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Background: An increasing number of children diagnosed with both low‐ and high‐risk neuroblastoma are surviving. Yet, treatment can be intensive and often multimodal, especially for high‐risk neuroblastoma, resulting in significant long‐term health problems. We aimed to describe neuroblastoma survivors' pediatric hospitalizations, readmissions, and their associated costs. Method: We conducted a population‐based study of all children (<18 years) residing in New South Wales (NSW), Australia, and hospitalized with a recorded diagnosis of neuroblastoma during 2001–2020. We used linked NSW Admitted Patient Data Collection and death registration data to examine the frequency, length of stay, and readmissions following the first admission when neuroblastoma was diagnosed (i.e., the index admission), and the associated hospitalization costs by age and timing postindex admission discharge. Results: In total, 300 children (64% aged <3 years) were hospitalized for neuroblastoma over the study period. The median number of readmissions and length of stay within 2 years postdischarge were 17 (interquartile range IQR: 5.5–25) and 45.5 (IQR: 10–125) days, and median cost per child was AUD$124,058 (IQR $34,217–$264,627). Following discharge from the index admission, there were 7088 readmissions (median: 20 per child, IQR: 7–29). Fifty‐eight percent of readmissions occurred within 1‐year postdischarge, primarily due to fever, nausea, abdominal pain, and respiratory conditions. Conclusion: The burden of health problems requiring hospitalization among neuroblastoma survivors results in significant associated healthcare costs, warranting further efforts to optimize health care for neuroblastoma survivors that focuses on early intervention and long‐term monitoring. [ABSTRACT FROM AUTHOR]

Objective: To examine academic outcomes among children hospitalised with a chronic health condition.Design: Population-level birth cohort.Setting: New South Wales, Australia.Participants: 397 169 children born 2000-2006 followed up to 2014.Intervention/exposure: Hospitalisations with a chronic condition.Main Outcome Measures: Academic underperformance was identified as 'below the national minimum standard' (BNMS) in five literacy/numeracy domains using the national assessment (National Assessment Program-Literacy and Numeracy) data. Multivariable logistic regression assessed the adjusted ORs (aORs) of children performing BNMS in each domain at each grade (grades 3, 5 and 7, respectively).Results: Of children hospitalised with a chronic condition prior to National Assessment Program-Literacy and Numeracy (NAPLAN) (16%-18%), 9%-12% missed ≥1 test, with a maximum of 37% of those hospitalised ≥7 times, compared with 4%-5% of children not hospitalised. Excluding children who missed a NAPLAN test, more children hospitalised with a chronic condition performed BNMS across all domains and grades, compared with children not hospitalised (eg, for BNMS in reading at grade 3: n=2588, aOR 1.35 (95% CI 1.28 to 1.42); for BNMS in numeracy at grade 3: n=2619, aOR 1.51 (95% CI 1.43 to 1.59)). Increasing frequency and bed-days of hospitalisation were associated with 2-3 fold increased odds of performing BNMS across all domains and grades. Children hospitalised with mental health/behavioural conditions had the highest odds of performing BNMS across all domains at each grade.Conclusions: Children hospitalised with a chronic condition underperform academically across literacy/numeracy domains at each school grade. Health and educational supports are needed to improve these children's academic outcomes. [ABSTRACT FROM AUTHOR]

Patients undergoing heart and lung transplantation are a unique and heterogenous group. Nutrition status prior to transplant is associated with mortality and morbidity following transplantation. The dietitians at St Vincent's Hospital, Sydney provide comprehensive nutrition care both prior to and following transplantation to optimise the nutrition status of these patients. A dietitian-led clinic within the transplant workup clinic has been implemented, with a soon to commence research project embedded, that will evaluate the impact of pre-operative dietetic interventions on patient outcomes post-transplant. It is hoped that this research will guide service development and contribute to the limited existing literature highlighting the important role of dietetics within heart and lung transplantation. [ABSTRACT FROM AUTHOR]

