In this episode Dr Lorna Hack speaks to Dr Priyank Rajan, a clinical fellow working in Oncology & Haematology, about the lived experience of a cancer diagnosis.
Resources discussed:
-Under 16s cancer experiencesurvey
(https://under16cancerexperiencesurvey.co.uk/visual-summaries)
- Patient and parent perspectives on paediatric cancer multidisciplinary team working and national advisory panels in the UK: a qualitative research study
(https://adc.bmj.com/content/109/4/321)
Charities:
-Teenage Cancer Trust
-Young Lives vs Cancer
Dr Rajan’s book recommendations: ‘The Emperor of All Maladies’ by Siddhartha Mukherjee and ‘The Surrender Experiment’ by Michael Singer.
Please let us know your thoughts. Your feedback will help us keep the podcast relevant to you. Perhaps you’d like to suggest an article for a future episode? If you are interested in contributing leave us a comment!
In this episode, Dr Felicity Cooksey speaks to Dr Kate McCann about adverse childhood experiences. Dr Kate McCann is a community child health consultant and member of the Trauma Informed Strategy Group in Somerset.
We discuss how adverse childhood experiences may impact a child’s development and the importance of recognising and responding to childhood trauma.
Recommended Resources:
TED Talks
• Dr Nadine Burke Harris – TED talk: How childhood trauma affects health across a lifetime.
• Molly Wright- TED talk: How Every Child Can Thrive by Five
Articles
• Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998 May;14(4):245-58.
• Nelson CA, Scott RD, Bhutta ZA, Harris NB, Danese A, Samara M. Adversity in childhood is linked to mental and physical health throughout life. BMJ. 2020 Oct 28;371:m3048.
Books
• The Body Keeps the Score by Bessel van der Kolk
• The Deepest Well by Dr Nadine Burke Harris
• Goodnight Mister Tom by Michelle Magorian
• The Secret Garden by Frances Hodgson Burnet
Websites
• The Bucharest Early Intervention Project. Available at https://www.bucharestearlyinterventionproject.org/
• Center on the Developing Child at Harvard University https://developingchild.harvard.edu/
• EHCAP- Mindful Emotion Coaching https://mindfulemotioncoaching.co.uk/
• UK trauma council https://uktraumacouncil.org/
• Oxford Brain Story https://www.oxfordbrainstory.org/
This episode, the Paedshub Pod team got together for our annual roundup. Felicity Cooksey, Leila Ellis, Lorna Hack and Paulina Connolly discuss 12 articles that we enjoyed over the past year from ADC. Happy New Year!
Articles & related resources:
1. Barriers to initiating and implementing palliative and end of life care for children with life-limiting conditions- A mixed methods study in a UK Children’s Hospital.
https://adc.bmj.com/content/107/Suppl_2/A299.1
2. Pharmacokinetic and pharmacodynamic data from the NEOLEV1 and NEOLEV2 studies.
https://adc.bmj.com/content/109/10/854
3. Family poverty, neighbourhood greenspace and perinatal outcomes.
https://adc.bmj.com/content/109/12/1017
4. Near-fatal and fatal asthma and air pollution: are we missing an opportunity to ask key questions?
https://adc.bmj.com/content/109/8/616
5. Fifteen-minute consultation: The prepubescent gender-diverse child: how to answer parents’ questions.
https://ep.bmj.com/content/109/3/106
Additional resources:
https://cass.independent-review.uk/home/publications/final-report/
6. Children born to subfertile couples, how are they doing? Evidence from research.
https://adc.bmj.com/content/early/2024/04/07/archdischild-2023-326023
7. Delivery room dextrose gel for preterm hypoglycaemia (the GEHPPI study): a randomised placebo-controlled trial.
https://fn.bmj.com/content/early/2024/11/17/archdischild-2024-327313
8. Fifteen-minute consultation: Group A streptococcal pharyngitis, diagnosis and treatment in children.
https://ep.bmj.com/content/109/5/210
Additional resources:
FeverPAIN score: https://www.mdcalc.com/calc/3316/feverpain-score-strep-pharyngitis#evidence
9. Nasogastric tube feeding under physical restraint of children and young people with mental disorders: a comprehensive audit and case series across paediatric wards in England. https://adc.bmj.com/content/109/8/649
10. Recognition, prevention and management of ‘digital harm’.
https://ep.bmj.com/content/109/3/120
Additional resources:
11. Achieved oxygen saturations and risk for bronchopulmonary dysplasia with pulmonary hypertension in preterm infants.
https://adc.bmj.com/content/109/11/941
12. Fifteen-minute consultation: Empowering children, young people and families through shared decision-making: a practical guide.
https://ep.bmj.com/content/109/6/264
Our entertainment recommendations:
Books:
Films & Series:
In this episode Dr Lorna Hack speaks to Dr Anirban Majumdar about Spinal Muscular Atrophy, and the remarkable advances made in managing this condition in the twenty-first century.
Dr Majumdar is a Consultant Paediatric Neurologist at the Bristol Royal Hospital for Children, and delivers the regional Neuromuscular Service.
We discuss: the genetic basis of SMA, the targets of disease modifying treatments, the pros and cons that guide treatment choice, and monitoring of treatment efficacy.
Article: https://adc.bmj.com/content/108/Suppl_2/A199
Dr Majumdar’s book recommendations: ‘Yellowface’ by R. F. Kuang and ‘The Spanish Civil War’ by Antony Beevor.
In this episode, Dr Felicity Cooksey talks with Dr Marie Monaghan about idiopathic intracranial hypertension. Dr Monaghan is a general paediatric consultant with a specialist interest in epilepsy, based at Bristol Royal Hospital for Children. She co-authored a paper titled ‘Consensus recommendations for the assessment and management of idiopathic intracranial hypertension in children and young people’, which was published in Archives of Disease in Childhood.
Dr Monaghan discusses her experiences of working abroad, why cases of idiopathic intracranial hypertension are predicted to rise and how to approach a suspected case.
Link to the full article: Consensus recommendations for the assessment and management of idiopathic intracranial hypertension in children and young people | Archives of Disease in Childhood (bmj.com)
In this episode, Dr Leila Ellis welcomes Nicola O'Donnell to the podcast to discuss psychosocial support for childhood cancer survivors. Nicola is a Health Psychologist and is completing the final year of a PhD with the University of York exploring psychoeducation interventions for young people with retinoblastoma funded by the Childhood Eye Cancer Trust (CHECT).
Resources:
Charities:
Support lines:
Book recommendation:
Please let us know what you thought of this episode. Your feedback will help us keep the podcast relevant to you. Let us know what you think about the format, length, choice of articles or anything else. Perhaps you’d like to suggest an article for a future episode? Here are your options for getting in touch:
In this episode Dr Lorna Hack speaks to Dr Dinesh Giri about obesity, it's growing prevalence and associated complications. Tertiary management for obese children is discussed, including the increasing use of medication.
Dr Giri is a Paediatric Endocrine Consultant at the Bristol Royal Hospital for Children, and is part of the team who run the weight management service.
Dr Giri's book recommendation: 'The Secret' by Rhonda Byrne
Articles discussed:
Gap in obesity monitoring in preschool children:
https://adc.bmj.com/content/108/Suppl_2/A64.2
Review of paediatric fatty liver disease:
https://adc.bmj.com/content/106/1/3
Waist-to-height-ratio superior to BMI in identifying obese children:
https://www.nature.com/articles/s41390-024-03112-8
Resources for families:
https://beezeebodies.com/resources/
Thank you for listening!
In this episode Dr Paulina Connolly welcomes Professor Ramanan to the Podcast. Professor Ramanan is a Consultant Paediatric Rheumatologist at Bristol Royal Hospital for Children, and Associate Editor of Archives of Disease in Childhood. They explore the evidence behind current treatment strategies for Kawasaki disease, reviewing the recent paper from Archives titled 'Infliximab for intensification of primary therapy for patients with Kawasaki disease and coronary artery aneurysms at diagnosis'
The full link to the article can be found below:
https://adc.bmj.com/content/108/10/833
Prof Ramanan also references the recent editorial in ADC 'Thinking beyond intravenous immunoglobulin for Kawasaki disease' which provides an overview of the current adjunctive treatments and supporting evidence:
https://adc.bmj.com/content/108/10/781
In this episode, Dr Felicity Cooksey talks with Dr Denize Atan about nutritional blindness. Dr Atan is an Associate Professor and an Honorary Consultant in Neuro-ophthalmology at the Bristol Eye Hospital. She co-authored a review published in Archives of Disease in Childhood titled ‘Nutritional blindness from avoidant-restrictive food intake disorder- recommendations for the early diagnosis and multidisciplinary management of children at risk from restrictive eating.’
