Archives of disease in childhood
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Multicenter Study
Place of death and palliative care following discharge from paediatric intensive care units.
To determine where children die following discharge from paediatric intensive care units (PICUs) in Great Britain and to investigate if this varies by discharge to palliative care. ⋯ Children referred to palliative care services at discharge from PICU are more likely to die in the community (home or hospice) than children not referred to palliative care.
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Randomized Controlled Trial
Scald risk in social housing can be reduced through thermostatic control system without increasing Legionella risk: a cluster randomised trial.
To quantify the effects of a thermostatic control system in social (public) housing on the prevalence of dangerous (>60°C) water temperatures and on fuel consumption. ⋯ The thermostatic control with daily sterilisation was effective in capping hot water temperatures and therefore reduced scald risk. Although expected to save energy, fuel consumption was increased relative to the control group. Trial registration ClinicalTrials.gov ID: NCT00874692.
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'Liberating the NHS' and the new outcomes framework place information at the heart of the management of the National Health Service (NHS) and develop further the quality framework defined by Lord Darzi. In support of children, paediatricians have a responsibility to understand the informatics agenda and to ensure that data collection is as accurate as possible. There are particular difficulties in supplying a comprehensive health record for children and providing them with the benefits of access to their health records. It is essential that paediatricians work to ensure that these problems are overcome and that children do not miss out because of legal, practical and ethical issues which can be overcome, but often are permitted to stand in the way of real improvements.
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Postindustrial human activity has contributed to rising atmospheric levels of greenhouse gases causing global warming and climate change. The adverse effects of climate change affect children disproportionately, especially in the developing world. Urgent action is necessary to mitigate the causes and adapt to the negative effects of climate change. Paediatricians have an important role in managing the effects of climate change on children and promoting sustainable development.
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Randomized Controlled Trial
Improved junior paediatric prescribing skills after a short e-learning intervention: a randomised controlled trial.
Medication errors are common, with junior doctors accounting for the majority in acute healthcare. Paediatrics is uniquely challenging, but the evidence base to guide prescribing education is limited. The authors set out to develop a short, educationally sound, low cost e-learning resource for paediatric prescribing to improve junior doctors' prescribing skills and to evaluate its effectiveness. ⋯ This short e-learning resource significantly improved the paediatric prescribing skills of junior doctors. Outcomes were maintained at 3 months, suggesting the utility of low cost, low fidelity, educationally sound e-learning interventions. However, the direct impact on patient outcomes following this intervention has yet to be determined.