Abstract:
:Advances in paediatric care mean that more children with complex medical problems (heart disease, neurodevelopmental problems and so on) are surviving their early years. This has important implications for the design and delivery of healthcare given their extensive multidisciplinary requirements and susceptibility to poor outcomes when not optimally managed. Importantly, their medical needs must also be understood and addressed within the context of the child and family's life circumstances. There is growing recognition that many other factors contribute to a child's complex health needs (CHNs), for example, family problems, fragmentation of health and care provision, psychological difficulties or social issues.To facilitate proactive care for these patients, we must develop accurate ways to identify them. Whole Systems Integrated Care-an online platform that integrates routinely collected data from primary and secondary care-offers an example of how to do this. An algorithm applied to this data identifies children with CHNs from the entire patient population. When tested in a large inner-city GP practice, this analysis shows good concordance with clinical opinion and identifies complex children in the population to a much higher proportion than expected. Ongoing refinement of these data-driven processes will allow accurate quantification and identification of need in local populations, thus aiding the development of tailored services.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Aitchison K,McGeown H,Holden B,Watson M,Klaber RE,Hargreaves Ddoi
10.1136/archdischild-2019-317373subject
Has Abstractpub_date
2020-05-13 00:00:00eissn
0003-9888issn
1468-2044pii
archdischild-2019-317373pub_type
杂志文章abstract::The pulmonary response to inhalation challenge with nebulised distilled water was measured in 100 sedated infants with a history of wheeze. Lung function was measured by total body plethysmography. Satisfactory results were obtained in 88 infants. Fifty one were considered to have responded by developing a greater tha...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.8.948
更新日期:1991-08-01 00:00:00
abstract:OBJECTIVES:To investigate outcome, management, and prevention in Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. DESIGN:Ascertainment through British Paediatric Surveillance Unit and questionnaires to responding paediatricians. SETTING:The UK and Republic of Ireland, September ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.78.3.217
更新日期:1998-03-01 00:00:00
abstract::Fine needle aspiration biopsy (FNAB) offers a simple outpatient technique for specimen collection in child tuberculosis suspects with peripheral lymphadenopathy. To perform FNAB with mycobacterial culture on an outpatient basis requires use of a sterile transport medium to facilitate bedside inoculation, maintain orga...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2009.164038
更新日期:2010-01-01 00:00:00
abstract::A picture archiving and communication system (PACS) is a computerised means of replacing the roles of conventional radiological film. This review describes the Hammersmith PACS, and discusses the advantages and disadvantages of PACS systems. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.83.1.82
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of nasopharyngeal (NP) carriage of pneumococcus (Streptococcus pneumoniae) and describe the antibiotic resistance patterns and serotypes in young children attending group day care in London. DESIGN AND SUBJECTS:Cross-sectional survey of attendees at a sample of registered child day...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2007.126359
更新日期:2007-12-01 00:00:00
abstract::Twenty five patients with encephalitis were studied prospectively, and their clinical and virological features compared with outcome. Among 22 patients with laboratory confirmation of virus infection, evidence of direct effect on the central nervous system by the virus occurred significantly more often both in those w...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.11.1156
更新日期:1987-11-01 00:00:00
abstract::A 24 hour energy balance study was carried out on 20 black Kenyan children with acute measles and repeated after recovery. The energy content of a weighed 24 hour food intake and of a simultaneous collection of faeces and urine was determined by bomb calorimetry. Energy expenditure was measured by indirect calorimetry...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.61.1.61
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:To examine the policy, administration, and supervision of medicine administration in primary schools within the Greater London area (GLA). DESIGN:A prospective survey using postal questionnaires sent to 172 randomly selected primary schools within the GLA. PARTICIPANTS:Head teachers of primary schools. RES...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2003.047258
更新日期:2004-11-01 00:00:00
abstract:AIM:To document the impact that rapid increases in HIV infection in hospitalised children at Chris Hani Baragwanath Hospital has had on in-hospital mortality. METHODS:Hospital discharge summaries from January 1992 to the end of 1996 were reviewed. RESULTS:There were 20 733 admissions in the five year period; 7985 (39...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.83.3.227
更新日期:2000-09-01 00:00:00
abstract::This study compared the availability and the licensing status of analgesic drugs marketed in three European countries (Italy, France and the UK) and evaluated the evidence on safety and efficacy in the paediatric population of the drugs reported in the European Medicines Evaluation (EMA) document "Assessment of Pediat...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.2009.179549
更新日期:2010-09-01 00:00:00
abstract::Hospital clowning is a programme in healthcare facilities involving visits from specially trained actors. In the paediatric intensive care unit (PICU), clowning may appear inappropriate and less intuitive. The patient could appear too ill and/or sedated, the environment too crowded or chaotic and the parents too stres...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2016-311583
更新日期:2017-07-01 00:00:00
abstract::Up to date reference ranges were established for fasting renal excretion of calcium, phosphorus, and magnesium on 101 healthy children aged 2-15 years. A normal range for intact parathyroid hormone was also measured. The indices of calcium and magnesium excretion showed no correlation with age or sex so that a common ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.65.11.1208
更新日期:1990-11-01 00:00:00
abstract::Thirty jaundiced neonates with diarrhoea who were being treated with phototherapy and 30 matched control infants were studied to try and find out the cause of the diarrhoea. Faecal osmolality and electrolyte concentrations were measured, which gave clear evidence that the diarrhoea arose from intestinal secretion. Rec...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.8.1161
