Legacy University The Gambia's Dr. Emmanuel Udemezue Onyekwelu M.D. Conferred with Honorary DSc

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DSc (Honoris Causa)

Dr. Emmanuel Udemezue Onyekwelu M.D.

Doctrin de Science Award Honoris Causa

is

The Pride of Gambia

Recipients of Honorary DSc are recognized as Resource person, Consultants & Advisors of international repute in Community Development, Education and Management

Mission of Honorary DSc is to produce Technologists of caliber by imparting quality Education to the students

Mission of Honorary DSc is to promote research and extension among Universities and other research organizations in all aspects of research, extension and training.

Mission of Honorary DSc is to undertake consultancies and studies in Community Development, Education and Management

Mission of Honorary DSc is to provide advisory services for Social Engineering

This is international selection based upon merit. Every year Honorary DSc is awarded to World's 100 Most Influential International Celebrities who have made significant contributions in the transformation of society.

Honorary DSc is awarded by International Agency for Standards and Ratings, it is valid international recognition, recognizing Vice Chancellor, Minister, Judge, Legislative Members, Policy Makers, Professors, Director, Principal, Head of Institutes, Company Owners, Chairman, Advocates, Engineers, Doctors, Patent owners, Editors, Scientists, Civil Servants and many more across all continents of world including America, Europe, Africa, Asia & Australia, which is World's Largest Talent Pool with Rank 1.

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* This Global program recommends international organizations in identification, selection, recruitment, promotion and retention of World’s Most Influential People.

Exclusive Interview with Dr. Emmanuel Udemezue Onyekwelu for Public Broadcast

Dr. Emmanuel Udemezue Onyekwelu

Question: What inspired you to enter into Paediatrics?

Answer:

Thanks for availing me the opportunity to undertake this notable and worthy interview.

Answer:

In my opinion, Paediatrics is a rewarding career indeed. As a paediatrician, you are given the privilege to oversee the growth, development, and health of your patients throughout each stage of their life from conception, childhood and adolescence, and you have the ability to make a positive impact on the life of each child that comes into your care.

My inspiration to undertake an academic and clinical career in Paediatrics is multifaceted at the first instance, since I come primarily from a scientific background I aimed to apply scientific knowledge and understanding in the improvement of the children’s health and wellbeing globally.

Secondly, by undertaking a career in paediatrics, I felt I would be accomplished in offering a scientific health care delivery that cuts across all age groups from conception, intrauterine life, through birth to infancy up to parenthood and the family unit in a unified model.

Thirdly, I anticipated that a stint in Paediatrics would offer me the opportunity to be an expert and a leader in an established and pivotal medical specialty.

Also a career in Paediatrics would indeed offer me an opportunity for lifelong learning which it did.

My mentors and parents inculcated in me that they did not just want me to do what will make me happy, but that they expected me to make a difference in any career that I undertake in life which eventually leads to utmost and sustained happiness.

The circumstances surrounding my entrance into Paediatric training which was inspirational and philosophical augured well with the calling I had for a career in Paediatrics which was just much more, greater than just getting a job. Following my experience and career in Paediatrics, I have always counseled and mentored my scholars during career guidance sessions and other discursive activities, that, interest in a career, with potential benefit to nature and the society should guide their choices rather than current trends and fiduciary factors, because experientially, the interest in the career keeps the scientist , scholar or practitioner going, when fiduciary factors are not tentatively very favourable and positive until conditions naturally improve as it always does with dedication and perseverance.Although, working with children can be demanding and stressful at times, especially when the patients are very ill, confused, in pain and out of of their senses,I still found it very interesting overall. In addition to requiring education and training, medical careers in paediatrics require patience, love for children and a very gifted, dedicated, diligent and special personality.

Thank you

Question: Since how long, you been into this scientific field and in which cities you have been associated for health practice, teaching, research, commercial and training programs?

Answer:

I have been in the scientific field of Paediatrics since qualification as a medical doctor in Nigeria in January 1993. .

I have been associated with several cities in West Africa,North Africa,Europe,South Africa,Middle East,Oceania,Australasia ,North America,South America,Caribbeans and Asia for health practice, teaching, research, commercial and training programs related to Paediatrics and childhealth..

These cities include but not confined to Jos, Nnewi, Enugu Porthacourt, Onitsha,Assaba, Kaduna, Warri, Kwale Benin City, Ibadan, Ile-Ife, Ado-Ekiti, Akure, Ondo, Abeokuta, Umuahai, Aba, Abakiliki, Orlu, Mgbidi,

Markurdi, Nsukka, Abuja, Lagos, Owerri, Akure, Ihiala all in Nigeria In addition to Johannesburg, Capetown, Accra, Kumasi, Cape Coast, Takorodi, Secondi, Lome, Cotonou, Ouagadougou, Bamako, Freetown, Monrovia, Banjul, BasseDakar, Abidjan, Libraville, Lambarene, Harare, Bulawayo, Bengai, Duoala, Yauonde, Casablanca , Algiers, Rabat and Cairo etc.

I equally undertook educational visits to several notable cities in the British Isles such as London, Newcastle, Essex, Colchester, Cardiff, Glarmagon, Swansea, Conventry,

Birmigham, Liverpool, Edinburgh, Glasgow, Dundee, Strachclyde Inverness, Dublin, Cork, Limerick, Galaway, County Claire, Belfast, Londonderry and Ulsteretc .

In addition to conferences and training programmes in Paris, Bruxelles, Munich,Hannover,Bari,,Genoea,SestrilLeventi ,Budapest,Vienna,Debrechen etc.

Thank you.

Question: What are your future plans for health practice, research and training programs in Paediatrics?

Answer:

Since the constituents and scope of global child health with regards to health practice, research and training programs in Paediatrics is increasingly complex my approach and strategy to address the gaps in these areas would be triangulated and multifaceted.

Anecdotally, although there is a relatively robust evidence for the effectiveness of individual, private, institutional, local, regional, national, continental and global developmental, educational, governance and research initiatives in reducing child mortality, but this has not been a focus and target of several health initiatives and interventions.

My futuristic plans will include,to be involved in interventions , research investigations and projects that will strengthen health systems through proffering support for local child and maternal health governance ,building-up child health institutions of training capacity and capability prowess , empowering local,voluntary ,national ,regional .continental and global paediatric academic and professional associations/societies , creating opportunities for contribution and scientific governance at institutional, community, provincial ,regional, national, continental and global levels, and educational and research networks of support for personnel and staff working in child health and Paediatrics in the hinter lands in addition to the .remote and underserved areas.

In the more vulnerable, high morbidity and mortality regions with enormous Paediatric Pathological , burden to meet the clinical, educational and public health gaps, I will propose the need for an enhancement in the education and training of child health nurse practitioners,child developmentalists multidisciplinary,multispecialty Paediatric nurses and the development and identification of systems for continual professional developments for Paediatric doctors,nurses,nutritionists and other Paediatric allied health workers .

Also I will encourage initiative with active interest and involvement in in-house observatory systems research and operational research, gap analysis and situation analysis, especially those that contribute directly to pivotal issues in child health and Paediatric policy ,in addition to the strengthening and scaling up of achievable data aggregation, collection, analysis and management systems ,would be some of my other proposed plan that could be implemented.

Since a consistent and rigorous collaboration and co-operation is imperative to address the numerous complexities and challenges of child health and Paediatric health practice,I will favour a programme that promctes research and training programs in Paediatrics development especially in developing and emerging settings, at the global, continental, national, provincial and district levels, among paediatricians, child health nurses nurses, nutritionists , other Paediatric allied health workers and policy makers.

Although the plans for my contributions to each of these sectoral and societal units will be different, but it is an approach ,strategy and need which has been partly, but not currently ,earnestly,optimally or utmostly met by any of these entities as a group.

In my opinion, a substantial increase in skilled personnel globally will be imperative,if child health and Paediatric health practice, services, research and training programs in Paediatrics are to be fully developed and health targets are to be reached,although this will be required more in developing and emerging regions .

This will imply an account and reconsideration of the complex and pivotal roles and remits that need to be assumed by the contextual child health , paediatric clinical, research and public health staff in addition to their professional development needs.

Furthermore, the growing interests in strengthening Paediatric and Child health systems may need to incorporate support for multiphased institutions of training in addition for the support and d sponsorships for the roles of professional associations of Paediatrics.

Thank You

Question: What kind of businesses can be started in Paediatrics by businessmen? What minimum infrastructure would it need?

Answer:

Paediatrics as a specialty is an extensive and wide scoped medical specialty offering a lot of opportunity for a businessman or entrepreneur who is good willed and determined to invest in it.

On the basis of availability and opportunity,a potential businessman or social entrepreneur may wish to invest in several ,some or almost all of Paediatric disciplines,domain or specialties which may include ,but not confined to paediatric dentistry, childcare respite facilities, clinics,hospitals, diagnostic and imaging facilities,research , nonprofit organizations, medical specialists, and even schools such ascrèches,kindergartens,nurseryschools,primaryschools,secondaryschools,grammerschools,conservatories etc.

Whichever paediatric endevour the potential business man or social entrepreneur wants to invest in he must adopt one basu business approach which is that of having an algorithmic customized Paediatric business plan.

Anecdotally and traditionally, the minimum infrastructure needed to commence a business in Paediatrics would include, but not limited to the conception and development of an algorithmic customized Paediatric business plan which will assist the investor not only to obtain the funding that they may need to execute and implement the project , but also to serve as a blueprint for their business operation. A good customized paediatric business plan at the conception stage of a Paediatric business will ensure a credible management, growth of the business and expansion of the Paediatrics business brand to a novel market.

Ideally on the basis of opportunity and the budget allowing, the development of a good customized algorithmic paediatric business plan, may imply the engagement of professional business plan managers, writers and advisors who will work to ensure that the Paediatric entrepreneurial investor businessman will be in a vantage position to succeed despite odds.

Other Pivotal Infrastructural requirements will be needed before a customized paediatrics Business plan is established especially the working and start off capital. etc.

When you are starting a paediatrics business, it is essential to make sure that you have taken the necessary steps for the business to thrive.

One of the most critical challenges that all business owners face is to ensure they start or operate their business with enough capital and a business investment in Paediatrics is not exempted from this requirement. This is evident as studies have shown that most startup businesses fail within the first year generally due to lack of planning, which results in under-capitalization.

It is important to identify and secure a strategic location in which to offer the Peaditric business services in addition to marketing the paediatric business services to the regional market via social media, mobile apps, and creating partnerships with businesses that currently serve the paediatric business market.

Most importantly of all, it is crucial to have a professionally developed customized paediatric business plan to help identify and break down these trends and patterns along with a full five -year financial model forecasting future revenue.

In the establishment of a dedicated and customized paediatric business the need for a reliable customized paediatrics business plan is an axiom.

A paediatrics business plan must be carefully constructed to convey the Paediatric business’ mission, its various amenities, servicesto be offered, and the credentials of its management team and its plans for profit making, in this way it will appeal to other potential financiers and investors.

From my experience, most startup paediatric businesses fail within the first year of its commencement generally because of lack of planning, which results in under-capitalization.

I always counseled that whether one is looking to commence a general paediatric clinic or a paediatric specialist facility,diagnostic centre, conservatory or sanatorium , it is essential to have a credible and qualitative paediatric business plan prepared by professionals to ensure that onespaediatric business is in a position to succeed.

There are several paediatric business plan managers who could assist one in this endevour , they know how much the potential investors require to kickoff a successful paediatrics business, and they are there to assist you enter the market with a competitive approach and strategy .

