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Aim: To quantify use of complementary and alternative medicine (CAM) in children with non-malignant, life-limiting illness. Method: A self-administered questionnaire was sent to families who received care from a community children's nursing and psychology team for children with non-malignant, life-limiting conditions. Results: A total of 32 per cent of respondents had used up to seven types of CAM for their child and 43.4 per cent had used CAM for themselves or other family members. Most parents used CAM to enhance general wellbeing rather than treat specific diagnoses. A total of 58.3 per cent felt the therapy was helpful, 50 per cent had tried conventional medicine first, and 63.9 per cent of users discussed their use of CAM with a doctor or community nurse. Conclusion: The rate of CAM use is significantly higher in this population than found in many previous cross-sectional studies. This may reflect the different needs and expectations of families with children with non-malignant, life-limiting illnesses. [ABSTRACT FROM AUTHOR]

Objective: To audit doctors' knowledge of informed consent. Design: 10 consent scenarios with "true", "false", or "don't know" answers were completed by doctors who care for children at a large district general hospital. These questions tested clinicians' knowledge of who could give consent in different clinical situations. Setting: Royal United Hospital, Bath, UK. Results: 51 doctors participated (25 paediatricians and 26 other clinicians). Paediatricians scored higher than other clinicians (average correct response 69% v 49%). Only 36% (9/25) of paediatricians and 8% (2/ 26) of other clinicians realised that the biological father of a child born before 1 December 2003 needed a court order or a parental responsibility agreement to acquire parental responsibility, and thus be able to consent on behalf of his child, if he was not married to the child's mother. Non-paediatric clinicians were unsure or incorrect when tested on situations where people with parental responsibility do not agree, or where young people (<16 years), who are Fraser competent do not want to consult their parents. Most clinicians did not know that the parents of a 20-year-old man with severe learning difficulties are unable to consent to surgery on his behalf, and many non-paediatricians were unclear on who could give consent when a child lived with foster parents. Conclusion: Clinicians who obtain consent for the treatment of children need to increase their knowledge on who is able to give informed consent to ensure best (legal and safe) practice. [ABSTRACT FROM AUTHOR]

Examines the immunization status among children with disabilities attending special schools in England. Details on children's right to protection from infectious diseases; Reasons for lack of immunization; Serious implications of diseases to children with disabilities.

Over the last century, changes in legislation, social constructs and the perceptions of what family life 'should' look like have significantly transformed the process of adoption in England. The role of adoption has shifted from providing orphaned children a stable new home to today's regulated process mainly supporting children who have suffered early physical or social adversity. This provides significant challenges to adopters, paediatricians, child psychiatrists and teachers who can only support adopted children by understanding their needs., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To find out whether doctors who work with children have a basic knowledge of tissue and organ donation which would allow them to initiate discussions with families., Methods: Anonymous self-completed questionnaire containing basic information about donation administered to 56 doctors working in paediatrics, emergency medicine and intensive care in one district general hospital., Results: 89% doctors were aware that children could donate solid organs after death although 39.3% thought incorrectly that premature babies were eligible. Respondents were generally less knowledgeable about age limits for tissue (heart valve and eye), blood and bone marrow donation. The overall average score on the questionnaire was only 49.9%, this score did not vary with grade or paediatric training., Conclusion: Participants had poor knowledge about tissue and organ donation, which would make approaching families difficult. This study has identified an important training need for all doctors involved in the care of dying children.

Aim: To discover whether community children's nurses and other members of the multi-disciplinary team had changed their practice in the light of the 'copying letters' initiative recommended by the Department of Health and to seek their views on the process., Method: A documentary analysis of the notes was undertaken on 30 sets of notes chosen at random from the community children's nursing team's caseload and the total number of letters in each child's notes was retrospectively recorded for periods before and after the implementation of the 'copying letter initiative'. In addition, 14 community children's nurses were interviewed about their communication practice., Results: Letters accounted for 70 per cent of the total correspondence in the children's notes. Most of the 466 letters were from doctors (65 per cent) with nine per cent having been sent by community children's nurses. Before the initiative 70 per cent of letters from medical staff were copied compared to 74 per cent afterwards, with community children's nurses copying 19% of letters before and 47% afterwards. Only 13 were sent to the child. Nurses commented on changes to their practice since the copying initiative began and reported varying use of other forms of communication such as text messaging and email. CONCLUSION Professionals should be encouraged to copy letters to parents and children. A number of technologies are available to facilitate communication between patients, parents and other health care professionals. Careful consideration must be given to their introduction to ensure their use conforms to legal and professional codes and good practice principles.

Background: there are few studies in the literature describing or evaluating the workload of children's community nurses prior to and following the death of a child with a non-oncological life-limiting disorder., Method: a documentary analysis of nursing records of all children under the care of the Lifetime Service who died during a 5-year period was carried out., Results: the number of visits and telephone calls involving children's community nurses in the end of life and bereavement periods was analysed and the level of the input to families found to vary widely. In total, the number of visits range from 0 to 50 (median 8). The total number of telephone calls made or received for each child ranged from 0 to 127 (median 20). Calls and visits were with a wide range of people relating to diverse subject areas and continued even when children were in hospital., Conclusion: community children's nurses liase with a wide range of professionals and organisations and the nature of their workload at the end of life is often hidden.