• Adolescent Health
• Allergy and Immunology
• Analgesia

During a recent on-call, while manging an infant with a complex life-limiting condition, I referred to one of the recently published fifteen-minute consultation articles. The article not only provided management options for a complex emergent situation but also gave a platform for cohesive learning opportunity for the team. In that moment, I felt privileged to have the high-quality input that our authors give us. They not only generously share their expertise but also their experiences, which makes their contributions so clinically valuable. In this edition, the two-part series article on ‘Child Bereavement’ by Shona Johnston and colleagues illustrates this point well (see pages 163 and 169) . The group has produced a heartfelt, insightful article which is grounded in the realism of what bereaved parents experience and their strong insights into healthcare systems. This confers true cognizance about where potential systemic improvements can be made in healthcare. Being both clinicians and bereaved parents, they provide a powerful overview of the challenging logistics involved in management and highlight how subtleties in communication can be of crucial importance. These articles are a must read.

A consistent health screening for those with chronic disease like diabetes is an effective way of improving outcomes and long-term costs. Microalbuminuria is an important clinical marker for diabetic kidney disease, with early detection and treatment potentially slowing down disease progression. The fifteen minute consultation article by Isabella Weber and colleagues on ‘Management of albuminuria in children and young people with diabetes’ provides a fantastic overview of screening, investigations and treatment (see page 158). The authors have incorporated and highlighted differences in recently updated international guidelines by the International Society for Paediatric and Adolescent Diabetes (ISPAD), the American Diabetic Association (ADA) and National Institute for Health and Care Excellence (NICE). They provide a simple synopsis of how to manage elevated albuminuria and guide us on complex decision-making, using established guidelines and illustrated by a composite case. This article is therefore my editor’s choice and a recommended read.

E&P is unique in that authors usually reflect on their personal clinical practice and experiences, including how common pathologies are managed between general paediatric and subspecialist teams. Heechan King and colleagues provide a practical framework on what to do when encountering children with palpitations, recommending thresholds of referral to specialist paediatric cardiac services (see page 152) . The article also touches on the logistics of capturing relevant arrythmia data and need for prolonged non-invasive cardiac monitoring; with the variety of relevant devices now available to local services, this can proceed without first necessitating paediatric cardiology referral.

Drug dosing in the neonatal and paediatric population is often challenging. The biological maturity of paediatric/neonatal patients vary according to age as well as individual characteristics, which means that pharmacological intervention is complicated by variable consistency of effect. In our review article, Dotan Shaniv and Karel Allegaert describe the pharmacokinetics and their clinical relevance in this population (see page 184). The authors highlight available tools which can support appropriate dose selection, including measures like therapeutic drug monitoring and the use of standardised paediatric formularies, as well as considering clinical drug interactions, to overcome the pitfall of polypharmacy. The basic principles of applied pharmacokinetics highlighted in this article provide clinicians with practical solutions on how to improve pharmacotherapy in this population.

Increasingly, managing malignancies involve a variety of therapeutic permutations. In recent years, the addition of immunotherapy to already existing treatment protocols have changed the lives of many children with cancer. The article by Eleni Syrimi and Shivani Bailey focuses on one of these therapies- ‘CAR T-cells’, which has gained significant attention following remarkable success. The article is valuable for clinicians who care for children with cancer to understand the fundamentals of this relatively novel approach (see page 191).

Again, I am running out of space to list everything of excellence, I hope that you enjoy this edition and continue to write for us and share your valuable experiences. As an aside, I find the best way to keep up with general learning through this journal is to subscribe to alerts—try it! Thank you, as always, to everyone for their invaluable support.