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Many countries have developed hospital-at-home (HAH) models to bring hospital services closer to home. Although some countries already have a long tradition of HAH for adults, paediatric HAH has been developed more recently. Specificities of paediatric care make it difficult to directly extend an adult HAH model to the paediatric population. The objective of this study is to compare the organisation of paediatric HAH in four countries: France, Australia (states of Victoria and New South Wales), the Netherlands and Belgium. Ultimately, lessons can be drawn for further development in the countries analysed and/or for implementation in other countries.

Legal documents and other grey literature were analysed to describe the legal context for the provision of paediatric HAH in the selected countries. In addition, semi-structured in-depth interviews were conducted with key informants from paediatric HAH organisations in these countries, addressing the following topics: historical background, legal framework, functioning of HAH models, workforce, number of services, profile of children, type of care activities, funding, coordination with other providers and quality of care. Results were reviewed by a content expert from the respective country.

Organisational differences were highlighted in terms of coordinating actor (hospital or home nursing care services), decision-making process, range of clinical conditions treated, territorial organisation, qualifications and expertise of the team members, medical expertise, financing, responsibilities, etc.

There is no single preferred model for the provision of HAH care for children. There is a large variety in almost all aspects of organisation. There are, however, also some common characteristics across the different models. Notably, paediatric expertise of nurses within the HAH team was considered indispensable in all programmes.

Globally, cancer represents an increasing proportion of child mortality as progress against infectious causes is made. Approximately 400,000 children will develop cancer, each year, around the world. Only about half of these cancers will ever be diagnosed. In high-resource settings, 80% of children will survive, but only about 30% will survive in low-resource settings. Digital solutions have a valuable role in increasing health professional knowledge, skills and empowerment to diagnose, treat and otherwise care for children and adolescents with cancer. This review sought to identify digital resources that support the training and development of the paediatric oncology workforce in resource -poor settings.

This paper presents a narrative descriptive review of peer-reviewed publications and digital platforms that contribute to health professionals' education and training regarding paediatric oncology, particularly in rural and other low-resource settings.

Digital solutions were identified for building communities of practice, facilitating access to information and support and providing access to training, education and supervision specifically for paediatric oncology health professionals. A total of 33 resources are discussed in depth. A quality assessment of the digital resources is provided using the Currency, Relevance, Authority, Accuracy and Purpose (CRAAP) tool and suggestions to improve the quality of resources are discussed.

The authors anticipate that this summary of digital resources for the global paediatric oncology professional community will inform digital health investments and design of digital innovations to meet emerging needs and will have an impact on the workforce in the real world. Ultimately, this work will contribute to an improvement in the diagnosis and treatment of children and adolescents with cancer in resource-poor settings.

This is the first discussion and summary of digital education platforms which educate, train and offer support to health professionals with respect to paediatric oncology. These digital platforms are often aimed at, and are essential for, health professionals in rural and other low-resource settings.

The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved.

A qualitative case study primarily consisting of interviews.

The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination.

The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability.

The purpose of this paper is to feedback the results of a survey of paediatric occupational therapists completed by the Paediatric Advisory Group (PAG) regarding perceptions and practices of the assessment of need (AON) process. This survey was completed to gather feedback from occupational therapists about the impact of the AON process on paediatric occupational therapy practice in Ireland.

A questionnaire was developed by the authors, who were on the PAG committee, to specifically gather quantitative and qualitative information about the AON. A snowball sampling method was utilised. The results were grouped into themes related to the practices and recommendations from occupational therapists nationally.

Surveys were returned from 98 paediatric occupational therapists with a wide national geographical spread with the majority working in the HSE. The amount of time spent on AON assessments, as well as the length of reports, varied nationally. The process of how assessments were completed (unidisciplinary or multidisciplinary) and whether a diagnosis was provided was inconsistent. Concerns were raised about the negative ethical impact of the AON on service provision and intervention and the need for further training of staff along with more frequent assessment reviews. The respondents also highlighted concerns about the increasing age of the AON criteria, with no increase in resources, and they provided suggestions for improvements for the future.

