Latest & greatest articles for children

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Top results for children

141. Nurses lack confidence in escalating or identifying children at risk of abuse and neglect

Nurses lack confidence in escalating or identifying children at risk of abuse and neglect Nurses lack confidence in escalating or identifying children at risk of abuse and neglect Discover Portal Discover Portal Nurses lack confidence in escalating or identifying children at risk of abuse and neglect Published on 6 December 2016 doi: On the face of it, nurses are well placed to safeguard children, but asking them about their experiences reveals barriers which hinder that role. The research (...) . There is also a tension between being seen as caring, compassionate and trustworthy, and watching for abuse and neglect in vulnerable families. Current training is not enough to equip nurses with the necessary skills to confidently and effectively safeguard children. Instead, education could be tailored to specific situations. These findings were based on international studies where child protection policies and services and the training and expectations of nurses differ. Therefore, they may not all

2019 NIHR Dissemination Centre

142. Risks and benefits of ondansetron for children with acute gastroenteritis

Risks and benefits of ondansetron for children with acute gastroenteritis Risks and benefits of ondansetron for children with acute gastroenteritis Discover Portal Discover Portal Risks and benefits of ondansetron for children with acute gastroenteritis Published on 7 February 2017 doi: Giving ondansetron to children with acute gastroenteritis can stop vomiting, reduce the risk of oral rehydration treatment failing, and reduce the chances of needing intravenous rehydration. But the drug can (...) worsen diarrhoea symptoms. This systematic review looked for evidence about ondansetron’s effectiveness in stopping vomiting and for any impact on diarrhoea or other side effects. Only five out of the 10 included trials reported on diarrhoea related outcomes and they all used different outcome measures so the results could not be combined. This means that although diarrhoea is a recognised side-effect, it is still not known to what extent children given ondansetron may be at risk of recurring

2019 NIHR Dissemination Centre

143. Parent-focused therapy has some long-term benefits for children with autism

Parent-focused therapy has some long-term benefits for children with autism Parent-focused therapy has some long-term benefits for children with autism Discover Portal Discover Portal Parent-focused therapy has some long-term benefits for children with autism Published on 14 February 2017 doi: A parent-focused therapy for young children with autism continues to have beneficial effects on symptoms and communication almost six years after the end of treatment. This UK randomised controlled trial (...) investigated the effects of a one-year social communication therapy in 152 UK children aged two to four years with severe autism. The therapy, partly delivered by parents, aimed to help them adapt their style of interacting with their child. Children who received the intervention had less severe symptoms at the end of the initial one-year intervention period than those who received treatment as usual. When these children were followed up nearly six years later at age seven to 11 years, children who had

2019 NIHR Dissemination Centre

144. Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease

Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Discover Portal Discover Portal Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Published on 14 February 2017 doi: Early treatment with corticosteroids on top of standard therapy reduces the risk of serious heart problems in children under five with the rare vascular (...) disease, Kawasaki disease. The disease needs to be recognised early, but can be hard to spot outside specialist care because it is so rare. It is now the commonest cause of acquired heart disease in children and delayed diagnosis can have serious consequences. Blood vessels supplying the heart become inflamed, increasing the risk of heart attack and death in later life. The disease is about 20 times more common in people of Japanese origin. This summary of the evidence found that adding

2019 NIHR Dissemination Centre

145. GP letter to improve medication adherence did not reduce unplanned care for children with asthma

GP letter to improve medication adherence did not reduce unplanned care for children with asthma GP letter to improve medication adherence did not reduce unplanned care for children with asthma Discover Portal Discover Portal GP letter to improve medication adherence did not reduce unplanned care for children with asthma Published on 14 March 2017 doi: A one-off GP letter reminding parents of children with asthma to use their medications over the August summer holiday did not prevent (...) a characteristic annual peak in unplanned care on returning to school in September, but did lead to more prescriptions. Unplanned care represents visits to the GP or accident and emergency that is not part of the child’s asthma care plan. They do not include scheduled medical review or visits for repeat prescriptions. The letter prompted about a third more parents to collect inhaler prescriptions in August than parents receiving no letter. But this failed to reduce the high proportion of children receiving

