{"title":"Does referral to a paediatric trauma unit affect outcome","authors":"Elisabeth Boddé, M. Dijk, A. B. As","doi":"10.12715/APR.2018.5.4","DOIUrl":"https://doi.org/10.12715/APR.2018.5.4","url":null,"abstract":"Background: There has been much debate in international literature about whether it is better to treat trauma patients at the injury site, at a nearby facility, or to transport them to a specialized emergency health care facility. Previous studies comparing directly admitted and referred patients showed contradicting results and very few studies focused on children. The aim of this research was to obtain an overview of the potential differences in outcome between directly admitted and referred patients in the setting of the Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods: A 5-year retrospective medical folder audit was conducted of 209 children admitted to the Red Cross War Memorial Children’s Hospital with an abbreviated injury score of three or four. We compared outcomes between directly admitted patients and patients referred from other health institutions. Results: There was no difference in mortality or length of stay of the patients in the Red Cross War Memorial Children’s Hospital. Directly admitted patients reached the hospital within a median of 60 minutes (interquartile range, IQR, 52 to 84) compared to 185 minutes (IQR 120 to 302) for referred patients (p<0.01). Conclusions: To shorten delay time for referred patients, the on-field triage system needs to be improved. Also, ambulance personnel need to be trained to perform treatments on site, to replace an initial non-trauma hospital, and transport patients directly to a specialized emergency health care facility.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"24 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66240259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susan J Astley, Julia M Bledsoe, Julian K Davies, John C Thorne
{"title":"Comparison of the FASD 4-Digit Code and Hoyme et al. 2016 FASD diagnostic guidelines.","authors":"Susan J Astley, Julia M Bledsoe, Julian K Davies, John C Thorne","doi":"10.12715/apr.2017.4.13","DOIUrl":"https://doi.org/10.12715/apr.2017.4.13","url":null,"abstract":"<p><strong>Background: </strong>As clinicians strive to achieve consensus worldwide on how best to diagnose fetal alcohol spectrum disorders (FASD), the most recent FASD diagnosstic systems exhibit convergence and divergence. Applying these systems to a single clinical population illustrates contrasts between them, but validation studies are ultimately required to identify the best system. Currently, only the 4-Digit Code has published comprehensive validation studies.</p><p><strong>Methods: </strong>The 4-Digit Code and Hoyme 2016 FASD systems were applied to the records of 1,392 patients evaluated for FASD at the University of Washington to: 1) Compare the diagnostic criteria and tools used by each system, 2) Compare the prevalence and concordance of diagnostic outcomes and assess measures of validity.</p><p><strong>Results: </strong>Only 38% of patients received concordant diagnoses. The Hoyme criteria rendered half as many diagnoses under the umbrella of FASD (n=558) as the 4-Digit Code (n=1,092) and diagnosed a much higher proportion (53%) as fetal alcohol syndrome/partial fetal alcohol syndrome (FAS/PFAS) than the 4-Digit Code (7%). Key Hoyme factors contributing to discordance included relaxation of facial criteria (40% had the Hoyme FAS face, including patients with confirmed absence of alcohol exposure); setting alcohol exposure thresholds prevented 1/3 with confirmed exposure from receiving FAS/FASD diagnoses; and setting minimum age limits for Alcohol-Related Neurodevelopmental Disorder prevented 79% of alcohol-exposed infants with neurodevelopmental impairment a FASD diagnosis. The Hoyme Lip/Philtrum Guides differ substantively from the 4-Digit Lip-Philtrum Guides and thus are not valid for use with the 4-Digit Code.</p><p><strong>Conclusions: </strong>All FASD diagnostic systems need to publish comprehensive validation studies to identify which is the most accurate, reproducible, and medically valid.</p>","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39138442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dental anxiety in Hong Kong preschool children: Prevalence and associated factors","authors":"M. Wong, Shf Lai, H. Wong, Y. Yang, C. Yiu","doi":"10.12715/APR.2017.4.10","DOIUrl":"https://doi.org/10.12715/APR.2017.4.10","url":null,"abstract":"Background: This study is designed to determine the prevalence of dental anxiety and contributing factors in Hong Kong preschool children. Methods: All first-time visitors between the ages of three and five to the Prince Philip Dental Hospital, Hong Kong between were recruited between August 2014 and June 2015. Questionnaires on background information, parent’s self-reported Modified Dental Anxiety Scale (MDAS), and parental proxy of the Modified Child Dental Anxiety Scale (MCDAS) were completed by parents. An oral examination was carried out to assess and record the caries experience and oral hygiene status of the child. The child’s dental anxiety