Archives of Disease in Childhood-Education and Practice Edition最新文献

{"title":"Neurological presentation does not always mean a neurological diagnosis.","authors":"Saskia Woolgrove, Saad Ahmed, Kapil Garg, Peter Bale, Tom Walton","doi":"10.1136/archdischild-2023-326589","DOIUrl":"10.1136/archdischild-2023-326589","url":null,"abstract":"<p><p>This case article takes you on a journey starting with a paediatric patient presenting with sudden-onset lower limb paralysis and paraesthesia. Differential diagnoses, investigations and management are discussed as the case progresses, ultimately leading to the underlying cause.</p>","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":"312-316"},"PeriodicalIF":1.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifteen-minute consultation: Empowering children, young people and families through shared decision-making: a practical guide.","authors":"Arvind Nagra, Isabella Darshani Fuller, Gary Connett, Ben C Reynolds, Kay Tyerman, Dean Wallace, Evgenia Preka, Kirsten Armstrong, Neeta Patel, Sarah Shameti, James Edelman, Rosemary Dempsey, Caroline Elizabeth Anderson, Rodney Gilbert, Mushfequr R Haq, Matthew Harmer, Yincent Tse","doi":"10.1136/archdischild-2023-325513","DOIUrl":"10.1136/archdischild-2023-325513","url":null,"abstract":"<p><p>Shared decision-making (SDM) is a collaborative approach to healthcare decision-making that involves patients and healthcare professionals working together to make decisions that are informed by the best available medical evidence, as well as the patient's values, preferences and goals. The importance of SDM and the intricate interplay among parents, children and young people (CYP), and healthcare professionals are increasingly acknowledged as the crucial aspects of delivering high-quality paediatric care. While there is a substantial evidence base for SDM improving knowledge and reducing decisional conflict, the evidence for long-term measures such as improved health outcomes is limited and mainly inconclusive. To support healthcare teams in implementing SDM, the authors offer a practical guide to enhance decision-making processes and empower CYP and their families.</p>","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":"264-270"},"PeriodicalIF":1.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifteen-minute consultation: The approach to the child with precocious puberty.","authors":"Beatrice Lorenzon, Francesca Burlo, Ludovica Barbi, Gianluca Tamaro, Gianluca Tornese","doi":"10.1136/archdischild-2023-326217","DOIUrl":"10.1136/archdischild-2023-326217","url":null,"abstract":"<p><p>Precocious puberty has traditionally been defined as the onset of secondary sexual characteristics occurring before age 8 years in girls and 9 years in boys. This earlier onset of puberty may have significant physical and psychological consequences if left untreated. Moreover, it should be excluded that pubertal signs are not secondary to malignancies, other organic aetiologies or associated syndromic phenotypes. Initial assessment involves a thorough medical history and physical examination; a hand and wrist X-ray to determine bone age, and hormonal tests might be indicated to confirm the diagnosis and to determine the origin of hormonal production. Treatment options depend on the underlying cause. Given the complexity of the differential diagnosis, this article aims to familiarise clinicians with the different steps that can be taken when precocious puberty is suspected.</p>","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":"271-275"},"PeriodicalIF":1.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach to neonatal thrombocytopenia.","authors":"Megan Dunlop, Nick Fordham, Timothy Watts, Yinru Lim","doi":"10.1136/archdischild-2024-327519","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327519","url":null,"abstract":"<p><p>A low platelet count (thrombocytopenia) is a common finding especially in neonates who are admitted to the neonatal intensive care unit. Due to the varied causes that can lead to neonatal thrombocytopenia, assessment and management can be challenging. Having an understanding of the causes of neonatal thrombocytopenia and their natural progression would help guide subsequent management. Therefore, we will be exploring the different circumstances where thrombocytopenia occurs and how to interpret and manage the neonate with thrombocytopenia in this interpretations article.</p>","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making medical education great again: analysing trainee feedback to identify key drivers of trainee satisfaction and improve experience.","authors":"Katheryn Ferin, Tony Hufflett, Thomas Rance, Jonathan Round","doi":"10.1136/archdischild-2024-327580","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327580","url":null,"abstract":"<p><strong>Objectives: </strong>The London School of Paediatrics (LSP) surveys trainees annually regarding their training placements. There is a wide variation in satisfaction. We explored the last 5 years of data to identify trends and determine predictors of overall trainee satisfaction.