Since one will need capital to support his paediatric business plans, this is where business plan experts come in since they will ensure that the contextual paediatric business plan maintains the highest achievablestandards in order to meet the needs and requirements of banks, financial institutions and investors.

Development of The Business Plan for Pediatrics

Several business plan teams have developed efficient and convenient processes with customized and individualized needs of the paediatrics industry in mind, giving the paediatric business investor an opportunity to have more of their time focused on the other aspects of their businesses while they conduct the time-consuming research and analysis required to develop a credible and professional business plan.

Indeed, most business plan managers value their client’s paediatrics business as much as the proprietors themselves do, and they are actually there to help make the business plan idea a reality through proffering a convenient, professional, and affordable process.

PAEDIATRIC BUSINESS PLAN CONSULTATIONS

During the development of the Paediatric business plan, the business plan development and management firms will assign one of their professional business plan writers to work directly with the potential investors to discuss and implement the investor’s ideas. The professional business plan writer will also provide input and strategic steps to be taken during the development of the paediatric business plan.

PAEDIATRIC BUSINESS MARKET RESEARCH

Market Research is an essential component in a paediatric business plan development. Effective business partnership with the most reputable market research firms regionally, nationally and globally has ensured that the market research delivered by most paediatric business plan managers contains real-time data that accurately reflects the paediatric investors potential market needs..

PAEDIATRIC BUSINESS SECTORIAL ANALYSIS

Sectorial analysis includes a thorough investigation of the Paediatric business investment sector to determine any trends or patterns in this discipline.

Thanks to the effort of the Paediatric business firms who through sustainable partnerships with the best market research firms available, are able to offer a complete breakdown of the gap and situation analysis of the pivotal and relevant sectors.

PAEDIATRIC BUSINESS MARKET APPROACH AND STRATEGY

Most credible business plan teams will be able to develop a strategic marketing plan through research and exploration to illustrate new opportunities to reach the investors paediatric target market in order to set ones Paediatric business well poised in a competitive atmosphere.

PAEDIATRIC BUSINESS FINANCIAL MODEL

Whether one is overseeing an established paediatric business or a new starter, ensuring that one has a well developed financial model and projections in place are essential when presenting the overall paediatric business plan.

PAEDIATRIC BUSINESS DESIGN & DELIVERY

Once the plan is finalized, the business planning firms, professional graphic designers will provide a credible and substantive products copy of the paediatric business plan for the investor and his managers to distribute to their potential lenders and other investors whwere applicable.

It is heartening that over the last several years, that the processes of creating quality business plans have been perfected.

Paediatric business plans are better presented in an algorithmic sequence for consistency and easy comprehension.

In this way the potential client’s will spend less time reviewing their customized paediatric business plans ,in this way,they will be enabled to invest more of their time into the actual paediatric businesses.

Basically, effective paediatric business plan development involves the salient steps including at the first instance an initial consultation, where the contextual paediatric business overall goals are discussed with the paediatric business plan consultant.

Also, at this point, the Paediatric business plan questionnaire will be completed and there could be need for an initial payment to be made to the Paediatric business plan development firm.

In the second instance, the business plan will need to undergo further development, at this point the investor or his manager will need to work directly with one of thepaediatric business plan firm’s writers to discuss and develop the contextual customized paediatric business plan.

Thirdly, once the investing team receive the draft ,they will have the opportunity to provide feedback to the business plan development team to finalize the overall paediatric business plan.

Finally , in the paediatric business plan design and delivery stage, once the paediatric business plan has been finalized, the business plan development firms graphic design team will design, print and convey the plan to the paediatric business investing team for distribution.

Paediatric business investors whether they are Pediatricians, Paediatric Nurses or other allied health care workers or not ,do not spend years in medical school, endure long daysof hard work and sleepless nights during their internship and residency, and then start their own paediatric business practices because they just love running a business.

All investors, physicians, and especially paediatricians, have an unrelenting passion for helping patients, notjust operating an enterprise solely for fiduciary benefits, however in the interim, the Paediatric business has to be financially viable in order to be able to achieve these .

Unfortunately, a paediatric practice is a very complicated business, with many mobile parts, and managing it requires very specialized business tools. Questions such as: what is the collection rate of the paediatric practice, what is the daily patient volume that the paediatric business practice, realizes and what are the fixed and variable costs in addition to its overall overhead are all important to ensuring the sustainability of the paediatric business.

Additionally, leveraging business tools such as automation of such things as billing and marketing functions will not only assist to grow the paediatric practice but will allow the paediatricians to concentrate on patient care and management.

This is where the engagement of a basic automated electronic health records archiving and retrieving systems and platforms has proven to be invaluable.

Although there are several features of this paediatric–focused electronic health records archiving and retrieving systems and platforms , but several archivists and implementation specialists selected some that could assist a paediatric practice become a successful business overall.

The platform allows electronic health records archiving and retrieving system orders to be linked to appropriate ongoing procedural terminology codes. These codes are used by health insurerance companies to determine the amount of reimbursement a paediatrician will receive for the services provided. This linkage allows services, such as immunizations, infant welfare and nutritional services to be easily billed when the paediatrician clicks on the order button. These ongoing procedural terminology codes are then sent to the practice management area of the platform to be billed and submitted to the health insurance company.

Although some of these features are not imperative for a budding Paediatric business practice,however they offer a unique opportunity for peaditric business practices to regulate how their clinical protocols, generate billing information, it equally gives them more accuracy and speeds up the process in a paediatric specialized practice where every second is relevant

This means billers do not need to memorize hundreds of different rules.

These automated electronic linkage assistive devices are very efficient and proficient time-savers and could improve the overall efficiency of the paediatric business practices.

These automated electronic linkage assistive devices could equally be used by paediatric business practices to improve their capacity by being able to order more than one laboratory investigation contemperoneously and simultaneously.

For instance, if a practice routinely runs a set of laboratory investigative tests at a specific age well infant clinic visit, they could very easily order them all with a single click.

The protocol configuration tool of these paediatric-focused platform allows the paediatrician or nurse to place the correct orders based on the reason for the well infant visit or age of the patient. This allows the clinician to easily select the correct set of immunizations and/or developmental screenings etc.

Stnadard protocols are thereby linked to appointment visit reasons for instance when a ten months old comes in for a well infant visit ,the software brings up the appropriate protocol with all of the typical orders used during that type of visit. The immunizations, laboratory investigations and even evidence based guidelines are lined up for the paediatrician. If a well infant visit turns into a sick infant visit, one click adds the sick protocol to the chart or modifies the protocol completely to the sick infant protocol.

Also , when clients schedule same-day appointments an eligibility request immediately goes out to the health insurance plan. The office staff is not required to open a browser to check on the eligibility of a patient. Instead, they see the eligibility response when they check the patient in at the front desk.

It’s not unusual for a parent with a sick child who scheduled to see the paediatrician to bring along a sibling who may also have similar symptoms. These electronic devices make it easy for clinicians to open a sibling chart and create a visit in real time. This allows the paediatrician to have a tab for each patient making it simple to jump back and forth between patients as needed. Moreover, the paediatrician could share clinical elements, such as family or problem lists, from sibling to sibling very easily.

Because the automated electronic linkage systems devises platform embeds paediatric functionality throughout the system, managing the immunization process is easier, faster and more accurate.

Immunization orders placed by paediatricians update the childs immunization record immediately.

Parents could also print the region, state or school specific immunization forms instead of filling them out manually. There is also an automated electronic linkage-driven immunization forecaster that helps doctors to easily identify patients who are behind on their immunizations.

These electronic assistive devises also features an immunization inventory tool that allows a practice to add immunization lot numbers as soon as immunization shipments are received. In this way administrators could disallow use of a specific lot until the previous lots are depleted. They can also easily access the immunization inventory tool while editing a patient's immunization order to deplete a previous lot and activate a reserve lot.

There will be need for the Paediatric Practice to develop A unique way to track their patients growth points

Since patient growth tracking is extremely important for the young patients of paediatricians.However, thiscould also be a tedious job that needs to be done.

However, with some electronic devices, growth points are automatically added to growth charts when the vitals of the patients are taken and recorded. There will be need also for manual and electronic systems that has growth charts for premature babies and patients with chromosomal disorders such as Down Syndrome etc.

Family-style billing with the correct data will need to be processed efficiently

Paediatric practice management system with family-style billing should be encouraged, this implies that a family gets one bill, not one bill per patient. When a mother calls the office to schedule an appointment or walks in for today’s visit, the health staff has all of her family’s financial history at their fingertips.

Also, the Paediatric business practice must always have the ability to review these charges before posting and submitting to health insurance companies.

A handy and rich storehouse of paediatric content makes counseling easier

Another important aspect of a Paediatric business practice will be the encouragement of the availability of an exclusive, paediatric patients handouts – which enables the paediatrician to counsel parents and children on a wide variety of topics and send this content directly to the patients portal on the paediatric business practices website.

Patients handouts from the UNICEF, WHO, AAP, multilaterals,bilaterals , non-governmental organisations,and the regional ministries of health in addition to those such as that from paediatric care online or paediatric patient education should be made handy and easily available through online and print copies to the parents,children and care givers , and these hand outs should be modifiable by the paediatricians based on the diagnoses selected in the current visit or any diagnosis on the patient’s problem list. The parents could also search for any handout.

In my view, a private and an independent paediatric practice is more than a medical home for children – it is also a second home, supported and sustained by the paediatric business.

Therefore, the social entrepreneur’s, investors and their stakeholders should be ready to improve their performance in order to increase their numbers, these will be achievable whenone has the right business plan, approach, strategy and implementations in addition to a dedicated paediatric-focused support team, on their side.

Before venturing into a paediatric business, investors must endevour to take an overview of the investment company that they have chosen, and ask themselves the question on why they have chosen that particular business plan management company?

Other aspects and issues that will need to be factored in by the investors and their relevant stakeholders include but not confined to the appropriate financial management tools,clinical workflow tools,mobile solutions ,companies interoperability, personalized support systems, their pricing odels,theirresults,their overall overview,paediatric benchmarks,client testimonials and success stories to be shared etc.

Also the investors should be willing to learn with their business planning and investment company through knowledgebase, companyblog, client forum, company protocols library, resources, company users’ ,conferences,paediatricsupergroupConferences,events& trainings etc.

Other relevant aspects they will need to addressed includes but not confined to insights to be gained and the potential paediatric business Impact of COVID-19, available paediatrics resource center, cost impact calculator.

They will equally need to assess iftheir paediatric business practice will measure up to the need to have a clients blog,the company’s blog, a journal such as the Independent paediatrician resource ,request for a direct consultation , meet our team, events& trainings, career development and the establishment of effective and sustainable partnerships.

There should be clear guidelines on how to request for a direct consultation and the availability of brochures and client support resource .The Paediatric business operator should be willing to control their future.

Finally ,also of seminal importance is the need for the entrepreneurial paediatrician starting up a paediatric business to encourage and implement the diversification of his business entrepreneural portfolios from the onset of the paediatric business , investments into risk free dividend and profit yielding equities, capital investments ,real estate investments etc.

Athough the paediatric business plan could be commenced on a rented property, it will be in the interest of the paediatric business proprietors to aim and implement plans that will achieve customised real estate ownership ,which should be designed and specially built for this paediatric business purpose as early as will be achievable.

Thank You.

Question: What are your recommendations to improve the standards of journals publishing research articles on Paediatrics?

Answer:

The standard of journals publishing research articles in paediatrics is usually gauged by several bibliometric indexes of which impact factor of a Paediatric Journal is the most commonly employed.

