Demographic characteristics of the specific language-impairment (SLI) and control (C) groups.

<p>Mann-Whitney <i>U</i>-test to compare median scores and Chi-square test to compare percentage.</p

Health-Related Quality of Life for Children and Adolescents with Specific Language Impairment: A Cohort Study by a Learning Disabilities Reference Center

<div><p>Objectives</p><p>To assess the health-related quality of life (HRQOL) of children with specific language impairment (SLI).</p><p>Study Design</p><p>In a prospective sample at a Learning Disabilities Reference Center, proxy-rated HRQOL (KIDSCREEN-27) was assessed for children with SLI and unaffected children from January 1, 2014 to March 31, 2015. Quality of life predictors for children with SLI were evaluated by recording the length and number of speech therapy and psychotherapy sessions and the specific school organization that the children had participated in. The KIDSCREEN scores of the two groups were compared using nonparametric statistics.</p><p>Results</p><p>The questionnaires were completed by the parents of 67 children with SLI and 67 unaffected children. For children with SLI, the mean HRQOL scores were significantly lower for physical and psychological well-being, autonomy and parent relation, social support, and school environment compared to the reference group, controlling for age and parental education (β = -6.7 (-12.7;-.7) P = 0.03, β = -4.9 (-9.5;-.3) P = 0.04, β = -8.4 (-14.2;-2.6) P = 0.005, β = -11.6 (-19.5;-3.7) P = 0.004, β = -7.1(-12.4;-1.7) P = 0.010, respectively). Multivariate analyses in the group of children with SLI found that children who had undergone psychotherapy sessions or who had been enrolled in specific schooling programs had reduced HRQOL scores in social support and school environment and that children who were in a special class had higher scores in physical well-being.</p><p>Conclusion</p><p>Children with SLI had significantly lower HRQOL scores as compared to unaffected children. Measurement of HRQOL could serve as one of the strategies employed throughout the follow-up of these individuals to provide them with the most appropriate and comprehensive care possible.</p></div

Characteristics of the specific language-impairment (SLI) group regarding other cognitive impairments, individual rehabilitation and specific school organization.

<p>Characteristics of the specific language-impairment (SLI) group regarding other cognitive impairments, individual rehabilitation and specific school organization.</p

Comparison of the KIDSCREEN scores of the specific language-impairment (SLI) and control (C) groups.

<p>Comparison of the KIDSCREEN scores of the specific language-impairment (SLI) and control (C) groups.</p

Multivariate analyses on KIDSCREEN in specific language-impairment (SLI) group, controlling for age and parental education.

<p>Multivariate analyses on KIDSCREEN in specific language-impairment (SLI) group, controlling for age and parental education.</p

Why Children with Severe Bacterial Infection Die: A Population–Based Study of Determinants and Consequences of Suboptimal Care with a Special Emphasis on Methodological Issues

<div><p>Introduction</p><p>Suboptimal care is frequent in the management of severe bacterial infection. We aimed to evaluate the consequences of suboptimal care in the early management of severe bacterial infection in children and study the determinants.</p><p>Methods</p><p>A previously reported population-based confidential enquiry included all children (3 months- 16 years) who died of severe bacterial infection in a French area during a 7-year period. Here, we compared the optimality of the management of these cases to that of pediatric patients who survived a severe bacterial infection during the same period for 6 types of care: seeking medical care by parents, evaluation of sepsis signs and detection of severe disease by a physician, timing and dosage of antibiotic therapy, and timing and dosage of saline bolus. Two independent experts blinded to outcome and final diagnosis evaluated the optimality of these care types. The effect of suboptimal care on survival was analyzed by a logistic regression adjusted on confounding factors identified by a causal diagram. Determinants of suboptimal care were analyzed by multivariate multilevel logistic regression.</p><p>Results</p><p>Suboptimal care was significantly more frequent during early management of the 21 children who died as compared with the 93 survivors: 24% vs 13% (p = 0.003). The most frequent suboptimal care types were delay to seek medical care (20%), under-evaluation of severity by the physician (20%) and delayed antibiotic therapy (24%). Young age (under 1 year) was independently associated with higher risk of suboptimal care, whereas being under the care of a paediatric emergency specialist or a mobile medical unit as compared with a general practitioner was associated with reduced risk.</p><p>Conclusions</p><p>Suboptimal care in the early management of severe bacterial infection had a global independent negative effect on survival. Suboptimal care may be avoided by better training of primary care physicians in the specifics of pediatric medicine.</p></div

Patient characteristics and care pathways before admission to a pediatric intensive care unit, quality of care and their association with outcome by dead and alive children and univariate and multivariate analysis.

<p>aOR, adjusted odds ratio; 95% CI, 95% confidence interval; IQR, interquartile range.</p>§<p>Logistic regression model.</p>a<p>Age and no. of suboptimal care were treated as continuous variables (no deviation to linearity).</p>b<p>Severity signs were hemodynamic failure, purpura, conscientiousness impairment, respiratory distress, meningism, behavioural changes or hypotonia.</p>c<p>Others were 2 pneumonia with pleural effusion and a septic shock following pyelonephritis in a child with malformative uropathy in the deceased group, and 2 septic shock on bacterial cellulitis and a bacterial tracheitis in the survivor group.</p>d<p>Others were, for survivors, <i>Haemophilus influenzae</i> (n = 3), Group B <i>Streptococcus</i> (n = 1), <i>Staphylococcus aureus</i> (n = 1), and for deceased children, <i>E.coli</i> (n = 1), Group A <i>Streptococcus</i> (n = 1), <i>Salmonella spp (n = 1)</i> and <i>Mycoplama pneumoniae</i> (n = 1).</p><p>Patient characteristics and care pathways before admission to a pediatric intensive care unit, quality of care and their association with outcome by dead and alive children and univariate and multivariate analysis.</p

Risk factors for medical suboptimal care.

<p>*Multivariate analysis involved a hierarchical logistic regression model with random intercept and effects.</p><p>**Significant associations remained when age was transformed into polynomials (X = 10/[age – 2.5]), aOR for age 1.04, 95% CI 1.01–1.07, p = 0.003.</p><p>Risk factors for medical suboptimal care.</p

Additional file 1: of Reporting studies on time to diagnosis: proposal of a guideline by an international panel (REST)

The 35-item checklist previously used to evaluate the completeness of reporting of studies on time to diagnosis. (DOCX 18 kb