Medicine and Health Sciences Commons^™

Feasibility Of And Experience Using A Portable Mri Scanner In The Neonatal Intensive Care Unit., Maura Sien, Amie L. Robinson, Houchun H. Hu, Christopher R. Nitkin, Ara Hall, Marcie G. Files, Nathan S. Artz, John T. Pitts, Sherwin S. Chan

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: A portable, low-field MRI system is now Food and Drug Administration cleared and has been shown to be safe and useful in adult intensive care unit settings. No neonatal studies have been performed. The objective is to assess our preliminary experience and assess feasibility of using the portable MRI system at the bedside in a neonatal intensive care unit (NICU) at a quaternary children's hospital.

STUDY DESIGN: This was a single-site prospective cohort study in neonates ≥2 kg conducted between October and December 2020. All parents provided informed consent. Neonates underwent portable MRI examination in the NICU with support …

Risk Factors For Community-Acquired Bacterial Infection Among Young Infants In South Asia: A Longitudinal Cohort Study With Nested Case–Control Analysis, Nicholas E. Connor, Mohammad Shahidul Islam, Luke C. Mullany, Nong Shang, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi, Sajid Bashir Soofi, Muhammad Imran Nisar, Pinaki Panigrahi, Kalpana Panigrahi

Department of Paediatrics and Child Health

Objective: Risk factors predisposing infants to community-acquired bacterial infections during the first 2 months of life are poorly understood in South Asia. Identifying risk factors for infection could lead to improved preventive measures and antibiotic stewardship.
Methods: Five sites in Bangladesh, India and Pakistan enrolled mother-child pairs via population-based pregnancy surveillance by community health workers. Medical, sociodemographic and epidemiological risk factor data were collected. Young infants aged 0-59 days with signs of possible serious bacterial infection (pSBI) and age-matched controls provided blood and respiratory specimens that were analysed by blood culture and real-time PCR. These tests were used to build …

Neurodevelopment Assessment Of Small For Gestational Age Children In A Community-Based Cohort From Pakistan, Sabahat Naz, Zahra Hoodbhoy, Ali Jaffar, Sidra Kaleem Jafri, Babar Hasan, Devyani Chowdhury, Melissa Gladstone

Department of Paediatrics and Child Health

Background: Children born small for gestational age (SGA) may experience more long-term neurodevelopmental issues than those born appropriate for gestational age (AGA). This study aimed to assess differences in the neurodevelopment of children born SGA or AGA within a periurban community in Pakistan.
Methods: This was a prospective cohort study in which study participants were followed from the pilot Doppler cohort study conducted in 2018. This pilot study aimed to develop a pregnancy risk stratification model using machine learning on fetal Dopplers. This project identified 119 newborns who were born SGA (2.4±0.4 kg) based on International Fetal and Newborn Growth …

Transforming Obesity Prevention For Children (Topchild) Collaboration: Protocol For A Systematic Review With Individual Participant Data Meta-Analysis Of Behavioural Interventions For The Prevention Of Early Childhood Obesity, Kylie E. Hunter, Brittany J. Johnson, Lisa Askie, Rebecca K. Golley, Louise A. Baur, Ian C. Marschner, Rachael W. Taylor, Luke Wolfenden, Charles T. Wood, Seema Mihrshahi, Alison J. Hayes, Chris Rissel, Kristy P. Robledo, Denise A. O'Connor, David Espinoza, Lukas P. Staub, Paul Chadwick, Sarah Taki, Angie Barba, Sol Libesman, Ana Maria Linares

Nursing Faculty Publications

INTRODUCTION: Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of individual and trial-level subgroups. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and …

Unpacking The Behavioural Components And Delivery Features Of Early Childhood Obesity Prevention Interventions In The Topchild Collaboration: A Systematic Review And Intervention Coding Protocol, Brittany J. Johnson, Kylie E. Hunter, Rebecca K. Golley, Paul Chadwick, Angie Barba, Mason Aberoumand, Sol Libesman, Lisa Askie, Rachael W. Taylor, Kristy P. Robledo, Seema Mihrshahi, Denise A. O'Connor, Alison J. Hayes, Luke Wolfenden, Charles T. Wood, Louise A. Baur, Chris Rissel, Lukas P. Staub, Sarah Taki, Wendy Smith, Ana Maria Linares

Nursing Faculty Publications

INTRODUCTION: Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behaviour change techniques (BCTs), (2) explore similarities and differences in BCTs used to target behaviours and (3) explore effectiveness of intervention components in preventing childhood obesity.

