Whilst it is often assumed that there is little in the way of evidence to guide practice in child psychiatry the truth is somewhat more complex. Our evidence base has in fact developed considerably over the last 20 years and whilst there are still many gaps in our understanding it is now possible to practice evidence based healthcare for many developmental mental health problems that affect both children and adolescents.
The complexity of diagnostic techniques for paediatric genetic conditions has increased exponentially in the last two or three decades. In tandem with this, paediatric subspecialists are dealing more and more with increased parental expectations for rapid diagnosis and effective management
In March 2011 the civil war in Syria broke out. To date, there have been over 250,000 deaths and over half the country has been internally or externally displaced. Since Feb 2013 over 2000 severely wounded Syrians have crossed the border into Israel. Most of the children have come to Ziv Hospital in Tzfat in Israel’s far north, where Michael Harari works as a paediatrician. They have posed unique medical, social, emotional and political challenges. Michael will talk of his experience in dealing with these issues, and some of the medical lessons learnt along the way.
Newborn screening is one of the most successful public health programs in Australia. Every year, Victoria’s newborn screening program prevents serious childhood disability or death in about 80 Victorian children. The program is run on behalf of the Victorian government by Victorian Clinical Genetics Services in the Murdoch Childrens Research Institute. 2016 marks the 50th anniversary of the program and today’s Grand Round is part of a one day symposium celebrating the history and achievements of the program. A panel of speakers will reflect on what newborn screening has meant for them, how Victoria’s program developed and is currently run and what the future may hold.
While there was tremendous improvement in global child health during the Millennium Development Goal era, huge gaps remain in access to healthcare, nutrition and sanitation etc. A number of lessons from the MDGs and key demographic and epidemiologic trends in the last decade have increased our understanding of the role of health in development and the priorities in global child health. Priorities in health and development were recently articulated in the United Nations Sustainable Development Goals (SDGs).
Acute lymphoblastic leukaemia is the most common malignancy in children. Although 5 years event-free survival rates reach 90%, some children still succumb to the disease and others achieve cure with significant late effects. Improving on this will require alternative treatments. This Grand Round will describe new options for refractory disease, and discuss some of the ethical aspects of embarking on these new treatment options.
Our understanding of lung growth through childhood and adolescence and the impact of disease has changed in recent years. New measurement techniques have shown alveolarisation to continue through adolescence. A number of longitudinal studies within the Campus have provided invaluable information on the outcome of childhood asthma into the adult years which, when combined with the outcome studies of extreme prematurity provide new insight into lung growth. Care of the growing lung is important to ensure optimal lung growth through childhood and adolescence to prevent early onset of lung disease in adulthood.
Variation in care has been long recognised and is often a part of good clinical practice. However, sometimes variation in care is unwarranted and can lead to variation in quality of care and increased costs. The inaugural Australian Atlas of Variation in Healthcare will be launched later this month by the federal minister for health, Susan Ley. Harriet Hiscock will present data on variation in care for some of the paediatric conditions included in the Atlas and discuss reasons why such variation might be occurring.
Surprising to many in Australia, the age band with by far the greatest number of Emergency Department (ED) presentations is that of children 0-4 years of age. Other paediatric age bands are also among the highest in absolute numbers of ED presentations. Understanding the reasons why parents seek ED care for their child for lower urgency conditions, the actual availability of GP services and patterns of use of alternative emergency services can assist in the efficient organisation and delivery of health services for children in Australia.
Surgical care has long been viewed by donors as too costly and complex for low-resource health systems, apart from narrowly focused programs such as surgical contraception. The Lancet Commission on Global Surgery is an extensive review of the need for surgical care in low-resource health systems, the cost-effectiveness of these services, and the Commission’s framework for surgery that is safe, affordable, and timely.
