Archives of Disease in Childhood最新文献

{"title":"Paediatric cardiac donation following circulatory determination of death: where do we stand?","authors":"Louise Kenny, Dale Gardiner, David Shaw, Emma Simpson, Joe Brierley","doi":"10.1136/archdischild-2024-328065","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328065","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of home blood pressure screening in the paediatric outpatient clinic setting.","authors":"Jessie R Mackay, Jonathan P Glenning, Brittany M Grantham, Kylie Clark, Jonathan P Mynard, Catherine N Olweny, Catherine Quinlan, Gabriel Dabscheck","doi":"10.1136/archdischild-2024-327391","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327391","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the acceptability and feasibility of home-based blood pressure (BP) screening in a group of paediatric patients with known elevated risk of developing hypertension.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Specialist outpatient clinic and patient homes.</p><p><strong>Patients: </strong>52 children and adolescents living with neurofibromatosis type 1.</p><p><strong>Interventions: </strong>Clinic BP measured thrice manually and once via an automated device; home BP measured daily with the same device for 3 days.</p><p><strong>Main outcome measures: </strong>Acceptability and feasibility were assessed with a Children's Anxiety Meter-State score, the comparability of home and clinic BPs, a parental survey, assessment of costs and the device return rate.</p><p><strong>Results: </strong>Home systolic BP and diastolic BP were statistically similar to both clinic manual (95% CI -4.78 to 0.13; -4.80 to 0.93) and automatic BPs (95% CI -4.44 to 2.08; -0.54 to 5.52). Anxiety scores (95% CI -0.57 to 0.35) were also similar between settings. Participants and their families reported that home BP measurement was easy, took ~10 min and minimally interrupted family life. Families also largely preferred home BP screening (73% 'yes', 23% 'not sure', 3% 'no'), and 90% returned their devices. Families reported substantial costs in attending clinic, which could be reduced with access to this home BP programme.</p><p><strong>Conclusions: </strong>Home BP screening was acceptable and feasible, with home BPs comparable to clinic measurements, no associated anxiety and preferred by families. Telehealth with home BP screening is a viable alternative to in-person appointments, which could reduce individual costs, and foster greater equity of care and access to health services.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus outcomes between health professionals and parents for oral corticosteroids in treating preschool wheeze: a multi-national survey and nominal group technique study.","authors":"Bohee Lee, Stephen W Turner, Jasmine Hine, Ann McMurray, Damian Roland, Meredith Louise Borland, Peter Csonka, Jonathan Grigg, Theresa W Guilbert, Tuomas Jartti, Abraham Oommen, Steff Lewis, Steve Cunningham","doi":"10.1136/archdischild-2024-327696","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327696","url":null,"abstract":"<p><strong>Objective: </strong>To obtain priority consensus for outcome measures of oral corticosteroid treatment of preschool wheeze that represent stakeholder groups.</p><p><strong>Design: </strong>(1) A systematic review to identify a set of outcome measures; (2) an international survey for healthcare professionals (HCPs) and a nominal group meeting with parents; (3) a final consensus nominal group meeting with key HCPs (trial investigators and paediatric emergency medicine clinicians) and the same parent group.</p><p><strong>Main outcome measures: </strong>Consensus priority of treatment outcome measures, outcome minimal clinically important differences (MCIDs) and level of concerns about adverse effects.</p><p><strong>Results: </strong>Through an iterative process engaging HCPs and parents, the final consensus on a primary outcome was Wheezing Severity Score (WSS). Secondary outcomes prioritised as a revisit to general practice/emergency department, rehospitalisation, length of hospital stay (LOS), time back to normal, doses of short-acting beta-agonists and additional steroid course. Compared with placebo, clinicians considered the median MCID change in WSS at 4 and 12 hours as 40% (IQR 29-51%) and 50% (37-63%) and 5 hours (4-6 hours) for LOS, and 2 days (2-3 days) for a time back to normal. Parents identified MCIDs which were frequently longer than physiologically observed impacts in trials. Concerns about multiple steroid doses were most prevalent.</p><p><strong>Conclusions: </strong>Stakeholders prioritised change in WSS as the most favourable outcome measure. Our study demonstrated the potential of parent/patient engagement in co-creating patient research outcomes. Incorporating this result in the design of future clinical research will provide a more holistic assessment of the impact of treatment while ensuring relevant primary research outcomes.