Latest & greatest articles for children

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Top results for children

1. Obesity in children

Obesity in children Obesity in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Obesity in children Last reviewed: December 2018 Last updated: January 2019 Summary Behavioural and environmental factors are primarily responsible for the dramatic increase in obesity in the past two decades, although genes play an important role in regulation of body weight. Calculating body mass index (BMI) is the most widely (...) accepted method of screening for obesity in children. Abnormal BMI cut-offs in children are determined by age- and sex-specific percentiles. The dramatic increase in childhood obesity has led to a marked increase in the diagnosis of impaired glucose tolerance and type 2 diabetes mellitus in children. Preventing excessive weight gain in children is of paramount importance in confronting the obesity epidemic, as obesity is difficult to treat at all ages, and obese children tend to become obese adults

BMJ Best Practice2019

2. Chest physiotherapy for pneumonia in children.

Chest physiotherapy for pneumonia in children. BACKGROUND: Pneumonia is a lung infection that causes more deaths in children aged under five years than any other single cause. Chest physiotherapy is widely used as adjuvant treatment for pneumonia. Physiotherapy is thought to help remove inflammatory exudates, tracheobronchial secretions, and airway obstructions, and reduce airway resistance to improve breathing and enhance gas exchange. This is an update of a review published in 2013 (...) . OBJECTIVES: To assess the effectiveness of chest physiotherapy with regard to time until clinical resolution in children (from birth to 18 years) of either gender with any type of pneumonia. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 1), which includes the Cochrane Acute Respiratory Infections Group Specialised Register, MEDLINE (22 February 2018), Embase (22 February 2018), CINAHL (22 February 2018), LILACS (22 February 2018), Web of Science (22

Cochrane2019

3. Vaccination likely to reduce flu in healthy children

Vaccination likely to reduce flu in healthy children Vaccination likely to reduce flu in healthy children Dissemination Centre Discover Portal NIHR DC Discover Vaccination likely to reduce influenza in healthy children Published on 22 May 2018 doi: In healthy children aged two to 16, vaccines are likely to reduce laboratory-confirmed cases of influenza and may reduce the risk of influenza-like illness compared to placebo. Seven children need to receive the live vaccine to prevent one case (...) of confirmed influenza. Twenty children need to be vaccinated to prevent one case of influenza-like illness. This updated Cochrane review included 41 trials of either live attenuated (weakened) or inactivated influenza vaccines, with over 200,000 participants. The evidence gave a moderate to high level of certainty about their effects on influenza, but only a low certainty about the effect on influenza-like illness due to problems in reporting and data capture. The finding supports the benefits

NIHR Dissemination Centre2018

4. A school-based lifestyle intervention didn’t help children avoid unhealthy weight gain

A school-based lifestyle intervention didn’t help children avoid unhealthy weight gain Signal - A school-based lifestyle intervention didn’t help children avoid unhealthy weight gain Dissemination Centre Discover Portal NIHR DC Discover A school-based lifestyle intervention didn’t help children avoid unhealthy weight gain Published on 13 February 2018 The Healthy Lifestyle Programme delivered to 9-10-year-old school children did not reduce their weight over the course of two years. Around (...) a third remained overweight or obese, the same as in schools that followed the standard syllabus. This trial, funded by the NIHR, assigned schools across Devon to follow a lifestyle programme in Year five. The comprehensive curriculum included drama and activity workshops, personal goal setting and parental involvement. Children made better food choices, but this did not affect weight outcomes. It was almost certain the programme wouldn’t give value for money. Programmes addressing the wider school

NIHR Dissemination Centre2018

5. Takeaways linked to increased cardiovascular risk factors and obesity in children

Takeaways linked to increased cardiovascular risk factors and obesity in children Signal - Takeaways linked to increased cardiovascular risk factors and obesity in children Dissemination Centre Discover Portal NIHR DC Discover Takeaways linked to increased cardiovascular risk factors and obesity in children Published on 13 February 2018 Children who eat takeaways once or more each week have more body fat and higher low-density lipoprotein (LDL) “bad” cholesterol levels than those who never (...) or hardly ever eat them. Their diets were also higher in fat and lower in protein and calcium. This cross-sectional study looked in depth at eating habits and risk markers for coronary heart disease, obesity and diabetes in 2,529 children in England. Though this type of study can only show an association between takeaways and risk markers, it is one of the first of its type, and the results do give cause for concern. Increasing numbers of people are eating takeaways in the UK. Local authorities

