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Article: The impact of the COVID-19 pandemic on child health

Nijman, Ruud G.

2021 Volume 45, Issue 6, Page(s) 249

Language	English
Document type	Article
ZDB-ID	2909041-6
ISSN	2567-9430
Database	Current Contents Medicine

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Article ; Online: What does SARS-CoV-2 tell us about the aetiology of environmental triggers for diabetes in children and young people?

Ponmani, Caroline / Lyttle, Mark D / Barrett, Michael / Hulse, Tony / Nijman, Ruud G / Roland, Damian

Acta paediatrica (Oslo, Norway : 1992)

2023 Volume 112, Issue 12, Page(s) 2462–2464

MeSH term(s)	Child ; Humans ; Adolescent ; SARS-CoV-2 ; COVID-19 ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/etiology
Language	English
Publishing date	2023-09-11
Publishing country	Norway
Document type	Journal Article
ZDB-ID	203487-6
ISSN	1651-2227 ; 0365-1436 ; 0803-5253
ISSN (online)	1651-2227
ISSN	0365-1436 ; 0803-5253
DOI	10.1111/apa.16971
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Retrospective analysis of North West London healthcare utilisation by children during the COVID-19 pandemic.

Mongru, Rohan / Rose, Danielle F / Costelloe, Ceire / Cunnington, Aubrey / Nijman, Ruud G

BMJ paediatrics open

2022 Volume 6, Issue 1

Abstract: Objective: To explore the impact of the measures taken to combat COVID-19 on the patterns of acute illness in children presenting to primary and secondary care for North West London.: Design/setting/participants: Retrospective analysis of 8 309 358 ... ...

Abstract	Objective: To explore the impact of the measures taken to combat COVID-19 on the patterns of acute illness in children presenting to primary and secondary care for North West London. Design/setting/participants: Retrospective analysis of 8 309 358 primary and secondary healthcare episodes of children <16 years registered with a North West London primary care practice between 2015 and 2021. Main outcome measures: Numbers of primary care consultations, emergency department (ED) attendances and emergency admissions during the pandemic were compared with those in the preceding 5 years. Trends were examined by age and for International Statistical Classification of Diseases and Related Health Problems 10th Revision-coded diagnoses of: infectious diseases, and injuries and poisonings for admitted children. Results: Comparing 2020 to the 2015-2019 mean, primary care consultations were 22% lower, ED attendances were 38% lower and admissions 35% lower. Following the first national lockdown in April 2020, primary care consultations were 39% lower compared with the April 2015-2019 mean, ED attendances were 72% lower and unscheduled hospital admissions were 63% lower. Admissions >48 hours were on average 13% lower overall during 2020, and 36% lower during April 2020. The reduction in admissions for infections (61% lower than 2015-2019 mean) between April and August 2020 was greater than for injuries (31% lower). Conclusion: The COVID-19 pandemic was associated with an overall reduction in childhood illness presentations to health services in North West London, most prominent during periods of national lockdown, and with a greater impact on infections than injuries. These reductions demonstrate the impact on children of measures taken to combat COVID-19 across the health system.
MeSH term(s)	COVID-19/epidemiology ; Child ; Communicable Disease Control ; Delivery of Health Care ; Humans ; London/epidemiology ; Pandemics ; Patient Acceptance of Health Care ; Retrospective Studies
Language	English
Publishing date	2022-09-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2399-9772
ISSN (online)	2399-9772
DOI	10.1136/bmjpo-2021-001363
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study.

Ponmani, Caroline / Nijman, Ruud G / Roland, Damian / Barrett, Michael / Hulse, Tony / Whittle, Victoria / Lyttle, Mark D

Archives of disease in childhood

2023 Volume 108, Issue 10, Page(s) 799–807

Abstract: Objectives: To describe the incidence of new onset paediatric diabetes mellitus, clinical characteristics and patterns of presentation to emergency departments (ED) during the COVID-19 pandemic, and to assess whether this increase was associated with ... ...