The impact factor of a Paediatric Journal is the quotient of the number of citations corresponding to articles published in a journal in the twenty four months prior to the current contexual Paediatric Journal edition, divided by the number of research articles -original articles, systematic reviews, scientific letters published in the journal in the same period within the particular twenty four months.

Authors, journal editors, reviewers, referees, scientific investigators, study sponsors, scientific institutions librarians, publishers, scientific medical writers and the contexual journals readership all have individual and collective roles to play in ensuring the credibility and standards of scientific journals are improved.

Since the authors appears to be the ones that benefit most from journal article publications and role ,their role appears to be the most critical and decisive in the improvement and success of Paediatric journal, I will discuss their roles and remits first and then dwell and punctuate further on that of the other scientific stakeholders.

From the scientific point of view, the areas that will need to be strengthened by the contexual journal authors for articles submitted for publication to Paediatrics journals include, but not confined to the inclusion of thematic and relevant aspects.

Secondly, Paediatric Journal authors should strive to emphasis on the originality and current relevance of the topic rather than dwelling on known or previously described facts.

They should aim to be paediatric authors of research question/topic of immense current interest or relevance rather than authors of reseagh topics with limited applicability to clinical practice

The paediatric authors should adhere to the good practice of avoidance of poor generalizability to other settings

They should encourage the avoidance of articles with little interest/use to target audience

With regards to the design and methodologies, the potential authors should ensure that there should be an adequate design and methodogical approach in place to address the research question,in this aspect this implies that the contexual research study design must be robust, ensure good choices of primary and secondary outcomes,good application of research data and the avoidance of limitations in sample selection and statistical analysis as much as would be achievable.

Also it is pertinent that the paediatric authors undertake the interpretations of the findings with well-grounded and founded conclusions in addition to the employ of inferences that mustbe justified by the research study findings.

They must practice the encouragement of the considerations for alternative explanations, insistence on the comparison with previous evidence, theavoidance of underestimation or overestimation of the actual contribution of the study in addition to the practice of proffering a discussion on the limitations of the study etc.

Paediatric authors should asle do well to be diligent and practice the insistence on the need for the structure and writing of the manuscript to comply with the guidelines for authors in the contextual paediatric Journal, proper structuring and organization of the articles submitted for publication, avoidance of errors in semantic, syntax or grammar, flawed logic through the use of a native english language proof reading services etc.

Additionally, theoverall message of the article must be very concise, precise, lucid and clear,these are some of the achievable steps that could be employed to improve the overall standards of paediatric journals.

Improving the standards of Paediatric Journals could also be equally achieved through the design of robust paediatric clinical trials

Since children are not small adults, and the risk of serious side effects in young children administered over-the-counter cough and cold medications is immense ,I will highlight the need for more attention to be given in developing the evidence base on which to base the therapeutic decisions for the care of children. Physicians who treat children often must decide between withholding treatment proven effective in older patients or using medications off-label, with insufficient information about drug dose, metabolism, known side effects or appropriate formulations. However, there is strong pressure for change, and to improve the number, quality and reporting of paediatric clinical trials. The WHO, UNICEF and several other child health themed multilaterals has been advocating for better medicinals for children, and legislative incentives globally especially in developed countries encourage the conduct of paediatric clinical trials. There is an urgent need for emerging countries to act with similar legislative incentives in this area in other to enhance the standards of research articles published in their Paediatric journals.

Since clinical practice guidelines are based on meta-analyses and systematic reviews, which until recently, have been largely dependent on published reports of clinical trials. For years, publication bias has been known to have a major influence on the array of research studies available to review, and investigators/authors have been as much at fault as journal editors in delaying or not publishing studies with elusive, negative or inconclusive results. However, there has been a major shift among journal editors to encourage the submission of well-designed clinical trials regardless of the research results.

Also, for over two decades now, registration of clinical trials has been promoted by the WHO, as required by journals of the International Committee of Medical Journal Editors and increasingly demanded by research ethics boards. Registration makes publicly available the fact that a study is/has been conducted, and records the features of study design and outcome measures. It is, thus, possible to examine the difference between what was proposed at the start -registration of a research study and what was ultimately presented for publication, which guards against the tendency for authors to submit, and for journals to accept, only the statistically significant findings of a study. Medical journal editors have also been influential in standardizing the elements of clinical trial reports. The Consolidated Standards of Reporting Trials statement improves the ability to assess results and to make meaningful comparisons among studies, thereby promoting intercollegiate paediatric research data sharing.

There is room for continued improvement. Adult trial publications dominate the literature and are increasing at a faster rate than paediatric trials in almost all specialties a lot of work needs to be done to improve methodological issues surrounding the conduct and reporting of paediatric reseach studies.

Not all paediatric journals stipulate adherence to reporting guidelines. Several authors found that many paediatric journals do not include recommendations that aim to improve publication practice in their author instructions, this should not be the case.

Moreover, they found that approximately one-fifth of journals did not require authors to disclose conflicts of interest at the time of manuscript submission, and more than three-quarters did not require/recommend trial registration this is a scientifically retrogressive step that ought to be discouraged.

Previous comparisons of the registered and published primary outcomes of several randomized controlled trials conducted in adults, and revealed that fewer than one-half of the studies were adequately registered, and that there was selective reporting of outcomes favouring statistically significant results. Several reviews indicate that the risk of bias is prevalent in paediatric clinical trials, although lower in studies that are registered . There is also concern that the regulatory agencies for paediatric novel drug development do not fully capture study considerations that are important to children such as the nature of a drug formulation, length of follow-up to assess long-term impacts such as effects on growth and development, and whether parents were involved in planning the study.

National and international organizations are evolving to enhance the design, conduct and reporting of trials involving children. Standards for Research in Child Health are some of the global initiatives that brings together an international group of leading methodologists, clinicians, regulators, funders and decision makers who aim to enhance the quality, ethics and reliability of paediatric clinical research by promoting the use of evidence-based standards or guidance for clinical studies with children .

These child friendly agencies are addressing topics such as adequate sample sizes, the need for data safety and monitoring committees, risk of bias, and recruitment and consent in addition to several adaptations to include child-relevant elements. There are national and international subspecialty paediatric research networks striving in earnest to facilitate research into medicines for children.

Why should and how can paediatricians contribute? First, better trials mean better care and better outcomes for the global children. Therefore, paediatricians should engage in clinical trials research, either through research study design, auditing, monitoring, quality assurance, medical writing, scientific investigations, editing and publication of research results, collaboration or encouragement of children and families.

Secondly, the Paediatric research sponsors of all developmental character will need to support journals in the promotion of guidelines on the reporting of clinical trials. Authors’ conflicts of interest must be declared; there should be documentation of clinical trial registration before commencement of study enrollment; and the regulatory and funding agencies paediatric research reporting formats should be followed. Thirdly, when we are involved in the development or adoption of clinical practice guidelines, we should expect scrutiny of trial registration information to determine whether unreported studies have been conducted such as what could be in the grey medical literature and whether there has been selective reporting of outcomes favouring statistically significant results.

I encourage and recommend Paediatric authors to publish their articles in credible and prestigious paediatric scientific journals. .

Although such an option ,may be seen as a challenging and daunting task for several reasons such as but not limited to ,the difficulty in designing and performing competitive, credible and high quality research, the high rates of rejection in most high-impact factor journals, and the absence of systematized training in the methodology of biomedical publications in the curricular programs. If to this is added the progressive complexity of the instructions for authors and the formal requirements that most journals impose, it is logical that there is a hindrance to potential paediatric authors. On the other hand, the pressure and the demand for authorship of scientific articles to be able to get academic and professional positions and promotions of a distinctive level are increasing. However, what at first glance seems a gloomy perspective, it is not so much if some key aspects related to the structure and writing of manuscripts and the systematics of the editorial process of the journals are known and applied, which, in short, continue being in force since the aphorism publish or perish has stood the test of time.

As described in this interview, the steps to follow are straightforward, logical, and interrelated, so getting off to a good start and completing the various stages properly and in the right order always represents a clear advantage of ensuring the final success of having your paediatric research paper accepted.

Paediatrics journals, like journals in any other specialities, play a key role in the main objective of contributing to advancing scientific knowledge, providing sufficient evidence to support decision-making and changes in clinical practice. Journals are useful to paediatricians and the larger scientific community in their double role as sources to increase knowledge and vehicles to disseminate the results of paediatric scientific research, therefore their optimal development should be encouraged.

On the other hand, I ought to discuss some of the current circumstances. For example, the immoderate growth of scientific evidence, which seems to not be reaching a plateau or have any bounds, some investigators stated that they had not been able to replicate the experiments of other researchers, associated with the pressure to publish and the selective publication of data. In the field of paediatric journals, the scientific relevance of the studies in relation to the particular interests of the readership is a key factor in their selection. Yet, many journals with a high impact at the international level that rank in the first quartile acknowledge that they received many more high-quality manuscripts that they are able to accommodate in the number of pages contained in each issue, and this excess supply contributes to lower acceptance rates:

The movement of open access journals, secondary or companion journals to consolidated, prestigious journals, emerged precisely to create room for scientifically relevant works that cannot be fitted in the main stream journals.

In addition to the surplus of studies, there are multiple reasons for rejection that mainly have to do with the scientific relevance and originality of the research, the methodological approach and strategy of analysis and flaws in the presentation, structure and writing of the manuscript .

From this point, the article summarizes key points that paediatricians should take into account in the drafting of a manuscript to be able to compete successfully in the screening performed by high-impact journals to accept and publish outstanding works.

Publishing when there is something worth conveying

The scientific article is the final product of a research project. It is an axiom that, the chances that a manuscriptgets published depend almost always andmostly exclusively on the quality of the research undertaken, so it is essential to prioritise the study conception and design and ensure the suitability and sustainability of the study protocol. Therefore, it is important to publish when the quality, suitability and sustainability of the planned and performed study guarantee and interest in the dissemination of its findings, or, in plain terms, when “one has something to say” of scientific interest, that contributes knowledge and is useful based on the conceptual and methodological validity of the research.

For this to be possible, it is advisable that authors must have a multidisciplinary and integral understanding of the fundamentals of epidemiology and statistics, the characteristics and function of journals, the key stages in the editorial and peer review processes, ethics consensus guidelines, the structure of scientific articles and the rules of scientific writing.

Reviewing the literature

Without an adequate review of what has been published in the extant literature, recent past and currently it is not always possible to provide adequate context for the research question or to proceed to the development of the research project itself. Having a rigorous and confident comprehension of the current knowledge on the subject before undertaking the research confirms the scientific relevance of the study, in simple terms, the contribution the study will make provides the necessary justification if funding has to be obtained. The errors that derive from an inadequate review of the literature and that therefore affect the foundations on which the study is developed are practically impossible to remedy at later stages. The potential for publication is directly proportional to the adequacy of the conception of the study.

These are some of the areas that will need to be emphasized during the training of Paediatric scholars in scientific medical writing.

Deciding on the type of article

Even within the specific field of paediatrics, journals may differ in the types of articles they will accept for publication as original articles, brief communications , letters to the editor, scientific letters, descriptive reviews, systematic reviews with and without meta-analyses, editorials, articles on commission or special articles), clinical cases, images and videos, news etc. For this reason, it is pertinent to decide on the type of article and the corresponding format before starting on the manuscript, which evidently depends on the research that has been undertaken. Being thoroughly acquainted with the objectives and purpose of each section of the journal is not just important, but crucial in order to choose the ideal format for each work, as the degree of competition and the rate of acceptance vary, in some cases substantially on the basis of the type of article.

