Paediatrics and Child Health (United Kingdom)最新文献

The social determinants of health are increasingly well understood by paediatricians. Policy and individual practitioner actions are emerging and have been described in previous Social Paediatrics symposia in this journal. This article describes a Poverty Truth Commission; an innovative approach to addressing the impact of poverty of children's health. This brings people who may not otherwise spend much time together, takes away job titles and uses the power of storytelling to effect change in the members of the commission and beyond.

Evidence based medicine is all well and good, but what should you do when there is no evidence? How might you act differently if the absence of evidence relates to an acute problem, a complex chronic issue or a life-limiting situation? This is even more likely to be an issue when dealing with particular groups of patients. There is often a paucity of evidence when considering treatments or interventions for children and young people. This paper will guide the readers through various levels of absence of evidence, and while it won't be able to tell you what to do, it will give you different ways of looking at the problem.

Research is increasingly important for the delivery of the best possible paediatric care and in the training of healthcare professionals. Many young clinicians are now looking for some way of becoming involved in research during their training, and some will wish to develop a formal academic component to their career or study for a higher postgraduate degree. Research funding is essential to enable high quality research, but training in how to apply for such funding is limited. While it is no substitute for detailed guidance and support from a trusted and experienced research colleague, this article aims to provide practical guidance for new researchers setting out to write their first grant proposal. It stresses the importance of being proactive in selecting the correct research environment, ensuring adequate support and supervision and identifying the necessary knowledge and expertise needed to deliver the project efficiently and effectively. It also highlights the important steps involved in developing a proposal, writing and submitting the application, and provides suggestions for maximizing chances of success. Whilst the focus of this article is based upon the authors' experience in the UK, the general principles are more widely applicable to healthcare professionals working with babies, children and young people everywhere.

Online and virtual learning grew exponentially during the coronavirus pandemic in all areas, including medical education. It is now a well-established part of clinical teaching. This raises questions about which learning content should be delivered online; how it should be delivered and, crucially, how to engage learners in the online environment. We summarise a range of approaches and key considerations to enable appropriate clinical content to be delivered online and propose a number of teaching modalities for use within medical education. Preparation, including faculty training and development, is key to the ongoing effectiveness and success of online learning. We provide an online learning checklist and suggest ground rules to consider when approaching online teaching. Furthermore, we summarise a number of online platforms, applications and resources that aim to enhance learner engagement and encourage you to explore, innovate and reflect on your online teaching journey as an educator.

Paediatric health research is fraught with both ethical and practical challenges that can hinder the successful completion of research studies. Listening to, and acting on, the voices of children and young people in the design and delivery of paediatric health research (otherwise known as Patient and Public Involvement) is one way to overcome such challenges. This paper describes our experiences of working directly with children and young people in various health research initiatives. We recount our journey of involving children and young people as partners and give examples to demonstrate the unique knowledge and insights gained in the production of high-quality research. This short review showcases the many benefits gained if meaningful involvement occurs, including greater understanding of children and young people's perspectives and the impact this has on research studies. We provide various practical resources for researchers on how to meaningfully involve children and young people as partners, how to develop age-appropriate information and guidance to support the ethical review process.

Quality improvement (QI) is a systematic and co-ordinated approach to solving a problem (Quality improvement made simple. The Health Foundation, 2021) and is used to improve safety, effectiveness, and experience of care within healthcare. The approach to QI should be pro-active and patient centred. Within paediatrics this requires us to consider the voice of children and young people when designing improvement to ensure we are meeting their needs. Understanding the key principles and methodology of QI is essential to ensure success when bringing about change. However, formal training in this has been limited and variable amongst doctors in training. The use of data underlies every stage of QI from considering the problem, to the measurement of improvement. With the appropriate use of both quantitative and qualitative data being instrumental in bringing about meaningful change. This article highlights provides some helpful background for those considering their next QI project. It stresses the importance of undertaking data driven improvement, whilst also detailing best practise and challenges, particularly in relation to children and young people. It provides a practical guide on how to use data effectively within QI in a structured approach.

In order to understand or conduct research, it is important that all clinicians have at least a basic grasp of the commonly encountered statistical tests. Each has its limitations but there is usually a best or more appropriate test to use for a given set of data. This is a key skill for all clinicians and is one of the curriculum competencies identified by the Royal College of Paediatrics of Child Health. Much to the chagrin of many trainees it is also tested in the RCPCH examinations. A basic understanding of some of the more commonly encountered tests is helpful: it allows a more thorough appreciation of the data that are being presented in published studies and for those undertaking the RCPCH Theory and Science examination offers ‘marks for free’. This short article provides simple guidance on how to pick the best test to use for different types of data. It is aimed at a novice who might consider themselves to be at step zero rather than step one.

High quality clinical guidelines play a fundamental role in improving healthcare and reducing unwarranted variations in practice. They are based on best available evidence, are developed with the appropriate ‘stakeholder’ engagement, and are subjected to external peer review. Development of clinical guidelines for children and young people (CYP) may be particularly challenging due to a lack of available evidence in an age group that is dominated by rare disease. Arguably, a lack of quality evidence increases the need for clinical guidelines. This review introduces key concepts in high quality clinical guideline development.

With paediatric emergency attendances on the increase, it's more important than ever to ensure the health information we provide to patients and their families is relevant and targeted to its intended population. In an ever-evolving social media driven world modern families want quick, clear and reliable resources they can trust. This article explores the need to modernise patient and family education resources so that they are the first choice over less medically factual resources available on the internet and various apps. I believe that with further supportive research and evidence that patient and family education can be significantly improved and redefine the impact health information can have on attendance, knowledge, and patient satisfaction. Through this article I discuss the barriers to change, the current developments and previous work that has been done around patient and family education in paediatrics, and the potential for future developments in this field.

Sudden unexplained death in childhood (SUDC) is the sudden and unexpected death of a child between 1 and 18 years of age, which remains unexplained after a thorough investigation. Although it is the 4th leading category of death in England and Wales for children aged 1–4 years, there is limited awareness of SUDC and limited research into this field. There are currently no known modifiable risk factors or prevention strategies. SUDC deeply impacts families and is particularly difficult due to the sudden nature, the potential trauma of finding a child, and a lack of any clear reason. For most bereaved families understanding why their child died is very important but this is not possible following SUDC. Parents may have grief complicated by post-traumatic stress disorder (PTSD) and paralysing fear for the survival of any other siblings or pregnancies. This article is written by a professional with personal experience of losing a child to SUDC and both authors have years of experience working with and listening to families. It summarises important considerations and recommendations for any professional who could potentially interact with an affected family.