The survey was sent to all AOTI and PAG members via gatekeepers and then forwarded to others, resulting in a snowball sampling technique; however, this does not represent all paediatric occupational therapists nationally as membership in these groups is voluntary.

The concerns and inequities raised in the survey regarding occupational therapy practices of completing the AON process need to be shared with relevant stakeholders both at the occupational therapy management level and in the HSE and Department of Health/Disability. The PAG will continue to highlight these concerns from their members to relevant parties and by disseminating findings in articles such as this.

Ethical concerns were raised by some members about the equity of access to interventions as a result of the AON process. The social implication of this for families and children is pertinent, particularly in the context of the increased age in the AON criteria without any increase in resources.

The PAG aims to support paediatric occupational therapists nationally and the committee often gathers feedback from members regarding concerns which affect day-to-day practice in paediatric OT. Sharing of this information with IJOT readers helps to highlight the challenges faced by paediatric occupational therapists nationally.

Modern healthcare services are commonly based on shared models of care, in which a strong emphasis is placed upon the views of those in receipt of services. The purpose of this paper is to examine the parents’ experiences of their child’s neuropsychological assessment.

This was a mixed-methodology study employing both quantitative and qualitative measures.

The questionnaire measure indicated a high overall level of satisfaction. Qualitative analysis of parental interviews provided a richer insight into the parental experience and indicated four major themes.

Implications covered three major areas. Firstly, whilst a high value was placed upon the assessment, the need for further comprehensive neurorehabilitation and intervention was highlighted. Secondly, this study highlights the significant adversity experienced by such families and subsequent unmet psychological needs which also require consideration. Finally, findings from the current study could assist in improving future measures of satisfaction in similar services.

This is the first published study of parental experiences of and satisfaction with paediatric neuropsychological assessment in the UK.

To ensure that paediatric surgery patients receive appropriate intravenous fluids post‐operatively.

Retrospective case‐series study of paediatric patients undergoing major abdominal surgery, comparing fluids received with a target regimen and noting the effect on urine output and serum sodium.

Patients in the study received larger amounts of fluid than the target regimen. Urine outputs were normal to high. Post‐operative sodium levels were normal in all patients.

Paediatric surgery fluid management is an ongoing and important subject for debate. Audit can help improve implementation of accepted fluid management protocols. Interdepartmental seminars, a national survey of practice, and revision of fluid management protocols have resulted from this survey.

A healthy, balanced and nutritious diet for children and young people is essential for normal growth and development. Vending machines can be a source of food and drink high in fat, sugar and salt, and can undermine healthy eating messages. The purpose of this paper is to examine the contents of vending machines available in the vicinity of paediatric wards and paediatric out‐patient departments in hospitals in Wales.

Questionnaires are completed by staff in the Department of Child Health in each NHS Trust in Wales. This paper summarises the results.

Most vending machines found in the vicinity of paediatric wards and paediatric out‐patient departments in hospitals in Wales contain a majority of foods high in fat salt and sugar. Only a few contain over 50 per cent of drinks classified as healthy.

There is no universally agreed definition of healthy food as related to individual products. This study looks at the availability of foods and drinks classified as “unhealthy” but does not look at the overall diet of the children in the ward.

The results of this study should encourage NHS Trusts to consider the contents of vending machines in the vicinity of paediatric wards and paediatric out‐patient departments in hospitals.

There is much rhetoric around the potential of vending machines to contribute to an unhealthy diet. This is the first paper to identify specific problems with hospital vending machines.

Paediatric congenital esophageal atresia surgery typically requires delicate and dexterous operations in a narrow and confined workspace. This study aims to develop a novel robot assisted surgical system to address these challenges.

