Preventing accidents in children under five

PHE have produced a new guide with the Child Accident Prevention Trust (CAPT) that equips all staff who work with children under five to help reduce the number of deaths and injuries | PHE

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Whether you work for a health service, early years education, play schemes, nurseries or are a childminder, this guide will help you help parents and carers keep their children safe from injuries. A serious accident has the potential to cause life-changing disability and disfigurement. A toddler who gets a severe bath water scald will require years of painful skin grafts. A fall at home can result in permanent brain damage. As well as the immediate physical impact, the injuries can have longer term effects on school readiness, education, employment, emotional wellbeing and family relationships.

This guidance, produced in association with the Child Accident Prevention Trust (CAPT), is for all staff working with children under 5 years and covers the 5 injury priorities:

  • choking, suffocation and strangulation
  • falls
  • burns and scalds
  • poisoning
  • drowning

The guidance also covers fire and roads. Each injury priority includes data for England, actions for health professionals and safety messages for parents and carers.

Read  the full overview here

Read the full guidance here

Acute Otitis Media During Infancy: Parent-reported Incidence and Modifiable Risk Factors

Prins-van Ginkel, A.C. et al. (2017) Pediatric Infectious Disease Journal. 36(3) pp. 245–249

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Acute otitis media (AOM) is a common infection during infancy. By the age of 1 year, 25%–36% of children have experienced at least 1 episode of AOM and approximately 20% of children develop recurrent AOM.AOM is one of the main reasons for primary care visits, specialist referral, antibiotic consumption and surgical ear, nose and throat procedures among young children.But besides the high burden on health care, AOM also poses a high burden on parents and families; during an episode of AOM, which lasts on average 6–9 days, most parents are absent from work for 2–3 days and experience reduced quality of life because of lack of sleep and concerns about their child’s health. For these reasons, prevention of AOM is of major public health and economic importance.

With this study, we aim to determine the impact of day care attendance, breastfeeding and tobacco smoke and the effect of timing of these risk factors in the first year of life on the occurrence of AOM symptom episodes. To capture both medically and nonmedically attended AOM symptom episodes, we investigated the association between these risk factors and parent-reported AOM symptom episode occurrence in the community in a cohort of Dutch infants.

Read the full article here

Rudeness in paediatric care

Ward Platt, M. Archives of Disease in Childhood. Published Online: 24 February 2017

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‘Who is that rude man? He must be someone important.’ The man referred to was a very self-important associate medical director, well known for his lack of common courtesy. My colleague’s remark held another grain of truth, too: the ability to be rude, and for this to go unchallenged, is clearly associated with hierarchy. If you are someone important, you can get away with behaviours that would not necessarily be tolerated in another context. But rudeness can also arise between equals and from patients (or parents). It can be corrosive in a workplace where there are plenty of other stress factors, and may even have implications for patient safety.

There have been two recent papers relevant to rudeness in paediatric care, both from Riskin et al.1 ,2 The first of these, a randomised controlled trial, involved a standardised simulation in which both diagnostic and procedural skills were assessed for quality. There were clear group differences between the arms of the trial exposed and not exposed to mild professional rudeness: diagnostic and procedural performances were both adversely affected.

Read the full correspondence article here

Improving Early Identification and Intervention for Children at Risk for Autism Spectrum Disorder

Rotholz, D. et al. (2017) Pediatrics. 139(2)

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Objectives: To provide an example of a successful, novel statewide effort to increase early identification of young children at risk for autism spectrum disorder (ASD) using a 2-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination.

Conclusions: Improvements in early identification and intervention are feasible through collaborative policy change. The South Carolina Act Early Team and its key stakeholders committed to improving outcomes for this population used existing tools and methods in new ways to improve early identification of children with ASD and to make available evidence-based intervention services. This example should be replicable in other states with key stakeholders working collaboratively for the benefit of young children with

Read the full abstract here

New tool developed to help avoid adverse drug reactions

Researchers have developed a new tool to help avoid adverse reactions to medicines | ScienceDaily

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Previous research at Alder Hey found that three out of every 100 children admitted to hospital experience an ADR due to a medicine taken at home. 22% of these ADRs might have been avoidable. Examples of ADRs which were avoidable included: diarrhea with antibiotics, and constipation with medicines given to relieve pain and vomiting related to chemotherapy.

The team also found that around 1 in 6 children experienced at least one ADR whilst in hospital, which is similar to findings in adults. More than half of the ADRs seen in children in hospital were due to medicines used in general anaesthesia and for the treatment of pain after surgery.

Most of the ADRs were not severe and resolved soon after the medicine was stopped. The five most common ADRs seen were nausea and/or vomiting, itching, constipation, diarrhea and sleepiness.

Read the full overview here

Read the original research abstract here

Understanding the needs of disabled children with complex needs or life-limiting conditions

This report by the Council For Disabled Children and The True Colours Trust looks at what we can learn from national data on the numbers of children with complex needs or life-limiting conditions.

Together with the True Colours Trust, we commissioned this piece of research because we wanted a definitive picture of the type of data that is available; to understand what this data tells us about the population and whether it shows us anything useful in terms of developments and/or changes in the population; to identify gaps in current data collection; and to develop an action plan with key stakeholders to drive forward improvements.

It’s the first analysis of the numbers of disabled children with complex needs and life-limiting conditions in over a decade, and estimates that numbers have increased dramatically by over 50% since 2004, from 49,300 to 73,000 children and young people.

Read the full overview here

Read the full report here

Better Beginnings: Improving health for pregnancy

Being healthy is the best start to pregnancy for a woman and child | NIHR

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Image source: NIHR

Preparing for pregnancy can focus attention on health, such as eating a healthy balanced diet or losing excess weight, as well as avoiding risks from smoking, alcohol and drug use. Ensuring the best care for long-term physical and mental health conditions is important for a healthy pregnancy, as well as addressing complex social needs.

Getting the best start in life for children is a UK policy priority, focused on preventing problems and early intervention to improve outcomes. NIHR research evidence into modifiable factors to influence health before, during and after pregnancy is growing and helping to inform policy and practice.

This themed review brings together NIHR research on different aspects of health before, during and after pregnancy. It features:

  • 46 published studies
  • 28 ongoing studies or interim results
  • Questions for clinicians, commissioners, public health professionals and others

Read the full overview here

Read the full report here