paediatrics

Childhood obesity is increasing, particularly in low- and middle-income countries. In high–income countries, while prevalence may be plateauing, it remains high; and we are seeing an increase among children living in disadvantage. In January 2016, a report by the World Health Organisation’s Commission on Ending Childhood Obesity called for prevention efforts to target early life, specifically three critical periods: preconception and pregnancy, infancy and early childhood and older childhood and adolescence. An early-life focus is important because the health and social impact of excess weight and obesity in childhood persists into later stages of life, negatively affecting health, educational attainment and general life quality. Current high rates of childhood obesity are the product of a perfect early-life storm. Understanding the combination of factors that put children living in disadvantage at risk of obesity provide a clear focus for public health action. A perfect storm More children are now growing up in societies that facilitate weight gain and obesity by creating environments where a healthy choice is not the cheapest or the easiest option. Our recent review identified a range of factors likely to influence a child’s increased weight gain. These include maternal factors, prior to and during pregnancy. Diet, smoking, being overweight or obese when becoming pregnant, gaining excess weight during pregnancy and developing gestational diabetes can all increase the risk of the child being overweight. A father being overweight or obese at conception is also a risk for the child’s future weight. In the early months and years of a child’s life, many factors pose a risk to becoming overweight. These include the child not being breastfed or being breastfed for too short a time. A child’s risk of obesity is also strongly affected by the diet they learn to enjoy from the start of life, so early food...
What is your day-to-day work like? How do you help improve or save people's lives through your work? I work in Ljubljana University Medical Centre, Ljubljana, Slovenia and I’m head of the Paediatric Trauma Unit. I studied and received my medicine degree in the same city, in Ljubljana University. I’ve specialised in orthopaedic trauma for 16 years. Caring for an injured child requires special knowledge, precise management and great attention-to-detail. An injured child has unique needs and a multidisciplinary approach is needed to deal with the emotional as well as the medical needs of the child. But the majority of my work involves adult trauma patients and my focus in particular is on elbow, hand and wrist trauma and reconstructions. It’s a busy, challenging role with complicated procedures, especially when it’s a poly-trauma patient with severe and multiple injuries. Every injury creates a different amount of stress: physical and psychological. If there is a severe injury to a part of the body or to multiple parts, the patient’s health status is not the same as it was before. My job as a trauma surgeon is to improve and to regenerate the function of the injured part of the body as close as possible to what it was previously. So with different treatment modalities I strive to improve the patients live. This can be done diversely : with non-operative or a surgical treatment, depending on the type of injury. What do you think are the challenges facing the healthcare system and your profession in particular? The line of work we carry out is very complex and demanding. Having a team that can take into account the specificities of the injured patient is key, as well as supporting the family who are facing considerable emotional turmoil and worry. A high-level of education...
For Sophie, New Year’s Eve was as much an “I don’t have cancer anymore” party as it was a celebration of her 18 th birthday. To mark World Cancer Day , This Is Medtech shares Sophie’s tribute to 2016 and to life itself. “Cancer sucks. Everyone knows that. But believe it or not, even cancer has its silver lining,” she says of New Year’s Eve 2015/2016, which was the best night of her life thanks to Make-A-Wish Australia , a charity that grants wishes to children with life-threatening illnesses. 1 The evening of music and spectacular fireworks at the Lord Mayor’s New Year’s Eve party in Sydney marked a new beginning for Sophie, who was diagnosed at the age of 13 with Stage 4 medulloblastoma, a common type of childhood brain cancer. “I endured endless days in hospital beds undergoing chemo and radiation,” she says, adding that this gave her plenty of time to think about her wish. Brain cancer is the second most common type of cancer in children, followed by leukaemia, or cancer of the blood cells. According to the Children’s Cancer and Leukaemia Group in the UK, childhood cancers can be quite different from those affecting adults in that they tend to occur in different parts of the body and they respond differently to treatment. It’s encouraging to know that the survival rate for children’s cancer has more than doubled since the 1960s, and that about 82% of all children can now go into complete remission. For some children’s cancers, the remission rate is even higher. Everybody’s cancer story is unique Cancer treatment is individualised and therefore varies from patient to patient. However, the three main types of treatment are surgery, radiotherapy and chemotherapy. If the disease hasn’t spread to other parts of the body, surgery can...