The link to the full article can be found below:
https://adc.bmj.com/content/early/2023/07/05/archdischild-2022-325189
Dr Atan discusses the importance of asking about diet, why growth measurements can lead to false reassurance and the traffic light algorithm they propose for managing patients with ARFID who are at risk of visual and other neurological complications.
Dr Atan’s book recommendation was ‘Lessons in Chemistry’ by Bonnie Garmus.
This episode the Paedshub Pod team Felicity Cooksey, Leila Ellis and Paulina Connolly discuss 12 articles that we enjoyed over the past year from ADC. Happy Christmas!
Leila's recommendations from Fetal and Neonatal:
Marshall A, Ladlow OJ, Bannink C, et al. Apnoea-triggered increase in fraction of inspired oxygen in preterm infants: a randomised cross-over study Archives of Disease in Childhood - Fetal and Neonatal Edition.
https://fn.bmj.com/content/early/2023/08/28/archdischild-2023-325849
Cromb D, Hall M, Story L, et al. Clinical value of placental examination for paediatricians. Archives of Disease in Childhood - Fetal and Neonatal Edition
https://fn.bmj.com/content/early/2023/09/26/archdischild-2023-325674
Suonpera E, Lanceley A, Ni Y, et al. Parenting stress and health-related quality of life among parents of extremely preterm born early adolescents in England: a cross-sectional study. Archives of Disease in Childhood - Fetal and Neonatal Edition
https://fn.bmj.com/content/early/2023/10/24/archdischild-2023-325429
van Hasselt TJ, Gale C, Battersby C, et al. Paediatric intensive care admissions of preterm children born <32 weeks gestation: a national retrospective cohort study using data linkage. Archives of Disease in Childhood - Fetal and Neonatal Edition.
https://fn.bmj.com/content/early/2023/11/03/archdischild-2023-325970
Felicity's recommendations from Archives:
Byrne S, Sledge H, Franklin R on behalf of the CORAL Study group, et al. Social communication skill attainment in babies born during the COVID-19 pandemic: a birth cohort study Archives of Disease in Childhood 2023;108:20-24
https://adc.bmj.com/content/108/1/20
Pereyra-Elías R, Carson C, Quigley MA. Association between breastfeeding duration and educational achievement in England: results from the Millennium Cohort Study Archives of Disease in Childhood 2023;108:665-672.
https://adc.bmj.com/content/108/8/665
Zhang CX, Quigley MA, Bankhead C, et al. Ethnic differences and inequities in paediatric healthcare utilisation in the UK: a scoping review Archives of Disease in Childhood 2023;108:518-524.
https://adc.bmj.com/content/108/7/518
Storch-De-Gracia P, Fernández JL, Velasco R, et al. Invasive bacterial infection in children with fever and petechial rash in the emergency department: a national prospective observational study. Archives of Disease in Childhood 2023;108:445-450.
https://adc.bmj.com/content/108/6/445
Paulina's recommendations from Education & Practice:
Abdalhady M, Harrison CM. Early switch of intravenous to oral antibiotic therapy in clinically well neonates with a probable bacterial infection is as effective as a full course of intravenous antibiotics therapy. Archives of Disease in Childhood - Education and Practice 2023;108:290-291.
https://ep.bmj.com/content/108/4/290
Low A, Blyth FJ. Infants reported for maltreatment had an increased risk of death from medical causes. Archives of Disease in Childhood - Education and Practice 2023;108:142.
https://ep.bmj.com/content/108/2/142
Barrington J, Polley C, van Heerden C, et al. Parents’ attitudes to medical education on paediatric ward rounds. Archives of Disease in Childhood -Education and Practice 2023;108:134-138.
https://ep.bmj.com/content/108/2/134
Mulholland M, Glancy C, Sweeney E, et al. An ulcerated lesion in a previously well child. Archives of Disease in Childhood - Education and Practice 2023;108:74-76.
