BMJ Paediatrics Open

ObjectiveTo compare hospital activity, patient casemix and medication prescribing and administration before and during the COVID-19 emergency. DesignRetrospective observational study SettingA specialist childrens hospital in the UK PatientsInpatients aged 25 and younger treated at a specialist childrens hospital between 29 April 2019 and 6 September 2020 ResultsThere were 21,471 day cases and inpatients treated during the 16 month study period. Day cases (no overnight stay) dropped by around...

BackgroundPublic health restrictions are an essential strategy to prevent the spread of COVID-19; however, unintended consequences of these interventions may have led to significant delays, deferrals and disruptions in medical care. This study explores clinical cases where the care of children was perceived to have been negatively impacted as a result of public health measures and changes in healthcare delivery and access due to the COVID-19 pandemic. MethodsThis study used a qualitative multip...

Care-experienced children - also referred to as children in out-of-home care, children in foster care, or looked after children - face additional barriers to good physical health compared to those without care experience. Despite good health in early years being vital to long-term quality of life, there is little research on physical health outcomes in young care-experienced children. This scoping review aimed to collate and review peer-reviewed published literature to identify gaps and inform f...

ObjectiveTo compare Pediatric Emergency attendance pre-COVID 19 to that during COVID 19 pandemic and to study changes in patient profiles attending Pediatric Emergency Department during COVID 19 pandemic. MethodsWe conducted a retrospective cross-sectional observational study and collected data from Medical Record Section during the COVID-19 pandemic from January to June 2020 and compared it with data from 2019 in similar months. Data collected was analyzed to find out the impact of COVID - 19 ...

BackgroundPhysical symptoms without an identified organic cause are frequently observed in adolescents. These symptoms are often linked to psychiatric comorbidities, posing diagnostic and management challenges for healthcare professionals. ObjectiveTo assess the proportion of pediatric emergency room visits for physical symptoms without organic etiology among adolescents with Patient Health Questionnaire-13 (PHQ-13) somatic symptoms. To assess the proportion of patients with somatic symptoms wh...

BackgroundSymptoms of SARS-CoV-2 infection in children are nonspecific and shared with other common acute viral illnesses (fever, respiratory or gastrointestinal symptoms, and cutaneous signs), thus making clinical differential diagnosis tricky. In Italy, first line management of pediatric care is handed over to Primary Care Pediatricians (PCPs), who were not allowed to directly perform diagnostic tests during the recent COVID-19 outbreak. Without a confirmatory diagnosis, PCPs could only collec...

Studies of quality of life (QoL) routinely exclude children with complex needs. These children struggle to access leisure activities, particularly those with severe communication needs or challenging behaviour. Sparkle provides specialised leisure services to children and young people (0-17 years) with complex needs in South Wales, UK. We aimed to evaluate previously validated tools to measure QoL with this population. Three tools were assessed over a 6-year period - PedsQL, KINDLR and QI-Disab...

UK Lockdown measures introduced in March 2020 aimed to mitigate the spread of Covid-19. Although seeking healthcare was still permitted within restrictions, paediatric emergency department attendances reduced dramatically and led to concern over risks caused by delayed presentation. Our aim was to gain insight into healthcare decisions faced by parents during the first wave of the Covid-19 pandemic and to understand if use of urgent healthcare, self-care, and information needs differed during l...

BackgroundSocial transition, defined as all outward changes in gender expression to align with and affirm ones gender identity, has been richly described in qualitative studies, but quantitative research often lacks the detail required to capture its full complexity. To date, no studies have quantitatively examined how this process varies in young people over time. MethodsLongitudinal data were obtained from 234 trans and gender diverse Australian young people (ages 8-17) attending a specialist...

ObjectivesTo determine any change in referral patterns and outcomes in children (0-18) referred for child protection medical examination (CPME) during the covid-19 pandemic compared to previous years. DesignRetrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown. SettingBirmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288,000 ...

