BackgroundDiagnosis of life threatening childhood illness or injury can lead to significant distress reactions in parents, with many experiencing clinically significant levels of post-traumatic stress symptoms. These symptoms can have long-term adverse impacts on parent mental health, family functioning, and the adjustment of the ill child. Independent studies have found such reactions in several different illness groups. However, very little research has systematically compared the prevalence, impact and trajectories over time of post-traumatic stress symptoms in parents across different childhood illness groups with an acute life threat. The current study seeks to map the course of post-traumatic stress reactions in parents of children with various life threatening illnesses over an 18 month period, and identify factors that predict successful adaptation in families.Method/DesignThe current study described is of a prospective, longitudinal design. The sample included parents of children admitted to four major hospital departments at the Royal Children’s Hospital, Melbourne, Australia, for a life threatening illness or injury. Eligible parents were those who were caregivers of children aged 0-to 18-years admitted to the Oncology, Cardiology, Neurology and Pediatric Intensive Care Unit. Parents were recruited acutely, and completed self-report questionnaires at four time-points: within the first 4 weeks (T1:); then at 4 months (T2); 7 months (T3); and 19 months (T4) after admission. Questionnaires assessed parent and child mental health and wellbeing, and a number of risk and reliance factors such child illness factors, parent demographic factors, and psychosocial factors.DiscussionThis study is one of the first to document the trajectory of post-traumatic stress responses in parents of very ill children, across illness groups. Given that it will also identify risk and resilience factors, and map the course of parent outcomes over an 18 monthperiod, it has the potential to inform novel strategies for intervention.

1indicate that 19% of Canadians (4.6 million people) have hypertension. Worldwide, over 54% of stroke, 47% of ischemic heart disease and 13.5% of all deaths are because of high blood pressure. [2][3][4] Blood pressure measurement is one of the most commonly performed tests in family practice. However, because of the inherent variability 5 of blood pressure, issues about where, by whom and how it is measured are of paramount importance. Accuracy can be affected by factors such as equipment, patient or operator variability, white-coat hypertension, masked hypertension, night-time dippers (hypertensive patients who display nocturnal decreases in blood pressure) versus nondippers and intervisit variability and episodic peaks. The importance of the accurate measurement of blood pressure is underscored by the fact that reductions in systolic blood pressure of more than 5 mm Hg, or even as small as 2-4 mm Hg, are clinically important. 6 The average effect on blood pressure of a single antihypertensive drug at a standard dose or a single lifestyle change can be as high as 10 mm Hg systolic and 6 mm Hg diastolic. 7,8The end result is that the measurement error frequently exceeds the effect size of therapy or lifestyle modification.Because community pharmacies are frequently visited by patients and because pharmacists are encouraged to monitorComparison of blood pressure measurements using an automated blood pressure device in community pharmacies and family physicians' offices: a randomized controlled trial Background: Accurate measurement of blood pressure is the foundation of appropriate diagnosis, treatment and ongoing management of hypertension. The use of automated blood pressure devices in community settings such as pharmacies provide opportunities for additional blood pressure measurement; however, it is important to ensure that these measurements are comparable to those taken in physicians' offices using the same devices. We conducted a randomized controlled trial to assess whether blood pressure readings assessed by use of an automated device differed according to the setting, specifically in community pharmacies and family physicians' offices.

This study provides promising support for the PAT as a psychosocial screener for families of infants and older children across illness conditions.

Objective Paediatric status epilepticus (SE) has potential for long‐term sequelae. Existing data demonstrate delays to aspects of care. The objective of the present study was to examine the feasibility of collecting data on children with paediatric SE and describe current management strategies in pre‐hospital and in‐hospital settings. Methods A pilot, prospective, observational cohort study of children 4 weeks to 16 years of age with SE, in four EDs in Australia. Clinical details including medications administered, duration of seizure and short‐term outcomes were collected. Follow up occurred by telephone at 1 month. Results We enrolled 167 children with SE. Mean age was 5.4 years (standard deviation [SD] 4.1), and 81 (49%) male. Median seizure duration was 10 min (interquartile range 7–30). Midazolam was the first medication administered in 87/100 (87%) instances, mean dose of 0.21 mg/kg (SD 0.13). The dose of midazolam was adequate in 30 (35%), high (>0.2 mg/kg) in 44 (51%) and low (<0.1 mg/kg) in 13 (15%). For second‐line agents, levetiracetam was administered on 33/55 (60%) occasions, whereas phenytoin and phenobarbitone were administered on 11/55 (20%) occasions each. Mean dose of levetiracetam was 26.4 mg/kg (SD 13.5). One hundred and four (62%) patients were admitted to hospital, with 13 (8%) admitted to ICU and seven (4%) intubated. Conclusion In children presenting with SE in Australia medical management differed from previous reports, with midazolam as the preferred benzodiazepine, and levetiracetam replacing phenytoin as the preferred second‐line agent. This pilot study indicates the feasibility of a paediatric SE registry and its utility to understand and optimise practice.