The proposed surgical robot consists of two symmetrical slave arms with nine degree of freedoms each. Each slave arm uses a rigid-dexterous configuration and consists of a coarse positioning manipulator and a distal fine operation manipulator. A small Selective Compliance Assembly Robot Arm (SCARA) mechanism was designed to form the main component of the coarse positioning unit, ensuring to endure large forces along the vertical direction and meet the operational demands. The fine positioning manipulator applied the novel design using flexible shafts and universal joints to achieve delicate operations while possessing a high rigidity. The corresponding kinematics has been derived and then was validated by a co-simulation that was performed based on the combined use of Adams and MATLAB with considering the real robot mass information. Experimental evaluations for the tip positioning accuracy and the ring transfer tasks have been performed.

The simulation was performed to verify the correctness of the derived inverse kinematics and demonstrated the robot’s flexibility. The experimental results illustrated that the end-effector can achieve a positioning accuracy within 1.5 mm in a confined 30 × 30 × 30 mm workspace. The ring transfer task demonstrated that the surgical robot is capable of providing a solution for dexterous tissue intervention in a narrow workspace for paediatric surgery.

A novel and compact surgical assist robot is developed to support delicate operations by using the dexterous slave arm. The slave arm consists of a SCARA mechanism to avoid experiencing overload in the vertical direction and a tool manipulator driven by flexible shafts and universal joints to provide high dexterity for operating in a narrow workspace.

Play occupation has been identified as an essential part of children’s lives, and it subsequently features in paediatric occupational therapy. However, few studies address the current place of play and play occupation in occupational therapy practice. This study aims to address this gap in knowledge by exploring paediatric occupational therapists’ perspectives on the place of play and play occupation in occupational therapy practice in Ireland.

A cross-sectional online survey was conducted to gather data about the current use of play in the occupational therapy for children under 12 years. Convenience sampling and snowball recruitment techniques were used to recruit paediatric occupational therapists. Data were analysed using descriptive statistics and qualitative content analysis.

In total, 65 therapists responded to the survey (estimated response rate, 32%). Results are organised into four sections: demographics and practice context, play assessment practices, use of play in practice and perceived barriers to play-centred practice. Respondents reported that they valued play as a childhood occupation. However, the survey findings identified that the primary focus was on play as a means to an end. Lack of education on play (research, theory and interventions) and pressures in the workplace have been identified as barriers to play-centred practice.

Findings indicate that there is a mismatch between therapists valuing play as an occupation and how play is used in occupational therapy practice. Unless clarifications are made about play occupation as being different to skills acquisition in childhood, play occupation will continue to get overlooked as an authentic concern of occupation-centred practice. Thus, play as occupation deserves further attention from educators, researchers and practitioners as a means of strengthening occupation-centred practice, in particular play-centred practice in the paediatric context.

Play has been described as an important occupation in childhood, and consequently, it features in paediatric occupational therapy. However, little is known about the current place of play in occupational therapy practice. This study addresses this gap by considering the current place of play in occupational therapy practice in Ireland.

This review paper seeks to conceptualise childhood obesity through clinical, operational, and financial procedures. It informs multiple disciplines about: the trajectory of paediatric obesity and current recommendations; the trends in the clinical, administrative/policy and financial worlds of paediatric obesity; and discusses commonly misunderstood collaborative terms.

The paper is based on analysis of national and international policy documents and research papers in the field.

Paediatric obesity treatment teams, programmes, and providers could all benefit from a document that bridges the disciplines of medicine, other professions, and financial management. A family centred, multidisciplinary approach is necessary at all stages of obesity treatment care and the three‐world model discussed is helpful in achieving this. The clinical, operational, and financial aspects of the service need to be integrated in a way that reduces the barriers to accessing services.

The paper combines perspectives from different service sectors: clinical, operational, and financial. To facilitate interdisciplinary cooperation, it offers common definitions of terms that often have different meanings for those involved.