Table of contents
June 2022 - Volume 107 - 6
Clinical law for clinical practice
Paediatric emergency medicine
- Epidemiology and mapping of child road casualties (16 February, 2022)
A short report presenting paediatric road traffic collision data from three sources in Wales. Compares reporting between datasets and discusses epidemiological factors associated with road traffic collisions.
Global child health
- Continuous positive airway pressure for children in resource-limited settings, effect on mortality and adverse events: systematic review and meta-analysis (8 December, 2021)
A systematic review of the efficacy of CPAP in the treatment of pneumonia in children outside the neonatal period in low-and middle-income countries. The effect on patient outcomes is highly context dependent, and the context in which CPAP is safe can be understood from the review - intensive or high dependency care areas where there is close nursing monitoring, regular physician supervision, training for staff in CPAP and pneumonia care, and where other quality improvement processes are in place.
- National scale of neonatal CPAP to district hospitals in Malawi improves survival for neonates weighing between 1.0 and 1.3 kg (1 November, 2021)
This paper demonstrates the effectiveness of a quality improvement program for the use of early CPAP among neonates weighing 1.0-1.3 kg in Malawi. This nurse-led CPAP program showed a significant improvement in mortality rates that was sustained during the follow-up period.
- Association of childhood tracheomalacia with bronchiectasis: a case–control study (14 October, 2021)
In this case-control study, Thomas et al identify a significant association between tracheomalacia and bronchiectasis (adjusted Odds Ratio 13) which should guide the investigation of children with tracheomalacia and chronic cough.
- Daytime urotherapy in nocturnal enuresis: a randomised, controlled trial (24 January, 2022)
Daytime wetting is distressing to parents and children who can feel powerless to fix the problem. This randomised trial suggests for those whose problem is significant enough to reach secondary care detailed advice-giving isn't helpful and alarms should be used first-line.
- Rate and severity of radiological features of physical abuse in children during the first UK-wide COVID-19 enforced national lockdown (17 February, 2022)
There has been conflicting evidence on whether incidents of physical child abuse became more frequent during the 2020-21 Covid-related lockdowns. This study of abuse-related radiological investigations from hospitals in northern England revealed no such increase.
- Informed consent and assent guide for paediatric clinical trials in Europe (1 December, 2021)
Young people and researchers gathered together to synthesise and rate the advice from all the EU systems they could find about paediatric clinical trials to create a simpler, patient-led, framework for information to aid meaningful trial consent discussions.
- Income support for parents of children with chronic conditions and disability: where do we draw the line? A policy review (22 November, 2021)
International comparisons of income support policies across seven nations show unemployed parents or carers of children with chronic conditions or disability qualified for 32 of the 58 policies. Most policies required a child tohave an impaired ability to function, not just a chronic condition or disability.
- Five-year follow-up of new cases after a coeliac disease mass screening (17 December, 2021)
This Swedish study of children screened for coeliac disease and followed up five years later showed that around a third with positive serology but normal biopsy had since developed coeliac disease. Conversely, very few children with negative serology became coeliac.
- Clinical impact of a gastrointestinal PCR panel in children with infectious diarrhoea (17 December, 2021)
A prospective study of rapid PCR testing for stool pathogens in children with diarrhoea. Results were generally available two days more quickly than standard culture. This allowed more rational decisions about use of antibiotics in quarter of cases.
- Extensive use of on-pack promotional claims on commercial baby foods in the UK (28 February, 2022)
This study reports an online survey of promotional claims made on packaging of commercial baby foods. Claims were very common and often made to suggest foods were 'healthy'. The authors suggest regulation is needed to prevent inappropriate marketing
- A new model to deliver scheduled outpatient care (10 December, 2021)
Enhanced referral vetting and joint primary/secondary care paediatric clinics, delivered across clusters of networked primary care practice, are a feasible means of managing secondary care demand.