] children in need but not in care (CIN); [3] children on the Child Protection Register but not in care (CPR); [4] children in care - i.e. removed from the family home and looked after by the local authority (CLA). Our primary outcome was education outcomes at age 16 years. Secondary outcomes were all cause emergency hospital admissions, and emergency admissions for external causes/injuries.ResultsChildren in receipt of social services intervention were more likely to not attain the expected level upon leaving statutory education at age 16 after adjusting for ACEs and other characteristics (for children who had been in out-of-home care (conditional OR: 1·76, (95%CI) 1·25 − 2·48), in need (2·51, 2·00–3·15) and those at risk (i.e., on the child protection register) (4·04, 2·44 − 6·68). For all-cause emergency admissions, all social care groups were at greater risk compared to children in the general population (children in care (conditional HR: 1·31, 1·01–1·68), children in need (1·62, 1·38 − 1·90), and children at risk (1·51, 1·11 − 2·04).ConclusionsAll groups receiving social service intervention experience poorer educational and health outcomes than peers in the general population. Children who remain with their home parents or caregivers but are identified as ‘in need’ or ‘at risk’ by social care practitioners require further research. Integrated support is needed from multiple sectors, including health, educational and social care.

Hidradenitis Suppurativa and Maternal and Offspring Outcomes

Hidradenitis suppurativa (HS) is associated with morbidity in persons of reproductive age, but the effect on maternal and offspring outcomes is understudied. To determine the association of HS with pregnancy outcomes and maternal and child morbidity in the long term. This population-based longitudinal cohort study with up to 16 years of follow-up took place between 2006 and 2022 in Quebec, Canada. . Maternal HS. Outcomes included hypertensive disorders of pregnancy, gestational diabetes, and other birth outcomes as well as the long-term risk of hospitalization up to 16 years after delivery. The study used adjusted log-binomial and Cox proportional hazards regression models to estimate the association between maternal HS and pregnancy outcomes or hospitalization following pregnancy. Outcomes in both mothers and offspring were assessed. There were 1 324 488 deliveries during the study, including 1332 (0.1%) among mothers with HS. Compared with patients without HS, patients with HS had a greater risk of hypertensive disorders of pregnancy (risk ratio [RR], 1.55 [95% CI, 1.29-1.87]), gestational diabetes (RR, 1.61 [95% CI, 1.40-1.85]), and severe maternal morbidity (RR, 1.38 [95% CI, 1.03-1.84]). In neonates, maternal HS was associated with risk of preterm birth (RR, 1.28 [95% CI, 1.07-1.53]) and birth defects (RR, 1.29 [95% CI, 1.07-1.56]). In the long term, HS was associated with 2.29 times the risk of maternal hospitalization (95% CI, 2.07-2.55) and 1.31 times the risk of childhood hospitalization (95% CI, 1.18-1.45), including hospitalization for respiratory, metabolic, psychiatric, and immune-related morbidity over time. This cohort study found that HS is associated with adverse maternal and offspring outcomes in the peripartum period and in the long term. Early detection and management of HS may help mitigate these outcomes.

Burden of Illness Associated With Respiratory Syncytial Virus, Influenza, and Coronavirus Disease 2019 in Infants and Young Children in Ontario, Canada, 2018-2023: A Population-Based Canadian Immunization Research Network Study.