For instance, in cases in which it is possible to reduce the length of the manuscript and adapt the format to a brief communication or even a scientific letter, it is worthwhile accepting that the acceptance rates for these types of article tend to be higher compared to conventional original articles.

Independently of the type of article chosen, the authors must be aware of the need to convey the message and theme of the article clearly and explicitly, both in the abstract and in the discussion and conclusion. The message is simply the interpretation of the primary outcome. With a simple but compelling sentence, the reader should be able to understand the scientific contribution of the study that is what it contributes and what makes it relevant.

Choosing the right journal

On this point, the main objective is to achieve acceptance of the manuscript in the first attempt, that is, to get published in the first journal to which the article is submitted. All authors should participate and agree in the decision regarding the most suitable journal for submission, which, whenever possible and for the purpose of efficiency, should be made along with the type of article before starting to write the manuscript.

The open-access journal model involves making information available online permanently and with no restrictions to access. The term open access was defined as such through official statements. The upsurge and acceptance of this journal modality have been enormous, with a yearly growth rate of nearly one in five.

At present, two journal models coexist. The first consists of conventional journals distributed by subscription, and the second of open-access journals, although journals in the first model tend to have a hybrid format, so that they allow publication of selected articles under open-access conditions if the authors desire. Any form of open-access publication nearly always or in the case of hybrid journals, almost always involves payment of article processing charges once the manuscript has been formally accepted for publication.

The pros and cons of publishing in an open access journal which includes the speed of publication, article is uploaded within a day to two of acceptance although there might be publication fees.

Anecdotally, the overall acceptance rates tend to be higher although the articles may not eventually not be indexed in PubMed and PubMed Central

Indeed open access may be the sole or nearly sole option to publish certain types of articles such as case reports, and putatively open access journals may be able to manage possibly lower quality articles.

In open access publication principles, the copyright remains with the authors and is not transferred to the journal.

Open access publications facilities metadata acquisitions, and also allows a proximate overview of the number of downloads and number of visits to the article.

It facilitates citation of its articles by other scholars.

It provides a very valuable source of information in low-resource settings.

When it comes to selecting an open-access journal, it is essential to verify that the editorial process includes the peer review system as a quality standard. The Directory of Open Access Journals -DOAJ, is a database that includes a considerable number of open-access peer-reviewed journals.

The type of publication notwhitstanding, selecting the right journal can still be a daunting and challenging task.

The suitability of the Paediatric journal considered for submission of the article could be assessed by following a few basic sequential steps, as proposed in an algorithmic format such as but not confined to giving due considerations to the mission statement and scope of the paediatric journal, reading the guide for authors, to verify that the journal publishes the type of article in context, searching the paediatric journal to see whether similar articles has been previously published in the journal and, if published , it may be worthwhile to verify if any of these articles could be included in the references of the contexual paper before submission and their authors of these articles could be proposed as potential peer reviewers since anecdotally previous studies have suggested a tendency toward more favourable recommendations regarding publication by reviewers suggested by authors versus those selected by editors.

Sponsors, Editors, authors and readers alike should be acquainted with a basic algorithm for choosing the right journal and steps to be taken to avoid commonly encountered mistakes in choosing the right journal.

Achieving publication in the first journal the article is submitted to has the advantage of saving time, especially in journals with an agile editorial process. In addition, it can be important to be the first in describing a novel scientific finding. The time intervals elapsed from the initial submission of a manuscript and final publication vary between journals, but it is reasonable to expect a median of nine months for the entire process, including peer review and the revision by the authors. The cumulative delay resulting from a succession of rejections is among the most negative factors that may contribute to detract from the interest in the new evidence provided by the article.

Paediatric authors could be reassured that ,although receiving an article rejection letter could be discouraging, frustrating and disappointing, however receiving a rejection letter could be an open door for the publication of the contexual article in a more credible specialty paediatric journal following a more diligent revision.

Admittedly ,this may have implications, for further research and scientific proof reading such as the, the need to choose a new paediatric journal, which can cause delays of several weeks in multicentre studies involving multiple authors, to update the references, which entails reviewing and rewriting portions of the text, chiefly the introduction and the discussion, and to adapt the manuscript to the guidelines for authors of the new journal, which is a significant additional effort if there are many differences between the rejected manuscript and the current version. If the language is different, the text needs to be translated. Also, ethical declaration forms -such as disclosures of conflicts of interest need to be updated and signed again by each of the authors. In case of several rejections, the time lost may be of many months or even more than one year, and the scientific information may be altered by the changes introduced to the manuscript to adapt it for each newly selected journal. Lastly, if after switching to a journal with a lower impact factor, to a speciality journal or to a new type of article the manuscript is still not accepted, authors may end up losing interest and the manuscript ends up shelved. The proportion of papers that are never published after being rejected tends to range from one in six to one third.

Also to improve the quality of Paediatric Journal Authors should avoid frequent errors in choosing a Paediatric Journal such as but not restricted to overestimating the actual scientific contribution of the study, overestimating the originality of the scientific research ,considering the impact factor as the sole criterion for selection ,choosing a general journal when the subject of the article is specialized or highly specialized ,a failing to consider the field of interest of the journal’s readership ,failing to consider open-access journals which may sometimes be the best available option ,believing that having published in the journal in the past guarantees acceptance, believing that knowing the editor or someone in the editorial team guarantees acceptance ,trusting the opinion of a renowned scientist that hasread the manuscript perhaps cursorily or out of obligation in addition to submitting the manuscript for submission sake.

Paediatric Authors should be encouraged to Follow the guidelines for authors

This is a relatively common challenge for authors in general since, occasionally the guidelines for authors may be ambiguous, subtle, complicated or obtrusive and therefore not amenable for easy and lucid comprehension.

It is getting more and more fashionable for paediatric journals to request that their authors should write their manuscripts using a template that automatically adapts the submitted text to style guidelines regarding font, line spacing, attachment of tables, legends and figures etc. In addition to having such guidelines printed on paper at hand while writing the manuscript in the computer, it is also useful to have the full text of an article of the same type published in the journal of interest to use as a model.

Given the importance of adequacy of Paediatric journal standard and impact factor in determining the credibility of a Paediatric Journal, it is worthwhile for authors to check and confirm that their manuscript has been prepared along the guidelines for authors suggested by the Paediatric Journal, where they will get their manuscript submitted.

In this discussion, I will undertake an overview of some of the crucial points that paediatric Journal authors will have to see accomplished in their check list, before having their manuscript submitted for publication. These check list items includes but not limited to:

Writing the article cover letter

Any manuscript submission must be accompanied by a formal cover letter -transmittal letter addressed to the editor in chief of the journal. The letter should include the title of the manuscript, the section of the journal for which it is submitted, a summary of the characteristics of the study and salient results, a brief statement about the scientific contribution of the study relative to the previous literature and the reason for choosing the particular journal for the submission. It is also possible to suggest certain reviewers or request that others be excluded. Any other detail that could be relevant to the assessment of the manuscript by the editor should de included in the cover letter.

Although, the letter must be signed by the corresponding author, however, it is pertinent that it should be read and approved by all authors before it is sent.

Resolving ethical concerns before the article submission.

Paediatric Journals are increasingly demanding compliance with different ethical principles concerning research and publication, so individual authors frequently have to fill out related forms personally.

I have itemised and discussed some of the thoughts and concerns on this subject, it is an axiom that any work submitted to a paediatric journal must be original, that is, the submitted work has not been published previously and, of course, that there is no form of ethical scientific misconduct involved in its publication, for instance plagiarism. The emergence of the so-called predatory journals open-access journals that published articles in exchange for a fee paid by authors without applying minimum quality standards may contribute to promoting duplicate publication and plagiarism.

The malpractice of publishing copies of articles published in a domiciliary Language in a print regional journal and having it translated and published in English Language in an international online journal is a form of plagiarism and should be discouraged.

Paediatric authors should always endevour to acquaint themselves with some aspects of commonly debated and contentious issues of utmost considerations before submitting their manuscript for publication.

Listing of Author’s and the order

On the basis of article categorizations, certain types of article such as a methodological scientific correspondence to the Journal editor, there may be a limit in the number of authors that can be listed on the author’s column.

The credits for first and last author credit may be shared.

The listing order is established by the authors.

The number and order of the authors may not be modified after submitting the manuscript.

Any changes in the author listing must be justified and approved by the Paediatric Journal editor.

Corresponding author

Usually listed as the first or the last author, although, the choice is left to the authors.

However,it is a good scientific practice to have the nominal identity of the corresponding author and his full academic and professional contact co-ordinates indicated as a foot print of the first page of the journal article.

For some multidisciplinary ,multispecialty , multicentric international paediatric studies there may be two or more corresponding authors on the basis of the scientific specialty and disciplines or geographical region especially in the era of print paediatric journals, when the use of electronic mails were uncommon.

Some paediatric journals may ask for the electronic mail address of the institution and also the address of all of the authors or an individual author.

Paediatric Author Contributorships.

Accepted criteria for Pediatric Authorship.

A Paediatric Journal author is an academic who has made a significant and substantive intellectual contributions to a published study in a Paediatric Journal.

A `Paediatric Journal author is required to meet the following minimum criteria:

The paediatric journal author has `made a substantial contribution to the study conception and design, the acquisition of data, or analysis and interpretation of data; and management of data, the drafting the article or its critical revision for important intellectual content to the final approval of the version to be published, and is in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

It is pertinent to point out that acquisition of funding, collection of data, or general supervision of the research group alone does not constitute a sufficient basis for authorship.

These criteria have to be met before any one should be listed as an author, and everyone who meet these criteria should be listed as authors. Articles submitted with an unexpectedly large number of authors invite scrutiny by editors and reviewers for clear justification for the presence of each person on the authorship list. Some Pediatric Journal allows a statement of equal contribution for the two first authors and two senior authors these are commonly referred to as contributed equally as co-first authors or contributed equally as co-senior authors.

It is pertinent to determine and decide on authorship issues, including the order of listing , before the submission of the article. Some Paediatric journals do not allow the addition or removal of authors or changes to the authors listing order after a manuscript has been submitted without an explicit approval from the editors.

If published, author names and affiliations will appear as seen in the submitted manuscript Word document and the final typeset proofs.

All authors must ensure that their information is correct before proffering their endorsement of the manuscript.

Interestingly, several notable high impact paediatric journals tends to favour the concept of authors contribution and indeed several current prestigious journal favours the use of the term contributorships as more`scientific and there is growing interest in this more representative and encompassing bibliographic terminology with Journal editors, referees ,moderators ,publishers , librarians and several information professionals and other academic bibliographic assessors. In this way articles with collective or co-operate authorship authors are asked to provide specific information of the relative contribution of each author, from the conception of the study through its design, data management, medical writing, statistical analysis etc and occasionally the percentage effort of each author may be requested.

Sources of Funding

Any funding received must be disclosed and research grant number, the research study funding organization, city, country indicated using the format specified by the contexual paediatric journal.

Conflicts of interest

Conflicts of interest related to the current study manuscript and in the past three to five years must be disclosed .This retrospective period varies from one journal to the other.

A conflict of interest exists whenever an author has a personal economic, scientific, institutional, family or business relationship that could influence or bias the interpretation of the findings of the study or its conclusions.

Frequent situations that involve conflicts of interest include employment by a pharmaceutical company or in a related industry, personal or professional relationships being an advisor, speaker, opinion leader, member of an administrative board, direct family relationships, receiving research grants economic logistics, owning stock or stock options, ownership or patents active, or fees or honoraria for other activities for consulting, congress registration fees, trips, courses, workshops.

This is particularly of relevance in pharmacotherapeutic agents,biologicals and surgical and medical assistive advices ,where the authors could have been amenable to inducements from the firms manufacturing these therapeutic agents, it is possible that they have been offered stock options ,sponsored to attend and speak in an international conference ,or supported to write and publish a scientific work or offered a form of honorarium for scientific consultancy.In as much as such gifts may not affect the results and report of the study,and indeed may not add up to any form of conflict of interest ,however,Good scientific Research practice recommends that they are better declared when the firm in question manufactures or promotes the given therapeutic and assistive heath agent ,rather than undisclosed incentives uncovered subtly.This is usually an indispensable requisite to evaluate the work .From my anecdotal experience,I suppose that scientific paediatric journal authors have been forthcoming in making this disclaration,however,it might still be that there are still some who fall short of this standard.

In fact, the existence of a conflict of interest involving the pharmaceutical industry does not invalidate the neutrality of the scientists involved in the research, what does invalidate the work is the nondisclosure of such conflicts.

Given the concerns with erratic pharmacokinetics and toxicity challenges in the Paediatric age group, it will be pertinent to encourage Paediatric journal authors as clinical scientists to do well to undertaken and report their research studies with scientific ingenuity and probity since declaration of conflicts of interest does not unfavourable influence the selection process of the article for publication and confidentiality is maintained throughout the editorial process

In the case of editors and reviewers, conflicts of interest may be any circumstance that could compromise the impartiality or confidentiality of the editorial process or the peer review.

In a similar endevour to improve the Paediatric Journal Standards, concerned editors should renege from the review or refereeing article manuscripts where there some concerns of conflict of Interests may be evoked without waiting to be asked or compelled to do so.

Acknowledgments

It may be necessary to provide a written statement from the individuals mentioned in the article agreeing to the acknowledgment

Also the criteria to be attained for one to listed in the acknowledgement column is usually indicated by some Paediatric Journals equally.

Access to the published data

It is pertinent for Paediatric Journal Authors to proffer a note on how to access the data from the physical Libraries or digital libraries where the articles are catalogued or indexed for an easy access to the data .Also relevant information on where the articles could be accessed such as the repository and other line, archives or the Paediatric Journal authors themselves will be important for the grey paediatric literature and journals, etc.

Providing adequate and credible responses to the Paediatric Journal reviewers comments and questions.

The publication process is an important academic process that requires may require some degree of patience from the author. The type of patience that is expected from a Paediatrician, a Paediatric Nurse, a Child developmentalists, and other allied paediatric health staff is very similar to that which will be expected from a Paediatric Journal Author. Although the value of being patient was inculcated in the training and assessment of every heath curriculum, but this positive virtue was emphasised especially for those training curricular with significant paediatric content and patient encounter.

However, I will hasten to comment that a lot more patience will be expected from a Paediatric author for obvious reasons like unpredictable pharmacokinetics and toxicity profiles of several pharmacokinetic agents and several challenges with their clinical trials and regulatory challenges.

Anecdotally ,on the basis of my experience in this theme as a Paediatric Journal author and as a Paediatric Journal Editor,reviewer, referee ,moderator and reader, I could assert that overall the Paediatric Journal Authors and Editors is balanced cordial, however there were some occasional challenges, which if not properly managed may compromise the Paediatric Journal scientific standard.

Although this may not really be the case, but if imagined there are so many challenges, some of which, I have pointed out in this discussion ,these include,but not confined to the need for paediatric authors to agree never neglect any of the reviewers’ comments, or leave any question unanswered; if the concerns of the reviewers are not clear, this should be acknowledged openly as opposed to responding with confrontational arguments; paediatric journal authors may need to contemplate, whether including critical comments by reviewers among the limitations of the study would be appropriate in a particular instance; they should respond exclusively and explicitly to reviewer comments; always paediatric authors should engage a polite demeanour and be cautious of the length and breadth of their responses, an undue modification the content of text may not always be necessary, unless this was specifically requested for by the Paediatric Journal Editor,when the inclusion of a citation is suggested by the editor , accept this recommendation and add a small reference to your work in the text ,since the reviewer is almost always an expert in that area.

It is a good scientific practice to acknowledge the reviewer by making a statement such as the authors express their gratitude to the reviewers for the comments of the reviewer, which were found useful by the authors in improving the quality of the manuscript.

Finally, it is essential to adhere to the deadlines established for the revision or to officially request an extension. The revised manuscript and the responses to reviewers should also be approved by each of the authors.

Paediatric Journal Authors should Endevour to have themselves Acquainted With Their Intending Journals Acceptance Criteria

Of much relevant and importance to the paediatric article readers is the selection of the Journal that they subscribe to and read.

Anecdotally I have been observed that Pediatric Journal authors tend to favour the Peadiatric Journals with much articles of interest for their readership, in this sense it is implied that the academic readership is very selective of the articles that they read.

The readership of a contexual Paediatric Journal includes mostly but not confined to specialist pediatricians and subspecialist paediatricians, pediatric researchers and educators, Paediadrtic nurses, family health physicians, scientists, public health personnel and child health policy-makers.

On the basis of my experience in this theme, established Paediatrics Journals receive a lot more high-quality manuscripts than could manage on the average their submitted article acceptance rate could be computed to be between fifteen percent to twenty five percent.

Anedotally, one of the reasons for an outright article rejection, before further in house or extramural review is because the theme of the article has been thought by the paediatric journal editors to be irrelevant to its readership and therefore , outside the paediatric journals scope, this mismatch is most frequent with subject specific specialty journal .In such instances, most Paediatric Journal editors do well to offer the authors a reference to other relevant subject specific Journals of the contexual parent journal or its journal consortium ,while offering the authors the option of looking elsewhere if warranted.

In other instances, Paediatric Journal articles rejected articles following initial overview by the in house editors, without being sent out for extramural editorial review, on the basis of unacceptable and incorrigible methodological flaws, this is most frequent with articles submitted for publication as an original research article, where there is an abysmal compromise of basic scientific principles in the conception and generation of the hypothesis guiding the research study or in the research study design randomisation,blinding,interventional allocation,data collection,analysis and management ,in such instances the editors felt that it was very unlikely that the articles could be accepted following extramural editorial reviews and as such will not wish to border their overwhelmed and very busy honorary reviewers who are very much engaged with other intramural and extramural academic and domestic responsibilities .

Good scientific practices and principles suggest that all manuscripts to be considered for publication should be peer reviewed, including those written by members of the Paediatric Journal Editorial Board themselves. Paediatric Journal peer reviewers are usually selected by the editors, however in some instances,it is the practice that the authors may be asked to recommend select a specified number of peer reviewers for selection, this is most likely to be the case in some paediatric sub-specialty journals managing some very highly specialised Paediatric subspecialty subject .

Over all the selection of article reviewers is contextually contingent on their possession of expertise and a vested interest in the theme of the manuscript. Ideally achieving a balanced editorial decision may require the decision of at least three reviewers, however in some ambiguous instances,some paediatric journal editors have been obliged to appoint as much as nine reviewers ,in other instances ,the need to referee the decisions of these reviewers were warranted.

However, in most instances, finally, it is the Journal editor in Chief who decides on what gets published following further unbiased consultation if warranted in some challenging cases with considerable ambiguity.

However, on the average following an accomplished extramural review, Paediatric Journal editors will commonly take any of the following decisions

Recommended for accept and publication process, ; Accept with Minor Revisions, Accept with major revisions, decline with the option to resubmit following further clarifying research study and corrective remedial measures and proof reading ,declined and adviced to consider submission to another journal following scholarly guidance and counselling on scientific research study and writing.

In some instances a rejected manuscript may not be resubmitted or the manuscript may be rejected with an option to resubmit following an extensive guided revision. The resubmitted manuscript may need to be sent out to a new set of external reviewers for further independent and unbiased peer review, however following resubmission, the manuscript may or may not be accepted for publication.

For obvious scientific reasons the decision of recommending the acceptance of a manuscript following some form of revision is the most frequent in original scientific studies sent in for publication in scientific Paediatric Journals and should be current online ,since the Paediatric Journal author may be contacted to include the references for very recently published articles in the text ,which were made available online very recently ,which are considered by the editors to be credible and will have a lot of implications for the discussions and impacts of the research and the publications of the author.

In other instances, it is known that some Journals may allow very established and senior authors who are usually seasoned research scientists ,and could indeed be paediatric Journal editor in chief themselves, who for scientific credibility have decided not to publish some original scientific journal article especially the ones dealing with drug trials in their own Paediatric Journal ,may because of the possibility of conflict of interests be allowed to suggest reviewers who they believe should not review the manuscript ,however, they will be expected to provide a cogent reason for this decision.

For an utmost credibility of Paediatric journals and its high standards, editors usually ensure that authors guidelines and instructions for manuscript preparation and submission is clearly specified and lucid ,so the onus lies with the Paediatric Journal authors to do well to endevour to carefully follow these beneficial editorial guides.

Authors should ensure that their article manuscripts are meticulously proofread before undertaking their submissions to credible Paediatric Journals.

The golden rule to diligently follow the specified Paediatric Journal authors guide must not be taken for granted by the intending Paediatric Journal Authors, since the manuscripts that do not follow the authors instructions will not be considered for review.

Also, a grossly compromised manuscript preparation standards will evoke concerns on the adequacy of the author’s management of their manuscripts implying that the article may not be accepted for publication in a Paediatric Journal.

Paediatric authors are best adviced to be adept in the preparation of their manuscripts, so that they could achieve a scholarship output of a relatively high quality and good standards which guarantees the acceptance of their article in a high impact factor Journal.

More often than not several Paediatric Journal editorial and publication offices have in place inbuilt automated electromagnetic devices, which could be used to scan article manuscripts submitted for publication in their Journal for plagiarism.

Most Paediatric Journal Editors do well to contact the contexual authors if there are concerns that their work could have been a product of plagiarism. Most Paediatric Journals will follow the recommendations of the globally recognised and accepted committee on publication ethics for concerns about plagiarism or any other manuscript-related ethical misconduct or issue.

Manuscripts are usually assessed by the Paediatric journal editors and reviewers on the basis of its basic scientific relevance, contribution of a new body of scientific knowledge, originality, scientific prowess, consistency with ethical principles and standards, clinical relevance, and clarity of content. Some Paediatrics Journal will not publish manuscripts that focus only on animal experimental research. Refer to the sections below on the particular considerations for each of the manuscript types that appear in the journal. Authors should also consider the comprehensive reporting guidelines for a wide variety of study designs that are readily available online. These can be helpful in improving manuscript clarity and completeness.

One of the axiomatic and recommended guides for ensuring the optimization of the standard for Paediatric Journals is to ensure that the contexual Paediatric Journal is fiduciarily well endowed.

Although some paediatric journals encourage their Paediatric Journal authors to pay article publication charges and gain revenue through subscription and article access charges, this may not be the case in all instances of the Paediatric Journal management policies where the Journal aim to get endowed from private-public sponsorship on the basis of their credibility, adherence `and tenacity to the principles of good research practices ,good clinical practices, good laboratory practices, good pharmaceutical practices, good manufacturing practices, good statistically practices and good scientific professional ethical practices, in such instances a lot of considerations is given to good publication practices ,this is where keeping to credible publication ethics comes in.

In this discussion I will indicate and annotate on some of these publications ethical issues which if religiously adhered to could considerably improve the standards and quality of our Paediatric Journals ,these includes, but not confined to:

Need For Institutional Review Board Approvals.

Good Clinical Research Practice suggests that most Paediatric Journals would insist that all studies, involving human subjects must be approved by the appropriate official institutional review board or demonstrated to be exempted from such approvals. This should conventionally be documented in the Methodology section of the manuscript.

