Archives of disease in childhood
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To investigate what patterns of bruising are diagnostic or suggestive of child abuse by means of a systematic review. ⋯ When abuse is suspected, bruising must be assessed in the context of medical, social, and developmental history, the explanation given, and the patterns of non-abusive bruising. Bruises in non-mobile infants, over soft tissue areas, that carry the imprint of an implement and multiple bruises of uniform shape are suggestive of abuse. Quality research across the whole spectrum of children is urgently needed.
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To assess the reliability of mortality risk assessment using the Paediatric Risk of Mortality (PRISM) score and the Paediatric Index of Mortality (PIM) in daily practice. ⋯ In daily practice severity of illness scoring using the PRISM and PIM risk adjustment systems is associated with wide variability. These differences could not be explained by the physician's level of experience. Reliable assessment of PRISM and PIM scores requires rigorous specific training and strict adherence to guidelines. Consequently, assessment should probably be performed by a limited number of well trained professionals.
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From April 2005 all doctors in the UK will be expected to be able to demonstrate their fitness to practice as part of the GMC revalidation procedures. The revalidation process is explicitly linked to the consultant appraisal process implemented in 2001. Central to both processes is the development of a folder (portfolio) of supporting evidence. ⋯ This paper describes what a portfolio is, summarises the evidence for their use in appraisal and assessment, and provides guidance on the collection of evidence for revalidation purposes. In addition, it explores the distinction between appraisal and revalidation. Some evaluation data on perceived benefits and drawbacks by participants in appraisal in a paediatric setting is also included to inform conclusions and thoughts on planning for the future.