更新日期:1989-08-01 00:00:00
abstract:AIMS:To investigate whether infants who died of SIDS were more likely to have higher acute and lifetime average exposures to outdoor carbon monoxide (CO) and nitrogen dioxide (NO2) than comparison healthy infants. METHODS:A total of 169 case and 169 matched control infants born between 1988 and 1992, were studied. CO ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2004.057091
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To determine if administration of oral prednisolone to preschool children with acute wheeze alters respiratory outcomes. DESIGN:Double-blind, randomised, placebo-controlled equivalence trial. SETTING:Three hospitals in New Zealand. PATIENTS:477 children aged 24-59 months with acute wheeze associated with r...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2020-318971
更新日期:2020-10-16 00:00:00
abstract:OBJECTIVE:Early diagnosis and treatment initiation are important factors for successful treatment of mucopolysaccharidosis type I (MPS I). The purpose of this observational study was to assess whether age at diagnosis and time to first treatment for individuals with MPS I have improved over the last 15 years. STUDY DE...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2020-319040
更新日期:2020-11-02 00:00:00
abstract::A special conditions register (SCR) linked to the child health system's register of all children has been in use in West Sussex since 1977. This paper describes the aims, organisation, and use of the SCR and gives examples of the aggregated data that may be obtained. Of the 155,000 children aged 0-17 resident in West ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.8.927
更新日期:1991-08-01 00:00:00
abstract::A quantitative morphological assessment was carried out of the cellularity and staining properties of the cells of the layers of the human cerebellar cortex, both in the normal child and in 41 children suffering from a series of disorders including mental retardation. A computerized image analyser and highly standardi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.12.964
更新日期:1976-12-01 00:00:00
abstract:INTRODUCTION:Fetal anticonvulsant syndrome (FACS) describes the pattern of physical and developmental problems seen in those children exposed to certain antiepileptic drugs (AEDs) in utero. The diagnosis of FACS is a clinical one and so excluding alternative diagnoses such as genetic disorders is essential. METHODS:We...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2018-316547
更新日期:2020-04-01 00:00:00
abstract::Imaging has many uses, but in cases of suspected child abuse, radiographs and CT scans are vital in identifying fractures and head injury that may not be clinically obvious. There are growing concerns about the small but potential adverse effects of radiation, including cancer, in the paediatric population as a result...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2015-308418
更新日期:2015-12-01 00:00:00
abstract::Lipofuscin develops in cells when peroxidation damage occurs. Its development in the liver of patients receiving prolonged parenteral nutrition suggests that peroxidation damage by free radicals has occurred. Deficiencies in antioxidants such as vitamin E may be an important contributing factor. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.60.8.774
更新日期:1985-08-01 00:00:00
abstract::Two infants presented with a salt-losing syndrome, the presenting features of which were subtle. One case appeared to be transient. Deficient production of aldosterone was shown by plasma renin activity and plasma aldosterone profile. Gas chromatography-mass spectrometry of urine indicated a defect in 18-dehydrogenati...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.52.7.580
更新日期:1977-07-01 00:00:00
abstract::In 10 children with cystic fibrosis and persisting steatorrhoea, supplementation with taurine (30-40 mg/kg/day) was given for two months as an adjunct to the usual pancreatic enzyme treatment. A three day fat and energy balance was performed in patients with cystic fibrosis, before and after the supplementation, and i...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.9.1082
更新日期:1992-09-01 00:00:00
abstract:AIM:To evaluate the risk factors for breakthrough varicella in a follow up study of a cohort of 181 healthy children immunised when aged 9-24 months with a reformulated Oka strain varicella vaccine (SmithKline Beecham Biologicals/Oka). DESIGN:The children were randomised in a double blind manner into one of four group...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.79.6.478
更新日期:1998-12-01 00:00:00
abstract::A trial was conducted using sequential analysis by pairs to compare the efficacy of corticosteroids and salicylates in the treatment of acute rheumatic carditis. The results show a significantly favourable effect of steroid treatment both in clinical response and in reduction of the erythrocyte sedimentation rate. In ...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章
doi:10.1136/adc.59.5.410
更新日期:1984-05-01 00:00:00
abstract::A randomised double blind, two period cross over study was designed to compare the ability of 51 hospitalised asthmatics with acute exacerbations to use each of two inhalers. The inhalers compared were a new breath actuated metered dose inhaler, the Autohaler inhalation device, and a dry powder device, the Rotahaler. ...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.68.4.477
更新日期:1993-04-01 00:00:00
abstract::Sixteen blind babies who were considered to be showing the characteristics of delayed visual maturation were studied prospectively. The diagnosis was made on clinical grounds, and the criteria for this are discussed. All of these infants developed visual responses between 4 and 6 months of age and had normal or near n...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.59.2.107
更新日期:1984-02-01 00:00:00
abstract::An infant with chronic cytomegalovirus hepatitis and a child with atypical Alagille's syndrome had vitamin D deficiency rickets due to malabsorption. Both received ultraviolet irradiation. This treatment corrected biochemical abnormalities and healed the rickets. In the infant use of a sunlamp at home maintained norma...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.4.617
更新日期:1989-04-01 00:00:00
abstract::Three of five children who were born to consanguineous parents developed Guillain-Barré syndrome before they were 3 years old. The syndrome is rare in early childhood and we suggest that there may be a genetic element in the pathogenesis. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.9.1078
更新日期:1991-09-01 00:00:00
abstract:AIMS:To determine whether delayed capillary refill time (>3 seconds) is a useful prognostic indicator in Kenyan children admitted to hospital. METHODS:A total of 4160 children admitted to Kilifi District Hospital with malaria, malarial anaemia, acute respiratory tract infection (ARI), severe anaemia (haemoglobin <50 g...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2003.032516
更新日期:2004-10-01 00:00:00