Latest news with #Paediatrics
Irish Times
11-06-2025
- Health
- Irish Times
Letters to the Editor, June 11th: On hospital consultants, gender issues and book censorship
Sir, – Paediatricians are perceived as the kinder and less worldly members of the medical profession. That they have developed a toxic work environment for themselves and their nursing and junior medical colleagues is sad and dangerous. Few of their GP colleagues knew or suspected it. As Priscilla Lynch has pointed out (' Children's health crisis will roll on until we have transparency,' June 9th) neither did the Department of Health, the Minister, the NTPF and the HSE know about it until it was reported in the media. Paediatrics in Dublin operates in discrete sites without much recourse to GP or hospital colleagues and where poor professional behaviours can be normalised and kept secret. Paediatrics will now be decanted from three different hospitals with differing traditions, patient bases and cultures on to an expensive new facility. Expecting them to work harmoniously is a highly irresponsible pipe dream. READ MORE The history of hospital mergers in Dublin is an unhappy one with Beaumont and Tallaght taking years to settle. In the business world mergers are commonplace with attendant job threats keeping staff in line with employer expectations. In hospital mergers this does not apply as staff unions will negotiate for all existing staff to keep their jobs, with possibly some dislocation payments as well. This applies to the consultant staff too, meaning that management can't manage. How are managers expected to deal with a few highly unionised, well-paid doctors with track records of bullying junior staff and playing the system. Changing a toxic culture will not be easy. The sites of two of the hospitals being merged on to the new hospital may soon be up for sale in a rampant property market. It is not clear who will be the beneficiaries. A proportion of the proceeds of such sales needs to be earmarked to allow management of those who are burnt out, those wishing early retirement and those who do not embrace the unrivalled opportunities the new facility offers. Funding of multidisciplinary ethics and professional seminars are needed to develop an ethos to make a success of the new hospital. This is after all a professional issue where respect for colleagues, junior and senior, has been damaged. The fiascos of previous mergers would be avoided, and patients will be sure to receive the care they deserve. The introverted and secretive nature of existing paediatric practice needs to be addressed with good open management, adherence to employment contracts and governance that draws on international experience. Yours, etc TOM O'DOWD MD GPs at Tallaght Cross, Dublin. Reporting on gender issues Sir, – I was delighted to see Hugh Linehan's article asking some long overdue soul-searching questions about Irish media's reticence on covering gender issues (' Why is there so little coverage of gender identity issues in the Irish media ?' June 10th) and highlighting the shameful quiet cancelling of Stella O'Malley. Throughout that difficult period Stella was helping hundreds of families in Ireland and around the world through Genspect, the Irish based organisation she founded. These families were desperately trying to support loved ones experiencing gender dysphoria, but had been devastated by ideological capture among mental health and medical professionals. As a psychotherapist watching this happen within her profession Stella spoke up and did something when she thought people were being harmed, the same way others have bravely spoken up in the past. I hope now the tide seems to be turning away from loud activist voices and towards the evidence on gender issues that Irish media gets back to basics reporting the facts even when the facts aren't popular. – Yours, etc, LOUISE WHELAN, Greystones, Co Wicklow. Sir, – Why is Hugh Linehan's article on the lack of coverage of gender identity issues hidden in the Business section? – Yours, etc, DR JOHN DOHERTY, Gweedore, Co Donegal. Sir, –Congratulations on Hugh Linehan's long overdue article on the topic of gender identity and the silence of the Irish media. This refusal to cover the issue of gender identity in Irish society and all its implications is shameful and reflects the worst type of censorship – self censorship. The boycotting and failure to cover anything that might be construed as gender critical views, authors, news items, women's sports, women's groups, etc., has echoes of the worst excesses of the State censorship in the last century. I now look forward to more coverage and analysis of the issues and developments involved in gender identity theory such as the Cass Report, the banning of puberty blockers, the UK Supreme Court ruling, the attitude of our political parties, etc. JULIA ANDERSON Co Wicklow. Sir, – I was appalled to read Hugh Linehan's description of the Cass Report as 'a years-long, evidence based review of youth gender services led by a respected paediatrician' without any acknowledgement of the controversy and allegations of bias that surround the report, as well as its criticism internationally by many professional bodies, healthcare providers, academics and researchers. Particularly