BACKGROUND: Separation anxiety disorder (SAD) is a common childhood condition characterised by excessive distress related to separation from attachment figures, often leading to social, emotional, and academic difficulti...BACKGROUND: Separation anxiety disorder (SAD) is a common childhood condition characterised by excessive distress related to separation from attachment figures, often leading to social, emotional, and academic difficulties. If untreated, SAD can increase the risk of future psychopathology, highlighting the importance of effective interventions. AIM: This scoping review systematically maps and analyzes the current evidence on intervention strategies to reduce separation anxiety and promote emotional and social well-being in children. METHOD: Following Arksey and O'Malley's framework and PRISMA-ScR guidelines, a comprehensive search was conducted across multiple databases (PubMed, PsycINFO, Scopus, etc.) for studies published from 2005 to 2025. Inclusion criteria focused on original peer-reviewed research evaluating therapeutic, parental, or educational interventions targeting separation anxiety in children. RESULT: Eight studies from diverse settings demonstrated that interventions such as child-centred group play therapy, attachment-based play, art therapy, storytelling, laughter yoga, and schedule-based paradoxical therapy effectively reduced separation anxiety symptoms. These approaches also improved social-emotional skills, resilience, and parent-child relationships. Combining therapies and involving parents enhanced outcomes, while the importance of school transition strategies was highlighted. DISCUSSION: Findings suggest that multimodal, relationship-focused interventions are most effective in alleviating separation anxiety and fostering broader emotional development. Incorporating expressive activities and strengthening attachment bonds are crucial, and tailored, culturally sensitive approaches are recommended. CONCLUSION: A comprehensive, developmentally sensitive framework integrating therapeutic, familial, and educational strategies holds promise for effective management of childhood separation anxiety. Further research with larger, diverse samples is needed to confirm long-term benefits.
Klein LD, Lui K, Chughtai AA
… +13 more, Osborn DA, Guaran R, McPhee AJ, Brandenberg U, Callander I, Amir LH, Sulfaro C, Brown R, Irving DO, Hoad V, Pink J, Clifford V, Australian and New Zealand Neonatal Network
BACKGROUND AND AIM: In 2018, a pasteurised donor human milk (PDHM) service was established within Australia's national blood service, Lifeblood, and subsequently expanded to a national service. Before 2018, five milk ban...BACKGROUND AND AIM: In 2018, a pasteurised donor human milk (PDHM) service was established within Australia's national blood service, Lifeblood, and subsequently expanded to a national service. Before 2018, five milk banks operated in Australia, but most infants admitted to Australian neonatal intensive care units (NICUs) still did not have access to PDHM. This study aimed to compare infant outcomes before and after Australian NICUs had access to an assured supply of PDHM from Lifeblood. METHODS: Cohort study utilising Australian and New Zealand Neonatal Network data for infants born < 32 weeks' gestation admitted to 15 NICUs across Australia over a 3-year period (2018-2020; n = 4395 infants). The primary study factor was NICU access to an assured supply of PDHM from Lifeblood. Neonatal outcomes were compared in periods with "PDHM available" versus "PDHM not available". The primary outcome was the proportion of infants born < 28 weeks' gestation who developed NEC. Secondary outcomes included duration of parenteral nutrition, retinopathy of prematurity, infection, death, length of stay, weight at discharge, and breast milk feeding at discharge. RESULTS: After adjusting for confounding risks, NEC relative risk was 38% lower for infants born < 28 weeks' (aRR 0.62, 95% CI 0.46-0.83) when Lifeblood PDHM was available. Weight at discharge (2828.8 vs. 2939.56 g, p = 0.001) was lower when PDHM was available. Breast milk feeding at discharge, infections and death were not associated with PDHM availability. CONCLUSIONS: Reliable access to PDHM was associated with reduced risk of NEC for infants born < 28 weeks' gestation in Australian NICUs.
