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NIHR Signal Clinicians prescribe antibiotics for childhood respiratory tract infection based on assessment, rather than parental expectation
Implied parental expectation of antibiotic prescription does not appear to affect clinician prescribing for childhood respiratory tract infection in primary care. Parents typically accept clinicians’ treatment recommendations based on symptoms and signs, with a minority seeking further home care advice. This NIHR-funded analysis of 56 videoed primary care consultations is the first such study to be carried out in the UK, covering diverse populations from both deprived and affluent neighbo...
NIHR Signal Diet and physical activity interventions targeting children and youth have different, yet small, effects on preventing obesity
Obesity prevention interventions which include both diet and physical activity may reduce the risk of obesity in pre-school children. Once at school, physical activity appears to be more effective for weight loss than diet alone. Resulting weight loss form any intervention, if any, has been very small with unclear benefits to the individual or population. This NIHR-supported Cochrane systematic review pooled the results of 153 global randomised-control trials (sevenfrom the UK) aiming to preven...
NIHR Signal Length of steroid course for childhood nephrotic syndrome makes little difference to later recurrences
For children with a first presentation of nephrotic syndrome, an extended sixteen-week treatment regimen with prednisolone does not reduce the risk of relapse compared with the standard eight-week course. Most children will experience a relapse with either regimen, but the longer course may delay it by a month or so which may, in turn, reduce the resource use, such as emergency department visits, shorter admissions and less need to see the GP. This can also make the longer course cheaper overall...
NIHR Signal Virtual reality can help reduce the pain and anxiety of stressful medical procedures for children
Virtual reality shows promise in helping to distract children from self-reported pain and anxiety during medical procedures. Younger children in particular may benefit from the intervention. This review of seventeen trials looked at virtual reality interventions tested in trials with children receiving treatment for burns, dental and tumour related health needs, and during needle insertion for intravenous access. Results suggested a marked impact on pain and anxiety of children from these immer...
NIHR Signal Non-invasive brain stimulation may improve outcomes for children with brain injury
Non-invasive brain stimulation may help improve limb function in children with motor disorders following brain injury, such as cerebral palsy or one-sided weakness. This is a relatively safe procedure where pads placed on the head deliver electric or magnetic currents, which are thought to activate the motor areas of the brain. This review evaluated 14 trials, including 306 children comparing two types of brain stimulation with a control group. It found that these types of stimulation may impro...
NIHR Signal Levetiracetam is a useful alternative to phenytoin in stopping prolonged epileptic seizures in children
Levetiracetam is as effective as phenytoin at stopping prolonged epileptic seizures in children. In this trial, levetiracetam stopped 70% of children convulsing compared with 64% for phenytoin within 35 to 45 minutes. Adverse events were similar. This combined with the fact levetiracetam may be easier to administer safely make it an important option. Most epileptic seizures stop by themselves within a few minutes, but sometimes they continue for much longer. If this happens emergency treatment ...
NIHR Signal Insights into the transfer between children’s and adults’ services for young people with selected long-term conditions
How young people with type 1 diabetes, autistic spectrum disorder and cerebral palsy experience the transition to adult services depends on their condition and locality. Adult and children’s services need to work together to ensure they are offering young people the sources of support and resilience they need. This NIHR-funded study found that children with type 1 diabetes were more likely to receive help shown to aid transition. For example, around two-thirds said they had met a member o...
NIHR Signal Psychological therapies may improve parenting skills in parents of children with chronic illness
Psychological therapies appear to show promise in helping improve self-reported parenting behaviour of parents of children and adolescents with cancer, chronic pain, diabetes or traumatic brain injury. Cognitive behavioural therapy (CBT) and problem-solving therapy (PST) appear particularly valuable in supporting this. Psychological therapies also seemed beneficial in improving the mental health of parents who have children with cancer and chronic pain, but not in studies of children with diabe...
NIHR Signal Iron deficiency in people with chronic kidney disease can be managed with either oral or IV therapy
For people with chronic kidney disease who are also iron deficient, intravenous iron improves haemoglobin levels and iron stores faster than oral iron. However, the evidence is inconclusive about whether it influences survival, cardiovascular death, or quality of life. Adverse effects and such as allergic reactions or gastrointestinal side effects and other practicalities are likely to determine the choice of a route of administration. Chronic kidney disease is a long-term condition categorised...
NIHR Signal Brain scan may predict long-term disabilities in babies with brain injury
Magnetic resonance spectroscopy, a type of scan which shows brain biochemistry, could help predict whether there will be long-term effects of brain injury (encephalopathy) in new-born babies. It is usually done alongside an MRI. Researchers scanned 82 babies being treated for brain injury, using MRI and also magnetic resonance spectroscopy. One biomarker tested at seven days after birth, thalamic N-acetylaspartate, correctly identified all babies who went on to have adverse developmental outcom...
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