Children and young people can have a wide range of life limiting conditions and may sometimes live with such conditions for many years. This guideline recommends that end of life care be managed as a long term process that begins at the time of diagnosis of a life limiting condition and entails planning for the future. Sometimes it may begin before the child’s birth. It is part of the overall care of the child or young person and runs in parallel with other active treatments for the underlying condition itself. Finally, it includes those aspects related to the care of the dying.
Many children receive no discharge plan after admission for severe asthma
Children admitted to hospital with severe asthma attacks generally receive “very effective and efficient” treatment and care, but more attention must be given to asthma education and review at discharge to help prevent future attacks and readmission, says a national audit by the British Thoracic Society.
The society’s National Paediatric Asthma Audit, published on 29 November, reviewed data on more than 5500 children over the age of 1 admitted with severe asthma attacks to 153 UK hospitals in November 2015 and found that most aspects of discharge from hospital were less than optimal.
Frozen tissue service offers fertility hope to young people with cancer
Scientists at Edinburgh University have developed a service to store testicular tissue from boys as young as 1 who are at risk of infertility because of cancer treatment. In future boys as well as girls might be able to have their fertility restored subsequent to chemotherapy.
The announcement comes after the birth of the first UK baby to be born after his mother had a transplant of her own, previously frozen, ovary tissue.
Disabled children risk further abuse after unsubstantiated referral for neglect, research finds
Children with disabilities who have an initial unsubstantiated referral for neglect are at increased risk of being maltreated subsequently, a research letter published in JAMA has warned.
Researchers analysed data from the National Child Abuse and Neglect Data System, which collects data on children reported to child protection services in the United States and Puerto Rico. A total of 12 610 children with disabilities and 476 566 without disabilities who had first time unsubstantiated referrals for neglect in 2008 were included in the study and followed up for four years.
Reducing sugary drink intake is linked to raised HDL cholesterol levels
Children who reduce their consumption of sugar sweetened drinks by just one serving a week see improvements in their high density lipoprotein (HDL) cholesterol levels, a study published in the Journal of Nutrition has found.
The US study used data from a multiethnic sample of 613 children aged 8 to 15 who were enrolled in a randomised double blind vitamin D supplementation trial. They self reported their intake of sugar sweetened beverages and had their fasting blood lipid concentrations measured at baseline.
Two thirds of the children were from low socioeconomic status households, almost half were overweight or obese, and 59% were from non-white or Caucasian ethnic groups. The researchers followed 380 of the children for 12 months.
Smoking ban cuts admissions for child respiratory infections
Banning smoking in public places has cut hospital admissions for childhood respiratory infections in England by 11 000 a year, new research has estimated.
Researchers from the United Kingdom and the Netherlands said that evidence has shown that smoke-free public environments will benefit children’s health but that the exact effect on respiratory tract infections is unclear.
UK death rates in children’s heart surgery have almost halved over past decade
More children survived for at least 30 days after heart surgery at the end of the past decade than at the start, an analysis has found. The death rate fell from 4.3% to 2.6% of cases.
The findings have prompted the researchers to call for a shift away from scrutinising short term survival to looking at the longer term effects of heart surgery in children, such as measures of ill health and the effect on functional capacity.
BMJ Learning: Vitamin D and children
BMJ Learning are looking at how vitamin D deficiency presents in children. Do you know what investigations to carry out when you suspect it? And lastly do you know how to manage vitamin D deficiency once it is diagnosed?