https://ep.bmj.com/content/108/1/74
Our book recommendations:
And finally our Podcast recommendations:
The BNFc recommends age-banded dosing for children prescribed oral paracetamol for non-post operative pain. This was recently challenged by Kirstie Wright and her colleagues following their study published in Archives of Disease in Childhood. Evaluation of age-banded dosing of oral paracetamol in hospitalised children: a retrospective analysis using clinical data in a tertiary paediatric hospital | Archives of Disease in Childhood (bmj.com)
In this episode, Dr Felicity Cooksey meets with Ceri Gaskell, a specialist pharmacist at Bristol Royal Hospital for Children, to explore the debate.
Resources:
· Paracetamol | Drugs | BNFC |NICE
· UKMIQA-drug-dosing-in-childhood-obesity-1.docx (live.com)
· Medicine dosing in childhood obesity | RCPCH
Ceri’s Favourite Book: Pride and Prejudice by Jane Austen
In this episode, Dr Leila Ellis welcomes Dr Alicia Regan to the podcast to discuss neurodevelopmental care in the neonatal unit. Alicia is a paediatric registrar with a special interest in neonatal medicine based in the South West. She has been working with colleagues to introduce the South West Cuddle Bundle aiming to educate staff and parents on the benefits of cuddles in the neonatal unit.
Publications:
Websites:
Book recommendation:
If you have questions after listening to this episode or if you would like to become a Cuddle Champion, you can contact Alicia (alicia.regan1@nhs.net) or the South West Neonatal Network team.
In this episode, Dr Felicity Cooksey welcomes Dr Michelle Cutland to the podcast. Dr Cutland is clinical director for the children’s service at a Sexual Assault Referral Centre in the South West of England and clinical co-lead for Physical Signs of Child Sexual Abuse 3rd Ed, which is due for release in August 2023.
They discuss communicating with children and young people following disclosures of sexual harm, the importance of reinforcing bodily autonomy to children and the updates to Physical Signs of Child Sexual Abuse (also known as the ‘purple book’).
Resources
· Data on the scale and nature of CSA The scale and nature of CSA - CSA Centre
· RCPCH Child Protection Portal Child protection resources – RCPCH Child Protection Portal
· Physical Signs of Child Sexual Abuse Physical signs of child sexual abuse - evidence-based review | RCPCH
· Child centre of expertise for child sexual abuse- indicators of abuse (Signs & Indicators Template - CSA Centre), communicating with children Communicating with Children Guide - CSA Centre
· The Green House (Home - The Green House (the-green-house.org.uk)
· Somerset Phoenix project (Somerset Phoenix Project)
· Pants: The Underwear Rule (Talk PANTS & Join Pantosaurus - The Underwear Rule | NSPCC)
Book recommendations
· My Dark Vanessa by Kate Elizabeth Russell
· Bird of Winter by Alice Hiller
· Indescribable by Candice Harris
Television recommendation
· Unbelievable series 1, episode 1 (available on Netflix)
If you have questions after listening to this episode, you can contact Michelle via her email address (Michelle.Cutland@uhbw.nhs.uk) or discuss with your local safeguarding lead.
