Abstract - Edge Hill University
A systematic review of the organizational, environmental, professional and child and family factors influencing the timing of admission to hospital for children with serious infectious illnessShort title: Factors influencing timing of admission to hospital for children with serious infectious illnessBernie Carter1, Damian Roland2, Lucy Bray1, Jane Harris3, Poornima Pandey4, Jo Fox5, Enitan D Carrol6, Sarah Neill71Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK 2Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.3Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK.4Children’s and Adolescent Services, Kettering General Hospital NHS Foundation Trust, Kettering, UK.5Faculty of Health & Social Care, University of Chester, Chester, UK6Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, UK 7School of Nursing and Midwifery, University of Plymouth, Plymouth, UK.Corresponding author: Bernie Carter, bernie.carter@edgehill.ac.uk ORCID ID:?0000-0001-5226-9878AbstractBackground: Infection, particularly in the first 5 years of life, is a major cause of childhood deaths globally, many deaths from infections such as pneumonia and meningococcal disease are avoidable, if treated in time. Some factors that contribute to morbidity and mortality can be modified. These include organisational and environmental factors as well as those related to the child, family or professional.Objective: Examine what organizational and environmental factors and individual child, family and professional factors affect timing of admission to hospital for children with a serious infectious illness. Design: Systematic review.Data sources: Key search terms were identified and used to search CINAHL Plus, Medline, ASSIA, Web of Science, The Cochrane Library, Joanna Briggs Institute Database of Systematic Review.Study appraisal methods: Primary research (e.g. quantitative, qualitative and mixed methods studies) and literature reviews (e.g., systematic, scoping and narrative) were included if participants included or were restricted to children under 5 years of age with serious infectious illnesses, included parents and/or first contact health care professionals in primary care, urgent and emergency care and where the research had been conducted in OECD high income countries. The Mixed Methods Appraisal Tool was used to review the methodological quality of the studies.Main findings: Thirty-six papers were selected for full text review; 12 studies fitted the inclusion criteria. Factors influencing the timing of admission to hospital included the variability in children’s illness trajectories and pathways to hospital, parental recognition of symptoms and clinicians non-recognition of illness severity, parental help-seeking behaviour and clinician responses, access to services, use and non-use of ‘gut feeling’ by clinicians, and sub-optimal management within primary, secondary and tertiary services.Conclusions: The pathways taken by children with a serious infectious illness to hospital are complex and influenced by a variety of potentially modifiable individual, organisational, environmental and contextual factors. Supportive, accessible, respectful services that provide continuity, clear communication, advice and safety-netting are important as is improved training for clinicians and a mandate to attend to ‘gut feeling’.Implications: Relatively simple interventions such as improved communication have the potential to improve the quality of care and reduce morbidity and mortality in children with a serious infectious illness.Key wordsSerious infectious illness; factors; timing; admission; gut feeling; pathway; childIntroductionAlthough infection, particularly in the first 5 years of life, is a major cause of childhood deaths globally and in the UK ADDIN EN.CITE <EndNote><Cite><Author>Roser</Author><Year>2020</Year><RecNum>822</RecNum><DisplayText>(1)</DisplayText><record><rec-number>822</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">822</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Roser, M.</author><author>Ritchie, H. </author><author>Dadonaite, B.</author></authors></contributors><titles><title>Child & Infant Mortality.</title></titles><dates><year>2020</year></dates><urls><related-urls><url>';(1), many deaths from infections such as blood stream infection and invasive meningococcal disease are avoidable, if treated in time ADDIN EN.CITE <EndNote><Cite><Author>Wolfe</Author><Year>2011</Year><RecNum>823</RecNum><DisplayText>(2)</DisplayText><record><rec-number>823</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">823</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wolfe, Ingrid</author><author>Cass, Hilary</author><author>Thompson, Matthew J.</author><author>Craft, Alan</author><author>Peile, Ed</author><author>Wiegersma, Pieter A.</author><author>Janson, Staffan</author><author>Chambers, T. L.</author><author>McKee, Martin</author></authors></contributors><titles><title>Improving child health services in the UK: insights from Europe and their implications for the NHS reforms</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>d1277-d1277</pages><volume>342</volume><number>mar08 1</number><dates><year>2011</year></dates><isbn>0959-8138</isbn><urls><related-urls><url>;(2). However, differences are evident between high and low-income countries and between high-income countries; it is notable that approximately five more children die every day from avoidable causes, such as pneumonia, meningitis and septicaemia, in the UK compared to Sweden, the best in Europe PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Xb2xmZTwvQXV0aG9yPjxZZWFyPjIwMTE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (2-4). In the UK, the latest Child Death Reviews data - all child deaths - (year ending March 2019), identified modifiable factors (factors which may have contributed to the child's death, which could potentially be modified to reduce the risk of future deaths), in nearly 4 in every 10 deaths reviewed in children aged 28 days-364 days and those aged 15-17 years ADDIN EN.CITE <EndNote><Cite><Author>Community and Mental Health Team</Author><Year>2019</Year><RecNum>826</RecNum><DisplayText>(5)</DisplayText><record><rec-number>826</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">826</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Community and Mental Health Team, NHS Digital</author></authors></contributors><titles><title>Child Death Reviews</title></titles><number>30/12/2019</number><dates><year>2019</year></dates><publisher>NHS Digital</publisher><urls><related-urls><url>;(5). The report shows that of the 75 serious case reviews (not limited to serious infectious illness) that took place, 85% were identified as having modifiable factors, a higher proportion than the 74% reported in the previous year (ending 31 March 2018) ADDIN EN.CITE <EndNote><Cite><Author>Community and Mental Health Team</Author><Year>2019</Year><RecNum>826</RecNum><DisplayText>(5)</DisplayText><record><rec-number>826</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">826</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>Community and Mental Health Team, NHS Digital</author></authors></contributors><titles><title>Child Death Reviews</title></titles><number>30/12/2019</number><dates><year>2019</year></dates><publisher>NHS Digital</publisher><urls><related-urls><url>;(5). Modifiable factors which may influence timing of presentation to primary or secondary care can be related to organisational and environmental factors as well as those related to the child, family or professional. Organisational and environmental factors include: difficulties accessing primary care PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GcmFuY2lzPC9BdXRob3I+PFllYXI+MjAxMTwvWWVhcj48
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ADDIN EN.CITE.DATA (2, 8); direct access to HCPs with paediatric training in primary care ADDIN EN.CITE <EndNote><Cite><Author>Wolfe</Author><Year>2011</Year><RecNum>823</RecNum><DisplayText>(2)</DisplayText><record><rec-number>823</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">823</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wolfe, Ingrid</author><author>Cass, Hilary</author><author>Thompson, Matthew J.</author><author>Craft, Alan</author><author>Peile, Ed</author><author>Wiegersma, Pieter A.</author><author>Janson, Staffan</author><author>Chambers, T. L.</author><author>McKee, Martin</author></authors></contributors><titles><title>Improving child health services in the UK: insights from Europe and their implications for the NHS reforms</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>d1277-d1277</pages><volume>342</volume><number>mar08 1</number><dates><year>2011</year></dates><isbn>0959-8138</isbn><urls><related-urls><url>;(2); and missed opportunities for antibiotic prescribing and failure to obtain antibiotics ADDIN EN.CITE <EndNote><Cite><Author>Grant</Author><Year>2012</Year><RecNum>830</RecNum><DisplayText>(9)</DisplayText><record><rec-number>830</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">830</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Grant, CC</author><author>Harnden, A</author><author>Mant, D</author><author>Emery, D</author><author>Coster, G</author></authors></contributors><titles><title>Why do children hospitalised with pneumonia not receive antibiotics in primary care?</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>21-27</pages><volume>97</volume><number>1</number><dates><year>2012</year></dates><urls><related-urls><url>;(9). Professional factors include the challenge experienced by some health care professionals in determining whether or not a child is seriously ill at first presentation PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CdW50aW54PC9BdXRob3I+PFllYXI+MjAxMTwvWWVhcj48
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ADDIN EN.CITE.DATA (10, 11). This challenge exists despite infectious illness in childhood constituting approximately 50% of children’s GP consultations and 12% of children’s hospitalisations ADDIN EN.CITE <EndNote><Cite><Author>Health Protection Agency</Author><Year>2005</Year><RecNum>832</RecNum><DisplayText>(12)</DisplayText><record><rec-number>832</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">832</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>Health Protection Agency,</author></authors><tertiary-authors><author>Health Protection Agency</author></tertiary-authors></contributors><titles><title>Health Protection in the 21st Century. Understanding the Burden of Disease; preparing for the future.</title></titles><dates><year>2005</year></dates><pub-location>London</pub-location><urls></urls></record></Cite></EndNote>(12). Child and family related factors include: parents’ perception of criticism from professionals consulted PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Kb25lczwvQXV0aG9yPjxZZWFyPjIwMTM8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (6, 7, 15, 16). The uncertainties experienced by parents may be compounded by the repeated message for the public not to use emergency services for minor illness ADDIN EN.CITE <EndNote><Cite><Author>NHS Institute for Innovation and Improvement </Author><Year>2010</Year><RecNum>837</RecNum><DisplayText>(17)</DisplayText><record><rec-number>837</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">837</key></foreign-keys><ref-type name="Report">27</ref-type><contributors><authors><author>NHS Institute for Innovation and Improvement ,</author></authors><tertiary-authors><author>NHS Institute for Innovation and Improvement</author></tertiary-authors></contributors><titles><title>Focus on Children and Young People Emergency and Urgent Care Pathway. Delivering on Quality and Value</title></titles><dates><year>2010</year></dates><pub-location>Coventry</pub-location><urls><related-urls><url>;(17); this may result in delayed presentation to healthcare PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5OZWlsbDwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (15) resulting in the child's illness becoming more serious than if earlier treatment had been sought. A cohesive consideration of the literature on factors that may influence the timing of presentation is not available within the literature; this systematic review aimed to synthesise the existing evidence.MethodsA systematic review was undertaken to locate, appraise and synthesise evidence to answer our review question: what organizational and environmental factors and individual child, family and professional factors affect timing of admission to hospital for children with a serious infectious illness? Note: Admission to hospital was defined as having presented to hospital and being actively investigated and treated. The conduct and reporting of this study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance for systematic reviews PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb2hlcjwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (18). There is no published copy of the review protocol.Definition of serious infectious illnessSerious infectious illness (SII) includes diagnoses such as pneumonia, bronchiolitis, meningitis, encephalitis, and sepsis. Specific criteria exist for each disease to determine its seriousness reflecting different requirements; these include identification of significant bacterial pathogen, clinical signs of sepsis, radiological confirmation plus other specific criteria PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11) (see Supporting Information File 1 for definitions and criteria for serious infectious illness).Search strategyA comprehensive search strategy with no date limits was undertaken in the following databases: CINAHL Plus with full text, Medline, ASSIA, Web of Science, The Cochrane Library and the Joanna Briggs Institute Database of Systematic Review. The search was originally undertaken in September 2015 and it was updated in March 2019 and June 2020 (last date of search 10th June 2020). Both thesaurus and free text terms were searched. In order to enhance the rigour of our search, an adapted version of PICO was used to ensure that our search was directly relevant to the research question (see Table 1). Truncation and proximity operators were employed to increase the sensitivity of the search (see Supporting Information File 2 for Full Medline Search). Reference lists of key texts were also searched for any additional papers. Our detailed search strategy is presented in Table 2.Table 1: Adapted PICO that structured the searchPICO DefinitionRelated search termsParticipantsChildren with a focus on those under 5yrs old with serious infectious illness and their familiesFamily OR Families OR parent*OR caregiver* OR caretaker*OR carer*OR mother OR father AND Child* OR infant* or bab* or P?diatric*AND Serious infectio* OR Septi* (to capture septicaemia and septic) OR Sepsis OR Pneumonia OR Mening* (to capture meningococcal disease and meningitis) OR Encephalitis OR RespiratoryFirst contact health care professionals in primary care, urgent & emergency careGeneral practi* (to capture general practice and general practitioners) OR Health visitor OR Paramedic*Family doctor OR Family physician OR Nurse OR Practice nurse OR Community children’s nurse OR P?diatric nurse OR children’s NursContextPrimary care, first contact services, care in the homeOut of hours OR After hoursAmbulatory care OR Urgent care OR Emergency careAmbulance serviceNHS111 OR telephone service OR telephone triage OR helplineCommunity OR Primary careFirst contact* InterestFactors affecting timing of admission to hospital/children’s journey Tim* of admission OR dela* admission OR late presentation OR deter presentation OR dela* presentationTim* of treatment OR dela* treatment OR late treatment OR earl* treatment OR timely treatment OR timely consultation OR dela* consultation Tim* of assessment OR dela* assessment OR late assessmentTim* of referral OR del* referral OR late referralEarl* diagnosis OR Late diagnosis OR Missed opportunities OR Recognition OR earl* intervention OR interpretation of symptoms OR identification of symptomsBarriers to healthcare OR access to health*Preventable OR increased OR decreased AND morbidity OR mortalitySafety netting OR Information seeking