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Background and aims: The College of Emergency Medicine has consistently identified pain score recording as essential in the provision of adequate analgesia in the Paediatric acute care setting. This study recorded patients' stated pain scores in realtime at set defined time points. Methods: A prospective, observational pilot study utilising convenience sampling of children aged 5 - 15 years was conducted in the Ormskirk District General Hospital Paediatric Emergency Department, UK (20,815 presentations pa) 10 - 24th July 2009. Self-reported pain scores in acute pain were recorded every 15 minutes for 4 hours, using a combination of a numeric rating scale from 0-10 and the Wong-Baker FACES pain scale. Results: During the study period 54 patients were enrolled, 7.27 % (n = 743) of the attendances, with 47 completing the 4 hour pain score period. All patients showed a reduction in their pain scores compared to their pain score on presentation. Maximal pain score reduction occurred within 1 hour (varied treatment regimes - medical / nonmedical). Some patients showed secondary peaks in pain towards 4 hours. Conclusions: Mapping patients' pain through sequential pain scoring should provide valuable information to predict intervention responses and in the future may be facilitated by a patient-controlled real-time pain assessment electronic device. In addition we envisage calculating the area under the curve for pain versus time graphs, which may make us re-evaluate moderate pain regimes.

Environmental enteropathy and asymptomatic excretion of enteropathogens have been demonstrated in apparently healthy subjects. L and H socioeconomic level are associated with different degrees of environmental contamination. The expired H2 excretion (EHE) was studied in fasted school age children 4 to 14 years old, aiming to quantitate the abnormal colonization of the small intestine by means of a noninvasive technique. Samples of EHE were obtained during fasting and every 15 minutes during 240 minutes after the ingestion of 150mg/kg of lactulose. H2 was measured in a Quintron Microlyzer 12i chromatograph. In 39/156 (25.0%) of the L group children and in 55/155 (35.5%)of the H group children (55,7% males and 19,8% females) excreted more than 10 ppm of EHE during fasting. EHE increased more than 20 ppm during the first 90 minutes in 11/156 (7,1%) of L and 27/155 (17,4%) of H children (p

A program to improve bladder and bowel continence was evaluated in a preschool with four developmentally retarded children. During baseline, the children were taken to the toilet on a regular schedule, once an hour. The training program increased this frequency to once every 15 minutes for the 1st week, every 30 minutes the 2nd week, every hour the 3rd week, and every 2 hours in the 4th week. Using the toilet appropriately was reinforced with social praise and liquids. Accidents resulted in a brief verbal reprimand and simple correction (i.e., going to the bathroom, changing clothes, and sitting on the toilet). All four children showed improvement in their bladder and bowel continence. Results of the program are discussed in terms of improved efficiency of toilet training programs and their use with developmentally retarded preschool children.