jarring in a piece calling for honesty of discussion, such an omission is, at best, misleading and deeply irresponsible. – Yours, etc, EOGHAN O'SULLIVAN, Dublin. Sir, – Hugh Linehan's article erroneously describes Stella O'Malley as 'an activist with a clear ideological stance'. Providing children and their parents with accurate information about potentially harmful or unnecessary interventions honours the clinician's obligation to act in the patient's best interests and upholds their duty to do no harm. This is not activism, it's ethical practice. If advocating for evidence-based, compassionate care makes one an 'activist', then every parent, doctor, psychotherapist, and indeed every journalist, deserves the badge. And if activism is the measure of a concerned and moral adult, what does it say about those who don't qualify? – Yours, etc, SANDRA ADAMS, Baldoyle, Dublin 13. Gardening leave Sir, – I recently retired from the health sector and I now have a huge interest in gardening. I can work at my own pace. If a plant is in the wrong place I can reposition it or get rid of it altogether. Other plants can be kept in check by a good 'clipping.' I can have great ideas and change them next season if they don't work out. I can ease off in the winter and start afresh in the spring. So if you want job satisfaction gardening is the answer. – Yours, etc, MARY WALSH, Stillorgan, Dublin. Parking and entitlement Sir, – I am lucky enough to live on a residential street in Dublin comprised of terraced housing. Parking is on-street and is essentially a free for all. Our nine-year-old son has a disability and a part of his condition is that he is a flight risk. Some households on our street have up to five cars, parking where they like while choosing to place a cone outside their own residence, thereby preventing others from parking there. We have politely requested that members from a multi-car household avoid parking outside our house if possible. Because of our son's disability. But when I made this request again today after a car had been left outside our door for four days I was informed that because people pay road tax they can park where they like. ''That's how it works,' they said. Yes. Indeed. They said that because there is not an accessible sign painted outside our house they can continue to park there. Also true. Not all disabilities are highly visible. They are not all the same. Although we are entitled to apply for a blue badge, because my son has no mobility issues. we cannot avail of an accessible parking space outside our home. The irony is that he is in danger because he is very mobile. A flight risk. With no sense of personal safety. And he is very fast. I look forward to the day when I do not have to constantly advocate for my son. When outdated bylaws catch up. And when above all the world is a kinder place. Where requests by parents of vulnerable children with additional needs are met with empathy, understanding, consideration and respect. – Yours, etc, REBECCA KEHOE, Dublin 3 Sir, – Brendan Murphy writes about careless parking. (Letters, June 10th). I live in a 1960s house, having purchased it in 1967. My house, like most of the time, had a garage, into which you put your car at night time. There was room on the driveway for the car during the day. However, nowadays, as my generation motor away to the great car park in the sky, our houses are being purchased by families who arrive with several large SUV type cars. The first thing they do is to convert the garage into a room or office. Thus, with their large cars they park one on the driveway and their other cars are parked on the road, one outside their own house, the others outside the houses of our neighbours. While I understand that the roadway is open parking for everyone, this situation quickly escalates to obstructions for those driving past, resulting in zig-zag manoeuvring and braking hard as one tries to drive up or down the road. A further complication is that if two cars park directly opposite each other the road is blocked. I've seen it happen. Believe me, it can only get worse. – Yours, etc, TONY CORCORAN, Rathfarnham, Dublin 14. Censorship and books Sir, – Ray Burke's report ( An Irishman's Diary, June 10th) of President Michael D Higgins's anecdote about being refused a copy of Bertrand Russell's book, Why I Am not a Christian, in the 1960s by the Galway librarian reminded me of my experience in the main library in Waterford when I requested a copy of Lewis Carrolls' Alice in Wonderland in the 1970s. I got the book alright, but not before the librarian had closely questioned me as to why I wanted it. I can only speculate that this was due to the fact that I was a male in his 20s at the time. Surely this was a case of honi soit qui mal y pense? There was rather a lot of that around books at the time. – Yours, etc, Séamus MCKENNA, Maynooth, Co Kildare. Sir, Ray Burke's Irishman's Diary, on book censorship reminded me of a story my former French teacher at St Columb's College in Derry told. He said he was stopped crossing the Border at the Irish Customs post in Aughnacloy when the customs officer spotted a copy of Émile Zola's Germinal sitting on the passenger seat. 