Bubble Wrap PLUS – June 2024

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). 

This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

In this month’s list of the journal club, we would like to draw your attention to some studies that caught our interest. 

The Lancet published a trial on a new vaccination technique that may overcome barriers to immunisation, such as strict cold-chain requirements, poor infrastructure, and concern about vaccine wastage. Microneedle patches (MNPs) are a new technological innovation to improve vaccine coverage, especially in developing countries. This (phase 1/2) RCT showed similar seroconversion rates between traditional vaccines and the MNPs. Importantly, the safety and tolerability of the MNPs were excellent.

However, there is still work to do: We need implementation studies in hard-to-reach locations, success rates with non-medical staff delivering and administering the MNPs, and expanding study participant eligibility to include broader age groups (particularly 6–9-month-olds) and vulnerable populations such as malnourished children. This will improve the generalisability of the findings. We are looking forward to being updated on these exciting new opportunities. 

Out-of-hospital cardiac arrest is associated with poorer outcomes, so training as many people as possible in the community in cardiopulmonary resuscitation (CPR) has the potential to close this gap, but manikins and courses are not cheap. Peixoto-Pino and colleagues investigated the option of training primary school children in a low-cost way. They used a (low-cost, ~€5) manikin with visual qualitative feedback and compared the results with the skills acquired by practice on a conventional manikin.

School children were allocated to the lost-cost (LoCoMan) or standard manikin (control) group. All participants practised for one hands-on skill session before performing a post-test on an instrumented CPR manikin. The control group achieved better chest compression depth, while the LoCoMan group showed more compressions with adequate chest recoil. The authors conclude that the approach can incentivise teachers to teach CPR and provide education outside the formal environment. Similar training initiatives (i.e. MiniPOP and others) have achieved great results. 

A frequently asked question in paediatric practice: “Look at this photo, are the stools of my baby supposed to be green/dark/mustard colour/almost black?” The study by Solasaari et al. described the defecation patterns of healthy infants in the first months of life. Parents completed weekly online questionnaires about feeding, gastrointestinal function, and crying. They found that defecation frequency was highest at the age of 3 weeks.

Not surprisingly, stool was most often yellow or light brown and nearly black stools were reported in the first week of life in 3.4%. Nearly half of the infants had green stool colour for at least one week. One in ten reported blood in stools, and one in twenty had recurrent episodes. Hard stools were rare (≤ 1%). The authors conclude that there is a large spectrum of defecation patterns in healthy term infants. 

We hope this month’s list will keep you interested in the progress in our field!

You will find the list is broken down into four sections:

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments!