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摘要： Introduction It is the greatest honour of my career to stand before you in the presidential poncho for this, the 46th Annual Meeting of the International Society for Paediatric Neurosurgery. I would like to start by thanking you all for being here, and thank our host and Annual Meeting Chair, Professor Shlomi Constantini and the local organizing committee, as well as our Scientific Chair, Professor Anthony Figaji (Tony) and the ISPN scientific committee. It is a big enough task to put together a meeting such as this, made even more challenging by the record number of abstracts received this year, but they have given us a program that showcases our specialty at its finest, so please join me in congratulating them for a job very well done. A special thank you to Tony for his warm and generous introduction, it has been a joy to transition from your teacher to mentor and friend and watch your career develop, and I cannot tell you how much it meant to hear your words today. As you said,... This is a preview of subscription content, log in to check *** AcknowledgementsI would like to thank the members of the ISPN for the honour of serving as your president, and my colleagues on the Executive Board for their contributions over the past year. Thank you to Dr. David Roytowski for introducing me to the concept of the value proposition, to Dr. Nelleke Langerak for the assistance with Fig. 8, and to Professor Matthew Wood for his thought-provoking discussions. I would like to acknowledge my colleagues in Cape Town and above all, Karen for your faith in Africa and setting the example as the finest children’s doctor I know, and my family for your constant *** address is dedicated to the memory of my colleague and friend, the late Professor Bongani Mayosi, Dean of the Faculty of Health Sciences, who devoted his life to improving the lives of all Africans through *** with ethical standardsConflict of interestThe author declares no conflict of intere

关键词： Donation after circulatory death (DCD)   Nursing attitudes   Nursing knowledge   Organ and tissue donation   Paediatric Intensive Care Unit (PICU)   Qualitative research  

摘要： Objective: This study explored nurses' knowledge, attitudes and feelings towards donation after circulatory death identifying these domains as barriers and facilitators to nurses effectively undertaking their role in the donation after circulatory death donation process. Design: A single-phase qualitative study design. Setting: One paediatric cardiac intensive care unit in a tertiary paediatric hospital in England. Methods: Data was collected from eight paediatric cardiac intensive care nurses using semi-structured face to face or telephone interviews facilitated by a clinical vignette. Qualitative content analysis was undertaken adopting both inductive and deductive lenses. Key findings: Three categories were deductively generated within which eleven inductively generated themes were situated. Barriers included: knowledge deficits of both process and resources;assumptions about parental views and reluctance to facilitate sensitive discussions, facilitators included positive attitudes toward donation aligned with a strong professional ethos and family-centred values. Conclusions: The paper identifies barriers to the donation after circulatory death process including nurses feeling unprepared for their role, anxiety over family approach and communication methods and support. Highlighted is the need for specific educational interventions, appropriate resources and development of paediatric focussed policy to guide practice. Facilitators to donation include timely, sensitive and appropriate family discussions, trusting nurse-family relationships and improved public awareness. (C) 2019 Elsevier Ltd. All rights reserved.

关键词： Steps   reporting   Pediatrics  

摘要： This commentary is on the original article by van Karnebeek et al. on pages 1208‐1213 of this issue.

关键词： childhood   efficacy   haemolytic anaemia   renal disease   safety  

摘要： AimAtypical haemolytic uraemic syndrome (aHUS) is a debilitating condition that can cause significant morbidity and mortality in children if not adequately and promptly treated. This report shares real-world data on the use of eculizumab in children with aHUS. MethodsWe report our experience with the use of eculizumab in 14 children with aHUS. ResultsThe median age at aHUS diagnosis was 12months (range: 2-108months), with six (42.9%) patients presenting in infancy and six (42.9%) being males. Eculizumab therapy was associated with haematological and thrombotic microangiopathy responses in 14 (100%) and 13 (92.9%) patients after a median of 9days (range: 7-12days) and 9.5days (range: 7-14days), respectively. None of the six patients who were previously treated with plasma therapy required any further infusions. Of the six patients who previously required dialysis, only one patient continued to do so and eventually received a renal transplant. The median time to >= 25% decrease in serum creatinine level in the remaining patients was 16days (range: 14-21days), and estimated glomerular filtration rate increased from a median of 17-101mL/min/1.73m(2). The safety profile was similar to that reported in the literature, and 10 patients continue to receive therapy, with 3 being on the drug for 4 or more years. ConclusionOur study adds to the growing body of evidence highlighting the efficacy and safety of eculizumab for the management of children with aHUS.

关键词： Mesoeuropean landscape "plus"   Morphodynamic classification scheme   Weathering   Physical-chemical regime   NW Morocco  

摘要： The origin of the landscape spreading across NW Morocco (Meseta, Atlas Mts. Foreland) is geodynamically controlled by two collisional and one extensional regime, while climate changes had only a minor impact on the shaping the landscape. The existing landscape pertains to the series characterized by highly to partially eroded mountain blocks of Paleozoic and Early Mesozoic age which is represented at its best by the relics of the Variscan orogeny resultant in what is called "Mesoeurope". The Mesoeuropean landscape in Morocco is described by four morphodynamic units. MD 1 (0.4-1.8 Ma/generation 3) has brought about landforms in a fluvial (-alluvial) depositional environment with a strong aeolian influence at its margins. Its drainage patterns feature a moderate to gentle dip of the palaeo-current with a predominantly meandering depositional regime. The major minerals are quartz, calcite, smectite, and smectite-illite mixed-layers (submature landscape). MD 2 (2.0-3.0 Ma/generation 2) involves coastal-marine processes of a microtidal environment. Only quartz warrants mentioning as major constituent (supermature landscape). MD 3 (Neogene/generation 1) is the core zone with extensive planation and chemical weathering which gave rise to amorphous silica and smectite-group minerals (mature landscape). MD 4 (Quaternary/generation 4) encompasses landforms typical of alluvial-fluvial environments evolving under a moderate to strong palaeo-current in the foothills of the Atlas Mts. Aside of quartz, calcite, chlorite, muscovite, illite, and feldspar, labile heavy minerals are as widespread as the calcitic carbocretes. Modern structural disturbances are accountable for the immature landforms and high preservation potential of labile mineral constituents. A morphodynamic comparison between the reference type of "Mesoeurope" and the current morphodynamic type under study in Morocco results into a binary classification scheme encompassing two phases, an older one called phase of pl

关键词： Encephalitis   Parenting behavior   Schools   Children   Etiology   Pediatrics   Child health   Human families  

摘要： Background Encephalitis, characterised as inflammation of the brain tissue, is an important cause of acquired brain injury in children. Objective clinical outcomes vary significantly between affected patients, however they do not always correlate with quality of life as reported by parents. The aim of this study was to explore how parents experience and interpret outcomes in relation to their child who has been affected by encephalitis. Methods Data were derived from in-depth, semi-structured interviews, with 15 parents of 12 children and young people affected by encephalitis. Paediatric cases were identified from the retrospective arm of the research programme 'ENCEPH-UK-Understanding and Improving the Outcome of Encephalitis', and from the prospective UK childhood meningitis and encephalitis cohort study (UK-ChiMES, 2012 to 2016). Data were analysed thematically. Results Parents' perspectives on important outcomes for their child and family changed during the different stages of the encephalitis illness trajectory: from acute illness, recovery and rehabilitation, then reintegration into everyday life. Parents' understanding of their children's overall outcome was informed by their own experiences, involving comparisons with other children and reflections on their child's problems before, during and after the acute illness. Conclusion Outcomes in paediatric encephalitis need to be understood in terms of the context of the patient and family experience as well as the timeframe of recovery. The research highlights the need to include more patient, parent and/or carer reported outcome measures during patient assessment, and that assessment should be repeated during recovery as family concerns change. In the longer term, these parameters could be included in clinical and rehabilitation practice to further support child recovery.

关键词： Touch   sensation   measurement   physiotherapist   occupational therapist  

摘要： Background: Tactile impairments are common in children with cerebral palsy (CP), however assessment is not routinely carried out by therapists. We investigated a multi-faceted Knowledge Translation intervention to improve Knowledge, remove Barriers and enhance Practice of tactile assessments by paediatric therapists. Method: Twelve therapists from a state-wide service for children with CP (seven physiotherapists, five occupational therapists;12 female) received: written information, demonstration videos, a face-to-face workshop, equipment provision, and on-call mentoring. Therapists completed pre-post-intervention questionnaires reporting their perceived tactile assessment Knowledge, current Practices and implementation Barriers. Results: Following intervention, therapists improved Knowledge of correct (1) tactile impairment prevalence in children with CP (pre 3/12;post 9/12), (2) tactile assessment items (e.g. Registration - pre 1/12;post 9/12;Localisation - pre 2/12;post 10/12), and (3) equipment choice (e.g. Monofilaments - pre 1/12;post 10/12). Tactile assessment Practice improved slightly. All major clinician-level implementation Barriers were resolved and less obvious organisational-level Barriers were identified for follow-up. Conclusion: A 12-month multi-faceted Knowledge Translation intervention can improve tactile assessment Knowledge, resolve major clinician-level implementation Barriers, and identify less obvious organisational-level Barriers to be addressed to achieve maximum Practice improvement. Ongoing multi-faceted knowledge translation processes are essential for high-performing organisations.