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Fifteen-minute consultation: Paediatric night sweats--when to reassure and when to investigate
This article aims to provide a structured approach to the management of paediatric night sweats. How are... (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - January 19, 2023 Category: Pediatrics Authors: Ryan, A., Higgins, P., Bland, R. M. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: Evaluation of paediatric torticollis
Torticollis refers to a state in which the neck is twisted due to excessive contraction or shortening of the muscles on one side. Congenital muscular torticollis, which is more common than acquired torticollis, has an incidence of 0.3%–1.9% among all live births. The clinical approach to torticollis depends on the age at presentation, duration of torticollis and presenting symptoms. The underlying aetiology for torticollis varies with the age of the child. Torticollis can be a presenting feature for life-threatening conditions and thus requires careful evaluation. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - January 19, 2023 Category: Pediatrics Authors: Dayasiri, K., Rao, S. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: The dizzy child
We present a structured approach to the assessment and management of a child presenting with dizziness in a general, non-neurological specialty or community paediatric outpatient setting. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - January 19, 2023 Category: Pediatrics Authors: Crunkhorn, R., Dasgupta, S., Seal, A. K., Dasgupta, S. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: A structured approach to the assessment of a child with earache
Earache, or otalgia, in children is common. Diagnosis can be challenging due to the range of causes. Assessment involves a thorough history and examination. Identification of associated otological symptoms, including discharge, hearing loss, vertigo and facial nerve weakness, is helpful and can aid diagnosis. Examination should involve looking at the external ear, otoscopy to assess the ear canal and tympanic membrane and documentation of facial nerve function. If otological examination is normal, further examination looking for non-otological causes may be guided by the history. Investigations are often unnecessary but ma...
Source: Archives of Disease in Childhood - Education and Practice - January 19, 2023 Category: Pediatrics Authors: Halliday, E., Wooles, N., Grainger, J. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Epistle
A significant change in junior doctors’ training is nigh with a shorter duration and adaption of part-time working patterns. Simultaneous adaptations in teaching and learning is thus required. A junior doctor’s daily routine now includes coordinating care of patients with complicated pathways, navigation of complex IT systems and being au fait with equipment. This needs significant time investment and it all erodes into hectic clinical schedules. In addition, increasing case complexity and the social, ethical and legal dilemmas which are accentuated by the omni-presence of social media brings further challenges...
Source: Archives of Disease in Childhood - Education and Practice - January 19, 2023 Category: Pediatrics Authors: Gupta, N. Tags: Highlights from this issue Source Type: research

Virtual reality reduced measured levels of pain, fear and anxiety scores during venepuncture for children aged 5-12 years compared to control
Review of: Gerceker GÖ, Ayar D, Özdemir EZ, et al. Effects of virtual reality on pain, fear and anxiety during blood draw in children aged 5–12 years old: a randomised controlled study. J Clin Nurs 2020;29:1151–61. Study question: What is the effect of two different virtual reality modalities on venepuncture-related pain, fear and anxiety levels in children during blood sample collection? Study design Setting: Specialist hospital venepuncture clinic in Izmir, Turkey. Patients: 136 patients aged 5–12 years. Design: Prospective randomised controlled trial (RCT). Randomisation: Random allocat...
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Wooding, E. L. Tags: Key publications in paediatrics: Picket Source Type: research

Prophylactic malaria chemoprevention reduces readmission and death rate in children previously admitted to hospital for treatment of severe anaemia
Study design: Multi-site, double-blind, randomised, placebo-controlled trial across Kenya and Uganda. Allocation: 1:1 ratio to receive either postdischarge malaria chemoprevention or placebo. Randomisation was performed by a computer-generated randomisation schedule prepared by an independent statistician. Patients: 1049 children, 524 in the chemoprevention group and 525 in the placebo group. Children were less than 5 years of age at time of enrolment. Children who had been admitted to hospital with severe anaemia and fulfilled the eligibility criteria underwent randomisation to enter the study. All children received a 3-d...
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Murphy, S. Tags: Key publications in paediatrics: Picket Source Type: research