Quick tips: vitamin D and children
And here are our most popular modules on ophthalmology:
Glaucoma – chronic open angle glaucoma and ocular hypertension – in association with NICE
The sticky eye: diagnostic picture tests
Sticky eye: diagnostic picture tests – part 2
The red eye: diagnostic picture tests
NHS Networks: News updates – children
Children and young people’s health report The first annual report by the Children and Young People’s Health Outcomes Forum has praised progress but also highlighted areas where more needs to be done. Read more »
New resources for keeping children safe Public Health England has launched two new resources for local authorities on preventing accidents to children and young people in the home and on the road. Read more »
Number of pregnant mums smoking falls to record low New figures show that only 12 percent of mothers said they were smokers at the time they gave birth, the lowest percentage in eight years of data collection. Read more »
Antibiotics for early-onset neonatal infection A summary of selected new evidence relevant to NICE clinical guideline 149 ‘Antibiotics for early-onset neonatal infection: antibiotics for the prevention and treatment of early-onset neonatal infection’ (2012). Read more »
BMJ Learning: Pain – June 10 2014
You see a 28 year old tennis player who has pain in his right knee. This started during a match four days ago. He twisted to hit a ball but his foot remained in the same position. What is most likely to be going on? And what tests would you do? If you are not sure then this module will help. Click on the link to complete it today:
And here are our most popular modules on pain:
eBulletin for children, families and maternity
Children, Families and Maternity e-bulletin: May 2013
Children, Families and Maternity bulletin for May 2013.
PDF, 74KB, 8 pages Published by DoH
New resource available from the Centre for Nursing Innovation
Centre for Nursing Innovation
Extract from newsletter
The links below enable you to freely download and share the latest Improvement Insights, part of the FoNS Dissemination Series Improvement Insights.
Each of these one-page summaries reports on the innovative ways in which nurse-led teams across the UK have been supported by FoNS to work with patients, relatives and staff in their drive to deliver excellent care.
Volume 8 Numbers 1-10:
- Embedding Excellent Nutrition Care Practices in an Acute Hospital Ward
- Establishing a Nurse Led Respite Ward within a Hospice
- Evaluation of ‘Back to the floor Friday’ at Imperial College Healthcare NHS Trust
- An Action Research Project Exploring the Utility of Rectal Irrigation in Children
- The Establishment of the Heathfield Healthcare Centre in HMP Wandsworth
- Improving the Patient Journey within a Minor Injuries Unit
- Improving the Patient Experience of Admission to an Older Persons Acute Mental Health Ward
- Supporting Patients in their Own Homes
- Involving Service Users’ Stories in Developing Mental Health Services: The Process of Capturing, Enabling and Supporting Service Users’ Expertise and Experiences
- Oral Care Management for Children, Young People and their Families in the Palliative Care Setting
FoNS is committed to supporting the development of nursing and healthcare practice and one of the ways we achieve this is by providing freely accessible information. All the projects and initiatives reported on have been supported by one of FoNS’ practice based development and research programmes and have aimed to:
- Respond to the needs of patients
- Improve patients’ experience of care
- Be evidence based (including practice knowledge and service users’ experience)
- Make changes to practice
- Share their learning
Eyes on Evidence for March
Analysis of data from a large randomised controlled trial suggests that intensive glucose control in critically ill patients is associated with moderate to severe hypoglycaemia, and a higher risk of death.
At its January meeting the NICE Accreditation Advisory Committee accredited 2 guidance programmes.
NICE recently published Evidence Updates on:
- Strategies to prevent unintentional injuries among children and young people aged under 15
- Hyperglycaemia in acute coronary syndromes
- Common mental health disorders
Better health outcomes for children and young people
This pledge aims to make improvements to the health of children and young people and is part of the government’s response to the Children and Young People’s Health Outcomes Forum.
It commits signatories to put children, young people and families right at the heart of decision making and improve every aspect of health services – from pregnancy through to adolescence and beyond.
Asthma quality standard
The King’s Fund
This quality standard on the diagnosis and treatment of asthma in adults, young people and children aged 12 months and older argues that an integrated approach to services is vital. The new quality standard on asthma consists of a prioritised set of specific, concise and measurable statements that, when delivered collectively, should contribute to improving the effectiveness, quality, safety and experience of care for people with the condition.
BMJ Modules: 4 February 2013
Abdominal conditions in children are common and have a wide range of causes. In this latest module Dr Ian Wacogne outlines the common causes of various abdominal problems in children and how to recognise and manage them.
Common problems in children 2: abdominal conditions
Also here are some of BMJ’s modules on oral health. They give an important update on a range of common dilemmas.
