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Article: School Mental Health Program in India-Issues and Possible Practical Solutions.

Raman, Vijaya / Thomas, Shanti

Indian journal of psychological medicine

2023 Volume 45, Issue 3, Page(s) 283–288

Language	English
Publishing date	2023-04-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2622378-8
ISSN	0975-1564 ; 0253-7176
ISSN (online)	0975-1564
ISSN	0253-7176
DOI	10.1177/02537176231165033
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Article ; Online: Street and working children: a call for rights-based approach to their health and well-being.

Seth, Rajeev / MacRae, Pia / Goldhagen, Jeffrey / Raman, Shanti

BMJ paediatrics open

2024 Volume 8, Issue 1

MeSH term(s)	Child ; Humans ; Homeless Youth
Language	English
Publishing date	2024-03-28
Publishing country	England
Document type	Journal Article
ISSN	2399-9772
ISSN (online)	2399-9772
DOI	10.1136/bmjpo-2023-002486
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Article: Did Inequalities in Mothers' and Children's Health and Well-Being in Japan Increase through the Pandemic? Evidence from Nationwide Surveys and Routinely Collected Data.

Takeuchi, Hajime / Satoh, Yoichi / Raman, Shanti / Spencer, Nick

Children (Basel, Switzerland)

2024 Volume 11, Issue 3

Abstract: Marginalised families faced significant challenges during the COVID-19 pandemic. This study explores inequalities in Japanese mothers' and children's health and well-being and family economic stability before and during the pandemic. Data sources were as ...

Abstract	Marginalised families faced significant challenges during the COVID-19 pandemic. This study explores inequalities in Japanese mothers' and children's health and well-being and family economic stability before and during the pandemic. Data sources were as follows: nationwide surveys in 2019 and 2021 of families with children using medical institutions across Japan; infant mortality and adolescent suicide rates between 2018 and 2021 from publicly available sources. Outcomes by poor and non-poor families were compared for 2019 and 2021 using simple descriptive statistics. Poor mothers' part-time working increased from 41% to 61% and regular employment was reduced by two thirds. The well-being of poor mothers worsened from 39% to 55%. Employment opportunities and well-being did not change for non-poor mothers. School subsidies among poor families increased from 23% to 55%. The infant mortality rate (IMR) among unemployed families increased significantly from 12.9/1000 to 18.2/1000 between 2018 and 2021 compared with a decreasing overall IMR from 1.9/1000 to 1.7/1000. Suicide rates in 10-19-year-olds increased over the same period although no socio-economic indicators were available. Inequalities in mothers' and children's health and well-being indicators and family economics increased between 2019 to 2021 in Japan. This study cannot attribute causes but suggests a possible role of the pandemic.
Language	English
Publishing date	2024-03-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children11030330
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Article ; Online: Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study.

Amarasena, Lahiru / Zwi, Karen / Hu, Nan / Lingam, Raghu / Raman, Shanti

BMJ open

2023 Volume 13, Issue 10, Page(s) e064497

Abstract: Objectives: To examine the changing health needs of refugee children and young people (CYP) entering Australia, in relation to key government policy changes.: Study design: Retrospective analysis of health service use data over 11 years.: Setting: ...

Abstract	Objectives: To examine the changing health needs of refugee children and young people (CYP) entering Australia, in relation to key government policy changes. Study design: Retrospective analysis of health service use data over 11 years. Setting: Paediatric refugee clinics in South Western Sydney (SWS), the Australian region with the largest annual resettlement of refugees. Participants: Refugee CYP (≤25 years) attending the SWS paediatric refugee clinics for their first visit between 2009 and 2019. Measures: Clinician defined health conditions categorised as communicable and non-communicable disease (NCD). Results: Data were analysed for 359 CYP, mean age 9.3 years; 212 male (59.1%). Most CYP (n=331, 92.2%) had health problems identified; 292 (81.3%) had ≥1 NCD and 24 (6.7%) had ≥1 communicable disease. The most frequent individual NCDs were dental disease (n=128, 35.7%) and vitamin D deficiency (n=72, 20.1%). Trend analysis showed increased odds of identifying an NCD from 2013 onwards (crude OR 1.77, 95% CI 1.06 to 2.96). Neurodevelopmental problems, especially Global Developmental Delay (n=31, 8.6%), emerged as more prevalent issues in the latter half of the decade. There were significantly increased odds of identifying a neurodevelopmental problem in 2016-2019, especially in 2016-2017 (adjusted OR 2.93, 95% CI 1.34 to 6.40). Key policy changes during this period included acceptance of refugees with disabilities from 2012, additional Australian Humanitarian Programme intake from the Eastern Mediterranean region and mandatory offshore processing for those seeking asylum by boat from 2013. In response to the changing needs, local health services adopted nurse-led primary healthcare screening, early childhood services, youth and disability clinics. Conclusions: Refugee CYP in Australia are presenting with a growing burden of NCDs, with neurodevelopmental problems contributing. Government policy changes affect the sociodemographics of resettled populations, influencing health profiles. Paediatric refugee health services need to be responsive to the changing needs of these populations to optimise well-being.
MeSH term(s)	Adolescent ; Child ; Humans ; Male ; Child, Preschool ; Australia/epidemiology ; Refugees ; Retrospective Studies ; Noncommunicable Diseases/epidemiology ; Ambulatory Care Facilities
Language	English
Publishing date	2023-10-18
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-064497
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Article ; Online: Changing landscape of paediatric refugee health in South Western Sydney, Australia

