Signs and symptoms in children with a serious infection: a qualitative study

BACKGROUND: Early diagnosis of serious infections in children is difficult in general practice, as incidence is low, patients present themselves at an early stage of the disease and diagnostic tools are limited to signs and symptoms from observation, clinical history and physical examination. Little is known which signs and symptoms are important in general practice. With this qualitative study, we aimed to identify possible new important diagnostic variables. METHODS: Semi-structured interviews with parents and physicians of children with a serious infection. We investigated all signs and symptoms that were related to or preceded the diagnosis. The analysis was done according to the grounded theory approach. Participants were recruited in general practice and at the hospital. RESULTS: 18 children who were hospitalised because of a serious infection were included. On average, parents and paediatricians were interviewed 3 days after admittance of the child to hospital, general practitioners between 5 and 8 days after the initial contact. The most prominent diagnostic signs in seriously ill children were changed behaviour, crying characteristics and the parents' opinion. Children either behaved drowsy or irritable and cried differently, either moaning or an inconsolable, loud crying. The parents found this illness different from previous illnesses, because of the seriousness or duration of the symptoms, or the occurrence of a critical incident. Classical signs, like high fever, petechiae or abnormalities at auscultation were helpful for the diagnosis when they were present, but not helpful when they were absent. CONCLUSION: behavioural signs and symptoms were very prominent in children with a serious infection. They will be further assessed for diagnostic accuracy in a subsequent, quantitative diagnostic study

Creativity talent development: Fostering creativity in schools

How do we prepare gifted students to be leaders who can tackle the complex social, environmental, medical, political, technological, economic and ethical challenges in our globalised society? International rhetoric about the importance of developing creativity in twenty-first century education in our current global climate often stands in stark contrast to educational systems that still emphasise performativity, standardised curricula and testing. Creativity has been conceptualised as a continuum with four forms of creativity: Big-C (eminent) creativity, Pro-c (professional) creativity, little-c (everyday) creativity and mini-c (intrapersonal) creativity. Educational creativity (ed-c) as an additional form of creativity, useful for discussions on creativity in education, is proposed in this chapter. Creativity’s relationship to intelligence and giftedness is also discussed in relation to two major schools of thought, namely, creativity as an essential component of intelligence/giftedness and creativity as a domain of intelligence/giftedness. The development of creativity has been largely the purview of stand-alone creativity training programs, which have been popular in gifted education and talent development programs. However, it is argued that teaching for creativity needs to be infused throughout the curriculum using empirical research of how education can develop students’ creative capacity. Findings from the literature about how creativity can be fostered in schools, as well as original research on environmental influences on students’ creativity, as reported by young people themselves in research conducted with students in selective secondary schools in Australia will be presented in this chapter. Understanding how highly creative students are creative to varying degrees, depending on how environments support or inhibit creativity, has practical implications for students, teachers, school administrators, teacher education and educational policy regarding how we can foster creative engagement and development of creative intelligence in schools.<br/