Registration of Clinical Trials.

Most Paediatric Journals follow the Good Research Practice standards of ensure that for research results from all clinical trials to be published in their Paediatric Journal, that the Journal must be registered in a World Health organization-approved Clinical Trial registry prior to enrollment of its initial cohorts. The Research Reports from unregistered clinical trials will be sent back to the authors without any review.

The registry name and registration number of the research study should be included on the title page.

Editorial Board Members as Authors.

Although some Paediatric journal could allow a contexual Paediatric Journal editorial board members to submit articles to be considered for publication,however,these articles will undergo the same standardised rigorous peer review like all the other articles submitted to the Paediatric Journal, since unbiased and independent peer review for Paediatric Journals have been automated for some journals where the article manuscript management system automatically blinds a user with an intramural accessibility from accessing an article manuscript that they have authored, so paediatric journal authors who are editorial board members cannot access the article manuscript from the intramural phase once it has been submitted for peer review.

Paediatric Journal Indexing:

One of the evidence based ways of improving the standard of a Paediatric Journal is to achieve an indexing of the journal in a credible database, since this markedly improves the visibility of the Journals and lends it amenable to scientific scrutiny and critique, indeed, aiming to attain the criteria needed to achieve the indexing of a paediatric journal in acredible data base in itself through a herd like effect remarkably improves the standard and quality of that contexual Paediatric Journalduring the course of this indexing processes.

Consideration of Race and Ethnicity

Paediatric Journal authors should handle racial and ethnicity issues with the merit and sensitivity that they deserve on the basis of the guide given in the Paediatric Journal Authors guidelines since ethnicity and racism are getting more and more indistinct and inconsequential and appears to be a thing of the naïve and primitive past rather than of the developing present.

The Journal Style

All aspects of the manuscript, including the formatting of tables, illustrations, and references and grammar, punctuation, usage, and scientific writing style, should be prepared according to the most current Manual of Style recommended by the contextual Paediatric Research Journal.

Titles.

It is pertinent for Paediatric journals authors to do well to adhere to the guidelines given to authors on how to manage the titles of their articles, this is particularly important since the article title is the most conspicuous and widely circulated flag of an article and portrays in a few word the whole story that the authors want to tell the world.

Several Pediatrics Journal conventionally follow the normatively standardized guidelines Manual of Style for article titles. On the average, titles should be concise and informative and precise, containing the salient themes of the scientific paper.

An unduly overassertive sentence s should be discouraged as they tend to overemphasize a conclusion, as are themes, which are more appropriate for editorials and commentaries. Subtitles, if used, should expand on the title; however, the title should be able to stand on its own. It is appropriate to include the study design such as Randomized Controlled Trial, Prospective Cohort Study, Retrospective study, systematic review, metanalysis, critical study etc. in subtitles. The location of a study should be included only when the results are unique to that location and not generalizable. Abbreviations and acronyms should be avoided as much as would be achievable. The full title will appear on the article, the inside table of contents, and in the journal abstracted and in the contextual Paediatric Journal indexed data base.

Some Paediatric Journal set a limit to the number of words, characters including spaces that could be allowed for Full titles and short titles.

Abbreviations.

Most Paediatric Journal will suggest that the abbreviations could be used if they are established and widely recognized in the scientific community .Abbreviations should normally be listed and defined on the Title Page and. It is pertinent that unusual abbreviations derived erratically and inconsistently should be avoided as much as would be achievable.

It is recommended that all terms to be abbreviated in the text should also be spelled out at first mention, followed by the abbreviation in parentheses. The abbreviation may appear in the text thereafter. Abbreviations may be used in the abstract if they have been used frequently in the text.

Abbreviations should be avoided in the tables and figures, if the have to be used they should be redefined in the footnotes.

Units of Measure.

The units of measurements to be used by the Paediatric Journal Articles Authors should be contingent on the guideline and specifications given by the contextual Paediatric Journal this is variable on the basis of the region where the journal is domiciled, this is why it is advisable for Paediatric Journal article authors to commence the decision of where they will anticipate to get their research study published at the inception of the research study,indeed several Paediatric Research funding bodies and research grants sponsors may suggest that principal investigators should include this in their research proposal application.

Proprietary Products.

Paediatric Journal Authors should use generic nonproprietary names of drugs or devices unless the inclusion and mention of a trade name is pertinent to the discussion. If a proprietary product is cited, the name and location of the manufacturer must also be included.

Page Numbers and Line Numbers.

Paediatric Journal Authors are advised to include page numbers and line numbers in their manuscript so that editors and peer reviewers may very easily identify and point out areas and items of interest to the authors for the revisions or clarifications of ambiguous points ,it also allows editors to communicate effectively with Paediatric Journal Reviewers on certain points of interest and importance in an article undergoing editorial review .Unlike page numbers, line numbers may be continuous or restart on each page.

References.

It the responsibility of the Paediatric Journal Authors to ensure the accuracy of the references cited in their work. Citations should be numbered in the order in which they appear in the text. Reference style should follow that of the recommended Manual of Style presented in the contextual Paediatric Journals,Authors guide.

The use of redundant references should be avoided.

Some Paediatric Journals will recommend that the abbreviated journal names should be consistent with and reflect the style adopted by the IndexMedicus.

The quality and style of the references of an article continues to be considered an important fact in the assessment of the quality of a Paediatric Journal article.

Although technological advancement appears to be rapidly ongoing, some Paediatric Journals may still recommend that if their authors used reference management software such as EndNote to in the preparation of their manuscript, they may still have to be advised to convert the file to plain text prior to submission.

Authors Guidelines For Clinical Trials and Epidemiological Studies.

Most Paediatric Journal Article Authors will assess a paediatric research study to assess, if it could conventionally qualify as a clinical trial before its publication as has been stated by the contextual paediatric Journal authors.

On the basis of good scientific research practices, a study is considered a clinical trial if it prospectively assigns randomized or unrandomised humansubjects to intervention or concurrent comparison or control groups to study the cause-and-effect relationship between a medical intervention and a health outcome. Medical interventions in this context will include drugs, surgical procedures, devices, behavioral treatments, process-of-care modifications etc.

Paediatric journals, like other Journals expect authors that intend to report the results of their clinical trials, to affirm that they have had their studies registeredat the World Health Organization-approved national or international registry for clinical trials prior to the enrollment of the first research cohort .

The trial registry name, registration number, and date of registration must be listed on the title page. Some other Paediatric Journal will expect authors to de well and also provide this registration information in the main methodologies section of the report.

All articles reporting results of clinical trials must include the Data Sharing Statement on their Title Page.

Authors may also be required to complete other Forms and employing a flowchart and checklist which should submitted along with their manuscript.

Also Paediatric Article Authors should do well to follow the appropriate check list for observational epidemiological studies before the submission of articles pertaining to this category.

Several credible and pertinent informative resource on these requirements and the appropriate contextual registries have been produced and are available.

Reuse of Data Sets

Conventionally, some Paediatric Journals insist that if an author’s manuscript uses the same, identical or similar data contained in a previously published articles, then the authors of the contextual journal article must state this in the cover letter and provide citations and references to the related or possibly duplicative materials.

If a separate manuscript by the same authors using the same data set is under review or accepted but not yet published in another journal, the authors must state this in the cover letter and provide enough information to assure that the manuscript submitted to contextual Paediatric Journal is not duplicative.

Data Sharing Policies.

With the need to undertake more clinical trials emanating frequently, and given the need to avoid undue duplicity and repetition, and fiduciary ineptitutde there has been a growing interest in data sharing, partnerships, consortiaespeciallyamongst co-operative collaborative multicentric studies regionally, internationally and globally.

The need to achieve some harmonization and to promote consistency in paediatric research study editorial and publication processes implies thatseveral Paediatric journalswill require their authors to include data sharing statements in articles that report results of clinical trials.

Some of these data sharing statements should include:

The data that will be shared, the start and end dates of data availability,whetherdeidentified participant data (including data dictionaries) will be shared, whether additional documents will be made available, access criteria, how the data will be made available, the data sharing statement must be included on the title page of your manuscript and entered into the section provided in the manuscript management system.

Paediatric Journal authors, who will not be sharing their data, will need to insert the appropriate statement on their title page and in the manuscript submission system.

Data Sharing Statement:

Deidentified individual participant data will not be made available.

For Paediatric Journal Authors who will be sharing their data , refer to the table in the data sharing section of the Journal clinical trials Authors Guidelines page for examples of how to incorporate the required information into your statement, and refer to the example below if appropriate for your Journal.

Data Sharing Statement: Deidentified individual participant data (including data dictionaries) will be made available, in addition to study protocols, the statistical analysis plan, and the informed consent form. The data will be made available upon publication to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal. Proposals should be submitted to ____________[INSERT EMAIL ADDRESS OR OTHER CONTACT INFORMATION].

Aims and scope of journal

Some Pediatric Journals publishes original translational research papers, invited reviews, and commentaries on the etiologies and treatment of diseases of children and disorders of development, extending from basic science to epidemiology and quality improvement.

Topic Areas Covered By Most Paediatrics Journals

Adolescent Medicine, Allergy, Anesthesia, Behavior, Cardiology, Cardiometabolic Disorders, Controversies, Critical Care, Development, Developmental Biology, Emergency Medicine, Endocrinology, Environmental Health, Epidemiology, Fetus & Pregnancy, Gastroenterology, General Pediatrics, Genetics & Epigenetics, Health Services Research, Hematology, Hyperbilirubinemia, Immunology, Infectious Disease, Microbiome, Neonatal Neurology, Neonatology, Nephrology, Neuroimaging, Neurology, Nutrition, Obesity, Oncology, Patient Safety, Pharmacology, Precision Medicine, Public Health, Pulmonology, Quality Improvement, Regenerative Biology, Rheumatology, Stem Cells, Substance Abuse, Transplantation, Toxicology perinatology rtc.

Transformative Publishing models

Some Paediatric Journals are Transformative Journal s. When research is accepted for publication, authors can choose to publish using either the traditional publishing route OR via immediate gold Open Access.

Some Paediatric Journals Are actively committed to becoming a fully Open Access journal. They will increase the number of articles we publish OA, with the eventual goal of becoming a fully Open Access journal. A journal that commits to this process is known as a Transformative Journal.

Transformative Journals

Authors may need to take specific actions to achieve compliance with funder and institutional open access mandates. If your research is supported by a funder that requires immediate open access (e.g. according to Plan S principles) then you should select the gold OA route, and we will direct you to the compliant route where possible. For authors selecting the subscription publication route our standard licensing terms will need to be accepted including our self-archiving policies. Those standard licensing terms will supersede any other terms that the author or any third party may assert apply to any version of the manuscript.

Journal metrics

The current journal citation metrics for some Paediatric Journals Pediatric Research are as follows are uually stated at the journals authors webpage such as

Impact Index

2-year Impact Factor*: 3.745

5-year Impact Factor*: 3.976

Immediacy index*: 1.521

Eigenfactor® score*: 0.01458

Article influence score*: 1.098

JCR Rank*: PEDIATRICS 16/129

Journal Citation Score*: 1.48

SNIP: 1.128

SJR: 1.078

Current Journal Citation Reports® Science Edition -Clarivate Analytics, 2020-

Abstracted/indexed in

Crossref

PubMed

British Library

CAS

Copyright Clearance Center

EBSCO

ExLibris

GNM Healthcare

Clarivate Analytics (Web of Science)

PORTICO

Scopus

ProQuest

Yewno

UNSILO

ISJN and eISJN

ISSN and eISSN

Affiliations To International Paediatric Societies

This is a recommended step to improve the standards of Paediatric Journals.