Karen Zwi / Shanti Raman / Raghu Lingam / Nan Hu / Lahiru Amarasena

BMJ Open, Vol 13, Iss

a retrospective observational study

2023 Volume 10

Abstract: Objectives To examine the changing health needs of refugee children and young people (CYP) entering Australia, in relation to key government policy changes.Study design Retrospective analysis of health service use data over 11 years.Setting Paediatric ... ...

Abstract	Objectives To examine the changing health needs of refugee children and young people (CYP) entering Australia, in relation to key government policy changes.Study design Retrospective analysis of health service use data over 11 years.Setting Paediatric refugee clinics in South Western Sydney (SWS), the Australian region with the largest annual resettlement of refugees.Participants Refugee CYP (≤25 years) attending the SWS paediatric refugee clinics for their first visit between 2009 and 2019.Measures Clinician defined health conditions categorised as communicable and non-communicable disease (NCD).Results Data were analysed for 359 CYP, mean age 9.3 years; 212 male (59.1%). Most CYP (n=331, 92.2%) had health problems identified; 292 (81.3%) had ≥1 NCD and 24 (6.7%) had ≥1 communicable disease. The most frequent individual NCDs were dental disease (n=128, 35.7%) and vitamin D deficiency (n=72, 20.1%). Trend analysis showed increased odds of identifying an NCD from 2013 onwards (crude OR 1.77, 95% CI 1.06 to 2.96). Neurodevelopmental problems, especially Global Developmental Delay (n=31, 8.6%), emerged as more prevalent issues in the latter half of the decade. There were significantly increased odds of identifying a neurodevelopmental problem in 2016–2019, especially in 2016–2017 (adjusted OR 2.93, 95% CI 1.34 to 6.40). Key policy changes during this period included acceptance of refugees with disabilities from 2012, additional Australian Humanitarian Programme intake from the Eastern Mediterranean region and mandatory offshore processing for those seeking asylum by boat from 2013. In response to the changing needs, local health services adopted nurse-led primary healthcare screening, early childhood services, youth and disability clinics.Conclusions Refugee CYP in Australia are presenting with a growing burden of NCDs, with neurodevelopmental problems contributing. Government policy changes affect the sociodemographics of resettled populations, influencing health profiles. Paediatric refugee health services need ...
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2023-10-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Identifying vulnerable children's stress levels and coping measures during COVID-19 pandemic in Japan: a mixed method study.

Takeuchi, Hajime / Napier-Raman, Sharanya / Asemota, Osamagbe / Raman, Shanti

BMJ paediatrics open

2022 Volume 6, Issue 1

Abstract: Background: The COVID-19 pandemic has disproportionately affected vulnerable children and youth. In Japan, despite evidence that the paediatric age group holds a lower risk of infection than the older population, there was a nationwide closure of ... ...

Abstract	Background: The COVID-19 pandemic has disproportionately affected vulnerable children and youth. In Japan, despite evidence that the paediatric age group holds a lower risk of infection than the older population, there was a nationwide closure of schools as an early public health measure. Acknowledging that school closures brought heightened psychological and physical stress among Japanese children, we aimed to explore vulnerable children's experiences of the COVID-19 pandemic in Japan, focusing on socially disadvantaged subset of the population. Methods: We used an adapted version of the 'Perceived Stress Scale for Children', with additional free-text space, delivered online to children attending three non-profit organisations which provide support for this group of vulnerable persons and families experiencing social disadvantage. Simple descriptive analysis was undertaken on the quantitative data; we used thematic and content analysis for the qualitative data. Results: Thirty-six children participated in the online survey, mean age was 11.3 years, majority (61%) were male. The mean overall stress score (score distribution width: 0-39) was 14.8, with no difference in score distribution by age or gender. Free-text responses obtained revealed a range of stressors and protective factors. Schooling, COVID-19 fears, family tension and pandemic measures were sources of stress; family-in particular, the support of the mother-food, friendship and recreation were sources of comfort. While most responses indicated positive coping mechanisms, some displayed maladaptive behaviours. Conclusions: The children in this cohort had high mean stress scores overall. Responses indicated that they were acutely reactive to COVID-19 as well as pandemic public health measures, and that missing schooling and contact with friends exacerbated their stress. Family was a source of strength as well as stress. A tailored public health response to COVID-19 needs to take into account the concerns voiced by vulnerable child populations be based on equity and child rights.
MeSH term(s)	Adaptation, Psychological ; Adolescent ; COVID-19/epidemiology ; Child ; Female ; Humans ; Japan/epidemiology ; Male ; Mothers ; Pandemics ; Stress, Psychological/epidemiology
Language	English
Publishing date	2022-02-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2399-9772
ISSN (online)	2399-9772
DOI	10.1136/bmjpo-2021-001310
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Article ; Online: Effect of the learning curve on survival after laparoscopic liver resection for colorectal metastases.

