1463 e-Letters

  • The Prevalence of ADHD is 5% in Childhood.
    Michael A. Colvin

    Professor Taylor, quoting a sound meta-analysis by Polanczyk et al published 16 years previously, declares that the prevalence of ADHD is around 5%. He appears convinced that the prevalence has not changed and does not change, and he explains that rates which differ from around 5% are either due to over-diagnosis or under-diagnosis.

    I hope I am not being impudent in suggesting that the professor has a rather in...

    Show More
  • Re: What we may have missed
    Eric Taylor

    Thanks to Dr Colvin for his interest. I should like to clarify that an "unspoken assumption" of genetic determinism did not underlie my review. I agree with his points on the aetiology: the balance of genetic and environmental influences and their interaction deserve much more study. The aetiology, however, is an issue rather separate from prevalence. Even if countries did differ in their actual rates (rather than just...

    Show More
  • Conclusions not justified by findings
    Charlotte M Wright
    It is encouraging to see a clinical service making an effort to examine the patterns of growth found in their condition. However the conclusions drawn from their data seem greatly overstated. They describe a pattern of 'progressive growth failure' in nearly a quarter of children with ataxia telangiectasia (AT), yet there is an average decline across all children of less than half a centile space over 3 years. These children are...
    Show More
  • Integrated services for infants, children and young people
    Elaine P Lockhart

    This article helps us think about how we would like to provide services to infants, children and young people (ICYP) in response to changing needs, financial constraints and a push for multi-agency integrated working. We propose that paediatric services should have integrated mental health expertise in primary care, community and hospital based services. This would allow for prevention and early intervention, development...

    Show More
  • The lost children
    brian mcnicholl

    Wright and Wales highlight the issues of childhood obesity but there is a lack of clear guidance on who should deal with it. The suggestion to " opportunistically discuss a childs weight" is easier said than done. Whose responsibility is it ? There is little immediate consequence if it is not done. Obesity is rarely the presenting complaint to a doctor. So tackling obesity, in addition to the primary complaint is two co...

    Show More
  • Re:Bruising in children with bleeding disorders - Limitations
    Peter Collins

    Dear Editors

    We thank Drs Chakraborty and Morris for their interest in our study. We acknowledge that the children without bleeding disorders were only recruited in south Wales whilst those with bleeding disorders were recruited in centres around the UK. Given the data available we are not able to comment on whether children are likely to bruise differently dependent on where they live.

    We agree that...

    Show More
  • What we may have missed
    Michael A. Colvin

    Two alternative explanations are given by Professor Taylor for the global problem with ADHD diagnosis, but he overlooks one interesting possibility- perhaps the reported prevalences are about right. That is, perhaps the rates really do vary considerably between populations and are rising in the USA and in other countries.

    Professor Taylor recognises some obvious facts. Firstly, there is a large unmet need. Seco...

    Show More
  • Acute, unplanned paediatric admissions and earlier consultant review
    Julian M Sandell

    The team from Evelina are to be commended for questioning the current direction of travel of acute hospital practice, seeking to find "policy- based evidence" supporting the drive for increasingly consultant-delivered healthcare and their detailed report should help inform wider discussions, not just in paediatrics but across the entire spectrum of acute hospital medicine.

    Apart from two specific instances (very sh...

    Show More
  • Re: Apple juice for rehydration.
    Robert Scott-Jupp

    I am grateful to Prof Weizman for his response to my Archivist article. Like him, I was concerned that the saccharide content and high osmolality of apple juice might make diarrhoea worse, not better. However, the authors of this article did not find this. It is possible that their surveillance for this adverse effect was inadequate but this cannot be deduced from the article. Archivist can only convey what authors report...

    Show More
  • The challenges of communication to address Moral Distress
    Trisha Prentice

    We thank Dr Kraemer for his constructive response and commend his initiative to facilitate weekly staff meetings within neonatal intensive care units. We concur that communication is an essential component of addressing not only moral distress but improving workplace culture.

    As Dr Kraemer notes, finding the best forum for such discussions continues to be challenging. In our various institutions we continue to...

    Show More