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Olusanya BO, Cheung VG, Hadders-Algra M, Breinbauer C, Smythe T, Moreno-Angarita M, Brinkman S, Almasri N, Figueiredo M, de Camargo OK, Nnanna IC, Block SS, Storbeck C, Olusanya JO, Berman BD, Wertlieb D, Williams AN, Nair MKC, Davis AC, Wright SM. Sustainable Development Goals summit 2023 and the global pledge on disability-focused early childhood development. Lancet Glob Health 2023; 11:e823-e825. [PMID: 37202016 DOI: 10.1016/s2214-109x(23)00178-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 05/20/2023]
Affiliation(s)
| | - Vivian G Cheung
- Department of Pediatrics, Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA
| | - Mijna Hadders-Algra
- University Medical Centre Groningen, Department of Pediatrics, Division of Developmental Neurology, and Faculty of Theology and Religious Studies, University of Groningen, Groningen, The Netherlands
| | - Cecilia Breinbauer
- Director of Child and Adolescent Health Programs Center for Healthy Development, Seattle, WA, USA
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Sally Brinkman
- Fraser Mustard Centre, Telethon Kids Institute, School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Nihad Almasri
- Department of Physiotherapy, The University of Jordan Queen Rania Al Abdallah St, Amman, Jordan
| | - Marta Figueiredo
- European Network of Occupational Therapy in Higher Education: Escola Superior de Saúde do Alcoitão, Alcabideche, Portugal
| | | | - Ike Chinonye Nnanna
- Child and Adolescent Mind Institute Africa, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Sandra S Block
- National Center for Children's Vision and Eye Health, Chicago, IL, USA; School-based Vision Clinics Illinois Eye Institute at Princeton School, Chicago, IL, USA
| | - Claudine Storbeck
- Centre for Deaf Studies, University of the Witwatersrand, Johannesburg, South Africa
| | - Jacob O Olusanya
- Centre for Healthy Start Initiative, Ikoyi Lagos, 101223, Nigeria
| | - Brad D Berman
- University of California San Francisco, Benioff Children's Hospitals, Progressions, Developmental, and Behavioral Pediatrics, Walnut Creek, CA, USA
| | - Donald Wertlieb
- Partnership for Early Childhood Development & Disability Rights, Department of Child Development, Tufts University, Medford, MA, USA
| | - Andrew N Williams
- Virtual Academic Unit, Northampton General Hospital, Northampton, UK
| | - M K C Nair
- NIMS-SPECTRUM-Child Development Research Centre, NIMS Medicity, Neyyattinkara, Thiruvananthapuram, India
| | - Adrian C Davis
- Vision and Eye Research Institute, Faculty of Medical Science, Anglia Ruskin University, Cambridge, UK; Department of Population Health Science, London School of Economics, London, UK
| | - Scott M Wright
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Olusanya BO, Gulati S, Berman BD, Hadders-Algra M, Williams AN, Smythe T, Boo NY. Global leadership is needed to optimize early childhood development for children with disabilities. Nat Med 2023; 29:1056-1060. [PMID: 37055569 DOI: 10.1038/s41591-023-02291-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Affiliation(s)
| | - Sheffali Gulati
- Center of Excellence & Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Brad D Berman
- UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Mijna Hadders-Algra
- Department of Pediatrics, Division of Developmental Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Faculty of Theology and Religious Studies, University of Groningen, Groningen, The Netherlands
| | - Andrew N Williams
- Virtual Academic Unit, Children's Directorate, Northampton General Hospital, Northampton, UK
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nem Yun Boo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
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3
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Olusanya BO, Gladstone M, Wright SM, Hadders-Algra M, Boo NY, Nair MKC, Almasri N, Kancherla V, Samms-Vaughan ME, Kakooza-Mwesige A, Smythe T, del Castillo-Hegyi C, Halpern R, de Camargo OK, Arabloo J, Eftekhari A, Shaheen A, Gulati S, Williams AN, Olusanya JO, Wertlieb D, Newton CRJ, Davis AC. Cerebral palsy and developmental intellectual disability in children younger than 5 years: Findings from the GBD-WHO Rehabilitation Database 2019. Front Public Health 2022; 10:894546. [PMID: 36091559 PMCID: PMC9452822 DOI: 10.3389/fpubh.2022.894546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/12/2022] [Indexed: 01/22/2023] Open
Abstract
Objective Children with developmental disabilities are associated with a high risk of poor school enrollment and educational attainment without timely and appropriate support. Epidemiological data on cerebral palsy and associated comorbidities required for policy intervention in global health are lacking. This paper set out to report the best available evidence on the global and regional prevalence of cerebral palsy (CP) and developmental intellectual disability and the associated "years lived with disability" (YLDs) among children under 5 years of age in 2019. Methods We analyzed the collaborative 2019 Rehabilitation Database of the Global Burden of Disease (GBD) Study and World Health Organization for neurological and mental disorders available for 204 countries and territories. Point prevalence and YLDs with 95% uncertainty intervals (UI) are presented. Results Globally, 8.1 million (7.1-9.2) or 1.2% of children under 5 years are estimated to have CP with 16.1 million (11.5-21.0) or 2.4% having intellectual disability. Over 98% resided in low-income and middle-income countries (LMICs). CP and intellectual disability accounted for 6.5% and 4.5% of the aggregate YLDs from all causes of adverse health outcomes respectively. African Region recorded the highest prevalence of CP (1.6%) while South-East Asia Region had the highest prevalence of intellectual disability. The top 10 countries accounted for 57.2% of the global prevalence of CP and 62.0% of the global prevalence of intellectual disability. Conclusion Based on this Database, CP and intellectual disability are highly prevalent and associated with substantial YLDs among children under 5 years worldwide. Universal early detection and support services are warranted, particularly in LMICs to optimize school readiness for these children toward inclusive education as envisioned by the United Nations' Sustainable Development Goals.