This month Dr Tabitha Campbell, GP trainee, joins Dr Paulina Connolly to talk through the 15-minute Consultation paper: “What do paediatricians need to know about child refugee and migrant health needs?” by Dr Aoife Ryan & Dr Alison Kelly from the Online First section of ADC Education & Practice: https://ep.bmj.com/content/early/2023/01/26/archdischild-2022-324836
Dr Campbell originally found the 3-D assessment on Paediatric FOAMed: “The 3-D Assessment for Refugee, Asylum-Seeking or Trafficked Children”, an excellent article by Dr Laura C. Wood: https://www.paediatricfoam.com/2018/03/refugee-asylum-seeking-trafficked-children/
Another extremely useful resource by the RCPCH - Refugee and asylum seeking children and young people - guidance for paediatricians: https://www.rcpch.ac.uk/resources/refugee-asylum-seeking-children-young-people-guidance-paediatricians
WHO estimates of Tuberculosis incidence are easiest to find on the Gov.uk website: https://www.gov.uk/government/publications/tuberculosis-tb-by-country-rates-per-100000-people/who-estimates-of-tuberculosis-incidence-by-country-and-territory-2020-accessible-text-version
But for more comprehensive data on TB you can read the WHO yearly global report: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022/tb-disease-burden/2-1-tb-incidence
And there’s also advice on testing for infection in their guidelines: https://www.who.int/publications/i/item/9789240056084
The landing page for RCPCH resources for FGM including links to government guidance: https://www.rcpch.ac.uk/resources/female-genital-mutilation-resources
And free online learning: https://www.rcpch.ac.uk/resources/female-genital-mutilation-online-learning
The Refugee council website has a wealth of information. Below is the page discussing Mental health support for refugees, and also a link at the bottom of the page: https://www.refugeecouncil.org.uk/our-work/mental-health-support-for-refugees-and-asylum-seekers/
Dr Campbell’s recommended book was: “Where the Crawdad’s Sing” by Delia Owens, and her recommended Podcast was the “Off Menu” by comedians Ed Gamble and James Acaster.
This episode was recorded in front of a live audience at the 2023 RCPCH Annual Conference, Glasgow. Dr Felicity Cooksey and Dr Leila Ellis were joined by an expert panel to discuss: What could the role of the general paediatric ward be in caring for a young person with a mental health presentation?
Panelists included:
During the live session, we read a poem by Anna Perkins ‘An NG Feed’ which is available to read in the NHS Paediatric restrictive practices and nasogastric feeding guidance (https://ngt-restrictive-practice.nhs.uk/)
Resources
Book recommendations
In this episode Dr Paulina Connolly discusses recent articles looking at the neonatal microbiome, dysbiosis and interventions intended to manipulate the microbiome & improve neonatal outcomes:
This month Dr Simon Parke, Paediatric Oncologist, joins Dr Paulina Connolly to discuss the research paper: "Can I go home now? The safety and efficacy of a new UK paediatric febrile neutropaenia protocol for risk-stratified early discharge on oral antibiotics" by Dr Jackson et al from the March 2023 edition of Archives of Disease in Childhood (https://adc.bmj.com/content/108/3/192). Dr Parke's film recommendation is "The Princess Bride", and his book recommendation "Love in the Time of Cholera" by the author Gabriel García Márquez.
In this episode, Dr Rebecca Treleaven discusses the complexities of the clinician parent exchange and how to improve our communication skills through the review article: “Vulnerabilities in clinician–parent exchanges and the cascade of communication traps: a review”
In this episode, Dr Felicity Cooksey has a conversation with Dr Helen Leveret about child poverty and how paediatricians can advocate for reducing health inequalities. They discuss the article Child poverty and health inequalities in the UK: a guide for paediatricians | Archives of Disease in Childhood (bmj.com).
Resources:
https://bmjpaedsopen.bmj.com/content/6/1/e001631- Dr Singh & Dr Uthayakumar-Cumarasamy review on the Cost of living crisis: a UK crisis with global implications – A call to action for Paediatricians.
https://www.rcpch.ac.uk/key-topics/child-health-inequalities- the RCPCH child health inequalities toolkit to assist anyone interested in developing their knowledge, improving their communication with families, starting QI projects & advocating for change on a local and national level.
Supporting child health fighting poverty | Wellbeing and Health Action Movement (whamproject.co.uk) – A movement to inform, empower and unite clinicians who fight child poverty and health inequality.
https://www.rcpch.ac.uk/news-events/news/child-health-inequalities-podcast-1-talking-families - this edition of the RCPCH podcast discusses how to have meaningful & approachable conversations with families around living in poverty.
In this episode, Dr Felicity Cooksey & Dr Leila Ellis have a conversation with Katie Heard, a Specialist Pharmacist with an interest in antimicrobials and infectious diseases, about Group A Strep & looking at the interim clinical guidance from the UK HSA. They discuss signs of Streptococcal infections and Scarlet fever, local statistics, the FeverPAIN score & the recent changes to it, testing and prescribing advice taking into consideration current supply issues.
Resources discussed:
UK HSA Interim Clinical Guidance & Safety netting advice:
Resources for learning more about rashes in a range of skin tones:
The Kidzmed prescribing project:
