{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:35:48Z","timestamp":1792010148715,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T00:00:00Z","timestamp":1582675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Early Career Fellowship (1104644)"],"award-info":[{"award-number":["Early Career Fellowship (1104644)"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Practitioner Fellowship (1136222)"],"award-info":[{"award-number":["Practitioner Fellowship (1136222)"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014607","name":"The Royal Children's Hospital Foundation","doi-asserted-by":"publisher","award":["2018\u2010987"],"award-info":[{"award-number":["2018\u2010987"]}],"id":[{"id":"10.13039\/100014607","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine re\u2010presentation rates for self\u2010harm in patients aged 0\u201318\u2009years to the ED of a tertiary paediatric hospital in Melbourne, Australia, and associated patient, family and hospital presentation factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data for presentations from 1 July 2016 to 31 December 2018 were extracted from the hospital's electronic medical record system. Self\u2010harm presentations were identified through automated, rule\u2010based coding and manual review of medical notes. Re\u2010presentation rates for intervals up to 12\u2009months were estimated using survival methods with risk factor associations examined using Cox regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 952 presentations for self\u2010harm after 1 January 2017, 529 were considered first presentations. An estimated 15% (95% confidence interval [CI] 12\u201319), 20% (95% CI 17\u201324) and 23% (95% CI 19\u201327) re\u2010presented for self\u2010harm within 3, 6 and 12\u2009months, respectively. A total of 82% of all presentations were for girls. Patients were more likely to re\u2010present if they had previously presented more than once, were flagged as vulnerable (hazard ratio [HR] 1.35, 95% CI 1.08\u20131.68), had a history of substance abuse (HR 1.30, 95% CI 1.03\u20131.64), were female (HR 1.43, 95% CI 0.92\u20132.21), had self\u2010cut (HR 1.38, 95% CI 0.96\u20131.97), had an aggressive behaviour response team called during the visit (HR 1.44, 95% CI 0.85\u20132.45) or had a history of depression (HR 1.27, 95% CI 0.99\u20131.63).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this paediatric ED, almost one in four patients re\u2010presented with self\u2010harm within 12\u2009months. Previous presentations and other factors were associated with risk of re\u2010presenting, although no factor was strongly predictive. Future research might examine the generalisability of these findings across settings and explore strategies for prevention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13485","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T08:55:28Z","timestamp":1582707328000},"page":"320-326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Repeated presentation of children and adolescents to the emergency department following self\u2010harm: A retrospective audit of hospital data"],"prefix":"10.1111","volume":"32","author":[{"given":"Peter","family":"Summers","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Dentistry and Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Health Services Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"O'Loughlin","sequence":"additional","affiliation":[{"name":"Health Services Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Health Services Research Unit The Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinead","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"Emergency Department The Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Borschmann","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry and Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Adolescent Health Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Carlin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry and Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Clinical Epidemiology and Biostatistics Unit Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3017-2770","authenticated-orcid":false,"given":"Harriet","family":"Hiscock","sequence":"additional","affiliation":[{"name":"Health Services Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Health Services Research Unit The Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.00434"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.00589"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja18.00213"},{"key":"e_1_2_8_5_1","volume-title":"Definition of Non\u2010Suicidal Self\u2010Injury","author":"International Society for the Study of Self\u2010Injury","year":"2007"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084282"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0089944"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.09.009"},{"key":"e_1_2_8_9_1","article-title":"Child and adolescent emergency department presentations for self\u2010harm: population\u2010based data from Ontario, Canada","volume":"78","author":"Bethell JM","year":"2017","journal-title":"Diss. 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