Journal of paediatrics and child health
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J Paediatr Child Health · Sep 2011
Improved neonatal survival and outcomes at borderline viability brings increasing ethical dilemmas.
With improvements in neonatal intensive care over the past five decades, the limits of viability have reduced to around 24 weeks' gestation. While increasing survival has been the predominant driver leading to lowering the gestation at which care can be provided, these infants remain at significant risk of adverse long-term outcomes including neuro-developmental disability. ⋯ Inevitably, these ethical dilemmas need to consider the uncertainty of the long-term prognosis and challenges surrounding providing or withdrawing active treatment. Further reduction in the gestational age considered for institution of intensive care will need to be guided by short- and long-term outcomes, community expectations and the availability of sufficient resources to care for these infants in the neonatal intensive care unit and beyond.
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J Paediatr Child Health · Aug 2011
Historical ArticleFrom small beginnings: the euthanasia of children with disabilities in Nazi Germany.
Although they are the lesser known Nazi atrocities, it is estimated that some 5000-8000 children with physical and intellectual disabilities were killed in Nazi Germany under a programme of euthanasia. Chronologically, they were a precedent, being the Nazis' first organised and systematic killing programme that would later enlarge to include adults with disabilities and ultimately, to the broader programme of racially motivated 'euthanasia' of the holocaust. ⋯ This paper outlines the origins and development of the programme, examines how families were involved and affected and looks at what motivated the medical staff involved with the killing. The history of the Nazi child euthanasia programme has a number of important lessons for practicing doctors and health policy-makers in the 21st century.
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J Paediatr Child Health · Aug 2011
ReviewChild nutrition and lower respiratory tract disease burden in New Zealand: a global context for a national perspective.
To consider the contribution of malnutrition to acute lower respiratory infection (ALRI) disease burden in children <5 years old in New Zealand (NZ). ⋯ The contribution of malnutrition to ALRI disease burden in NZ requires greater clarification. Such clarification is necessary to inform the development of nutritional policy, which seeks to improve early child health.
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J Paediatr Child Health · Aug 2011
ReviewClimate change: the implications for child health in Australasia.
Children are particularly vulnerable to the health effects of climate change, the biggest global health threat of the 21st century. However, the worst effects on child health can be avoided, and well-designed climate policies can have important benefits for child health and equity. We call on child health professionals to seize opportunities to prevent climate change, improve child health and reduce inequalities, and suggest useful actions that can be taken.