Abstract	Objectives: To describe the incidence of new onset paediatric diabetes mellitus, clinical characteristics and patterns of presentation to emergency departments (ED) during the COVID-19 pandemic, and to assess whether this increase was associated with SARS-CoV-2 infection. Design: Retrospective medical record review. Setting: Forty nine paediatric EDs across the UK and Ireland. Patients: All children aged 6 months to 16 years presenting to EDs with (1) new onset diabetes or (2) pre-existing diabetes with diabetic ketoacidosis (DKA), during the COVID-19 pandemic (1 March 2020-28 February 2021) and the preceding year (1 March 2019-28 February 2020). Results: There were increases in new onset diabetes (1015 to 1183, 17%), compared with background incidence of 3%-5% in the UK over the past 5 years. There were increases in children presenting with new onset diabetes in DKA (395 to 566, 43%), severe DKA (141 to 252, 79%) and admissions to intensive care (38 to 72, 89%). Increased severity was reflected in biochemical and physiological parameters and administration of fluid boluses. Time to presentation from symptom onset for children presenting with new onset diabetes and DKA were similar across both years; healthcare seeking delay did not appear to be the sole contributing factor to DKA during the pandemic. Patterns of presentation changed in the pandemic year and seasonal variation was lost. Children with pre-existing diabetes presented with fewer episodes of decompensation. Conclusions: There were increases in new onset diabetes in children and a higher risk of DKA in the first COVID pandemic year.
MeSH term(s)	Child ; Humans ; Diabetic Ketoacidosis/epidemiology ; Diabetic Ketoacidosis/diagnosis ; COVID-19/complications ; COVID-19/epidemiology ; Pandemics ; Retrospective Studies ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/epidemiology ; Diabetes Mellitus, Type 1/diagnosis ; Ireland/epidemiology ; SARS-CoV-2 ; Emergency Service, Hospital ; United Kingdom/epidemiology
Language	English
Publishing date	2023-05-17
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2022-325280
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Article ; Online: Adoption of C-reactive protein rapid tests for the management of acute childhood infections in hospitals in the Netherlands and England: a comparative health systems analysis.

Dewez, Juan Emmanuel / Nijman, Ruud G / Fitchett, Elizabeth J A / Li, Edmond C / Luu, Queena F / Lynch, Rebecca / Emonts, Marieke / de Groot, Ronald / van der Flier, Michiel / Philipsen, Ria / Ettelt, Stefanie / Yeung, Shunmay

BMC health services research

2024 Volume 24, Issue 1, Page(s) 351

Abstract: Background: The adoption of C-reactive protein point-of-care tests (CRP POCTs) in hospitals varies across Europe. We aimed to understand the factors that contribute to different levels of adoption of CRP POCTs for the management of acute childhood ... ...

Abstract	Background: The adoption of C-reactive protein point-of-care tests (CRP POCTs) in hospitals varies across Europe. We aimed to understand the factors that contribute to different levels of adoption of CRP POCTs for the management of acute childhood infections in two countries. Methods: Comparative qualitative analysis of the implementation of CRP POCTs in the Netherlands and England. The study was informed by the non-adoption, abandonment, spread, scale-up, and sustainability (NASSS) framework. Data were collected through document analysis and qualitative interviews with stakeholders. Documents were identified by a scoping literature review, search of websites, and through the stakeholders. Stakeholders were sampled purposively initially, and then by snowballing. Data were analysed thematically. Results: Forty-one documents resulted from the search and 46 interviews were conducted. Most hospital healthcare workers in the Netherlands were familiar with CRP POCTs as the tests were widely used and trusted in primary care. Moreover, although diagnostics were funded through similar Diagnosis Related Group reimbursement mechanisms in both countries, the actual funding for each hospital was more constrained in England. Compared to primary care, laboratory-based CRP tests were usually available in hospitals and their use was encouraged in both countries because they were cheaper. However, CRP POCTs were perceived as useful in some hospitals of the two countries in which the laboratory could not provide CRP measures 24/7 or within a short timeframe, and/or in emergency departments where expediting patient care was important. Conclusions: CRP POCTs are more available in hospitals in the Netherlands because of the greater familiarity of Dutch healthcare workers with the tests which are widely used in primary care in their country and because there are more funding constraints in England. However, most hospitals in the Netherlands and England have not adopted CRP POCTs because the alternative CRP measurements from the hospital laboratory are available in a few hours and at a lower cost.
MeSH term(s)	Child ; Humans ; Netherlands ; C-Reactive Protein/analysis ; Point-of-Care Testing ; Hospitals ; Systems Analysis
Chemical Substances	C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2024-03-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-024-10698-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Management of Children With Fever at Risk for Pediatric Sepsis: A Prospective Study in Pediatric Emergency Care.

Nijman, Ruud G / Jorgensen, Rikke / Levin, Michael / Herberg, Jethro / Maconochie, Ian K

Frontiers in pediatrics

2020 Volume 8, Page(s) 548154

Abstract: Objective: ...

Abstract	Objective:
Language	English
Publishing date	2020-09-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2020.548154
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Article ; Online: Clinical practice guidelines for acute otitis media in children: a systematic review and appraisal of European national guidelines.

Suzuki, Hijiri G / Dewez, Juan Emmanuel / Nijman, Ruud G / Yeung, Shunmay

BMJ open

2020 Volume 10, Issue 5, Page(s) e035343

Abstract: Objectives: To appraise European guidelines for acute otitis media (AOM) in children, including methodological quality, level of evidence (LoE), astrength of recommendations (SoR), and consideration of antibiotic stewardship.: Design: Systematic ... ...