Aim: To determine population-based prevalence, hospital use and costs for children admitted to hospital with chronic conditions.Methods: We used hospital admissions data for children aged <16 years, 2002-2013 in New South Wales, Australia.Results: Of all admissions, 35% (n = 692 514) included a diagnosis of a chronic condition. In 2013, prevalence was 25.1 per 1000 children. Children with greater socio-economic disadvantage or living in regional and remote areas had lower prevalence, but a higher proportion of emergency admissions. Prevalence rates were highest for respiratory and neurological conditions (9.4, 7.4 per 1000, respectively). Mental health conditions were most common in older children. Admissions involving chronic conditions had longer length of stay (3.0 vs. 1.6 days), consumed more bed-days (50% of total) and involved 43% of total hospital costs.Conclusion: Differences in prevalence and use of hospital services suggest inequities in access and need for more appropriate and equitable models of care. [ABSTRACT FROM AUTHOR]

Aim: Enteral tube feeding (ETF) is an important part of treatment for paediatric cancer patients. Without nutritional therapy, the prevalence of under-nutrition during treatment for childhood cancer may be as high as 50%. To ensure that the appropriate initiation of ETF is optimised, information on the views of key stakeholders regarding ETF is needed. Methods: In total, 48 interviews were conducted with parents of paediatric cancer patients (n = 20), patients (n = 10) and members of the paediatric oncology health-care team (n = 18). Semistructured interviews were used to elicit information from participants, and the data were analysed using a content analysis approach. The interviews focused on views regarding: (i) attitude toward, and impact of, ETF; (ii) information and support regarding ETF; and (iii) clinical management of ETF. Results: There was agreement between stakeholders on the impact of ETF on patients, both positive (good nutrition, weight gain and decreased anxiety) and negative (physical appearance, invasive insertion procedure and comfort). There were discordant perceptions regarding the timing and type of information provided on the use of ETF, as well as the decision-making process used. Conclusions: By standardising the information given to parents and enhancing understanding of parent, patient and health-care worker perceptions about ETF, the initiation of tube feeding may be optimised. This may positively impact patient outcomes in the future. [ABSTRACT FROM AUTHOR]

At Barangaroo South on Sydney's central business district waterfront, Australia, Lend Lease is working with the New South Wales government on the A$6 billion (£4 billion) transformation of a former container port into a thriving business, residential and leisure precinct. The vision is that Barangaroo South will enhance Sydney's position as an internationally appealing, globally competitive, environmentally sustainable city. The development will be Australia's first large-scale carbon dioxide neutral precinct. Barangaroo South will feature three commercial towers ranging in height from 39 to 49 storeys, sharing a common, two-level basement to be retained around its perimeter by an approximately 770 m long diaphragm wall, socketed into Sydney sandstone. As the basement excavation will be below sea level, it is essential that the site retention wall for the basement also acts as a cut-off against groundwater ingress. This paper provides an overview of the design and construction challenges facing the installation of the diaphragm wall and the innovative solutions adopted to overcome these challenges. [ABSTRACT FROM AUTHOR]

Objectives. We assessed the effects of levels and duration of exposure to televised antismoking advertising on cognitive and behavioral changes. Methods. We used data from a serial cross-sectional telephone survey with weekly interviews of adult smokers and recent quitters in New South Wales, Australia (n = 13 301), between April 2005 and December 2010. We merged survey data with commercial TV ratings data to estimate individuals' exposure to antismoking advertising. Results. Logistic regression analyses indicated that after adjustment for a wide range of potential confounders, exposure to antismoking advertising at levels between 100 and 200 gross rating points per week on average over 6 to 9 weeks was associated with an increased likelihood of having (1) salient quitting thoughts and (2) recent quit attempts. Associations between exposure for shorter periods and these outcomes were not significant. Conclusions. Broadcasting schedules may affect the success of antismoking ads. Campaign planners should ensure advertising exposure at adequate frequency over relatively sustained periods to maximize impact. [ABSTRACT FROM AUTHOR]