As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transitions to endemicity and respiratory syncytial virus (RSV) and influenza reestablish their seasonal circulation patterns, understanding their comparative burden on infants and children can guide health system responses and funding priorities. This was a population-based cohort study of children aged <5 years in Ontario, Canada, from September 2018 to August 2023 using linked health administrative databases. Seasonal cohorts comprised 731 838 to 763 660 children. RSV- and influenza-related hospital admission rates immediately decreased in March 2020. In 2021-2022, RSV-related admissions rebounded but remained 8%-11% lower than prepandemic seasons, whereas 2022-2023 RSV-related admissions increased 105%-113% versus prepandemic seasons and peak admissions occurred in November versus December. Influenza did not rebound until 2022-2023, when admissions were 28%-37% higher than prepandemic seasons. Coronavirus disease 2019 (COVID-19)-related admissions remained low until 2021-2022 and were lower than RSV-related admissions across all age groups during prepandemic and pandemic seasons. By contrast, 2021-2022 COVID-19-related admissions exceeded prepandemic influenza-related admissions by 30%-40% but decreased by 45% in 2022-2023 and were lower than prepandemic influenza-related admissions, except among infants aged <12 months who remained at highest risk. There was no distinct seasonal pattern for COVID-19-related admissions during the study. RSV remains a major cause of childhood hospitalization. Although COVID-19 appears to be receding, its disease burden as it transitions to endemicity remains to be established. The unprecedented peaks in RSV-related hospital admissions during 2022-2023, together with the return of influenza and ongoing SARS-CoV-2 transmission, underscore the need to strengthen systems for real-time surveillance and to proactively prepare for critical healthcare scenarios.

Predicting Mental Health Hospitalizations Among First Nations Adults in Residential Treatment

Indigenous peoples in Canada experience disproportionately higher rates of hospitalization for mental health and substance use concerns than non-Indigenous populations. Ambulatory care sensitive conditions are community-level markers of mental illness which can theoretically be managed through community-based health services, and therefore should not require urgent care services. Previous mental health related ambulatory sensitive conditions have included psychotic and mood disorders; however, limited research has explored these relationships of increased hospitalization among specific health disorders with Indigenous populations. This study analyzed predictors of prior mental health hospitalizations among a predominately First Nations population seeking residential treatment for substance use. We hypothesized that increased co-morbid mental health concerns would predict increased hospitalizations for mental health concerns, and this relationship would be moderated by higher Adverse Childhood Experience (ACE) scores. Logistic regression showed that for every increase in each reported mental health concern, the odds of prior hospitalization was 1.6 times higher among this sample, although ACEs did not moderate this relationship. Participants with depressive, anxiety-related, psychotic, and personality-related disorders reported proportionally more hospitalization. Although study results suggest ACEs are not a useful predictor of hospitalization, their presence has previously shown to exacerbate co-morbid concerns, and thus, may influence prior hospitalization history indirectly. Further research can explore relationships between exposure to childhood trauma and hospitalization, particularly in consideration of access to tertiary mental health services.

Screening for psychological distress in childhood and mental health-related hospital attendance among young adults

ObjectivesThe prevalence of mental disorders is high and increasing among children and young people. Investigating the relationship between self-reported poor mental health and mental health service utilisation can provide evidence on the benefits of universal screening, but longitudinal data is rare. ApproachData from a nationally representative English cohort (Next Steps) were linked to NHS Hospital Episode Statistics. GHQ-12 assessed psychological distress in Next Steps at age 15; participants were followed until their first mental health-related hospital presentations or were censored at the end of the study (age 27). Cox proportionate hazard models with survey weights estimated associations. ResultsOut of 4058 young people included in the analyses, 19% reported high levels of distress at age 15. During the 12-year follow-up, 5.3%, 2.9% and 2.7% of the participants had at least one mental disorder, drug/alcohol misuse and self-harm presentation, respectively, and 4.2% had a mental health treatment. Higher GHQ-12 scores were associated with mental disorder presentations (HR=1.10, 95% CI:1.04-1.16), and mental health treatments (HR=1.14, 95% CI:1.08-1.20). Associations were weaker for young people living in deprived areas, or if their main parent had lower education. ConclusionsAdolescent psychological distress predicts subsequent hospital attendance in young adulthood, but there are treatment gaps in service utilisation among more disadvantaged individuals. Detecting youth with mental health difficulties through universal screening, may facilitate early intervention, improve life-course outcomes, and reduce secondary healthcare use. ImplicationsLinked cohort and administrative data can improve our understanding on long-term healthcare utilisation and treatment needs.

The severity of respiratory syncytial virus infection in children during the SARS-CoV-2/COVID-19 pandemic: A nationwide study of 11,915 cases in Germany.