2019 NIHR Dissemination Centre

146. Very strict blood sugar control in critically ill children provides no benefit

Very strict blood sugar control in critically ill children provides no benefit Very strict blood sugar control in critically ill children provides no benefit Discover Portal Discover Portal Very strict blood sugar control in critically ill children provides no benefit Published on 23 May 2017 doi: Strict control of blood sugar levels for critically ill children in ICU with high blood sugar did not increase the number of days they spent outside of ICU in the first month. The trial was stopped (...) early as more infections and very low glucose levels were recorded in the strict control group. This trial found that using insulin to control blood sugar to within 4.4 to 6.1 mmol/L, rather than 8.3 to 10mmol/L, in critically ill children made no difference to the number of days they spent in the intensive care unit. This trial indicates that maintaining blood sugar control within tight boundaries in this group is of no benefit and may be harmful. It is time to review the target blood sugar levels

2019 NIHR Dissemination Centre

147. Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children

Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children Discover Portal Discover Portal Regular use of fluoride mouthrinse is an option to reduce tooth decay in school children Published on 8 November 2016 doi: A reduction in tooth decay of about 27% can be expected from the supervised regular use of fluoride mouthrinsing by school children. Tooth decay has a significant (...) impact on health and wellbeing. It is more common in disadvantaged communities and can be prevented by good oral hygiene and diet with reduced sugar intake. Children and young people are encouraged to brush their teeth regularly with fluoride toothpaste and some schools in the UK have supervised programmes to encourage this. This review included 37 trials where children received supervised mouthrinsing in schools, but did not compare this with supervised toothbrushing. Current guidance recommends

2019 NIHR Dissemination Centre

148. Simple approaches to weight management of children and adolescents in primary care may not work

Simple approaches to weight management of children and adolescents in primary care may not work Simple approaches to weight management of children and adolescents in primary care may not work Discover Portal Discover Portal Simple approaches to weight management of children and adolescents in primary care may not work Published on 8 November 2016 doi: Brief education and motivational interventions delivered by primary care professionals in several short consultations had only a marginal effect (...) on weight loss among overweight or mildly obese children and young people. Obesity can cause immediate health and wellbeing issues in children but also has significant implications for their long term health. Given that many of these health problems will present in a primary care setting, commissioners have been interested in primary care based programmes to tackle obesity and the “intensity” of the intervention required to make a difference. The findings that a few sessions in primary care

2019 NIHR Dissemination Centre

149. Fluoride-based treatments alone are not enough to stop tooth decay in young children

Fluoride-based treatments alone are not enough to stop tooth decay in young children Fluoride-based treatments alone are not enough to stop tooth decay in young children Discover Portal Discover Portal Fluoride-based treatments alone are not enough to stop tooth decay in young children Published on 22 November 2016 doi: Providing a set of additional fluoride-based treatments at dental appointments for children aged two to three years was no better than health education at preventing tooth decay (...) . A range of public health measures to reduce sugar consumption are also needed. The treatment involved providing fluoride toothpaste and applying a fluoride varnish to the teeth at each six-monthly appointment for three years. This large NIHR-funded trial in Northern Ireland found no difference in the number of children developing tooth decay, though children in the treatment arm had fewer teeth showing signs of decay. The estimated cost was £2,093 per child who avoided tooth decay. The minimal effect

2019 NIHR Dissemination Centre

150. Vomiting is the most common adverse effect among children and young people sedated for emergency procedures

Vomiting is the most common adverse effect among children and young people sedated for emergency procedures Vomiting is the most common adverse effect among children and young people sedated for emergency procedures Discover Portal Discover Portal Vomiting is the most common adverse effect among children and young people sedated for emergency procedures Published on 27 September 2016 doi: Vomiting is the most common adverse event when sedating a child or young person undergoing a procedure (...) in the emergency department, occurring in 55.5 out of 1,000 cases. Agitation occurred in 17.9/1,000 cases, and hypoxia – lack of oxygen – in 14.8 out of 1,000 cases. Serious breathing problems needing intervention to provide ventilation were rare, but highlight the need for experienced staff when giving sedation to children. This systematic review included 41 studies, six of which were UK-based. It pooled the frequency of adverse events when using different sedation drugs, alone or in combination