Shanti, Hiba / Raman, Rakesh / Chakravartty, Saurav / Belgaumkar, Ajay P / Patel, Ameet G

BJS open

2022 Volume 6, Issue 2

Abstract: Background: Laparoscopic liver resection (LLR) is a highly demanding procedure with great variability. Previously published randomized trials have proven oncological safety of laparoscopic liver resection (LLR) as compared to open surgery. However, ... ...

Abstract	Background: Laparoscopic liver resection (LLR) is a highly demanding procedure with great variability. Previously published randomized trials have proven oncological safety of laparoscopic liver resection (LLR) as compared to open surgery. However, these were started after the learning curve (LC) was established. This leaves the question of whether the LC of LLR in the early laparoscopic era has affected the survival of patients with colorectal liver metastasis (CRLM). Methods: All consecutive LLRs performed by a single surgeon between 2000 and 2019 were retrospectively analysed. A risk-adjusted cumulative sum (RA-CUSUM) chart for conversion rate and the log regression analysis of the blood loss identified two phases in the LC. This was then applied to patients with CRLM, and the two subgroups were compared for recurrence-free (RFS) and overall survival (OS). The analysis was repeated with propensity score-matched (PSM) groups. Results: A total of 286 patients were included in the LC analysis, which identified two distinct phases, the early (EP; 68 patients) and the late (LP; 218 patients) phases. The LC was applied to 192 patients with colorectal liver metastasis (EPc, 45 patients; LPc, 147 patients). For patients with CRLM, R0 resection was achieved in 93 per cent: 100 per cent in the EPc group and 90 per cent in the LPc group (P = 0.026). Median OS and RFS were 60 and 16 months, respectively. The 5-year OS and RFS were 51 per cent and 32.7 per cent, respectively. OS (hazard ratio (h.r.) 0.78, 95 per cent confidence interval (c.i.) 0.51 to 1.2; P = 0.286) and RFS (h.r. 0.94, 95 per cent c.i. 0.64 to 1.37; P = 0.760) were not compromised by the learning curve. The results were replicated after PSM. Conclusion: In our experience, the development of a laparoscopic liver resection programme can be achieved without adverse effects on the long-term survival of patients with CRLM.
MeSH term(s)	Colorectal Neoplasms/pathology ; Humans ; Laparoscopy/methods ; Learning Curve ; Liver/pathology ; Retrospective Studies
Language	English
Publishing date	2022-04-05
Publishing country	England
Document type	Journal Article
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrac020
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Article ; Online: Clinical Pathways for the Identification and Referral for Social Needs: A Systematic Review.

Wong-See, Harmonie / Calik, Anna / Ostojic, Katarina / Raman, Shanti / Woolfenden, Susan

Pediatrics

2023 Volume 151, Issue 3

Abstract: Context: Recognition of the importance of the social determinants of child health has prompted increased interest in clinical pathways that identify and refer for social needs.: Objective: The aim of this systematic review was to determine the ... ...

Abstract	Context: Recognition of the importance of the social determinants of child health has prompted increased interest in clinical pathways that identify and refer for social needs. Objective: The aim of this systematic review was to determine the effectiveness of interventions that identify and refer for social needs for families with children aged 0 to 18 years attending outpatient community and ambulatory healthcare services. Data sources: We searched the following databases: Medline, Embase, PsychINFO, CINAHL, Emcare, EBMR. Study selection: Studies were included if children and their families underwent a process of identification and referral for social needs in outpatient community and ambulatory healthcare services. Data extraction: Initial searches identified 5490 titles, from which 18 studies (73 707 families and children) were finally retained. Results: Intervention pathways were grouped into 3 categories based on whether identification and referral for social needs was conducted with only targeted community resources, a navigator, or with clinician training. The majority of studies reported positive outcomes; with an increase in social needs identification, an increase in referrals following identification, or a reduction in social needs. Child health outcome results were inconsistent. Limitations: The search terms used may have provided bias toward countries in which these terms are in use. The heterogeneity of outcome measures between included studies meant a meta-analysis was not possible. Conclusions: Despite evidence that clinical pathways for children and families help reduce social needs, evidence for improvements in child health is insufficient. Further studies from diverse settings are needed to inform clinical practice to optimize child health outcomes.
MeSH term(s)	Child ; Humans ; Critical Pathways ; Referral and Consultation
Language	English
Publishing date	2023-02-08
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2022-056837
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Article ; Online: Violence Against Children: Recognition, Rights, Responses.