Respiratory syncytial virus (RSV) infection is a major cause of childhood hospitalization. The COVID-19 pandemic has disrupted the usual seasonal pattern of RSV, resulting in high activity during the off-season. This study aims to evaluate the effects of the pandemic on the severity of RSV infections. Data from 11,915 children hospitalized due to RSV infection between 2016 and 2022 were analyzed. The hospitalized patients were categorized into two groups, from January2016 to February 2020 (PreCoV19 group) and from March 2020 to December 2022 (CoV19 group). The hospitalization duration, intensive care unit (ICU) admissions, length of stay at ICU, mechanical ventilation requirement and duration, Elixhauser comorbidity index scores, and in-hospital mortality were analyzed. Children in the PreCoV19 group had a mean age of 0.4 ± 0.7, whereas those in the CoV19 group had a mean age of 0.6 ± 1.0 years. Children during the pandemic had significantly shorter hospital stays (4.3 ± 2.6 days) compared to children of the pre-pandemic period (4.9 ± 3.3 days). Although ICU admission rates did not change, the duration of ICU stays decreased in the CoV19 group. Moreover, the in-hospital mortality did not differ between the groups. A multivariable analysis showed that younger age, regardless of the pandemic period, was associated with prolonged hospital stays, higher ICU admission rates, and an increased requirement for mechanical ventilation. Our findings highlight significant changes of the clinical characteristics of RSV infections during the pandemic, with implications for clinical management and public health strategies.

Simultaneously implementing pathways for improving asthma, pneumonia, and bronchiolitis care for hospitalized children: Protocol for a hybrid effectiveness-implementation, cluster-randomized trial.

Asthma, pneumonia, and bronchiolitis are the top causes of childhood hospitalization in the United States, leading to over 350,000 hospitalizations and ≈$2 billion in costs annually. The majority of these hospitalizations occur in general/community hospitals. Poor guideline adoption by clinicians contributes to poor health outcomes for children hospitalized with these illnesses, including longer recovery time/hospital stay, higher rates of intensive care unit transfer, and increased risk of hospital readmission. A prior single-center study at a children's hospital tested a multicondition clinical pathway intervention (simultaneous implementation of multiple pathways for multiple pediatric conditions) and demonstrated improved clinician guideline adherence and patient health outcomes. This intervention has not yet been studied in community hospitals, which face unique implementation barriers. To study the implementation and effectiveness of a multicondition pathway intervention for children hospitalized with asthma, pneumonia, or bronchiolitis in community hospitals. We will conduct a pragmatic, hybrid effectiveness-implementation, cluster-randomized trial in community hospitals around the United States (1:1 randomization to intervention vs. wait-list control). Our primary outcome will be the adoption of 2-3 evidence-based practices for each condition over a sustained period of 2 years. Secondary outcomes include hospital length of stay, ICU transfer, and readmission. This hybrid trial will lead to a comprehensive understanding of how to pragmatically and sustainably implement a multicondition pathway intervention in community hospitals and an assessment of its effects. Enrollment began in July 2022 and is projected to be completed in September 2024. Primary analysis completion is anticipated in March 2025, with reporting of results following.

THE ROLE OF PSYCHOLOGY IN PEDIATRIC PALLIATIVE CARE: A participant observation experience report

Hospitalization in childhood can be characterized as a stressful and distressing event for patients and families, especially in cases of illnesses or chronic conditions that require pediatric palliative care (PPC). The hospital psychologist who works in PPC contributes, among other things, to minimize the suffering resulting from illnesses. The purpose of this article was to report the experience of participant observation, as a field activity of a Psychology guided research practice discipline, about the work in PPC of a psychologist in a public hospital in the South of Brazil. This is an observational study, of a qualitative and descriptive nature, of six episodes of participant observation recorded by a Psychology undergraduate in a field diary and analyzed through categorical content analysis. During the observations, the psychologist worked with nine companions and eleven children in hospitalized PPC. It was found that the most required activities for the psychologist were the following categories: listening and supporting family members, to express emotions and encourage self-care; mediation between family members and the healthcare team, for better communication; playful activities with children, to distract and form bonds; and doing records in medical records, to inform and guide the team. In the field of PPC, the psychologist's work must be based on a biopsychosocial perspective of individuals, with the purpose of promoting comprehensive and humanized care. However, considering the complexities present in PPC and the tensions inherent to the hospital context, the psychologist must also be aware of his self-care needs during his professional practice.