'You might want to put that out of view,' said the official tactfully, 'Her books are not allowed here.' – Yours etc, JOE MCLAUGHLIN. Scotland. Trump and the US electorate Sir, – Lest we forget, because of our own focus on the damage he has already caused and the future potential damage to our economic and democratic lifestyle, US president Donald Trump has imposed and continues to inflict as much, if not more, trauma and prejudice on his own US citizens. He had already allowed Elon Musk run riot as de facto head of the 'department of government efficiency,' (Doge). As late as last Friday he asked the US Supreme Court to permit his administration to proceed with dismantling the department of education and now we see his plans to deploy some 700 US Marines (a military force trained to kill) on the streets of Los Angeles in addition to the already deployed National Guard troops. It gives me no pleasure to say so, but hopefully the narcissistic and vindictive behaviour of this president will prompt future US electorates to be very careful of what it wishes for and in the process sustain the greater civilised world. – Yours, etc, MICHAEL GANNON, Kilkenny. A picture paints 1,000 words Sir, – The photograph of the rescue from rubble near Jabalia in the northern Gaza Strip yesterday (Irish Times, June 10th) after the Israeli strike reduced me to tears. Look at the little girl in the man's arms up close. Shame on all of us who allow this to happen. Shame on so - called ''humanity'. I try mostly not to look to stop the upset, the rage building more and more against all of those who allow this to happen. Well done to all those who protest great and small. Thank you for highlighting this awful atrocity. Keep doing it please. I wonder will this little girl survive? – Yours, etc, GERALDINE MCGINLEY, Dunfanaghy, Co Donegal. Junior Cycle English test Sir, – The Irish National Organisation of Teachers of English (INOTE) has noted with dismay the inclusion of a question exclusively on short stories on last week's Junior Cycle English paper. Asking a question about 'how setting vitally influences character action' in short stories in a state exam is unwise and unfair. Narrowing the focus to short stories exclusively will have disadvantaged a significant number of students, something we absolutely reject as useful in a state exam. A much fairer question would have allowed students to discuss setting in a short story OR a novel. Every year INOTE has felt disappointed with some questions asked of our students in the JC English exam. Despite plenty of reasonable and fair questions, too often we have noted questions that are either much too narrow in focus or much too ambitious in scope for students, questions that are known in teaching circles as 'Gotcha!' questions. After a three-year journey in the classroom that values creativity, discussion and critical thinking, asking these types of questions is simply unfair on hardworking students desperate to showcase what they've learned. We sometimes wonder whether the SEC is aware of what 15 year old English students are capable of in such a highly time-pressured exam. We would urge the SEC to reduce the number of questions on the HL JC paper, embed more student choice and flexibility and also to be more realistic in their question design. Our students deserve the chance to shine. It is the least they deserve. – Yours etc, MIKEY MEALLY, INOTE chairman Co Laois.
Irish Examiner
09-06-2025
- Health
- Irish Examiner
Teenage girls' TikTok skincare regimes offer little to no benefit, research shows
Skincare regimes demonstrated by young influencers on TikTok offer little to no benefit, researchers have found, adding that on the contrary they raise the risk of skin irritations and lifelong allergies in children. The team behind the study say there has been a rise in young girls sharing videos of complex skincare routines with moisturisers, toners, acne treatments and anti-ageing products. In the first study of its kind, researchers analysed such videos on the platform and found the regimes are not only laborious – some girls wake up as early as 4.30am to fit in their routines – but pricey, unnecessary and potentially harmful. 'The risks associated with using these products, especially in young girls, far outweighs whatever marginal benefit you may get from using the active ingredients,' said Dr Molly Hales, the first author of the research from Northwestern University. Hales added that while social media can be a place for playfulness and self-expression, young girls do not need such regimes. 'The danger is when girls get the message that this is something that they have to do to take care of their skin and to protect their health,' she said. These products don't increase the health of your skin and they probably worsen your skin integrity over time. Instead, she said a gentle cleanser once or twice a day and the application of sunscreen is sufficient. Writing in the journal Paediatrics, Hales and colleagues report how they created two TikTok accounts, purportedly for 13-year-olds, and accumulated a sample of 100 skincare routines videos filmed by young people. The team found all but one of the 82 creators were girls, and their age ranged from 7-18. 