level was rated using the Clinical Anxiety Rating Scale (CARS). Ordered logistic regression analysis was performed to assess the association of parent’s and children’s characteristics with the CARS scores. Results: Among 299 children, the mean CARS score reported was 1.16 (SD 1.06) with only 8% of the subjects rating 3 or above, indicating those who were uncooperative and demonstrated real behavioural problems that might interfere with dental procedures. Data analysis showed that the child’s age (p=0.004, OR=0.659, 95%CI=0.497-0.872), the child’s previous dental experience (p=0.013, OR=0.518, 95%CI=0.307-0.867), parental proxy MCDAS score (p=0.002, OR=2.439, 95%CI=1.376-4.353), and the dental attendance pattern of the parents (p=0.013, OR=0.530, 95%CI=0.321-0.870) were associated with the CARS scores. Conclusion: Dental behavioural management problems are not prevalent in Hong Kong preschool children, but such problems are associated with both the parent’s and child’s characteristics such as the child’s age, previous dental experience, and dental attendance pattern of the parents.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"4 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66240228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. AnjumN., Arkar, Adebunmi O. Adeyiga, D. Reynolds, Tara K. Cielma, Nabile M. Safdar, EglalShalaby-Rana
{"title":"Inguinolabial hernia containing ovary, fallopian tube and uterus infemale children","authors":"B. AnjumN., Arkar, Adebunmi O. Adeyiga, D. Reynolds, Tara K. Cielma, Nabile M. Safdar, EglalShalaby-Rana","doi":"10.12715/apr.2017.4.3","DOIUrl":"https://doi.org/10.12715/apr.2017.4.3","url":null,"abstract":"Background: Inguinolabial hernia is a common cause of groin swelling in young female children. This study aimed to describe the sonographic appearance and frequency of inguinolabial hernia containing ovary, fallopian tube, and uterus in female children. Methods: Using a radiology search engine, all female children less than 2 years of age who underwent sonography for groin swelling over a 7-year period were retrospectively reviewed. Results: Of 38 patients (mean age 9.2 months) with groin swelling, 31 (82%, mean age 1.9 months) had an inguinal hernia while 7 (18%, mean age 16.5 months) had other etiologies. The hernia sac contained ovary and/or fallopian tube in 26/31 patients (84%), 9 of whom also had the uterus in the sac. Four cases had a male gonad; these were later proven to have androgen insensitivity syndrome (AIS). The bowel was present in only one case. Other etiologies were abscess (n=1), lymphadenitis (n=3), and hydrocele of Canal of Nuck (n=3). Correct sonographic diagnosis was made prospectively in 36/38 cases and retrospectively in 2 cases. All inguinal hernias were successfully treated. Conclusions: Ovary, fallopian tube, and uterus were the most common contents of the hernia sac, with bowel rarely present. Sonography accurately depicted reproductive organs in the hernia and also helped to exclude other causes of inguinolabial swelling.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"4 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66240047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spatiotemporal evolutionary dynamics of norovirus GII.4 variants","authors":"R. Kulkarni, A. Walimbe, S. Chitambar","doi":"10.12715/apr.2017.4.5","DOIUrl":"https://doi.org/10.12715/apr.2017.4.5","url":null,"abstract":"Background: Noroviruses (NoVs) are the second most common cause of sporadic childhood gastroenteritis worldwide. NoVs of the GII.4 genotype are predominant globally and undergo continuous evolution in the VP1 gene, encoding the major capsid protein, resulting in the emergence of novel variants, with fourteen GII.4 variants identified to date. Methods: The present study investigated the spatiotemporal evolutionary dynamics of the globally circulating GII.4 NoVs using Bayesian approach, phylogeographic, and migration pattern analyses on a dataset of complete VP1 sequences representing each of the GII.4 variants. Results: The estimated mean evolutionary rate for GII.4 VP1 was 5.1x10-3 nucleotide substitutions per site per year (sub/site/yr), the time to Most Recent Common Ancestor (tMRCA) was ~1971, and the most probable ancestral location was the United States of America (USA). The fourteen known GII.4 variants displayed variable evolutionary rates (4.5–7.4x10-3 sub/site/yr) and tMRCA (~1984 to ~2006), with the majority having USA/Asia as their ancestral location. Migration pattern analysis indicated the important role of Australia-New Zealand, India, and Southern Europe in the global dispersal of GII.4 noroviruses. Conclusion: The study contributes to the understanding of GII.4 norovirus evolutionary dynamics.