OR information giv* OR Recognising symptoms OR health seekingHealth service OR health systemsTimely treatment OR Rapid managementOutcomeConsequences of factors affecting timing of admission such as timely treatment, early or delayed diagnosis, increased or decreased morbidity/mortalityTable 2: Detailed search strategyFamily OR families OR parent* OR caregiver* OR caretaker OR carer* OR mother OR fatherANDChild* OR infant* or bab* or P?diatric*ANDSerious infection* OR Septi* or Sepsis OR Pneumonia OR mening* OR encephalitis OR RespiratorySeverity of illnessANDGeneral practi* OR Health visitor OR Paramedic* OR Family doctor OR Family physician OR Nurse OR Practice nurse OR Community children’s nurse OR P?diatric nurse OR children’s NurseANDTim* of admission OR dela* admission OR late presentation OR deter presentation OR dela* presentationTim* of treatment OR dela* treatment OR late treatment OR earl* treatment OR timely treatment OR timely consultation OR dela* consultation Tim* of assessment OR dela* assessment OR late assessmentTim* of referral OR del* referral OR late referralEarl* diagnosis OR Late diagnosis OR Missed opportunities OR Recognition OR earl* intervention OR interpretation of symptoms OR identification of symptomsBarriers to healthcare OR access to health*Preventable OR increased OR decreased AND morbidity OR mortalitySafety netting OR Information seeking OR information giv*OR Recognising symptoms OR health seekingHealth service OR health systemsTimely treatment OR Rapid managementANDOut of hours OR After hoursAmbulatory care OR Urgent care OR Emergency careAmbulance serviceNHS111 OR telephone service OR telephone triage OR helplineCommunity OR Primary careFirst contact* LIMITS Academic journals Language- EnglishNo limits set on dateInclusion criteria and study selectionStudies were included in the review if they fulfilled all of the criteria identified in Table 3. Our intention in focusing on high income countries was to examine a pool of articles where differences due to access to, capacity and organisation of health care were minimised. This was felt to be important as our review was Stage 1 of a larger UK-based study and we needed the findings to directly inform our research in relation to the UK health care context. A two-stage approach to screening was adopted. Stage 1 involved the independent screening of titles and abstracts (performed by JF, SN). References clearly meeting the inclusion criteria, or those where relevance was unclear, were taken forward to the next stage. Stage 2 involved the full-text screening of the studies against the inclusion criteria (performed by JF, SN, BC). We attempted to obtain full-text articles as this was seen as important in the quality appraisal process; authors were contacted to obtain the full-text articles not readily available via other sources. In order to minimize selection bias, at least two reviewers considered each paper in both stages of the screening process. If consensus could not be agreed or uncertainty existed, a third reviewer was involved in screening. Table 3: Inclusion and exclusion criteriaInclusion criteriaPrimary research including quantitative studies (e.g., randomized controlled clinical trials, non-randomized controlled trials, cohort studies, case-control studies, cross-sectional analytic studies, incidence or prevalence studies), qualitative studies (e.g., ethnography, phenomenology, grounded theory, and qualitative description), mixed method studies and literature reviews (e.g., systematic, meta-analysis, scoping, narrative, and integrative).Published in EnglishSample including or restricted to children under 5 years of age with serious infectious illnessesParents/carers/ first contact health professionalsChildren presenting late or who would have benefitted from earlier treatmentResearch conducted in OECD high income countries.Exclusion criteriaPublished in other languagesExclusively about adult illnessesNot about children with infectious illnessChildren in the sample all over 5 years of ageSample group exclusively children with HIV/ AIDS, complex or chronic childhood illness without infectious illnessResearch conducted in low- or middle-income countriesData analysis and synthesisA comprehensive data extraction form was developed, piloted and used to extract data specific to the aims and objectives of the review; this form aimed to provide consistency and transparency in documenting and reporting. This form was uploaded onto Google docs and two reviewers (JH and DR) extracted into the online form. This form was then exported as a .csv file and its content reviewed, refined and condensed. Tables 4 (condensed summary) and Supporting Information File 3: (detailed summary) present the data extraction. Due to clinical and methodological heterogeneity, a narrative approach to data synthesis and presentation was undertaken. Table 4: Condensed Data Extraction SummaryAuthor, Year, CountryStudy DesignNo in SampleChild age, Socioeconomic Status (SES), Disease Characteristics, Parent age/genderHelp-seeking behaviours, Organisational factors, Environmental factors, SES, Other findings.Crocker (2013) UK ADDIN EN.CITE <EndNote><Cite><Author>Crocker</Author><Year>2013</Year><RecNum>828</RecNum><DisplayText>(7)</DisplayText><record><rec-number>828</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">828</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Crocker, Joanna C.</author><author>Evans, Meirion R.</author><author>Powell, Colin V. E.</author><author>Hood, Kerenza</author><author>Butler, Christopher C.</author></authors></contributors><titles><title>Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization</title><secondary-title>European Journal of General Practice</secondary-title></titles><periodical><full-title>European Journal of General Practice</full-title></periodical><pages>213-220</pages><volume>19</volume><number>4</number><dates><year>2013</year></dates><accession-num>23815375</accession-num><urls><related-urls><url>;(7)Design: Mixed methods sequential sub sample design. N=151 Child age: 6 months-16yrs (mean 5yrs)SES: All quintiles represented.Disease: Community acquired pneumonia or empyema.Parent: Carer gender not recordedHelp-seeking behaviours: Late/non-consulters significantly less likely to have taken antibiotics before presenting to hospital, & significantly more likely to have obtained advice (e.g., NHS Direct Telephone helpline) and had significantly more rapid onset of illness.? Various parent factors reported (e.g., did not think earlier symptoms were serious/unusual due to child initially improving). Organisational: Various factors for no GP presentation (e.g. GP surgery closed). Environmental: Various factors for late/no GP presentation (e.g. unable to travel to GP surgery). SES: Late/non-consultation?associated with lack of home ownership, WIMD quintile and higher ratio of children: adults in household.?Emery (2015), New Zealand PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5FbWVyeTwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (19)Design: Mixed methods. N=856Child age: <5yrs (mean 19mths). SES: Measured by household deprivation score. Disease: Pneumonia. Help-seeking behaviours: Various factors were associated with likelihood of ED presentation: increased (e.g. lower parental satisfaction scores for communication); decreased (e.g. children whose caregivers would take them back to the same doctor if still unwell). Various factors were associated with likelihood of ED admission: increased (children who had made more health professional visits before presentation); decreased (e.g., children whose caregivers would take them to a hospital ED if they had been seen the previous day by their GP and were still unwell). Organisational: Various factors associated with increased likelihood of presenting (e.g. GP worked ?20hr week) and increased likelihood of hospital admission with pneumonia (e.g., antibiotics prescribed by GP before ED presentation).Francis (2011), UK ADDIN EN.CITE <EndNote><Cite><Author>Francis</Author><Year>2011</Year><RecNum>827</RecNum><DisplayText>(6)</DisplayText><record><rec-number>827</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">827</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Francis, Nick A</author><author>Crocker, Joanna C</author><author>Gamper, Arla</author><author>Brookes-Howell, Lucy</author><author>Powell, Colin</author><author>Butler, Christopher C</author></authors></contributors><titles><title>Missed opportunities for earlier treatment? A qualitative interview study with parents of children admitted to hospital with serious respiratory tract infections</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>154-159</pages><volume>96</volume><number>2</number><dates><year>2011</year></dates><urls><related-urls><url>;(6)Design: Qualitative study. N=22Child age: 16 months-13yrs (median 4yrs).SES: Not reported. Disease: Empyema, pneumonia, peritonsillar abscess, mastoiditis, lateral sinus thrombosis.Parent: Mothers (n=22), father (n=1)Help-seeking behaviours: All parents described potentially serious symptoms. Although most regarded these symptoms as unusual/worrying, nearly half described delay of 24h or more between first identifying the symptom(s) and consulting. Parents not consulting earlier because of a fear of ‘overreacting’, not wanting to ‘bother’ service or past experience. Organisational (parent reported): Delays included difficulties with GP appointment system (e.g., prolonged waits for emergency appointments), failures/problems of appropriate triage, and failures of HCPs to respond appropriately after child had developed one or more serious symptoms. Grant (2012), New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Grant</Author><Year>2012</Year><RecNum>830</RecNum><DisplayText>(9)</DisplayText><record><rec-number>830</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">830</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Grant, CC</author><author>Harnden, A</author><author>Mant, D</author><author>Emery, D</author><author>Coster, G</author></authors></contributors><titles><title>Why do children hospitalised with pneumonia not receive antibiotics in primary care?</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>21-27</pages><volume>97</volume><number>1</number><dates><year>2012</year></dates><urls><related-urls><url>;(9)Design: Case series.N=280Child age: <5yrs (median 17mths).SES: NZ Index of Social Deprivation. Disease: Pneumonia. Other findings: Receipt of antibiotic more likely if child seen by own General Practitioner (GP), less likely if the primary care clinician failed to make a diagnosis of LRTI. Mild pneumonia associated with increased likelihood of being prescribed antibiotics.? Children with no opportunity to receive antibiotics had more rapidly evolving illness than those with opportunity to receive antibiotics. Various reasons for missed opportunity to receive antibiotics.Kilpi (1991), Finland PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaWxwaTwvQXV0aG9yPjxZZWFyPjE5OTE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (20)Design: Prospective cases series. N=286 Child age: 3 months-15yrs (mean 2.9yrs).SES: Not reported.Disease: Included bacterial meningitis, haemophilus influenzae type b. Other findings: Level of consciousness significantly poorer in children with short history of illness than those with long history. Seizures before or on admission were more common in the short history than the intermediate or long history groups. Children with long history of illness significantly younger than those ill for up to 48hr. McIntyre (2005), Australia ADDIN EN.CITE <EndNote><Cite><Author>McIntyre</Author><Year>2005</Year><RecNum>845</RecNum><DisplayText>(21)</DisplayText><record><rec-number>845</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">845</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McIntyre, P B</author><author>MacIntyre, C R</author><author>Gilmour, R</author><author>Wang, H</author></authors></contributors><titles><title>A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>391-396</pages><volume>90</volume><number>4</number><dates><year>2005</year></dates><urls><related-urls><url>;(21)Design: Case series.N=122Child age: 1.78-179mths (median 13mths). SES: Not reported.Other findings: Significant diagnostic and prognostic predictors of outcome were not having a lumbar puncture done, intensive care admission, intubation, any neurological abnormality, seizures within 48 hours, and higher temperature. The only significant therapeutic factor was administration of corticosteroids with or before antibiotics.?Nadel (1998), UK ADDIN EN.CITE <EndNote><Cite><Author>Nadel</Author><Year>1998</Year><RecNum>841</RecNum><DisplayText>(22)</DisplayText><record><rec-number>841</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nadel, S.</author><author>Britto, J.</author><author>Booy, R.</author><author>Maconochie, I.</author><author>Habibi, P.</author><author>Levin, M.</author></authors></contributors><titles><title>Avoidable deficiencies in the delivery of health care to children with meningococcal disease</title><secondary-title>Journal of Accident & Emergency Medicine</secondary-title></titles><periodical><full-title>Journal of accident & emergency medicine</full-title></periodical><pages>298-303</pages><volume>15</volume><number>5</number><keywords><keyword>meningitis</keyword><keyword>treatment delays</keyword><keyword>mortality</keyword><keyword>children</keyword><keyword>inappropriate treatment</keyword></keywords><dates><year>1998</year></dates><isbn>1351-0622</isbn><accession-num>9785154</accession-num><urls><related-urls><url>;(22)Design: Prospective case note review. N=54Child age: 1 week-15.7yrs (median 2.95yrs)SES: Not reported.Disease: Meningococcal septicaemia, meningococcal meningitis.Help-seeking behaviours: Various reasons for some parents delaying presentation (e.g., hesitation to call GP, inappropriately reassured by advice over phone). In all cases, parents were unaware of signs of serious illness in their child. Other findings: Among children with septicaemia delay from onset until treatment initiation was longer for those who died compared with survivors. Okike (2017), UK ADDIN EN.CITE <EndNote><Cite><Author>Okike</Author><Year>2017</Year><RecNum>843</RecNum><DisplayText>(23)</DisplayText><record><rec-number>843</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">843</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Okike, Ifeanyichukwu O</author><author>Ladhani, Shamez N</author><author>Anthony, Mark</author><author>Ninis, Nelly</author><author>Heath, Paul T</author></authors></contributors><titles><title>Assessment of healthcare delivery in the early management of bacterial meningitis in UK young infants: an observational study</title><secondary-title>BMJ Open</secondary-title></titles><periodical><full-title>BMJ Open</full-title></periodical><pages>e015700</pages><volume>7</volume><number>8</number><dates><year>2017</year></dates><urls><related-urls><url>;(23)Design: Retrospective medical case note review.N=97Child age: <90 days SES: Addressed by parental accommodation.Disease: Included Group B strep, E Coli, other gram-negative/positive bacteria. ?Parent age: (median) mothers 29yrs; fathers 32yrs.Help-seeking behaviour: 20 parents took infants straight to the hospital, remainder phoned GP or 24-hour telephone service or contacted community midwife. Majority of parents presented to hospital within 24 hours of onset of symptoms. Organisational: Uncertainty in recognition, over-reliance on the presence of fever, waiting for urine samples before giving antibiotics and waiting for handover between shifts. Other findings: 55% infants triaged in Emergency Department during normal working hours. Thompson (2006), UK ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24)Design: Observational study. N=448Child age: ≤16yrs.SES: Not reported. Disease: Meningococcal disease Help-seeking behaviour: 51% of children seen by GP were sent to hospital from the 1st consultation. In most children, disease progressed very rapidly. 25% children had symptoms in the two weeks before the onset of meningococcal disease. Only 7% children had seen a doctor in the week before the onset of disease. 