Hyperemesis gravidarum and the risk of offspring morbidity: a longitudinal cohort study.

Hyperemesis gravidarum has the potential to affect the long-term health of offspring. We examined whether maternal hyperemesis gravidarum was associated with the risk of hospitalization for childhood morbidity. We conducted a longitudinal cohort study of 1,189,000 children born in Quebec, Canada, between April 2006 and March 2021. The main exposure measure was maternal hyperemesis gravidarum requiring hospitalization in the first or second trimester. The outcome was any pediatric admission between birth and 16years of age, with follow-up ending in March 2022. We used Cox regression models adjusted for maternal and socioeconomic factors to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between maternal hyperemesis gravidarum and childhood hospitalization. Among 1,189,000 children, 6904 (0.6%) were exposed to maternal hyperemesis gravidarum. Hospitalization rates at age 16years were higher for children exposed to hyperemesis gravidarum than unexposed children (47.6 vs 43.9 per 100 children). Relative to no exposure, hyperemesis gravidarum was associated with a 1.21 times greater risk of any hospitalization before 16years (95% CI 1.17-1.26). Hyperemesis gravidarum was associated with hospitalization for neurologic (HR 1.50, 95% CI 1.32-1.71), developmental (HR 1.51, 95% CI 1.29-1.76), digestive (HR 1.40, 95% CI 1.30-1.52), and allergic disorders (HR 1.39, 95% CI 1.24-1.56). When contrasted with preeclampsia, hyperemesis gravidarum was a stronger risk factor for these outcomes. Maternal hyperemesis gravidarum is associated with an increased risk of childhood hospitalization, especially for neurologic, developmental, digestive, and atopic disorders. • Hyperemesis gravidarum is associated with neurodevelopmental disorders in offspring. • However, the effect of hyperemesis gravidarum on other childhood morbidity is unclear. • In this longitudinal cohort study of 1.2 million children, maternal hyperemesis gravidarum was associated with a greater risk of hospitalization before age 16years. • Exposure to hyperemesis gravidarum was associated with developmental, neurologic, atopic, and digestive morbidity in childhood.

The UK Soft Drinks Industry Levy and childhood hospital admissions for asthma in England

Sugar sweetened beverage consumption has been suggested as a risk factor for childhood asthma symptoms. We examined whether the UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, was associated with changes in National Health Service hospital admission rates for asthma in children, 22 months post-implementation of SDIL. We conducted interrupted time series analyses (2012-2020) to measure changes in monthly incidence rates of hospital admissions. Sub-analysis was by age-group (5-9,10-14,15-18 years) and neighbourhood deprivation quintiles. Changes were relative to counterfactual scenarios where the SDIL wasn’t announced, or implemented. Overall, incidence rates reduced by 20.9% (95%CI: 29.6-12.2). Reductions were similar across age-groups and deprivation quintiles. These findings give support to the idea that implementation of a UK tax intended to reduce childhood obesity may have contributed to a significant unexpected and additional public health benefit in the form of reduced hospital admissions for childhood asthma.

Clinical profile of dengue fever and dengue haemorrhagic fever in Indonesian children: A six year retrospective study

