Effectiveness of interventions to directly support food and drink intake in people with dementia: systematic review and meta-analysis.

Background: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking.

National hospital data for intussusception: Data linkage and retrospective analysis to assess quality and use in vaccine safety surveillance.

Objectives: To assess the quality of national Hospital Episode Statistics (HES) data for intussusception, and evaluate this routinely collected database for rotavirus vaccine safety surveillance by estimating pre-vaccination trends in intussusception hospitalisation.

Methods: Data linkage was performed between HES and prospective intussusception data from the British Paediatric Surveillance Unit (BPSU), followed by capture-recapture analysis to verify HES data quality. Inclusion criteria were infants aged less than 12 months and admitted for intussusception to National Health Service (NHS) hospitals in England from March 2008 to March 2009.

Deaths in children with epilepsies: a UK-wide study.

Purpose: This UK-wide review of deaths in children with epilepsies was undertaken to ascertain any demographic, clinical, organisational, or management factors associated with the deaths, and to determine the extent to which any of these may have deviated from nationally agreed best practice.

Method: Paediatricians across the UK were asked to notify any deaths in children with epilepsies over a 10-month period. Hospital and community case notes were reviewed by pairs of case assessors using a structured assessment tool combining holistic and criterion-based approaches.

Transition From Child to Adult Care--'It's Not a One-Off Event': Development of Benchmarks to Improve the Experience.

The transition from child to adult services is a crucial time in the health of young people who may potentially fall into a poorly managed 'care gap'. A multi-site, multi-staged study was undertaken to identify the key aspects of a transitional programme of care for young people. Through a process of mapping, which involved drawing on primary and secondary data, a clinical practice-benchmark tool was developed.

An evaluation of demographic factors affecting performance in a paediatric membership multiple-choice examination.

Objective: To determine if demographic factors are associated with outcome in a multiple-choice, electronically marked paediatric postgraduate examination.

Method: Retrospective analysis of pass rates of UK trainees sitting Membership of the Royal College of Paediatrics and Child Health (MRCPCH) part 1B from 2007 to 2011. Data collected by the RCPCH from examination candidates were analysed to assess the effects of gender, age, and country and university of medical qualification on examination outcome.

Career intentions and choices of paediatricians entering training in the UK.

Introduction: The paediatric workforce has grown substantially in recent years. Roles have changed considerably with the introduction of working time legislation and a move towards a trained doctor solution. By gaining a better understanding of paediatric trainees' career intentions, this study aims to assess whether the right workforce is being trained to meet the future demand for paediatric services in the UK.

Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison.

Aims: Improving glycaemic control in people with Type 1 diabetes is known to reduce complications. Our aim was to compare glycaemic control among people with Type 1 diabetes using data gathered in regional or national registries.

Methods: Data were obtained for children and/or adults with Type 1 diabetes from the following countries (or regions): Western Australia, Austria, Denmark, England, Champagne-Ardenne (France), Germany, Epirus, Thessaly and Thessaloniki (Greece), Galway (Ireland), several Italian regions, Latvia, Rotterdam (The Netherlands), Otago (New Zealand), Norway, Northern Ireland, Scotland, Sweden, Volyn (Ukraine), USA and Wales) from population or clinic-based registries.

Developing clinical guidelines: how much rigour is required?

Clinical guidelines that are rigorously developed play a fundamental role in improving healthcare and reducing unnecessary variations in practice. National guidelines are increasingly used by healthcare professionals, patients and commissioners; however, national bodies are unable to meet the demand for guidance on all topics. There are fewer resources available for guidance produced locally or by specialty groups, and it is necessary to achieve a balance between pragmatism and rigour while conforming to the widely accepted norms of what constitutes a good guideline.

Clinical audit: still an important tool for improving healthcare.

The use of data to challenge and improve healthcare has a long and distinguished history but has often failed to bring about expected improvements. It has never become fully embedded in clinical practice, probably because data alone are insufficient to drive change. There is now a greater appreciation that changing and improving healthcare requires changing behaviours.

Ascertainment of early onset eating disorders: a pilot for developing a national child psychiatric surveillance system.

Background:   A Child & Adolescent Psychiatric Surveillance System was established as part of a British Paediatric Surveillance Unit study of early onset eating disorders (EOED).

Method:   A study of EOED presenting to paediatricians was undertaken through the BPSU over 15 months in 2005-06.

Results:   Monthly report cards compliance was 83%, identifying 208 EOED cases.

'Now I understand': consulting parents on chart design and parental information for the UK-WHO child growth charts.

Background: Regular assessment of growth is an important part of child health surveillance in the UK and most parents are very interested in their child's growth. UK parents are given a personal child health record (PCHR), including growth charts, which are plotted during baby clinic visits. Parents were consulted as part of the process of designing new UK charts to incorporate the World Health Organization growth standard.

Risk score to stratify children with suspected serious bacterial infection: observational cohort study.

Objectives: To derive and validate a clinical score to risk stratify children presenting with acute infection.

Study Design And Participants: Observational cohort study of children presenting with suspected infection to an emergency department in England. Detailed data were collected prospectively on presenting clinical features, laboratory investigations and outcome.

Evaluation of temperature-pulse centile charts in identifying serious bacterial illness: observational cohort study.

Background: Distinguishing serious bacterial infection (SBI) from milder/self-limiting infections is often difficult. Interpretation of vital signs is confounded by the effect of temperature on pulse and respiratory rate. Temperature-pulse centile charts have been proposed to improve the predictive value of pulse rate in the clinical assessment of children with suspected SBI.