Congenital heart disease (CHD) is the most common birth defect. Little is known of the impact of having a sibling with CHD. Available literature documents negative impact of having a sibling with other chronic conditions. This literature review considers empirical evidence investigating the impact of having a sibling with CHD. Twelve databases were searched, and 202 articles retrieved. Eleven articles met the inclusion criteria and were subject to data extraction, quality appraisal, and narrative synthesis. Three themes emerged: changes in normal life, impact on siblings, and factors affecting the extent of impact on siblings. Only one intervention study was identified, 5 of 10 studies were conducted over 20 years ago, and only 4 studies included children as participants. Evidence suggests siblings of children with CHD experience adverse life changes which lead to negative impacts in several domains. Evidence is inconclusive regarding mitigating factors of these impacts. Further research is needed to understand the experiences of being a sibling of a child with CHD.

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The principles of minimising harm, and ensuring distributive justice for children should be applied. Most children will recover from COVID-19, but their future will be affected by the socio-economic consequences of the pandemic.Their right to an open future, necessarily entails that their future interests are fully considered.

Purpose To explore siblings' perceptions of having a brother or sister with congenital heart disease in the UK during the COVID-19 pandemic. Design and methods Siblings of children with congenital heart disease aged 8–17 years old were interviewed via video call technology between September 2020 and February 2021. We conducted reflexive thematic analysis of these interviews to generate themes. Findings Interviews took place with 17 siblings, predominantly of white ethnicity n = 15 (86%). Most siblings interviewed were first born in the family n = 15 (88%), and most children with CHD were the youngest n = 15(88%). Four themes were generated; My sibling is vulnerable, what does this mean for my family, I have a responsibility to protect my brother or sister, our family time during the pandemic and adjustment and adaptations to pandemic life. Conclusions Siblings identified difficult aspects of the pandemic and these related to concerns about their brother's or sister's vulnerability, family impact, and keeping their sibling safe. They also identified adjustments they made to keep their family functioning throughout the COVID-19 pandemic. Despite the worry and uncertainty siblings experienced, they valued increased family cohesion which helped to mitigate some challenges of the restrictions imposed in the UK. Practice implications Honest and open communication is valued by siblings. It is vital to ensure siblings receive the support they need to ensure they keep up with their schooling and social commitments as pandemic related restrictions ease.

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BackgroundSocietal use of digital technology rapidly increased during the global Coronavirus disease 2019 pandemic. Face-to-face services converted to online provision, where possible. This affected many clinical academics undertaking research projects. AimThis paper explores conducting online research interviews with children and young people about sensitive topics. DiscussionDigital inclusion, ethical issues surrounding safety, support and consent are considered, along with choice of data collection tools. A discussion on physical proximity in qualitative interviews with this population, and its role in data quality, is presented. Benefits in the context of researcher personal experience are also investigated. Disadvantages of online interviews are acknowledged and ways to mitigate these discussed. ConclusionMany researchers had to adapt data collection methods during the pandemic. Our experiences of conducting virtual interviews during this time are discussed. Advantages for researcher include cost-effectiveness, time efficiency and greater geographical reach of participants. However, children and young people's perspectives are unknown. Specific ethical issues using this method with children and young people need careful consideration Implications for practice More research is required on undertaking virtual interviews from the perspectives of children and young people as participants. Acquisition of virtual consent and assent should be investigated to standardised good research practices.

vitamin K and PIVKAII levels if they consumed a minimum of 200 mls prescribed sip feed or 400-800 mls gastrostomy feed daily.16/16 (100%) patients took a multivitamin/mineral supplement; none contained vitamin K. Summary The prevalence of vitamin K deficiency is 37.5% in this cohort. Patients whom were not consuming gastrostomy/ sip feeds of at least 200 mls daily were at greatest risk of vitamin K deficiency. Patients on a micronutrient supplement remain at risk of vitamin K deficiency, as most contain no vitamin K. Prescribing a vitamin/mineral supplement that contains vitamin K is prudent.12-week supplementation of oral vitamin K (5 mg/day for 1-10 years and 10 mg/day for 12-17 years) adequately improved stores.

Background: Teenagers represent a small proportion of patients on paediatric intensive care units (PICU) in the United Kingdom. During a time when their development is rapidly changing, an admission to PICU causes additional disruption. The impact of critical illness on psychological health after discharge has not been widely reported within this population.Aim and objectives: To measure anxiety that teenagers report 48-96 hours and 4 weeks after discharge from PICU. To explore teenagers' experiences of being admitted onto PICU.Design: Two-phase mixed methods, explanatory sequential design.Methods: This single-site study was conducted between February and July 2018. An NHS Ethics committee approved the study. Teenagers were screened if they were aged 13-18 years old and had an elective or emergency admission to PICU for longer than 24 hours. Hospital Anxiety and Depression Scale, Anxiety subscale (HADS-A) was administered on paper and completed with the researcher present. Semistructured interviews were conducted in-person and over the telephone, audiorecorded and transcribed verbatim. Data were analysed using inductive thematic analysis.Results: Nine of eighteen participants (50%) obtained scores indicating levels of anxiety which were mild (n = 3; 17%), moderate (n = 2; 11%), or severe (n = 4; 22%) 48-96 hours after PICU discharge. Four weeks later, all participants scored below the clinically significant cut-off level for the HADS-A-1 Teenagers described their experiences on PICU within three themes:1. Memories of treatments, side effects, and the PICU environment 2. Losing a sense of self Feeling cared forConclusions: Measured levels of anxiety had resolved in this small sample, 4 weeks after PICU discharge. This finding was not consistent with qualitative data that indicated that many experiences shared by participants were anxiety provoking.