27 research outputs found
Contact Burns:The Influence of Agents and Mechanisms of Injury on Anatomical Burn Locations in Children <5 Years Old and Associations with Child Protection Referrals
Agents, mechanisms and clinical features of non-scald burns in children: a prospective UK study
ABSTRACT
Aims: To inform childhood burn prevention by identifying demographics, clinical features and circumstances of unintentional non-scald burns.
Methods: A prospective cross-sectional study was conducted across Cardiff, Bristol and Manchester, including six emergency departments, three minor injury units and one burns unit between 13/01/2013-01/10/2015. Data collected for children aged <16 years with any burn (scald, contact, flame, radiation, chemical, electrical, friction) included: demographics, circumstances of injury and clinical features. Scalds and burns due to maltreatment were excluded from current analysis.
Results: Of 564 non-scald cases, 60.8% were male, 51.1% were 0.6meters and 76.5% affected the hands. Hairstyling devices were the most common agent of contact burns (20.5%), 34.1% of hairstyling devices were on the floor. 63.7% of children aged 10-15 years sustained contact burns of which 23.2% were preparing food, and in burns from hairstyling devices, 73.3% were using them at the time of injury.
Conclusions: Parents of toddlers must learn safe storage of hazardous items. Older children should be taught skills in safe cooking and hairstyling device use
Multicentre Observational Study Describing the Systemic Response to Small-Area Burns in Children:MISTIC study
Interim Foundation Year One (FiY1) and preparedness for foundation year 1:A national survey of UK foundation doctors
A longitudinal investigation of childhood communication ability and adolescent psychotic experiences in a community sample
Background:
Some childhood speech and language impairments precede psychosis but it is not clear whether they also precede adolescent psychotic experiences and whether this association is specific to psychotic experiences.
Methods:
Pragmatic language and expressive speech and language (parent-assessed using the Children's Communication Checklist) at age 9 and psychotic experiences and depression at ages 12 and 18 were investigated in 7659 participants from the Avon Longitudinal Study of Parents and Children. Associations were investigated using multivariate modelling.
Results:
Poorer pragmatic language at 9 years was associated with psychotic experiences at both ages (12 years OR 1.22, 95% CI 1.11, 1.34; 18 years OR 1.25, 95% CI 1.10, 1.41) but only with depression at 18 years (OR 1.10, 95% CI 1.00, 1.22). Poorer expressive speech and language ability was not associated with psychotic experiences or depression at either age. There was evidence that pragmatic language was specifically associated with psychotic experiences at age 12 but no evidence that the strength of any of the associations changed over time.
Conclusions:
Deficits in pragmatic language precede early and late adolescent psychotic experiences and early adolescent depression. Interventions aimed at helping children improve pragmatic language skills may reduce the incidence of adolescent psychopathology and associated psychological disorder and dysfunction later in life
The impact of developmental coordination disorder on educational achievement in secondary school
Burns and Scalds Assessment Template:Standardising clinical assessment of childhood burns in the Emergency Department
Objectives The Burns and Scalds Assessment Template (BaSAT) is an evidence-based proforma coproduced by researchers and ED staff with the aim of (1) standardising the assessment of children attending ED with a burn, (2) improving documentation and (3) screening for child maltreatment. This study aimed to test whether the BaSAT improved documentation of clinical, contributory and causal factors of children’s burns.
Methods A retrospective before-and-after study compared the extent to which information was recorded for 37 data fields after the BaSAT was introduced in one paediatric ED. Pre-BaSAT, a convenience sample of 50 patient records of children who had a burn was obtained from the hospital electronic database of 2007. The post-BaSAT sample included 50 randomly selected case notes from 2016/2017 that were part of another research project. Fisher's exact test and Mann-Whitney U tests were conducted to test for statistical significance.
Results Pre-BaSAT, documentation of key data fields was poor. Post-BaSAT, this varied less between patients, and median completeness significantly (p<0.001) increased from 44% (IQR 4%–94%) to 96% (IQR 94%–100%). Information on ‘screening for maltreatment, referrals to social care and outcome’ was poorly recorded pre-BaSAT (median of 4% completed fields) and showed the greatest overall improvement (to 95%, p<0.001). Documentation of domestic violence at home and child’s ethnicity improved significantly (p<0.001) post-BaSAT; however, these were still not recorded in 36% and 56% of cases, respectively.
Conclusion Introduction of the BaSAT significantly improved and standardised the key clinical data routinely recorded for children attending ED with a burn
The management of small area burns and unexpected post-burn illness in children under five years of age - A costing study in the English healthcare setting
The objective of this economic study was to evaluate the resource use and cost associated with the management of small area burns, including the additional costs associated with unexpected illness after burn in children of less than five years of age. This study was conducted as a secondary analysis of a multi-centre prospective observational cohort study investigating the physiological response to burns in children. 452 children were included in the economic analysis (median age = 1.60 years, 61.3% boys, median total burn surface area [TBSA] = 1.00%) with a mean length of stay of 0.69 days. Of these children, 21.5% re-presented to medical care with an unexpected illness within fourteen days of injury.
The cost of managing a burn of less than 10% TBSA in a child less than five years of age was £785. The additional cost associated with the management of illness after burn was £1381. A generalised linear regression model was used to determine the association between an unexpected illness after burn, presenting child characteristics and NHS cost. Our findings may be of value to those planning economic evaluations of novel technologies in burn care