A prospective multicentre clinical study was initiated to evaluate the safety and potential clinical benefit of non-invasive vagus nerve stimulation (nVNS) for the treatment of bronchoconstriction exacerbations in asthmatics. Due to slow enrolment and design changes of the device, the study was prematurely terminated after enrolment of four eligible patients. Three of the four patients were considered treatment successes based on improvement in FEV1, improvement in VAS dyspnoea scoring, and the absence of device-related adverse events.Trial RegistrationClinicalTrials.gov Identifier: NCT01385306

AimsTo improve response rate to the NPDA PREMS questionnaire.MethodsPatients/parents/carers were asked to fill in the questionnaire online while waiting to see the doctor at the diabetes clinic. A medical student facilitated the process and explained the questions, if requested.ResultsData from 75 questionnaires was analysed.The young people filled out 56% of the questionnaires (36% by the mother). Age range was 2–18 years, with 38% in the 15–17 year age group, 53% were male. There was a range of ethnicities with the majority (79%) describing themselves as White British.61% were on multiple daily insulin injections (MDI). 38% were on insulin pump therapy (CSII).77% said they were seen within an hour of arriving for their appointment. Families said they had enough time to discuss their concerns with the doctors (87%), nurses (80%), dietitians (69%) and psychological services (45%). 73% said they got responses to telephone calls, emails and texts in a timely manner.. 84% said they could contact the diabetes team during working hours with75% saying that they could get advice from the hospital at all hours.Families said they received enough information about managing:High (99%) and low (100%) blood glucose levels Illness (93%) Carbohydrate counting (93%) Exercise (92%) Future health (81%) Emotional wellbeing (84%) Diabetes at school/nursery (92%) CSII (76%) Glucose monitoring (72%) Bolus advisor blood glucose metres (79%)100% were able to understand the written information. 79% felt they received appropriate dietary advice. 95% felt their religious beliefs were respected. 43% were offered an interpreter and 97% would recommend this clinic to others.ConclusionsResponse rate was dramatically improved (75/90 in 3 months compared to previous NPDA PREMS 84/180 in 6 months) by the presence of a facilitator and electronic completion of the questionnaire at clinic.Overall families were satisfied with the care they received from the paediatric diabetes team at Nottingham Children’s Hospital..Areas of the service which appear to require further analysis of feedback and possible improvements are access to psychological support, access to dietetic advice and information on technologies.

IntroductionAccurate information from service users helps in the development and improvement of service provision. Inaccurate or misleading information can be unhelpful and damaging. There is a standardised PREMS, which forms part of the yearly NPDA. Results are in the public domain.AimTo determine how accurately the current PREMS reflected the views of the families attending a tertiary children’s hospital.MethodsFamilies waiting to be seen were asked to fill in an electronic PREMS (August to October 2015). The process was facilitated by a medical student. There were 25 quantitative questions, identical to the standard PREMS used for parents/carers’ responses. Written free text explanations for each answer and verbal feedback from the families to the facilitator were collated.Results75 questionnaires were completed. The responses accurately represented the families’ views, except in 5 questions, where feedback revealed that the questions were ambiguous and/or that there was not an appropriate answer to choose from, eg: 1) 13% thought “waiting time” meant the time between arrival at the clinic to being seen by the doctor, rather than by any member of the diabetes team. 2) There was no option for the families to state “not applicable”, when they felt that the question was not relevant to them, eg: a) 55% responded “no” to “rate whether psychological services gave you enough time to discuss your questions and concerns,” when they had not felt the need to have additional psychological support services b) 5% responded “no” to “our religious and/or cultural beliefs were respected,” when they felt that this question was not relevant to them. c) 57% responded “no” to “were you offered an interpreter”, when they did not need an interpreter. d) 89% families, who were not using insulin pumps, responded “disagree”, when asked if they had received sufficient information regarding pump technology, because they thought this question was not relevant to them.ConclusionWe found that some of the PREMS questions were open to misinterpretation by the families or did not have an appropriate response option available. To improve accuracy and reliability of information gained we would suggest revisions could be made to these questions.