Validation and comparison of geostatistical and spline models for spatial stream networks.

Scientists need appropriate spatial-statistical models to account for the unique features of stream network data. Recent advances provide a growing methodological toolbox for modelling these data, but general-purpose statistical software has only recently emerged, with little information about when to use different approaches. We implemented a simulation study to evaluate and validate geostatistical models that use continuous distances, and penalised spline models that use a finite discrete approximation for stream networks. Data were simulated from the geostatistical model, with performance measured by empirical prediction and fixed effects estimation. We found that both models were comparable in terms of squared error, with a slight advantage for the geostatistical models. Generally, both methods were unbiased and had valid confidence intervals. The most marked differences were found for confidence intervals on fixed-effect parameter estimates, where, for small sample sizes, the spline models underestimated variance. However, the penalised spline models were always more computationally efficient, which may be important for real-time prediction and estimation. Thus, decisions about which method to use must be influenced by the size and format of the data set, in addition to the characteristics of the environmental process and the modelling goals. ©2015 The Authors. Environmetrics published by John Wiley & Sons, Ltd.

The development of a designated dental pathway for looked after children.

OBJECTIVE: To explore the impact of a community-based dental care pathway on the dental care of children entering residential or foster care. DESIGN: The study used qualitative data collected during interviews with children who used the service, their carers and key professionals involved in the pathway, and routine quantitative data concerned with care entry and the dental service use. RESULTS: The dental pathway facilitated dental care access for children entering statutory care, met the dental needs of service users even when dental care provision proved challenging, and offered a consistent dental service regardless of care moves. Improved interagency integration and support was reported by key professionals as was better dissemination and documentation of dental assessments and outcomes. CONCLUSION: The dental care pathway had a beneficial impact on the dental access and experiences of children who used it, promoted better interagency working and facilitated record keeping. These findings call for extension of the service to a wider population to allow further evaluation of its impact and efficacy in different regional areas and contexts.

Topical silver sulphadiazine: side effects and urinary excretion.

Silver sulphadiazine has been used as a topical antimicrobial agent in a large group of children with burns and scalds. Four developed neutropenia and two an erythema multiforme rash which were thought to be due to sulphadiazine sensitivity. To assess the extent of sulphadiazine absorption in children, the urinary excretion was measured in a group of 8 patients with a mean area of injury of 13 per cent BSA. The mean urinary concentration of sulphadiazine was 31.8 mg/l.

Anomalous origin of left coronary artery from pulmonary artery associated with an aorto-pulmonary septal defect.

Aorto-pulmonary septal defects and anomalous origins of left coronary artery from pulmonary artery are briefly discussed. The difficulties of diagnosis and surgical correction are put forward in a situation when the left coronary artery arises from a site of high pressure and saturation, such as the pulmonary artery in the presence of an aorto-pulmonary septal defect, as in the case described.