Background: Dengue infection is still a significant public health problem in Indonesia. An appropriate clinical profile is helpful in early identification of patients with a high risk for severe dengue infection. Objectives: To report the prevalence, characteristics, and clinical outcomes of patients with dengue fever (DF) and dengue haemorrhagic fever (DHF). Method: This was a retrospective study of childhood hospitalisation in Siloam Hospitals Lippo Village, Indonesia from January 2015 to December 2020. Demographic data, clinical signs, and laboratory findings were collected and processed using SPSS version 26. Results: Of 528 patients, 85.6% were DF, 10.4% were DHF grades I and II, and 4% were DHF grades III and IV. Median ages of patients with DF, DHF grades I and II, and DHF grades III and IV were 10.9, 12.4 and 8.5 years respectively. Common clinical symptoms of DF patients were headache (67.5%), loss of appetite (41.8%), and vomiting (40.9%). While 52.7% patients with DHF grades I and II had respiratory symptoms, 42.9% patients with DHF grades III and IV had hepatomegaly. Conclusions: Common clinical symptoms of DF and DHF patients were headache, loss of appetite and vomiting. Whilst 52.7% patients with DHF grades I and II had respiratory symptoms, 42.9% patients with DHF grades III and IV had hepatomegaly.

Rotavirus Hospitalization in Early Childhood: Fine Motor Skills and Cognition at 6 Years Old in a Population-Based Cohort Study.

Rotavirus is linked to severe childhood gastroenteritis and neurological complications, but its impact on neurodevelopment remains uncertain. We examined data from 1 420 941 Korean children born between 2009 and 2011, using the Korean National Health Insurance System. We assessed neurodevelopmental outcomes at age 6 years using the validated Korean Developmental Test, covering 6 major domains, with propensity score-based inverse probability weighting including consideration of covariates sex, birth weight, changes in body weight from birth to 4-6 months of age, head circumference at 4-6 months of age, residence at birth, economic status, infant feeding types, and birth year. The main analysis that encompassed 5451 children with rotavirus hospitalization and 310 874 unexposed individuals revealed heightened odds of suspected delays in fine motor skills and cognition among exposed children. Our results suggest an association between rotavirus-related hospitalization in infancy and suspected delays in fine motor function and cognition in 6 year olds.

Epidemiology of Respiratory Syncytial Virus Hospitalizations in Poland: An Analysis from 2015 to 2023 Covering the Entire Polish Population of Children Aged under Five Years.

Respiratory syncytial virus (RSV) is an important cause of childhood hospitalizations. The aim of the study was to estimate the rates of RSV-related hospitalizations in children aged less than 5 years in Poland. This retrospective observational cohort study was based on data obtained from the National Health Fund in Poland regarding all acute respiratory tract infections and RSV-coded admissions of children (age < 5 years) to public hospitals between July 2015 and June 2023. Patients were stratified based on the following age groups: 0-1 month, 2-3 months, 4-6 months, 7-12 months, 13-24 months, and 25-60 months. The number of RSV-related hospitalizations increased every season, both before and through the ending phase of the coronavirus disease 2019 (COVID-19) pandemic. The COVID-19 pandemic was associated with a shift in the seasonality pattern of RSV infection. Hospitalization rates per 1000 inhabitants were the highest for children aged 0-12 months, reaching 47.3 in the 2022/23 season. Within this group, the highest hospitalization rate was observed for children aged 2-3 months-94.9 in the 2022/23 season. During the ending phase of the COVID-19 pandemic, the observed increase in admission rates was 2-, 4-, and 5-fold the pre-COVID rate for children aged <12 months, 12-24 months, and 25-60 months, respectively. In Poland, RSV infections cause a significant burden in hospitalized children aged less than 5 years. RSV-related hospitalizations were most frequent in children aged less than 1 year. The COVID-19 pandemic was associated with a shift in the seasonality pattern of RSV infections. After the pandemic, more RSV-related hospitalizations were observed in older children (aged 13 months and older) vs. the pre-pandemic phase.

Investigation of polypharmacy and potential drug-drug interactions in a group of hospitalized pediatric patients: a single-center study

