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Clinical scenario: A mother brought her infant to the hospital with bronchiolitis and incidentally asked if I would recommend the use of infant sleeping bags to protect against Sudden Infant Death Syndrome as several of her friends use them. Structured question: Can infant sleeping bags be recommended by medical professionals as protective against Sudden Infant Death Syndrome? Methods: A literature search was performed. Trials were included if they had an English version available and the papers examined the impact that sleeping bag use had on risk of SIDS or its risk factors. Cochrane Library search found eight trials, two of which were found to meet inclusion criteria. MEDLINE was searched using the search terms ((baby sleeping bag) OR infant sleeping bag) OR cotton sleeping sack. Forty-seven papers were found, two of which were found to meet the inclusion criteria, one of which had already been found in the Cochrane Library search. One further paper was found through searching citations of the papers included. Discussion: Sleeping bags are used in 48-95% of infants in the UK and advocated for by the Lullaby Trust for their safety in the prevention of SIDS. The case control studies included found that sleeping bags are as safe, if not safer than other bedding when examining SIDS as an outcome. For sleeping bags to be safe they must be well made and appropriately used, which includes the correct size, Tog, clothing and other bedding for bedroom temperature. [ABSTRACT FROM AUTHOR]

Aims To investigate medical students' experiences and perception of support following a patient's death, contrasting their experiences in the UK, and while overseas during their elective period. Methods An anonymous online questionnaire was distributed to all final year medical students at one UK medical school in November 2009. Results 220 students were contacted, 60% responded. 72% (94) of medical students had been involved in end- of-life care at some point during their course; students on elective experiencing patient death across all ages. Some students saw many patients dying during their elective period. Students had mixed emotions following a patient's death. In the UK, students reported feeling shocked, upset and sad. When overseas, many students were angry or frustrated, and many reported feelings of injustice. Following a death, students found talking to people beneficial, but when overseas they turned to friends and family using email and Facebook, rather than talking to local doctors and nurses. Only 13% (16) of medical students thought their medical training had prepared them sufficiently to deal with death. Of those who did feel prepared some said they had gained this knowledge through working as a healthcare assistant. Conclusions Students feel ill prepared for experiencing the death of a patient. Even though they may have 'medical knowledge' they are still lacking in emotional support and are often inadequately supported around the time of a patient's death. Medical schools should consider their curricula so that students are aware of the possible experiences and emotions which they may face when involved with the death of a patient, and students should be given advice on whom to turn to for support. [ABSTRACT FROM AUTHOR]

The article discusses a report within the issue regarding a study investigating the amount of child protection training for pediatricians in Great Britain and abroad. According to the authors, child abuse is a global problem and child protection awareness, training, and procedures differ from country to country. They argue that the cultural background of pediatricians likely influences their clinical practice and thresholds. An overview of the research methodology used, which includes a pre-piloted questionnaire sent to 50 junior pediatricians in England who trained overseas, and statistics related to the results of the questionnaire, including the percentage of pediatricians that received child protection training as undergraduates, is presented.

The article reviews Great Britain's child protection training uptake and child protection awareness in a district general hospital and suggests ways to improve this practice. It utilizes the journal articles "What To Do if You Are Worried a Child is Being Abused," from the Department of Health, and "Working Together to Safeguard Children" from the Department of Education and Skills, and discusses how these reports relate to the development of improved staff training opportunities in the hospital. The study revealed that junior hospital staff often had little child protection training.

The article discusses aspects of reducing dog bites in children. Topics include data from the Health and Social Care Information Centre has showed the increase in hospital admissions for dog bites and strikes in Wales and England, the important role of a dog in family life, and a dog safety programme has resulted to an increase in children's ability to determine risk situations involving dogs.

Evaluates the telephone immunization hotline service for health professionals involved in regular vaccination programmes in Great Britain. Enquiries regarding general issues of vaccination; Identification of questions answered quickly; Avoidance of referral to an outpatient clinic in hotline advice.

Background: Many adolescents are having sex and adolescents with life-limiting illnesses are no exception. It is therefore important for health care professionals to take a sexual history and provide advice about sexually transmitted diseases, unintended pregnancies, and ways of reducing high-risk sexual behaviors. Consultations should provide a forum for discussion and education. A literature review revealed no previous studies on this topic. Objective: Our aim was to review medical consultations between adolescents with life-limiting illnesses and pediatricians to establish whether sex was discussed. Methods: The clinical medical notes of 25 adolescents aged 12 to 18 years, under the care of a community team specializing in patients with nonmalignant life-limiting conditions at a District General Hospital in the United Kingdom (UK) were selected at random. Researchers retrospectively reviewed handwritten notes and typed letters in the medical records with a view to establishing whether a sexual history was taken on any occasion. Results: None of the health care professionals took a sexual history from any of the adolescents on any occasion despite multiple clinic attendances. Conclusion: Sexual health is described by the World Health Organization as a basic human right. Clinicians may struggle to accept that adolescents with life-limiting illnesses may want to talk about sex, and this study has highlighted it as a topic that is generally ignored. Health professionals should include sexual health in routine palliative assessments. Adolescents with life-limiting illnesses should not be denied the right to holistic health care. [ABSTRACT FROM AUTHOR]

