Pub Date : 2016-02-24DOI: 10.1136/archdischild-2015-309450
Denise Thwaites Bee, D. Murdoch-Eaton
You have a question, or want to find out current perceptions about a subject, and a comprehensive literature search does not give the answer. A questionnaire or survey, if appropriately designed and administered, can be an easy and efficient way to collect data. However, a well-designed tool is essential to provide meaningful answers. Guidance on good questionnaire design is available.1–4 This can be framed around three simple steps: preparation—evaluation—delivery. Analysis and interpretation are the final stages of completing the research. Is a survey method the most appropriate research tool to answer the question? Questionnaires are useful to investigate opinions or attitudes of a population. If a questionnaire is chosen as the research tool, the next step is to identify whether a validated instrument already exists. If a tool needs to be designed, what format would be of greatest value in answering the enquiry; a structured interview or a self-completed written form? The latter can gather a large amount of rich data, while the former provides a deeper understanding through semistructured questioning.3 Self-completed questionnaires require careful construction with clear articulation of purpose. Their success depends strongly on format as well as the wording; use an attractive, easy to navigate presentation and ensure the length is kept as short as possible. Consider whether to include open or closed questions, or a combination of both. Questions should only include a single point, written unambiguously and contained within short sentences. Wording should be appropriate for your survey population and avoid jargon to reduce potential confusion. Closed questions can provide large amounts of easily handled (often numerical) data. Open questions, as in free …
{"title":"Questionnaire design: the good, the bad and the pitfalls","authors":"Denise Thwaites Bee, D. Murdoch-Eaton","doi":"10.1136/archdischild-2015-309450","DOIUrl":"https://doi.org/10.1136/archdischild-2015-309450","url":null,"abstract":"You have a question, or want to find out current perceptions about a subject, and a comprehensive literature search does not give the answer. A questionnaire or survey, if appropriately designed and administered, can be an easy and efficient way to collect data. However, a well-designed tool is essential to provide meaningful answers.\u0000\u0000Guidance on good questionnaire design is available.1–4 This can be framed around three simple steps: preparation—evaluation—delivery. Analysis and interpretation are the final stages of completing the research.\u0000\u0000Is a survey method the most appropriate research tool to answer the question? Questionnaires are useful to investigate opinions or attitudes of a population. If a questionnaire is chosen as the research tool, the next step is to identify whether a validated instrument already exists. If a tool needs to be designed, what format would be of greatest value in answering the enquiry; a structured interview or a self-completed written form? The latter can gather a large amount of rich data, while the former provides a deeper understanding through semistructured questioning.3\u0000\u0000Self-completed questionnaires require careful construction with clear articulation of purpose. Their success depends strongly on format as well as the wording; use an attractive, easy to navigate presentation and ensure the length is kept as short as possible. Consider whether to include open or closed questions, or a combination of both. Questions should only include a single point, written unambiguously and contained within short sentences. Wording should be appropriate for your survey population and avoid jargon to reduce potential confusion. Closed questions can provide large amounts of easily handled (often numerical) data. Open questions, as in free …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78398032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-23DOI: 10.1136/archdischild-2015-308222
H. Sadreddini, E. Starkey