Young people recovering from cancer may lack adequate support post-treatment, yet little is known about the types of support and information young Australians and their families need. This study investigated adolescent/young adult cancer survivors' and their families' perceptions of care and support needs after completing cancer treatment. Seventy semi-structured interviews were conducted with 19 survivors (mean age 16.1 years), 21 mothers, 15 fathers and 15 siblings. Interviews were recorded, transcribed and analysed using the conceptual framework of Miles and Huberman. Post-treatment, participants regarded medical staff positively but were reluctant to ask for their help fearing it may deflect resources away from patients still receiving treatment. Appraisals of social workers' and psychologists' support post-treatment were mixed. Formal emotional support was rarely accessed and participants reported that any additional funds should be directed to greater psychological support in this period. Participants also reported the need for additional financial support post-treatment. Clinicians need to be aware that while young people and their families may not demand support post-treatment, they may 'suffer in silence' or burden family members and friends with the responsibility of providing emotional support, though they may be experiencing distress also. [ABSTRACT FROM AUTHOR]

Starting or returning to school after intense medical treatment can be academically and socially challenging for childhood cancer survivors. This study aimed to evaluate the school (re)entry experience of children who had recently completed cancer treatment. Forty-two semi-structured telephone interviews were conducted to explore parents' perceptions of their child's (re)entry to school after completing treatment (23 mothers, 19 fathers, parent mean age 39.5 years; child mean age 7.76 years). Interviews were analysed using the framework of Miles and Huberman and emergent themes were organised using QSR NVivo8. Parents closely monitored their child's school (re)entry and fostered close relationships with their child's teacher to ensure swift communication of concerns should they arise. The most commonly reported difficulty related to aspects of peer socialisation; survivors either displayed a limited understanding of social rules such as turn taking, or related more to older children or teachers relative to their peers. Additionally, parents placed a strong emphasis on their child's overall personal development, above academic achievement alone. Improved parent, clinician and teacher awareness of the importance of continued peer socialisation during the treatment period is recommended in order to limit the ongoing ramifications this may have on school (re)entry post-treatment completion. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the study on pilot-testing the fertility decision aid (DA) in women diagnosed with breast cancer.

Purpose: To report the pattern of uveitis in patients attending a tertiary uveitis service in Sydney, Australia.Methods: The charts of patients seen between January 2009 and December 2015 were retrospectively reviewed. Data pertaining to patient demographics, eye examination on presentation, work-up and final diagnoses were collected.Results: The total number of patients with uveitis seen over this period was 1165. There were 650 males (56%) and 515 females (44%). There were 838 patients aged 17-60 years (72%) and 327 patients aged >60 years (28%). Uveitis was anterior in 735 patients (63%), posterior in 234 patients (20%), pan in 109 patients (9%), and intermediate in 87 patients (8%). The most common associations were HLA-B27+ve (264 patients; 22.8%), sarcoidosis (78 patients; 6.7%) and Fuchs (33 patients; 2.8%), while VZV (51 patients; 4.4%), HSV (49 patients; 4.2%), tuberculosis (49 patients; 4.2%) and toxoplasmosis (48 patients; 4.1%) were the most common infectious causes of uveitis. No identifiable association was found in 389 patients (33.4%). HLA-B27 was more common in the younger age group compared with the older age group (p<0.001, χ2-test), but there was no difference between the age groups for no identifiable cause (p value 0.24) and sarcoidosis (p value 0.08).Conclusions: This retrospective case review reveals a broad spectrum of uveitis in a tertiary referral service in Sydney, Australia. It is comparable with other major studies around the world. [ABSTRACT FROM AUTHOR]

Background: The high mortality of severe anorexia nervosa causes clinicians to consider any legal avenues for coercing acutely-ill patients to remain in treatment or refeeding programs, such as mental health laws or adult guardianship laws., Method: Review of pattern of laws for coercing treatment in various jurisdictions and retrospective file analysis over 4.7 years for a specialist anorexia unit in the State of New South Wales, Australia, to isolate attributes associated with resort to two different avenues of legal coercion., Results: Coercion is most likely indicated for patients with more chronic histories (prior AN admissions), already known to the unit, where they present with other psychiatric illnesses and a low BMI. Compared to voluntary admissions, coerced patients were significantly more likely to experience the refeeding syndrome (an indicator of being seriously medically compromised). They were more likely to be tube fed and placed on a locked unit., Limitations: Sample size, limited variables and retrospective analysis method., Conclusions: The study suggests that, where available, clinicians will use legal coercion to help treat severe medical crisis situations, or manage behaviors such as vomiting, excessive exercise/sit-ups, or of absconding to no fixed abode when patients are very young.