Children with asthma: hospital care

During this period of the year, asthma becomes a much more important problem for many young children and their families than during other periods of the year. In this article, the authors describe the factors which produce this problem, how a child should be cared for immediately, which type of complementary tests are recommended, what the medical care should entail and what the nursing treatment should consist of. The final objective of all this is to enable the asthmatic child to carry on his/her normal lifestyle.     

Children in the hospital: elements of quality in drawings

Not much is known about how children perceive the quality of care that they receive in hospitals. This study set out to describe elements of quality in children's drawings of an ideal hospital. Thirty-five drawings were collected from children aged between 4 and 11 years during their stay in a university hospital in Finland. They were coded using the method of content analysis. The two main categories extracted from the analysis were the environment and the people of their ideal hospital. The emphasis was on the environment; patients, parents, and nurses appeared less frequently in the drawings. The findings showed that children are capable of offering valuable insights into the elements of quality through the medium of drawing.     

Chaplaincy in hospice and hospital: findings from a survey in England and Wales.

The purpose of this study was to identify and compare key features of spiritual care provision in hospices and acute hospitals within England and Wales. A survey by postal questionnaire was carried out on the perceptions of senior chaplains in 151 hospices and 194 hospital trusts. The overall response rate was 76%. The findings of the survey suggest (a) a trend away from establishing chapels as the spiritual focal point within hospitals and hospices, (b) the development of broader roles for chaplains, (c) a different level of service provision between hospices with funded chaplaincies and hospices with voluntary chaplaincies, (d) a wide range of non-religious spiritual care requirements on the part of patients and (e) a more frequent requirement for religious care in hospitals rather than hospices.     

Children in the hospital: issues of power and vulnerability

Findings from a phenomenological study into the experience of pediatric nurses highlight the unequal power relationships between children and adults, including parents and health care providers. Based on the principle of 'in the child's best interest' this thinking has the potential to deny children an age appropriate right to be involved in health care decisions and may conflict with the tenets of the United Nations Convention on the Rights of the Child. Adults are presumed competent to make health care decisions, children are presumed incompetent without any validation as to whether the child has the knowledge and ability to make the decision. Consent does not only apply to major procedures, but to all patient care activities. The right of access to children's bodies is always in the hands of others and some everyday practices may conflict with protective behavior education.     

Children presenting to hospital with acute alcohol intoxication

Aims

To investigate the problem of children presenting to hospital with alcohol intoxication.

Methods

An observational study was conducted over 18 months profiling children who presented to hospital with acute alcohol intoxication, proved by laboratory tests on blood alcohol levels (BALs). The study was part of a multicentre‐funded injury prevention project based on the widely accepted Canadian Hospital Injury Reporting and Prevention Programme.

Results

62 children (31 boys), mean age 14.5 years, presented with alcohol intoxication proved by BALs. The mean BAL was 203 mg/dl (standard deviation (SD) 80.7). As a point of reference, 56 (90%) children had BAL above the UK legal driving limit of 80 mg/dl. The most common type of alcohol consumed was spirits, in the form of whisky, gin, vodka and tequila. No significant association was seen between age and BAL. Children with high alcohol levels were much more likely to have lower Glasgow Coma Scores (p<0.001), but in contrast with conventional teaching, there was no association between blood glucose levels and BALs. The median Glasgow Coma Score on admission to the emergency department was 12. 15 (24%) children had a score ⩽8/15. Injuries were present in 21 (34%) children, most of which were minor injuries. Minor head injury was most common, accounting for 42% of the injuries. The most common cause of injury was a fall.

Discussion

The results of this study confirm the heavy use of alcohol by some young children. This highlights a definite problem, which needs to be dealt with by a variety of measures, giving particular consideration to the ease of access to alcohol by children.The relationship between alcohol misuse and attendance in the emergency department is well established for adults.¹ In adults there is also a clear correlation between alcohol misuse and severity of injury.^2,3,4 However, little is known about alcohol misuse and mechanisms of injury in children.⁵ Children in the UK are reported to have the highest rates of drunkenness, binge drinking and alcohol consumption in Europe.⁶ Although deaths in children from the toxic effects of alcohol are rare, co‐morbidity is positively correlated with risk‐taking behaviours such as substance misuse, criminal activity, depression, suicide, conduct disorder, early pregnancy, poor educational attainment and unemployment.⁷ The purpose of this study is to profile children presenting to the emergency department with acute alcohol intoxication proved by blood alcohol levels (BALs). This may facilitate the implementation of effective intervention and preventive strategies to reduce alcohol‐related injury and comorbidity.     

The Establishment of Classes for Language Handicapped Children in the State of New South Wales

Man's perceptual endowment has allowed him to receive a unique set of sounds from his auditory environment. The arbitrary patterning and sequencing of these particular aural stimuli has formed an efficient and economical medium for the transmission of information to and from individuals in varying environments and at various distances. The psychological processes involved in decoding and encoding these sounds are species-specific, and are crucial to the development of oral language. These components of auditory behaviour, and their relationships to articulatory behaviour and to language is now known to be critically important to the emergence of normal human communication. Assessing and treating deficiencies in the auditory-motor channels is often a prerequisite to the commencement of remediation for an obvious disability in articulation together with any language deficits which may also accompany the presenting problem.     

A comparison of mite populations in mattress dust from hospital and from private houses in Cardiff, Wales.

Fifty mattress dust samples from private houses were examined--all were mite infested. Dermatophagoides pteronyssinus occurred in all samples and accounted for 81% of all mites. In thirty-two paired samples the total mite population of bedroom floor dust was only 10% of that found in the corresponding mattress dust. D. pteronyssinus was the dominant species in both and the population of this mite amounted to 7-5% of that found in the mattress dust. An analysis of mattress dust from 100 hospital beds showed that ninety-four mattresses were mite free; the other six contained only seven mites, all D. pteronyssinus. It is suggested that frequent changing and washing of bed linen and brushing and cleaning of mattresses were the main factors in preventing mite infestation in the Cardiff hospitals.     

Children with attention deficit hyperactivity disorder and attendance at hospital.

The aim of this study was to identify the risk of injury for children with attention deficit hyperactivity disorder. Children with attention deficit hyperactivity disorder were matched with controls and attendances at the Accident and Emergency department and injury rates were compared. Children with attention deficit hyperactivity disorder are at a greater risk of injury and also attend the Accident and Emergency department more frequently. The pattern and causation of injury is also different. This paper identifies attention deficit hyperactivity disorder as a predisposing cause of injury.