When any patient uses a medicine, it has the ability to cause a noxious and unintended response known as an ‘adverse drug reaction’ (ADR). A drug allergy is defined as an ADR with specific clinical features compatible with an immunological mechanism that re-occurs on re-exposure to that offending drug. Sometimes, it can be a challenge to decide from the clinical history alone as to whether a drug reaction is allergic or not without the need for further investigations. In September 2014, the National Institute for Health and Care Excellence (NICE) published a guideline entitled ‘Drug allergy: diagnosis and management of drug allergy in adults, children and young people’.1 This was developed due to variation in provision of care for people with a suspected drug allergy and to optimise best practice advice on the diagnosis, documentation and communication of drug allergy. Our focus here will be on the recommendations for children and young people. The British Society for Allergy and Clinical Immunology (BSACI) guidelines for the management of drug allergy were published in 20082 with an update which can be found in box 1. The European Association of Allergy and Clinical Immunology (EAACI) also published an international consensus of drug allergy in February 2014.3 Both of these look at the management of drug allergy within the secondary-care and tertiary-care setting, including details on specialist investigations, in contrast to the NICE guideline, which is aimed at all health professionals who review and manage children including in primary care. Differences between these guidelines are demonstrated in table 1. View this table: Table 1 Comparison of guidelines Box 1 ### Resources
{"title":"Drug allergy: diagnosis and management of drug allergy in adults, children and young people; a look at NICE guidance","authors":"H. Sadreddini, E. Starkey","doi":"10.1136/archdischild-2015-308222","DOIUrl":"https://doi.org/10.1136/archdischild-2015-308222","url":null,"abstract":"When any patient uses a medicine, it has the ability to cause a noxious and unintended response known as an ‘adverse drug reaction’ (ADR). A drug allergy is defined as an ADR with specific clinical features compatible with an immunological mechanism that re-occurs on re-exposure to that offending drug. Sometimes, it can be a challenge to decide from the clinical history alone as to whether a drug reaction is allergic or not without the need for further investigations.\u0000\u0000In September 2014, the National Institute for Health and Care Excellence (NICE) published a guideline entitled ‘Drug allergy: diagnosis and management of drug allergy in adults, children and young people’.1 This was developed due to variation in provision of care for people with a suspected drug allergy and to optimise best practice advice on the diagnosis, documentation and communication of drug allergy. Our focus here will be on the recommendations for children and young people.\u0000\u0000The British Society for Allergy and Clinical Immunology (BSACI) guidelines for the management of drug allergy were published in 20082 with an update which can be found in box 1. The European Association of Allergy and Clinical Immunology (EAACI) also published an international consensus of drug allergy in February 2014.3 Both of these look at the management of drug allergy within the secondary-care and tertiary-care setting, including details on specialist investigations, in contrast to the NICE guideline, which is aimed at all health professionals who review and manage children including in primary care. Differences between these guidelines are demonstrated in table 1.\u0000\u0000View this table:\u0000\u0000Table 1 \u0000Comparison of guidelines\u0000\u0000\u0000\u0000Box 1 \u0000### Resources","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81396851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-23DOI: 10.1136/archdischild-2015-309475
L. Matarazzo, A. Delise, F. Zennaro, R. Bussani, S. Demarini, I. Berti, A. Ventura
An ethnic Bengali baby boy presented at birth with a purplish tender lesion on the medial side of his right knee (figure 1A). In the following weeks, the lesion remained stable in size. An ultrasound scan showed a solid mass, slightly heterogeneous, with a vascular pole but no bone involvement (figure 1B). Figure 1 (A) Clinical presentation at diagnosis. (B) An ultrasound shows a solid, moderately vascularised and slightly heterogeneous mass, with a vascular pole but no bone involvement. What is your diagnosis? 1. Congenital haemangioma 2. Vascular malformations 3. Infantile myofibroma 4. Malignant tumours 5. Tufted angioma The correct answer is E. Tufted angioma (TA) represents a benign vascular tumour that may be congenital, acquired, sporadic or hereditary.1 It usually occurs during infancy or early childhood on the neck, trunk or upper extremities.2 It appears as a dusky red, violaceous solitary tumour or infiltrating plaque, sometimes …