Childrens attendances in paediatric emergency departments have fallen precipitously in North East England and elsewhere in recent months. We analysed data from 3 hospitals to understand which children were not being brought during the COVID-19 lockdown. In our population there is no evidence of a disproportionate impact on children belonging to vulnerable sociodemographic groups and no obvious change in illness acuity among those children still attending. However we noted a marked reduction in ...

The prevalence of pediatric pain, either related to the childs hospital visit or as a result of diagnostic and/or therapeutical interventions, is of primordial importance in pediatric emergency departments (PEDs). In this study, we evaluate the evolution of pain assessment and management in Portuguese PEDs through eleven years. To this end, we prepared a questionnaire addressed to head physicians of 45 the Portuguese PEDs in 2007 and compared the responses to those provided in 2018, where we al...

BackgroundPaediatric attendances to Emergency Departments (EDs) in the UK are increasing, particularly for younger children. Neonates present a challenge due to their non-specific presentations. Community services are under increasing pressure and parents may preferentially bring their children to the ED, even for non-urgent problems. Neonatal attendances have not been extensively studied, but previous reviews have shown many are well, often not requiring specific medical intervention. This stud...

BackgroundModified Free Water Protocols (MFWPs) are increasingly referenced in UK paediatric dysphagia practice despite no published paediatric evidence of safety or efficacy. AimsTo examine how, for whom, and why MFWPs are used or discussed by UK Speech and Language Therapists (SLTs), whether clinicians can reference any supporting evidence, and how outcomes are monitored. MethodsCross-sectional online survey of UK paediatric dysphagia SLTs with Likert-scale, yes/no, and open-ended items; dat...

BackgroundMajor congenital anomalies (CAs) occur in 2.3% of livebirths and are associated with lower educational attainment in affected children. Understanding how attainment changes throughout primary school would inform parents, schools and organisations and help plan support. ObjectivesWe compared school enrolment and attainment at ages 5, 7 and 11 in children with different CAs and their peers in England using linked administrative hospital and education data in the ECHILD database. Method...

Leisure activities during childhood are vital to quality of life and wellbeing, however parents report poor quality of life and infrequent leisure participation for children with complex disabilities. Sparkle, a charity in South Wales, delivers specialist leisure activities aimed at providing children with disabilities with access to the same opportunities as any other child. We explored the impact of this provision on psychosocial domains of quality of life for children with complex disabilitie...

IntroductionSpigelian hernia (SH) is an aponeurotic defect, either acquired or congenital, in Spiegels semilunar line. SH is exceptional in pediatric patients. MethodsA comprehensive non-systematic review of the previous literature was conducted. Eligible studies were identified by searching the primary existing medical bibliography databases. Median and interquartile range or mean and standard deviation were used to describe quantitative variables and proportions for categorical variables. The...

ObjectiveSurgical site infections (SSIs), especially deep/organ-space SSIs, are common and serious complications following appendectomy. This review aimed to explore the interventions that have been implemented to reduce the risk of SSIs in pediatric appendicitis patients. MethodsA literature search was performed using PubMed, Cochrane, and Embase databases of studies in English published between January 01, 1973, and April 30, 2023. Studies on pediatric patients ([≤] 18 years) with appendic...

BackgroundEnsuring the right drug for the right clinical condition in children under five years of age will dramatically reduce morbidity and mortality rates in developing countries where these values are alarmingly high. This study evaluated prescribing in children under the age of five attending pediatric outpatient clinics at three Central hospitals in Delta State, Nigeria, using the Pediatics: Omission of Prescriptions and Inappropriate Prescription (POPI) tool. MethodsThis was a prospectiv...

PurposeRecent guidance has resulted in an increased level of interest in the wellbeing of children and young people, including those with complex needs. Evaluation of quality of life in this population is notoriously difficult, but has become increasingly vital when assessing the value of a service. MethodsA previously validated tool, Quality of life Inventory-Disability (QI-Disability), was used in conjunction with parental reports on quality-of-life measures for children and young people befo...