Fifteen-minute consultation: The dizzy child

Vestibular disorders are often overlooked in children and may cause significant morbidity. About a third of children presenting with problems in balance show a vestibular pathology and the overall prevalence of paediatric vertigo is about 5%. Appropriate diagnosis and holistic management can have a significantly positive impact on a child’s quality of life and can be very rewarding. We present a structured approach to the assessment and management of a child presenting with dizziness in a general, non-neurological specialty or community paediatric outpatient setting.

Variation in referrals from primary care to scheduled paediatric services in North and East Scotland -a cross-sectional study

Background Factors contributing to decisions to refer children for scheduled appointments at medical paediatric outpatient clinics are not well understood. Our aim was to describe practice-level characteristics associated with referrals to general paediatric clinics. Methods In this cross-sectional study the setting was general practices in three health boards in Scotland, NHS Grampian, NHS Highland and NHS Tayside The outcome was average annual number of referrals per 1000 children between 2011 and 2017. Univariate and multivariate analyses related the outcome to practice characteristics. For each practice the following characteristics were determined: distance from hospital; area deprivation; number of children registered; presence of ≥ 1 general practitioner with a child health interest and practice ownership. Results There were 62 practices in NHS Grampian, 63 in NHS Highland, and 65 in NHS Tayside; representative annual number of referrals to paediatric clinics per capita were 22, 34, and 35/1000 respectively. In the multivariate model, the number of referrals was inversely related to number of children in the practice (0.8 % fall per 1000 children [95 % confidence interval, CI, 0.5, 1.1]) and was higher from practices in the more deprived areas by a mean 55 % [95 % CI 9, 121] compared to less deprived areas. The number of referrals from a practice rose by 0.91 % [95 % CI 0.86, 0.97] for each additional partner in the practice. Conclusion Some practice-level characteristics were related to the standardised number of referrals, and associations differed between regions.

Patient flow analysis in a children’s clinic

Patient flow analysis was used to assess the waiting time of patients referred to a large paediatric outpatient department, and also the lengths of the consultations of the paediatricians and interns. The average waiting times to see the paediatricians and interns were 77 minutes and 7.8 minutes, respectively. The average lengths of consultation for the paediatricians and interns were 3.4 minutes, and 7.7 minutes, respectively

Exposure and use of digital media among under-five children

Background: The use of digital media, such as television, smart phones, tablets, iPod has become a significant part of children’s lives. Children's exposure to digital media is increasing, as are concerns about the impact that screen time has on children and families. The study evaluates the exposure and use of digital media among under five children.Methods: The study was conducted among mothers of under-five children attending Paediatric outpatient department of a hospital. The sample included 150 mothers of under-five children. A structured questionnaire was used to collect data on selected demographic variables. A modified rating scale was used to elicit data regarding the exposure and use of digital media among under-five children.Results: Around half of children were exposed to smartphones between 1-2 years of age. During infancy around forty percent of children were exposed to smart phones. More than half the mothers used mobile devices while doing household chores. A higher proportion of under five children had increased screen time and large proportion (65.3%) of under-five children had high levels of exposure to digital media.Conclusions: A significant number of under five children were using the digital media and screen time exposure exceeded than that of recommended limit.