{"title":"A congenital purplish tumour","authors":"L. Matarazzo, A. Delise, F. Zennaro, R. Bussani, S. Demarini, I. Berti, A. Ventura","doi":"10.1136/archdischild-2015-309475","DOIUrl":"https://doi.org/10.1136/archdischild-2015-309475","url":null,"abstract":"An ethnic Bengali baby boy presented at birth with a purplish tender lesion on the medial side of his right knee (figure 1A). In the following weeks, the lesion remained stable in size. An ultrasound scan showed a solid mass, slightly heterogeneous, with a vascular pole but no bone involvement (figure 1B).\u0000\u0000\u0000\u0000Figure 1 \u0000(A) Clinical presentation at diagnosis. (B) An ultrasound shows a solid, moderately vascularised and slightly heterogeneous mass, with a vascular pole but no bone involvement.\u0000\u0000\u0000\u0000What is your diagnosis? \u0000\u00001. Congenital haemangioma\u0000\u00002. Vascular malformations\u0000\u00003. Infantile myofibroma\u0000\u00004. Malignant tumours\u0000\u00005. Tufted angioma\u0000\u0000The correct answer is E. Tufted angioma (TA) represents a benign vascular tumour that may be congenital, acquired, sporadic or hereditary.1 It usually occurs during infancy or early childhood on the neck, trunk or upper extremities.2 It appears as a dusky red, violaceous solitary tumour or infiltrating plaque, sometimes …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89160610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-04DOI: 10.1136/archdischild-2014-307941
A. Saha, M. Tighe, A. Batra
Faecal calprotectin (FC) is a neutrophil-derived protein released in stool in response to mucosal inflammation. It is a simple, cheap and non-invasive test with high sensitivity and moderate specificity, which can be useful in the diagnosis and monitoring of inflammatory bowel disease (IBD). FC levels correlate well with bowel inflammation (both macroscopic and histological activity) and are not influenced by disease location or type of IBD. Despite the shortcoming with regards to specificity, it is the high sensitivity of FC that makes it a valuable screening tool in the diagnosis of IBD. It is especially effective in identifying children with low probability of IBD who would not benefit from further investigations. The cut-off value selected has a significant impact on the diagnostic accuracy of the test, influencing its sensitivity and specificity, and must be interpreted judiciously. Its role in disease monitoring is as an add-on test to Paediatric Ulcerative Colitis Activity Index and Paediatric Crohn's Disease Activity Index scores and can be used to differentiate disease relapse from functional symptoms. High levels of FC are also seen in a number of other conditions, such as gastrointestinal infections and coeliac disease. It is recommended that infective causes affecting the gut must be excluded first, before FC is measured.
{"title":"How to use faecal calprotectin in management of paediatric inflammatory bowel disease","authors":"A. Saha, M. Tighe, A. Batra","doi":"10.1136/archdischild-2014-307941","DOIUrl":"https://doi.org/10.1136/archdischild-2014-307941","url":null,"abstract":"Faecal calprotectin (FC) is a neutrophil-derived protein released in stool in response to mucosal inflammation. It is a simple, cheap and non-invasive test with high sensitivity and moderate specificity, which can be useful in the diagnosis and monitoring of inflammatory bowel disease (IBD). FC levels correlate well with bowel inflammation (both macroscopic and histological activity) and are not influenced by disease location or type of IBD. Despite the shortcoming with regards to specificity, it is the high sensitivity of FC that makes it a valuable screening tool in the diagnosis of IBD. It is especially effective in identifying children with low probability of IBD who would not benefit from further investigations. The cut-off value selected has a significant impact on the diagnostic accuracy of the test, influencing its sensitivity and specificity, and must be interpreted judiciously. Its role in disease monitoring is as an add-on test to Paediatric Ulcerative Colitis Activity Index and Paediatric Crohn's Disease Activity Index scores and can be used to differentiate disease relapse from functional symptoms. High levels of FC are also seen in a number of other conditions, such as gastrointestinal infections and coeliac disease. It is recommended that infective causes affecting the gut must be excluded first, before FC is measured.","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82232674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-02DOI: 10.1136/archdischild-2015-309344
D. J. Cottrell
Medically unexplained symptoms are common and not always easy to manage. A wide range of symptoms may be presented and anxiety in the child, family and paediatrician about the possibility of a missed serious organic diagnosis may hamper effective management. Evidence-based approaches to a number of different presenting problems share a number of components. A model for assessment and management based on clinical experience and this evidence base is described.