76.1% parents had noticed 1/more of early symptoms before hospital admission. Other findings: Fever was 1st symptom to be noticed in children <5yrs; headache 1st to be seen in those >5yrs. First specific clinical signs of sepsis: leg pain, abnormal skin colour, cold hands and feet, and, in older children, thirst. 1st classic symptom of meningococcal disease to emerge was rash. Urbane (2019), Latvia PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5VcmJhbmU8L0F1dGhvcj48WWVhcj4yMDE5PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (25)Design: Prospective observational study. N=162Age: 2mths-17.8yrs (median 43.5mths).SES: Not reported. Disease: Included UTI, sepsis, pneumonia, acute osteomyelitis with bacteraemia Parent age: Median: mothers 34yrs; fathers 33yrs. Help-seeking behaviour: 59.9% parents stated belief that fever itself is indicative of serious illness, some parents believed that other symptoms must be considered as well when evaluating the severity of illness, few parents did not believe that fever is indicative of serious illness. No association was found between the belief that fever is indicative of serious illness and parental concern. Other findings: The presence of clinician’s “gut feeling” was significantly more common in children who developed serious bacterial infection than in those who did not, as was “sense of reassurance” in the cases with no serious bacterial infection.Van den Bruel (2012), Belgium PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11)Design: Observational study.N=3890Age: 0-16yrs (mean 5.05yrs).SES: Not reported.Disease: Pneumonia, pyelonephritis, sepsis, meningitis, cellulitis & bacterial lymphangitis. Other findings: Gut feeling that something was wrong despite clinical assessment of a non-serious illness increased risk of serious illness & acting on this feeling had potential to prevent cases being missed at cost of 44 false alarms. Compared with clinical impression that the children were seriously ill, gut feeling was consistently more specific, irrespective of the children’s age or diagnosis or the seniority of the doctor. ? Young (2001), New Zealand PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb3VuZzwvQXV0aG9yPjxZZWFyPjIwMDE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (26)Design: Qualitative. N=12Age: <2yrs. SES: Not reported. Disease: Viral or bacterial pneumonia.Help-seeking behaviour: Caregivers perceived themselves to be competent (e.g., prompt taking them to doctor, knew instinctively the child was unwell) but felt these subjective feelings dismissed by the doctor leading to mistrust. All parents sent home after the initial consultation but quick to return to doctor if they felt their child was not improving. Personal barriers to accessing GP existed (e.g. lack of knowledge about services, feeling dismissed as unimportant by HCPs). Organisational: Most caregivers visited 2 or more doctors in the community before being referred/self-referring. Environmental: Non-financial barriers for attending accident/medical setting rather than GP reported (e.g., GP fully booked, limited transport to GP).Appraisal of study qualityThe Mixed Methods Appraisal Tool (MMAT): version 2018 ADDIN EN.CITE <EndNote><Cite><Author>Hong</Author><Year>2018</Year><RecNum>839</RecNum><DisplayText>(27)</DisplayText><record><rec-number>839</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">839</key></foreign-keys><ref-type name="Electronic Article">43</ref-type><contributors><authors><author>Hong, Q.N</author><author>Pluye,P.</author><author>Fàbregues, S.</author><author>Bartlett, G.</author><author>Boardman, F.</author><author>Cargo, M.</author><author>Dagenais, P.</author><author>Gagnon, M-P.</author><author>Griffiths, F.</author><author>Nicolau, B.</author><author>O’Cathain, A.</author><author>Rousseau, M-C.</author><author>Vedel, I.</author></authors></contributors><titles><title>Mixed Methods Appraisal Tool (MMAT) Version 2018: User Guide.</title><secondary-title>Registration of Copyright (#1148552), Canadian Intellectual Property Office, Industry Canada</secondary-title></titles><periodical><full-title>Registration of Copyright (#1148552), Canadian Intellectual Property Office, Industry Canada</full-title></periodical><dates><year>2018</year></dates><urls></urls></record></Cite></EndNote>(27) was used to review, but not score, the methodological quality of the included studies. The MMAT facilitates the critical appraisal process "by providing, within a single tool, methodological quality criteria for different designs" PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib25nPC9BdXRob3I+PFllYXI+MjAxOTwvWWVhcj48UmVj
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ADDIN EN.CITE.DATA (28) p57. Five reviewers (BC, DR, SN, LB, PP) independently reviewed the extracted data and quality assessed the included studies. The quality assessment of the included studies is detailed in Table 6. Since none of the studies had a clear research question, we modified the first screening question to include clear aims/objectives. Key quality issues related to the research design not being clearly stated, challenges of recruiting representative sample, and studies being underpowered (see Table 4 and Supporting Information File: Table 3). Note: Although the two studies we have reported as mixed methods did not self-define themselves as such, they used both quantitative and qualitative (interview) methods. ResultsThe search located 2283 references, a further 16 papers were identified from other sources and 2299 records were screened, duplicates and ineligible papers removed leaving 36 eligible for full text review which were read and assessed against the inclusion and exclusion criteria for the review; of these, 24 papers were excluded. The primary reasons for exclusion were; data not from OECD high income country (n=17), not focused on factors influencing timing of admission (n=5), case report (n=1), and literature review presenting combined data (n=1). Twelve papers were included in the review (see Figure 1 for PRISMA flow diagram). Figure 2 presents the summary of the findings.Figure 1: PRISMA Flow Diagram-190831-42354500Figure 2: Overview of factors influencing timing of admissionOverview of included studiesData reported on studies undertaken in the UK (n=5) PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Dcm9ja2VyPC9BdXRob3I+PFllYXI+MjAxMzwvWWVhcj48
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ADDIN EN.CITE.DATA (20), Australia ADDIN EN.CITE <EndNote><Cite><Author>McIntyre</Author><Year>2005</Year><RecNum>845</RecNum><DisplayText>(21)</DisplayText><record><rec-number>845</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">845</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McIntyre, P B</author><author>MacIntyre, C R</author><author>Gilmour, R</author><author>Wang, H</author></authors></contributors><titles><title>A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>391-396</pages><volume>90</volume><number>4</number><dates><year>2005</year></dates><urls><related-urls><url>;(21), Latvia PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5VcmJhbmU8L0F1dGhvcj48WWVhcj4yMDE5PC9ZZWFyPjxS
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Tm90ZT4A
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ADDIN EN.CITE.DATA (11), both hospital and primary care (n=1) ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24), via a register/database (n=2) PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NY0ludHlyZTwvQXV0aG9yPjxZZWFyPjIwMDU8L1llYXI+
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ADDIN EN.CITE.DATA (21, 23). The number of participants included in the studies ranged from 12 PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb3VuZzwvQXV0aG9yPjxZZWFyPjIwMDE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (26) to 3890 PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (19); response bias ADDIN EN.CITE <EndNote><Cite><Author>Crocker</Author><Year>2013</Year><RecNum>828</RecNum><DisplayText>(7)</DisplayText><record><rec-number>828</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">828</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Crocker, Joanna C.</author><author>Evans, Meirion R.</author><author>Powell, Colin V. E.</author><author>Hood, Kerenza</author><author>Butler, Christopher C.</author></authors></contributors><titles><title>Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization</title><secondary-title>European Journal of General Practice</secondary-title></titles><periodical><full-title>European Journal of General Practice</full-title></periodical><pages>213-220</pages><volume>19</volume><number>4</number><dates><year>2013</year></dates><accession-num>23815375</accession-num><urls><related-urls><url>;(7); recall bias (n=5) PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5HcmFudDwvQXV0aG9yPjxZZWFyPjIwMTI8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (6, 24); incomplete data ADDIN EN.CITE <EndNote><Cite><Author>McIntyre</Author><Year>2005</Year><RecNum>845</RecNum><DisplayText>(21)</DisplayText><record><rec-number>845</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">845</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McIntyre, P B</author><author>MacIntyre, C R</author><author>Gilmour, R</author><author>Wang, H</author></authors></contributors><titles><title>A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>391-396</pages><volume>90</volume><number>4</number><dates><year>2005</year></dates><urls><related-urls><url>;(21); and study being underpowered PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11).Table 5: MMAT synthesisAuthorScreening questionsCriteria specific to study design Qualitative criteriaAuthor (year)Clear research questions or aims/ objectives?Does data address research questions?Is qualitative approach appropriate?Are qualitative data collection methods adequate?Are findings adequately derived from the data?Interpretation of results substantiated by data?Is there coherence across all stages of study?Francis et al (2011)YesYesYes. YesYesYesYesYoung (2001)YesYesYesYesCT YesYesQuantitative non-randomized criteriaAuthor (year)Clear research questions or aims/ objectives?Does data address research questions?Are participants representative of target population?Are measurements appropriate?Are there complete outcome data?Are confounders accounted for the design/ analysis?Is intervention /exposure as intended?Emery et al. (2015)YesYesYesYes. YesYes. N/A. Quantitative descriptive criteriaAuthor (year)Clear research questions or aims/ objectives?Does data address research questions?Is sampling strategy relevant?Is sample representative of the target population?Are measurements appropriate?Is risk of nonresponse bias low?Is statistical analysis appropriate?Grant et al. (2012)YesYesYesYesYesCTYesKilpi et al (1991)YesYesYesCTYesCTYesMcIntyre et al. (2005)YesYesYesYesYesYesYesOkike et al. (2017)YesYesYesCTYes. NoYesThompson et al (2006)YesYesYesYesYesNoYesUrbane et al. (2019)YesYesYesNoYesCTYesVan den Bruel (2012)YesYesYesYesYesYesYesMixed methods criteriaAuthor (year)Clear research questions clear aims/ objectives?Does data address research questions?Is there an adequate rationale for using mixed methods?Are different study components integrated?Are the outputs of integration adequately interpreted?Are inconsistencies results addressed?Are quality criteria adhered to?Crocker et al. (2013)YesYesNoYesCTYesYesNadel et al. (1998)YesYesNoYesYesNoNoPresenting symptomsA range of presenting symptoms (respiratory, neurological, systemic) were reported within the studies. Some symptoms were specific for meningococcal disease or pneumonia. A limited number of symptoms were reported for children presenting with either meningococcal disease or pneumonia; these were increased respiratory rate, breathing difficulties; vomiting, poor feeding; and increased sleeping, lethargy, drowsiness PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5HcmFudDwvQXV0aG9yPjxZZWFyPjIwMTI8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (20, 23), abnormal skin colour, thirst, and rash ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24). Most symptoms occurred before first medical contact ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24).Timing-related factorsDelays occurred within both home and primary care settings. Delays in presentation to either primary or secondary care were associated with issues related to recognition, presentation, interpretation and treatment (primarily administration of parenteral antibiotics) PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Pa2lrZTwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (21-23). For children with septicaemia the delay from onset was longer for those who died compared with survivors ADDIN EN.CITE <EndNote><Cite><Author>Nadel</Author><Year>1998</Year><RecNum>841</RecNum><DisplayText>(22)</DisplayText><record><rec-number>841</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nadel, S.</author><author>Britto, J.</author><author>Booy, R.</author><author>Maconochie, I.</author><author>Habibi, P.</author><author>Levin, M.</author></authors></contributors><titles><title>Avoidable deficiencies in the delivery of health care to children with meningococcal disease</title><secondary-title>Journal of Accident & Emergency Medicine</secondary-title></titles><periodical><full-title>Journal of accident & emergency medicine</full-title></periodical><pages>298-303</pages><volume>15</volume><number>5</number><keywords><keyword>meningitis</keyword><keyword>treatment delays</keyword><keyword>mortality</keyword><keyword>children</keyword><keyword>inappropriate treatment</keyword></keywords><dates><year>1998</year></dates><isbn>1351-0622</isbn><accession-num>9785154</accession-num><urls><related-urls><url>;(22). Delay between presentation and initiation of treatment for meningitis was 2-12 hours (9 children had repeat visits to GP, 7 taken to A&E without further attempts to see GP) ADDIN EN.CITE <EndNote><Cite><Author>Nadel</Author><Year>1998</Year><RecNum>841</RecNum><DisplayText>(22)</DisplayText><record><rec-number>841</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nadel, S.</author><author>Britto, J.</author><author>Booy, R.</author><author>Maconochie, I.</author><author>Habibi, P.</author><author>Levin, M.</author></authors></contributors><titles><title>Avoidable deficiencies in the delivery of health care to children with meningococcal disease</title><secondary-title>Journal of Accident & Emergency Medicine</secondary-title></titles><periodical><full-title>Journal of accident & emergency medicine</full-title></periodical><pages>298-303</pages><volume>15</volume><number>5</number><keywords><keyword>meningitis</keyword><keyword>treatment delays</keyword><keyword>mortality</keyword><keyword>children</keyword><keyword>inappropriate treatment</keyword></keywords><dates><year>1998</year></dates><isbn>1351-0622</isbn><accession-num>9785154</accession-num><urls><related-urls><url>;(22). Median time from onset of first feature to first help in infants (meningitis) was 5 hours and this median was longer for infants with poor outcomes than those who recovered without sequelae ADDIN EN.CITE <EndNote><Cite><Author>Okike</Author><Year>2017</Year><RecNum>843</RecNum><DisplayText>(23)</DisplayText><record><rec-number>843</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">843</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Okike, Ifeanyichukwu O</author><author>Ladhani, Shamez N</author><author>Anthony, Mark</author><author>Ninis, Nelly</author><author>Heath, Paul T</author></authors></contributors><titles><title>Assessment of healthcare delivery in the early management of bacterial meningitis in UK young infants: an observational study</title><secondary-title>BMJ Open</secondary-title></titles><periodical><full-title>BMJ Open</full-title></periodical><pages>e015700</pages><volume>7</volume><number>8</number><dates><year>2017</year></dates><urls><related-urls><url>;(23). There was close correspondence between median time of onset of meningococcal rash and first medical contact ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24). 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ADDIN EN.CITE.DATA (6, 7, 19, 22-26); parents of younger children were more likely to consult than those with older children ADDIN EN.CITE <EndNote><Cite><Author>Crocker</Author><Year>2013</Year><RecNum>828</RecNum><DisplayText>(7)</DisplayText><record><rec-number>828</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">828</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Crocker, Joanna C.</author><author>Evans, Meirion R.</author><author>Powell, Colin V. E.</author><author>Hood, Kerenza</author><author>Butler, Christopher C.</author></authors></contributors><titles><title>Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization</title><secondary-title>European Journal of General Practice</secondary-title></titles><periodical><full-title>European Journal of General Practice</full-title></periodical><pages>213-220</pages><volume>19</volume><number>4</number><dates><year>2013</year></dates><accession-num>23815375</accession-num><urls><related-urls><url>;(7). Parents sought help for their sick child from a range of different health care sources including A&E, urgent care, GP, 24hr NHS direct line telephone service, midwife, website PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Dcm9ja2VyPC9BdXRob3I+PFllYXI+MjAxMzwvWWVhcj48