NIHR Dissemination Centre2018

6. Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia

Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia Signal - Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia Dissemination Centre Discover Portal NIHR DC Discover Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia Published on 27 February 2018 Post-operative vomiting is common in children (...) . One strategy is to use an intravenous anaesthetic, which is known to cause lower rates of sickness than inhaled anaesthetics. There are disadvantages to this though, such as the need for injections before a child is asleep, slowing of the heart and difficulty in monitoring depth of the anaesthetic. This review of four trials included 558 children who had an operation to correct a squint. A third of children in each anaesthetic group had post-operative vomiting. There was no difference in time

NIHR Dissemination Centre2018

7. Young children from deprived areas are more at risk of serious burns and scalds

Young children from deprived areas are more at risk of serious burns and scalds Signal - Young children from deprived areas are more at risk of serious burns and scalds Dissemination Centre Discover Portal NIHR DC Discover Young children from deprived areas are more at risk of serious burns and scalds Published on 24 January 2017 Five in every 1,000 children under four are injured by burns and scalds each year in England, although these injuries are becoming less common. Serious injuries (...) needing hospital treatment happen more often to children from deprived areas than wealthy areas. The study looked at general practice data from 1998 to 2013. It showed a steady decline in children having burns and scalds over the 15 year period, and the gap between least- and most-deprived areas has narrowed. However, children from the most deprived areas are more than twice as likely to need hospital treatment. Children aged 15 to 17 months are most at risk. Most burns and scalds are preventable

NIHR Dissemination Centre2018

8. Risks and benefits of ondansetron for children with acute gastroenteritis

Risks and benefits of ondansetron for children with acute gastroenteritis Signal - Risks and benefits of ondansetron for children with acute gastroenteritis Dissemination Centre Discover Portal NIHR DC Discover Risks and benefits of ondansetron for children with acute gastroenteritis Published on 7 February 2017 Giving ondansetron to children with acute gastroenteritis can stop vomiting, reduce the risk of oral rehydration treatment failing, and reduce the chances of needing intravenous (...) rehydration. But the drug can worsen diarrhoea symptoms. This systematic review looked for evidence about ondansetron’s effectiveness in stopping vomiting and for any impact on diarrhoea or other side effects. Only five out of the 10 included trials reported on diarrhoea related outcomes and they all used different outcome measures so the results could not be combined. This means that although diarrhoea is a recognised side-effect, it is still not known to what extent children given ondansetron may

NIHR Dissemination Centre2018

9. Parent-focused therapy has some long-term benefits for children with autism

Parent-focused therapy has some long-term benefits for children with autism Signal - Parent-focused therapy has some long-term benefits for children with autism Dissemination Centre Discover Portal NIHR DC Discover Parent-focused therapy has some long-term benefits for children with autism Published on 14 February 2017 A parent-focused therapy for young children with autism continues to have beneficial effects on symptoms and communication almost six years after the end of treatment. This UK (...) randomised controlled trial investigated the effects of a one-year social communication therapy in 152 UK children aged two to four years with severe autism. The therapy, partly delivered by parents, aimed to help them adapt their style of interacting with their child. Children who received the intervention had less severe symptoms at the end of the initial one-year intervention period than those who received treatment as usual. When these children were followed up nearly six years later at age seven

NIHR Dissemination Centre2018

10. Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease

Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Signal - Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Dissemination Centre Discover Portal NIHR DC Discover Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Published on 14 February 2017 Early treatment with corticosteroids on top of standard therapy reduces the risk of serious heart problems in children under five (...) with the rare vascular disease, Kawasaki disease. The disease needs to be recognised early, but can be hard to spot outside specialist care because it is so rare. It is now the commonest cause of acquired heart disease in children and delayed diagnosis can have serious consequences. Blood vessels supplying the heart become inflamed, increasing the risk of heart attack and death in later life. The disease is about 20 times more common in people of Japanese origin. This summary of the evidence found

