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Background: Medicines designed for adults may be inappropriate for use in children in terms of strength, dosage form and/or excipient content. There is currently no standardised method of assessing the age-appropriateness of a medicine for paediatric use. Aim: To develop and test a tool to assess whether a dosage form (formulation) is appropriate for children and estimate the proportion of formulations considered 'inappropriate' in a cohort of hospitalised paediatric patients with a chronic illness. Method: A multi-phase study: patient data collection, tool development, case assessments and tool validation. Inpatients aged 0–17 years at two UK paediatric/neonatal hospitals during data collection periods between January 2015 and March 2016. Written informed consent/assent was obtained. Medicines assessed were new or regularly prescribed to inpatients as part of their routine clinical care. All medicine administration episodes recorded were assessed using the Age-appropriate Formulation tool. The tool was developed by a consensus approach, as a one-page flowchart. Independent case assessments were evaluated in 2019. Results: In 427 eligible children; 2,199 medicine administration episodes were recorded. Two assessors reviewed 220 episodes in parallel: percentage exact agreement was found to be 91.7% (99/108) and 93.1% (95/102). In total, 259/2,199 (11.8%) medicine administration episodes involved a dosage form categorised as 'age-inappropriate'. Conclusion: A novel tool has been developed and internally validated. The tool can identify which medicines would benefit from development of an improved paediatric formulation. It has shown high inter-rater reliability between users. External validation is needed to further assess the tool's utility in different settings. [ABSTRACT FROM AUTHOR]

Background: Evidence supporting personalised treatment for asthma based on an individual's genetics is mounting. The views of children and young people (CYP), parents and healthcare professionals (HCPs) about this evolution of clinical care are not known.Methods: A pilot prospective questionnaire-based study was undertaken of CYP with asthma, their parents and HCPs at a secondary/tertiary children's hospital in the UK.Results: Fifty-nine questionnaires were distributed and 50 returned (response rate 84.7%), comprising 26 CYP (10 were 5-11 years, 11 were 12-15 years and 5 were 16-18 years old), 13 parents and 11 HCPs. For all types of data, personal information was ranked as the 'most important' (n=19, 47.5%) and 'most private' (n=16, 40%), but with considerable variation across groups. Within health data, allergies were rated as 'most important' (n=12, 30.8%), and mental health records the 'most private' (n=21, 53.8%), again with variation across groups. A 'personalised genetic asthma plan' was acceptable to the majority overall (n=40, 80.0%). With regard to sharing CYP's genetic data, 23 (46%) of participants were happy for unconditional sharing between HCPs, and 23 (46%) agreed to sharing solely in relation to the CYP's asthma management. Forty-two (84.0%) of participants felt CYP should be informed about genetic data being shared, and the majority felt this should commence by 12 years of age.Conclusion: The use of genetic information to guide management of asthma in CYP is largely acceptable to CYP, parents/guardians and HCPs. However, there are key differences between the opinions of CYP, parents and HCPs. [ABSTRACT FROM AUTHOR]

Sustainable drainage systems (SuDS) can be a key tool in the management of extremes of rainfall, due to their capacity to attenuate and treat surface water. Yet, implementation is a complex process, requiring buy-in from multiple stakeholders. Buy-in is often undermined by a lack of practical evidence and monitoring of implemented SuDS. In this paper, we present a collaborative case study between a local authority, university and the UK Environment Agency. This partnership approach enabled the installation of SuDS and monitoring equipment to address surface runoff in the north east of England. Ultrasonic sensors were installed in the drainage network to evaluate the attenuation of surface water. SuDS were installed during an atypically wet spring, followed by a hot and dry summer, providing a range of conditions to assess their performance. Results demonstrate that there was a statistically significant difference in the detected flow level in manholes downstream of the SuDS interventions. Several challenges occurred, from signal obstacles in wireless telecommunication services, to logistical constraints of installing sensors in the drainage network, and issues with the adoption of property level SuDS. These issues require further research. Qualitative support for partnership working was crucial to increase the capacity for delivering SuDS. To ensure the success of future schemes and likelihood of SuDS uptake, partnership working and engaging with communities is vital. [ABSTRACT FROM AUTHOR]