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ADDIN EN.CITE.DATA (7, 23). Broadly those factors that hindered initial and ongoing help-seeking could be placed into three categories: understanding, relational, and fear related. Issues related to understanding included parents/carers not recognising their child’s symptoms as being problematic and therefore not seeking help from a GP ADDIN EN.CITE <EndNote><Cite><Author>Crocker</Author><Year>2013</Year><RecNum>828</RecNum><DisplayText>(7)</DisplayText><record><rec-number>828</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">828</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Crocker, Joanna C.</author><author>Evans, Meirion R.</author><author>Powell, Colin V. E.</author><author>Hood, Kerenza</author><author>Butler, Christopher C.</author></authors></contributors><titles><title>Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization</title><secondary-title>European Journal of General Practice</secondary-title></titles><periodical><full-title>European Journal of General Practice</full-title></periodical><pages>213-220</pages><volume>19</volume><number>4</number><dates><year>2013</year></dates><accession-num>23815375</accession-num><urls><related-urls><url>;(7), difficulty in assessing and/or interpreting their child's condition PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GcmFuY2lzPC9BdXRob3I+PFllYXI+MjAxMTwvWWVhcj48
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ADDIN EN.CITE.DATA (6, 22), and poor understanding of their child's illness post-consultation ADDIN EN.CITE <EndNote><Cite><Author>Francis</Author><Year>2011</Year><RecNum>827</RecNum><DisplayText>(6)</DisplayText><record><rec-number>827</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">827</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Francis, Nick A</author><author>Crocker, Joanna C</author><author>Gamper, Arla</author><author>Brookes-Howell, Lucy</author><author>Powell, Colin</author><author>Butler, Christopher C</author></authors></contributors><titles><title>Missed opportunities for earlier treatment? A qualitative interview study with parents of children admitted to hospital with serious respiratory tract infections</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>154-159</pages><volume>96</volume><number>2</number><dates><year>2011</year></dates><urls><related-urls><url>;(6), belief that fever is key indicator of serious illness PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5VcmJhbmU8L0F1dGhvcj48WWVhcj4yMDE5PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (6, 7), fear of over-reacting or appearing neurotic ADDIN EN.CITE <EndNote><Cite><Author>Francis</Author><Year>2011</Year><RecNum>827</RecNum><DisplayText>(6)</DisplayText><record><rec-number>827</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">827</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Francis, Nick A</author><author>Crocker, Joanna C</author><author>Gamper, Arla</author><author>Brookes-Howell, Lucy</author><author>Powell, Colin</author><author>Butler, Christopher C</author></authors></contributors><titles><title>Missed opportunities for earlier treatment? A qualitative interview study with parents of children admitted to hospital with serious respiratory tract infections</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>154-159</pages><volume>96</volume><number>2</number><dates><year>2011</year></dates><urls><related-urls><url>;(6), hesitancy to call GP at weekend/night ADDIN EN.CITE <EndNote><Cite><Author>Nadel</Author><Year>1998</Year><RecNum>841</RecNum><DisplayText>(22)</DisplayText><record><rec-number>841</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nadel, S.</author><author>Britto, J.</author><author>Booy, R.</author><author>Maconochie, I.</author><author>Habibi, P.</author><author>Levin, M.</author></authors></contributors><titles><title>Avoidable deficiencies in the delivery of health care to children with meningococcal disease</title><secondary-title>Journal of Accident & Emergency Medicine</secondary-title></titles><periodical><full-title>Journal of accident & emergency medicine</full-title></periodical><pages>298-303</pages><volume>15</volume><number>5</number><keywords><keyword>meningitis</keyword><keyword>treatment delays</keyword><keyword>mortality</keyword><keyword>children</keyword><keyword>inappropriate treatment</keyword></keywords><dates><year>1998</year></dates><isbn>1351-0622</isbn><accession-num>9785154</accession-num><urls><related-urls><url>;(22). Some parents were concerned about antibiotics being prescribed ADDIN EN.CITE <EndNote><Cite><Author>Francis</Author><Year>2011</Year><RecNum>827</RecNum><DisplayText>(6)</DisplayText><record><rec-number>827</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">827</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Francis, Nick A</author><author>Crocker, Joanna C</author><author>Gamper, Arla</author><author>Brookes-Howell, Lucy</author><author>Powell, Colin</author><author>Butler, Christopher C</author></authors></contributors><titles><title>Missed opportunities for earlier treatment? A qualitative interview study with parents of children admitted to hospital with serious respiratory tract infections</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>154-159</pages><volume>96</volume><number>2</number><dates><year>2011</year></dates><urls><related-urls><url>;(6).Organisational factorsOrganisational factors which did not facilitate review by the GP included surgery being closed ADDIN EN.CITE <EndNote><Cite><Author>Crocker</Author><Year>2013</Year><RecNum>828</RecNum><DisplayText>(7)</DisplayText><record><rec-number>828</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">828</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Crocker, Joanna C.</author><author>Evans, Meirion R.</author><author>Powell, Colin V. E.</author><author>Hood, Kerenza</author><author>Butler, Christopher C.</author></authors></contributors><titles><title>Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization</title><secondary-title>European Journal of General Practice</secondary-title></titles><periodical><full-title>European Journal of General Practice</full-title></periodical><pages>213-220</pages><volume>19</volume><number>4</number><dates><year>2013</year></dates><accession-num>23815375</accession-num><urls><related-urls><url>;(7), delays or difficulties getting an appointment with GP PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Dcm9ja2VyPC9BdXRob3I+PFllYXI+MjAxMzwvWWVhcj48
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ADDIN EN.CITE.DATA (6, 7), and GP declining to do a home visit ADDIN EN.CITE <EndNote><Cite><Author>Crocker</Author><Year>2013</Year><RecNum>828</RecNum><DisplayText>(7)</DisplayText><record><rec-number>828</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">828</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Crocker, Joanna C.</author><author>Evans, Meirion R.</author><author>Powell, Colin V. E.</author><author>Hood, Kerenza</author><author>Butler, Christopher C.</author></authors></contributors><titles><title>Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization</title><secondary-title>European Journal of General Practice</secondary-title></titles><periodical><full-title>European Journal of General Practice</full-title></periodical><pages>213-220</pages><volume>19</volume><number>4</number><dates><year>2013</year></dates><accession-num>23815375</accession-num><urls><related-urls><url>;(7). Lack of knowledge of services was identified PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb3VuZzwvQXV0aG9yPjxZZWFyPjIwMDE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (26). Low SES, as indicated by WIMD quintile, lack of home ownership, and higher ratio of children to adults in household, was associated with parents who were late or non-consulters with their GP before their child was hospitalised ADDIN EN.CITE <EndNote><Cite><Author>Crocker</Author><Year>2013</Year><RecNum>828</RecNum><DisplayText>(7)</DisplayText><record><rec-number>828</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">828</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Crocker, Joanna C.</author><author>Evans, Meirion R.</author><author>Powell, Colin V. E.</author><author>Hood, Kerenza</author><author>Butler, Christopher C.</author></authors></contributors><titles><title>Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization</title><secondary-title>European Journal of General Practice</secondary-title></titles><periodical><full-title>European Journal of General Practice</full-title></periodical><pages>213-220</pages><volume>19</volume><number>4</number><dates><year>2013</year></dates><accession-num>23815375</accession-num><urls><related-urls><url>;(7). Households in SES deprived areas were noted to be over-represented ADDIN EN.CITE <EndNote><Cite><Author>Grant</Author><Year>2012</Year><RecNum>830</RecNum><DisplayText>(9)</DisplayText><record><rec-number>830</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">830</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Grant, CC</author><author>Harnden, A</author><author>Mant, D</author><author>Emery, D</author><author>Coster, G</author></authors></contributors><titles><title>Why do children hospitalised with pneumonia not receive antibiotics in primary care?</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>21-27</pages><volume>97</volume><number>1</number><dates><year>2012</year></dates><urls><related-urls><url>;(9).Clinician factors: non-recognitionNon-recognition of (and therefore treat or refer) serious illness was a factor for clinicians in primary care, even in the presence of fever, petechiae/purpuric rash and other clinical features of serious illness ADDIN EN.CITE <EndNote><Cite><Author>Nadel</Author><Year>1998</Year><RecNum>841</RecNum><DisplayText>(22)</DisplayText><record><rec-number>841</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nadel, S.</author><author>Britto, J.</author><author>Booy, R.</author><author>Maconochie, I.</author><author>Habibi, P.</author><author>Levin, M.</author></authors></contributors><titles><title>Avoidable deficiencies in the delivery of health care to children with meningococcal disease</title><secondary-title>Journal of Accident & Emergency Medicine</secondary-title></titles><periodical><full-title>Journal of accident & emergency medicine</full-title></periodical><pages>298-303</pages><volume>15</volume><number>5</number><keywords><keyword>meningitis</keyword><keyword>treatment delays</keyword><keyword>mortality</keyword><keyword>children</keyword><keyword>inappropriate treatment</keyword></keywords><dates><year>1998</year></dates><isbn>1351-0622</isbn><accession-num>9785154</accession-num><urls><related-urls><url>;(22). Some GPs were not aware that the presence of diarrhoea does not rule out sepsis PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11, 25). In one study 'gut feeling' was not significantly predictive of the child being diagnosed with serious bacterial infection (SBI), although it was more commonly related to children who did, rather than did not, develop SBI PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5VcmJhbmU8L0F1dGhvcj48WWVhcj4yMDE5PC9ZZWFyPjxS
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11). ‘Gut feeling’ was most likely to be triggered by history of convulsions, parental concern and the child's appearance, pattern of breathing and level of drowsiness was also significant PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11). In children whose pattern of breathing and level of consciousness were indicative of clinical concern, clinician's 'gut feeling' was more likely to be provoked by parental concern PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11). GPs did not always act on their gut feeling that the child was seriously ill; 4/21 children admitted to hospital were not referred at first presentation despite the presence of ‘gut feeling’ PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11). These children did not differ significantly from those who were referred. ‘Gut feeling’ was relied on less as the clinicians gained experience PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11). DiscussionThis review supports existing evidence that the pathway to hospital is complex and modifiable factors exist that are amenable to intervention PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib2RraW5zb248L0F1dGhvcj48WWVhcj4yMDE2PC9ZZWFy
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ADDIN EN.CITE.DATA (29). Nature of illnesses and trajectoriesTypically, the studies addressed pneumonia and meningococcal disease and the presenting children were young (<5yrs), even in those studies including older children. The trajectories were variable even within the same diagnostic category, some trajectories were influenced by the child’s age with, for example, the median time between onset and admission to hospital for meningococcal disease being 13 hours in children younger than 1 year when compared to 22 hours in children aged 15-16 years ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24). Some children had been symptomatic two weeks before the onset of meningococcal disease, although few had seen their GP for these initial symptoms ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24). This variability ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24), as seen with other diagnoses, is an important element for clinicians to be aware of when a child presents to them.The children’s journeys to hospital took different routes with some parents going directly to A&E or urgent care services PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5OYWRlbDwvQXV0aG9yPjxZZWFyPjE5OTg8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (22, 26) indicating a persistence of parental concern which was not always acknowledged by the health professional. Considering evidence that a signi?cant proportion of attendances to the emergency department are appropriate ADDIN EN.CITE <EndNote><Cite><Author>Roland</Author><Year>2017</Year><RecNum>875</RecNum><DisplayText>(30)</DisplayText><record><rec-number>875</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582982843">875</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Roland, Damian</author><author>Jones, Sam</author><author>Coats, Tim</author><author>Davies, Ffion</author></authors></contributors><titles><title>Are Increasing Volumes of Children and Young People Presenting to Emergency Departments Due to Increasing Severity of Illness?</title><secondary-title>Academic Emergency Medicine</secondary-title></titles><periodical><full-title>Academic Emergency Medicine</full-title></periodical><pages>503-504</pages><volume>24</volume><number>4</number><dates><year>2017</year></dates><publisher>Wiley Subscription Services, Inc</publisher><isbn>1069-6563</isbn><urls><related-urls><url>;(30), a greater appreciation of parental concern by health professionals could enhance timely referral. Parental concern is included in the assessment algorithms of NICE guidelines on sepsis and meningitis PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5FeGNlbGxlbmNlPC9BdXRob3I+PFllYXI+MjAxMDwvWWVh