NIHR Dissemination Centre2018

11. GP letter to improve medication adherence did not reduce unplanned care for children with asthma

GP letter to improve medication adherence did not reduce unplanned care for children with asthma Signal - GP letter to improve medication adherence did not reduce unplanned care for children with asthma Dissemination Centre Discover Portal NIHR DC Discover GP letter to improve medication adherence did not reduce unplanned care for children with asthma Published on 14 March 2017 A one-off GP letter reminding parents of children with asthma to use their medications over the August summer holiday (...) proportion of children receiving unplanned care in September (45% of children in the letter group compared to 44% in the control group). Most of the unplanned care was not for asthma, which may be why the letter had little impact. It remains unclear why children with asthma are more likely to access unplanned care. This NIHR-funded trial was large, well-designed and, despite problems with labelling planned and unplanned care, is likely to be reliable. Share your views on the research. Why was this study

NIHR Dissemination Centre2018

12. Central lines coated with antibiotics reduce bloodstream infections in children

Central lines coated with antibiotics reduce bloodstream infections in children Signal - Central lines coated with antibiotics reduce bloodstream infections in children Dissemination Centre Discover Portal NIHR DC Discover Central lines coated with antibiotics reduce bloodstream infections in children Published on 10 May 2016 Children in intensive care had lower rates of infection when using antibiotic coated central lines (also called central venous catheters) compared to standard central (...) lines or those coated with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines could reduce bloodstream infections in paediatric intensive care units. The researchers say cost-effectiveness, based on six-month hospital resource data, will be reported

NIHR Dissemination Centre2018

13. National tobacco control policies linked to improvements in children’s health

National tobacco control policies linked to improvements in children’s health Signal - National tobacco control policies linked to improvements in children’s health Dissemination Centre Discover Portal NIHR DC Discover National tobacco control policies linked to improvements in children’s health Published on 17 January 2018 National smoke-free legislation in advanced economies is linked to reduced rates of preterm birth, asthma hospitalisations and serious throat and chest infections (...) in children. Comprehensive smoke-free policies appear to be more effective than policies with only partial or selective introduction. Smoking increases health risks for the smoker and others through second-hand exposure. Although the number of people smoking in the UK is falling, eight million UK adults still smoke, and an estimated five million children are exposed to second-hand smoke. Children are vulnerable to smoke due to their small, developing lungs and immune systems. Evaluations of tobacco

NIHR Dissemination Centre2018

14. Very strict blood sugar control in critically ill children provides no benefit

Very strict blood sugar control in critically ill children provides no benefit Signal - Very strict blood sugar control in critically ill children provides no benefit Dissemination Centre Discover Portal NIHR DC Discover Very strict blood sugar control in critically ill children provides no benefit Published on 23 May 2017 Strict control of blood sugar levels for critically ill children in ICU with high blood sugar did not increase the number of days they spent outside of ICU in the first month (...) . The trial was stopped early as more infections and very low glucose levels were recorded in the strict control group. This trial found that using insulin to control blood sugar to within 4.4 to 6.1 mmol/L, rather than 8.3 to 10mmol/L, in critically ill children made no difference to the number of days they spent in the intensive care unit. This trial indicates that maintaining blood sugar control within tight boundaries in this group is of no benefit and may be harmful. It is time to review the target

NIHR Dissemination Centre2018

15. Type 2 diabetes is becoming more common in children

Type 2 diabetes is becoming more common in children Signal - Type 2 diabetes is becoming more common in children Dissemination Centre Discover Portal NIHR DC Discover Type 2 diabetes is becoming more common in children Published on 25 July 2017 The number of children being diagnosed with both type 1 and type 2 diabetes is rising, but new cases of type 2 diabetes, the form associated with being overweight, has risen five-fold in about five years. New analysis in this NIHR-supported study suggest (...) that type 2 diabetes now accounts for up to a third of diabetes diagnoses in children. Amongst 100,000 school age children about six new cases of type 2 diabetes a year could be expected in the 1990s. This increased to about 33 new cases per year by the end of the next decade (2009 to 2013). Data was taken from the UK Clinical Practice Research Datalink, a primary care database of electronic health records. Children who are obese have about a four times greater risk of developing type 2 diabetes compared

