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ObjectivesThe royal college of paediatrics and child health list safeguarding as a core competency for paediatric trainees. The advent of progress plus has led to many junior paediatric postgraduate doctors in training advancing through their career with potentially little guidance on how to approach cases involving safeguarding or child protection.Our objectives were to:Increase awareness of the child protection process and safeguarding proceduresDemonstrate how to fill out a child protection proforma and strategy meetingFacilitate simulation for candidates to undertake a child protection with debrief and signpost to useful resourcesMethodsWe designed a child protection study day that consistent of a series of lectures followed by a simulated scenarios with facilitation from experienced registrars with an interest in or those who had subspecialised in safeguarding. The candidates were briefed at the start of the day with a trigger warning due to some of the content that would be discussed and received a series of lectures from faculty detailing the legal misnomers, physical injuries that they may see, a live demonstration of how to fill in a child protection booklet and a fictionalised depiction of what a simulation would look like.ResultsCandidates were asked to fill in a pre and post questionnaire. The pre-survey highlighted that none of the attendees had been placed in a community post with just over a half having read a child protection report and two thirds having never accessed the Child Protection Companion Tool.100 percent of all attendees felt the course had addressed any concerns or questions they had felt before attending.When asked about the demonstration of a child protection and strategy meeting attendees praised the realistic depiction and the sense of following through the patient journey.Using a likert scale 14/15 attendees found the event very useful.ConclusionOverall candidates extorted the utility of this course in helping them prepare for scenarios where they may face safeguarding and be required to complete a child protection medical examination.Our survey highlighted that many candidates felt unprepared to lead on such scenarios before this intervention. The authors believe that such a training day, a hybrid of lectures, demonstrations, simulation and group debrief should be incorporated into regional training across deaneries particularly in the advent of Progress Plus,1 including exploring further teaching surrounding sudden unexpected death in infants and children.ReferenceRoyal College of Paediatrics and Child Health. RCPCH Progress+ core syllabus (from summer 2023). [Internet] Available from: https://www.rcpch.ac.uk/resources/rcpch-progress-plus-curriculum-syllabi (accessed 28th October 2023).

This paper introduces a novel technique to evaluate comfort properties of zinc oxide nanoparticles (ZnO NPs) coated woven fabrics. The proposed technique combines artificial neural network (ANN) and golden eagle optimizer (GEO) to ameliorate the training process of ANN. Neural networks are state-of-the-art machine learning models used for optimal state prediction of complex problems. Recent studies showed that the use of metaheuristic algorithms improve the prediction accuracy of ANN. GEO is the most advanced methaheurstic algorithm inspired by golden eagles and their intelligence for hunting by tuning their speed according to spiral trajectory. From application point of view, this study is a very first attempt where GEO is applied along with ANN to improve the training process of ANN for any textiles and composites application. Furthermore, the proposed algorithm ANN with GEO (ANN-GEO) was applied to map out the complex input-output conditions for optimal results. Coated amount of ZnO NPs, fabric mass and fabric thickness were selected as input variables and comfort properties were evaluated as output results. The obtained results reveal that ANN-GEO model provides high performance accuracy than standard ANN model, ANN models trained with latest metaheuristic algorithms including particle swarm optimizer and crow search optimizer, and conventional multiple linear regression.

ObjectivesRespiratory distress is the commonest cause of term admission to Neonatal Unit. However, two-thirds were only admitted for less than 48 hours.1 The audit as outlined in the ATTAIN SOP: Avoiding Term Admissions in Neonatal Units – Respiratory Management of Term infant in the First Hour Following Birth and analyse the outcome for babies in whom ‘Trial of PEEP’ is attempted. In this audit trial of PEEP was performed in new-borns > 37 weeks’ gestation who requiring respiratory support immediately after birth. PEEP was given at 6cm H2O for 30 minutes. [figure 1] The outcomes were then analysed to identify potential avoidance of term admission and rooms for improvement in practice.Abstract 6048 Figure 1MethodsPatient samples were collected between March and June 2023. Initial collection in March to May was not effectively collected with missing information, prompting a creation of specialized form and allocation to colleagues in May to June. Additional data on babies undergoing ‘trial of PEEP’ was identified. Excel was used for analysis, focusing on descriptive analysis.ResultsIn this study, a total of 19 patients were included, but 4 of them were excluded because positive end-expiratory pressure (PEEP) was applied more than 1 hour after birth. Among the new-borns who received a PEEP trial at birth, 40% successfully avoided admission to the Neonatal Unit (NNU). [figure 2] Impressively, 83% of these new-borns did not require septic screens or antibiotics, underscoring the effectiveness of PEEP. Additionally, 66% of the babies admitted to NNU only needed high-flow oxygen support for less than 8 hours. Notably, three infants received PEEP for less than 30 minutes and were immediately admitted to the NNU due to ongoing respiratory distress, while three others with similar PEEP durations were observed in the postnatal ward after their respiratory effort normalized. Prolonged rupture of membrane (PROM) was identified in three patients who developed respiratory distress at 5 hours, 6 hours and 1 hour with significant meconium and failed the ‘Trial of PEEP’.Abstract 6048 Figure 2ConclusionThe initial findings suggest that employing the ‘Trail of PEEP’ during delivery benefits term and late-preterm infants experiencing respiratory distress at birth. This approach appears to lower admissions to the Neonatal Nursing Unit (NNU), promoting maternal-infant bonding, reducing antibiotic usage, and potentially saving costs by averting NNU admissions. However, it’s important to note that patients with Premature Rupture of Membranes (PROM) may have a distinct respiratory distress mechanism and may not respond as effectively to PEEP.ReferenceReducing harm leading to avoidable admission of full-term babies into neonatal units, NHS Improvement, February 2017.

