Welcome to the 9th EAPS Congress Programme Scheduling

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Proton pump inhibitors (PPIs) are potent drugs to control symptoms caused by gastric acid in the upper gastrointestinal tract. PPIs are recommended by international pediatric guidelines as the most effective drugs in gastroesophageal reflux disease, used both as a diagnostic test based on symptom relief after 4-8 weeks and for continued treatment when necessary.

In infants the guidelines do however not recommend PPIs as part of the diagnostic process due to a high proportion with transient physiologic reflux symptoms and the difficulties in interpretation based on symptoms only. Systematic reviews of several controlled trials in infants fail to identify any benefit compared to placebo.

In Norway and Sweden the use of PPIs in infants has increased by more than five-fold from 2007 to 2020. Denmark has seen an even higher use with more than 80 prescriptions per 1000 infants in 2017, but the use has decreased by 42% in 2020. For Norway and Sweden, a change in international guidelines has not until now resulted in any appreciable change in the ever-increasing use.

Side effects of early and long-term PPI use are of concern, with influences of the gut and airway microbiota and risk of gastrointestinal and respiratory tract infections. Moreover, a slightly increased risk of fractures and adverse food reactions calls for caution in liberal use of PPIs. Clearly, PPIs in infants presenting with transient regurgitation without symptoms warranting investigation should be avoided and represents an unnecessary medicalization.

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Appropriate pediatric pain assessment and management in the Pediatric Emergency Department (PED) is an important aspect of care. Under-treatment of pain has been reported in many studies as a persistent problem, and there are still large gaps in our knowledge, depriving children of adequate analgesia.

Studies that have examined analgesic administration in the PED found that multiple factors were independently associated with inadequate pain management: age and sex, presenting complaint, pain severity, triage score, time of arrival, ethnicity and race, crowding, and even type of insurance.

One way to overcome the problem of inadequate analgesia is to establish a triage nurse-initiated analgesia (TNIA) protocol that empowers nurses to administer analgesics early and without physician authorization. In adults, TNIA has been shown to be associated with decreased time to provision of analgesia and improved patient satisfactaction.

An overview of current research of TNIA in pediarics, will be presented.

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Organisations which are research active are known to have better patient outcomes, increased patient satisfaction, improved organisational efficiency and also improved staff satisfaction and staff retention. Despite the many benefits of research, there are reports from across all health care disciplines of challenges to being involved with research and developing a career as a research-active professional. Research activity is often not seen as core business and is often perceived by organisations to be an optional ‘extra’. Barriers to staff involvement in research include lack of time, lack of skills and awareness, lack of training and opportunities, lack of funding, lack of organisational support and lack of research culture; with increased challenges identified for Nurses, Midwives and Allied Health Professional (NMAHPs). Helpfully there are increasing numbers of publications identifying strategies and means to overcome barriers and support staff engagement with research. Examples include initiatives to engage clinical staff in local research delivery, schemes which provide funded (protected) time and support, schemes which help with mentorship and supervision, training and development opportunities to gain practical experience of research and schemes to enhance academic links with universities and clinical academic development. The creation and implementation of innovative schemes such as these creates a workforce who are research aware and active, a strong research culture and promotes patient access to clinical research.

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Antibiotic awareness among physicians aims to encourage best practices of antibiotic use among health workers and policy makers to avoid the further emergence and spread of drug-resistant infections. Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials, improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms. The purpose of the antibiotic stewardship programs can be summarized as using antibiotics only when needed, with the most suitable antibiotic agent, with the right dose, at the right time and for the appropriate duration. Major components of the programs are adequate personnel, activities, education and preparation of guidelines.

To address the challenge of antibiotic stewardship in Europe, we conducted a survey of such programs in European countries that are represented in European Academy of Pediatrics (EAP) with a final goal of harmonizing antimicrobial stewardship among EAP member countries.

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Very preterm (< 32 weeks gestation; VPT) or very low birth weight birth (< 1500g birth weight; VLBW) births account for up to half of perinatal and infant deaths, children with impairments and disabilities and more than a third of the health and educational budgets for children across Europe.

The overall aim of the RECAP preterm Project is to improve the health, development and quality of life of these children and adults by developing the RECAP preterm Cohort Platform, a sustainable, geographically diverse and multidisciplinary database of national and European cohorts of babies born very preterm or with very low birth weight (VPT/ VLBW cohorts). This network contains cohorts constituted over a 30 year time span and is designed to optimize the use of population data for research and innovation in healthcare, social and education policy. Pooling data from 24 very preterm cohorts provides exciting opportunities to generate new knowledge about the consequences of preterm birth. The project partners have created 11 interesting Modules to provide you with an overview of very preterm cohorts and collaborative research principles and techniques (see E-learning course). Furthermore, the Happ-e, an electronic cohort study for adults born preterm was launched in several languages was launched.

This presentation provides a short overview of the completed www.recap-preterm.eu with some selected results with implications of care. Information of how to collaborate with this federated data base will be provided.

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Early life is an important window of opportunity to improve health across the full lifecycle. An accumulating body of evidence suggests that exposure to adverse stressors during early life leads to developmental adaptations, which subsequently affect disease risk in later life. Also, geographical, socio-economic, and ethnic differences are related to health inequalities from early life onwards. To address these important public health challenges, many European pregnancy and childhood cohorts have been established over the last 30 years. Combining data will lead to the possibility of identifying smaller effect estimates, and the opportunity to better identify risk groups and risk factors leading to disease across the lifecycle across countries. The EU Child Cohort Network, established by the Horizon2020-funded LifeCycle Project, brings together nineteen pregnancy and childhood cohorts, together including more than 250,000 children and their parents. A large set of variables has been harmonised and standardized across these cohorts. The harmonized data are kept within each institution and can be accessed by external researchers through a shared federated data analysis platform using the R-based platform DataSHIELD. The EU Child Cohort Network has an open character. All protocols for data harmonization and setting up the data analysis platform are available online. The EU Child Cohort Network creates great opportunities for researchers to use data from different cohorts, during and beyond the LifeCycle Project duration. It also provides a novel model for collaborative research in large research infrastructures with individual-level data.