These Paediatric Journals could then publish original translational research papers, invited reviews, and commentaries on the etiologies and treatment of diseases of children and disorders of development, extending from basic science to epidemiology and quality improvement.

They have an established reputation built up over several years with wide visibility and in print.

Publishing with PR and Springer Nature provides an author with a wide range of benefits:

License to Publish

These Paediatric Journals does not require authors of original research papers to assign copyright of their published contributions. Authors grant the Paediatric Journals an exclusive license to publish, in return for which they can re-use their papers in their future printed work.

In addition, authors are encouraged to archive their version of the manuscript in their institution's repositories (as well as on their personal web sites), six months after the original publication. Authors should cite the publication reference and doi number on any deposited version, and provide a link from it to the published article on Some Paediatric Journals website. This policy complements the policies of the US National Institutes of Health, the Wellcome Trust and other research funding bodies around the world. Some Paediatric Journals recognizes the efforts of funding bodies to increase access of the research they fund, and strongly encourages authors to participate in such efforts.

Daily publication online

New articles in Some Paediatric Journalss, are published daily online ahead of the archival print issue, ensuring the research is made publicly available and can be cited as soon as possible after acceptance for publication. The online publication is a preliminary, unedited version, available on average less than a week after receipt by production.

Supplementary online material

Authors are invited to submit additional supporting material such as data sets or video for publication in the online version of the journal. Online supplementary material makes the most of the Web as a delivery platform and can often give articles greater depth, making them more useful to readers.

Quality

Authors who choose to publish in any the contexual paediatric journal journal consortia can be assured that its staff's publishing, editorial and production skills are committed to maintaining the highest possible quality and standards.

Exposure - widest possible readership

Some Paediatric Journals, are available online via site licenses to academic, corporate and government institutions and consortia. Journals are available to members of these itemised academic research institutions at the click of a mouse, adding speed and visibility to authors' research papers.

Regular free e-mail alerts

Content published in this contexual journal has the potential to reach scientists around the world who have signed up for Some contexual Paediatric Journals free table of contents e-alerts, ensuring additional exposure to authors. These e-alerts allow recipients to click through to the full article if they subscribe or work at an institution with a site license, or click through to the article's abstract for other readers.

Focused subject areas on specified databases

From paediatric immunology to,paediatric bio-chemistryto paediatric bio-physics, genetics to materials, subject-specific areas provide a focused environment for readers, providing a monthly updated focus for a particular field.

Abstracting and indexing

Some Paediatric Journals is included in the leading abstracting and indexing services including ISI, MEDLINE, EMBASE and BIOSIS. Extensive reference linking to MEDLINE, ISI, Chemport and others via services such as Crossref and DOI numbers provide seamless online linking between articles and databases.

Media coverage

The Some Paediatric Journals press office provides information about exceptionally interesting papers published throughout Springer Nature. More than 2,000 journalists and media organizations worldwide subscribe to the press service, ensuring that papers receive maximum exposure in the world's most important media channels including newspapers, magazines, radio and television.

Extending science further - global collaborations

Some Paediatric Journals support some projects aimed at making current research available to a broader community of scientists and practitioners.

Some Paediatric Journals, are in WHO's HINARI -Health InterNetwork Access to Research Initiative) program, which provides free access to public institutions in developing countries.

Newsfeeds

Some Paediatric Journals now provides its latest table of contents as an RSS web feed. This allows users with an RSS reader to receive automatic updates whenever new content is added to these pages.

Receive Pediatric Research's current issue table of contents.

Paediatric Authors Find out more about RSS feeds, how to download an RSS reader and see all the news feeds offered by some these Paediatric Journals

Editorial policy

This Paediatric Journals adheres to the highest standards concerning its editorial policies on publication ethics and scientific misconduct. The journal follows guidance produced by bodies that include the Committee on Publication Ethics -COPE, the World Association of Medical Editors -WAME, the Council of Science Editors and the International Committee of Medical Journal Editors -ICMJE.

These Paediatric Journals have dedicated Author Hub policies page, including information about our Editors’ roles and responsibilities.

Authors are required to submit a statement that their study obtained ethics approval (or a statement that it was not required and why) and that participants gave informed consent. Our Editors will consider whether the work is morally acceptable as determined by the World Medical Association’s Declaration of Helsinki. In addition to this, in line with contextual l Medical Council guidelines, an article that contains personal medical information about an identifiable living individual requires patients explicit consent in the format of a signed BMJ patient consent form) before we will publish it. Please find further details on BMJ research ethics policies (human participants and animals and consent for publication; including a link to the downloadable consent form.

The journal encourages academic and scientific collaborations between investigators from low- LIC and middle income countries -MIC and those from high income countries HIC. In research that is conducted in LIC and MIC, the journal prefers that these collaborations are reflected with local authors appearing high on the author listing, ideally as first and/or second, and for the contribution of contributors from LIC and MIC to be properly recognised, in terms of author numbers and seniority.

To make the best decision on how to deal with a manuscript This contexual paediatric journals needs to know about any competing interests authors may have; this includes any commercial, financial or non financial associations that may be relevant to the submitted article. Authors must download and complete a copy of the ICMJE Conflict of Interest disclosure form. In addition to this Some Paediatric Journals ensures that all advertising and sponsorship associated with the journal does not influence editorial decisions, is immediately distinguishable from editorial content and meets all other BMJ guidelines. Please find more information about competing interests and a link to the form.

All Paediatric Journals take seriously all possible misconduct. Anyone with concerns that a submitted article describes something that might be considered to constitute misconduct in research, publication or professional behaviour should forward their concerns to the journal. The publisher will deal with allegations appropriately following ICMJE and COPE guidelines. Corrections and retractions are considered where an article has already been published; corrections, expressions of concern or a retraction notices will be published as soon as possible in line with the contextual Paediatric Journals correction and retraction policy.

Copyright and authors’ rights

As an open access journal, Some Paediatric Journals adheres to the Budapest Open Access Initiative definition of open access. Articles are published under an exclusive licence or non-exclusive licence creative commons licence.

Some Authors or their employers retain copyright. Such open access articles can be reused under the terms of the relevant Creative Commons licence to facilitate reuse of the content.

When publishing in Some Paediatric Journalsauthors choose between two licence types – CC-BY-NC and CC-BY -Creative Commons open access licences require payment of an article processing charge.

As an author you may wish to post your article in an institutional or subject repository, or on a scientific social sharing network. You may also link your published article to your preprint if applicable. What you can do with your article, without seeking permission, depends on the licence you have chosen and the version of your article. Please refer to the contexual Paediatric Journals author self archiving and permissions policies page for more information.

Preprints

Preprints foster openness, accessibility and collaboration by allowing authors to make their findings immediately available to the research community and receive feedback on an article before it is submitted to a journal for formal publication.

Some Paediatric Journals fully supports and encourages the archiving of preprints in any recognised, not-for-profit server such as medRxiv.

Some Paediatric Journals does not consider the posting of an article in a dedicated preprint repository to be prior publication.

Preprints are reports of work that have not been peer-reviewed; Preprints should therefore not be used to guide clinical practice, health-related behaviour or health policy. For more information, please refer to our Preprint policy page.

Article processing charges

There are no submission, colour or page charges.

There is a 25% discount for articles where the corresponding author is a from a contextual Paediatric Journals member organisation or where the corresponding author has reviewed the contexual Paediatric Journals within the previous 12 months. These discounts cannot be combined.

Find out if you are eligible for institutional funding

A number of institutions have open access agreements with some Paediatric Journals which can either cover the whole cost of open access publishing for authors at participating institutions or can allow authors to receive a discount of the Article Processing Charge -APC.

Visit Some Paediatric Journals open access agreements page to find out whether your institution is a member and what discounts you may be entitled to.

Some Paediatric Journals also grants waivers and discounts in specific circumstances, for more information on publishing open access with Some Paediatric Journals visit our Author Hub.

Please note that applications for waivers or discounts should be made during initial submission and not after an article has been accepted. Editors are not involved in this process and the ability to pay has no bearing on editorial decisions. Payment will not be required unless your article is accepted. Accepted articles will not be published until payment has been received. Some Paediatric Journals does not refund APCs once paid.

Provenance and peer review process

Some Paediatric Journals submissions are predominantly unsolicited; the journal commissions Editorials occasionally. Articles submitted to Some Paediatric Journals Open are subject to external open peer review; at least two external reviewer reports are obtained before an Original research, Protocol or Review article is accepted for publication. When a paper has been submitted from the Editor, Deputy or Associate Editors’ departments, they have no role in the reviewing or decision making process. This also applies to any Associate Editors who are authors, in which instance the reviewing process is handled by the Editor-in-Chief.

Upon publication, all previous versions of the manuscript are made available, as are the reviewers’ comments and authors’ replies to those comments. Exceptions are made only when an article is accepted based on reviews received at another Paediatric Journals journal and the reviewers have not granted permission for their reviews to be posted online.

Some Paediatric Journals also has a panel of expert statistical reviewers. They are assigned by the editor to papers with more than a basic level of statistical analysis. Other statistics reviewers may be invited on an ad hoc basis.

Some Paediatric Journals requests that all reviewers adhere to a set of basic principles and standards during the peer-review process in research publication; these are based on the COPE Ethical Guidelines for Peer Reviewers. Please refer to our peer review terms and conditions policy page.

Reviewers are now able to share their activity by connecting their review to their ORCID account. As Some Paediatric Journals is an open peer-reviewed Journal, information about the Journal, review, and article will be uploaded -title, DOI, URL, etc into the reviewer’s ORCID record. Records are uploaded once a final decision or revision has been made on the article. Please find more information about ORCID andSome Paediatric Journals policy on our Author Hub.

Some Paediatric Journals is committed to transparency. Every article we publish includes a description of its provenance-commissioned or not commissioned and whether it was internally or externally peer reviewed.

Some Paediatric Journals are committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions.In rare instances we determine after careful consideration that we should not make certain portions of the prepublication record publicly available.

Plagiarism is the appropriation of the language, ideas or thoughts of another without crediting their true source and representation of them as one’s own original work.

Some Paediatric Journals are members of CrossCheck by CrossRef and iThenticate. iThenticate is a plagiarism screening service that verifies the originality of content submitted before publication. Some Paediatric Journals runs manuscripts through iThenticate during the peer review process. Authors, researchers and freelancers can also use iThenticate to screen their work before submission by visiting www.ithenticate.com.etc.

Reader responses, questions and comments to published content are welcomed by Some Paediatric Journals ; these should be submitted electronically via the journals website. Post-publication peer review is encouraged via rapid responses. Please find further details on how to publish a response and the terms and requirements.

Reporting patient and public involvement in research

Some Paediatric Journals encourages active patient and public involvement in clinical research as part of its patient and public partnership strategy. To support co-production of research we request that authors provide a Patient and Public Involvement statement in the methods section of their papers, under the subheading ‘Patient and public involvement’.

Some Paediatric Journals appreciate that patient and public involvement is relatively new and may not be feasible or appropriate for all papers. We therefore continue to consider papers where patients were not involved. Please note that this practice is only applicable for Original Research Articles, Study Protocols, and Original Research Letters.

The Patient and Public Involvement statement should provide a brief response to the following questions, tailored as appropriate for the study design reported (please find example statements here):

At what stage in the research process were patients/the public first involved in the research and how?

How were the research question(s) and outcome measures developed and informed by their priorities, experience, and preferences?

How were patients/the public involved in the design of this study?