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ADDIN EN.CITE.DATA (37, 46), empowering parents to contradict clinicians ADDIN EN.CITE <EndNote><Cite><Author>Nadel</Author><Year>1998</Year><RecNum>841</RecNum><DisplayText>(22)</DisplayText><record><rec-number>841</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nadel, S.</author><author>Britto, J.</author><author>Booy, R.</author><author>Maconochie, I.</author><author>Habibi, P.</author><author>Levin, M.</author></authors></contributors><titles><title>Avoidable deficiencies in the delivery of health care to children with meningococcal disease</title><secondary-title>Journal of Accident & Emergency Medicine</secondary-title></titles><periodical><full-title>Journal of accident & emergency medicine</full-title></periodical><pages>298-303</pages><volume>15</volume><number>5</number><keywords><keyword>meningitis</keyword><keyword>treatment delays</keyword><keyword>mortality</keyword><keyword>children</keyword><keyword>inappropriate treatment</keyword></keywords><dates><year>1998</year></dates><isbn>1351-0622</isbn><accession-num>9785154</accession-num><urls><related-urls><url>;(22), establishing and sustaining trust PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb3VuZzwvQXV0aG9yPjxZZWFyPjIwMDE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (19) is an important component to consider in enhancing service provision.Access to servicesDelayed diagnosis predicts morbidity ADDIN EN.CITE <EndNote><Cite><Author>McIntyre</Author><Year>2005</Year><RecNum>845</RecNum><DisplayText>(21)</DisplayText><record><rec-number>845</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">845</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McIntyre, P B</author><author>MacIntyre, C R</author><author>Gilmour, R</author><author>Wang, H</author></authors></contributors><titles><title>A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>391-396</pages><volume>90</volume><number>4</number><dates><year>2005</year></dates><urls><related-urls><url>;(21) as does rapid disease trajectory PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaWxwaTwvQXV0aG9yPjxZZWFyPjE5OTE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (2, 8, 43). Some general practice emergency access systems may not work as well as they should in achieving sensitivity identifying those developing complicated respiratory tract infections ADDIN EN.CITE <EndNote><Cite><Author>Francis</Author><Year>2011</Year><RecNum>827</RecNum><DisplayText>(6)</DisplayText><record><rec-number>827</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">827</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Francis, Nick A</author><author>Crocker, Joanna C</author><author>Gamper, Arla</author><author>Brookes-Howell, Lucy</author><author>Powell, Colin</author><author>Butler, Christopher C</author></authors></contributors><titles><title>Missed opportunities for earlier treatment? A qualitative interview study with parents of children admitted to hospital with serious respiratory tract infections</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>154-159</pages><volume>96</volume><number>2</number><dates><year>2011</year></dates><urls><related-urls><url>;(6). Caregivers should be instructed on what to do outside the opening hours of the family practice if the child's condition worsens PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb3VuZzwvQXV0aG9yPjxZZWFyPjIwMDE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (6, 22, 49). Findings suggest that there is potential benefit in considering shifting the focus from classic symptoms to early recognition of sepsis ADDIN EN.CITE <EndNote><Cite><Author>Thompson</Author><Year>2006</Year><RecNum>844</RecNum><DisplayText>(24)</DisplayText><record><rec-number>844</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">844</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Thompson, Matthew J.</author><author>Ninis, Nelly</author><author>Perera, Rafael</author><author>Mayon-White, Richard</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Harnden, Anthony</author><author>Mant, David</author><author>Levin, Michael</author></authors></contributors><titles><title>Clinical recognition of meningococcal disease in children and adolescents</title><secondary-title>The Lancet</secondary-title></titles><periodical><full-title>The Lancet</full-title></periodical><pages>397-403</pages><volume>367</volume><number>9508</number><keywords><keyword>meningitis</keyword><keyword>meningococcal disease</keyword><keyword>symptoms</keyword><keyword>pre-hospital</keyword><keyword>primary care</keyword></keywords><dates><year>2006</year><pub-dates><date>2006/2/10/</date></pub-dates></dates><isbn>0140-6736</isbn><urls><related-urls><url>;(24).Evidence from the studies focusing on clinician ‘gut feeling’ of something being wrong reveals contradictory findings. In our review one study demonstrated a link between ‘gut feeling’ and a child’s risk of serious illness PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5VcmJhbmU8L0F1dGhvcj48WWVhcj4yMDE5PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (25) whilst the other noted ‘gut feeling’ was not significantly predictive of SII PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11). However, it is important to recognise that contradictions may arise from factors such as differences in the settings, experience of the clinician, differences in prevalence of serious infection and availability of continuity of care. Such factors may have influenced the statistical power of the prognostic value of “gut feeling”. Other studies considering ‘gut feeling’ or ‘clinical impression’ in relation to the assessment of the acutely ill child, emphasise its value in clinical prediction that ‘something is wrong’ PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WZXJiYWtlbDwvQXV0aG9yPjxZZWFyPjIwMTM8L1llYXI+
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ADDIN EN.CITE.DATA (50, 51). However, despite a contradictory evidence base, it is hard to ignore the proposition that a clinician's ‘gut feeling’ should make three things mandatory: carry on careful examination, seek more experienced advice, and give parents carefully worded advice to act as safety net PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (6, 47) such as that provided by , ensuring junior paediatricians receive advanced life support training ADDIN EN.CITE <EndNote><Cite><Author>Nadel</Author><Year>1998</Year><RecNum>841</RecNum><DisplayText>(22)</DisplayText><record><rec-number>841</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nadel, S.</author><author>Britto, J.</author><author>Booy, R.</author><author>Maconochie, I.</author><author>Habibi, P.</author><author>Levin, M.</author></authors></contributors><titles><title>Avoidable deficiencies in the delivery of health care to children with meningococcal disease</title><secondary-title>Journal of Accident & Emergency Medicine</secondary-title></titles><periodical><full-title>Journal of accident & emergency medicine</full-title></periodical><pages>298-303</pages><volume>15</volume><number>5</number><keywords><keyword>meningitis</keyword><keyword>treatment delays</keyword><keyword>mortality</keyword><keyword>children</keyword><keyword>inappropriate treatment</keyword></keywords><dates><year>1998</year></dates><isbn>1351-0622</isbn><accession-num>9785154</accession-num><urls><related-urls><url>;(22), improved supervision from consultants ADDIN EN.CITE <EndNote><Cite><Author>Ninis</Author><Year>2005</Year><RecNum>917</RecNum><DisplayText>(47)</DisplayText><record><rec-number>917</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1583759625">917</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ninis, Nelly</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Pollock, Jon I.</author><author>Nadel, Simon</author><author>Britto, Joseph</author><author>Maconochie, Ian</author><author>Winrow, Andrew</author><author>Coen, Pietro G.</author><author>Booy, Robert</author><author>Levin, Michael</author></authors></contributors><titles><title>The role of healthcare delivery in the outcome of meningococcal disease in children: case-control study of fatal and non-fatal cases</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>1475</pages><volume>330</volume><number>7506</number><dates><year>2005</year></dates><isbn>0959-8138</isbn><urls><related-urls><url>;(47) and more robust documentation of the child's symptoms and condition at each stage of the journey, in primary ADDIN EN.CITE <EndNote><Cite><Author>Grant</Author><Year>2012</Year><RecNum>830</RecNum><DisplayText>(9)</DisplayText><record><rec-number>830</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">830</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Grant, CC</author><author>Harnden, A</author><author>Mant, D</author><author>Emery, D</author><author>Coster, G</author></authors></contributors><titles><title>Why do children hospitalised with pneumonia not receive antibiotics in primary care?</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>21-27</pages><volume>97</volume><number>1</number><dates><year>2012</year></dates><urls><related-urls><url>;(9) and secondary ADDIN EN.CITE <EndNote><Cite><Author>Ninis</Author><Year>2005</Year><RecNum>917</RecNum><DisplayText>(47)</DisplayText><record><rec-number>917</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1583759625">917</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ninis, Nelly</author><author>Phillips, Claire</author><author>Bailey, Linda</author><author>Pollock, Jon I.</author><author>Nadel, Simon</author><author>Britto, Joseph</author><author>Maconochie, Ian</author><author>Winrow, Andrew</author><author>Coen, Pietro G.</author><author>Booy, Robert</author><author>Levin, Michael</author></authors></contributors><titles><title>The role of healthcare delivery in the outcome of meningococcal disease in children: case-control study of fatal and non-fatal cases</title><secondary-title>BMJ</secondary-title></titles><periodical><full-title>BMJ</full-title></periodical><pages>1475</pages><volume>330</volume><number>7506</number><dates><year>2005</year></dates><isbn>0959-8138</isbn><urls><related-urls><url>;(47) care. Improving relational continuity also has the potential to improve the recognition of deterioration as the clinician will able to augment the written record with memories of preceding encounters with the child.Strengths and limitationsThis systematic review used a robust and iterative methodological approach and included an analysis of study quality. The number of studies included was small and the methodological approach and focus of the studies and diagnosis of child was diverse, thus making it challenging to draw clear conclusions. Although poor reporting quality (e.g. research questions not reported) was evident in some of the studies, overall, the quality of the studies was sound with most studies clearly identifying limitations relating to their study population. A common limitation was that many studies had reporting or recall bias. Recruitment is likely to have utilised both families and parents with significant concerns or those who came to harm, so are not representative. Some studies were underpowered. Predominantly data collection was retrospective, and while this was often a necessity due to study design, it was difficult to evaluate how this may have impacted on interpretation in many studies. The term ‘admission to hospital’ is rarely clarified meaning comparison across studies is difficult. Our decision to include a wide age range rather than concentrating solely on children under the age of 5 reduces the focus on the age group most typically presenting. Some findings such as the likelihood of admission with pneumonia being increased when antibiotics were prescribed by GP before admission (Nadel et al., 1998), perhaps are less applicable since the introduction of pneumococcal vaccine.Implications for practiceIn summary, supportive, accessible, respectful services that provide continuity, clear communication and advice are important and have the potential to reduce the reasons why some parents may hesitate to seek or continue to seek help. High quality training and support for clinicians to spot the sick child and encouragement to attend to ‘gut feeling’ have the potential to improve identification of the sick child within any of the settings where a child presents. Improved parent-facing information that recognises the diversity of health literacy should be available to inform parents and clearly instruct them how to act.Directions for further researchOur findings indicate that further research is needed to better understand the doctor-patient relationship, in particular to identify the sources of perceived criticism and how such criticism can be reframed as helpful advice. Further research on parental concern and how to recognise it would enhance health professionals’ ability to recognise important symptoms and enhance timely referral.ConclusionOur conclusions need to be considered in relation to the limitations of the studies reviewed and the risk of bias we have previously noted. We found reasonably robust evidence that both clinician-related and parent-related factors impact on the timeliness of a child’s journey to hospital but less depth of cohesive evidence in relation to environmental and organisational and contextual factors. However, where the evidence exists these factors seem inextricably linked. Acknowledgement/disclaimerThis paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0416-20011). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.References ADDIN EN.REFLIST 1.Roser M, Ritchie H, Dadonaite B. Child & Infant Mortality.; 2020.2.Wolfe I, Cass H, Thompson MJ, Craft A, Peile E, Wiegersma PA, et al. Improving child health services in the UK: insights from Europe and their implications for the NHS reforms. BMJ. 2011;342(mar08 1):d1277-d.3.Wolfe I, Donkin A, Marmot M, Macfarlane A, Cass H, Viner R. UK child survival in a European context: recommendations for a national Countdown Collaboration. Archives of Disease in Childhood. 2015;100(10):907-14.4.Wolfe I, Thompson M, Gill P, Tamburlini G, Blair M, van den Bruel A, et al. Health services for children in western Europe. The Lancet. 2013;381(9873):1224-34.munity and Mental Health Team ND. Child Death Reviews: NHS Digital; 2019 [Available from: NA, Crocker JC, Gamper A, Brookes-Howell L, Powell C, Butler CC. Missed opportunities for earlier treatment? A qualitative interview study with parents of children admitted to hospital with serious respiratory tract infections. Archives of Disease in Childhood. 2011;96(2):154-9.7.Crocker JC, Evans MR, Powell CVE, Hood K, Butler CC. Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization. European Journal of General Practice. 2013;19(4):213-20.8.Parliamentary and Health Service Ombudsman An avoidable death of a three-year-old child from sepsis. A report by the Health Service Ombudsman for England on an investigation into a complaint from Mr and Mrs Morrish about The Cricketfield Surgery, NHS Direct, Devon Doctors Ltd, South Devon Healthcare NHS Foundation Trust and NHS Devon Plymouth and Torbay Cluster. . London; 2014.9.Grant C, Harnden A, Mant D, Emery D, Coster G. Why do children hospitalised with pneumonia not receive antibiotics in primary care? Archives of Disease in Childhood. 2012;97(1):21-7.10.Buntinx F, Mant D, Van den Bruel A, Donner-Banzhof N, Dinant G-J. Dealing with low-incidence serious diseases in general practice. British Journal of General Practice. 2011;61(582):43-6.11.Van den Bruel A, Thompson M, Buntinx F, Mant D. Clinicians’ gut feeling about serious infections in children: observational study. British Medical Journal. 2012;345(7876):14-.12.Health Protection Agency. Health Protection in the 21st Century. Understanding the Burden of Disease; preparing for the future. London; 2005.13.Jones CHD, Neill S, Lakhanpaul M, Roland D, Singlehurst-Mooney H, Thompson M. The safety netting behaviour of first contact clinicians: a qualitative study. BMC Family Practice. 2013;14(1).14.Neill SJ, Coyne I. The Role of Felt or Enacted Criticism in Parents’ Decision Making in Differing Contexts and Communities: Toward a Formal Grounded Theory. Journal of Family Nursing. 