Healthcare professional experiences and attitudes on unlicensed/off-label paediatric prescribing and paediatric clinical trials.

Objectives: To investigate the knowledge and views of a range of healthcare professionals (consultant paediatricians, general practitioners (GPs), community pharmacists and paediatric nurses) regarding the use of unlicensed/off-label medicines in children and the participation of children in clinical trials.

Methods: A regional study in which a survey instrument with 39 items was issued to 500 randomly selected GPs, all community pharmacists (n?=?512), 50 hospital consultants and 150 paediatric nurses in Northern Ireland.

Results: Approximately half (46.5%) of the 1,212 healthcare professionals approached responded to the questionnaire. The majority of respondents indicated their familiarity with the term unlicensed (82.9%) or off-label (58.6%) prescribing with the most frequently quoted reason for such prescribing being younger age (33.6%). Apart from community pharmacists, most respondents reported having gained their knowledge through personal experience. Even though a large percentage of respondents expressed concerns about the safety (77.8%) or efficacy (87.9%) of unlicensed/off-label prescribing in children, only 30.7% reported informing parents/guardians of these concerns on the use of such medicines in children. In addition, only 56% of respondents believed that unlicensed/off-label medicines should undergo clinical trials in children. Overall, 28.4% of respondents (20.1% of GPs, 41.4% of community pharmacists, 27.7% of paediatric nurses and 94% of consultant paediatricians) indicated their willingness to be actively involved in, and recruit their patients for paediatric clinical research.

Conclusion: The use of unlicensed and off-label medicines remains a major issue in paediatric medicine. Until such times as more licensed medicines are available for children, clear guidance should be developed to allow consistency in practice across the spectrum of healthcare professionals who are involved with such medicines in their routine practice.

Disordered eating attitudes among female adolescents with Type 1 Diabetes: Role of mothers.

Previous research has demonstrated that disordered eating among adolescent females with type 1 diabetes (T1D) is related to the weight loss and eating attitudes of their mothers. The present research sought to examine the extent to which female adolescents’ perceptions of their mother’s weight loss and eating attitudes and behaviours explained the adolescents’ disordered eating attitudes and behaviours. Female adolescents with T1D and their mothers completed self-report questionnaires during outpatient clinic visits. Adolescents’ perceptions of their mother’s frequency of dieting behaviour and the importance of thinness to their mother were significant covariates of the adolescents’ body dissatisfaction and drive for thinness. Attitudes about disordered eating were also explained by different elements of family cohesion and mothers’ attitudes to weight loss. Routinely assessing perceptions of family and maternal attitudes and adopting a systemic approach to the care of adolescent females with T1D may help with the identification and management of these at-risk individuals.

A national clinical scenario-based survey of clinicians' attitudes towards fresh frozen plasma transfusion for critically ill patients

Background: It is known that 20-30% of fresh frozen plasma (FFP) is used in intensive care units (ICUs), but little is known about variations in decision making between clinicians in relation to coagulopathy management. Our aim was to describe ICU clinicians' beliefs and practice in relation to FFP treatment of non-bleeding coagulopathic critically ill patients.

Attitudes towards women in politics: Gender, generation and party identification in Ireland

This article analyzes the effects of gender, generation and party support towards a greater inclusion of women in politics in the Republic of Ireland and Northern Ireland. It explores attitudes on this issue using the same question in the Irish National Election Study (INES) and the Northern Ireland Life and Times Survey (NILT). The article documents a consistent gender gap in both polities that persists across the generations, despite controls for socio-demographic factors. It also reveals an unexpected generational effect that we explain as the enduring legacy of politicization to women’s rights during the 1970s. Support among party identifiers for more women in politics follows predictable lines, yet gender and generational patterns persist. The gender gap and generational patterns found in the two polities on the island provide reason for concern among those committed to gender equality in representation.