BACKGROUND: Bronchopulmonary dysplasia (BPD) remains a major complication of extreme prematurity, but diagnosis and severity classification have become increasingly challenging in contemporary neonatal respiratory care....BACKGROUND: Bronchopulmonary dysplasia (BPD) remains a major complication of extreme prematurity, but diagnosis and severity classification have become increasingly challenging in contemporary neonatal respiratory care. Changing respiratory support practices and survival patterns have exposed limitations in older oxygen-centric definitions, while prognostic tools have emerged to estimate BPD severity or BPD or death risk earlier in the clinical course. OBJECTIVE: To map post-2016 evidence on BPD definitions, severity classifications, and severity/risk prediction tools in preterm infants, and to summarise differences in construction, classifiability, healthcare-context transportability, and prediction of clinically relevant outcomes. METHODS: This scoping review followed PRISMA-ScR reporting guidance and the JBI Population-Concept-Context framework. PubMed/MEDLINE, Embase, Web of Science, and Google Scholar were searched from January 1, 2017 to February 28, 2026, with citation chaining of eligible articles. No language restriction was planned at search level, but only English full-text articles were included because of feasibility. Two reviewers independently screened titles/abstracts and full texts; disagreements were resolved by consensus with a third author. Data were charted using a standardised framework and synthesised descriptively. Formal risk-of-bias appraisal was not performed because this was a scoping review. The review protocol was not registered, and no external funding was received. RESULTS: Eighteen studies met inclusion criteria after screening. Evidence clustered into conceptual revision of BPD definitions, comparative validation studies of newer definitions against short- and long-term outcomes, and severity/risk prediction tools including online estimators, machine-learning adaptations, and nomogram-based models. Newer support-mode-based definitions generally improved classifiability compared with oxygen-centric definitions and showed outcome gradients in representative cohorts; for example, one NRN definition correctly predicted death or serious respiratory morbidity in 81% of infants, while estimator performance varied by timing and cohort, with reported C-statistic/AUC values ranging from approximately 0.67 to 0.91 in key prediction-tool studies. CONCLUSIONS: Post-2016 BPD research shows a shift from oxygen-centred criteria toward contemporary support-based classification and dynamic risk estimation. Current evidence supports careful use-case-specific selection of definitions and cautious local validation of prognostic tools rather than a universal single best definition or estimator. Future work should harmonise outcome targets, strengthen external validation and calibration, and develop multidimensional, phenotype-informed classification systems.
AIM: In neonatal intensive care, the management of mechanical ventilation frequently transitions from non-invasive to invasive techniques. Predicting post-intubation oxygenation status is essential before intubation. We...AIM: In neonatal intensive care, the management of mechanical ventilation frequently transitions from non-invasive to invasive techniques. Predicting post-intubation oxygenation status is essential before intubation. We aimed to validate the correlation between the saturation oxygen pressure index (SOPI) during non-invasive positive pressure ventilation (NPPV) and post-intubation oxygenation saturation index (OSI), and to determine the SOPI cut-off values corresponding to the OSI after initiation of invasive mechanical ventilation. METHODS: This is a multicentre retrospective observational study. A total of 203 neonates who required synchronised intermittent mandatory ventilation after NPPV management for continuous positive airway pressure (CPAP) or bilevel positive pressure ventilation (BPPV) between April 2012 and January 2026 were enrolled. Pre-intubation SOPI and post-intubation OSI were calculated. Their correlations were analysed using Spearman's rank correlation coefficient. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of SOPI of all NPPV at OSI of 2.0, 3.0 and 4.0. RESULTS: SOPI was positively correlated with OSI (all NPPV: ρ = 0.699, p < 0.001; CPAP: ρ = 0.703, p < 0.001; BPPV: ρ = 0.670, p < 0.001). ROC curve analysis identified the optimal SOPI cut-off values as 1.49 (sensitivity 71.0%, specificity 86.5%) for OSI = 2.0, 2.30 (94.3%, 63.6%) for OSI = 3.0 and 2.49 (89.8%, 87.5%) for OSI = 4.0. CONCLUSIONS: SOPI is a useful predictive marker of post-intubation oxygenation status in newborns. It may serve as a non-invasive, continuous and objective tool for clinicians to assess the oxygenation status of newborns managed with NPPV.
J Paediatr Child Health
· 2026 Jun · PMID 42366603
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AIM: This study aimed to evaluate sleep disturbances in children with coeliac disease (CD) and to investigate their associations with serologic activity and adherence to a gluten-free diet (GFD). METHODS: This cross-sect...AIM: This study aimed to evaluate sleep disturbances in children with coeliac disease (CD) and to investigate their associations with serologic activity and adherence to a gluten-free diet (GFD). METHODS: This cross-sectional study included 203 children with biopsy-confirmed CD and 100 age- and sex-matched healthy controls. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC). Dietary adherence was evaluated according to tissue transglutaminase IgA (tTG-IgA) levels. RESULTS: Children with CD had significantly higher total SDSC scores compared with healthy controls (38.24 ± 9.23 vs. 31.76 ± 3.75, p < 0.001). Subscale scores for difficulties initiating and maintaining sleep (DIMS), daytime sleepiness (DOES) and sleep-wake transition disorders (SWTD) were also significantly higher in the CD group (all p < 0.001). Children with poor GFD adherence demonstrated significantly higher total SDSC scores and higher DIMS, DOES and night-time awakening scores compared with those showing good dietary adherence. tTG-IgA levels showed weak but statistically significant positive correlations with total SDSC scores, DIMS and DOES scores. ROC analysis demonstrated an association between higher SDSC total scores and elevated serologic activity (AUC = 0.84). CONCLUSION: Children with CD demonstrated higher sleep disturbance scores compared with healthy peers, particularly in domains related to sleep initiation and daytime functioning. Poor dietary adherence and higher serologic activity were associated with increased sleep disturbance severity. Further longitudinal studies are needed to clarify the clinical significance and long-term implications of these findings.