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-toxigenic <i>Corynebacterium diphtheriae</i>: beware the chronic ulcer.","authors":"Nelson Wang, Eloise Silvester, Kimberly Davis","doi":"10.1136/archdischild-2024-328001","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328001","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are children with neuromuscular diseases still eligible for paediatric palliative care?","authors":"Francesca Benedetti, Caterina Agosto","doi":"10.1136/archdischild-2024-327837","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327837","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A co-designed health education model to improve outcomes for children with emotional and behavioural difficulties: a study of acceptability, feasibility and impacts.","authors":"William Garvey, Lingling Chen, Frank Oberklaid, Harriet Hiscock","doi":"10.1136/archdischild-2024-327119","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327119","url":null,"abstract":"<p><strong>Objective: </strong>To assess the acceptability and impacts of a co-designed health education model aiming to improve outcomes for children with emotional and behavioural difficulties.</p><p><strong>Design: </strong>Qualitative focus group study.</p><p><strong>Setting: </strong>Six primary schools from metropolitan and rural settings in the state of Victoria, Australia.</p><p><strong>Participants: </strong>36 educators who engaged with the intervention between July and December 2021.</p><p><strong>Intervention: </strong>Co-designed community of practice, led by a paediatrician, with fortnightly tailored case-based discussions aiming to build educator capacity to identify and support children with emotional and behavioural difficulties.</p><p><strong>Main outcome measures: </strong>At the completion of the intervention, all educators were invited to participate in focus groups with their school group. The lead author facilitated the groups. Semistructured questions guided the sessions focusing on the motivation of participants, their experience of the intervention, its impact on their work and suggestions for possible improvements and impact upon their own well-being. Sessions were audio recorded, and field notes were taken by the facilitator. Interpretative phenomenological analysis was carried out to evaluate the data collected.</p><p><strong>Results: </strong>36 of 46 educators completed six focus groups (one per school). Participants were highly motivated due to the mental health needs of their students. Participants experienced the intervention as stimulating and providing practical strategies. Participants discussed the positive impact it had on their capacity to support children with emotional and behavioural difficulties as well as their own well-being.</p><p><strong>Conclusions: </strong>The intervention is highly acceptable to educators, and evaluating this intervention with a larger sample will inform expansion.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary aspiration after activated charcoal in unintentional acute poisonings in childhood.","authors":"Johanna Ramirez-Romero, Claudia Cifuentes Zamalloa, Amaia Elorza Elena, Beatriz Azkunaga, Santiago Mintegi","doi":"10.1136/archdischild-2024-327478","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327478","url":null,"abstract":"<p><strong>Introduction: </strong>Although the administration of activated charcoal (AC) is considered safe, the associated risk of pulmonary aspiration explains certain reluctance of physicians to use this procedure. The objective of this study was to analyse the rate of pulmonary aspiration in children receiving AC after accidental ingestion of a toxic substance.</p><p><strong>Methods: </strong>We carried out a substudy of a multicentre prospective registry-based cohort study including children presenting with acute poisoning to 58 paediatric emergency department (EDs) members of the Spanish Society of Pediatric Emergency Medicine between 2008 and 2022 on certain previously designated days.</p><p><strong>Results: </strong>During the study period, we registered 1983 episodes corresponding to accidental ingestion of a toxic substance in patients less than 7 years old. Of them, 517 (26.1%) received AC, 167 (32.3%) via a nasogastric tube. In most cases, the substance swallowed was a medication (paracetamol, psychotropics, and cough and cold medications accounting for 91.6% of episodes) and 419 children (81%) were asymptomatic on arrival to the ED. Gastric lavage was performed in 81 cases (15.7%). After receiving AC, 448 children (86.6%) were managed as outpatients (329 after a less than 24-hour stay in the ED observation unit).All patients did well, and no cases of pulmonary aspiration were reported, regardless of the route of AC administration.</p><p><strong>Conclusions: </strong>The administration of AC to children after accidental ingestion of a toxic substance seems to be safe, regardless of the route of administration. Efforts are required to improve the ED management of these children.</p>","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decisions under duress and the limits of data.","authors":"Nir Samuel, Silvia Bressan, Ruud Gerard Nijman","doi":"10.1136/archdischild-2024-328250","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328250","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving consent practices in paediatric populations: what can be done?","authors":"Matthew Formstone, Laura Bengree, Robert Wheeler","doi":"10.1136/archdischild-2024-327663","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327663","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full-cycle audit of the RCEM Best Practice Guidelines for the ingestion of super strong magnets in children using data from a UK prospective observational study.","authors":"Sierra Schaffer, Jonathan J Neville, Nigel J Hall","doi":"10.1136/archdischild-2024-327729","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327729","url":null,"abstract":"","PeriodicalId":8150,"journal":{"name":"Archives of Disease in Childhood","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}