Objective: To establish what staff support mechanisms are currently in place within children's hospices in the UK looking specifically at 'individual' staff support including mentoring and 'team' staff support including the use of debriefs. Design: A self-administered postal questionnaire study. Setting: Children's hospices in the UK. Main outcome measures: Looking at: use of team meetings; use and content of team debrief; availability of a bereavement counsellor for staff; availability of individual staff mentor and/or clinical supervisor and availability of internal and external training for staff. Results: There was a 76% response rate. Of the hospices that responded 100% of these held team meetings, had access to a bereavement counsellor and 'in house training' and 88% held a debrief after a significant or traumatic event. Conclusions: Looking after staff who care for dying children and their families is a priority. Children's hospices have good support structures in place for staff - the acute sector has much to learn. [ABSTRACT FROM AUTHOR]

Provides information on a study undertaken by psychologists and pediatricians in Great Britain to obtain the views of children, families and staff on what they thought constitutes an ideal hospital ward. Significance of a good adolescent hospital facility; Suggested ward improvements; Attitude of most adolescents toward the issue of food service.

The article reports on the high prevalence of Salmonella infections among infants and children due to exposure to exotic pets such as sugar gliders, hedgehogs and iguanas. Topics discussed include the transmission of Salmonella from reptiles to humans, the results of a study carried out by researcher J. Mermin and colleagues regarding the increasing incidence of reptile-associated salmonellosis in the U.S. and the preventive measures for reptile-associated Salmonella infections.

Surrogate pregnancies are becoming more common, but the law governing who can give consent following surrogate births is complex. Parental responsibility (PR) may be held by a variety of individuals, depending on the specific circumstances.We conducted a survey of paediatric medical staff within Health Education South West to establish knowledge regarding consent for a baby before a parental or adoption order is obtained. Our results showed that 19% of the 47 respondents answered all scenarios correctly. 43% of respondents knew that the surrogate mother had PR in all scenarios; however, 13% incorrectly assumed that either intended parent always had PR. Knowledge of other individuals who could provide consent in the scenarios was variable.Our survey revealed poor understanding regarding medicolegal aspects of consent in these complex situations, emphasising the need for more specific published guidance for primary and secondary healthcare professionals encountering these babies in the early postnatal period., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Competing interests: None declared.

'County lines' is the term used for the proliferating mobile phone lines used by gangs to infiltrate county towns where a profitable drug market is identified. The National Crime Agency reports that 88% of police areas in England and Wales have either an established or emerging County Lines problem in their area. With an estimated 46 053 aged 10-18 years in England in a gang, the activities of gangs and County Lines have a devastating impact on young people, vulnerable adults and local communities. Young people engaged in County Lines activities are at hugely increased risk of child sexual exploitation, criminal conviction, violence, drug addiction and trafficking. It is essential that healthcare staff receive a high standard of training as seen in other organisations and that time is taken to try to identify and intervene with those at risk of gang exploitation at an early stage, to try to prevent significant harm., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Aims: We investigated which patients with heart failure (HF) should receive specialist palliative care (SPC) by first creating a definition of need for SPC in patients hospitalised with HF using patient-reported outcome measures (PROMs) and then testing this definition using the outcome of days alive and out of hospital (DAOH). We also evaluated which baseline variables predicted need for SPC and whether those with this need received SPC., Methods and Results: PROMs assessing quality of life (QoL), symptoms, and mood were administered at baseline and every 4 months. SPC need was defined as persistently severe impairment of any PROM without improvement (or severe impairment immediately preceding death). We then tested whether need for SPC, so defined, was reflected in DAOH, a measure which combines length of stay, days of hospital re-admission, and days lost due to death. Of 272 patients recruited, 74 (27%) met the definition of SPC needs. These patients lived one third fewer DAOH than those without SPC need (and less than a quarter of QoL-adjusted DAOH). A Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score of <29 identified patients who subsequently had SPC needs (area under receiver operating characteristic curve 0.78). Twenty-four per cent of patients with SPC needs actually received SPC (n = 18)., Conclusions: A quarter of patients hospitalised with HF had a need for SPC and were identified by a low KCCQ score on admission. Those with SPC need spent many fewer DAOH and their DAOH were of significantly worse quality. Very few patients with SPC needs accessed SPC services., (© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.)