Family-integrated care for preterm infants in China
Review of: Hei M, Gao X, Li Y, et al. Family integrated care for preterm infants in China: a cluster randomized controlled trial. Journal of Pediatrics 2021;228:36–43. Study question Setting: 11 level 3 NICUs across eight provinces in China. All were similar in size and patient mix. Current practice in China is for neither parents to visit their baby on a NICU. Care is provided solely by medical and nursing staff. 323 patients were enrolled in the FIcare hospitals. 337 patients were enrolled in the standard care arm. Staff were trained on site in the FIcare model of practice. This included written protocols, parent e...
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Fraser, C., Harrison, C. M. Tags: Key publications in paediatrics: Picket Source Type: research

Prescribing in paediatric kidney impairment
This article aims to highlight several key principles prescribers should be aware of when managing these patients, with a particular focus on management in secondary care. Drug handling in the healthy kidney A person’s response to a drug is determined by a combination of pharmacokinetics and pharmacodynamics.2 Pharmacodynamics is concerned with the effect of the drug on the body. Pharmacokinetics is best described as the effect of the body on the drug and reflects the physiological processes of absorption,... (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Dowsett, T., Awan, S., McWilliam, S. Tags: Medicines update Source Type: research

Busy can be happy: 'Cake Thursday as a team bonding exercise
Implementation of ‘Cake Thursday’ as a team bonding and morale-boosting exercise. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Sullivan, E., Green, L., Ewer, A. K., Crombie, K., Rasiah, S. V., Singh, A. Tags: Quality improvement Source Type: research

Importance and impact of diversity in paediatric medical education
Despite the increasing diversity of the UK population, we continue to see inequalities in health outcomes in patients of ethnic minorities. Unfortunately, this increasing diversity is not reflected in educational resources, which often continue to feature few images of patients with darker skin tones. Given the lack of diversity in these resources, it is unsurprising that healthcare professionals find it challenging recognising, diagnosing and managing presentations of clinical conditions in darker skinned patients. The development of new online, accessible image banks of medical conditions in different skin tones, such as...
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Shanmugavadivel, D., Buonsenso, D., Chantiluke, K., Arora, M. Tags: Open access, Editor's choice, Learning and teaching Source Type: research

We are (paediatric) family: a peer-mentoring programme
This article will discuss the role of peer mentoring within paediatric training, drawing on experience and evidence... (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Tolan, S. Tags: Learning and teaching Source Type: research

What is realist research, when should we consider it, how and why?
Introduction Clinicians with medical training work in an environment where randomised controlled trials (RCTs) overshadow other forms of medical evidence in informing clinical practice, policy and guidance. It is no surprise that clinical researchers tend towards RCTs, since they are considered the ‘gold standard’ of research, placed firmly at the top of traditional hierarchies of evidence. RCTs are grounded in a positivist paradigm, seeking to answer the question ‘does this intervention work?’ by generating and testing a hypothesis in order to propose or dispute a particular truth. This approach ma...
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Mitchell, S., Ahmed, Z., Slowther, A.-M., Coad, J., Dale, J. Tags: Research in practice Source Type: research

Key messages from a guideline: RCEM best practice guideline--ingestion of super-strong magnets in children
Introduction The Royal College of Emergency Medicine (RCEM) published a best practice guideline in 2021 for the management of children presenting with suspected ingestion of super-strong rare earth magnets (REMs).1 The guidelines highlight the importance of raising awareness of the risks associated with such ingestion and provide guidance on clinical management.1 A National Patient Safety Alert has highlighted that over a recent 3.5-year period there were 24 incidents of delay in assessment/treatment of children who presented with REM ingestion.2 Reasons identified were: unwitnessed ingestion, adopting a ‘watch and w...
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Gangalam, V. K., Paul, S. P. Tags: Guideline review Source Type: research

Guideline review - human and animal bites: antimicrobial prescribing
Background An estimated 1%–2% of all new presentations to emergency departments in the UK are caused by animal bites.1 It is reported that roughly 50% of people sustain animal bites in their lifetime, with more than 90% of those from domestic animals.2 Dog bites are the most common presenting bite injury, followed by cat and human bites, respectively.3 4 It is difficult to define the incidence of human and animal bite injuries in the wider population, as many people do not report them, nor do they seek medical attention for them.3 Information about the guideline This guideline was produced by the National Institute f...
Source: Archives of Disease in Childhood - Education and Practice - November 17, 2022 Category: Pediatrics Authors: Fielding, P., Messahel, S. Tags: Guideline review Source Type: research