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Extremely long Australian paediatric outpatient waiting lists have resulted in large numbers of children waiting to see a paediatrician. Analyses of the patient referrals suggest that a large proportion of children may benefit from allied health input, in addition to being seen by the paediatrician. This paper provides an organisational strategy that involves streamlining Allied Health clinical services in an effort to assist with bringing down a Paediatric Out-patient waitlist. The paper describes principles to guide the formation of a Paediatric Allied Health Multi-Disciplinary team that proposes assessment and brief interventions. The service would focus on supporting the paediatricians through the use of structured procedures, telephone intakes, multidisciplinary triage, shared and standardised assessments, collaborative formulations and reports, brief interventions, clinical-community linkages, and allied health student support. A variety of additional important organisational principles are proposed to facilitate patient flow from the perspective of streamlining administrative processes, having adequate administrative support, shared responsibilities, teamwork, flexibility, carrying out intake assessments, determining which referrals were appropriate for allied health, and working closely with medical staff.

Objective: To understand software tasks aimed at improving cognitive abilities in school-aged children born pre-term to determine if paediatric clinic advice on manual exercises can be given if the software is inaccessible. Method: Exploration of software tasks and linking these to results of seminal experiments on cognitive ability. Outcome: It may be possible to performing some of these software tasks manually to improve working memory, however some further research on the efficacy of these techniques with school-aged children born pre-term are required.

IMPORTANCE: There is a paucity of high-quality evidence on the effect of care coordination on health-related quality of life among children with chronic noncomplex medical conditions (non-CMCs). OBJECTIVE: To examine whether care coordination delivered by an Allied Health Liaison Officer results in improved quality-of-life (QOL) outcomes for children with chronic non-CMCs and their families. DESIGN, SETTING AND PARTICIPANTS: This multicenter, open label, randomized clinical trial was conducted in pediatric outpatient clinics at 3 Australian hospitals with tertiary- and secondary-level pediatric care facilities. A total of 81 children with chronic non-CMCs and their families participated in the trial for a period of up to 12 months between October 2017 to October 2020. Primary care reviews were offered at 1 week, 3 months, and 6 months after diagnosis. INTERVENTIONS: Eligible children were randomized 1:1 to receive care coordination or standard care. Families of children receiving care coordination were provided access to an Allied Health Liaison Officer, who was responsible for facilitation of health care access across hospital, education, primary care, and community sectors. MAIN OUTCOMES AND MEASURES: The primary outcomes were scores on the Pediatric Quality of Life Inventory (PedsQL), version 4.0, and the PedsQL Family Impact Module, version 2.0, measured at 6 and 12 months. An intent-to-treat approach was used to analyze the data. RESULTS: Of 81 children (mean [SD] age, 8.2 [3.5] years; 55 [67.9%] male), 42 (51.9%) were randomized to care coordination and 39 (48.1%) to standard care. Compared with standard care, care coordination resulted in greater improvements in overall PedsQL scores (difference in score changes between groups, 7.10; 95% CI, 0.44-13.76; P = .04), overall PedsQL Family Impact Module scores (difference in score changes between groups, 8.62; 95% CI, 1.07-16.16; P = .03), and family functioning QOL (difference in score changes between groups, 15.83; 95% CI, 5.05-26.62; P = .004) at 12 months after diagnosis. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, care coordination improved the quality of life of children with chronic non-CMCs and their families. Further studies should explore specific non-CMCs that may benefit most from care coordination and whether an orientation among health services to provide such a coordination model could lead to longer-term improved clinical outcomes. TRIAL REGISTRATION: http://anzctr.org.au Identifier: ACTRN12617001188325

When teachers require on-going coaching in the management of students’ behaviours, Tele-Education may be used to bridge this competency gap. India’s education policy has had considerable success in increasing students, from rural and disadvantaged areas, participating and completing secondary schooling. However, it has also resulted in higher numbers of students with challenging classroom behaviours. Behavior management is not well addressed in the current national plan and little training is provided to teachers. Previous research on students defined the behavioural management issues as well as the skills requirements for teachers to manage and provide positive behavioural management. As a result, three brief online training modules were developed and three real time behavior management case discussions were provided to assist teachers (n = 10) to manage challenging behaviours by male students (n = 50) in a pre and post intervention single group design. The Tele-Educational intervention increased teacher application of behavior management principles and improved classroom behavior in young males, suggesting potential for the approach to be utilised in other parts of India or in other countries where there is a need for this training.

Caregiver Information Sheet. (DOCX 406 kb)

This study sought to experimentally validate two reported precipitants of chronic headaches, namely, negative affect (anxiety, anger, depression) and visual disturbance (flicker, glare, eyestrain), and to investigate whether they triggered common or different physiological mechanisms. Twenty-two male and 68 female subjects (46 with migraine, 29 with tension-type headache, and 15 controls) were submitted to antecedent challenges in the laboratory which induced negative affect or visual disturbance and to a control challenge. The results demonstrated that negative affect and visual disturbance can indeed precipitate headaches, and that the physiological responses associated with these antecedents differ, but the findings were not conclusive as to whether one or more physiological mechanisms are operative. Follow-up revealed that the antecedent challenges had significant effects on headache activity 48 to 72 hours after termination.