{"title":"Fifteen-minute consultation: Medically unexplained symptoms","authors":"D. J. Cottrell","doi":"10.1136/archdischild-2015-309344","DOIUrl":"https://doi.org/10.1136/archdischild-2015-309344","url":null,"abstract":"Medically unexplained symptoms are common and not always easy to manage. A wide range of symptoms may be presented and anxiety in the child, family and paediatrician about the possibility of a missed serious organic diagnosis may hamper effective management. Evidence-based approaches to a number of different presenting problems share a number of components. A model for assessment and management based on clinical experience and this evidence base is described.","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84694607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-02DOI: 10.1136/archdischild-2015-309415
G. Karagüzel, S. Kul, M. Imamoglu, A. Ökten, G. Karagüzel
A 6-month-old boy was referred to our clinic with a 4-month history of progressive bilateral breast enlargement (figure 1). There was no history of maternal medication, infection, trauma, nipple discharge, contact with oestrogen products or familial breast disorder. He had bilateral painless breast enlargement without nipple discharge and signs of inflammation. His testes were both palpable in the scrotum, measuring 2 mL in volume. Figure 1 General appearance of the patient. There were no signs of other endocrine abnormalities. 1. From the patient's clinical presentation, what is the most likely diagnosis? 1. Prepubertal gynaecomastia 2. 46,XX disorder of sex development 3. 17α-hydroxylase deficiency 4. 46,XY disorder of sex development 5. Breast abscess 2. Other than breast ultrasound, which investigation(s) would you perform (multiple answers are possible)? 1. Whole blood count and erythrocyte sedimentation rate 2. Prolactin, total testosterone and oestradiol 3. Free thyroxine, thyroid stimulating hormone (TSH) and cortisol 4. Human chorionic gonadotropic hormone 5. Karyotype …
{"title":"A 6-month-old boy with bilateral breast enlargement","authors":"G. Karagüzel, S. Kul, M. Imamoglu, A. Ökten, G. Karagüzel","doi":"10.1136/archdischild-2015-309415","DOIUrl":"https://doi.org/10.1136/archdischild-2015-309415","url":null,"abstract":"A 6-month-old boy was referred to our clinic with a 4-month history of progressive bilateral breast enlargement (figure 1). There was no history of maternal medication, infection, trauma, nipple discharge, contact with oestrogen products or familial breast disorder. He had bilateral painless breast enlargement without nipple discharge and signs of inflammation. His testes were both palpable in the scrotum, measuring 2 mL in volume.\u0000\u0000\u0000\u0000Figure 1 \u0000General appearance of the patient.\u0000\u0000\u0000\u0000There were no signs of other endocrine abnormalities.\u0000\u0000\u0000\u00001. From the patient's clinical presentation, what is the most likely diagnosis? 1. Prepubertal gynaecomastia\u0000 2. 46,XX disorder of sex development\u0000 3. 17α-hydroxylase deficiency\u0000 4. 46,XY disorder of sex development\u0000 5. Breast abscess\u0000\u00002. Other than breast ultrasound, which investigation(s) would you perform (multiple answers are possible)? 1. Whole blood count and erythrocyte sedimentation rate\u0000 2. Prolactin, total testosterone and oestradiol\u0000 3. Free thyroxine, thyroid stimulating hormone (TSH) and cortisol\u0000 4. Human chorionic gonadotropic hormone\u0000 5. Karyotype …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88109273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-02DOI: 10.1136/archdischild-2015-309048
E. Dyer, T. Waterfield, M. Eisenhut
There are over 300 new cases of imported paediatric malaria in the UK each year and this has been increasing over the last 20 years. Malaria in children is particularly difficult to diagnose because the initial presenting features are subtler than in adults and do not display the classical presenting features. However, they are also more likely to deteriorate rapidly and to develop severe malaria. The ‘gold standard’ for ruling out the diagnosis of malaria if clinically suspected is three negative thin and thick blood films, which require serial phlebotomy and the availability of trained technicians. There are now a range of other tests, including rapid diagnostic tests and PCR, as well as clinical features that make the diagnosis more or less likely. We explore the different tests available and whether these might replace the three negative blood films currently needed. We also look at whether we are able to use clinical features to aid the tests used for a diagnosis of imported malaria.