2018;24(3):443-69.15.Neill SJ. Containing acute childhood illness within family life: a substantive grounded theory. Journal of Child Health Care. 2010;14(4):327-44.16.Houston AM, Pickering AJ. 'Do I don't I call the doctor': a qualitative study of parental perceptions of calling the GP out-of-hours. Health Expectations. 2000;3(4):9.17.NHS Institute for Innovation and Improvement Focus on Children and Young People Emergency and Urgent Care Pathway. Delivering on Quality and Value. Coventry; 2010.18.Moher D, Liberati A, Tetzlaff J, Altman DG, Group P, The PG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine. 2009;6(7):e1000097.19.Emery DP, Milne T, Gilchrist CA, Gibbons MJ, Robinson E, Coster GD, et al. The impact of primary care on emergency department presentation and hospital admission with pneumonia: a case-control study of preschool-aged children. NPJ Primary Care Respiratory Medicine. 2015;25(1):14113.20.Kilpi T, Anttila M, Kallio MJT, Peltola H. Severity of childhood bacterial meningitis and duration of illness before diagnosis. The Lancet. 1991;338(8764):406-9.21.McIntyre PB, MacIntyre CR, Gilmour R, Wang H. A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis. Archives of Disease in Childhood. 2005;90(4):391-6.22.Nadel S, Britto J, Booy R, Maconochie I, Habibi P, Levin M. Avoidable deficiencies in the delivery of health care to children with meningococcal disease. Journal of Accident & Emergency Medicine. 1998;15(5):298-303.23.Okike IO, Ladhani SN, Anthony M, Ninis N, Heath PT. Assessment of healthcare delivery in the early management of bacterial meningitis in UK young infants: an observational study. BMJ Open. 2017;7(8):e015700.24.Thompson MJ, Ninis N, Perera R, Mayon-White R, Phillips C, Bailey L, et al. Clinical recognition of meningococcal disease in children and adolescents. The Lancet. 2006;367(9508):397-403.25.Urbane UN, Gaidule-Logina D, Gardovska D, Pavare J. Value of parental concern and clinician's gut feeling in recognition of serious bacterial infections: a prospective observational study. BMC Pediatrics. 2019;19(1):219-.26.Young N. The pre-hospital experiences of Samoan families who have had a child admitted to hospital with pneumonia : a qualitative investigation. Pacific Health Dialog. 2001;8(1):20-8.27.Hong QN, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, et al. Mixed Methods Appraisal Tool (MMAT) Version 2018: User Guide. Registration of Copyright (#1148552), Canadian Intellectual Property Office, Industry Canada [Internet]. 2018.28.Hong QN, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, et al. Improving the content validity of the mixed methods appraisal tool: a?modified e-Delphi study. Journal of Clinical Epidemiology. 2019;111:49-59.e1.29.Hodkinson P, Argent A, Wallis L, Reid S, Perera R, Harrison S, et al. Pathways to Care for Critically Ill or Injured Children: A Cohort Study from First Presentation to Healthcare Services through to Admission to Intensive Care or Death. PLoS ONE. 2016;11(1):e0145473.30.Roland D, Jones S, Coats T, Davies F. Are Increasing Volumes of Children and Young People Presenting to Emergency Departments Due to Increasing Severity of Illness? Academic Emergency Medicine. 2017;24(4):503-4.31.Excellence NIfHaC. Bacterial meningitis and meningococcal septicaemia. Management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care. NICE clinical guideline 102. Issued: June 2010 last updates: February 2015. . London: National Institute for Health and Clinical Excellence; 2010.32.Excellence NIfHaC. Sepsis: recognition, diagnosis and early management. NICE guideline. Published: 13 July 2016 .uk/guidance/ng51. London: National Institute for Health and Clinical Excellence. ; 2016 13th July 2016. Contract No.: NG51.33.Jones CHD, Neill S, Lakhanpaul M, Roland D, Singlehurst-Mooney H, Thompson M. Information needs of parents for acute childhood illness: determining ‘what, how, where and when’ of safety netting using a qualitative exploration with parents and clinicians. BMJ Open. 2014;4(1):e003874.34.Maguire S, Ranmal R, Komulainen S, Pearse S, Maconochie I, Lakhanpaul M, et al. Which urgent care services do febrile children use and why? Archives of Disease in Childhood. 2011;96(9):810-6.35.Roland D, Jones C, Neill S, Thompson M, Lakhanpaul M. Safety netting in healthcare settings: what it means, and for whom? Archives of Disease in Childhood (Education & Practice Edition). 2014;99(2):48-53.36.Neill SJ, Jones CHD, Lakhanpaul M, Roland DT, Thompson MJ, team ASr, et al. Parent's information seeking in acute childhood illness: what helps and what hinders decision making? Health Expectations. 2015;18(6):3044-56.37.Callery P. Maternal knowledge and professional knowledge: co-operation and conflict in the care of sick children. International Journal of Nursing Studies. 1997;34(1):27-34.38.Costet Wong A, Claudet I, Sorum P, Mullet E. Why Do Parents Bring Their Children to the Emergency Department? A Systematic Inventory of Motives. International Journal of Family Medicine. 2015;2015:978412-10.39.Hummel K, Mohler MJ, Clemens CJ, Duncan B. Why Parents Use the Emergency Department During Evening Hours for Nonemergent Pediatric Care. Clinical Pediatrics. 2014;53(11):1055-61.40.Benchimol EI, Fortinsky KJ, Gozdyra P, Van den Heuvel M, Van Limbergen J, Griffiths AM. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflammatory Bowel Diseases. 2011;17(1):423-39.41.Morrison AKMD, Myrvik MPP, Brousseau DCMDMS, Hoffmann RGP, Stanley RMMDM. The Relationship Between Parent Health Literacy and?Pediatric Emergency Department Utilization: A?Systematic Review. Academic Pediatrics. 2013;13(5):421-9.42.Ehrich K. Reconceptualizing ‘Inappropriateness’: Researching Multiple Moral Positions in Demand for Primary Healthcare. Health. 2003;7(1):109-26.43.Lass M, Tatari CR, Merrild CH, Huibers L, Maindal HT. Contact to the out-of-hours service among Danish parents of small children - a qualitative interview study. Scandinavian Journal of Primary Health Care. 2018;36(2):216-23.44.Jones CHD, Ward A, Hodkinson PW, Reid SJ, Wallis LA, Harrison S, et al. Caregivers' Experiences of Pathways to Care for Seriously Ill Children in Cape Town, South Africa: A Qualitative Investigation. PLoS ONE. 2016;11(3):e0151606.45.Ertmann RK, Reventlow S, S?derstr?m M. Is my child sick? Parents' management of signs of illness and experiences of the medical encounter: Parents of recurrently sick children urge for more cooperation. Scandinavian Journal of Primary Health Care. 2011;29(1):23-7.46.Carter B, Arnott J, Simons J, Bray L. Developing a Sense of Knowing and Acquiring the Skills to Manage Pain in Children with Profound Cognitive Impairments: Mothers' Perspectives. Pain Research and Management. 2017;2017:2514920.47.Ninis N, Phillips C, Bailey L, Pollock JI, Nadel S, Britto J, et al. The role of healthcare delivery in the outcome of meningococcal disease in children: case-control study of fatal and non-fatal cases. BMJ. 2005;330(7506):1475.48.Pollard AJ, Nadel S, Ninis N, Faust SN, Levin M. Emergency management of meningococcal disease: eight years on. Archives of Disease in Childhood. 2007;92(4):283-6.49.Haj-Hassan TA, Thompson MJ, Mayon-White RT, Ninis N, Harnden A, Smith LFP, et al. Which early 'red flag' symptoms identify children with meningococcal disease in primary care? The British Journal of General Practice. 2011;61(584):e97-e104.50.Verbakel J, Bruel A, Thompson M, Stevens R, Aertgeerts B, Oostenbrink R, et al. How well do clinical prediction rules perform in identifying serious infections in acutely ill children across an international network of ambulatory care datasets? BMC Medicine. 2013;11(1):10-.51.Verbakel JY, Lemiengre MB, De Burghgraeve T, De Sutter A, Aertgeerts B, Shinkins B, et al. Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial. BMC Medicine. 2016;14(1):131.52.Brent AJ, Lakhanpaul M, Thompson M, Collier J, Ray S, Ninis N, et al. Risk score to stratify children with suspected serious bacterial infection: observational cohort study. Archives of Disease in Childhood. 2011;96(4):361-7.53.Galetto-Lacour A, Zamora SA, Andreola B, Bressan S, Lacroix L, Da Dalt L, et al. Validation of a laboratory risk index score for the identification of severe bacterial infection in children with fever without source. Archives of Disease in Childhood. 2010;95(12):968-73.54.Finlow C, Thomas J. Disseminated herpes simplex virus: a case of eczema herpeticum causing viral encephalitis. The Journal of the Royal College of Physicians of Edinburgh. 2018;48(1):36-9.Supporting Information File 1: Definitions of serious infectious illness, developed from PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CcmVudDwvQXV0aG9yPjxZZWFyPjIwMTE8L1llYXI+PFJl
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ZT5=
ADDIN EN.CITE.DATA (11, 52, 53).DiagnosisCriteriaPneumoniaRespiratory symptoms and signs and focal consolidation on X-ray reported by a paediatric radiologist.BronchiolitisSevere bronchiolitis requiring PHDU care or PICU transfer.BacteraemiaIdentification of a significant bacterial pathogen in blood using culture or molecular methodsUrinary tract infectionGrowth of a single bacterial urinary tract pathogen at ≥105 colony-forming units/ml in an appropriate urine sample in the context of clinical signs of systemic involvement.MeningitisIdentification of a pathogen in CSF using culture or molecular methods, or clinical meningitis plus a cerebrospinal fluid analysis suggestive of viral or bacterial meningitisOsteomyelitisClinical signs, and radiological confirmation of bone changes Septic arthritisIsolation of a bacterial pathogen from a joint using culture or molecular methodsProbable SBIClinical signs of infection with at least 2 NICE sepsis high risk criteria, resuscitation>20mls/kg; or PHDU/PICU careClinical signs of infection on admission and prolonged admission, and administration of intravenous antibiotics beyond 72h despite negative culture results. EncephalitisClinical signs and contributory evidence on CSF analysis/ neuroimagingCellulitisAcute, diffuse, spreading infection of the skin, involving the deeper layers of the skin and the subcutaneous tissue.Suppurative cervical lymphadenitisEnlarged, inflamed and tender lymph node with or without fluctuance, usually unilateral. Clinical diagnosis is confirmed by positive culture or Gram stain of specimen obtained by needle aspiration or incision and drainage.Pre-septal & post-septal cellulitis Pre-septal cellulitis (periorbital cellulitis) is infection of the eyelid and surrounding skin anterior to the orbital septum. Orbital cellulitis (post-septal cellulitis) is infection of the orbital tissues posterior to the orbital septum.Eczema herpeticumClinical diagnosis and/or positive culture or molecular methodsDeep head and neck infectionsSuppurative infection of the neck, including:Peritonsillar abscess: Collection of pus located between the capsule of the palatine tonsil and the pharyngeal muscles.Retropharyngeal abscess: Collection of pus located in the retropharyngeal space (extending from the base of the skull to the posterior mediastinum, between the middle layer and the deep layer of the deep cervical fascia).Lateral pharyngeal space infection: Collection of pus located in the lateral pharyngeal space (bounded laterally by the carotid sheath).EndocarditisClinical concerns and Duke’s criteriaSupporting Information File 2: Search conducted in MEDLINE via EBSCOHost# Query Limiters/Expanders Last Run Via Results S23S1 AND S2 AND S3 AND S4 AND S15 AND S22Search modes - Boolean/PhraseInterface - EBSCOhost Research Databases Search Screen - 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Boolean/Phrase Interface - EBSCOhost Research Databases Search Screen - Advanced Search Database - MEDLINE268,738S5 Tim* of admission OR dela* admission OR late presentation OR deter presentation OR dela* presentationSearch modes - Boolean/Phrase Interface - EBSCOhost Research Databases Search Screen - Advanced Search Database - MEDLINE24,975 S4 General practi* OR Health visitor OR Paramedic* OR Family doctor OR Family physician OR Nurse OR Practice nurse OR Community children’s nurse OR P?diatric nurse OR children’s NurseSearch modes - Boolean/Phrase Interface - EBSCOhost Research Databases Search Screen - Advanced Search Database - MEDLINE390,500S3 Serious infection* OR Septi* or Sepsis OR Pneumonia OR mening* OR encephalitis OR Respiratory OR Severity of illnessSearch modes - Boolean/Phrase Interface - EBSCOhost Research Databases Search Screen - Advanced Search Database - MEDLINE 975,981S2 Child* OR infant* or bab* or P?diatric*Search modes - Boolean/Phrase Interface - EBSCOhost Research Databases Search Screen - 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Parents: Age, GenderHelp-seeking behaviours, Organisational factors, Environmental factors, SES, Other findings.Types of bias reported, Limitations stated, Populations excludedCrocker (2013) UK ADDIN EN.CITE <EndNote><Cite><Author>Crocker</Author><Year>2013</Year><RecNum>828</RecNum><DisplayText>(7)</DisplayText><record><rec-number>828</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">828</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Crocker, Joanna C.</author><author>Evans, Meirion R.</author><author>Powell, Colin V. E.</author><author>Hood, Kerenza</author><author>Butler, Christopher C.</author></authors></contributors><titles><title>Why some children hospitalized for pneumonia do not consult with a general practitioner before the day of hospitalization</title><secondary-title>European Journal of General Practice</secondary-title></titles><periodical><full-title>European Journal of General Practice</full-title></periodical><pages>213-220</pages><volume>19</volume><number>4</number><dates><year>2013</year></dates><accession-num>23815375</accession-num><urls><related-urls><url>;(7)Identify differences between children who consulted a General Practitioner (GP) and children who did not consult a GP before the day of hospital presentation with pneumonia or empyemaDesign: Mixed methods sequential sub sample design. Methods: self-completed questionnaire by parent/carers; interviews with sub-set of parents; patient hospital record review.Recruitment: Purposive. Recruiting clinicians approached carers of all eligible patients. In-patients from 7 hospitals with inpatient paediatric units in South Wales. Participated: N=151 (n=94 early consulters; n=57 late/non-consulters) completed questionnaire; subset (n=28) were interviewed.Age: 6 months-16 years (mean 5 years). Gender: 59.6% male for early consulters, 56.1% male for late and non-consulters.SES: All quintiles represented (measured using Welsh Multiple Index of Deprivation). Disease: Community acquired pneumonia (86.1%) or empyema (13.9%). Other: Among early consulters: mean age 3.82 years, 59.6% were male, 92.6% of white ethnicity. Among late and non-consulters: mean age 4.19 years and 56.1% were male and 96.5% were of white ethnicityPARENT: Gender: Carer gender not recordedHelp-seeking behaviours: Late/non-consulters significantly less likely to have taken antibiotics before presenting to hospital, & significantly more likely to have obtained advice from the NHS Direct Telephone helpline and website and had significantly more rapid onset of illness.? Among interviewed parents who had not seen General Practitioner (GP) prior factors included: did not consider consulting a GP earlier; did not think earlier symptoms were serious/unusual due to child initially improving; presumed asthma; thought abdominal pain was pulled muscle; child was alert/active; child's breathing was normal; & presumed common self-limiting infection (3.6%). Organisational: Factors for no GP presentation included: GP surgery was closed, difficulty getting a GP appointment, negative perceptions (including afraid of wasting doctor's time and anticipating GP would diagnose a viral infection). Environmental: Factors for late/no GP presentation: unable to travel to GP surgery and GP declined home visit (child too ill to move and carer had no car). SES: Late/non-consultation?associated with lack of home ownership, WIMD quintile and higher ratio of children to adults in the household.?Bias: Invitation bias, response bias, selection