Impact of care coordination on service utilisation for children with medically complex cerebral palsy.

Aim: Complex care programmes for children with medically complex cerebral palsy (CP) exist; however, evidence for their impact is limited. This study (i) explored the impact of The Royal Children's Hospital Complex Care Hub (CCH) on hospital service utilisation rates over a 3-year period for children with medically complex CP compared with those eligible but received routine care, and (ii) compared health, disability and socio-demographic characteristics of children and their families in both groups.

Methods: Electronic medical record data from 78 children (mean age 9.

Comprehensive care programmes for children with medical complexity.

Background: Children with medical complexity (CMC) represent a small, but growing, proportion of all children. Regardless of their underlying diagnosis, by definition, all CMC have similar functional limitations and high healthcare needs. It has been suggested that improving aspects of healthcare delivery for CMC improves health- and quality of life-related outcomes for children and their families and reduces healthcare-related expenditure.

Audit of enuresis referrals on the waiting list for a tertiary hospital outpatient clinic.

Aim: Enuresis, defined as intermittent incontinence occurring exclusively during sleep, affects 4-19% of children, but can be effectively treated using education and alarm-bell therapies. However, delays in treatment are likely to impact upon the quality of life of the child, parents and carers. Poor quality and incomplete referrals are thought to be a major driver of inefficiencies.

Polyethylene Glycol Dosing for Constipation in Children Younger Than 24 Months: A Systematic Review.

Objectives: Evaluate safety and effectiveness of Polyethylene glycol (PEG) for chronic constipation in children aged younger than 24 months. Identify the optimum dose of PEG to manage chronic constipation in children aged younger than 24 months.

Methods: In this systematic review, Embase, Medline Ovid, Pubmed, and the Cochrane Library were searched between January 1, 2000 and February 1, 2019.

Paediatric bladder dysfunction: A single centre experience of public hospital wait times.

Aim: Paediatric bladder dysfunction, including daytime urinary incontinence and enuresis, is a common and distressing condition. Unfortunately, children with these symptoms are often on waitlists for several months. This treatment delay may significantly impact upon the child and family unit.

Cerebral hypomyelination associated with biallelic variants of FIG4.

The lipid phosphatase gene FIG4 is responsible for Yunis-Varón syndrome and Charcot-Marie-Tooth disease Type 4J, a peripheral neuropathy. We now describe four families with FIG4 variants and prominent abnormalities of central nervous system (CNS) white matter (leukoencephalopathy), with onset in early childhood, ranging from severe hypomyelination to mild undermyelination, in addition to peripheral neuropathy. Affected individuals inherited biallelic FIG4 variants from heterozygous parents.

Children who soil: A review of the assessment and management of faecal incontinence.

Soiling is a common and distressing condition affecting children. In the vast majority of patients, it is associated with constipation. Most constipation is functional and is best thought of as difficulty achieving adequate bowel emptying.

Childhood constipation.

Background: Constipation is best defined as difficulty passing stools that may be infrequent (≤2 per week), painful and associated with stool retention. Childhood constipation is common, with a prevalence of 3-30% worldwide. Most constipation in children is functional and related to behavioural withholding after an unpleasant stool event.

Diagnostic scores, questionnaires, quality of life, and outcome measures in pediatric continence: A review of available tools from the International Children's Continence Society.

Purpose: We reviewed and collated information concerning the available tools for the measurement of symptoms and outcomes in pediatric continence.

Materials And Methods: MEDLINE, EMBASE, and CINHAL databases were searched for relevant articles published prior to December 2016 and independently screened by two researchers. Expert opinion was also widely sought through consultation with the ICCS Board membership and their professional networks and the multidisciplinary authorship group.

Transabdominal electrical stimulation increases colonic propagating pressure waves in paediatric slow transit constipation.

Background And Aims: In slow-transit constipation (STC) pancolonic manometry shows significantly reduced antegrade propagating sequences (PS) and no response to physiological stimuli. This study aimed to determine whether transcutaneous electrical stimulation using interferential current (IFC) applied to the abdomen increased colonic PS in STC children.

Methods: Eight children (8-18 years) with confirmed STC had 24-h colonic manometry using a water-perfused, 8-channel catheter with 7.

Slow-transit constipation with concurrent upper gastrointestinal dysmotility and its response to transcutaneous electrical stimulation.

Purpose: Transcutaneous electrical stimulation (TES) speeds up colonic transit in children with slow-transit constipation (STC). This study examined if concurrent upper gastrointestinal dysmotility (UGD) affected response to TES.

Methods: Radio-nuclear transit studies (NTS) were performed before and after TES treatment of STC as part of a larger randomised controlled trial.

Trunk strength and mobility changes in children with slow transit constipation.

Background And Aim: It appears that there are no published reports on childhood slow transit constipation (STC) that have considered the state of the musculoskeletal components of the trunk in these children. The present study aimed to determine whether children with STC have different trunk musculoskeletal characteristics that might be related to their defecation difficulties, compared to controls.

Methods: With the aid of computer-analyzed photographs and clinical testing, 41 children with STC and 41 age-matched controls were examined for Marfanoid features, sitting posture, spinal joint mobility and trunk muscle strength.

Postnatal support for drug users: evaluation of a specialist health visiting service.

Women who misuse drugs require a high level of support during their pregnancy and in the postnatal period. A service to provide additional support to such women in the postnatal period was developed in Scotland, through the integration of a specialist health visitor (SHV) working within the existing multi-agency drug support team (DST). This paper reports on a study to identify views and experiences of both the women who use the service, and the health and social care professionals working with the SHV service, of its effects.

What psychosocial well-being in the postnatal period means to midwives.

Objective: to explore midwives' views of psychosocial well-being in the postnatal period.

Design: qualitative study using focus-group interviews conducted in 1999.

Setting: two community health centres and a school of nursing and midwifery in Scotland.