{"title":"How to interpret malaria tests","authors":"E. Dyer, T. Waterfield, M. Eisenhut","doi":"10.1136/archdischild-2015-309048","DOIUrl":"https://doi.org/10.1136/archdischild-2015-309048","url":null,"abstract":"There are over 300 new cases of imported paediatric malaria in the UK each year and this has been increasing over the last 20 years. Malaria in children is particularly difficult to diagnose because the initial presenting features are subtler than in adults and do not display the classical presenting features. However, they are also more likely to deteriorate rapidly and to develop severe malaria. The ‘gold standard’ for ruling out the diagnosis of malaria if clinically suspected is three negative thin and thick blood films, which require serial phlebotomy and the availability of trained technicians. There are now a range of other tests, including rapid diagnostic tests and PCR, as well as clinical features that make the diagnosis more or less likely. We explore the different tests available and whether these might replace the three negative blood films currently needed. We also look at whether we are able to use clinical features to aid the tests used for a diagnosis of imported malaria.","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88365493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-27DOI: 10.1136/archdischild-2015-308974
Michael Malley, M. Monaghan, Alisha Esmail, C. Neophytou, A. Cheng
A previously well 10-year-old girl presented with 3 months of L5-S2 back pain. This had started insidiously while in Sudan and woke her nightly. She reported 5 days of constipation and urinary frequency but no neurological symptoms, fevers or weight loss. Her body mass index was normal and she was premenarchal, although had signs of thelarche. Cardiovascular and respiratory examinations were normal. Routine observations were unremarkable. She reported L5-S2 pain upon lumbar extension (not present on palpation). No neurological signs were elicited. Abdominal examination revealed suprapubic fullness, clinically thought to represent constipation, with no organomegaly. What differentials should be considered? What are the red flag symptoms to elicit? Back pain affects 17%–26% of adolescents yet specific diagnoses are reached in only half of the cases.1 Significant pathologies should be carefully considered …
{"title":"An unusual cause of back pain","authors":"Michael Malley, M. Monaghan, Alisha Esmail, C. Neophytou, A. Cheng","doi":"10.1136/archdischild-2015-308974","DOIUrl":"https://doi.org/10.1136/archdischild-2015-308974","url":null,"abstract":"A previously well 10-year-old girl presented with 3 months of L5-S2 back pain. This had started insidiously while in Sudan and woke her nightly. She reported 5 days of constipation and urinary frequency but no neurological symptoms, fevers or weight loss. Her body mass index was normal and she was premenarchal, although had signs of thelarche.\u0000\u0000Cardiovascular and respiratory examinations were normal. Routine observations were unremarkable. She reported L5-S2 pain upon lumbar extension (not present on palpation). No neurological signs were elicited. Abdominal examination revealed suprapubic fullness, clinically thought to represent constipation, with no organomegaly.\u0000\u0000What differentials should be considered? What are the red flag symptoms to elicit?\u0000\u0000Back pain affects 17%–26% of adolescents yet specific diagnoses are reached in only half of the cases.1 Significant pathologies should be carefully considered …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76190753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-22DOI: 10.1136/archdischild-2015-309900
K. Keown, C. Hart, Michael Moran, A. Thompson
A 2-year-old girl presented to the local emergency department with 4 days of vomiting, poor oral intake and fever. ‘Noisy’ breathing and cough were noted by her parents in the preceding 12 h. She was initially given oral antibiotics for tonsillitis before developing audible stridor. Oral and nebulised steroids were given for presumed croup, and she was transferred to the nearby paediatric emergency department for further management. Intravenous access was established prior to transfer. On paediatric assessment, she appeared pale and sitting in a tripod position with her neck in extension. Soft inspiratory stridor was present with a loud, wet barking cough. Oxygen saturations were maintained with wafting oxygen but desaturated when distressed. She was tachycardic though capillary refill was normal. Intravenous ceftriaxone was administered to cover for bacterial tracheitis, and although she was maintaining her own airway, …