The sensitive detection and degradation of synthetic dyes are pivotal to maintain safety owing to the adverse side effects they impart on living beings. In this work, we developed a sensitive electrochemical sensor for the nanomolar-level detection of rhodamine B (RhB) using a dual-functional, silver-decorated zinc oxide (Ag/ZnO) composite-modified, screen-printed carbon electrode. The plasmon-enhanced photocatalytic degradation of organic pollutant RhB was also performed using this nanocomposite prepared by embedding different weight percentages (1, 3, and 5 wt%) of Ag nanoparticles on the surface of a three-dimensional (3D), hierarchical ZnO nanostructure based on the photoreduction approach. The structure and morphology of an Ag/ZnO nanocomposite were characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), elemental mapping, ultraviolet-visible (UV-vis) spectroscopy, and X-ray diffraction (XRD). The electrochemical sensor exhibited a very high sensitivity of 151.44 µAµM−1cm−2 and low detection limit of 0.8 nM towards RhB detection. The selectivity, stability, repeatability, reproducibility, and practical feasibility were also analyzed to prove their reliability. Furthermore, the photocatalysis results revealed that 3 wt% of the Ag/ZnO hybrid nanostructure acquired immense photostability, reusability, and 90.5% degradation efficiency under visible light. Additionally, the pseudo-first-order rate constant of Ag-3/ZnO is 2.186 min−1 suggested promising activity in visible light photocatalysis.

Economical and nanomolar-level determination of the analgesic drug, acetaminophen (APAP), is reported in this work. A novel ternary nanocomposite based on silver-doped sugar apple-like cupric oxide (CuO)-decorated amine-functionalized multi-walled carbon nanotubes (fCNTs) was sonochemically prepared. CuO nanoparticles were synthesized based on the ascorbic acid-mediated low-temperature method, and sidewall functionalization of CNTs was carried out. Important characterizations of the synthesized materials were analyzed using SEM, TEM, HAADF-STEM, elemental mapping, EDX, lattice fringes, SAED pattern, XRD, EIS, UV-Vis, micro-Raman spectroscopy, and FTIR. It was noted the sonochemically prepared nanocomposite diligently fabricated on screen-printed carbon electrode showcased outstanding electrocatalytic performance towards APAP determination. The APAP sensor exhibited ultra-low limit of detection of 4 nM, wide linear concentration ranges of 0.02–3.77 and 3.77–90.02 μM, and high sensitivity of 30.45 μA μM−1 cm−2. Moreover, further evaluation of the sensor’s performance based on electrochemical experiments showcased outstanding selectivity, stability, reproducibility, and repeatability. Further, excellent practical feasibility of the proposed APAP sensor was affirmed with excellent recovery larger than 96.86% and a maximum RSD of 3.67%.

In this study, an artificial neural network (ANN) is used for the prediction of tensile strength of nano titanium dioxide (TiO2) coated cotton. The coating process was performed by ultraviolet (UV) radiations. Later on, a backpropagation ANN algorithm trained with Bayesian regularization was applied to predict the tensile strength. For a comparative study, ANN results were compared with traditional methods including multiple linear regression (MLR) and polynomial regression analysis (PRA). The input conditions for the experiment were dosage of TiO2, UV irradiation time and temperature of the system. Simulation results elucidated that ANN model provides high performance accuracy than MLR and PRA. In addition, statistical analysis was also performed to check the significance of this study. The results show a strong correlation between predicted and measured tensile strength of nano TiO2-coated cotton with small error values.