Mouth cancer: recognising it and referring early
Mouth ulcers: a guide to diagnosis and management
HIV infection: diagnostic picture tests
Herpes simplex type 1 oral infection: a guide to diagnosis and treatment
NHS Networks – Cancer news
Singhal, R, et al: Journal of Bone and Joint Surgery: Septic arthritis vs transient synovitis in children
Septic arthritis vs transient synovitis in children: a tertiary healthcare centre study by R Singhal of MDGH and D Perry, FN Khan, D Cohen, HL Stevenson, LA James, JS Sampath and CE Bruce
Background Establishing the diagnosis in a child presenting with an atraumatic limp can be challenging. There is particular difficulty distinguishing septic arthritis (SA) from transient synovitis (TS) and consequently clinical prediction algorithms have been devised to differentiate the conditions using the presence of fever, raised erythrocyte sedimentation rate (ESR), raised white cell count (WCC) and inability to weight bear. Within Europe measurement of the ESR has largely been replaced with assessment of C-reactive protein (CRP) as an acute phase protein. We have evaluated the utility of including CRP in a clinical prediction algorithm to distinguish TS from SA.
Method All children with a presentation of ‘atraumatic limp’ and a proven effusion on hip ultrasound between 2004 and 2009 were included. Patient demographics, details of the clinical presentation and laboratory investigations were documented to identify a response to each of four variables (Weight bearing status, WCC >12,000 cells/m3, CRP >20mg/L and Temperature >38.5 degrees C. The definition of SA was based upon microscopy and culture of the joint fluid collected at arthrotomy.
Results 311 hips were included within the study. Of these 282 were considered to have transient synovitis. 29 patients met criteria to be classified as SA based upon laboratory assessment of the synovial fluid. The introduction of CRP eliminated the need for a four variable model as the use of two variables (CRP and weight bearing status) had similar efficacy. An algorithm that indicated a diagnosis of SA in individuals who could not weight-bear and who had a CRP >20mg/L correctly classified SA in 94.8% individuals, with a sensitivity of 75.9%, specificity of 96.8%, positive predictive value of 71.0%, and negative predictive value of 97.5%. CRP was a significant independent predictor of septic arthritis.
Spine Surgery in Children and Adolescents
Acetaminophen Improves Analgesia but does not Reduce Opioid Requirement After Major Spine Surgery in Children and Adolescents.
Long-term Reduction in Adverse Drug Events:
Date added: 24/05/2012
New UK obesity centre offers surgery to teens
A London hospital has set up the United Kingdom’s first specialist centre offering extreme weight loss surgery for children and teenagers.
Childhood obesity rates are rising fast in the UK, with latest statistics showing that a third of children aged 10-11 in England suffer from obesity or weight issues.
via New UK obesity centre offers surgery to teens – Health News – Health & Families – The Independent.
News from NHS Networks: Children with Diabetes
A new newsfeed: Children and Young People
Read all the latest news from the newly acquired CASH newsfeed covering Children and Young People on our Women and Children’s page.
Grateful thanks to the CASH Portal at http://www.netvibes.com/keeping-up-to-date#Home
CASH aims to keep health professionals up-to-date with new developments for the benefit of patient care and improved decision making. It is a collaborative service provided by librarians from around England who monitor and capture content from across 3 broad sectors – Primary Care, Secondary Care and Mental Health.
Eyes on Evidence: Meningitis
|The Meningitis Trust
NHS Evidence provides access to more than 300,000 reliable resources from 1,300 sources. The number of evidence providers we receive information from is increasing every month.
Fact sheets from the Meningitis Trust are a recent addition to the search. The resources are primarily patient support information and cover a range of issues including developmental difficulties following meningitis, recovering after leaving hospital, entitlement to statutory benefits, and coping with bereavement. There are also fact sheets written specifically for child carers, teachers and pupils, employers, colleges and universities, and health professionals.
The Meningitis Trust was one of the first charities to become a certified member of The Information Standard.
Involving children and young people in health services
Extract from The King’s Fund: NHS Confederation
Involving children and young people in health services
This report highlights the key findings and recommendations from an event held in September 2011 to discuss the key priorities for child health.