{"title":"A diagnosis not to get stuck on","authors":"K. Keown, C. Hart, Michael Moran, A. Thompson","doi":"10.1136/archdischild-2015-309900","DOIUrl":"https://doi.org/10.1136/archdischild-2015-309900","url":null,"abstract":"A 2-year-old girl presented to the local emergency department with 4 days of vomiting, poor oral intake and fever. ‘Noisy’ breathing and cough were noted by her parents in the preceding 12 h. She was initially given oral antibiotics for tonsillitis before developing audible stridor. Oral and nebulised steroids were given for presumed croup, and she was transferred to the nearby paediatric emergency department for further management. Intravenous access was established prior to transfer.\u0000\u0000On paediatric assessment, she appeared pale and sitting in a tripod position with her neck in extension. Soft inspiratory stridor was present with a loud, wet barking cough. Oxygen saturations were maintained with wafting oxygen but desaturated when distressed. She was tachycardic though capillary refill was normal. Intravenous ceftriaxone was administered to cover for bacterial tracheitis, and although she was maintaining her own airway, …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86024656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-22DOI: 10.1136/archdischild-2015-309500
J. Bate, Neil Ranasinghe, R. Ling, J. Preston, R. Nightingale, S. Denegri
Public and patient involvement (PPI) in health research is a dynamic partnership between patients and/or members of the public and researchers. Involvement is distinct from being subjects of research (participation) as patients contribute to the research process as advisors and sometimes co-researchers. In practice, this may mean involvement in prioritising and developing research ideas, contributing to study design, carrying out the research and research dissemination.1 It should be emphasised that involvement is carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them.2 PPI offers researchers valuable and unique insight into the particular condition being investigated to make research more relevant to patients. PPI is needed to improve the quality of research and increase accountability. It is also reported to have benefits of increased recruitment and retention of study participants.3 The reasons for this are varied. The research questions are more likely to be aligned with outcomes valued by patients. Recruitment materials designed with the public will be written more suitably and with greater relevance. Importantly, the public bring important insight into how burdensome study requirements are to everyday life. Additionally, the idea of PPI is itself appealing, which increases willingness to participate in research. For today's researchers, active PPI has further relevance as funding bodies frequently require evidence of PPI in the development of a research proposal and ask how patients and the public might be involved in the conduct of the research. For patients, it is ethical for them to have a voice in research that may have an impact on their health. Dame Sally Davies, chief medical officer for England, advocates PPI as the rule rather than the exception:No matter how complicated the research, or how brilliant the researcher, patients and the public always offer unique, invaluable insights. …
{"title":"Public and patient involvement in paediatric research","authors":"J. Bate, Neil Ranasinghe, R. Ling, J. Preston, R. Nightingale, S. Denegri","doi":"10.1136/archdischild-2015-309500","DOIUrl":"https://doi.org/10.1136/archdischild-2015-309500","url":null,"abstract":"Public and patient involvement (PPI) in health research is a dynamic partnership between patients and/or members of the public and researchers. Involvement is distinct from being subjects of research (participation) as patients contribute to the research process as advisors and sometimes co-researchers. In practice, this may mean involvement in prioritising and developing research ideas, contributing to study design, carrying out the research and research dissemination.1 It should be emphasised that involvement is carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them.2\u0000\u0000PPI offers researchers valuable and unique insight into the particular condition being investigated to make research more relevant to patients. PPI is needed to improve the quality of research and increase accountability. It is also reported to have benefits of increased recruitment and retention of study participants.3 The reasons for this are varied. The research questions are more likely to be aligned with outcomes valued by patients. Recruitment materials designed with the public will be written more suitably and with greater relevance. Importantly, the public bring important insight into how burdensome study requirements are to everyday life. Additionally, the idea of PPI is itself appealing, which increases willingness to participate in research.\u0000\u0000For today's researchers, active PPI has further relevance as funding bodies frequently require evidence of PPI in the development of a research proposal and ask how patients and the public might be involved in the conduct of the research. For patients, it is ethical for them to have a voice in research that may have an impact on their health.\u0000\u0000Dame Sally Davies, chief medical officer for England, advocates PPI as the rule rather than the exception:No matter how complicated the research, or how brilliant the researcher, patients and the public always offer unique, invaluable insights. …","PeriodicalId":8153,"journal":{"name":"Archives of Disease in Childhood: Education & Practice Edition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75047413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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