2019 NIHR Dissemination Centre

151. Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children

Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Discover Portal Discover Portal Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Published on 22 November 2016 doi: Regular daily steroid inhalers reduce the number of severe asthma exacerbations requiring soluble tablets or injections in wheezing preschool children by about a third. Intermittent (...) high-dose steroid inhalers, given only when symptoms of a cold begin, were also effective for children with occasional asthma or wheezing triggered by a virus. This strategy may reduce the overall dose of steroids given to these children, though adverse effects may still occur. Wheezing is initially treated with a β2 agonist inhaler which opens up the airways. UK guidelines recommend adding in a daily low-dose steroid inhaler if symptoms are persistent, which is in keeping with the findings

2019 NIHR Dissemination Centre

152. Young children from deprived areas are more at risk of serious burns and scalds

Young children from deprived areas are more at risk of serious burns and scalds Young children from deprived areas are more at risk of serious burns and scalds Discover Portal Discover Portal Young children from deprived areas are more at risk of serious burns and scalds Published on 24 January 2017 doi: Five in every 1,000 children under four are injured by burns and scalds each year in England, although these injuries are becoming less common. Serious injuries needing hospital treatment (...) happen more often to children from deprived areas than wealthy areas. The study looked at general practice data from 1998 to 2013. It showed a steady decline in children having burns and scalds over the 15 year period, and the gap between least- and most-deprived areas has narrowed. However, children from the most deprived areas are more than twice as likely to need hospital treatment. Children aged 15 to 17 months are most at risk. Most burns and scalds are preventable. The findings suggest

2019 NIHR Dissemination Centre

153. Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children

Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children Discover Portal Discover Portal Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children Published on 17 April 2018 doi: Intravenous lorazepam is as effective as intravenous diazepam for stopping children’s tonic-clonic seizures in hospital. Lorazepam also results in fewer breathing problems (...) than diazepam. Giving antiepileptic drugs intravenously generally stops seizures more quickly than giving the drugs buccally (in the cheek), intranasally (in the nose) or rectally. However, this effect can be cancelled out if administering the drug into the veins takes too long. Two of the 18 included trials were carried out in the UK, but they were all carried out in large children’s hospitals or departments similar to the UK. The new evidence confirms advice in the existing NICE guideline

2019 NIHR Dissemination Centre

154. Central lines coated with antibiotics reduce bloodstream infections in children

Central lines coated with antibiotics reduce bloodstream infections in children Central lines coated with antibiotics reduce bloodstream infections in children Discover Portal Discover Portal Central lines coated with antibiotics reduce bloodstream infections in children Published on 10 May 2016 doi: Children in intensive care had lower rates of infection when using antibiotic coated central lines (also called central venous catheters) compared to standard central lines or those coated (...) with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines could reduce bloodstream infections in paediatric intensive care units. The researchers say cost-effectiveness, based on six-month hospital resource data, will be reported elsewhere. Tis evidence is needed

2019 NIHR Dissemination Centre

155. Early exposure to peanut snacks can lead to sustained protection in high-risk children

Early exposure to peanut snacks can lead to sustained protection in high-risk children Early exposure to peanut snacks can lead to sustained protection in high-risk children Discover Portal Discover Portal Early exposure to peanut snacks can lead to sustained protection in high-risk children Published on 10 May 2016 doi: Early exposure, up to age five, to peanut products in children with severe eczema or egg allergy appears to induce tolerance that is sustained when peanut products are later (...) avoided, suggesting it is not necessary to keep eating peanuts long term. This trial and its follow up study examined the effect of giving peanut products to very young children (aged four to 11 months) who were at high risk of peanut allergy. Children given regular peanut butter snacks until five years of age were much less likely to have a peanut allergy than those avoiding peanuts. There was a benefit even if they had an initial positive skin prick test suggesting allergy at the start