bias, recall bias. Excluded populations: Children who saw a General Practitioner for pneumonia but never presented to hospital were not included so this excluded those likely to have had with less severe pneumonia.Emery (2015), New Zealand PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5FbWVyeTwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (19)Identify primary care factors associated with Emergency Department presentation and hospital admission of preschool-aged children with community-acquired pneumonia.Design: Mixed methods (part of larger case=control study). Methods: Modified General Practice Assessment Survey; primary care review; interview; & hospital record review.Recruitment: All eligible children approached in hospital setting. Controls randomly selected from the community. Participated: N=856: hospitalised with pneumonia (n=326); pneumonia discharged from ED (n=179); controls (n=351).Age: <5 years old (mean 19 months). SES: Measured by household deprivation score. Disease: Pneumonia (acute illness with cough or breathing difficulty plus in-drawing or tachypnoea). Other: Children admitted with pneumonia younger than those with pneumonia discharged from ED. Children with pneumonia had lower weight for height z-scores than community controlsHelp-seeking behaviours: Children less likely to present to ED with pneumonia included: those whose caregivers would take them back to the same doctor, or to an after-hours accident and medical centre when still unwell with a cough and fever, following visit to General Practitioner (GP) on previous day. Increased likelihood of ED presentation with pneumonia was associated with lower parental satisfaction scores for continuity of care, communication between the caregiver and GP & overall caregiver satisfaction with care. Children who had made more health professional visits before presentation had an increased likelihood of admission with pneumonia. Children whose caregiver would seek care from a complementary healer if child was unwell with a cough or fever less likely to be admitted with pneumonia. Children whose caregivers would take them to a hospital ED if they had been seen the previous day by their GP and were still unwell less likely to be admitted with pneumonia. Organisational: Children more likely to present with pneumonia included: those without a single, identified GP, whose GP worked part-time ?20hr week, whose GP had no immunisation recall. Likelihood of hospital admission with pneumonia increased when child's GP belonged to a Primary Health Organisation, when antibiotics were prescribed by the GP before ED presentation. Referral by a health professional compared with self-referral was associated with an increased likelihood of admission with pneumonia. Children without a single, identified GP were less likely to be admitted with pneumonia.Bias: Seasonal bias, uneven distribution.Francis (2011), UK ADDIN EN.CITE <EndNote><Cite><Author>Francis</Author><Year>2011</Year><RecNum>827</RecNum><DisplayText>(6)</DisplayText><record><rec-number>827</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">827</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Francis, Nick A</author><author>Crocker, Joanna C</author><author>Gamper, Arla</author><author>Brookes-Howell, Lucy</author><author>Powell, Colin</author><author>Butler, Christopher C</author></authors></contributors><titles><title>Missed opportunities for earlier treatment? A qualitative interview study with parents of children admitted to hospital with serious respiratory tract infections</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>154-159</pages><volume>96</volume><number>2</number><dates><year>2011</year></dates><urls><related-urls><url>;(6) Identify potential opportunities for earlier intervention among young children who develop a complicated respiratory tract infection (RTI).Design: Qualitative interview study. Methods: Interviews (guided).Recruitment: Purposive. Parents of all eligible children approached at a large teaching hospital (University Hospital of Wales). Participated: N=22.Age: 16 months-13yrs (median 4yrs).Gender: female (n=12), male (n=10):SES: Not reported but no wage earners (n=6), at least one PT wage earner (n=16). Disease: Empyema (n=12), pneumonia (n=8), peritonsillar abscess (n=1), mastoiditis and lateral sinus thrombosis (n=1). ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? PARENT: Gender: Mothers (n=22), father (n=1)Help-seeking behaviours: Difficulties in assessing the severity of their child’s illness or interpreting their child’s symptoms. All parents described potentially serious symptoms (most common: rapid breathing, panting or grunting). Although most regarded these symptoms as unusual/worrying, nearly half described delay of 24h or more between first identifying the symptom(s) and consulting a healthcare professional (HCP). Parents not consulting at an earlier time because of a fear of ‘overreacting’ and not wanting to ‘bother’ service or based on past experience, they did not believe their concerns would be taken seriously. One parent delayed consulting because believed antibiotics would be prescribed too readily,? one did not take child to an out-of-hours service as they would not know child’s past history, and one whose child was experiencing difficulty breathing, did not feel she was allowed to take her child directly to Emergency anisational (parent reported): Delays included: difficulties with General Practitioner (GP) appointment system, e.g., difficulties in getting through on the telephone, prolonged waits for emergency appointments, being told that there were no more emergency appointments that day, and having to wait for a doctor to call them back, sometimes hours later in the day. Failures/problems of appropriate triage included; inadequate telephone triage by practice nurse, parent felt incapable of assessing features of her child’s illness. Failures of HCPs to respond appropriately after child had developed one or more serious symptoms (rapid breathing, panting, grunting); prescribed antibiotics over the phone (without being seen), even though the child had developed breathlessness and panting since a previous consultation the week before. Parent not using a delayed prescription because confused by the doctor’s advice that this was ‘a viral infection’ and antibiotics were ‘a precaution’. Feeling dismissed after consulting in primary care, out-of-hours, Emergency Department and secondary care settings. Other sources of being dismissed: advised to give child over-the-counter medicines, belief child had been inadequately examined, leaving the consultation with a poor understanding of their child’s illness. Frustration at the outcome of their consultations: consultations rushed, unable to challenge clinical decisions.Bias: Retrospective bias. Limitations: Parents who had problems in pre-hospital management of child's illness might have been more likely to agree to participate. Data on those not recruited not available.? Excluded populations: Only one child with peritonsillar abscess, one mastoiditis and no cases of acute rheumatic fever included, so findings may not be relevant to children with these complications.Grant (2012), New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Grant</Author><Year>2012</Year><RecNum>830</RecNum><DisplayText>(9)</DisplayText><record><rec-number>830</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">830</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Grant, CC</author><author>Harnden, A</author><author>Mant, D</author><author>Emery, D</author><author>Coster, G</author></authors></contributors><titles><title>Why do children hospitalised with pneumonia not receive antibiotics in primary care?</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>21-27</pages><volume>97</volume><number>1</number><dates><year>2012</year></dates><urls><related-urls><url>;(9)Describe primary care antibiotic use for children subsequently hospitalised with community acquiredpneumonia.Design: Case series. Methods: Case series review and parents asked to describe child’s symptoms. Hospital medical records reviewed.Recruitment: Children with pneumonia were identified from daily review of admissions at children’s hospital in NZ Participated: N=280.Age: <5 years (median 17 months, IQR 9-26 months). Gender: 45% female. SES: Households in socioeconomically deprived areas over-represented (34% in bottom quintile) using NZ Index of Social Deprivation.Disease: pneumonia. Other: Of 220 who had opportunity to receive antibiotics, severe pneumonia (n=202), mild pneumonia (n=8).?Other findings: Receipt of antibiotic more likely if child seen by own General Practitioner (GP), less likely if the primary care clinician failed to make a diagnosis of LRTI. Mild pneumonia associated with increased likelihood of being prescribed antibiotics.? Children with no opportunity to receive antibiotics had more rapidly evolving illness than those with opportunity to receive antibiotics. Reasons for missed opportunity to receive antibiotic: 102/112 made at least one GP visit, 23/112 prescription written but not collected, 2 diagnosed pneumonia/bronchopneumonia but no antibiotic prescribed. Of remaining children, 28 presented with increased respiratory rate or breathing difficulty, other respiratory symptoms (cough, wheeze, noisy breathing) n=23, systemic symptoms (vomiting, poor feeding, increased sleeping, irritability, lethargy) n=49. 41 had respiratory and systemic presenting symptoms of which 30% did not have missed LRTI diagnosis in primary careBias: recall bias. Excluded populations: Only included children admitted to hospital therefore not possible to determine if primary care antibiotic treatment reduces risk of hospital admissionKilpi (1991), Finland PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaWxwaTwvQXV0aG9yPjxZZWFyPjE5OTE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (20)See whether duration of illness in childhood cases of bacterial meningitis before admission to hospital was related to the severity of illnessDesign: Prospective cases series. Methods: Questionnaire (parent); case note review.Recruitment: Purposive. n-patients,18 paediatric hospitals in Finland. Participated: N=286 eligible for analysis.?Age: 3 months-15 years (mean 2.9yrs, SD 3.2).Gender: male, 54%. SES: Not reported.Disease: Bacterial meningitis; haemophilius influenzae type b (69%); Nesseria meningitis (23%) streptococcus penumoniae (6%); Group B streptococcus (1%) Listeria monocytogenes (0.5%); E coli (0.5%). Other: Children with short duration of illness (<24h, n=141); intermediate duration (>24-48h, n=75); long duration (>48h, n=70).?Other findings: Level of consciousness significantly poorer in children with short history of illness than those with long history. Seizures before or on admission were more common in the short history (24%) than the intermediate (19%) or long history (9%) groups. Children with long history of illness significantly younger than those ill for up to 48hr. Full consciousness more common in children of 3 years or older than in the younger ones. Unconsciousness was equally common in the three age groups and in each group the children with the longest duration of symptoms did best. Infants had seizures slightly more often (26%) than older children (17%). Seizures not associated with duration of illness in the youngest age group, whereas in the two older age groups seizures occurred exclusively among children with a history of 48hr or less.Not statedMcIntyre (2005), Australia ADDIN EN.CITE <EndNote><Cite><Author>McIntyre</Author><Year>2005</Year><RecNum>845</RecNum><DisplayText>(21)</DisplayText><record><rec-number>845</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">845</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McIntyre, P B</author><author>MacIntyre, C R</author><author>Gilmour, R</author><author>Wang, H</author></authors></contributors><titles><title>A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis</title><secondary-title>Archives of Disease in Childhood</secondary-title></titles><periodical><full-title>Archives of Disease in Childhood</full-title></periodical><pages>391-396</pages><volume>90</volume><number>4</number><dates><year>2005</year></dates><urls><related-urls><url>;(21)Determine independent contribution of corticosteroid therapy and delayed diagnosis on outcome of childhood pneumococcal meningitis.Design: Case series (lab and hospital). Methods: Case note review; questionnaire (paediatrician/family physician).Recruitment: Population register established through laboratories in the study area. Laboratories and hospital surveillance system in Sydney Australia. Participated: N=122 eligible cases.?Age: 1.78-179 months (median 13 months). Gender: male, 62%. SES: Not reported.Other: Most cases (46.3%) occurred in children <5yrs. 1st presentation: hospital (40%), General Practitioner (GP) (60%). Of GP group, 32% had two or more presentations before admission to hospital. 12% whose first presentation was to hospital had more than one attendance. In 46% cases, hospital admission occurred more than 24 hours after the time of onset of symptoms recorded in the clinical records.Other findings: Significant diagnostic and prognostic predictors of outcome were not having a lumbar puncture done, intensive care admission, intubation, any neurological abnormality, seizures within 48 hours, and higher temperature. The only significant therapeutic factor was administration of corticosteroids with or before antibiotics.?Limitations: Some clinical data only available from medical records due to incomplete physician follow up, might mean underestimation of mild disability due to lesser degrees of morbidity not being detected at hospital or uncovered later.Nadel (1998), UK ADDIN EN.CITE <EndNote><Cite><Author>Nadel</Author><Year>1998</Year><RecNum>841</RecNum><DisplayText>(22)</DisplayText><record><rec-number>841</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">841</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nadel, S.</author><author>Britto, J.</author><author>Booy, R.</author><author>Maconochie, I.</author><author>Habibi, P.</author><author>Levin, M.</author></authors></contributors><titles><title>Avoidable deficiencies in the delivery of health care to children with meningococcal disease</title><secondary-title>Journal of Accident & Emergency Medicine</secondary-title></titles><periodical><full-title>Journal of accident & emergency medicine</full-title></periodical><pages>298-303</pages><volume>15</volume><number>5</number><keywords><keyword>meningitis</keyword><keyword>treatment delays</keyword><keyword>mortality</keyword><keyword>children</keyword><keyword>inappropriate treatment</keyword></keywords><dates><year>1998</year></dates><isbn>1351-0622</isbn><accession-num>9785154</accession-num><urls><related-urls><url>;(22)Evaluate to frequency of delays and suboptimal management in children with meningococcal diseaseDesign: Prospective case note review. Methods: Direct questioning (parents) & General Practitioner (GP) referral letters. Case note review.Recruitment: Purposive. First 54 in-patients diagnosed at tertiary paediatric department within the study period. Participated: N=54Age: 1 week-15.7yrs (median 2.95 yrs). Gender: male (n=31), female (n=23).SES: Not reported. Disease: Meningococcal septicaemia (n=42), meningococcal meningitis (n=12). Of?those with septicaemia, 15 also had clinical or lab evidence of meningitis.Help-seeking behaviours: Some parents delayed presentation due to hesitation to call General Practitioner (GP) or go to Emergency Department at night/ weekend, not appreciating significance of non-blanching rash, inappropriately reassured by advice over phone by Emergency Department or GP. In all cases, parents were unaware of signs of serious illness in their child. Other findings: Among children with septicaemia delay from onset until treatment initiation was longer for those who died compared with survivors. 