Aims: Polypharmacy involves the use of multiple medications to manage one or more clinical conditions. This study aimed to determine the prevalence of polypharmacy and potential drug-drug interactions during hospitalizations in childhood and to investigate the nature of common interactions.&#x0D; Methods: Data for this retrospective cross-sectional observational study were obtained from the hospital database records of pediatric patients admitted to the pediatric department of a university hospital during the first six months of 2020. A total of 601 pediatric prescriptions from 877 hospitalizations involving 2620 medications were examined for drug-drug interactions using the drugs.com/interaction checker tool.&#x0D; Results: Of the evaluated 601 patients, 48.1% were female and 51.9% were male children. The mean age of the hospitalized patients was 4.78±5.2 years, ranging from 0 to 18 years, with a median age of 2 years. The mean length of the hospital stay was 5.5 (min 1-max 56) days. The mean number of prescribed medications per child was 4.38±2.4 (min-max 1-16). Potential interactions were identified in 49.1% of the prescriptions. The prescription rate of antimicrobial treatment for hospitalized patients was 86%, and this group had a high occurrence of major drug-drug interactions (p

Factors Influencing Exclusive Breastfeeding in Saudi Arabia.

Exclusive breastfeeding is defined as the practice of providing infants with breast milk as their sole source of nourishment for the first six months of life. This study investigated the factors influencing exclusive breastfeeding practices in Makkah, Saudi Arabia. The study employed a descriptive cross-sectional study design. Data gathered from 340 mothers attending the Maternity and Childhood Hospital in Makkah provided insights into the demographic profiles and postpartum practices of participants. The study revealed the significance of early breastfeeding initiation and the provision of pre-birth breastfeeding information in extending the duration of exclusive breastfeeding. There was a statistically significant difference between mothers who had Cesarean section deliveries and those who had natural deliveries in terms of exclusive breastfeeding duration. These findings have essential implications for healthcare professionals, policymakers, and future research endeavors, emphasizing the importance of healthcare education and timely support in promoting extended exclusive breastfeeding practices.

Rapid genomic sequencing for genetic disease diagnosis and therapy in intensive care units: a review.

Single locus (Mendelian) diseases are a leading cause of childhood hospitalization, intensive care unit (ICU) admission, mortality, and healthcare cost. Rapid genome sequencing (RGS), ultra-rapid genome sequencing (URGS), and rapid exome sequencing (RES) are diagnostic tests for genetic diseases for ICU patients. In 44 studies of children in ICUs with diseases of unknown etiology, 37% received a genetic diagnosis, 26% had consequent changes in management, and net healthcare costs were reduced by $14,265 per child tested by URGS, RGS, or RES. URGS outperformed RGS and RES with faster time to diagnosis, and higher rate of diagnosis and clinical utility. Diagnostic and clinical outcomes will improve as methods evolve, costs decrease, and testing is implemented within precision medicine delivery systems attuned to ICU needs. URGS, RGS, and RES are currently performed in <5% of the ~200,000 children likely to benefit annually due to lack of payor coverage, inadequate reimbursement, hospital policies, hospitalist unfamiliarity, under-recognition of possible genetic diseases, and current formatting as tests rather than as a rapid precision medicine delivery system. The gap between actual and optimal outcomes in children in ICUs is currently increasing since expanded use of URGS, RGS, and RES lags growth in those likely to benefit through new therapies. There is sufficient evidence to conclude that URGS, RGS, or RES should be considered in all children with diseases of uncertain etiology at ICU admission. Minimally, diagnostic URGS, RGS, or RES should be ordered early during admissions of critically ill infants and children with suspected genetic diseases.

Infant Whole-Cell Versus Acellular Pertussis Vaccination in 1997 to 1999 and Risk of Childhood Hospitalization for Food-Induced Anaphylaxis: Linked Administrative Databases Cohort Study

