National Child Research Articles

Streptococcus pyogenes carriage rate, associated factors and antimicrobial susceptibility profiles among urban and rural schoolchildren at Gondar city, Northwest Ethiopia

Streptococcus pyogenes remains one of the top ten causes of mortality from infectious diseases. Children in low-income nations have high carrier rates of Streptococcus pyogenes, which can serve as a source of infections, including simple superficial infections that may lead to invasive and post-streptococcal diseases, particularly among schoolchildren. This study aimed to assess the prevalence of Streptococcus pyogenes, associated factors, and antimicrobial susceptibility profiles among urban and rural public schoolchildren in Gondar City, Northwest Ethiopia. A school-based comparative cross-sectional study was conducted via a multistage sampling technique among elementary schoolchildren from April to June 2022 in Gondar City. Sociodemographic and clinical data were collected via a pretested structured questionnaire. Standard microbiological methods were used to collect and process throat swabs to isolate Streptococcus pyogenes. An antimicrobial susceptibility test was performed via the disk diffusion method. Epi-Info version 7.2.5 was used to enter the data, which were then exported to SPSS version 25 for analysis. Logistic regression analysis was used to determine the strength of associations between variables, and p < 0.05 was considered statistically significant. The overall prevalence of Streptococcus pyogenes in 438 children was 11.2% (n = 49), with 71.43% (35/49) being urban and 28.57% (14/49) being rural. Low-income parents, hospital admission history, and cigarette smoking in the home were found to be substantially linked with Streptococcus pyogenes carriage among students (p < 0.05). All the Streptococcus pyogenes isolates were susceptible (100%) to penicillin and cefotaxime, but 18.8% and 12.25% of the isolates were resistant to amoxicillin and tetracycline, respectively. The prevalence of Streptococcus pyogenes throat carriage among was intermediate. All the isolates were sensitive to penicillin and cefotaxime, but 18.8% and 12.25% of the isolates were resistant to amoxicillin and tetracycline, respectively. Thus, regular screening and surveillance of Streptococcus pyogenes among schoolchildren should be conducted to minimize carriage or infections and maintain the rational use of antimicrobials. Health education about cigarette smoking in the house also needs to be provided to and the community.

Prevalence of Obstructive Sleep Apnea in Vietnamese Children with Attention Deficit Hyperactivity Disorder (ADHD).

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder among children with attention deficit hyperactivity disorder (ADHD). This study aims to determine the prevalence of OSA in children with ADHD, compare the differences in clinical characteristics between children with ADHD-OSA and those without OSA (ADHD-nonOSA), and to identify the correlation between OSA and ADHD in children. This cross-sectional descriptive study was conducted on 524 children with ADHD, aged 6-12years, at the Vietnam National Children's Hospital from October 2022 to September 2023. Respiratory polygraphy was used to determine the prevalence of OSA in this study population; clinical data of children with ADHD-OSA and ADHD-nonOSA were collected and analyzed in each group. The severity of ADHD symptoms was measured by the Vanderbilt ADHD Parent Diagnosis Rating Scale (VADPRS questionnaire), and the severity of OSA was defined by Apnea-Hypopnea Index (AHI). The prevalence of OSA in children with ADHD was 23.3%, with the majority of moderate-to-severe OSA. Significant differences were observed in sleep onset time, total sleep duration, and various sleep-related behaviors, such as bedtime resistance and difficulty waking up in the morning, between children with ADHD-OSA and ADHD-nonOSA (p < 0.001, p < 0.001, p < 0.05, and p < 0.005, respectively). The severity levels of inattention, hyperactivity, and behavioral disorders were significantly higher in children with moderate-to-severe OSA compared to those with mild OSA (p < 0.005, p < 0.005, and p < 0.001, respectively). There were significant correlations between AHI with inattention scores (r = 0.677; p < 0.0001), hyperactivity scores (r = 0.438; p = 0.05), behavioral disorder scores (r = 0.342; p < 0.05), and anxiety/depression scores (r = 0.357; p < 0.05) measured by VADPRS questionnaire. OSA is a common sleep-related breathing disorder in children with ADHD, which might exacerbate ADHD symptoms. Thus, screening of OSA in children with ADHD is essential during the management of ADHD in this population.

