Characteristics of cases and controls on admission to hospital.

<p>*Using the 1978 World Health Organization standards.</p

Iron deficiency and the number, type, duration and outcome of acute seizures in cases.

<p>*Seizure manifestation described by parent.</p>†<p>Using chi square test for trend.</p>‡<p>BCS = Blantyre Coma Score (Score 0–2 = coma, 3–4 impaired consciousness, 5 = full consciousness).</p

Dose – Response relationship between plasma ferritin levels or the proportion of patients with iron deficiency and the number of seizures a child had during the acute illness.

<p>*Test for linear trend; z = 1.46 and p = 0.143.</p><p>**Test for linear trend; z = 0.75 and p = 0.455.</p

Study selection for the meta-analysis.

<p>Figure 1 is a flow diagram that shows the selection of studies for the meta-analysis investigating the association between iron deficiency and acute seizures in children.</p

Studies of iron deficiency and seizures in children.

<p>Abbreviations: CRP = C-reactive protein, Hb = Hemoglobin = HCT, hematocrit, ID = iron deficiency, MCV = mean cell volume, RBC = red blood cells, RDW = red blood cell distribution width, SD = standard deviation and TIBC = total iron binding capacity.</p

Iron deficiency, α-thalassemia genotypes and acute seizures.

<p>*Microcytosis is defined as age-corrected normal values (MCV<70 fl/µl in children <2 years, <73 fl/µl in children 2–4 years, <75 fl/µl in children 5–7 years and <76 fl/µl in children ≥8 years).</p>†<p>In patients with malaria, iron deficiency was defined as plasma ferritin<30µg/ml if CRP<50mg/ml or as ferritin<273µg/ml if CRP≥50mg/ml and in those without malaria, it was defined as plasma ferritin<12µg/ml if CRP<10mg/ml or as ferritin<30µg/ml if CRP≥10mg/ml.</p>‡<p>Iron deficiency and hemoglobin <11g/dl.</p>§<p>Chi square test for trend.</p

Implementing early rehabilitation and mobilisation for children in UK paediatric intensive care units: the PERMIT feasibility study.

Early rehabilitation and mobilisation encompass patient-tailored interventions, delivered within intensive care, but there are few studies in children and young people within paediatric intensive care units. To explore how healthcare professionals currently practise early rehabilitation and mobilisation using qualitative and quantitative approaches; co-design the Paediatric Early Rehabilitation and Mobilisation during InTensive care manual of early rehabilitation and mobilisation interventions, with primary and secondary patient-centred outcomes; explore feasibility and acceptability of implementing the Paediatric Early Rehabilitation and Mobilisation during InTensive care manual within three paediatric intensive care units. Mixed-methods feasibility with five interlinked studies (scoping review, survey, observational study, codesign workshops, feasibility study) in three phases. United Kingdom paediatric intensive care units. Children and young people aged 0-16 years remaining within paediatric intensive care on day 3, their parents/guardians and healthcare professionals. In Phase 3, unit-wide implementation of manualised early rehabilitation and mobilisation. Phase 1 observational study: prevalence of any early rehabilitation and mobilisation on day 3. Phase 3 feasibility study: acceptability of early rehabilitation and mobilisation intervention; adverse events; acceptability of study design; acceptability of outcome measures. Searched Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PEDro, Open grey and Cochrane CENTRAL databases. Narrative synthesis. In the scoping review we identified 36 full-text reports evaluating rehabilitation initiated within 7 days of paediatric intensive care unit admission, outlining non-mobility and mobility early rehabilitation and mobilisation interventions from 24 to 72 hours and delivered twice daily. With the survey, 124/191 (65%) responded from 26/29 (90%) United Kingdom paediatric intensive care units; the majority considered early rehabilitation and mobilisation a priority. The observational study followed 169 patients from 15 units; prevalence of any early rehabilitation and mobilisation on day 3 was 95.3%. We then developed a manualised early rehabilitation and mobilisation intervention informed by current evidence, experience and theory. All three sites implemented the Paediatric Early Rehabilitation and Mobilisation during InTensive care manual successfully, recruited to target (30 patients recruited) and followed up the patients until day 30 or discharge; 21/30 parents consented to complete additional outcome measures. The findings represent the views of National Health Service staff but may not be generalisable. We were unable to conduct workshops and interviews with children, young people and parents to support the Paediatric Early Rehabilitation and Mobilisation during InTensive care manual development due to pandemic restrictions. A randomised controlled trial is recommended to assess the effectiveness of the manualised early rehabilitation and mobilisation intervention. A definitive cluster randomised trial of early rehabilitation and mobilisation in paediatric intensive care requires selection of outcome measure and health economic evaluation. The study is registered as PROSPERO CRD42019151050. The Phase 1 observational study is registered Clinicaltrials.gov NCT04110938 (Phase 1) (registered 1 October 2019) and the Phase 3 feasibility study is registered NCT04909762 (Phase 3) (registered 2 June 2021). This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 17/21/06) and is published in full in Health Technology Assessment; Vol. 27, No. 27. See the NIHR Funding and Awards website for further award information

Whose voice?: an exploration of the current policy interest in pupil involvement in school decision-making

Personal cover image 1: Study logo. (DOC 21 kb