Adults' efforts to limit their children's intake of sweet snacks and drinks are being undermined by earlier and earlier influences in the child's life and by access to money, which allows the child to out-manoeuvre his or her parents. This is compounded by the provision of additional income, mostly from grandparents.

Background There is evidence to suggest that the family is becoming a more democratic unit and that the ability of children to influence adult decision-making processes should not be underestimated. A study was undertaken to investigate whether children can influence adult decision- making in relation to the use of sugary snacks. Method A cross-sectional interview study; children aged 7-8 years from twenty inner-city Manchester primary schools were interviewed about their pocket money and their perceived levels of influence on the consumption of sugary snacks within their household. Twelve of the questions were scored '1' if the child answered 'yes' (denoting that the child usually got his/her own way) or 'zero' for 'no' (denoting that the child believed the adult was in control). This was reported as the child's influence score within a range of 0-12. Results The mean influence score for the group ( n=340) was 4.7 and was independent of the child's gender, ethnicity or number of children in the family. Sixty-eight per cent ( n=232) of the children reported that they usually received sweet items whenever they asked for them. Sixty-three per cent ( n=215) of the children admitted to pestering their parents when greeted with a 'no' response, with nearly two-thirds of the 'pesterers' reporting a successful outcome. Evidence of the children's autonomy was shown by nearly three-quarters of the group stating that they received pocket money. Conclusions In this study, adults' efforts to limit their children's intake of cariogenic food/drink are being undermined by children having an increased degree of freedom either to make or influence decisions particularly about sweet snacks.

Background The widely automated method using indirect ion specific electrodes (ISE) potentiometry for determination of sodium concentration is prone to interference from lipaemia. Manufacturer-specified lipaemic (L)-index cut offs may underestimate the effects of endogenous lipaemia. Methods We assessed the interference on sodium concentration caused by endogenous lipaemia in 32 residual samples (from 13 patients) using indirect ISE (Cobas® 8000 modular analyser with c702 module, Roche diagnostics) and direct ISE (GEM 4000 premier, Werfen) potentiometric methods. Regression analysis (linear and non-linear) was used to determine a reliable (L)-index cut off for reporting sodium concentration. Results There was a poor correlation observed between triglyceride concentration and (L)-index. There was significant negative interference caused by endogenous lipaemia within analysed samples. Non-linear regression demonstrated a negative interference of approximately 5% at an (L)-index of 250. Conclusion At present the manufacturer advises not to report sodium concentration by indirect ISE on the Cobas® 8000 modular analyser if the (L)-index is> 2000. However this has been determined by the addition of exogenous lipids (Intralipid®) and it is clear that this is not comparable to endogenous lipaemia. To ensure patient safety, clinical laboratories should consider lowering the cut off for (L)-index that they use for reporting sodium concentration.

Background and aims: This qualitative project sought to evaluate the FreeStyle Libre flash glucose monitor (FSLFGM) from the perspective of patients of an outpatient diabetes clinic. The aim was to evaluate patients’ experience of the device, and based thereon to create a brief assessment pro-forma for routine clinic use to justify continued prescription.Method: A purposive sample was recruited. Telephone interviews were conducted until saturation was achieved. A total of 10 patients were interviewed using a flexible topic guide created in collaboration with the multidisciplinary diabetes team and a consultative panel of people with diabetes. Thematic analysis was used to analyse the interviews.Results and conclusions: Four superordinate themes, along with subordinate themes, were identified and triangulated by members of the multidisciplinary diabetes team: (1) checking bloods; (2) freedom; (3) impact on others; and (4) perceived disadvantages. Overall, patients reported a strongly positive experience of using the FSLGM, with all expressing a desire to continue use. Using these themes, a brief pro-forma was created for use in review clinics to facilitate discussion and to support decision-making about continued prescription.