Impact of trauma center status on radiology resident performance in detecting non-accidental trauma on the WIDI SIM exam.

To evaluate whether adult and pediatric trauma center status, as well as the presence of dedicated child protection teams, influences radiology resident performance in detecting non-accidental trauma on the Emergent/Critical Care Imaging Simulation (WIDI SIM) exam. We retrospectively analyzed 639 WIDI SIM exam scores for four pediatric non-accidental trauma cases completed by radiology residents across 33 programs. Residents were stratified by level (R1-R4) and institutional factors, including adult trauma center status, pediatric trauma center status, and child protection team presence. Additionally, 2022 pediatric physical abuse counts per state were obtained from the National Child Abuse and Neglect Data System and normalized between 0 and 1. We employed a negative binomial generalized linear model (GLM). The outcome was regressed on resident level, trauma center status variables, child protection team presence, and normalized abuse counts. Higher resident training level was significantly associated with better performance (R1=3.6, R2=5, R3=6.1, R4=7.9; P<0.001). Adult trauma center accreditation was also associated with higher scores (4.6 vs. 3.3; P<0.001). In contrast, pediatric trauma center status, child protection team presence, and normalized state-level abuse counts were not significantly associated with resident performance (all P>0.05). Resident experience and adult trauma center accreditation were significantly associated with better radiology resident performance in detecting non-accidental trauma in a simulated call environment. Pediatric trauma center status, child protection team presence, and statewide abuse prevalence were not associated with detection performance. These findings suggest the need for targeted educational interventions at non-adult trauma centers and emphasize the importance of experience in developing diagnostic proficiency for non-accidental trauma.

A nationwide registry-based cohort study of the association between childhood dental caries and gingivitis with type 2 diabetes in adulthood.

Evidence suggests a bidirectional relationship between oral health status and type 2 diabetes (T2D) in adults. Studies on associations between childhood oral health and T2D in adulthood are lacking. This is a nationwide Danish registry-based cohort study of individuals born between 1963 and 1972, having at least one registration in the National Child Odontology Registry between 1972 and 1987 (n = 627,758). Follow-up lasted from 1995 to 2018. Main exposure variables were the highest achieved levels of dental caries and gingivitis between 1972 and 1987. The outcome was T2D diagnosis during follow-up. Data was analyzed using Cox-regression, stratified on sex, with age as the underlying timescale and highest achieved level of education between age 25-30years as Cox-strata. Main analyses were conducted with and without age-restrictions (T2D diagnosis before/after age 40). Compared to lowest-level references, high levels of gingivitis associated with increased hazard ratios (HRs) of T2D in both males (HR [95% confidence interval]: 1.59 [1.47; 1.72]) and females (1.87 [1.68; 2.08]), as did severe dental caries (males: (1.15 [1.04; 1.27], in females: 1.19 [1.06; 1.35]). Below age 40, gingivitis associated with increased HRs in males (1.84 ([1.58; 2.15]) and females (1.94 [1.63; 2.30]). Above age 40, both exposures displayed higher HRs in males (high gingivitis: 1.52 [1.39; 1.66] vs. severe caries: 1.23 [1.09; 1.38]) and females (1.83 [1.59; 2.10] vs. 1.37 [1.17; 1.59]). Data suggest an association between childhood dental caries and gingivitis with risk of receiving a T2D diagnosis in adulthood. However, results are affected by residual confounding warranting further studies.

Only Children by Choice vs. Only Children by Circumstances: Why Do Some Women Have Only One Child?

In an attempt to stimulate further theory and research on only children, we introduce two conceptual distinctions: Only children as independent variables vs. only children as dependent variables; and only children by choice vs. only children by circumstances. What little scientific research exists on only children to date focuses almost exclusively on only children as independent variables and fails to make a distinction between only children by choice and only children by circumstances. A focus on only children by choice as dependent variables explores the question of why some women choose to have only one child. As an empirical illustration, analyses of prospectively longitudinal data with a nationally representative sample in the United Kingdom (National Child Development Study) show that women who experience pregnancy complications are significantly less likely to have another child and significantly more likely to have only one child. Our results suggest that increased chances of pregnancy complications that American women now experience alone can explain about 10% of the increase in the number of only children in the United States in the last half century. If certain genes incline women to have pregnancy complications, it is possible that only children by circumstances are genetically more similar to children with siblings than to only children by choice.

Child welfare worker perspectives on documentation and case recording practices in Canada: A mixed-methods study protocol.

In health care and child welfare, clinical records and case notes serve multiple functions. When records are aggregated and processed to create administrative data, they can be analyzed and used to inform policy development and decision-making. To be useful, such data should be complete, accurate, and recorded in a standardized way. However, sources of bias and error can impact the quality of administrative data. During the development of national child welfare data in Canada, child welfare sector partners expressed concerns about the accuracy and completeness of data about children and families. This protocol describes a study that seeks to answer two questions: 1) What individual and institutional factors influence how client data is recorded by child welfare workers in Canada? 2) What data quality issues are created through documentation and case recording practices that may impact the use of clinical case management system data for public health statistics? In this protocol, we describe an exploratory mixed methods study that involves an online survey, interviews with a purposive sample of child welfare workers, and a document review of case recording guidelines. To be eligible for the study, participants must have worked at a child welfare agency or department with clinical documentation responsibilities as a part of their job. We will use descriptive statistics to analyze the survey data and thematic analysis to analyze the qualitative data. This study will help uncover strengths, limitations, and possible sources of bias created through case recording and documentation practices in child welfare. Study results will be shared through presentations to interest holders and will inform the further development of national child welfare data in Canada.

Anthropometric Trajectories in Children Prior to Development of Inflammatory Bowel Disease

Poor nutrition and growth in childhood have short-term and long-term consequences, so understanding the timing of the onset of an impaired nutritional status is crucial for diagnosing and treating inflammatory bowel disease (IBD) at its earliest stage. To assess anthropometric trajectories before a pediatric diagnosis of IBD and growth recovery after diagnosis. This population-based cohort study included children born in Denmark from January 1, 1997, through December 31, 2015, with weight and length or height measurements at birth and at least 1 length or height and weight measurement at school age based on the Danish Medical Birth Register and the Danish National Child Health Register. Within this population, all individuals diagnosed with IBD at ages 5 to 17 years, according to the Danish National Patient Register, were identified. Data were analyzed from October 13, 2023, to April 17, 2024. A pediatric diagnosis of IBD compared with the corresponding population without the disease. The outcome measures were z scores for length or height, weight, and body mass index (BMI [calculated as weight in kilograms divided by height in meters squared]) before and after pediatric IBD diagnosis compared with reference and sibling populations. The final study population included 916 133 individuals (51.2% male) with a median of 3 pairs of length or height and weight measurements collected (IQR, 2-6 pairs). Of those, 1522 (median age, 14.3 years [IQR, 11.8-16.3 years]; 763 female [50.1%]) were diagnosed with IBD (851 [55.9%] with Crohn disease [CD] and 671 [44.1%] with ulcerative colitis [UC]). Compared with children without IBD, individuals with a later diagnosis of CD had declining anthropometric measures 3 years (weight: mean, -0.12 g [95% CI, -0.20 to -0.03 g]; BMI: mean, -0.13 [95% CI, -0.21 to -0.04]) and 1 year (length or height: mean, -0.20 cm [95% CI, -0.29 to -0.10 cm]) prior to diagnosis, whereas this was observed 1 year prior to a diagnosis of UC for weight (mean, -0.12 g [95% CI, -0.22 to -0.02 g]) and BMI (mean, -0.13 [95% CI, -0.23 to -0.03]). Deviating anthropometric patterns persisted after diagnosis, with the slowest recovery observed in children with CD. The findings of this large-scale population-based cohort study of anthropometrics in children suggest impaired nutritional status as assessed by weight up to 3 years and by length or height 1 year before a diagnosis of CD and by weight up to 1 year before a diagnosis of UC. These findings emphasize that the onset of pediatric IBD may occur years prior to diagnosis, that growth recovery may first occur after diagnosis and treatment, and that frequent nutritional screenings may help ensure a healthy transition to adulthood.

