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Aim: Expert recommendations for child/adolescent obesity include extensive investigation for weight‐related comorbidities, based on body mass index (BMI) percentile cut‐offs. This study aimed to estimate the cost of initial investigations for weight‐related comorbidities in children/adolescents with obesity, according to international expert guidelines. Methods: The annual mean cost of investigations for weight‐related comorbidities in children/adolescents was calculated from a health‐funder perspective using 2019 cost data obtained from three New Zealand District Health Boards. Prevalence data for child/adolescent obesity (aged 2–14 years) were obtained from the New Zealand Health Survey (2017/2018), and prevalence of weight‐related comorbidities requiring further investigation were obtained from a previous New Zealand study of a cohort of children with obesity. Results: The cost of initial laboratory screening for weight‐related comorbidities per child was NZD 28.36. Based on national prevalence data from 2018/2019 for children with BMI greater than the 98th percentile (obesity cut‐off), the total annual cost for initial laboratory screening for weight‐related comorbidities in children/adolescents aged 2–14 years with obesity was estimated at NZD 2,665,840. The cost of further investigation in the presence of risk factors was estimated at NZD 2,972,934. Conclusions: Investigating weight‐related comorbidities in New Zealand according to international expert guidelines is resource‐intensive. Ways to further determine who warrants investigation with an individualised approach are required. [ABSTRACT FROM AUTHOR]

The goal of this position paper on ventilatory support at home for children is to provide expert consensus from Australia and New Zealand on optimal care for children requiring ventilatory support at home, both non-invasive and invasive. It was compiled by members of the Thoracic Society of Australia and New Zealand (TSANZ) and the Australasian Sleep Association (ASA). This document provides recommendations to support the development of improved services for Australian and New Zealand children who require long-term ventilatory support. Issues relevant to providers of equipment and areas of research need are highlighted. [ABSTRACT FROM AUTHOR]

Background: There is minimal literature available on the long-term outcome of pediatric non-cystic fibrosis (CF) bronchiectasis., Aim: To document 5-year outcomes of children with chest computerized tomography (CT) scan diagnosed bronchiectasis from a tertiary New Zealand (NZ) respiratory clinic., Methods: Review of a clinical database identified 91 children. Demographics, clinical data, lung function, chest X-ray (CXR), sputum, presumed etiology, admission data, and the NZ deprivation index (NZDep) were collected. Univariate and multivariate regression were used to correlate clinical findings with lung function data and CXR scores using the Brasfield Scoring System., Results: Of the 91 children, 53 (59%) were Pacific Island, 22 (24%) Maori, 14 (15%) European, and 2 (2%) Other. The median follow-up period was 6.7 years (range 5.0-15.3 years) and median age at diagnosis was 7.3 years (range 11 months-16 years). Lung function data (n = 64) showed a mean decline of -1.6% predicted/year. In 30 children lung function declined (mean FEV(1) -4.4% predicted/year, range 1-17%), remained stable in 13 and improved in 21 children (mean FEV(1) of +3% predicted/year, range 1-15%). Reduced lung function was associated with male gender, chronic Haemophilus influenzae infection, longevity of disease, and Maori and Pacific Island ethnicity. There was a significant correlation with FEV(1) and CXR score at beginning (n = 47, r = 0.45, P = 0.001) and end (n = 26, r = 0.59, P = 0.002) of the follow-up period. The only variable consistently related to CXR score was chronic Haemophilus influenzae infection occurring in 27 (30%) (r(2)  = 0.52, P = <0.0001). Only four children were chronically infected with Pseudomonas species. Six children died., Conclusion: In our experience despite management in a tertiary multidisciplinary bronchiectasis clinic, progression of lung disease continues in a group of children and young adults., (Copyright © 2011 Wiley-Liss, Inc.)