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"55 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66240153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can neem oil help eliminate lice? Randomised controlled trial with and without louse combing","authors":"Christine M. Brown, I. Burgess","doi":"10.12715/apr.2017.4.9","DOIUrl":"https://doi.org/10.12715/apr.2017.4.9","url":null,"abstract":"Background: Neem oil and wet combing with conditioner are both claimed to facilitate elimination of head louse infestation. The aim of this pilot study was to identify whether a 1% neem oil lotion showed activity itself and/or enhanced the effectiveness of combing in treating infestation. Methods: We treated 47 participants with 1% neem-based lotion on four occasions 3-4 days apart in a randomised, community based trial, analysed by intention to treat. The participants were randomly divided between two groups: One group used a grooming comb (placebo) and the other a head louse detection and removal comb (wet combing with conditioner method) to systematically comb the hair. Cure was defined as no lice on both Day 10 and Day 14. Results: The cure rates of 6/24 (25.0%) for the placebo comb group and 8/23 (34.8%) for the louse comb group were not significantly different. Conclusion: These results indicate that this formulation of neem oil was ineffective in the treatment of head louse infestations, even when accompanied by combing. Both combing methods were also ineffective, despite being implemented throughout by trained professionals.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"4 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66240208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Mondal, M. Islam, M. I. Hossain, S. Huq, K. Shahunja, Md Nur Haque Alam, T. Ahmed
{"title":"Post discharge morbidities and mortalities among children with severeacute malnutrition who did not undergo nutrition rehabilitation","authors":"P. Mondal, M. Islam, M. I. Hossain, S. Huq, K. Shahunja, Md Nur Haque Alam, T. Ahmed","doi":"10.12715/APR.2017.4.15","DOIUrl":"https://doi.org/10.12715/APR.2017.4.15","url":null,"abstract":"Background: This prospective study evaluated the post discharge morbidities among children with severe acute malnutrition (SAM), including diarrhea and/or other acute illnesses, who did not agree to undergo the nutrition rehabilitation (NR) phase of management of SAM at Dhaka Hospital of icddr,b, Bangladesh. The probable causes of not undergoing NR were family and other unavoidable commitments. Methods: We prospectively followed up 90 children aged 6–59 months of both sexes suffering from SAM with associated morbidities who presented at the Dhaka Hospital of icddr,b during the period of May to August 2014 and did not undergo NR following acute phase management. Three follow-up schedules were planned at two week intervals. For the second follow-up, caregivers brought their children to the follow-up unit, while the others were carried out over the phone. Results: During the first follow-up, 37 of 70 (53%) reported different morbidities. Only 7 children came for the second follow-up and all of them required hospitalization for different morbidities. On third follow-up, 23 of 58 (40%) children reported morbidity. The odds of morbidities were 7.7 times higher (95% CI: 2.33– 26.58, p<0.0001) among the children who came from a poor family (monthly income < USD 127). Conclusions: Children with SAM and diarrhea bypassing the NR frequently suffered from different types of morbidities. Nutrition rehabilitation is an important component of the management of SAM. As such, nutrition programs should consider the inclusion of the community-based management of acute malnutrition for the complete management of SAM in young children.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"4 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66239986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Quirk, C. Glazebrook, Rebecca D Martin, H. Blake
{"title":"“We don’t worry about diabetes that much”: a qualitative study exploring perceptions of physical activity among children with Type 1 Diabetes","authors":"H. Quirk, C. Glazebrook, Rebecca D Martin, H. Blake","doi":"10.12715/APR.2016.3.2","DOIUrl":"https://doi.org/10.12715/APR.2016.3.2","url":null,"abstract":"Background: Despite the health benefits of physical activity, children across the population are insufficiently active. Physical activity is essential in the management of Type 1 Diabetes Mellitus (T1DM), therefore its promotion should be a priority, yet little research has explored the experience of physical activity from the viewpoint of children with this condition. This study sought to provide insight into how children with T1DM perceive and participate in physical activity to further the design of initiatives and clinical interventions that promote active lifestyles in this population. \u0000Methods: Researchers collected data through in-depth interviews with twelve children aged 9-11 years with T1DM in the UK. Interviews were recorded, transcribed verbatim and data were analysed using thematic analysis. \u0000Results: The overarching themes captured: children’s understanding of physical activity; children’s physical activity is motivated by friendship and social interaction; children’s physical activity is motivated by positive perceptions, fun and enjoyment; children describe how their family helps them to be active; school provides children with an opportunity to be active; children’s access to facilities and outdoor space encourages physical activity; children refer to personal mastery and competence in physical activity and; children perceive difficulties that make physical activity harder. \u0000Conclusions: This study is the first to distinguish children’s perceptions toward physical activity from other key stakeholders. Listening to children has identified what they believe is important, for example enjoyment and socialisation, which should be considered when developing strategies to promote physical activity in this population.