METHODS AND ANALYSIS: Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as …

Poliovirus Excretion Among Children With Primary Immune Deficiency In Pakistan: A Pilot Surveillance Study Protocol, Asma Sadruddin Pethani, Zaubina Kazi, Ujala Nayyar, Muhammad Shafiq-Ur-Rehman, Mohammad Tahir Yousafzai, Mach Ondrej, Ali Faisal Saleem

Department of Paediatrics and Child Health

Introduction: Children with primary immunodeficiency disorders (PID) are more susceptible to developing viral infections and are at a substantially increased risk of developing paralytic poliomyelitis. Such children, if given oral polio vaccines tend to excrete poliovirus chronically that may lead to the propagation of highly divergent vaccine-derived poliovirus (VDPV). Consequently, they may act as a reservoir for the community by introducing an altered virus potentially imposing a risk to global polio eradication. However, the risks of chronic and prolonged excretion are not well characterised in the study context. This study seeks to establish a pilot surveillance system for successful identification …

A Novel Approach To Explore Safety-I And Safety-Ii Perspectives In In Situ Simulations-The Structured What If Functional Resonance Analysis Methodology., Ralph James Mackinnon, Karin Pukk-Härenstam, Christopher S. Kennedy, Erik Hollnagel, David Slater

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: With ever increasingly complex healthcare settings, technology enhanced simulation (TES) is well positioned to explore all perspectives to enhance patient safety and patient outcomes. Analysis from a Safety-II stance requires identification of human adjustments in daily work that are key to maintaining safety. The aim of this paper is to describe an approach to explore the consequences of human variability from a Safety-II perspective and describe the added value of this to TES.

METHODS: The reader is guided through a novel application of functional resonance analysis methodology (FRAM), a method to analyse how a system or activity is affected …

Lung Ultrasound Patterns In Paediatric Pneumonia In Mozambique And Pakistan, Amy Sarah Ginsburg, Pio Vitorino, Zunera Qasim, Jennifer L. Lenahan, Jun Hwang Jun Hwang, Alessandro Lamorte, Marta Valente, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan

Department of Paediatrics and Child Health

Objective: Improved pneumonia diagnostics are needed, particularly in resource-constrained settings. Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing pneumonia. The objective was to explore LUS patterns associated with paediatric pneumonia.
Methods: We conducted a prospective, observational study among children aged 2 to 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at two district hospitals in Mozambique and Pakistan. We assessed LUS and chest radiograph (CXR) examinations, and viral and bacterial nasopharyngeal carriage, and performed a secondary analysis of LUS …

Intergrowth-21st Project International Inter-Nda Standards For Child Development At 2 Years Of Age: An International Prospective Population-Based Study, Michelle Fernandes, José Villar, Alan Stein, Eleonora Staines Urias, Cutberto Garza, Cesar G. Victora, Fernando C. Barros, Enrico Bertino, Manorama Purwar, Maria Carvalho, Zulfiqar Ahmed Bhutta

Woman and Child Health

Objectives: To describe the construction of the international INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) standards for child development at 2 years by reporting the cognitive, language, motor and behaviour outcomes in optimally healthy and nourished children in the INTERGROWTH-21st Project.
Design: Population-based cohort study, the INTERGROWTH-21st Project.
Setting: Brazil, India, Italy, Kenya and the UK.
Participants: 1181 children prospectively recruited from early fetal life according to the prescriptive WHO approach, and confirmed to be at low risk of adverse perinatal and postnatal outcomes.
Primary measures: Scaled INTER-NDA domain scores for cognition, language, fine and gross motor skills and behaviour; vision outcomes measured …

Teachers’ Perceptions And Understanding Of Children’S Fluid Intake, Kristy Howells, Tara Coppinger

Publications

No public health data exists on elementary teachers’ perceptions of both their own fluid intake and of their elementary school aged children’s fluid intake. A total of 271 (20 males, 251 females) teachers in developed areas of Australia, Belgium, England, Ireland, United Arab Emirates, and the United States of America completed an online questionnaire (Feb–Mar 2019) on: (i) their fluid intake, (ii) their perception and understanding of children’s fluid intake and (iii) barriers in the school day that they felt prevented school children consuming fluids. Overall, the data indicated that teachers consume considerably lower amounts than recommended themselves, but have …