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Affiliation(s)
- Bolajoko O. Olusanya
- Centre for Healthy Start Initiative, Lagos, Nigeria,*Correspondence: Bolajoko O. Olusanya
| | - Melissa Gladstone
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Scott M. Wright
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Mijna Hadders-Algra
- Division of Developmental Neurology, Department of Paediatrics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Nem-Yun Boo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - M. K. C. Nair
- Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, Kerala, India
| | - Nihad Almasri
- Department of Physiotherapy, The University of Jordan, Amman, Jordan
| | - Vijaya Kancherla
- Department of Epidemiology Epidemiologist, Center for Spina Bifida Prevention Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Angelina Kakooza-Mwesige
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Ricardo Halpern
- Child Development Outpatient Clinic, Hospital da Criança Santo Antônio, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil
| | - Olaf K. de Camargo
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Jalal Arabloo
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Eftekhari
- Department of Toxicology and Pharmacology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amira Shaheen
- Division of Public Health, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sheffali Gulati
- Center of Excellence & Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Andrew N. Williams
- Virtual Academic Unit, Children's Directorate, Northampton General Hospital, Northampton, United Kingdom
| | | | - Donald Wertlieb
- Eliot-Pearson Department of Child Development, Tufts University, Medford, MA, United States
| | - Charles R. J. Newton
- Kenya Medical Research Institute–Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, KiIifi, Kenya
| | - Adrian C. Davis
- Department of Population Health Sciences, London School of Economics, London, United Kingdom,Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, United Kingdom
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Olusanya BO, Boo NY, Nair M, Samms-Vaughan ME, Hadders-Algra M, Wright SM, Breinbauer C, Almasri N, Moreno-Angarita M, Arabloo J, Arora NK, Block SS, Berman BD, Burchell G, de Camargo OK, Carr G, del Castillo-Hegyi C, Cheung VG, Halpern R, Hoekstra R, Lynch P, Mulaudzi MC, Kakooza-Mwesige A, Ogbo FA, Olusanya JO, Rojas-Osorio V, Shaheen A, Williams AN, Servili C, Gladstone M, Kuper H, Wertlieb D, Davis AC, Newton CR. Accelerating progress on early childhood development for children under 5 years with disabilities by 2030. Lancet Glob Health 2022; 10:e438-e444. [PMID: 35038406 PMCID: PMC7613579 DOI: 10.1016/s2214-109x(21)00488-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 09/10/2021] [Accepted: 10/13/2021] [Indexed: 12/30/2022]
Abstract
The likelihood of a newborn child dying before their fifth birthday (under-5 mortality rate) is universally acknowledged as a reflection of the social, economic, health, and environmental conditions in which children (and the rest of society) live, but little is known about the likelihood of a newborn child having a lifelong disability before their fifth birthday if he or she survives. Available data show that globally the likelihood of a child having a disability before their fifth birthday was ten times higher than the likelihood of dying (377·2 vs 38·2 per 1000 livebirths) in 2019. However, disability funding declined by 11·4% between 2007 and 2016, and only 2% of the estimated US$79·1 billion invested in early childhood development during this period was spent on disabilities. This funding pattern has not improved since 2016. This paper highlights the urgent need to prioritise early childhood development for the beneficiaries of global child survival initiatives who have lifelong disabilities, especially in low-income and middle-income countries, as envisioned by the Sustainable Development Goals agenda. This endeavour would entail disability-focused programming and monitoring approaches, economic analysis of interventions services, and substantial funding to redress the present inequalities among this cohort of children by 2030.
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O'Dell FJ, Williams AN, Poland A. The contributions of William Money MRCS to smallpox vaccination and control - A little-known story. Vaccine 2021; 39:4914-4919. [PMID: 34272094 DOI: 10.1016/j.vaccine.2021.06.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 11/30/2022]
Abstract
This history of vaccinology article outlines the work of William Money (1790-1843), who conducted a study related to smallpox disease, immunity, and vaccination. His hitherto unpublished study demonstrated that smallpox could be contracted more than once; notably, results from his studies showed that vaccination was not dangerous. He was also the author of a celebrated Vade Mecum in human anatomy. Here, we outline the work he conducted in England: from serving as the house surgeon at Northampton Infirmary to his post as a surgeon at the Royal Metropolitan Hospital in London.
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Affiliation(s)
- F J O'Dell
- Archivist, Archive and Museum Service, Northampton General Hospital, United Kingdom
| | - A N Williams
- Consultant Community Paediatrician, Curator of Archive, Virtual Academic Unit, Northampton General Hospital, United Kingdom
| | - A Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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6
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Olusanya BO, Hadders-Algra M, Breinbauer C, Williams AN, Newton CRJ, Davis AC. Setting the record straight on measuring SDG 4.2.1 - Authors' reply. Lancet Glob Health 2021; 9:e912. [PMID: 34143991 PMCID: PMC7613532 DOI: 10.1016/s2214-109x(21)00256-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/17/2021] [Indexed: 01/05/2023]
Affiliation(s)
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Division of Developmental Neurology, Department of Paediatrics, Groningen, Netherlands
| | | | - Andrew N Williams
- Virtual Academic Unit, Northampton General Hospital, Northampton, UK
| | - Charles R J Newton
- KEMRI-Wellcome Trust Research Program, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya
| | - Adrian C Davis
- Population Health Science, London School of Economics, London, UK
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Abstract
The physician and physiologist Dr William Harvey is known for having discovered that the heart pumps arterial blood round the whole body and receives venous blood from the periphery, which it forwards to the lungs for reoxygenation. Harvey's discovery was based on anatomical and physiological evidence and experiments using ligatures of varying tensions. As a clinician, however, Harvey does not appear to have appreciated the value of experiments in assessing treatment effects. Although he criticised Galenic views about the clinical value of experience and authority in the absence of accompanying empirical evidence, two handwritten prescriptions that he wrote for his friend and future biographer John Aubrey provide evidence that he conformed with Galenic theory when it came to drug therapy in clinical practice. This was consistent with his senior position in the College of Physicians, whose Pharmacopoeia Londinensis was based on Galenic principles, an appreciation of which was required for entry into the College. Harvey's prescriptions reflect this and open a window onto 17th-century therapeutic practice and the personal elements on which such practice was sometimes based.
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Affiliation(s)
- Andrew N Williams
- Virtual Academic Unit, CDC, Northampton General Hospital NHS Trust, Northampton NN1 5BD, UK
| | - Fred J O'Dell
- Archive and Museum Service, Northampton General Hospital NHS Trust, Northampton NN1 5BD, UK
| | - Jeffrey K Aronson
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, Woodstock Road, Oxford OX2 6GG
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8
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Olusanya BO, Hadders-Algra M, Breinbauer C, Williams AN, Newton CRJ, Davis AC. The conundrum of a global tool for early childhood development to monitor SDG indicator 4.2.1. The Lancet Global Health 2021; 9:e586-e587. [PMID: 33640036 PMCID: PMC7613544 DOI: 10.1016/s2214-109x(21)00030-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 12/27/2022]
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9
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Williams AN, Aronson JK. Was this Thomas Willis's greatest clinical success? Brain 2021; 144:e56. [PMID: 33774668 DOI: 10.1093/brain/awab143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Andrew N Williams
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, NN1 5BD, UK
| | - Jeffrey K Aronson
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, Oxford, OX2 6GG, UK
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10
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Williams AN. 'Welcome to the bargepole clinic'. Vaccine 2020; 38:8064-8065. [PMID: 33187764 DOI: 10.1016/j.vaccine.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Andrew N Williams
- Virtual Academic Unit, Northampton General Hospital, United Kingdom.
