Size and Taste Matters: Recent Progress in the Development of Age-Appropriate Medicines for Children

2017 ◽  
Vol 32 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Michael Rieder
Keyword(s):  
Recent Progress ◽  
Age Appropriate ◽  
Medicines For Children

scholarly journals WHO essential medicines for children 2011–2019: age-appropriateness of enteral formulations

2021 ◽  
pp. archdischild-2021-321831
Author(s):  
Ebiowei Samuel F Orubu ◽  
Jennifer Duncan ◽  
Catherine Tuleu ◽  
Mark A Turner ◽  
Anthony Nunn
Keyword(s):  
Age Groups ◽  
Essential Medicine ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Older Children ◽  
Efficacy Evaluation ◽  
7Th Edition ◽  
Age Related ◽  
Age Appropriate ◽  
Medicines For Children

IntroductionThe WHO Essential Medicine List for children (EMLc) is used for promoting access to medicines. The age-appropriateness of enteral (oral and rectal) formulations for children depend on their adaptability/flexibility to allow age-related or weight-related doses to be administered/prescribed and the child’s ability to swallow, as appropriate. There is scant information on the age-appropriateness of essential enteral medicines for children.ObjectiveTo evaluate the age-appropriateness of enteral essential medicines.Materials and methodsAge-appropriateness of all enteral formulations indicated and recommended in the EMLc 3rd to 7th (2011–2019) editions were determined by assessing swallowability and/or dose adaptability for children under 12 years, stratified into five age groups.ResultsEnteral formulations in the EMLc were more age-appropriate for older children aged 6–11 years than for younger children. In the 3rd edition, for older children, 77%, n=342, of formulations were age-appropriate. For younger children, age-appropriateness decreased with age group: 34% in those aged 3–5 years, 30% in those aged 1–2 years, 22% among those aged 28 days to 11 months and 15% in those aged 0–27 days. Overall, similar proportions were found for the 7th edition. In contrast, the majority of medicines in the 7th list were age-appropriate in targeted diseases like HIV and tuberculosis.ConclusionMost recommended enteral essential medicines in EMLc 2011 and 2019 were not age-appropriate for children <6 years. Medicines which are not age-appropriate must be manipulated before administration, leading to potential issues of safety and efficacy. Evaluation of the age-appropriateness of formulations for medicines to be included in EMLc could improve access to better medicines for children in the future.

scholarly journals Are age-appropriate antibiotic formulations missing from the WHO list of essential medicines for children? A comparison study

2017 ◽  
Vol 102 (4) ◽  
pp. 352-356
Author(s):  
Verica Ivanovska ◽  
Hubert G Leufkens ◽  
Carin MA Rademaker ◽  
Elizabeta Zisovska ◽  
Mariëlle W Pijnenburg ◽  
...  
Keyword(s):  
Essential Medicines ◽  
Administration Routes ◽  
Area Of Interest ◽  
Oral Formulations ◽  
Clinical Benefits ◽  
Age Appropriate ◽  
Therapeutic Needs ◽  
Medicines For Children ◽  
Dosing Accuracy ◽  
Weight Groups

ObjectiveThere is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of antibiotics listed on pertinent formularies that were not on the WHO Essential Medicines List for Children (EMLc).MethodsWe compared four medicines lists versus the EMLc and contrasted paediatric antibiotic formulations in relation to administration routes, dosage forms and/or drug strengths. The additional formulations on comparator lists that differed from the EMLc formulations were evaluated for their added clinical values and costs.ResultsThe analysis was based on 26 EMLc antibiotics. Seven oral and two parenteral formulations were considered clinically relevant for paediatric use. Frequently quoted benefits of oral formulations included: filling the gap of unmet therapeutic needs in certain age/weight groups (phenoxymethylpenicillin and metronidazole oral liquids, and nitrofurantoin capsules), and simplified administration and supply advantages (amoxicillin dispersible tablets, clyndamycin capsules, cloxacillin tablets, and sulfamethoxazole+trimethoprim tablets). Lower doses of ampicillin and cefazolin powder for injection could simplify the dosing in newborns and infants, reduce the risk of medical errors, and decrease the waste of medicines, but may target only narrow age/weight groups.ConclusionsThe identified additional formulations of paediatric antibiotics on comparator lists may offer clinical benefits for low-resource settings, including simplified administration and increased dosing accuracy. The complexity of both procuring and managing multiple strengths and formulations also needs to be considered.

scholarly journals Availability of Authorizations from EMA and FDA for Age-Appropriate Medicines Contained in the WHO Essential Medicines List for Children 2019

Pharmaceutics ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 316 ◽  
Author(s):  
Jose-Manuel delMoral-Sanchez ◽  
Isabel Gonzalez-Alvarez ◽  
Marta Gonzalez-Alvarez ◽  
Andres Navarro-Ruiz ◽  
Marival Bermejo
Keyword(s):  
Drug Product ◽  
Essential Medicines ◽  
World Health ◽  
European Medicines Agency ◽  
Drug Products ◽  
United States Food ◽  
Age Appropriate ◽  
States Food ◽  
Health Organization ◽  
Medicines For Children

Lack of age-appropriate commercially drug products availability is a common problem in pediatric therapeutics; this population needs improved and safer drug delivery. In addition, biopharmaceutic aspects, dosage requirements, and swallowing abilities demand pediatric forms different to adult formulations. The objective of this study was to evaluate the authorization availability from United States Food and Drug Administration (FDA) and European Medicines Agency (EMA) of oral essential medicines for children and analyze its age-appropriateness for oral administration in children. All oral drugs from 7th List of Essential Medicines for Children by World Health Organization (WHO) were selected. Availability of commercial drug products was collected from OrangeBook, Spanish drug product catalogue, British electronic Medicines Compendium, and the International Vademecum. Tablets, effervescent tablets, and capsules were considered as not age-appropriate forms. Liquid forms, powder for oral suspension, mini tablets, granules, and soluble films were considered as age-appropriate forms due to their flexibility. More than 80% of the studied drugs possess a commercial authorization in oral forms in both EMA and FDA. Nevertheless, around 50% of these formulations are not age-appropriate for most pediatric groups. This study shows the lack of age-appropriate medicines for children. More efforts are needed to improve development and approval of pediatric medicines.

Electron-Mirror Microscopic Aspects of Ferroelectric Domains of BaTiO3 And Ca2Sr (C2H5CO2)6

1970 ◽  
Vol 28 ◽  
pp. 478-479
Author(s):  
Teruo Someya ◽  
Jinzo Kobayashi
Keyword(s):  
Surface Layer ◽  
Electric Fields ◽  
Quantitative Study ◽  
Recent Progress ◽  
Ferroelectric Domain ◽  
Resolving Power ◽  
Surface Pattern ◽  
Crystal Surfaces ◽  
One Dimensional ◽  
Ferroelectric Domains

Recent progress in the electron-mirror microscopy (EMM), e.g., an improvement of its resolving power together with an increase of the magnification makes it useful for investigating the ferroelectric domain physics. English has recently observed the domain texture in the surface layer of BaTiO3. The present authors ) have developed a theory by which one can evaluate small one-dimensional electric fields and/or topographic step heights in the crystal surfaces from their EMM pictures. This theory was applied to a quantitative study of the surface pattern of BaTiO3).

The Nature of Oxide Surfaces: Topographic and Electronic Structure

1993 ◽  
Vol 51 ◽  
pp. 966-967
Author(s):  
Dawn A. Bonnell ◽  
Yong Liang
Keyword(s):  
Transition Metal Oxides ◽  
Electronic Structures ◽  
Recent Progress ◽  
Spatial Localization ◽  
Level Of Detail ◽  
Scanning Tunneling ◽  
Oxide Surfaces ◽  
Tunneling Microscopy ◽  
Considerable Effort ◽  
Complete Understanding

Recent progress in the application of scanning tunneling microscopy (STM) and tunneling spectroscopy (STS) to oxide surfaces has allowed issues of image formation mechanism and spatial resolution limitations to be addressed. As the STM analyses of oxide surfaces continues, it is becoming clear that the geometric and electronic structures of these surfaces are intrinsically complex. Since STM requires conductivity, the oxides in question are transition metal oxides that accommodate aliovalent dopants or nonstoichiometry to produce mobile carriers. To date, considerable effort has been directed toward probing the structures and reactivities of ZnO polar and nonpolar surfaces, TiO2 (110) and (001) surfaces and the SrTiO3 (001) surface, with a view towards integrating these results with the vast amount of previous surface analysis (LEED and photoemission) to build a more complete understanding of these surfaces. However, the spatial localization of the STM/STS provides a level of detail that leads to conclusions somewhat different from those made earlier.

Reliability of Clinician Judgments of Severity of Phonological Impairment

1995 ◽  
Vol 4 (3) ◽  
pp. 39-46 ◽  
Author(s):  
Susan K. Rafaat ◽  
Susan Rvachew ◽  
Rebecca S. C. Russell
Keyword(s):  
Conversational Speech ◽  
Speech Language Pathologists ◽  
Age Appropriate ◽  
Citation Form ◽  
Phonological Abilities ◽  
Preschool Aged Children

Pairs of speech-language pathologists independently rated severity of phonological impairment for 45 preschoolers, aged 30 to 65 months. Children were rated along a continuum from normal to profound. In addition to judging overall severity of impairment, the clinicians provided separate ratings based on citation form and conversational samples. A judgment of intelligibility of conversational speech was also required. Results indicated that interclinician reliability was adequate (80% agreement) for older preschool-aged children (4-1/2 years and above) but that judgments by speechlanguage pathologists were not sufficiently reliable for children under 3-1/2 years of age 40% agreement). Children judged to have age appropriate phonological abilities were not clearly distinguishable from children judged to have a mild delay. Educating speech-language pathologists regarding the normative phonological data that are available with respect to young preschoolers, and ensuring that such data are readily accessible for assessment purposes, is required.

Effects of Fundamental Frequency Contours on Sentence Recognition in Mandarin-Speaking Children With Cochlear Implants

2020 ◽  
Vol 63 (11) ◽  
pp. 3855-3864
Author(s):  
Wanting Huang ◽  
Lena L. N. Wong ◽  
Fei Chen ◽  
Haihong Liu ◽  
Wei Liang
Keyword(s):  
Cochlear Implants ◽  
Fundamental Frequency ◽  
Signal To Noise Ratio ◽  
Lexical Tone ◽  
Signal To Noise ◽  
Sentence Recognition ◽  
Test Conditions ◽  
Age Appropriate ◽  
F0 Contour ◽  
Appropriate Sentences

Purpose Fundamental frequency (F0) is the primary acoustic cue for lexical tone perception in tonal languages but is processed in a limited way in cochlear implant (CI) systems. The aim of this study was to evaluate the importance of F0 contours in sentence recognition in Mandarin-speaking children with CIs and find out whether it is similar to/different from that in age-matched normal-hearing (NH) peers. Method Age-appropriate sentences, with F0 contours manipulated to be either natural or flattened, were randomly presented to preschool children with CIs and their age-matched peers with NH under three test conditions: in quiet, in white noise, and with competing sentences at 0 dB signal-to-noise ratio. Results The neutralization of F0 contours resulted in a significant reduction in sentence recognition. While this was seen only in noise conditions among NH children, it was observed throughout all test conditions among children with CIs. Moreover, the F0 contour-induced accuracy reduction ratios (i.e., the reduction in sentence recognition resulting from the neutralization of F0 contours compared to the normal F0 condition) were significantly greater in children with CIs than in NH children in all test conditions. Conclusions F0 contours play a major role in sentence recognition in both quiet and noise among pediatric implantees, and the contribution of the F0 contour is even more salient than that in age-matched NH children. These results also suggest that there may be differences between children with CIs and NH children in how F0 contours are processed.

After Dismissal: Examining the Language, Literacy, and Cognitive Skills of Children With Remediated Speech Sound Disorders

2015 ◽  
Vol 16 (2) ◽  
pp. 50-59 ◽  
Author(s):  
Kelly Farquharson
Keyword(s):  
Public Schools ◽  
Speech Production ◽  
Cognitive Skills ◽  
Speech Sound ◽  
Typically Developing ◽  
Speech Sound Disorders ◽  
Academic Difficulties ◽  
The Public ◽  
Age Appropriate ◽  
Language Literacy

Speech sound disorders are a complex and often persistent disorder in young children. For many children, therapy results in successful remediation of the errored productions as well as age-appropriate literacy and academic progress. However, for some children, while they may attain age-appropriate speech production skills, they later have academic difficulties. For SLPs in the public schools, these children present as challenging in terms of both continuing treatment as well as in terms of caseload management. What happens after dismissal? Have these children truly acquired adequate speech production skills? Do they have lingering language, literacy, and cognitive deficits? The purpose of this article is to describe the language, literacy, and cognitive features of a small group of children with remediated speech sound disorders compared to their typically developing peers.

Age-Appropriate Restraints Save Lives in Wrecks

2006 ◽  
Vol 40 (7) ◽  
pp. 38
Author(s):  
NANCY NICKELL
Keyword(s):  
Age Appropriate
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