Comparing different estimated glomerular filtration rate equations in assessing glomerular function in children based on creatinine and cystatin C

WOS: 000438900600012BackgroundGlomerular filtration rate (GFR) is the best marker used to assess renal function. Estimated GFR (eGFR) equations have been developed, and the ideal formula is still under discussion. We wanted to find the most practical and reliable GFR in eGFR formulas. We compared serum creatinine (Scr)- and cystatin C (cysC)-based eGFR formulas in the literature. We also aimed to determine the suitability and the reliability of cysC for practical use in determining GFR in children. MethodsWe have enrolled 238 children in the study. Measurement of 24-hour creatinine clearance was compared with eGFR equations which are based on Scr, cysC, and creatinine plus cysC. ResultsOf the patients (n=238), 117 were males (49.2%), and 121 (50.8%) were females with a median age of 9.0years. The areas under the ROC curves of Counahan-Barratt and Bedside Schwartz were equal and 0.89 (with a 95% CI 0.80-0.97). The areas under the ROC curves were not significantly different in all cystatin C-based eGFR equations. The highest AUC values for differentiating normal vs abnormal renal functions according to CrCl24 were for the CKiD-cysC and CKiD-Scr-cysC equations. ConclusionsIn our study, compared with creatinine-based ones, the cystatin C-based formulas did not show much superiority in predicting eGFR. Still, we think Bedside Schwartz is a good formula to provide ease of use because, in this equation, the constant k is same for all age groups. However, the most valuable equations in determining chronic kidney disease are the CKiD-cysC and CKiD-Scr-cysC equations

Public health decision makers’ informational needs and preferences for receiving research evidence

Objectives: The purpose of this study was to identify decision-makers’ preferences for the transfer and exchange of research knowledge. This article is focused on how the participants define evidence-based decision-making and their preferences for receiving research evidence to integrate into the decision-making process. Methods: Semistructured interviews were conducted with a purposive sample of 16 Ontario public health decision-makers from six Ontario public health units in this fundamental qualitative descriptive study. The sample included nine program managers, six directors, and one Medical Officer of Health. Participants were asked to define the term evidence-based decision-making and identify preferred research dissemination strategies. The interviews were audio-taped, transcribed verbatim, and coded for emerging concepts. Results: Participants defined evidence-based decision-making as a process whereby multiple sources of information were consulted before making a decision concerning the provision of services. To facilitate integration of research evidence into the decision-making process, public health administrators appreciate receiving, in both electronic and hard copy, systematic reviews, executive summaries of research, and clear statements of implications for practice from health service researchers. Conclusions: Although consensus exists among participants concerning the definition of evidence based public health decision-making, ongoing efforts are required to continue to promote the use of research evidence in program planning and public health policy. It is also important to continue to improve the ease with which public health decision-makers access systematic reviews, as well as to ensure the relevance and applicability of the results to the practice setting

The altruism of pre-adolescent children's perspectives on 'worry' and 'happiness' in Australia and England

This article presents the perspectives of Australian and English children on the broad terms worry, happy and change. Utilizing a qualitative methodology, the study engaged with pre-adolescent children (‘tweens’) on the issues affecting them in the modern world. Participants were drawn from a large regional secondary school in Eastern Australia and a comparable regional secondary school in England. Students completed an open-ended questionnaire. In both contexts, many of the children identified specific personal and predominantly social priorities. In their responses, the children tended towards features in their lives that reflected the high importance of individual relationships. The factors that give rise to the identified importance of the family relationship reveal their prioritization of the conditions in their lifeworld. The children demonstrated an acute and sophisticated knowledge of their local community and the global world.They identified local and global issues as they impacted on them personally