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11
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Williams AN. Using the historical archives of a district general hospital. Arch Dis Child 2020; 105:1129-1130. [PMID: 31296600 DOI: 10.1136/archdischild-2019-317546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Andrew N Williams
- Virtual Academic Unit, Children's Directorate, Northampton General Hospital, Northampton, UK
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Olusanya BO, Wright SM, Nair M, Boo NY, Halpern R, Kuper H, Abubakar AA, Almasri NA, Arabloo J, Arora NK, Backhaus S, Berman BD, Breinbauer C, Carr G, de Vries PJ, del Castillo-Hegyi C, Eftekhari A, Gladstone MJ, Hoekstra RA, Kancherla V, Mulaudzi MC, Kakooza-Mwesige A, Ogbo FA, Olsen HE, Olusanya JO, Pandey A, Samms-Vaughan ME, Servili C, Shaheen A, Smythe T, Wertlieb D, Williams AN, Newton CR, Davis AC, Kassebaum NJ. Global Burden of Childhood Epilepsy, Intellectual Disability, and Sensory Impairments. Pediatrics 2020; 146:peds.2019-2623. [PMID: 32554521 PMCID: PMC7613313 DOI: 10.1542/peds.2019-2623] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Estimates of children and adolescents with disabilities worldwide are needed to inform global intervention under the disability-inclusive provisions of the Sustainable Development Goals. We sought to update the most widely reported estimate of 93 million children <15 years with disabilities from the Global Burden of Disease Study 2004. METHODS We analyzed Global Burden of Disease Study 2017 data on the prevalence of childhood epilepsy, intellectual disability, and vision or hearing loss and on years lived with disability (YLD) derived from systematic reviews, health surveys, hospital and claims databases, cohort studies, and disease-specific registries. Point estimates of the prevalence and YLD and the 95% uncertainty intervals (UIs) around the estimates were assessed. RESULTS Globally, 291.2 million (11.2%) of the 2.6 billion children and adolescents (95% UI: 249.9-335.4 million) were estimated to have 1 of the 4 specified disabilities in 2017. The prevalence of these disabilities increased with age from 6.1% among children aged <1 year to 13.9% among adolescents aged 15 to 19 years. A total of 275.2 million (94.5%) lived in low- and middle-income countries, predominantly in South Asia and sub-Saharan Africa. The top 10 countries accounted for 62.3% of all children and adolescents with disabilities. These disabilities accounted for 28.9 million YLD or 19.9% of the overall 145.3 million (95% UI: 106.9-189.7) YLD from all causes among children and adolescents. CONCLUSIONS The number of children and adolescents with these 4 disabilities is far higher than the 2004 estimate, increases from infancy to adolescence, and accounts for a substantial proportion of all-cause YLD.
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Affiliation(s)
| | - Scott M. Wright
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - M.K.C. Nair
- NIMS Spectrum Child Development Research Centre, NIMS Medicity, Thiruvananthapuram, Kerala, India
| | - Nem-Yun Boo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Ricardo Halpern
- Department of Pediatrics and Adolescence, University of Health Sciences of Porto Alegre, Porto Alegrel, Brazil
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amina A. Abubakar
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, KiIifi, Kenya
| | - Nihad A. Almasri
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Sophia Backhaus
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Brad D. Berman
- Department of Pediatrics, University of California, San Francisco Benioff Children’s Hospital, San Francisco, California,Progressions: Developmental and Behavioral Pediatrics, San Francisco, California
| | | | - Gwen Carr
- Ear Institute, University College London, London, United Kingdom
| | - Petrus J. de Vries
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Christie del Castillo-Hegyi
- Department of Emergency Medicine, CHI St. Vincent, Little Rock, Arkansas,Fed Is Best Foundation, Little Rock, Arkansas
| | - Aziz Eftekhari
- Department of Pharmacology and Toxicology, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Melissa J. Gladstone
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Rosa A. Hoekstra
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Vijaya Kancherla
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Mphelekedzeni C. Mulaudzi
- Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa
| | - Angelina Kakooza-Mwesige
- department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Felix A. Ogbo
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | | | | | | | - Maureen E. Samms-Vaughan
- Department of Child and Adolescent Health, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Amira Shaheen
- Division of Public Health, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Donald Wertlieb
- Eliot-Pearson Department of Child Development, Tufts University, Medford, Massachusetts
| | - Andrew N. Williams
- Virtual Academic Unit, Northampton General Hospital, Northampton, United Kingdom
| | - Charles R.J. Newton
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, KiIifi, Kenya
| | - Adrian C. Davis
- Ear Institute, University College London, London, United Kingdom
| | - Nicholas J. Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
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Williams AN, Walter S. Enchanted voice. Arch Dis Child 2020; 105:197-198. [PMID: 30381289 DOI: 10.1136/archdischild-2018-315795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/21/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Andrew N Williams
- Virtual Academic Unit, Children's Directorate, Northampton General Hospital, Northampton, UK