Oberg, Charles / Nathawad, Rita / Raman, Shanti / Goldhagen, Jeffrey

Pediatric clinics of North America

2021 Volume 68, Issue 2, Page(s) 357–369

Abstract: All forms of violence against children (VAC) are violations of children's rights. Traditional definitions of child maltreatment do not address the rapidly evolving global spectrum of VAC. In this article, we offer an expanded definition of VAC that ... ...

Abstract	All forms of violence against children (VAC) are violations of children's rights. Traditional definitions of child maltreatment do not address the rapidly evolving global spectrum of VAC. In this article, we offer an expanded definition of VAC that integrates the principles of child rights, clinical medicine, and public health. The authors further expand the socioecological model to establish a trans-societal sphere, composed of root-cause determinants of VAC, including climate change, globalization, armed conflict, etc. A child rights-based taxonomy of VAC is also presented. The authors conclude with recommendations to address VAC in the domains of clinical practice, systems development, and policy generation.
MeSH term(s)	Bullying/statistics & numerical data ; Child ; Child Abuse/prevention & control ; Child Abuse/statistics & numerical data ; Child Advocacy/legislation & jurisprudence ; Child Advocacy/standards ; Human Rights ; Humans ; United Nations ; Violence/prevention & control
Language	English
Publishing date	2021-02-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	215711-1
ISSN	1557-8240 ; 0031-3955
ISSN (online)	1557-8240
ISSN	0031-3955
DOI	10.1016/j.pcl.2020.12.008
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Article ; Online: Language outcomes at 4 years of linguistically diverse children born very preterm: an Australian retrospective single-centre study.

Tinoco Mendoza, Giannina / Stack, Jacqueline / Abdel-Latif, Mohamed E / Raman, Shanti / Garg, Pankaj

BMJ paediatrics open

2023 Volume 7, Issue 1

Abstract: Background: Very preterm children are at increased risk of language delays. Concerns have been raised about the utility of standardised English language tools to diagnose language delay in linguistically diverse children. Our study investigated the ... ...

Abstract	Background: Very preterm children are at increased risk of language delays. Concerns have been raised about the utility of standardised English language tools to diagnose language delay in linguistically diverse children. Our study investigated the incidence of language delay at 4 years in linguistically diverse very preterm children. Methods: Very preterm children born in South Western Sydney, Australia, between 2012 and 2016, were assessed with the Clinical Evaluation of Language Fundamentals Preschool-2 (CELF-P2) tool at 4 years of age. We sought to determine the incidence of language delay in this cohort using language scores from the CELF-P2 assessment tool, and explore potential predictors associated with language delay. Results: One hundred and sixty very preterm children attended the 4-year assessment out of the included 270 long-term survivors. At 4 years, 76 (52%) very preterm children had language delay diagnosed using the CELF-P2 assessment tool. Children who preferred a language other than English had lower average core language scores on the CELF-P2 assessment tool (75.1±14.4) compared with children that preferred English (86.5±17.9); p=0.002. Very preterm children growing up in households that preferenced a language other than English and those who were born from multiple births had higher odds of language delay at 4 years (AOR 10.30 (95% CI 2.82 to 38.28); p<0.001 and AOR 2.93 (95% CI 1.20 to 7.14); p=0.018, respectively). Assessing these children using an English language tool may have affected language scores at 4 years. Conclusions: In this metropolitan setting, very preterm children from linguistically diverse backgrounds were found to be vulnerable to language delays at 4 years. Further large-scale studies evaluating the language outcomes of linguistically diverse preterm children with more culturally appropriate tools are warranted. We question the utility of standardised English language tools to assess language outcomes of linguistically diverse populations.
MeSH term(s)	Infant, Newborn ; Child, Preschool ; Female ; Humans ; Child ; Australia/epidemiology ; Retrospective Studies ; Infant, Extremely Premature ; Language ; Language Development Disorders/diagnosis ; Language Development Disorders/epidemiology
Language	English
Publishing date	2023-07-20
Publishing country	England
Document type	Journal Article
ISSN	2399-9772
ISSN (online)	2399-9772
DOI	10.1136/bmjpo-2022-001814
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