Improving and decentralising neuropaediatric healthcare in Nicaragua by implementing an education programme. A pre-experimental study.

To improve and decentralize neuropediatric healthcare in Nicaragua by implementing an education program. This study is carried out as an international cooperation proyecto between September 2018 and June 2019. It has a pre-experimental and before-after design (on a single group) of the implementation of an education program. A total of 19 pediatrics and 6 nurses participated in a training program, and neuropediatric healthcare services were decentralized from the National Children's Hospital in Managua (La Mascota) to 19 regional and departmental hospitals in Nicaragua. For the implementation of this education program, nine Indicadors were measured during the training process and at the end of the proyecto and different results were obtained. The neuropediatric care, that was totally centered in a single hospital, has suffered drastic changes, increasing the number of electroencephalographs and follow up of patients in the regional hospitals, while reducing external consultations and waiting time for consultations in the central hospital. Likewise, a neuropediatric network was established, training was provided, and brochures were developed, resulting in an improving satisfaction of families with the care provided for their children. Our results revealed the real-life effectiveness of this education program in improving neuropediatric care in Nicaragua, supporting nonspecialized pediatricians and nurses for acting as decentralizing agents. The proposal reinforces universal access to basic health by focusing on different social determinants and may serve as a model to other low-income countries.

Lessons learned from the Eastern Europe and central Asia region on the elimination of HIV vertical transmission: insights from United Nations Children's fund.

Lessons learned from the Eastern Europe and central Asia region on the elimination of HIV vertical transmission: insights from United Nations Children's fund.

Roundtable discussion: Domestic worker organizing in Latin America and beyond

AbstractIn 2011, the International Labor Organization (ILO) adopted the Domestic Worker Convention (no. 189), which established labor standards for household workers, including protection from abuse, provisions to ensure freedom of movement for migrant domestic workers, coverage under national minimum wage, overtime, child labor, and human rights laws, and access to contact information of private employers and appropriate legal resources, among others. Domestic worker advocates throughout Latin America rallied behind the ILO's Domestic Worker Convention to ensure its ratification at the national level. Latin American and Caribbean nations account for 55% of the national signatories to the convention; at the same time, 77% of domestic workers in the region remain informally employed. The roundtable discussion brought together scholars conducting research in Argentina, Colombia, Ecuador, and Mexico, and among Central Americans in the United States, to address the impact of the ILO convention and to share their research on domestic work and domestic worker movements. How have the changes in domestic work regulation affected the organizing efforts of domestic workers? How are domestic workers advocating for their rights in the wake of the ILO Convention?

Short-term association between ambient air pollution and childhood non-allergic rhinitis: A time-series study at a National Children's Regional Medical Center, in Hefei, China, from 2015 to 2021.

The relationship between air pollution exposure and non-allergic rhinitis (NAR) risk in children is underexplored and uncertain. Therefore, the impact of numerous air pollutants on the incidence of NAR in a Chinese pediatric population were investigated. Data on daily outpatient visits for NAR among children aged 0-18 years from 2015 to 2021 were obtained from Anhui Provincial Children's Hospital. A quasi-Poisson generalized linear regression model combined with a distributed lag nonlinear model was applied to evaluate the association between air pollution and outpatient visits for childhood NAR. A total of 38233 NAR outpatients were included and a positive association and cumulative effects between air pollution and childhood NAR were observed. The relative risks (RRs) and 95 % confidence intervals (95 % CIs) for childhood NAR at the 75th percentile of NO2, SO2, PM10, PM2.5, O3, and CO against their minimum concentrations were 1.157 (95 % CI: 1.089, 1.23), 1.078 (1.005, 1.157), 1.168 (1.089, 1.252), 1.076 (1.02, 1.136), 1.033 (0.961, 1.11) and 1.07 (1.01, 1.134), respectively. The cumulative effects of the air pollutants were pronounced, which was much higher than each single effects. Furthermore, the risk estimates for childhood NAR during the cold season were higher than those in the warm season. Lastly, boys and school children were found to be more vulnerable to air pollutants than girls and preschool children. All these findings suggest that air pollutants have adverse effects on childhood NAR, even at levels below those recommended by the air quality guidelines. Our study results highlight the significance of paying attention to the effects of air pollutants to prevent NAR occurrence, particularly in boys and school children and during the cold season. Therefore, stronger control measures to mitigate air pollution must be implemented to decrease NAR incidence in the pediatric population.