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Olusanya BO, Davis AC, Wertlieb D, Boo NY, Nair M, Halpern R, Kuper H, Breinbauer C, de Vries PJ, Gladstone M, Halfon N, Kancherla V, Mulaudzi MC, Kakooza-Mwesige A, Ogbo FA, Olusanya JO, Williams AN, Wright SM, Manguerra H, Smith A, Echko M, Ikeda C, Liu A, Millear A, Ballesteros K, Nichols E, Erskine HE, Santomauro D, Rankin Z, Smith M, Whiteford HA, Olsen HE, Kassebaum NJ. Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Glob Health 2018; 6:e1100-e1121. [PMID: 30172774 PMCID: PMC6139259 DOI: 10.1016/s2214-109x(18)30309-7] [Citation(s) in RCA: 302] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/12/2018] [Accepted: 06/20/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The Sustainable Development Goals (SDGs) mandate systematic monitoring of the health and wellbeing of all children to achieve optimal early childhood development. However, global epidemiological data on children with developmental disabilities are scarce. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 provides a comprehensive assessment of prevalence and years lived with disability (YLDs) for development disabilities among children younger than 5 years in 195 countries and territories from 1990 to 2016. METHODS We estimated prevalence and YLDs for epilepsy, intellectual disability, hearing loss, vision loss, autism spectrum disorder, and attention deficit hyperactivity disorder. YLDs were estimated as the product of the prevalence estimate and the disability weight for each mutually exclusive disorder, corrected for comorbidity. We used DisMod-MR 2.1, a Bayesian meta-regression tool, on a pool of primary data derived from systematic reviews of the literature, health surveys, hospital and claims databases, cohort studies, and disease-specific registries. FINDINGS Globally, 52·9 million (95% uncertainty interval [UI] 48·7-57·3; or 8·4% [7·7-9·1]) children younger than 5 years (54% males) had developmental disabilities in 2016 compared with 53·0 million (49·0-57·1; or 8·9% [8·2-9·5]) in 1990. About 95% of these children lived in low-income and middle-income countries. YLDs among these children increased from 3·8 million (95% UI 2·8-4·9) in 1990 to 3·9 million (2·9-5·2) in 2016. These disabilities accounted for 13·3% of the 29·3 million YLDs for all health conditions among children younger than 5 years in 2016. Vision loss was the most prevalent disability, followed by hearing loss, intellectual disability, and autism spectrum disorder. However, intellectual disability was the largest contributor to YLDs in both 1990 and 2016. Although the prevalence of developmental disabilities among children younger than 5 years decreased in all countries (except for North America) between 1990 and 2016, the number of children with developmental disabilities increased significantly in sub-Saharan Africa (71·3%) and in North Africa and the Middle East (7·6%). South Asia had the highest prevalence of children with developmental disabilities in 2016 and North America had the lowest. INTERPRETATION The global burden of developmental disabilities has not significantly improved since 1990, suggesting inadequate global attention on the developmental potential of children who survived childhood as a result of child survival programmes, particularly in sub-Saharan Africa and south Asia. The SDGs provide a framework for policy and action to address the needs of children with or at risk of developmental disabilities, particularly in resource-poor countries. FUNDING The Bill & Melinda Gates Foundation.
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Williams AN, Mold B, Kilbey L, Naganna P. Forty years of referrals and outcomes to a UK Child Development Centre (CDC): Has demand plateaued? Child Care Health Dev 2018; 44:364-369. [PMID: 29460480 DOI: 10.1111/cch.12552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 12/07/2017] [Accepted: 12/30/2017] [Indexed: 11/26/2022]
Abstract
AIMS To explore 40 years of Child Development Centre (CDC) activity and outcomes at Northampton General Hospital 1974-2014. METHODS The study comprises 3 data sets: a published report from 1974 to 1999, an internal audit from 2001 to 2004, and more recent data collected from 2005 to 2014. The medical notes of all children who were assessed by the CDC in 2014 were reviewed, along with referral data collected by the CDC manager from this year and the preceding 10 years. RESULTS From January 1, 1974 to December 31, 2014, 3,786 children were assessed. The male to female ratio is 2.8:1 from 2005 to 2014. Referrals for behavioural difficulties increased from 10% (10/100 referrals) in 1999-2004 to 17.8% (18/101 referrals) in 2014. Similarly, referrals for social and communication problems, "interaction" increased two and a half fold from 10% (10/100 referrals) in 1999-2004 to 26.7% (27/101 referrals) in 2014. Between 2004 and 2014, numbers of referrals for "developmental delay" halved (22.2% to 12%). CONCLUSION We are aware of no other comparable extant UK CDC database. Services should plan for a referral rate of 6.5 per 1,000 preschool children. Between 1974 and 2014, there has clearly been a change in recorded assessment outcomes. From the mid-1980s, this reflects the change to a preschool assessment role and a shift away from purely educational outcome to include medical conditions. Covering 1974-2014, we demonstrate a clear increase in the number of referrals together with an increasing demand for assessments for social interaction and behavioural difficulties. This reflects the increased awareness of these neurodevelopmental difficulties and the changing diagnostic criteria which will now more likely result in an Autistic Spectrum Disorder diagnosis than previously. Together, these two features are most likely to have considerable implications for service development within Child Development Centres (CDCs) and Child Development Teams (CDTs).
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Affiliation(s)
- A N Williams
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK
| | - B Mold
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK
| | - L Kilbey
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK
| | - P Naganna
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK
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Williams AN. Thinking outside the box in clinical practice. Arch Dis Child Educ Pract Ed 2017; 102:310-313. [PMID: 28971833 DOI: 10.1136/archdischild-2017-313559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 11/04/2022]
Abstract
During difficult times we forget that as healthcare practitioners we are immensely privileged. We have a job, with regular work and generally don't have to worry about putting food on our families' table. But from a humanities perspective, we also have front row seats on the drama of life and no two days can be the same. Yet as we struggle to master our profession, the day to day realities of the job itself struggles to master us. If we become 'too hard' we may be fully competent yet fail to discharge our duties properly; however, should we become 'too soft', we may find ourselves not being able to discharge those duties at all. Striking that 'happy' balance is a decision we each make for ourselves every day during our decades of practice. For me, it has been necessary from the outset to include medical humanities within the clinico-medical perspective of daily practice. My definition of Medical Humanities will not only include medical history but also, stories, films and plays. This article relates some practices which I have found useful.
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Williams AN, O'Dell F. Dr Isaac Henry Gosset (1907-1965) inventor of the 'Gosset' icterometer and founder of Northamptonshire neonatal paediatrics. Arch Dis Child Fetal Neonatal Ed 2016; 101:F264-5. [PMID: 26251291 DOI: 10.1136/archdischild-2015-309161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 07/04/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Andrew N Williams
- Virtual Academic Unit, Children's Directorate, Northampton General Hospital, Northampton, UK
| | - Fred O'Dell
- Northampton General Hospital, Northampton, UK
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Affiliation(s)
- Andrew N Williams
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, United Kingdom
| | - Raman M Sharma
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, United Kingdom
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Eggens VR, Barth PG, Niermeijer JMF, Berg JN, Darin N, Dixit A, Fluss J, Foulds N, Fowler D, Hortobágyi T, Jacques T, King MD, Makrythanasis P, Máté A, Nicoll JAR, O'Rourke D, Price S, Williams AN, Wilson L, Suri M, Sztriha L, Dijns-de Wissel MB, van Meegen MT, van Ruissen F, Aronica E, Troost D, Majoie CB, Marquering HA, Poll-Thé BT, Baas F. EXOSC3 mutations in pontocerebellar hypoplasia type 1: novel mutations and genotype-phenotype correlations. Orphanet J Rare Dis 2014; 9:23. [PMID: 24524299 PMCID: PMC3928094 DOI: 10.1186/1750-1172-9-23] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 02/06/2014] [Indexed: 11/24/2022] Open
Abstract
Background Pontocerebellar hypoplasia (PCH) represents a group of neurodegenerative disorders with prenatal onset. Eight subtypes have been described thus far (PCH1-8) based on clinical and genetic features. Common characteristics include hypoplasia and atrophy of the cerebellum, variable pontine atrophy, and severe mental and motor impairments. PCH1 is distinctly characterized by the combination with degeneration of spinal motor neurons. Recently, mutations in the exosome component 3 gene (EXOSC3) have been identified in approximately half of the patients with PCH subtype 1. Methods We selected a cohort of 99 PCH patients (90 families) tested negative for mutations in the TSEN genes, RARS2, VRK1 and CASK. Patients in this cohort were referred with a tentative diagnose PCH type 1, 2, 4, 7 or unclassified PCH. Genetic analysis of the EXOSC3 gene was performed using Sanger sequencing. Clinical data, MR images and autopsy reports of patients positive for EXOSC3 mutations were analyzed. Results EXOSC3 mutations were found in twelve families with PCH subtype 1, and were not found in patients with other PCH subtypes. Identified mutations included a large deletion, nonsense and missense mutations. Examination of clinical data reveals a prolonged disease course in patients with a homozygous p.D132A mutation. MRI shows variable pontine hypoplasia in EXOSC3 mediated PCH, where the pons is largely preserved in patients with a homozygous p.D132A mutation, but attenuated in patients with other mutations. Additionally, bilateral cerebellar cysts were found in patients compound heterozygous for a p.D132A mutation and a nonsense allele. Conclusions EXOSC3 mediated PCH shows clear genotype-phenotype correlations. A homozygous p.D132A mutation leads to PCH with possible survival into early puberty, and preservation of the pons. Compound heterozygosity for a p.D132A mutation and a nonsense or p.Y109N allele, a homozygous p.G31A mutation or a p.G135E mutation causes a more rapidly progressive course leading to death in infancy and attenuation of the ventral pons. Our findings imply a clear correlation between genetic mutation and clinical outcome in EXOSC3 mediated PCH, including variable involvement of the pons.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Frank Baas
- Department of Genome Analysis, Academic Medical Centre, Amsterdam, the Netherlands.
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Affiliation(s)
- A N Williams
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK.
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Abstract
OBJECTIVES The aim of the study was to assess whether gastrostomy placement before 18 months of age results in a greater increase in z-score for weight and to assess whether admission rates were reduced postgastrostomy in this age group. DESIGN Retrospective cross-sectional study. SETTING Single-centre secondary care District General Hospital. PARTICIPANTS All children with a neurodisability with a gastrostomy in situ in September 2011 were included. Those with primary neoplasia and undergoing chemo or radiotherapy or being palliated for an aggressive neurodegenerative disorder were excluded. Those with cystic fibrosis, primary congenital heart disease or Inflammatory bowel disease were also excluded. Forty-one children underwent final analysis. Twenty-four children underwent gastrostomy insertion less than 18 months and 17 children were older than 18 months. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was z-scores for weight immediately pregastrostomy and 12 months postgastrostomy. Secondary outcomes were hospital admission rates pregastrostomy and postgastrostomy. Values were compared for those with gastrostomy insertion less than or equal to 18 months against those older than 18 months at insertion. RESULTS Z-score for weight increased significantly in both age groups. There was significantly increased mean difference in the z-score for weight of +1.33 pregastrostomy and postgastrostomy in the less than 18 months age group as compared with an increased mean difference in the z-score for weight of +0.45 in the older age group (p=0.021). There was no significant difference in the admission rates postgastrostomy insertion in either age group. CONCLUSIONS Gastrostomy insertion before 18 months of age results in greater z-score for weight gain in children with a neurodisability. This conclusion is limited by the lack of height and skin-fold thickness measurements. Further long-term matched control studies are required to determine the neurodevelopmental and clinical benefit of early gastrostomy placement in such children.
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Affiliation(s)
- Raman Sharma
- Department of Paediatrics, Virtual Academic Unit, Child Development Centre, Northampton, Northants, UK
| | - Andrew N Williams
- Department of Paediatrics, Virtual Academic Unit, Child Development Centre, Northampton, Northants, UK
| | - Win Zaw
- Department of Paediatrics, Northampton General Hospital, Northampton, Northants, UK
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Denny G, Sundvall P, Thornton SJ, Reinarz J, Williams AN. Historical and contemporary perspectives on children's diets: is choice always in the patients' best interest? Med Humanit 2010; 36:14-18. [PMID: 21393268 DOI: 10.1136/jmh.2009.003368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
On 29 March 1744, Thomasin Grace, a 13-year-old girl, was the first inpatient admitted to the Northampton General Infirmary (later the Northampton General Hospital). Inpatient hospital diets, then and now, are mainstays of effective patient treatment. In the mid-18th century there were four prescribed diets at Northampton: 'full', 'milk', 'dry' and 'low'. Previous opinions concerning these four diets were unfavourable, but had not been based upon an individual dietetic assessment. Thomasin would most likely have been given the milk diet, but use of the full diet cannot be excluded. 'Grace Everyman' is Thomasin's modern equivalent. Under current NHS guidelines Thomasin would be considered a paediatric patient, but in 1744 she would have been considered as an adult. This study undertakes a full dietetic analysis of all the prescribed diets available for Thomasin in 1744 and compares this against random choices for Grace from the 2009 inpatient menu from the paediatric (Paddington) ward, and the adult ward inpatient menu at the Northampton General Hospital. The results show that, for Thomasin, the 1744 milk and full diets met the current advised nutritional requirements for adequate dietary intake. However, for Grace, the present 2009 Paddington and adult ward menu, although generally meeting nutritional requirements, could, if Grace or her carer consistently chose poorly during a prolonged inpatient stay, lead to inadequate nutrition. This challenges assumptions that hospital diets were historically inadequate, and that choice in present day equates with satisfactory nutritional intake.
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Affiliation(s)
- G Denny
- Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK
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Abstract
This chapter reviews the fascinating history of child neurology and neurodisability from amongst its earliest recorded origins, Mesopotamian tablets, through to magnetic resonance imaging. It is the first review of such breadth in this area since Levinson in 1948. As well as covering the traditionally covered areas namely cerebral palsy, epilepsy, and mental retardation, the chapter explores other areas of pediatric neurodisability that have, since Levinson, become mainstream practice and now fall within this area of specialty. These conditions include the autistic spectrum disorders and attention deficit disorder. The dramatic advances in neural imaging and genetics in helping to explain different pediatric neurological conditions are also discussed as well as concepts and understanding concerning recovery from brain damage. The changing epidemiology of neurodisability through effective advances in acute neonatal and pediatric medical care, screening programs and social interventions are also related. Lastly, the fundamental reappraisal of society's attitude toward the disabled following World War II is explored. The lives of the disabled began to be seen to have value, belatedly gaining legal protection against discrimination, gaining dignity, independence, and for the first time being listened to.
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Affiliation(s)
- Andrew N Williams
- Virtual Academic Unit, Northampton General Hospital, Northampton, UK.
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Abstract
Monosodium glutamate (MSG) is a salt form of a non-essential amino acid commonly used as a food additive for its unique flavour enhancing qualities. Since the first description of the 'Monosodium glutamate symptom complex', originally described in 1968 as the 'Chinese restaurant syndrome', a number of anecdotal reports and small clinical studies of variable quality have attributed a variety of symptoms to the dietary ingestion of MSG. Descriptions of MSG-induced asthma, urticaria, angio-oedema, and rhinitis have prompted some to suggest that MSG should be an aetiologic consideration in patients presenting with these conditions. This review prevents a critical review of the available literature related to the possible role of MSG in the so-called 'Chinese restaurant syndrome' and in eliciting asthmatic bronchospasm, urticaria, angio-oedema, and rhinitis. Despite concerns raised by early reports, decades of research have failed to demonstrate a clear and consistent relationship between MSG ingestion and the development of these conditions.
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Affiliation(s)
- A N Williams
- Division of Allergy, Asthma, and Immunology, Scripps Clinic, San Diego, CA 92130, USA.
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Affiliation(s)
- L Smith
- Department of Dietetics, Northampton General Hospital, Northampton. NN1 5BD
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James RM, Williams AN. Two Georgian fathers: diverse in experience, united in grief. Med Humanit 2008; 34:70-79. [PMID: 23674584 DOI: 10.1136/jmh.2008.000281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The history of paediatrics and child health is increasingly recognised to be about children themselves and how they and their families cope and adapt to their medical condition rather than about medical practitioners and august institutions. This article considers two case studies, showing how two Georgian fathers cared for their children when sickness struck and their reactions when the children died. Davies (Giddy) Gilbert, FRS (1767-1840), was a member of Parliament first for Helston and later for Bodmin. (He married Ann Mary Gilbert in 1808 and formally changed his name to Gilbert; the change received royal approbation in January 1817.) Gilbert recorded the birth and development of his son Charles (1810-1813), in one of the very earliest developmental chronicles. He regularly recorded his child's progress, including height, weight, social interaction, communication skills and speech. Apparently in good health for most of his life, Charles developed an acute abdominal disorder and died unexpectedly. John Tremayne (1780-1851) was a member of Parliament for Cornwall. His son Harry (1814-1823) had increasing bilious attacks, headaches and a squint from the age of 6 years, and died despite the best medical advice available. Current medical opinion would presume an intracranial tumour. Tremayne graphically expressed his pain as he closely observed his son suffer, apparently as much from the treatments as from the disease itself. This study sheds light on clinical aspects of Georgian medical practice, the medical marketplace and the nature of relationships between these fathers and their children.
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Affiliation(s)
- R M James
- Oxford Brookes University, Oxford, UK
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Williams AN, Griffin NK. 100 years of lost opportunity. Missed descriptions of child abuse in the 19th century and beyond. Child Abuse Negl 2008; 32:920-924. [PMID: 18990446 DOI: 10.1016/j.chiabu.2007.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2004] [Revised: 11/14/2007] [Accepted: 12/08/2007] [Indexed: 05/27/2023]
Affiliation(s)
- A N Williams
- Department of Paediatrics, Northampton General Hospital, Northampton, UK
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Williams AN. Looking beyond the perspective of a limited metaphor. Arch Dis Child 2008; 93:184. [PMID: 18209003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Williams AN. Thomas Willis' understanding of cerebrovascular disorders. J Stroke Cerebrovasc Dis 2007; 12:280-4. [PMID: 17903941 DOI: 10.1016/j.jstrokecerebrovasdis.2003.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2003] [Revised: 06/19/2003] [Accepted: 07/01/2003] [Indexed: 10/26/2022] Open
Abstract
Thomas Willis (1621-1675) is recognized as the founder of clinical neuroscience. He conceived the word "neurologie" and, although immortalized by the arterial anastamosis at the base of the brain, his contributions to neuroscience were far wider and equally fundamental. This paper examines Willis' descriptions of cerebrovascular disorders, which he encountered in his practice.
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Affiliation(s)
- Andrew N Williams
- CDC Northampton General Hospital, Cliftonville, Northampton, United Kingdom. anw@doctors. org.uk
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Johnson S, Williams AN, Johnson C, Ou XM. The effects of antidepressant drug on ethanol-induced cell death. Drug Discov Ther 2007; 1:130-135. [PMID: 22504399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Alcoholism is a serious health problem. Alcohol-dependent subjects have many health-related problems, such as severe cognitive impairments, alcoholic liver disease and coronary heart disease, resulting from ethanol-induced cell injury or cell death. Understanding the mechanisms underlying the cell death may provide clues for novel treatment strategies to prevent alcohol-induced cell damage. Prolonged ethanol consumption causes apoptotic activity in a host of cell types - more obviously affecting the liver, heart and surprisingly affecting the brain. This study uses four cell lines: neuronal cell line (SH-SY5Y), glia cell line (U-118 MG), liver cell line (E47) and heart cell line (the rat H9c2), and addresses that alcohol does, in fact, cause cell death in these four cell types, whether ethanol induced cell death is through apoptotic pathway, and whether an monoamine oxidase (MAO) inhibitor (e.g. deprenyl) protects cells from the effects of alcohol. We have found that ethanol exposure lowers cell proliferation in all cell types, but affects brain cell lines (neuron and glioma) the most, while ethanol and deprenyl exposure in unison increases cell viability largely in brain cells, and then in liver cells. Our results suggest that MAO mediated apoptosis may contribute to ethanolinduced cell death. Individuals suffering from alcoholism or alcohol abuse may be treated with deprenyl to alleviate the apoptotic activity resulting from alcohol consumption and protect the body's cells from alcohol-induced death. In summary, this study demonstrates the effects of deprenyl as an anti-apoptotic agent against the detrimental effects of alcohol.
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Affiliation(s)
- S Johnson
- Department of Psychiatry, University of Mississippi Medical Center, Jackson, MS, USA
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Williams AN. "To observe well ... and thence to make himself rules": John Locke's principles and practice of child healthcare. Med Humanit 2007; 33:22-34. [PMID: 23674297 DOI: 10.1136/jmh.2006.000240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
It is often forgotten that the philosopher John Locke (1632-1704) was a highly regarded physician with a lifelong interest in medicine and was frequently consulted on medical matters, including the health of children. This child health aspect in Locke's history has been largely ignored, with even modern commentaries on Locke and medicine giving it only a cursory mention. However, it is clear that, in child health, Locke's influence is far more substantial than GF Still's and George Jackson's opinions, which limited Locke solely to Thoughts concerning education (1692/3). That a fundamental reappraisal of Locke's role in child healthcare is necessary and that his place as a pioneer of modern child healthcare needs to be proclaimed are emphasised here. As modern day child healthcare has evolved to embrace advocacy and learning disability, Locke's importance through his influence on paediatrics, child healthcare and human rights becomes more evident. Locke's influence in child healthcare comes not only through his other celebrated philosophical writings, but also through extensive personal correspondence and case records. As well as throwing light onto the 17th century aspects of child healthcare, Locke, through his enquiry and self-evident humility in his correspondence on medical matters, inspires and educates us with his pragmatic approach to the practice of medicine.
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Williams AN. Thomas Willis' paediatric general practice. Br J Gen Pract 2007; 57:70-3. [PMID: 17244432 PMCID: PMC2032708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
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Abstract
It has only recently been recognised that for more than a century before the opening of Great Ormond Street Hospital for Children (1852) children were treated and even admitted in English Voluntary Hospitals. Among the earliest English 18th century records, that contain the patient's age, are those found at the Northampton General Hospital within an archive dating from its foundation as the Northampton Infirmary in 1744. They afford a fascinating glimpse into both inpatient and outpatient child health. Although there are no medical notes as such, the hospital archive has recently rediscovered 1743 statutes, contemporary patient literature entitled Some Friendly Advice to a Patient (written by the Northampton Infirmary's founding physician Dr (later Sir) James Stonhouse), minute books, contemporary engravings of the outside and inside of the hospital and inpatient menus. Thus we can speculate with a high degree of certainty as to what would be the then current infirmary environment and treatments for illustrative examples of the children seen in the period 1744-45 (two inpatients and two outpatients). Interestingly one of the inpatient cases, Elizabeth Ager, a child with fever, was admitted against the infirmary regulations, suggesting already a stretching of boundaries in favour of paediatric admissions. This paper gives a flavour of 18th century hospital child healthcare in an era before the formal recognition of paediatrics as a medical specialty and preceding by more than a century the construction of specialist provision through the foundation of the first children's hospitals.
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Affiliation(s)
- A N Williams
- Child Development Centre, Northampton General Hospital, Northampton NN1 5BD, UK.
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Abstract
G.F. Still's History of Paediatrics restricted the philosopher John Locke's (1632-1704) influence in paediatrics to pedagology and specifically his Some Thoughts Concerning Education (1693). This significantly limits Locke's immense ongoing influence on child health care and human rights. Locke was a physician and had a lifelong interest in medicine. His case records and journals relate some of his paediatric cases. His correspondence includes letters from Thomas Sydenham, the "English Hippocrates" (1624-89) when Locke has sought advice on a paediatric case as well as other correspondence from parents regarding child health care and management of learning disability. Locke assisted and influenced Thomas Sydenham with his writing, and Locke's own work, Two Treatises on Government, clearly stated the rights of children and limitation of parental authority. Furthermore, Locke's thoughts on Poor Law, making an economic case for a workhouse in every parish, were implemented from 1834.
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Affiliation(s)
- A N Williams
- Child Development Centre, Northampton General Hospital, Northampton NNI 5BD, UK.
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Abstract
For more than a century before the opening of Great Ormond Street Hospital for Children (1852), children in England were treated and even admitted in voluntary hospitals in spite of rules prohibiting such care. The earliest English eighteenth century records, that contain the patient's age, are held in Northampton. Reviewing records from the Northampton General Infirmary (from 1903 the Northampton General Hospital) for the period 1744-45 gives a flavour of hospital child health care in an era before the formal recognition of paediatrics as a medical specialty and the construction of specialist provision. Indeed the first patient admitted to the Northampton General Infirmary on 29 March 1744 was Thomasin Grace, a 13 year old child. In Northampton, in its first year of operation, children as young as 2 years of age were seen in outpatients and from 8 years were admitted. Paediatric cases up to and including those 16 years of age made up 26% of the number of patients seen for that year. Within the first year of opening for children of 10 years of age and under, there were eight inpatient admissions and 18 children were treated in outpatients.
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Affiliation(s)
- A N Williams
- Child Development Centre, Northampton General Hospital, Northampton NN1 5BD, UK.
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Reinarz J, Williams AN. John Darwall, MD (1796-1833): the short yet productive life of a Birmingham practitioner. J Med Biogr 2005; 13:150-4. [PMID: 16059527 DOI: 10.1177/096777200501300309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This paper summarizes the life and work of John Darwall, a Birmingham physician whose work helped develop several fields of medicine, including occupational health, medical journalism and paediatrics.
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Affiliation(s)
- Jonathan Reinarz
- Centre for the History of Medicine, School of Medicine, University of Birmingham, UK.
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Williams AN, Arnott R. Letter to the editors: did a stone save Rome from destruction? J Hist Neurosci 2005; 14:81-82. [PMID: 15804760 DOI: 10.1080/096470490916438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Sébire G, Tabarki B, Saunders DE, Leroy I, Liesner R, Saint-Martin C, Husson B, Williams AN, Wade A, Kirkham FJ. Cerebral venous sinus thrombosis in children: risk factors, presentation, diagnosis and outcome. ACTA ACUST UNITED AC 2005; 128:477-89. [PMID: 15699061 DOI: 10.1093/brain/awh412] [Citation(s) in RCA: 308] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Neuroimaging and management advances require review of indications for excluding cerebral venous sinus (sinovenous) thrombosis (CSVT) in children. Our goals were to examine (i) clinical presentations of CSVT, (ii) prothrombotic risk factors and other predisposing events, (iii) clinical and radiological features of brain lesions in CSVT compared with arterial stroke, and (iv) predictors of outcome. We studied 42 children with CSVT from five European paediatric neurology stroke registries. Patients aged from 3 weeks to 13 (median 5.75) years (27 boys; 64%) presented with lethargy, anorexia, headache, vomiting, seizures, focal signs or coma and with CSVT on neuroimaging. Seventeen had prior chronic conditions; of the 25 previously well patients, 23 had recent infections, eight became dehydrated and six had both. Two children had a history compatible with prior CSVT. Anaemia and/or microcytosis (21 probable iron deficiency, five haemolytic, including two with sickle cell disease and one with beta-thalassaemia) was as common (62%) as prothrombotic disorder (13/21 screened). High factor VIII and homozygosity for the thermolabile methylene tetrahydrofolate reductase polymorphism were the commonest prothrombotic disorders. The superficial venous system was involved in 32 patients, the deep in six, and both in four. Data on the 13 children with bland infarction and the 12 with haemorrhage in the context of CSVT were compared with those from 88 children with ischaemic (AIS) and 24 with haemorrhagic (AHS) arterial stroke. In multiple logistic regression, iron deficiency, parietal infarction and lack of caudate involvement independently predicted CSVT rather than arterial disease. Five patients died, three acutely, one after recurrence and one after 6 months being quadriparetic and blind. Follow-up ranged from 0.5 to 10 (median 1) years. Twenty-six patients (62%) had sequelae: pseudotumour cerebri in 12 and cognitive and/or behavioural disabilities in 14, associated with epilepsy in three, hemiparesis in two and visual problems in two. Eighteen patients, including six with haemorrhage, were anticoagulated. Older age [odds ratio (OR) 1.54, 95% confidence limits (CI) 1.12, 2.13, P = 0.008], lack of parenchymal abnormality (OR 0.17, 95% CI 0.02, 1.56, P = 0.1), anticoagulation (OR 24.2, 95% CI 1.96, 299) and lateral and/or sigmoid sinus involvement (OR 16.2, 95% CI 1.62, 161, P = 0.02) were independent predictors of good cognitive outcome, although the last predicted pseudotumour cerebri. Death was associated with coma at presentation. Of 19 patients with follow-up magnetic resonance (MR) venography, three had persistent occlusion, associated with anaemia and longer prodrome. A low threshold for CT or MR venography in children with acute neurological symptoms is essential. Nutritional deficiencies may be modifiable risk factors. A paediatric anticoagulation trial may be required, after the natural history has been further established from registries of cases with and without treatment.
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Affiliation(s)
- G Sébire
- Service de neuropédiatrie, Université de Sherbrooke, Sherbrooke, Canada
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Abstract
We describe a pilot study to investigate whether drawing "Thomas the Tank Engine" could be as effective a measure of developmental progress as the Goodenough-Harris Draw A Man test against the ThOMAs test (The Other Means of Assessment), with internal validation. The study included 95 children aged between 3 and 11 years of age, including a subgroup of 13 children with registered special needs from community and general pediatric clinics within Birmingham, UK, as a means of validation. There was no significant evidence that ThOMAS was either culturally or sex biased. Using regression analysis, nine items were found to correlate highly with actual age, and their total score gave a correlation of 0.563 with age. Adding further items did not increase this. After being converted into age-standardized scores, ThOMAS was as sensitive and specific as the Draw A Man test, and more so above a defined age-standardized threshold. This pilot study suggests that drawing Thomas the Tank Engine would appear to be as sensitive and specific a means of identifying children with special needs as the Goodenough-Harris Draw A Man test. The relatively small sample size means that further research is necessary to further define the age standardizations and to refine the ThOMAs test.
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Abstract
John Darwall's (1796-1833) contribution to medicine has not attracted the attention it merits from medical historians. Although the Birmingham physician died at a relatively young age, his work in several fields of early nineteenth century medicine, including paediatrics, deserves to be both recovered and addressed, if only due to the light it sheds on medical practice in England during the first decades of the nineteenth century. Given its pioneering nature, his work on occupational health has attracted some attention, albeit minor.(1) However his contribution to the development of paediatrics, as represented by his most substantial publication, Plain Instructions for the Management of Infants (1830), has been completely ignored by historians of child health. This paper seeks to redress this particular oversight.
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Affiliation(s)
- A N Williams
- Northampton General Hospital, Northampton NN1 5BD, UK.
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Affiliation(s)
- C Essex
- Gulson Hospital, Coventry CV1 2HR, UK.
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Affiliation(s)
- A N Williams
- Child Development Centre, Northampton General Hospital, Northampton NN1 5BD, UK.
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Affiliation(s)
- A N Williams
- Child Development Centre, Northampton General Hospital, Northampton NN1 5BD, UK.
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Affiliation(s)
- A N Williams
- Child Development Centre, Northampton General Hospital, Northampton, NN1 5BD, UK.
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Ackland FM, Chandrakantha LE, Collinson J, Davis T, Griffin N, Hewertson J, Shribman S, Thompson F, Williams AN, Zaw W. The Good Samaritan. Arch Dis Child 2004; 89:688. [PMID: 15210512 PMCID: PMC1720001 DOI: 10.1136/adc.2003.042549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Alexander the Great was struck by a stone at the Siege of Cyropolis in 329 BC and was rendered temporarily blind and inaudible as a result. Although other authors have written extensively about the likely pathological effects of this injury, none have suggested carotid artery dissection as a possible cause. We present evidence that this should be considered as a differential diagnosis and how it might explain an unusual symptom seen at his deathbed in Babylon six years later.
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Affiliation(s)
- Andrew N Williams
- Centre for the History of Medicine, University of Birmingham Medical School, Birmingham, UK
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Sellathurai N, Clarke S, Williams AN. From containers to classrooms: converting capitalism's swords into ploughshares. Arch Dis Child 2004; 89:410. [PMID: 15102625 PMCID: PMC1719920 DOI: 10.1136/adc.2003.038364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- N Sellathurai
- Child Development Centre, Northampton General Hospital, Northampton NN1 5BD, UK
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