Our study provides further evidence that the 'clicky hip' referral can represent an underlying diagnosis of DDH and should, in our opinion, always lead to further clinical and radiological assessment. In the absence of universal ultrasound screening, we would encourage individual units to carefully assess their own outcomes and protocols for 'clicky hip' referrals and tailor ongoing service provision to local populations and local referral practices. Cite this article: Bone Joint J 2018;100-B:1249-52.
Introduction In 2014 our centre started a dedicated clinic for developmental dysplasia of the hip (DDH). The aim of the clinic was to streamline DDH referrals, enabling timely review, imaging and multidisciplinary treatment. Ongoing audit has been carried out based on the UK National Screening Committee newborn and infant physical examination (NIPE) guidelines, first published in 2008. Methods A three-year prospective audit was undertaken between 2014 and 2016 assessing compliance with NIPE standards (ST2b and ST2d) relating to timeliness of expert consultation following positive ultrasonography findings of DDH with positive examination or risk factors. Results A total of 257 babies born between January 2014 and December 2016 were seen in our dedicated DDH clinic, with 106 with abnormalities on ultrasonography and 54 requiring treatment. Compliance with 'expert consultation within 4 weeks of age for babies with an abnormality detected on clinical examination and positive ultrasonography' improved from 50% in 2014 to 53% in 2015 and 71% in 2016. Compliance with 'expert consultation within 8 weeks of age for babies with positive risk factors, negative examination and positive ultrasonography' improved from 65% in 2014 to 93% in 2015 and 100% in 2016. Conclusions This prospective audit assessing timeliness of expert consultation has demonstrated ongoing improvements between 2014 and 2016. A greater proportion of babies with ultrasonography evidence of DDH have been seen at the appropriate time. In the majority of cases, this has enabled timely non-invasive treatment with a Pavlik harness rather than surgery.
Creating and cultivating inclusive spaces for learning is paramount. It is the authors' belief that higher education faculty possesses the sole responsibility to intentionally make space for the inclusion of linguistic differences, especially in language learning environments. This chapter is built on the premise that all students can meaningfully contribute, learn, and succeed. Tapping into the notion of funds of knowledge sets the foundation that all students bring something unique and valuable to the learning space. In thinking about the learning environment and space as a collaboration, the authors redefine and reimagine what learning could look, feel, and be like. Therefore, this chapter marries theory with practice in supporting all students in meeting their goals and achieving success. This chapter explores techniques, approaches, and lived experiences of Black educators with collectively over 40 years of experience. In sharing this wisdom and understanding, the chapter will explore relevant challenges and obstacles within language learning environments.
BackgroundIn 2013, Child Health Reviews-UK recommended the introduction of epilepsy passports to improve communication and reduce morbidity and mortality associated with epilepsy. Since their introduction by the RCPCH in September 2015, epilepsy passports have yet to be evaluated.Aims1) To assess the need for epilepsy passports2) to evaluate staff and parents’ views on the usage and usefulness of the passportsMethodsPatients with an existing diagnosis of epilepsy attending a busy district general hospital in 2016 were offered passports and inclusion in the study. Staff and parents’ experience was assessed between January to April 2016 using questionnaires. All parents whose children had been newly given an epilepsy passport during the study period were asked for their opinion.Results121 attendances for epileptic seizures in children under 16 were recorded in 2015 with 22 children attending more than once and 1 child visiting 8 times. Only half the attendances resulted in admission indicating a need for education on managing short epileptic seizures at home.13 A and E staff members completed the questionnaire. All found epilepsy passports useful, particularly in cases with a language barrier or previous adverse drug reaction.11 parents were recruited for the study whose child did not previously have an epilepsy passport. All wanted a passport and thought it would help communication between themselves and healthcare professionals. English was not the first language for one family who felt it would be useful to communicate drug dosages and information on their child’s other diagnoses. 9 parents completed the follow-up questionnaire, 3 of which used their passport during the study period. The 3 that used them found them useful to communicate with the paramedics and doctors attending to their child, the other 6 stated they felt more confident just having the passport.ConclusionThese findings have implications for practice, as all hospitals should be aware of the reassurance and help epilepsy passports can bring. A longer, more quantitative study should be carried out to assess whether the passports are actually reducing A and E attendances, or time spent in A and E, as well as increasing parents’ confidence in their children’s care.
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