DoRA 2.0 | Database of Research Activity

Collaborative General Practitioner Shared Care Versus Self-Directed Care Following Critical Illness in Young Children: A Pilot Hybrid Effectiveness-Implementation Randomized Controlled Trial

Wed, 26 Aug 2026 00:00:00 GMT

Title: Collaborative General Practitioner Shared Care Versus Self-Directed Care Following Critical Illness in Young Children: A Pilot Hybrid Effectiveness-Implementation Randomized Controlled Trial Authors: Long, Debbie A; Tyack, Zephanie; Anthony, Lori; Dow, Belinda; Dunn, Leigh; Le Marsney, Renate; Pham, Trang M T; Best, James; Webb, Kerri-Lyn; Liley, Helen; Stocker, Christian; Thoms, Debra; Schlapbach, Luregn J; Moore, Charlotte; Lister, Paula; Bora, Samudragupta; Gibbons, Kristen Abstract: Up to one in three PICU survivors experience persistent developmental or psychologic challenges, and parents often report significant psychologic distress. Current health systems lack standardized pathways to support children and families after PICU. We aimed to assess the feasibility of a randomized controlled trial (RCT) of a collaborative general practitioner (GP) shared-care follow-up model of care intervention and the feasibility, acceptability, and appropriateness of the intervention. Multicenter, pilot, hybrid effectiveness-implementation study with parallel RCT. Trial registration: Australian and New Zealand Clinical Trials Registry, ACTRN12621000799853, June 24, 2021. Two PICUs in Queensland, Australia. Parents of children admitted to PICU from ages 2 months or older to younger than 4 years. Participants were randomized (1:1, web-based block randomization schedule) to 6 months of GP shared care (intervention) or self-directed care (active control). The primary outcome was trial feasibility. Secondary effectiveness and implementation outcomes included child neurodevelopmental vulnerability and parent psychosocial outcomes at 6 months and parental perception of the feasibility, acceptability, and appropriateness of the intervention, respectively. Between October 2021 and March 2023, 154 of 363 eligible parents (one per family) provided consent (42%); 69 were randomized to the intervention, and 72 to active control. Most parents were mothers (95%), 31-40 years old (54%), from metropolitan areas (72%). Children were predominantly male (64%), younger than 12 months old (41%), admitted for respiratory illness (39%). Retention (81%), fidelity (96%), and intervention acceptability was high (71-86%), but recruitment was low (42%) and intervention feasibility varied (35-82%). At 6 months, neurodevelopmental vulnerability rates were similar (shared care [39%] vs. active control [44%]; adjusted odds ratio (aOR), 0.72 [95% CI, 0.32-1.60]). Parenting stress was lower in the intervention group (median, 20 [interquartile range (IQR), 12-47]) vs. active control (median, 42 [IQR, 19-66]; difference, -23 [95% CI, -40 to -6]). A trial of a collaborative GP-shared-care model of care post-PICU is feasible and may reduce parenting stress. Further intervention refinement and a larger trial are warranted to evaluate clinical effectiveness, implementation, and scalability.

A 5-Year Retrospective Study on Infant Homicide Presenting as Cot Death: Are We Missing Infant Homicides?

Wed, 01 Dec 2021 00:00:00 GMT

Title: A 5-Year Retrospective Study on Infant Homicide Presenting as Cot Death: Are We Missing Infant Homicides? Authors: Tse, Rexson; Ioelu, Leilani; Chen, Matthew; McCarthy, Sinead; Glenn, Charley; Kesha, Kilak; Morrow, Paul; Stables, Simon Abstract: Being found dead in cot or bed is the most common presentation encountered with infant deaths. These deaths are often associated with unsafe sleep environment. The postmortem examination in such cases is often negative, and along with family objections, cultural, and other factors, may lead to a coroner considering not authorizing a postmortem examination. However, not identifying a homicide is a potential risk if a postmortem examination is not performed. This 5-year retrospective study investigated the proportion of infant homicide death initially presenting as cot death. Of a total of 103 cases of infants initially presenting as being found dead in cot or bed, 3 (approximately 3%) were classified as homicides after postmortem examination. During the study period, a total of 9 infant homicides were reported, translating to 33% (3 of 9) of infant homicides presented as cot deaths. Postmortem radiology was a valuable adjunct, but was unable to recognize 2 of the homicide cases with traumatic head injuries (with subdural hemorrhage and brain injury only). We strongly advocate that all infant deaths presenting as cot death require a full postmortem examination.

A 5-Year Retrospective Study on Infant Homicide Presenting as Cot Death

Fri, 01 Jan 2021 00:00:00 GMT

Title: A 5-Year Retrospective Study on Infant Homicide Presenting as Cot Death Authors: Tse, Rexson; Ioelu, Leilani; Chen, Matthew; McCarthy, Sinead; Glenn, Charley; Kesha, Kilak; Morrow, Paul; Stables, Simon Abstract: Being found dead in cot or bed is the most common presentation encountered with infant deaths. These deaths are often associated with unsafe sleep environment. The postmortem examination in such cases is often negative, and along with family objections, cultural, and other factors, may lead to a coroner considering not authorizing a postmortem examination. However, not identifying a homicide is a potential risk if a postmortem examination is not performed. This 5-year retrospective study investigated the proportion of infant homicide death initially presenting as cot death. Of a total of 103 cases of infants initially presenting as being found dead in cot or bed, 3 (approximately 3%) were classified as homicides after postmortem examination. During the study period, a total of 9 infant homicides were reported, translating to 33% (3 of 9) of infant homicides presented as cot deaths. Postmortem radiology was a valuable adjunct, but was unable to recognize 2 of the homicide cases with traumatic head injuries (with subdural hemorrhage and brain injury only). We strongly advocate that all infant deaths presenting as cot death require a full postmortem examination.

An analysis of child suicide from three centers (2008-2017)

Thu, 01 Dec 2022 00:00:00 GMT

Title: An analysis of child suicide from three centers (2008-2017) Authors: Olds, Kelly L; Tse, Rexson; Stables, Simon; Baker, Andrew M; Hird, Kathryn; Langlois, Neil E I; Byard, Roger W Abstract: Although the overall suicide rate worldwide has changed minimally over the past 100 years, different trends have been observed over time in the USA, Australia, and New Zealand (NZ). However, few studies have focused on suicides in children (< 18 years), making evaluation of possible trends difficult. The last 20 years has also seen an increase in childhood obesity, eating disorders, and body image issues for children in many developed nations; however, few studies have shown whether a significant proportion of child suicides have an abnormal BMI. The current study evaluates child suicides (from 2008 to 2017) in South Australia (Australia), compared with the jurisdictions of Auckland (NZ) and Hennepin County (USA). Demographic data (age, sex, ethnicity), body mass index (BMI), the number of cases of youth suicide, and the method of suicide from these three regions were collected and analyzed. Across the 10-year period, the jurisdiction of Auckland had a downward trend, while Hennepin County and South Australia had increasing numbers of cases. The most common method of child suicide in all centers was hanging, occurring in > 80% of cases in South Australia and Auckland and 56% in Hennepin County. Hennepin County had a greater proportion of suicides using firearms (28%), compared to 1.9% in Auckland and 5.1% in South Australia. Unusual means of suicide were used less frequently by youth than previously.