Aim
Human parechovirus (HPeV) is an increasingly recognised cause of severe illness and central nervous system infection in infants. Medium‐ to long‐term neurodevelopmental outcomes post‐HPeV infection remain unknown. This study aims to assess neurodevelopmental outcomes for children hospitalised as infants with HPeV infection in their second and third years of life.
Methods
This prospective cohort study followed children hospitalised with HPeV in Brisbane, Queensland during the 2017/2018 outbreak. Serial application of Ages and Stages Questionnaire (ASQ) was used to assess developmental progress in the second and third years of life. Data from clinical follow‐up, audiology and neuroradiology were included.
Results
In the second year of life, 63% (n = 29) of children showed some or significant concerns for developmental delay. This had largely been ameliorated by the third year of life when only 30% (n = 14) reported developmental concerns. Prematurity and apnoeas were associated with developmental concerns at 27–36 months of age. Communication was the most common domain of concern.
Conclusions
The majority of infants hospitalised with HPeV infection in 2017–2018 showed normalisation of developmental progress by 27–36 months of age. Further investigation into more subtle neurological impairments in later childhood is required. These results can help guide clinicians in counselling parents during the acute illness and in planning appropriate follow‐up.
Aims
Children with severe needle phobia find vaccination extremely distressing and can remain unvaccinated, which puts them at an increased risk of contracting and transmitting vaccine preventable disease. Referral to a specialist or hospital service may occur when they cannot be safely vaccinated in the community, but engagement of allied health services can be inconsistent. The aim of the study was to assess the impact of a multidisciplinary, consumer‐oriented model of care on vaccinations for needle phobic children.
Methods
Needle phobic children aged between 6 and 16 years attended multidisciplinary consultation, as part of a care package, to assess previous experiences and determine the level of intervention that was required to support vaccination. A multidisciplinary case meeting followed this appointment and an individualised plan formulated for each patient. The main outcome of the project was rate of successful vaccination.
Results
The care package resulted in a successful vaccination rate of 83% (n = 20) with 69 vaccines administered across three clinics. Of those successful, 90% required multiple injections per visit. The majority of patients indicated moderate to high level of anxiety. Supportive care was escalated and de‐escalated as tolerated.
Conclusions
Results demonstrate the diversity of patients presenting with needle phobia and indicate an individualised, collaborative approach is preferable to a ‘one size fits all’ model of care. The study highlights a need for the development of guidelines that streamline the assessment and individualisation of procedural anxiety plans to meet patient needs and embed these processes into standard care.
A four step Framework has been developed for implementation across adult public mental health services in NSW. The Framework focuses not only on collecting consumers' views of mental health services but on ensuring that procedures to report on and make changes based on this information are in place.
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