Knowledge and Attitude towards Exclusive Breast Feeding among Mothers Attending Antenatal Care (ANC) in Brikama District Hospital, Brikama, Gambia

The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend starting breastfeeding within the first hour after birth, exclusively breastfeeding (EBF) for the first six months, and continuing for up to two years or beyond, in addition to adequate complementary foods. A structured and pretested questionnaire was used to collect data from 384 mothers attending antennal health care at Brikama District Hospital in Brikama, Gambia, from 1st June to 30th June. The mean age (standard deviation (SD)) of the women was 26.69(±5.67) years and ranged from 16 to 49 years. Majority of the women were married (92.19 %) and from extended families (67.19 %). The findings indicate that majority of participants knew about EBF (88.28%) from health workers (58.22%). Furthermore, most mothers preferred breastfeeding for up to two years of age (58.85%) and agreed that babies should be breastfed on demand (65.63%). The knowledge and attitude of mothers towards EBF was very high and positive. Overall, most respondents knew about (85.94%) and favored (69.79%) EBF.

Rhabdoid Tumor of the Kidney and Soft Tissues: Results from National Wilms Tumor Study-5 and Children's Oncology Group Study AREN0321.

National Wilms Tumor Study-5 (NWTS-5) and AREN0321 evaluated the outcomes of children with rhabdoid tumor of the kidney (RTK) and malignant rhabdoid tumor of soft tissues (MRT). Eligible patients with RTK were enrolled prospectively on NWTS-5 (1995-2002) and treated with carboplatin and etoposide alternating with cyclophosphamide (Regimen RTK). Patients with RTK or MRT were enrolled on AREN0321 (2005-2012) and received vincristine, doxorubicin, and cyclophosphamide alternating with carboplatin, cyclophosphamide, and etoposide (Regimens UH-1 or dose-reduced Revised UH-1). We report event-free survival (EFS) and overall survival (OS) from each study. Thirty patients received Regimen RTK on NWTS-5; on AREN0321, 20 received UH-1 and 19 received Revised UH-1. Patient and disease characteristics were statistically similar between studies. Patients on AREN0321 had significantly improved EFS and OS compared to those on NWTS-5 (4-year EFS = 23.1% vs. 16.7%; p = 0.020; 4-year OS = 30.6% vs. 20.0%; p = 0.014), mostly driven by patients with Stage I/II disease (p = 0.05). Median time to an event was 3.6months on NWTS-5 compared to 7.2months on AREN0321. There were no differences in EFS or OS by revised versus original Regimen UH-1 on AREN0321, or by renal versus extra-renal primary disease when the studies were pooled. The more intensive treatment regimen used on AREN0321 improved EFS and OS overall, a result driven by patients with Stage I/II disease. Despite this improvement, outcomes for patients with rhabdoid tumor remain unsatisfactory and there is a need for novel therapeutic strategies.

