Research Article: The impact of out-of-hospital models of care on paediatric emergency department presentations

 

Archives of Disease in Childhood article

Objective To estimate the potential impact of enhanced primary care and new out-of-hospital models (OOHMs) on emergency department (ED) presentations by children and young people (CYP).

Conclusions High proportions of ED presentations by CYP could potentially be managed in new OOHMs or by enhancement of existing primary care.

Link article here

Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease

Persons with sickle cell disease (SCD) are particularly susceptible to infection. Infants and very young children are especially vulnerable. The ‘Co-operative Study of Sickle Cell Disease’ observed an incidence rate for pneumococcal septicaemia of 10 per 100 person years in children under the age of three years. Vaccines, including customary pneumococcal vaccines, may be of limited use in this age group. Therefore, prophylactic penicillin regimens may be advisable for this population. This is an update of a Cochrane Review first published in 2002, and previously updated, most recently in 2014.

Link to review here

NICE Technology appraisal: Immunosuppressive therapy for kidney transplant in children and young people

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Evidence-based recommendations on immunosuppressive therapies for preventing kidney rejection in children and young people. The therapies are basiliximab (Simulect), immediate-release tacrolimus (Adoport, Capexion, Modigraf, Prograf, Tacni, Vivadex), mycophenolate mofetil (Cellcept and non-branded versions), rabbit anti-human thymocyte immunoglobulin (Thymoglobuline), prolonged-release tacrolimus (Advagraf, Envarsus), mycophenolate sodium (Myfortic, Ceptava), sirolimus (Rapamune), everolimus (Certican) and belatacept (Nulojix).

This guidance replaces NICE technology appraisal guidance 99.

Link to guidance here

NICE Quality Standard: Cerebral palsy in children and young people

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This quality standard covers diagnosing, assessing and managing cerebral palsy in children and young people under 25. It describes high-quality care in priority areas for improvement.

Link to standard here

NICE Guideline: Child abuse and neglect

 

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This guideline covers recognising and responding to abuse and neglect in children and young people aged under 18. It covers physical, sexual and emotional abuse, and neglect. The guideline aims to help anyone whose work brings them into contact with children and young people to spot signs of abuse and neglect and to know how to respond. It also supports practitioners who carry out assessments and provide early help and interventions to children, young people, parents and carers.

Clinical features of abuse and neglect (including physical injury) are covered in NICE’s guideline on child maltreatment. Recommendations relevant to both health and social care practitioners appear in both guidelines.

Link to guideline here

PHE child Weight Management Services

Public Health England has published the following documents relating to commissioning child weight management services:

• A guide to delivering and commissioning Tier 2 Weight Management Services for children and their families – brings together evidence to support local commissioning and delivery of effective tier 2 weight management services for overweight and obese children and their families
• Capturing data: a tool to collect and record child weight management service data  –  ensures consistent collection and reporting of outcomes in tier 2 child weight management services
• What are the critical features of successful Tier 2 lifestyle weight management programmes for children aged 0-11 years?  –  a systematic review to identify the programme characteristics that are associated with successful outcomes in  Tier 2 weight management programmes for children

Let’s Talk About Weight: a step –by-step guide to conversations about weight management with children and families for health and care professionals – tools to support health and care professionals have conversations about weight management with children and their families.

NICE Technology Briefing: Thora-3Di for assessing asthma in children

• The technology described in this briefing is Thora‑3Di for assessing respiratory function in children with asthma.
• The innovative aspects are that the measurements are taken non-invasively without the need for special breathing manoeuvres, and provide information on right-versus-left lung function.
• The intended place in therapy would be instead of spirometry in secondary care in children for conditions such as asthma.
• The main points from the evidence summarised in this briefing are from 5 prospective, observational studies including a total of 129 patients and 139 healthy controls (young people and children) in secondary care. They show that Thora‑3Di may be as effective as spirometry in assessing asthma respiratory parameters in children and young people.
• Key uncertainties around the evidence or technology are that it is not clear which of the breathing parameters measured by Thora‑3Di are specific to assessing asthma, and that there is limited evidence comparing these measures with spirometry.
• The cost of Thora‑3Di is £25,000 per unit (exclusive of VAT). The resource impact is unclear, but using the device could save costs through quicker testing.

 Link to full assessment here