</p><p><strong>Methods: </strong>The survey is distributed annually to all London paediatric trainees with response rates of 86-90%. It explores overall placement satisfaction, followed by key questions covering staffing, supervision, teaching, facilities and other facets. The survey blends both quantitative and qualitative feedback.Satisfaction levels were analysed using time series trend analysis. Overall levels were compared using t-tests. Associations between satisfaction and components of the survey were identified using a convergence of multiple regression and other multivariate analyses.</p><p><strong>Results: </strong>Overall trainee satisfaction increased steadily until 2020. There was a considerable variation across sites, some having consistently higher or lower scores than the median, while others showed an upward or downward trend, or very variable pattern.By training levels, ST3 trainees consistently rated their placement below average and ST7 trainees above average. There was also a considerable variation in responses by training level with regard to perceived staffing levels and teaching.To understand the influences on overall satisfaction, regression coefficients were derived between specific metrics and overall satisfaction using multiple regression and then normalised to 100%. The explanatory power of this list to explain satisfaction overall is high at 82% R².Trainee satisfaction was most strongly correlated with workplace atmosphere and consultant support. Staffing, educational supervision, facilities and wider MDT (Multidisciplinary Team) support are associated with overall satisfaction, but to a lesser degree.</p><p><strong>Conclusions: </strong>Trainee satisfaction is crucial, affecting patient safety, retention and trainee mental health. Our analysis identified significant associations with satisfaction including modifiable elements such as consultant engagement and team morale. Staffing levels were less related to satisfaction than expected.Experimental data exploring the components of clinical training in real-world situations are lacking. These data use the natural experiment of placing trainees in different training locations to explore the factors that relate to their overall experience.</p>","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lump in my side: transplanted kidney or something more?","authors":"Nithiakishna Selvathesan, Valentina Bruno, Steve Alexander Balgobin, Bo Ngan, Deborah Levy, Chia Wei Teoh","doi":"10.1136/archdischild-2024-327904","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327904","url":null,"abstract":"","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifteen-minute consultation: How to manage neonatal bradycardia.","authors":"Sudeep Shrestha, Giacomo Buratti, Reem Husseiny, Nicola Storring, Prashanthi Katta","doi":"10.1136/archdischild-2024-327619","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327619","url":null,"abstract":"<p><p>Neonatal bradycardia is characterised by a heart rate below 80 bpm, irrespective of gestational age. It is generally self-resolving but, in some cases, represents an underlying pathology which may be cardiac or non-cardiac in origin. The common causes for bradycardia are non-cardiac in origin such as autonomic immaturity in premature infants, electrolyte imbalances, hypothyroidism and medications. Cardiac causes include-sinus bradycardia, conduction system abnormalities, congenital heart disease and channelopathies. Diagnostic investigations typically include a standard 12-lead ECG, 24-hour Holter monitor and an echocardiogram. This article aims to provide a practical framework for the management of neonates with bradycardia and guide further investigation and/or referral to specialist paediatric cardiology services.</p>","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A toddler with fever and coryzal symptoms.","authors":"Christy Wing Man Leung, Ting Fan Leung","doi":"10.1136/archdischild-2024-327738","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327738","url":null,"abstract":"","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifteen-minute consultation: Management of raised intracranial pressure in children.","authors":"Claire Rafferty, Deborah Cross","doi":"10.1136/archdischild-2024-327443","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327443","url":null,"abstract":"<p><p>Raised intracranial pressure (ICP) in children can be very challenging to recognise and manage. In order to minimise secondary brain injury, measures to reduce intracranial pressure must be initiated as soon as possible. Initial management is often commenced in District General Hospitals prior to transfer for definitive treatment. This article is aimed at general paediatricians and provides a framework for the initial stabilisation and management of a child with raised ICP, with discussion of the underlying physiological principles.</p>","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of respiratory syncytial virus disease by immunisation.","authors":"Tami R Benzaken, Conall Watson, Simon B Drysdale","doi":"10.1136/archdischild-2024-326964","DOIUrl":"https://doi.org/10.1136/archdischild-2024-326964","url":null,"abstract":"","PeriodicalId":55471,"journal":{"name":"Archives of Disease in Childhood-Education and Practice Edition","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}