Economic evaluation of childhood pneumococcal conjugate vaccination programs in Qinghai and Hainan provinces, China

ABSTRACT Background The burden of pneumococcal disease varies regionally in China, particularly affecting children in Qinghai and Hainan. Nevertheless, absence of pneumococcal conjugate vaccine (PCV) in the National Immunization Program (NIP) or local programs presents limited coverage. This study evaluated the health and economic impact of including PCV in immunization programs in Qinghai and Hainan. Research design and methods A decision tree Markov model was constructed to simulate health outcomes and lifetime costs among children under different 13-valent PCV (PCV13) vaccination strategies compared to current practices, from societal and healthcare perspectives. Data on epidemiology, vaccine efficacy, cost, and utility were obtained from literature or open databases. Sensitivity analyses were conducted to explore parameter uncertainty. Results Including three-dose PCV13 in provincial programs at NIP coverage (98.91%) could avert 7100 episodes and 118 deaths in Qinghai, and 6200 episodes and 66 deaths in Hainan. It was cost-effective at the $68.2/dose in private market and cost-saving at the United Nations Children’s Fund (UNICEF) recommended $25/dose for both provinces. Increasing coverage to 50% or 75% was also cost-effective. Sensitivity analyses confirmed results robustness despite parameter uncertainty. Conclusions Prioritizing PCV13 in immunization programs in Qinghai and Hainan could effectively reduce disease burden, improve population health, and promote health equity.

Supporting Children's Mental Health Needs in Disasters.

Public health emergencies, including climate-related and manmade disasters such as active shooter incidents, occur regularly in the United States. A comprehensive approach is needed to ensure that children's mental health needs are adequately addressed following disasters. This article summarizes the latest evidence on how health systems can effectively address children's unique developmental, social, emotional, and behavioral needs in the context of disasters. To do so requires the integration of mental health considerations throughout all disaster phases, including preparedness, response, and recovery. We discuss the role of traditional emergency response systems and emerging models for responding to mental health crises. These include the national children's disaster mental health concept of operations and specific resources such as crisis lines, mobile crisis units, and telemental health. To achieve a broader reach in addressing children's mental health needs during disasters, health systems can foster a "pediatric disaster system of care" by partnering with community touch points such as schools, faith-based organizations, public health, and law enforcement. Unique considerations during disasters are required to maintain access to care for children with preexisting behavioral health conditions. During disasters, attention is needed to promote equitable identification of mental health needs and linkage to services, particularly for minoritized groups and children living in rural, frontier, and high-poverty areas. Strategies to address children's mental health needs during disasters include the provision of psychological first aid, screening for and triaging mental health needs, and stepped care approaches that progressively allocate higher-intensity evidence-based treatments to children with greater and enduring needs.

Early Childhood Exposures to Fluorides and Cognitive Neurodevelopment: A Population-Based Longitudinal Study.

It is important to maintain confidence in the risk and benefit balance of major caries-preventive programs using fluoride. The ongoing debate about potential effects of early-life exposures to fluoride on cognitive neurodevelopment requires high-quality scientific evidence. This study aimed to investigate the potential effects of fluoride exposure on cognitive neurodevelopment assessed with the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV) in an Australian population-based sample. The sample was selected from the National Child Oral Health Study (NCOHS) 2012-2014. NCOHS collected data on socioeconomic factors, oral health behaviors, and residential history to estimate percentage lifetime exposure to fluoridated water during the first 5 y of life (%LEFW). NCOHS children were also examined by trained and calibrated examiners to assess dental fluorosis (a reliable and valid individual biomarker of total fluoride intake during early childhood). The sample was followed up in 2022-2023 to collect data on cognitive neurodevelopment (intelligence quotient [IQ]) using the WAIS-IV, which was administered by trained and calibrated qualified psychologists. Multivariable regression models were generated to investigate associations between the 2 exposure measurements (%LEFW and dental fluorosis) with full-scale IQ (FSIQ) scores, controlling for important confounding effects. Hypotheses of noninferiority were also tested, contrasting different levels of exposure to fluoride. Some 357 participants aged 16 to 26 y completed the WAIS-IV, with a mean FSIQ score of 109.2 (95% confidence interval [CI]: 107.8-110.5). The estimates of the multivariable regression models demonstrated slightly higher FSIQ scores among the exposed than the nonexposed. The adjusted β of 100%LEFW versus 0%LEFW was 1.07 (95% CI: -2.86, 5.01) and of having dental fluorosis versus no fluorosis was 0.28 (95% CI: -3.00, 3.57). The hypothesis of noninferiority tests found that FSIQ scores of those exposed and nonexposed to fluoride were equivalent. The study provided consistent evidence that early childhood exposure to fluoride does not have effects on cognitive neurodevelopment.