Evidence suggests that children who had received an initial priming dose of whole-cell pertussis (wP) vaccine, rather than acellular pertussis (aP) vaccine, had a lower risk of developing IgE-mediated food allergy, the most common cause of anaphylaxis-related hospital presentations ofchildhood. To assess the association between wP versus aP vaccination in infancy and subsequent hospital presentations for anaphylaxis. This study was preregistered under PMID 34874968. Perinatal records for a cohort of New South Wales-born children (1997-1999) receiving their first dose of pertussis-containing vaccine before age 4 months were probabilistically linked to hospital and immunization records. We used adjusted Cox models to estimate hazard ratios (aHRs) and 95% CIs for anaphylaxis-coded hospitalizations. There were 218,093 New South Wales-born children who received a first dose of wP or aP before age 4 months. Among these children, 86 experienced at least one hospitalization for food-induced anaphylaxis at age 5-15 years (range of events per patient, one to three). The person-time of follow-up was 1,476,969 years, and 665,519 years for children vaccinated with wP as a first dose (wP-1 children) and aP as a first dose (aP-1 children), respectively. The incidence rates for first hospitalization for food anaphylaxis were 3.5 (95% CI, 2.6-4.6) and 5.1 (95% CI, 3.5-7.1) per 100,000 child-years among wP-1 children and aP-1 children, respectively (aHR for wP vs aP= 0.47; 95% CI, 0.26-0.83). For first admission for venom anaphylaxis, the incidence rate was 4.9 (95% CI, 3.9-6.2) per 100,000 child-years among wP-1 children and 5.1 (95% CI, 3.5-7.1) per 100,000 child-years among aP-1 children (aHR for wP vs aP= 0.92; 95% CI, 0.53-1.60), and for all-cause anaphylaxis, the incidence rate was 10.6 (95% CI, 9.0-12.4) per 100,000 child-years among wP-1 children and 12.8 (95% CI, 10.2-15.8) per 100,000 child-years among aP-1 children (aHR for wP vs aP= 0.92; 95% CI, 0.53-1.60). Vaccination with wP in infancy was associated with a lower risk of hospitalizations for food-induced anaphylaxis (and therefore severe IgE-mediated food allergy) occurring in childhood.

COPD in Never-Smokers: BOLD Australia Study.

Tobacco smoking is the major risk factor for COPD, and it is common for other risk factors in never-smokers to be overlooked. We examined the prevalence of COPD among never-smokers in Australia and identified associated risk factors. We used data from the Australia Burden of Obstructive Lung Disease (BOLD) study, a cross-section of people aged ≥40 years from six sites. Participants completed interviews and post-bronchodilator spirometry. COPD was primarily defined as an FEV1/FVC ratio <0.70 and secondarily as the ratio less than the lower limit of normal (LLN). The prevalence of COPD in the 1656 never-smokers who completed the study was 10.5% (95% CI: 9.1-12.1%) [ratio<LLN 4.6%]. The likelihood of having COPD increased with advancing age [odds ratio (OR) 4.11 in those 60-69 years and OR 8.73 in those 70 years and older], having attained up to 12 years of education (OR 1.75) compared to those with more than 12 years, having a history of asthma (OR 2.30), childhood hospitalization due to breathing problems before age 10 years (OR 2.50), or having a family history of respiratory diseases (OR 2.70). Being overweight or obese was associated with reduced prevalence of COPD compared with being normal weight. In males and females, advanced age, a history of asthma, and childhood breathing problems before age 10 were factors that elevated the likelihood of COPD. However, in males, additional factors such as a higher body mass index and a family history of respiratory diseases also contributed to increased odds of COPD. COPD was prevalent in this population of never-smokers aged 40 years and over. This finding highlights the significance of risk factors other than smoking in the development of COPD.

Assessment of Play Therapy Services Available to Children Under Five Years in Hospitals in Plateau State

This study investigated the availability play therapy services in promoting nurturing care of early child development of under-five children visiting hospitals in Plateau state. The population for the study included all secondary and tertiary hospitals available in Plateau state. Stratified sampling was used to select hospitals each from the three geo political zones in Plateau State. Two local governments were selected from the three zones in the state. The descriptive survey design was used for the study. The instrument Childhood Hospital Play Services Assessment Scale was used. Reliability coefficient was determined to be 0.89. Data was collected over a period of six weeks. Two research assistants were used for the study. Data collected was analysed and results of the findings showed that few hospitals have play therapy service for children under age five in Plateau. Also, hospitals were found to face challenges lack of funds spaces and personnel to handle play therapy for children. It was also discovered that rural hospitals had fewer play therapy services compared to urban hospitals. It was recommended amongst others that Plateau State hospitals should prioritize awareness campaigns to educate healthcare professionals, parents, and the community about the importance and benefits of play therapy for children’s development, for children under five years.