65% children had delayed recognition or suboptimal treatment: typical clinical features were referred to hospital without receiving parenteral penicillin from GP (n=8), not recognised despite presence of fever, petechial/purpuric rash and clinical features of serious illness and not treated or referred (n=16). Delay between presentation and initiation of treatment was delayed 2-12 hours (median 8.5). Repeated visits to GP (n=9), taken to Emergency Department without further attempts to see GP (n=7).? Children presented directly to Emergency Department (n=17): typical clinical features on presentation (n=15). In 2, incorrect diagnosis made and antibiotic treatment withheld and in 1 treatment was delayed by 4 hours despite diagnosis – across 3 treatment delay was 2.5-12 hours. 71% had appropriate treatment in Emergency Department.? All 54 admitted into hospital.Bias: recall bias. Limitations: Debate about reliability of the signs of serious illness in children used in this study.Okike (2017), UK ADDIN EN.CITE <EndNote><Cite><Author>Okike</Author><Year>2017</Year><RecNum>843</RecNum><DisplayText>(23)</DisplayText><record><rec-number>843</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">843</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Okike, Ifeanyichukwu O</author><author>Ladhani, Shamez N</author><author>Anthony, Mark</author><author>Ninis, Nelly</author><author>Heath, Paul T</author></authors></contributors><titles><title>Assessment of healthcare delivery in the early management of bacterial meningitis in UK young infants: an observational study</title><secondary-title>BMJ Open</secondary-title></titles><periodical><full-title>BMJ Open</full-title></periodical><pages>e015700</pages><volume>7</volume><number>8</number><dates><year>2017</year></dates><urls><related-urls><url>;(23) Define early presenting features of bacterial meningitis in young infants in England and review the adequacy of individual case management compared with relevant national guidelines and expert panel review.Design: Retrospective medical case note review Methods: Questionnaire (parent); case note review.?Recruitment: Purposive. 48 hospitals representing all English regions. Participated: N=97 cases included in analysis.Age: <90 days (0-6 days 31%, 7-28 days 45%, 29-89 days 24%). Gender: male 54%. SES: Parental accommodation: Mothers 52% own home, 40% rented, 8% council home, Fathers 58% own home, 34% rented, 8% council. Disease: Group B strep (63%), E Coli (11%), Listeria monocytogenes (4%), Neisseria meningitis (4%), Other gram-negative bacteria (10%), Other gram-positive bacteria (5%). Other: admitted from home (68%), inpatient (32%). Median age higher among cases admitted from home (17 days) compared with those already in hospital (1 day). ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? PARENT: Age: (median) mothers 29yrs; fathers 32yrs.Help-seeking behaviour: 20 parents took infants straight to the hospital (Emergency Department or urgent care centre); remainder phoned General Practitioner (GP) or 24-hour NHS Direct telephone service or contacted community midwife; of these, 28% advised to stay at home. Most common features at onset of illness were poor feeding, lethargy and fever. Median time from onset of 1st features to 1st help was 5.0 hours. Majority of parents presented to hospital within 24 hours of onset of symptoms. 93% of infants who presented after 24 hours had fever or seizures or both at time they presented to hospital; of these 53% had attended their GP surgery before going to hospital, and, of these, three were reviewed at the Emergency Department/walk-in centre and sent home and two were initially seen by a community midwife. Remaining 47% infants were brought to hospital by their parents more than 24 hours from the onset of symptoms. 30% infants were assessed to have received inappropriate prehospital management. 12 infants with fever warranted further investigation according to the NICE guidelines and in 8, there was a delay in seeking help despite the presence of worrying clinical features. Organisational: uncertainty in recognition, over-reliance on the presence of fever, waiting for urine samples before giving antibiotics and waiting for handover between shifts. Other findings: 55% infants triaged in Emergency Department during normal working hours. 68% infants had onset of symptoms within 72 hours of birth and therefore assessed against the NICE early-onset antibiotic guidelines. The main differences between infants admitted from home and inpatient cases were age, presence of fever on presentation, timing of lumbar puncture and time to discharge from outpatient follow-up.Bias: recall bias. Limitations: Parents recruited at paediatrician’s discretion. Some parents may have agreed to participate simply because they were concerned about their child's long term outlook or about suboptimal healthcare.?Thompson (2006), UK ADDIN EN.CITE <EndNote><Cite><Author>Okike</Author><Year>2017</Year><RecNum>843</RecNum><DisplayText>(23)</DisplayText><record><rec-number>843</rec-number><foreign-keys><key app="EN" db-id="rsw0vrtw1w5se0evsvjp50eifa5sfvrtp0zs" timestamp="1582192911">843</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Okike, Ifeanyichukwu O</author><author>Ladhani, Shamez N</author><author>Anthony, Mark</author><author>Ninis, Nelly</author><author>Heath, Paul T</author></authors></contributors><titles><title>Assessment of healthcare delivery in the early management of bacterial meningitis in UK young infants: an observational study</title><secondary-title>BMJ Open</secondary-title></titles><periodical><full-title>BMJ Open</full-title></periodical><pages>e015700</pages><volume>7</volume><number>8</number><dates><year>2017</year></dates><urls><related-urls><url>;(23)Systematic assessment of the sequence and development of early symptoms of meningococcal disease before admission tohospital. Design: Observational study. Methods: Questionnaire (parent); interviews (General Practitioner (GP)); case note review.Recruitment: Purposive. UK hospitals & GP records. Participated: N=448 children with meningococcal disease, 103 died.Age: ≤16yrs.SES: Not reported Disease: Meningococcal disease (of the 448 children with meningococcal disease, 103 died).Help-seeking behaviour: 51% of children seen by General Practitioner (GP) were sent to hospital from the 1st consultation. In most children, the disease progressed very rapidly. The median time between onset and admission to hospital was 22h in the oldest children (15–16yrs) and less in younger children (13h in those younger than 1 year, 14h in those aged 1–4yrs, 20 h in those aged 5–14yrs). 25% children had symptoms in the two weeks before the onset of meningococcal disease, most of which were suggestive of URTI or LRTI. Only 7% children had seen a doctor in the week before the onset of disease. 76·1% parents had noticed 1/more of early symptoms before hospital admission; <10% children presented with classic signs of meningism or impaired consciousness without parents having previously recognised a haemorrhagic rash or early signs of sepsis. Other findings: Fever was 1st symptom to be noticed in children <5yrs; headache 1st to be seen in those >5yrs. Loss of appetite, nausea, and vomiting were early features for all age groups, with many children also having upper respiratory symptoms (sore throat and coryza). In all age groups, 1st specific clinical features that were signs of sepsis: leg pain, abnormal skin colour, cold hands and feet, and, in older children, thirst. Parents of younger children also reported drowsiness and difficulty in breathing and occasionally diarrhoea. Most sepsis symptoms occurred before the first medical contact. 1st classic symptom of meningococcal disease to emerge was rash. Median time of onset of specific meningitis symptoms (neck stiffness, photophobia, bulging fontanelle) was later, around 12–15h from onset of illness. Last signs (such as unconsciousness, delirium, or seizures) were seen at a median of 15h in infants (under 1yr), and about 24h in older children. Features that were present in more than half the children before admission to hospital were nonspecific (i.e., common in self-limiting viral illness) except for haemorrhagic rash, which emerged late (median 13h). 3 features of sepsis (leg pain, abnormal skin colour and cold hands and feet) occurred earlier in the illness. Median time of onset of the classic meningococcal features of haemorrhagic rash, meningism, and impaired consciousness was 13–22h. By contrast, the median time of onset of the early, non-specific symptoms was 7–12h.?Bias: recall bias. 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ADDIN EN.CITE.DATA (25)Assess the diagnostic value of parental concern and gut feeling at the Emergency Department of a tertiary hospitalDesign: Prospective observational study. Methods: Questionnaire (clinicians, parent); case note review.Recruitment: Purposive. ED of children's clinical University hospital in Riga. Participated: N=162.Age: 2 months -17.8 years (median 43.5 months); < 1yr (n=22); 1-5yrs (n=80).Gender: male 53.1%(n=86). SES: Not reported. Disease: serious bacterial infection present in 46 patients: UTI 4.3%, sepsis 1.9%, pneumonia 17.3%, acute osteomyelitis with bacteraemia 0.6%, bacterial meningitis with bacteraemia 0.6%, bacterial gastroenteritis 1.9%, acute appendicitis 1.2%, bacterial soft tissue infection 0.6%. Serious bacterial infection absent 71.6%. ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? PARENT: Age: mothers median 34yrs; fathers median 33yrs. Gender: Mothers, 88.3%.Help-seeking behaviour: 59.9% parents stated belief that fever itself is indicative of serious illness, some parents believed that other symptoms must be considered as well when evaluating the severity of illness, few parents did not believe that fever is indicative of serious illness. No association was found between the belief that fever is indicative of serious illness and parental concern. Other findings: The presence of clinician’s “gut feeling” was significantly more common in children who developed serious bacterial infection than in those who did not, as was “sense of reassurance” in the cases with no serious bacterial infection. Prognostic value of “gut feeling” in ruling in/out possibility of being diagnosed with serious bacterial infection in study population not significant. Likelihood of the patient being diagnosed with serious bacterial infection was higher when “gut feeling” expressed by certified paediatricians than by paediatric residents. Sense of reassurance associated with decreased likelihood of having serious bacterial infection. The rule-out value of sense of reassurance was not significant.Limitations: Non-representative of all febrile patients presenting to Emergency Department; sample size of parents providing consent small. Prevalence of serious bacterial infections non-representative of prevalence at study site. Parents of children in Emergency Department longer maybe more prone to consent. Excluded populations: Lower risk patients scarcely enrolled.Van den Bruel (2012), Belgium PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WYW4gZGVuIEJydWVsPC9BdXRob3I+PFllYXI+MjAxMjwv
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ADDIN EN.CITE.DATA (11)Investigate the basis and added value of clinicians "gut feeling" that infections in children are more serious than suggested by clinical assessmentDesign: Observational study. Methods: Case note review.Recruitment: Prospective consecutive series, Primary care, Flanders, Belgium. Participated: N=3890.?Age: 0-16yrs (mean 5.05yrs). Gender: male, 51.4%. SES: Not reported. Disease: 21/3890 admitted to hospital with serious infection; pneumonia (n=12), pyelonephritis (n=6), sepsis, meningitis, cellulitis & bacterial lymphangitis (n=1).Other: Of 3369 children assessed as non-serious illness, 6 subsequently admitted to hospital with serious infection. Of all children presenting to primary care, gut feeling present in 13/21 with serious & 107/3869 with non-serious infection. In children in whom clinical impression was non-serious illness (n=3369), gut feeling present in 2/6 with serious & 44/3363 with non-serious infection.Other findings: Gut feeling that something was wrong despite clinical assessment of a non-serious illness increased risk of serious illness & acting on this feeling had potential to prevent to cases being missed at cost of 44 false alarms. Compared with clinical impression that the children were seriously ill, gut feeling was consistently more specific, irrespective of the children’s age or diagnosis or the seniority of the doctor. ? Feature most strongly associated with gut feeling was a history of convulsions. Children’s appearance, pattern of breathing and level of drowsiness were also significant but much less likely to provoke gut feeling than parental concern. Temp did not influence gut feeling, history of cough or diarrhoea made it less likely. Weight loss and urinary symptoms were also independently associated with gut feeling. For every year of additional experience the clinician was 5% less likely to experience a gut feeling separate from their clinical assessment. Of the 21 children who were eventually admitted to hospital with a serious infection, nine were not referred at first contact (despite the initial clinical impression of a serious illness in four children) of these, mean age, mean duration of illness, & mean temperature did not differ significantly from those referred immediately at first contact. However, in four of the nine children (44%), the clinician had a gut feeling of something serious.Limitations: Analysing components of gut feeling was not the primary aim of the original study and so study was not powered to do so. Possible bias related to the diagnostic investigations - children for whom clinicians had a gut feeling were referred more often that children for whom clinicians did not have a gut feeling. Excluded populations: only included children assessed in primary care and not other clinical settings.Young (2001), New Zealand PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Zb3VuZzwvQXV0aG9yPjxZZWFyPjIwMDE8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (26)Describe the pre-hospital experiences; health actions and attitudes towards health services of Samoan families who have hada child hospitalised with pneumonia.Design: Qualitative. Methods: Interviews, open-ended, in-depth interviews.Recruitment: Purposive. maximum variation selection. In-patients, Starship children's hospital. 11/12 families were from West Auckland. Participated: N=12.Age: <2yrs. Gender: not reported. SES: Not reported. Disease: Viral pneumonia (n=10), bacterial pneumonia (n=2). Other: 6/8 referred were Samoan born and 2/4 self-referred were Samoan-born.Help-seeking behaviour: Caregivers perceived themselves to be: quick to recognise change from normal in their child, prompt taking them to doctor, able to distinguish this illness from previous non-urgent illnesses, knew instinctively the child was unwell (“mothers' instinct”), felt these subjective feelings dismissed by the doctor leading to mistrust and influenced the caregiver to seek help elsewhere. All parents sent home after the initial consultation but quick to return to doctor if they felt their child was not improving. Personal barriers to accessing General Practitioner (GP) included: lack of knowledge about services in area, poor communication, feeling uncomfortable asking questions, contradictory information given by healthcare professionals (HCPs), feeling concerns dismissed as unimportant by HCPs in the community. Organisational: Most caregivers visited 2 or more doctors in the community before being referred/self-referring, reasons included: mistrust of doctors, contradictory information given by different HCPs, & poor communication between HCPs & caregivers. Reasons for wanting to return to family doctor included being able to ask questions, feeling comfortable when communicating with the doctor and feeling concerns acknowledged as important.Environmental: Non-financial barriers for attending accident/medical setting rather than GP included: GP fully booked, working mothers unable to attend within opening hours, limited transport to GP, the GP further than the accident/medical clinic, child's symptoms became concerning in evening and GP closed.Limitations: some statements presented in paper appear to be assumptions made by author. ................
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