Challenges for neurodiverse children in acute medical hospitals and opportunities for the new National Children's Hospital to be 'neurodiversity-friendly'.

Neurodiversity refers to the variation in human cognitive, sensory, and communication experiences and reframes deficits as differences. Rates and duration of hospitalisation in neurodiverse children are higher compared to their neurotypical peers. Despite increased admissions, paediatric medical hospitals are poorly equipped to adequately support their unique cognitive, sensory, behavioural, and communication needs, which can have negative impacts on the experiences of patients, families, and staff. The literature supports several innovative and inclusive strategies, which present exciting opportunities for Ireland's new National Children's Hospital (NCH) to become a 'neurodiversity-friendly paediatric hospital'.

Oral Propranolol in the Treatment of Cutaneous Infantile Hemangioma in Children: A 3-Years Retrospective Study

Background: Infantile hemangioma is the most common vascular tumor in children. The primary pharmacological agent currently utilized for its treatment is propranolol, which demonstrates efficacy and minimal and non-severe side effects. Objective: To investigate the therapeutic outcomes and adverse effects of orally administered propranolol in the treatment of infantile hemangioma. Additionally, to explore patient data regarding disease manifestations and progression. Material and Methods: Retrospective data collection from medical records of patients diagnosed with cutaneous infantile hemangioma and treated at the National Children’s Health Institute for a duration of three years, between January 1, 2018 and December 31, 2020, was done. Results: The present study included 180 patients with infantile hemangioma. The male-to-female ratio was 1 to 2.3. The median age at diagnosis and treatment initiation was four months, ranging from 1 week to 18 months. Premature infants accounted for 28 cases (15.6%). The most common locations were the head, face, and neck with 67.8%, trunk with 16.1%, and limbs with 16.1%. The most prevalent complications were ulcerations for 12.2% and visual field defects for 0.6%. The average duration of propranolol treatment was 13.01 months. Favorable response was noted in 173 patients (96%) at the 2-week follow-up. By the 6-month follow-up, all patients exhibited positive treatment responses. Adverse effects were reported in two cases, including hypoglycemic seizure and irritability. Conclusion: Oral propranolol demonstrates favorable outcomes in treating infantile hemangioma. However, vigilant monitoring for severe adverse effects, particularly hypoglycemia-induced seizures must be done. Guardians must be informed and deeply concerned not to administer propranolol on an empty stomach, in the presence of poor feeding, or in poor physical condition. Keywords: Oral propranolol; Infantile hemangioma; Adverse events; Hypoglycemia

‘Never again’? Resonances of the past in contemporary Aboriginal and Torres Strait Islander child removal

Kevin Rudd’s 2007 Apology to Australia’s Indigenous Peoples acknowledged the devastating impact of child removal on Aboriginal and Torres Strait Islander families and communities and included a commitment that ‘the injustices of the past must never, never happen again’ (Parliament of Australia 2008). Today however, while First Nations children comprise 6% of the total child population in Australia, they make up 41% of children in out-of-home care (SNAICC 2024b). This article explores the history of Aboriginal and Torres Strait Islander child removal during the Stolen Generations era, considering the ongoing impacts of this history on First Nations families today. While there have been changes, I identify significant continuities between past and contemporary child removal. These disturbing resonances of the past highlight the failed promise of Australian governments to deliver meaningful change in contemporary First Nations child removal policies and practices and to ensure that the mistakes of the past are not being repeated.

45. Interventions and Nursing Care of Acute Poisoning Patients in the First 24 Hours of Hospitalization at the Center of Emergency and Poison Control, Vietnam National Children's Hospital in 2020

45. Interventions and Nursing Care of Acute Poisoning Patients in the First 24 Hours of Hospitalization at the Center of Emergency and Poison Control, Vietnam National Children's Hospital in 2020