Abstract	Objectives: To appraise European guidelines for acute otitis media (AOM) in children, including methodological quality, level of evidence (LoE), astrength of recommendations (SoR), and consideration of antibiotic stewardship. Design: Systematic review of the literature. Data sources: Three-pronged search of (1) databases: Medline, Embase, Cochrane library, Guidelines International Network and Trip Medical Database; (2) websites of European national paediatric associations and (3) contact of European experts. Data were collected between January 2017 and February 2018. Eligibility criteria: National guidelines of European countries for the clinical management of AOM in children aged <16 years. Data extraction and synthesis: Data were extracted using tables constructed by the research team. Guidelines were graded using AGREE II criteria. LoE and SoR were compared. Guidelines were assessed for principles of antibiotic stewardship. Results: AOM guidelines were obtained from 17 or the 32 countries in the European Union or European Free Trade Area. The mean AGREE II score was ≤41% across most domains. Diagnosis of AOM was based on similar signs and symptoms. The most common indication for antibiotics was tympanic membrane perforation/otorrhoea (14/15; 93%). The majority (15/17; 88%) recommended a watchful waiting approach to antibiotics. Amoxicillin was the most common first-line antibiotic (14/17; 82%). Recommended treatment duration varied from 5 to 10 days. Seven countries advocated high-dose (75-90 mg/kg/day) and five low-dose (30-60 mg/kg/day) amoxicillin. Less than 60% of guidelines used a national or international scale system to rate level of evidence to support recommendations. Under half of the guidelines (7/17; 41%) referred to country-specific microbiological and antibiotic resistance data. Conclusions: Guidelines for managing AOM were similar across European countries. Guideline quality was mostly weak, and it often did not refer to country-specific antibiotic resistance patterns. Coordinating efforts to produce a core guideline which can then be adapted by each country may help improve overall quality and contribute to tackling antibiotic resistance.
MeSH term(s)	Acute Disease ; Adolescent ; Anti-Bacterial Agents/therapeutic use ; Child ; Child, Preschool ; Europe ; Humans ; Infant ; Infant, Newborn ; Otitis Media/drug therapy ; Practice Guidelines as Topic
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2020-05-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2019-035343
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Clinical practice guidelines for acute otitis media in children

Juan Emmanuel Dewez / Hijiri G Suzuki / Ruud G Nijman

BMJ Open, Vol 10, Iss

a systematic review and appraisal of European national guidelines

2020 Volume 5

Abstract: Objectives To appraise European guidelines for acute otitis media (AOM) in children, including methodological quality, level of evidence (LoE), astrength of recommendations (SoR), and consideration of antibiotic stewardship.Design Systematic review of ... ...

Abstract	Objectives To appraise European guidelines for acute otitis media (AOM) in children, including methodological quality, level of evidence (LoE), astrength of recommendations (SoR), and consideration of antibiotic stewardship.Design Systematic review of the literature.Data sources Three-pronged search of (1) databases: Medline, Embase, Cochrane library, Guidelines International Network and Trip Medical Database; (2) websites of European national paediatric associations and (3) contact of European experts. Data were collected between January 2017 and February 2018.Eligibility criteria National guidelines of European countries for the clinical management of AOM in children aged <16 years.Data extraction and synthesis Data were extracted using tables constructed by the research team. Guidelines were graded using AGREE II criteria. LoE and SoR were compared. Guidelines were assessed for principles of antibiotic stewardship.Results AOM guidelines were obtained from 17 or the 32 countries in the European Union or European Free Trade Area. The mean AGREE II score was ≤41% across most domains. Diagnosis of AOM was based on similar signs and symptoms. The most common indication for antibiotics was tympanic membrane perforation/otorrhoea (14/15; 93%). The majority (15/17; 88%) recommended a watchful waiting approach to antibiotics. Amoxicillin was the most common first-line antibiotic (14/17; 82%). Recommended treatment duration varied from 5 to 10 days. Seven countries advocated high-dose (75–90 mg/kg/day) and five low-dose (30–60 mg/kg/day) amoxicillin. Less than 60% of guidelines used a national or international scale system to rate level of evidence to support recommendations. Under half of the guidelines (7/17; 41%) referred to country-specific microbiological and antibiotic resistance data.Conclusions Guidelines for managing AOM were similar across European countries. Guideline quality was mostly weak, and it often did not refer to country-specific antibiotic resistance patterns. Coordinating efforts to produce a ...
Keywords	Medicine ; R
Subject code	380
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Adoption of C-reactive protein point-of-care tests for the management of acute childhood infections in primary care in the Netherlands and England: a comparative health systems analysis.