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"3 1","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66239705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Essential Role of Growth Deficiency in the Diagnosis of Fetal Alcohol Spectrum Disorder.","authors":"Susan J Astley, Julia M Bledsoe, Julian K Davies","doi":"10.12715/apr.2016.3.9","DOIUrl":"https://doi.org/10.12715/apr.2016.3.9","url":null,"abstract":"<p><strong>Background: </strong>Laboratory studies confirm prenatal alcohol exposure (PAE) causes growth deficiency (GD). GD has traditionally been a core diagnostic feature of fetal alcohol spectrum disorders (FASD), but was removed from the Canadian and Australian FASD diagnostic guidelines in 2016. This study aimed to empirically assess the clinical role and value of GD in FASD diagnosis.</p><p><strong>Methods: </strong>Data from 1814 patients with FASD from the University of Washington Fetal Alcohol Syndrome Diagnostic & Prevention dataset were analyzed to answer the following questions: 1) Is there evidence of a causal association between PAE and GD in our clinical population? 2) Is GD sufficiently prevalent among individuals with PAE to warrant its inclusion as a diagnostic criterion? 3) Does GD aid the diagnostic team in identifying and/or predicting which individuals will be most impaired by their PAE?</p><p><strong>Results: </strong>GD significantly correlated with PAE. GD was as prevalent as the other core diagnostic features (facial and CNS abnormalities). GD occurred in all FASD diagnoses and increased in prevalence with increasing severity of diagnosis. The most prevalent form of GD was postnatal short stature. GD was as highly correlated with, and predictive of, severe brain dysfunction as the FAS facial phenotype. Individuals with GD had a two to three-fold increased risk for severe brain dysfunction. Sixty percent of patients with severe GD had severe brain dysfunction. GD accurately predicted which infants presented with severe brain dysfunction later in childhood.</p><p><strong>Conclusions: </strong>GD is an essential diagnostic criterion for FASD and will remain in the FASD 4-Digit Code.</p>","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/42/nihms-1649314.PMC7746136.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38394922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Krestina L. Amon, Karen Paxton, E. Klineberg, Lisa G. Riley, P. Hazell, S. Skinner, C. Hawke, K. Steinbeck
{"title":"Recruiting a young adolescent rural cohort: Costs and lessons learnt","authors":"Krestina L. Amon, Karen Paxton, E. Klineberg, Lisa G. Riley, P. Hazell, S. Skinner, C. Hawke, K. Steinbeck","doi":"10.12715/apr.2016.3.5","DOIUrl":"https://doi.org/10.12715/apr.2016.3.5","url":null,"abstract":"Background: Adolescent recruitment into longitudinal health studies is challenging. The aim of this paper is to report the detailed process and costs of recruiting young adolescents and their families into an intensive longitudinal study of the effects of puberty hormones on health, behaviour and wellbeing in early adolescence, based in regional/rural Australia. Methods: Participants were recruited using a saturation strategy of targeted methods (including school visits and community events) and non-targeted recruitment approaches (including print and electronic media advertising, and social media). Direct (face-to-face contact with the public) and indirect (behind-the-scenes preparatory activities) researcher hours were calculated for each of the recruitment strategies. Results: The study recruited 342 adolescent participants and a parent/guardian over two years. School and community-based recruitment required 6.2 and 6.0 researcher hours per activity, respectively. Direct researcher hours were primarily spent on delivering presentations and connecting with community members at community events. The majority of indirect hours were spent preparing and assembling information packs for distribution to students and parents during school visits. Non-targeted recruitment strategies using media advertising were the most frequently used methods. Researchers were estimated to have spent less than one hour for each media activity. In 27 months, an estimated $250,000 was spent on recruitment activities and resources. A combination of methods was used to recruit young adolescents and their families into a longitudinal health study. Conclusions: The financial costs and researcher time committed to this study highlight the labour-intensive nature of rec","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":"3 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66239774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}