NIHR Dissemination Centre2018

16. Online parental training may help to improve behaviour in children

Online parental training may help to improve behaviour in children Signal - Online parental training may help to improve behaviour in children Dissemination Centre Discover Portal NIHR DC Discover Online parental training may help to improve behaviour in children Published on 1 August 2017 Online parental training led to reasonable improvements in behaviour problems in children and young people, compared to no training. The findings of this review suggest that additional support and contact (...) packages with eleven 45 minutes weekly support sessions by phone. All showed improvements in children’s behaviour compared to no treatment. Taken together the results are similar to those found with similar face to face delivery methods. Delivering parental training online may also be more efficient and enable commissioners and providers to deliver training to greater numbers of people. However, consideration should be given to how the support offered can ensure that participants get the most out

NIHR Dissemination Centre2018

17. Fluoride varnish every six months helps protect children’s permanent teeth from decay

Fluoride varnish every six months helps protect children’s permanent teeth from decay Signal - Fluoride varnish every six months helps protect children’s permanent teeth from decay Dissemination Centre Discover Portal NIHR DC Discover Fluoride varnish every six months helps protect children’s permanent teeth from decay Published on 1 August 2017 Fluoride varnish and fissure sealant are equally good at preventing tooth decay on children’s first permanent back teeth when applied to six or seven (...) year olds in South Wales. Six applications of fluoride varnish were less expensive, by about £68 per child, for the NHS at 36 months compared to applying the more expensive fissure sealant. Children’s permanent back teeth are particularly vulnerable to decay when they first come through. The pitted biting surface can make these teeth difficult to keep clean to prevent decay. This NIHR-funded trial looked at two interventions to prevent decay: fluoride varnish applied six times every six months

NIHR Dissemination Centre2018

18. Silk clothing for children does not reduce objective measures of eczema severity

Silk clothing for children does not reduce objective measures of eczema severity Signal - Silk clothing for children does not reduce objective measures of eczema severity Dissemination Centre Discover Portal NIHR DC Discover Silk clothing for children does not reduce objective measures of eczema severity Published on 22 August 2017 Six months of wearing special silk clothing had no effect on objective measures of child eczema severity, infection rates or medication use. Children and carers (...) reported some small improvements in eczema severity on two scales but their awareness of the clothing worn by their child may have slightly influenced their judgment. Overall quality of life did not significantly improve. Specialist silk clothing is currently available on NHS prescription, but prior to this trial there was limited evidence to guide its use. The findings from this NIHR funded trial indicate that silk clothing is not very effective, and at almost £60,000 per year of quality-adjusted life

NIHR Dissemination Centre2018

19. Education targeted at both parents and GPs reduces antibiotic prescribing for children

Education targeted at both parents and GPs reduces antibiotic prescribing for children Signal - Education targeted at both parents and GPs reduces antibiotic prescribing for children Dissemination Centre Discover Portal NIHR DC Discover Education targeted at both parents and GPs reduces antibiotic prescribing for children Published on 30 August 2016 Interventions aimed at improving communication between GPs and parents could reduce unnecessary antibiotic prescribing for childhood upper (...) , one in the UK. It could be used to improve the training and information provided to help tackle inappropriate antibiotic prescribing. Perhaps most importantly it highlights the need to ensure parental involvement in the process. Share your views on the research. Why was this study needed? Upper respiratory infections include the common cold, tonsillitis and flu. Children tend to get these infections more often than adults because they have yet to build up immunity to them. The majority of upper

NIHR Dissemination Centre2018

20. “Triptans” can relieve migraines in children and adolescents

“Triptans” can relieve migraines in children and adolescents Signal - “Triptans” can relieve migraines in children and adolescents Dissemination Centre Discover Portal NIHR DC Discover “Triptans” can relieve migraines in children and adolescents Published on 13 September 2016 Triptans, a migraine medication, relieve migraine headache completely within two hours compared to placebo. Ibuprofen was also effective but less well studied. This review was also reassuring in that any side effects (...) of treatment were mild. Most evidence identified in this Cochrane review was for sumatriptan, a commonly prescribed treatment for adults, compared to placebo or dummy pills. A few studies examined other triptans or other painkillers, such as ibuprofen or paracetamol against placebo in children and adults. The findings support current guideline recommendations to prescribe nasal triptans for migraine in adolescents. Only nasal preparations are currently licensed for adolescents, whereas oral administration

NIHR Dissemination Centre2018