Dewez, Juan Emmanuel / Nijman, Ruud G / Fitchett, Elizabeth J A / Lynch, Rebecca / de Groot, Ronald / van der Flier, Michiel / Philipsen, Ria / Vreugdenhil, Harriet / Ettelt, Stefanie / Yeung, Shunmay

BMC health services research

2023 Volume 23, Issue 1, Page(s) 191

Abstract: Background: The use of point of care (POC) tests varies across Europe, but research into what drives this variability is lacking. Focusing on CRP POC tests, we aimed to understand what factors contribute to high versus low adoption of the tests, and ... ...

Abstract	Background: The use of point of care (POC) tests varies across Europe, but research into what drives this variability is lacking. Focusing on CRP POC tests, we aimed to understand what factors contribute to high versus low adoption of the tests, and also to explore whether they are used in children. Methods: We used a comparative qualitative case study approach to explore the implementation of CRP POC tests in the Netherlands and England. These countries were selected because although they have similar primary healthcare systems, the availability of CRP POC tests in General Practices is very different, being very high in the former and rare in the latter. The study design and analysis were informed by the non-adoption, abandonment, spread, scale-up and sustainability (NASSS) framework. Data were collected through a review of documents and interviews with stakeholders. Documents were identified through a scoping literature review, search of websites, and stakeholder recommendation. Stakeholders were selected purposively initially, and then by snowballing. Data were analysed thematically. Results: Sixty-five documents were reviewed and 21 interviews were conducted. The difference in the availability of CRP POC tests is mainly because of differences at the wider national context level. In the two countries, early adopters of the tests advocated for their implementation through the generation of robust evidence and by engaging with all relevant stakeholders. This led to the inclusion of CRP POC tests in clinical guidelines in both countries. In the Netherlands, this mandated their reimbursement in accordance with Dutch regulations. Moreover, the prevailing better integration of health services enabled operational support from laboratories to GP practices. In England, the funding constraints of the National Health Service and the prioritization of alternative and less expensive antimicrobial stewardship interventions prevented the development of a reimbursement scheme. In addition, the lack of integration between health services limits the operational support to GP practices. In both countries, the availability of CRP POC tests for the management of children is a by-product of the test being available for adults. The tests are less used in children mainly because of concerns regarding their accuracy in this age-group. Conclusions: The engagement of early adopters combined with a more favourable and receptive macro level environment, including the role of clinical guidelines and their developers in determining which interventions are reimbursed and the operational support from laboratories to GP practices, led to the greater adoption of the tests in the Netherlands. In both countries, CRP POC tests, when available, are less used less in children. Organisations considering introducing POC tests into primary care settings need to consider how their implementation fits into the wider health system context to ensure achievable plans.
MeSH term(s)	Child ; Humans ; C-Reactive Protein/analysis ; England ; Infections ; Netherlands ; Point-of-Care Systems ; Point-of-Care Testing ; Primary Health Care ; State Medicine ; Systems Analysis
Chemical Substances	C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2023-02-23
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-09065-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Diagnostic accuracy of MRI, CT, and [

Olthof, Ester P / Bergink-Voorthuis, Brenda J / Wenzel, Hans H B / Mongula, Jordy / van der Velden, Jacobus / Spijkerboer, Anje M / Adam, Judit A / Bekkers, Ruud L M / Beltman, Jogchum J / Slangen, Brigitte F M / Nijman, Hans W / Smolders, Ramon G V / van Trommel, Nienke E / Zusterzeel, Petra L M / Zweemer, Ronald P / Stalpers, Lukas J A / Mom, Constantijne H / van der Aa, Maaike A

Insights into imaging

2024 Volume 15, Issue 1, Page(s) 36

Abstract: Objectives: Imaging is increasingly used to assess lymph node involvement in clinically early-stage cervical cancer. This retrospective study aimed to evaluate the diagnostic accuracy of MRI, CT, and [: Methods: Women with International Federation of ...

Abstract	Objectives: Imaging is increasingly used to assess lymph node involvement in clinically early-stage cervical cancer. This retrospective study aimed to evaluate the diagnostic accuracy of MRI, CT, and [ Methods: Women with International Federation of Gynaecology and Obstetrics (FIGO) 2009 stage IA2-IIA cervical cancer and pretreatment imaging between 2009 and 2017 were selected from the Netherlands Cancer Registry. Patient-based and region-based (i.e. pelvic and common iliac) nodal status was extracted from radiology reports. Pathology results were considered the reference standard for calculating accuracy indices. Multiple imputation was used for missing pathology to limit verification bias risk. Results: Nodal assessment was performed in 1676 patients with MRI, 926 with CT, and 379 with [ Conclusions: [ Critical relevance statement: Accurate assessment of the nodal status in clinically early-stage cervical cancer is essential for tumour staging, treatment decision making and prognosis. Key points: • The accuracy of MRI, CT or [
Language	English
Publishing date	2024-02-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2543323-4
ISSN	1869-4101
ISSN	1869-4101
DOI	10.1186/s13244-023-01589-1
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