McPherson ZE, Shah M, Josephi-Taylor S
… +8 more, Dance B, Nash B, Heaps LS, Wright D, Hayward J, Elliot C, Steadson J, Ma A
J Paediatr Child Health
· 2026 Jun · PMID 42363586
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INTRODUCTION: Chromosome microarray (CMA) is a test commonly ordered by general paediatricians. It has diagnostic yield between 10%-15% in individuals with neurodevelopmental delay, autism and/or multiple congenital abno...INTRODUCTION: Chromosome microarray (CMA) is a test commonly ordered by general paediatricians. It has diagnostic yield between 10%-15% in individuals with neurodevelopmental delay, autism and/or multiple congenital abnormalities. CMA identifies copy number variants (CNV) including deletions and duplications, which may be pathogenic, variants of uncertain significance or benign. Interpretation of the clinical significance of these results can prove challenging without a structured approach. Readily available practical guidelines are lacking. AIMS: We aim to equip the general paediatrician with a practical guide to determine the clinical relevance of a CMA result, and when a referral to clinical genetics is recommended. RESULTS: We discuss the clinical indications for CMA and anticipated diagnostic yield for different conditions. We provide an overview of pre-test counselling and an approach to discussing results. A table is provided to guide interpretation of results and management implications for differing CMA results including pathogenic CNVs, variants of uncertain significance, variants in neurosusceptibility loci, incidental findings or regions of homozygosity. We discuss the value of segregation studies, potential implications for future family planning, limitations of testing and indications for referral to clinical genetics or other specialists, and further genomic testing. CONCLUSION: Paediatricians are increasingly expected to understand the implications of common genetic tests. A practical approach to ordering and interpreting CMA will help address much of the complexity around these results and also streamline referrals to genetics.
Noone AN, Bailey DN, Crawford TM
… +3 more, Richards S, Andersen CC, Stark MJ
J Paediatr Child Health
· 2026 Jun · PMID 42294843
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OBJECTIVE: Wearable newborn-monitoring devices are increasingly popular and widely available for home use. One approach includes the use of accelerometer detection of breathing movements. We investigated the accuracy of...OBJECTIVE: Wearable newborn-monitoring devices are increasingly popular and widely available for home use. One approach includes the use of accelerometer detection of breathing movements. We investigated the accuracy of breathing and apnoea detection by a wearable accelerometer in a simulated environment. DESIGN: This study used simulation as a method to evaluate the performance of a wearable accelerometer-based breathing detection device. A term mannequin fitted with an accelerometer suit wirelessly linked to a mobile app (Goldilocks) was NeoPuff ventilated through a cuffed endotracheal tube. Peak inspiratory pressure (PIP) levels of 5-25 cmHO were delivered with zero end expiratory pressure. Each trial consisted of 30 s of ventilation, followed by simulated apnoea (n = 150). App-based detection and alert times were recorded blinded to ventilation status. Detection accuracy across PIP levels was analyzed using Kruskal-Wallis tests followed by Dunn's multiple comparisons with Bonferroni correction. RESULTS: PIP level affected both apnoea detection (H(4) = 58.9, p < 0.0001) and breathing detection (H(4) = 86.5, p < 0.001) with performance reduced at 5 cmHO compared to higher PIP. Apnoea and breathing detection were most accurate at 20 cmHO. Mean (SD) apnoea detection alarm times ranged between 31(0) and 60(22.6) seconds, with no difference between PIP group (H(4) = 9.3, p > 0.05). CONCLUSIONS: The accelerometer displayed pressure-dependent accuracy, increasing with higher PIP, suggesting a minimum pressure threshold is needed for reliable monitoring. App alert times varied greatly, compounding the accuracy of adverse event detection. To determine their true utility, rigorous investigation of neonatal wearable home-monitoring devices is required.