Management And Outcomes Of Gastrointestinal Congenital Anomalies In Low, Middle And High Income Countries: Protocol For A Multicentre, International, Prospective Cohort Study, Naomi Jane Wright, Andrew Leather, Nick Sevdalis, Niyi Ade-Ajayi, Adesoji O. Ademuyiwa, Emmanuel A. Ameh, Justine Davies, Kokila Lakhoo, Samuel Parker, Muhammad Arshad

Section of Paediatric Surgery

Introduction: Congenital anomalies are the fifth leading cause of death in children globally, contributing an estimated half a million deaths per year. Very limited literature exists from low and middle income countries (LMICs) where most of these deaths occur. The Global PaedSurg Research Collaboration aims to undertake the first multicentre, international, prospective cohort study of a selection of common congenital anomalies comparing management and outcomes between low, middle and high income countries (HICs) globally.
Methods and Analysis: The Global PaedSurg Research Collaboration consists of surgeons, paediatricians, anaesthetists and allied healthcare professionals involved in the surgical care of children globally. Collaborators …

Defining And Measuring Quality In Acute Paediatric Trauma Stabilisation: A Phenomenographic Study., Ralph James Mackinnon, Karin Pukk-Härenstam, Ulrica Von Thiele Schwarz, Christopher S. Kennedy, Terese Stenfors

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: Trauma is the leading cause of death in children. The lack of an accepted definition of what constitutes a high-quality stabilisation of a traumatically injured child has limited the evaluation of direct interventions in simulation-based education and service-delivery models to improve trauma care. The aim of this study was to create a framework that delineates quality by exploring the perceptions of the multi-disciplinary team providing and improving this initial care.

Methods: Interviews were conducted with 36 experienced UK trauma team members and governance administrators (clinical directors to executive board level), from three standard UK trauma units. This study used …

What’S Coming For Health Science And Policy In 2018? Global Experts Look Ahead In Their Field, The Plos Medicine Editors, Soumya Swaminathan, Robin S. Room, Louise C. Ivers, Graham Hillis, Rebecca F. Grais, Zulfiqar Ahmed Bhutta, Peter Byass

Department of Paediatrics and Child Health

No abstract provided.

What’S Coming For Health Science And Policy In 2018? Global Experts Look Ahead In Their Field, Soumya Swaminathan, Robin S. Room, Louise C. Ivers, Graham Hillis, Rebecca F. Grais, Zulfiqar Ahmed Bhutta, Peter Byass

Department of Paediatrics and Child Health

In PLOS Medicine's first editorial of 2018, editorial board members and other leading researchers share their hopes, pleas, concerns, and expectations for this year in health research and policy.

Tuberous Sclerosis Complex In The Western Cape, South Africa: The Clinical Presentation Features, E. Kija, B. Schlegel, Pauline Samia, M. Wessels, J. M. Wilmshurst

Paediatrics and Child Health, East Africa

Tuberous sclerosis complex (TSC) is a genetic neurocutaneous condition, which affects multiple organ systems. This study aimed to determine the presenting features of children with TSC in Cape Town, South Africa. A cross-sectional study was conducted at a TSC clinic, and clinical features at presentation were prospectively collected. Thirty-nine children (23 boys; median age 10 (range 1 - 26) years; median diagnosis age 16 (0 - 153) months) were recruited. Twenty-one (54%) children presented with focal seizures. Seven (18%) children had epileptic spasms. Skin manifestations led to a diagnosis in 13 (33%) and neuroimaging in 22 (56%) children. Antenatal screening …

A Comparison Of Individual Versus Community Influences On Youth Smoking Behaviours: A Cross-Sectional Observational Study, Anna M. Adachi-Mejia, Heather A. Carlos, Ethan M. Berke, Susanne E. Tanski, James Sargent

Dartmouth Scholarship

Objectives: To compare individual with community risk factors for adolescent smoking. Design: A cross-sectional observational study with multivariate analysis.Setting: National telephone survey.Participants: 3646 US adolescents aged 13–18 years in 2007 recruited through a random digit-dial survey.