UK Paediatricians Research Articles

Violence against children: the UN report

> Understand that one person can do something about violence but many people can stop violence. > > No violence against children is justifiable; all violence against children is preventable....

The British Paediatric Surveillance Unit: the first 20 years

The BPSU has made a major contribution to paediatric medical epidemiology across the world In July 2006 the British Paediatric Surveillance Unit (BPSU) completed its twentieth year of surveillance into...

The information sources and journals consulted or read by UK paediatricians to inform their clinical practice and those which they consider important: a questionnaire survey

BackgroundImplementation of health research findings is important for medicine to be evidence-based. Previous studies have found variation in the information sources thought to be of greatest importance to clinicians but publication in peer-reviewed journals is the traditional route for dissemination of research findings. There is debate about whether the impact made on clinicians should be considered as part of the evaluation of research outputs. We aimed to determine first which information sources are generally most consulted by paediatricians to inform their clinical practice, and which sources they considered most important, and second, how many and which peer-reviewed journals they read.MethodsWe enquired, by questionnaire survey, about the information sources and academic journals that UK medical paediatric specialists generally consulted, attended or read and considered important to their clinical practice.ResultsThe same three information sources – professional meetings & conferences, peer-reviewed journals and medical colleagues – were, overall, the most consulted or attended and ranked the most important. No one information source was found to be of greatest importance to all groups of paediatricians. Journals were widely read by all groups, but the proportion ranking them first in importance as an information source ranged from 10% to 46%. The number of journals read varied between the groups, but Archives of Disease in Childhood and BMJ were the most read journals in all groups. Six out of the seven journals previously identified as containing best paediatric evidence are the most widely read overall by UK paediatricians, however, only the two most prominent are widely read by those based in the community.ConclusionNo one information source is dominant, therefore a variety of approaches to Continuing Professional Development and the dissemination of research findings to paediatricians should be used. Journals are an important information source. A small number of key ones can be identified and such analysis could provide valuable additional input into the evaluation of clinical research outputs.

Commentary

On the basis of their experiences in the United Kingdom, Estlin and Ablett express frustration in the preceding article over the organisational, procedural and ethical challenges faced by investigators participating in collaborative clinical trials in children with cancer. Their central message is that legislative regulations, ethical considerations, and varying national procedures have rendered the conduct of such clinical trials overly complex and burdensome, particularly with respect to the international collaboration needed for studies involving relatively small numbers of patients, informed consent and other human subject regulations, burgeoning data requirements, patient sample acquisition and processing, and information technology limitations. They indicate that more than 80% of UK paediatricians surveyed have ethical difficulties with phase I trials. They further contend that phase II trials lack ethical evaluation and that phase III trials are beset by methodological difficulties at all stages of development. They also illustrate how little research on the clinical trial process itself has been performed in paediatric oncology, and go on to plead for further studies on the clinical trial process in children and their families. They stress that these studies should include an understanding of other cultures and can be conducted in a climate of diplomacy and compromise.

A survey of paediatricians’ practice and training in routine infant eye examination

A survey of a sample of UK paediatricians was carried out to identify the practices and determine the training of those involved in routine surveillance examinations to detect ophthalmic disorders...

Definition of neonatal hypoglycaemia: is there a change?

To compare the definitions of neonatal hypoglycaemia in textbooks and among paediatricians in 1992 with those used in 1986. A questionnaire was sent to 420 neonatal paediatricians in the UK and to 88 Australian neonatal paediatricians in 1992 asking for their definition of hypoglycaemia in term babies and preterm/small-for-gestational-age (SGA) babies. Fourteen textbooks on neonatal paediatrics (published since 1990) were also surveyed for the definition of hypoglycaemia used in the text. The UK paediatricians were also asked, 'Do you believe that a baby who is hypoglycaemic but has no abnormal clinical signs is at less risk of neurological damage than a baby who is hypoglycaemic with abnormal signs?' The 1992 results were compared with the published results of a similar survey in 1986. There was a 68% response from neonatal paediatricians both in the UK and Australia. Similar to the 1986 results there continued in 1992 to be a wide range in the definition for hypoglycaemia (< 1(-4) mmol/L) among neonatal paediatricians and in textbooks. The median of the definition of hypoglycaemia for both term and preterm/SGA babies among paediatricians and in textbooks in 1992 was significantly different from the results in 1986. Compared with 1986 there was a significant increase in 1992 in the number of paediatricians and textbooks defining a safe blood glucose concentration as being at least 2 mmol/L Sixty per cent of UK neonatal paediatricians believe that a baby who is hypoglycaemic but has no abnormal clinical signs is at less risk of neurological damage than a baby who is hypoglycaemic with abnormal signs. From 1986 to 1992 there was a significant change in the definition of hypoglycaemia both among paediatricians and in neonatal textbooks compared with the definition in use during 1965-88. The findings suggest that neonatal paediatricians do change in their practice. The changes in the definition of hypoglycaemia may be due to the data available and discussion on hypoglycaemia since 1988. Neonatal paediatricians still attach significance to clinical signs associated with hypoglycaemia.

UK clinicians' knowledge of and attitudes to the prenatal diagnosis of single gene disorders.

Postal questionnaires were sent to 308 clinicians in the UK (general practitioners, obstetricians, clinical geneticists, neurologists, paediatricians, and paediatric neurologists) to assess their knowledge of, and attitudes to, the prenatal diagnosis of three common single gene disorders, Huntington's disease (HD), cystic fibrosis (CF), and Duchenne muscular dystrophy (DMD). Replies received numbered 213, a response rate of 69%. Overall, 95% of responding clinicians thought that offering prenatal diagnosis for the three test conditions was often or always appropriate. There was a correlation between the clinicians' estimates of life expectancy and their willingness to offer prenatal diagnosis (p less than 0.01). Among the non-geneticists questioned, fewer than 50% of general practitioners answered correctly regarding the availability of prenatal tests.