Archives of Disease in Childhood最新文献

Objective: To assess the acceptability and impacts of a co-designed health education model aiming to improve outcomes for children with emotional and behavioural difficulties.

Design: Qualitative focus group study.

Setting: Six primary schools from metropolitan and rural settings in the state of Victoria, Australia.

Participants: 36 educators who engaged with the intervention between July and December 2021.

Intervention: Co-designed community of practice, led by a paediatrician, with fortnightly tailored case-based discussions aiming to build educator capacity to identify and support children with emotional and behavioural difficulties.

Main outcome measures: At the completion of the intervention, all educators were invited to participate in focus groups with their school group. The lead author facilitated the groups. Semistructured questions guided the sessions focusing on the motivation of participants, their experience of the intervention, its impact on their work and suggestions for possible improvements and impact upon their own well-being. Sessions were audio recorded, and field notes were taken by the facilitator. Interpretative phenomenological analysis was carried out to evaluate the data collected.

Results: 36 of 46 educators completed six focus groups (one per school). Participants were highly motivated due to the mental health needs of their students. Participants experienced the intervention as stimulating and providing practical strategies. Participants discussed the positive impact it had on their capacity to support children with emotional and behavioural difficulties as well as their own well-being.

Conclusions: The intervention is highly acceptable to educators, and evaluating this intervention with a larger sample will inform expansion.

Introduction: Although the administration of activated charcoal (AC) is considered safe, the associated risk of pulmonary aspiration explains certain reluctance of physicians to use this procedure. The objective of this study was to analyse the rate of pulmonary aspiration in children receiving AC after accidental ingestion of a toxic substance.

Methods: We carried out a substudy of a multicentre prospective registry-based cohort study including children presenting with acute poisoning to 58 paediatric emergency department (EDs) members of the Spanish Society of Pediatric Emergency Medicine between 2008 and 2022 on certain previously designated days.

Results: During the study period, we registered 1983 episodes corresponding to accidental ingestion of a toxic substance in patients less than 7 years old. Of them, 517 (26.1%) received AC, 167 (32.3%) via a nasogastric tube. In most cases, the substance swallowed was a medication (paracetamol, psychotropics, and cough and cold medications accounting for 91.6% of episodes) and 419 children (81%) were asymptomatic on arrival to the ED. Gastric lavage was performed in 81 cases (15.7%). After receiving AC, 448 children (86.6%) were managed as outpatients (329 after a less than 24-hour stay in the ED observation unit).All patients did well, and no cases of pulmonary aspiration were reported, regardless of the route of AC administration.

Conclusions: The administration of AC to children after accidental ingestion of a toxic substance seems to be safe, regardless of the route of administration. Efforts are required to improve the ED management of these children.

Objective: Charles Bonnet syndrome (CBS) refers to the presence of visual hallucinations occurring secondary to visual impairment. The aim of this study was to understand the phenomenology of CBS in children and assess the emotional impact and support needs of patients and their families.

Design: Semistructured qualitative interview study.

Setting: UK.

Participants: Children (7-15 years) with an inherited retinal disease living with CBS and their parents.

Results: 10 participants were recruited from six families (dyadic interviews n=4; parent-only interviews n=2). Thematic analysis identified five superordinate themes relating to experiences of CBS: (1) diagnosis journey, (2) hallucination phenomenology, (3) impact of hallucinations, (4) understanding and managing hallucinations and (5) experiences of support. The impact of CBS was broad and heterogenous, causing significant disruption to patients' daily life. Limited awareness led to parents expressing largely negative healthcare experiences. Overall, the extent of knowledge and understanding of CBS was an indicator of successful self-management of the condition.

Conclusions: The journey towards understanding and managing CBS for both parents and children is challenging. Although coping strategies can lead to improved adjustment, visual hallucinations compounded the difficulty of living with a chronic visual impairment. Healthcare providers have an integral role in ensuring patients and families are effectively supported to allay fears and promote psychological well-being.