2019 NIHR Dissemination Centre

156. Education targeted at both parents and GPs reduces antibiotic prescribing for children

Education targeted at both parents and GPs reduces antibiotic prescribing for children Education targeted at both parents and GPs reduces antibiotic prescribing for children Discover Portal Discover Portal Education targeted at both parents and GPs reduces antibiotic prescribing for children Published on 30 August 2016 doi: Interventions aimed at improving communication between GPs and parents could reduce unnecessary antibiotic prescribing for childhood upper respiratory infections (...) to improve the training and information provided to help tackle inappropriate antibiotic prescribing. Perhaps most importantly it highlights the need to ensure parental involvement in the process. Share your views on the research. Why was this study needed? Upper respiratory infections include the common cold, tonsillitis and flu. Children tend to get these infections more often than adults because they have yet to build up immunity to them. The majority of upper respiratory infections are caused

2019 NIHR Dissemination Centre

157. “Triptans” can relieve migraines in children and adolescents

“Triptans” can relieve migraines in children and adolescents “Triptans” can relieve migraines in children and adolescents Discover Portal Discover Portal “Triptans” can relieve migraines in children and adolescents Published on 13 September 2016 doi: Triptans, a migraine medication, relieve migraine headache completely within two hours compared to placebo. Ibuprofen was also effective but less well studied. This review was also reassuring in that any side effects of treatment were mild. Most (...) evidence identified in this Cochrane review was for sumatriptan, a commonly prescribed treatment for adults, compared to placebo or dummy pills. A few studies examined other triptans or other painkillers, such as ibuprofen or paracetamol against placebo in children and adults. The findings support current guideline recommendations to prescribe nasal triptans for migraine in adolescents. Only nasal preparations are currently licensed for adolescents, whereas oral administration and use for children

2019 NIHR Dissemination Centre

158. Steroids rapidly reduce children’s croup symptoms and shorten hospital stays

Steroids rapidly reduce children’s croup symptoms and shorten hospital stays Corticosteroids for croup in children Discover Portal Discover Portal Steroids rapidly reduce children’s croup symptoms and shorten hospital stays Published on 27 November 2018 doi: Corticosteroids reduce symptoms of croup in children within two hours and continue to do so for at least 24 hours. They also cut the amount of time children spend in hospital by 15 hours and reduce return visits or readmissions from about (...) benefit from combining the two drugs. The findings support recommendations that all children with mild, moderate, or severe croup should be treated immediately with corticosteroids. Share your views on the research. Why was this study needed? Croup, or laryngotracheobronchitis, is a common childhood respiratory condition, characterised by the sudden onset of a seal-like barking cough, often accompanied by high-pitched wheezing, a hoarse voice, and difficulty breathing. It affects around 3% of children

2019 NIHR Dissemination Centre

159. Insulin pumps offer little value over multiple injections for children at the onset of diabetes

Insulin pumps offer little value over multiple injections for children at the onset of diabetes Insulin pumps or multiple injections for children at onset of diabetes Discover Portal Discover Portal Insulin pumps offer little value over multiple injections for children at the onset of diabetes Published on 20 November 2018 doi: Young people newly diagnosed with type 1 diabetes achieve similar blood glucose control by 12 months if they are treated with multiple daily insulin injections (...) or continuously via an insulin pump. Adverse events are rare and occur at similar rates. Pumps are more expensive with no clear benefit to quality of life. Both regimens are used in the management of type 1 diabetes, and the number of children using insulin pumps is rising. This NIHR-funded trial suggests that at an additional cost of £1,863 per patient annually with equivalent outcomes, the high costs of insulin pumps seem unjustified at this stage of the condition. However, continuous insulin may be more

2019 NIHR Dissemination Centre

160. Oral steroids do not help hearing for children with glue ear

Oral steroids do not help hearing for children with glue ear Glue ear hearing not helped by oral steroids Discover Portal Discover Portal Oral steroids do not help hearing for children with glue ear Published on 13 November 2018 doi: Oral steroids do not improve hearing, symptoms, or quality of life in children with glue ear. This NIHR-funded trial compared oral steroids with placebo for 389 children with glue ear, also called otitis media with effusion, and found no significant effect on those (...) outcomes. Glue ear is when the middle ear fills with fluid, often following an ear or respiratory infection. The fluid makes hearing more difficult. It usually resolves within three months without treatment, but if it lasts longer, the hearing loss may cause delayed language development or difficulties with communicating, for instance at school. This study shows that many children will improve spontaneously, even after three months of glue ear and confirms that steroids are not useful, even though

2019 NIHR Dissemination Centre