ObjectivesCareer progression for paediatric Postgraduate Doctors in Training (PgDiT) is dependent on the outcome achieved during the Annual Review of Competence Progression (ARCP). The ARCP panel assess the evidence provided in each PgDiT’s Kaizen e-Portolio to determine an ARCP outcome. Thus, it is vitally important that all PgDiT can confidently navigate and effectively utilise the Kaizen e-Portolio. The West Midlands Paediatric Trainees’ Committee have established an e-Portfolio peer-to-peer teaching session entitled ‘Kaizen Kafe’. This initiative aims to support and educate ST1 doctors and increase their confidence in navigating the Kaizen ePortfolio and ARCP process.MethodsA 2-hour training event was delivered to ST1 PgDiT in the West Midlands deanery. Topics covered included basic navigation of the ePortfolio, introduction to the RCPCH Progress curriculum and curriculum tagging, tips to using developmental logs effectively and preparing for ARCP. A pre and post-course online questionnaire was administered to event attendees, evaluating trainee confidence using Likert scales. Open-ended questions sought to identify barriers to using the ePortfolio and to highlight benefits of attending the training event.Results17 pre and post-course questionnaires were completed. 12% of attendees reported feeling confident about using the e-Portfolio prior to the event, with reported barriers including lack of time, high workload and uncertainty of how to navigate the platform. 100% of attendees reported feeling ‘confident’ or ‘very confident’ about using Kaizen following the training session, highlighting that event provided practical insights into using the ePortfolio and useful examples of mapping to the RCPCH curriculum. 12% of attendees reported feeling confident about preparing for ARCP prior to the event, compared to 100% of attendees feeling ‘confident’ or ‘very confident’ following the event. Attendees reported that topics covered were relevant to training and highlighted the benefits of near-peer teaching.ConclusionAttending Kaizen Kafe improved the self-reported confidence of ST1 Paediatric PgDiT with regards to using the e-Portfolio and navigating the ARCP process. Further Kaizen Kafe events could be organised and tailored to specific cohorts, such as International Medical Graduates and PgDiT who have transferred to the deanery. Events such as Kaizen Kafe provide equal opportunity for all PgDiT by ensuring all doctors are universally equipped with the tools to build their e-Portfolio confidence.

ObjectivesThe attrition rate during the early years of paediatric training in the UK remains a significant concern. Thus, it is important to ensure ST1 doctors are sufficiently supported from the outset of their training. The West Midlands Paediatric Trainees’ Committee have developed a ‘Welcome to Paediatrics’ day for new paediatric ST1 doctors, one day before their official start of training. The ‘Welcome to Paediatrics’ day aims to improve the confidence of ST1 doctors before commencing their first paediatric training post and to cultivate a sense of wellbeing.MethodsNewly recruited ST1 doctors in the region were invited to attend a ‘Welcome to Paediatrics’ face-to-face induction event. The training day consisted of a series of talks and workshops with topics such as portfolio, examinations and an open faculty-led conversation about challenges in paediatrics. Pre and post-event surveys were conducted before and after the event to evaluate the main concerns and to assess the impact of the event. The surveys consisted of open-ended questions with a Likert scale assessing confidence.ResultsThere were 28 and 17 responses for the pre and post-event survey respectively; all responses were anonymous. Braun’s framework was used to conduct a thematic analysis of the responses. The primary concerns of new ST1 doctors identified in the pre-session survey were broadly divided into six categories: portfolio, knowledge and skills expected, neonates, work-life balance, work environment and exams. In the post-event survey attendees focussed on the positive environment in which the event was conducted, with a particular focus on the benefit of honest reflections and discussions centered around wellbeing. The themes that attendees found most useful in the post-event survey included: wellbeing, portfolio, less than full time working and peer networking. Following the event there was a marked increase in confidence with 94% of attendees feeling ‘confident’ or ‘very confident’ after the event, compared to only 44% before the event.ConclusionsThe ‘Welcome to Paediatrics’ day increased the confidence of ST1 doctors starting paediatric training in the West Midlands. ST1 doctors appreciated the two-pronged approach, which provided both practical information as well as an emphasis on wellbeing. A similar day could be arranged in different deaneries and for different specialties.

To examine the impact race and socioeconomic status (SES) has on diabetes management among adults in North Carolina. Our study utilized data from the 2008 BRFSS to conduct a retrospective study and secondary data analysis. To account for the multistage survey design of BRFSS, SAS/SUDAAN was used to calculate adjusted and unadjusted odds ratios and 95% confidence intervals (CIs). Multiple regression analysis was performed to examine the impact race and SES has on diabetes management among North Carolina adults. The majority of the participants (63.34%) did not have good diabetes management based on the education and blood glucose criteria of our study. Non-Whites had higher odds than Whites to have good diabetes management practices (OR = 1.56, CI: 1.19, 2.03). Individuals who were low SES had poorer diabetes management than individuals who were identified as being high SES (OR = .81, CI: .60, 1.09). Disparities in good diabetes management practices were found among the variables of race, and SES. Findings from the study indicate that non-White adults had higher odds of good diabetes management practices than Whites in North Carolina. The results of this study could be used for policies and recommendations for health organizations. If health insurance policies required diabetes education classes a reduction in diabetes complications may be observed. Future studies should have a more accurate measurement of diabetes management; proxy measures were used in this study that relied on self-report and may not have provided the best measurement for diabetes management.

The majority of Americans identify themselves as belonging to some religious group. There is a mixed body of literature on whether or not religious affiliation has an influence on engaging in risky behaviors among young adults attending college. This study examined associations between religious affiliation, risky sexual practices, substance use, and family structure among a sample of predominantly white college females attending a southeastern university. Given the high risk of acquiring genital human papillomavirus infection as a result of high risk sexual practices, gaining a better understanding of how religious affiliation can be used to promote healthy sexual behaviors is warranted.