'Almost all content creators had clear, light skin without visible blemishes,' the researchers write, adding the videos 'made frequent reference to aspirational beauty ideals that may be tied to whiteness'. The study reveals the skincare regimes involved six products on average, often from the same brands, with a total average cost of $168 (€147). However, some involved more than a dozen products with a total cost of more than $500 (€437). 'Get Ready With Me' videos were the most common, followed by 'Skin Care Routine' and 'After School' skincare routine videos. The team found many of the ingredients in the featured products, such as citric acid, carry a risk of skin irritation and sun sensitivity – meaning they increase the chance of sunburn and other skin damage. Yet only 26% of the 84 videos showing daytime skincare routines included a sunscreen – something that authors called 'a significant missed opportunity'. Hales added the use of products with multiple active ingredients, or layering products with the same active ingredients, increases the risk of skin irritation. The researchers found that among the 25 top-viewed videos, 76% contained at least one potential contact allergen – often fragrance. The Guardian Read More The best SPFs for your face, as tested by a beauty editor
The Guardian
09-06-2025
- Health
- The Guardian
Teenage girls' TikTok skincare regimes offer little to no benefit, research shows
Skincare regimes demonstrated by young influencers on TikTok offer little to no benefit, researchers have found, adding that on the contrary they raise the risk of skin irritations and lifelong allergies in children. The team behind the study say there has been a rise in young girls sharing videos of complex skincare routines with moisturisers, toners, acne treatments and anti-ageing products. In the first study of its kind, researchers analysed such videos on the plaftorm and found the regimes are not only laborious – some girls wake up as early as 4.30am to fit in their routines – but pricey, unnecessary and potentially harmful. 'The risks associated with using these products, especially in young girls, far outweighs whatever marginal benefit you may get from using the active ingredients,' said Dr Molly Hales, the first author of the research from Northwestern University. Hales added that while social media can be a place for playfulness and self-expression, young girls do not need such regimes. 'The danger is when girls get the message that this is something that they have to do to take care of their skin and to protect their health,' she said. 'These products don't increase the health of your skin and they probably worsen your skin integrity over time.' Instead she said a gentle cleanser once or twice a day and the application of sunscreen is sufficient. Writing in the journal Paediatrics, Hales and colleagues report how they created two TikTok accounts, purportedly for 13-year-olds and, and accumulated a sample of 100 skincare routines videos filmed by young people. The team found all but one of the 82 creators were girls, and their age ranged from seven to 18 years old. 'Almost all content creators had clear, light skin without visible blemishes,' the researchers write, adding the videos 'made frequent reference to aspirational beauty ideals that may be tied to whiteness'. The study reveals the skincare regimes involved six products on average, often from the same brands, with a total average cost of $168 (£124). However, some involved more than a dozen products with a total cost of more than $500 (£369). 'Get Ready With Me' videos were the most common, followed by 'Skin Care Routine' and 'After School' skincare routine videos. The team found many of the ingredients in the featured products, such as citric acid, carry a risk of skin irritation and sun sensitivity – meaning they increase the chance of sunburn and other skin damage. Yet only 26% of the 84 videos showing daytime skincare routines included a sunscreen – something that authors called 'a significant missed opportunity'. Hales added the use of products with multiple active ingredients, or layering products with the same active ingredients, increases the risk of skin irritation. The researchers found that among the 25 top-viewed videos, 76% contained at least one potential contact allergen – often fragrance. Prof Tess McPherson of the British Association of Dermatologists, who was not involved in the work, said the study was important, backing up anecdotal reports of an increase in young people attending clinics with skin irritation. 'We're certainly seeing a huge increase in people wanting something they call perfect or flawless skin, which we know is unachievable [and] unhelpful – it doesn't make people happy,' she said. McPherson added she is aware of young people asking for birthday money to put towards expensive skincare products, many of which are now being targeted at young girls through appealing packaging. As well as the risks highlighted by the study, McPherson said the skincare videos contribute to an increase in stigma around conditions such as acne and eczema as well as a fear of ageing, a message she said was reinforced by women embracing Botox and fillers. 'Younger and younger children are seeking skincare products when they don't need them, they're not helpful,' she said. 'This is a very concerning statement on society and how we view how skin should look.'
Medscape
28-05-2025
- General
- Medscape
Guide Helps Assess Child Abuse–Related Head Injury
The Child and Youth Maltreatment Section of the Canadian Paediatric Society (CPS) has released a new Practice Point for the assessment of children with suspected traumatic head injury related to child maltreatment (THI-CM). This type of injury 'is not rare and frequently results in significant morbidity for the child and family,' the CPS told Medscape Medical News in email correspondence. 'Healthcare providers have important roles to play,' according to the new guidance. These include 'identifying and treating these children, reporting concerns of child maltreatment to child welfare authorities, assessing for associated injuries and medical conditions, supporting children and their families, and communicating medical information clearly to families and other medical, child welfare, and legal professionals.' The Practice Point was published online in Paediatrics & Child Health. 'Red Flags' Although no single injury is pathognomonic for CM, there are several 'red flags' that should prompt a healthcare provider to consider THI-CM, the CPS said. 'These include elements of the history, clinical presentation, and radiographic findings.' Red flags in the history include: No history of a traumatic event Reported mechanism of injury that is incompatible with the injury Injury event incompatible with the child's development Unexplained or unreasonable delay in presenting for medical care Repeated unexplained symptoms suggestive of head injury Red flags in the clinical presentation include: Head injury with apnea Intracranial injury and seizures Intracranial injury and retinal hemorrhages Red flags in the radiographic findings include: Subdural hemorrhages (intracranial, spinal) Cerebral ischemia, often multifocal Cerebral edema Rib fractures Classic metaphyseal fractures (corner or 'bucket handle' fractures in infants) Absent or incompatible history of trauma and: Skull fracture with intracranial injury Long bone fracture(s) with intracranial injury CPS also noted that the term THI-CM 'was chosen through an iterative process to reflect the current language (traumatic head injury) used by health professionals, separated from the opinion on the cause of the injury (level of concern for child maltreatment).' The terms 'shaken baby syndrome,' 'abusive head trauma,' 'non-accidental head injury,' and 'inflicted traumatic brain injury' are no longer recommended for use in Canada, they added. What to Do When Abuse Is Suspected If clinicians are concerned that CM may have occurred, they should approach the case with an open mind, be aware of possible bias, and have compassion for the child and family, according to the Practice Point. Other recommendations include: The patient's medical needs should be managed first, but medicolegal steps should also be considered. Clinicians need to recognize that the differential diagnosis for injuries includes trauma, medical conditions, mimics of injury, or any combination of these. During the physical examination, clinicians should be especially vigilant for seizures, which are common in infants who have sustained a symptomatic head injury due to maltreatment. Laboratory testing can be conducted to assess medical status, screen for unseen injuries, and evaluate for possible medical disorders. A CT scan of an infant or child's head is the neuroimage of first choice, and MRI is an appropriate alternative or adjunct in some cases. Provincial and territorial laws require that clinicians report any concerns of possible CM to their local child welfare agency. The Practice Point also stated that a pediatrician specialized in CM 'can help guide clinical assessment and communication with families, healthcare professionals, child welfare, and law enforcement.' Consultation with other specialists, including critical care, ophthalmology, neurosurgery, neurology, orthopedics, endocrinology, hematology, genetics, and rehabilitation, 'can assist as needed.' Notably, the American Academy of Pediatrics' (AAP's) guidance mirrors that of the CPS, Suzanne Haney, MD, professor of child abuse pediatrics at the University of Nebraska Medical Center and Nebraska Children's Hospital, Omaha, Nebraska, told Medscape Medical News. Suzanne Haney, MD Like the CPS, the AAP does not use the term 'shaken baby syndrome' to describe suspected head trauma due to abuse, she said. 'Instead, we use the term 'abusive head trauma.' Sometimes these kids are shaken, sometimes they're slammed, sometimes shaken and slammed, we don't necessarily know exactly what the forces are, but we do know that it's abusive and was done by someone.' Similar to the new Canadian guidance, Haney suggested advocating for the involvement of a child abuse expert when faced with a situation that suggests CM. 'Studies have shown that when you involve somebody with expertise, you are more likely to get the right diagnosis,' she said. 'Most major medical centers have a child abuse pediatrician, although unfortunately our numbers are far too small. We do have a number of colleagues who may not be board-certified but have a special interest or expertise in this area. So if clinicians can identify somebody in their area who has a special interest in child maltreatment, they can be very helpful.'