How were they involved in the recruitment to and conduct of the study?

Were they asked to assess the burden of the intervention and time required to participate in the research?

How were (or will) they be involved in your plans to disseminate the study results to participants and relevant wider patient communities (e.g. by choosing what information/results to share, when, and in what format)?

If patients were not involved please state this.

In addition to considering the points above we advise authors to look at guidance for best reporting of patient and public involvement as set out in the GRIPP2 reporting checklist.

If the Patient and Public Involvement statement is missing in the submitted manuscript we will request that authors provide it.

Article transfer service

Some Paediatric Journals are committed to ensuring that all good quality research is published. Our article transfer service helps authors find the best journal for their research while providing an easy and smooth publication process.

As part of this service, once authors agree to transfer their manuscript all versions, supplementary files and peer reviewer comments are automatically transferred; without the need to resubmit or reformat.

Authors who submit to Archives of Disease in Childhood and are rejected will be offered the option of transferring to SomePaediatric JournalsPaediatrics Open.

Please note that the article transfer service does not guarantee acceptance but you should receive a quicker initial decision on your manuscript.

Contact the Product Owner of the contexual Paediatric Journals Article Transfer Service for more information or assistance.

Data sharing

Some Paediatric JournalsPaediatrics Open adheres to the international Paediatric Journals Tier 2 data policy. We strongly encourage that data generated by your research that supports your article be made available as soon as possible, wherever legally and ethically possible. We also require data from clinical trials to be made available upon reasonable request.

To adhere to ICMJE guidelines, we require that a data sharing plan must be included with trial registration for clinical trials that begin enrolling participants on or after 1st January 2019. Changes to the plan must be noted in the Data Availability Statement and updated in the registry record. All research articles must contain a Data Availability Statement. For more information and FAQs, please see the contexual Paediatric Journals full Data Sharing Policy page.

Rapid responses

A rapid response is a moderated but not peer reviewed online response to a published article in BMJ Paediatrics Open; it will not receive a DOI and will not be indexed. Find out more about responses and how to submit a response.

Submission guidelines

Please review the below article type specifications including the required article lengths, illustrations, table limits and reference counts.

The word count excludes the title page, abstract, tables, acknowledgements, contributions and references. Manuscripts should be as succinct as possible.

For further support when making your submission please refer to the resources available on the contexual Paediatric Journals Author Hub.

Here you will find information on writing and formatting your research through to the peer review process and promoting your paper.

Some Paediatric Journals encourage authors to ensure that research articles are written in accordance with the relevant research reporting guideline.

Reporting Guidelines

The guidelines listed below should be followed where appropriate. Please use these guidelines to structure your article. Completed applicable checklists, structured abstracts and flow diagrams should be uploaded with your submission; these will be published alongside the final version of your paper.

Original research

Protocol

Review

Editorial

Original research letter

Young voices

Supplement

CONSORT Statement

For reporting of randomised controlled trials: please use the appropriate extension to the CONSORT statement, including the extension for writing abstracts

Open Access

Some Paediatric Journals publish articles using a traditional subscription model -Hybrid OA which is twelve month embargoto open access which is followed by a fort eight month open access period that does not allow posting to other open digital repositories such as PubMed Central etc.. For submissions with special open access or statutory government funding requirements, some Paediatric Journals offers Green OA and Gold OA options. During the manuscript submission process, the paediatric author should use the Funding Organization and Open Access Policy Specifications entry to state the authors preferences and whether you want Green or Gold OA.

In case of any need for clarification, the author is advised to kindly contact the journal’s editorial staff before the final final submission of the article.

Requirements

All submissions must adhere to the following format:

Most paediatric Journals require that all articles submitted for peer review must adhere to the following requirements:

Times New Roman font, size 12, black

Title Page, Contributors' Statement Page, Abstract, Acknowledgments, and References should be single-spaced

Only the Main Body Text should be double-spaced

Main Submission Document as a Microsoft Word file (no PDFs)

Include line and page numbering in your Word document -excluding the References.

Do not include page headers or footers in new submissions.

Do not include footnotes within the manuscript body. Footnotes are allowed only in tables/figures.

Refer to the Article Types section for specific guidelines on preparing a manuscript in each category. Note in particular the requirements regarding abstracts for different categories of article.

Double-Blind Peer Review Manuscript Formatting

Some Paediatric journals proffer the option of selecting single-blind or double-blind peer review.

However, if authors are selecting double-blind peer review, they must prepare their manuscript according to the following guidelines.

They should upload a separate document in Word format only containing their complete Title Page and Contributors’ Statement Page.

They should include ALL required Title Page and Contributors’ Statement Page information ortheir submission will be returned to you for correction.

When the authors are uploading their manuscript, they should upload the Title Page/Contributors’ Statement Page first by clicking the Upload your title page link.

The authors should please ensure that none of their other files have any identification information on them, including the name of their institution. If you wish to include acknowledgments, include an Acknowledgments section on the title page –please see Title Page.

In your manuscript file, remove references to the specific institution at which the study was performed and replace those mentions with generic descriptors of the setting as appropriate for example- our 500-bed freestanding children’s hospital in Eastern Nigeria .

Title Page

The Title Page should appear first in your manuscript document if you are selecting a single-blind peer review, or as a separate file if you are selecting double-blind peer review. If you select double-blind peer review and are including acknowledgments, those should appear at the end of the Title Page file. Depending on the individual needs of a paper, it may encompass more than one page.

Title pages for all submissions must include the following items -as shown in the sample Title Page:

Title –About 100 characters including spaces or less is recommended.

Author listing.

Full names for all authors, including degrees, and institutional/professional affiliations. These affiliations should list the institution where the research presented in the article was undertaken; if the affiliation has changed, add a note indicating the additional affiliation. If published, author names and affiliations will appear as seen in the submitted manuscript Word document and the final typeset proofs; all authors must ensure that their information is correct. Some Paediatrics Journals permits a statement of equal contribution for two first authors and two senior authors; on the title page, include asterisks by each name and a statement that reads: * Contributed equally as co-first authors or * Contributed equally as co-senior authors.

Corresponding Author.

The Contact information for the Corresponding Author including: name, address, telephone, and e-mail should be included. Note that the affiliation should list the institution where the research presented in the article took place; if the affiliation has changed, add a note indicating the additional affiliation.

Some Paediatrics Journals allow one Corresponding Author only; the position of Corresponding Author does not imply seniority or any other status.

Short title

A short title of about 60 characters including spaces or fewer is recommended.

Please it is worthwhile for authors to note that the short title may be used on the cover of the print edition.

Conflict of Interest Disclosures for all authors.

This includes any potential conflicts of interest, any relevant financial relationships, and any other relationships or activities that could be perceived to have influenced the work.

If none, state that: The authors have no conflicts of interest relevant to this article to disclose.

Funding/Support.

Any Research or project support, including internal funding, should be listed here; if the project was done with no specific support, please note that here.

Technical and other assistance should be indicated in the Acknowledgments section .

Open Access.

Some Pediatrics Journals offers Green OA and Gold OA options. If your funding body has open access requirements, contact the Editorial Office prior to submission.

If applicable, Clinical Trial registry name, registration number, and data sharing statement.

Most Paediatrics Journals adhere to ICMJE guidelines, which require that all trials must be registered with ClinicalTrials.gov or any other WHO Primary registry. All articles reporting results of clinical trials must also include the Data Sharing Statement.

Abbreviations.

Paediatric authors should do well to List and define abbreviations used in the text. If none, was applicable then they should state -Abbreviations: none.

Article Summary.

All articles with abstracts require this summary. This brief summary is limited to 30 words or less.

For accepted manuscripts, this will appear under the author names in the table of contents to give the reader a brief insight into what the article is about. It should entice the reader to read the full article.

For Regular Article submissions, include both the Whatis already Known on This Subject and the What This Study Adds summaries-see Regular Article type for description. These are not needed for any other article type.

If a title page does not include all of the above items, the submission may be returned to the authors for completion.

Contributors' Statement Page

All submissions excluding Commentaries must contain a Contributors’ Statement Page, directly following the Title Page(s)- and in the specific format described below. Manuscripts lacking a properly formatted Contributors' Statement Page will be returned to the authors for correction. If you select double-blind peer review, the Contributors’ Statement Page should be part of your separate Title Page file.

All persons designated as authors must qualify for authorship -see -Publication Ethics statement, and all those who qualify should be listed. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. The Contributors' Statement Page lists the authors and specifies the contribution(s) made by each individual. If multiple individuals have identical contributions they may be listed together; do not list an author more than once.

You must follow the required format when creating your Contributors’ Statement Page or your manuscript will be returned for correction.

Each author should only appear once.

Use names, not initials.

If multiple authors have identical contributions, you can list them in the same sentence; otherwise, list each author separately.

Conclude your statement by confirming that: All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Sample Contributors' Statement:

Dr X and Prof Y conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript.

Drs A, B, and C and Ms D designed the data collection instruments, collected data, carried out the initial analyses, and reviewed and revised the manuscript.

Dr E conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Note:

It is pertinent to note that the acquisition of funding, collection of data, or general supervision of a research group alone does not constitute a sufficient basis for authorship. Contributors who do not meet the criteria for authorship ,such as persons who helped enroll and recruit patients for the study, or professional editors should be listed in an Acknowledgments section placed after the manuscript’s conclusion and before the References section. Because readers may infer their endorsement of the data and conclusions, these persons must give written permission to be acknowledged. These permissions do not need to be submitted with the manuscript unless requested by the editors.

Word Count

To determine article length, the body of the manuscript should be count, from the beginning ofthe article to the Introduction and then to the end of the Conclusion.

The title page, contributors' statement page, abstract, acknowledgments, references, figures, tables, and multimedia are not usually included in the word count.

Figures, Tables, and Supplementary Material

For any figure, table, or supplementary material reproduced or adapted from another source, authors are required to obtain permission from the copyright holder, and proof of permission must be uploaded at the time of submission. The legend must include a statement that the material was used or adapted with permission.

Figures

Authors should number figures in the order in which they appear in the text.

Figures include graphs, charts, photographs, and illustrations. Each figure must include a legend -placed as a list appearing after the References that does not exceed 50 words. Abbreviations previously expanded in the text are acceptable.

Upload figures as separate files; list figure legends as the last item in your main Word/text file. Do not paste figures into your manuscript text/Word file.

There is no maximum number for figures.

Figure arrays should be clearly labeled, preassembled, and submitted to scale.

Figure parts of an array (A, B, C, etc.) should be clearly marked in capital letters in the upper left-hand corner of each figure part.

Technical requirements for figures:

The following file types are acceptable: TIFF, PDF, EPS, and PNG.

Color files must be in CMYK (cyan, magenta, yellow, black) mode.

Some Pediatrics Journals cannot accept Excel or PowerPoint files for any part of your submission. To repeat: upload figures as separate files; list figure legends as the last item in your main Word/text file. Do not paste figures into your manuscript text/Word file.

Style for figures:

Readers should be able to understand figures without referring to the text.

Avoid pie charts, 3-dimensional graphs, and excess ink in general.

Make sure that the axes on graphs are labeled, including units of measurement, and that the font is large enough to read.

Generally delete legends or other material from the graph if it makes the picture smaller. Color graphs should be interpretable if photocopied in black and white.

Tables

Tables should be numbered in the order in which they are cited in the text and include appropriate headers.

Tables should not reiterate information presented in the Results section, but rather should provide clear and concise data that further illustrate the main point.

Tabular data should directly relate to the hypothesis.

Table formatting should follow the current edition of the International Manual of Style.

There is no maximum number of tables, but redundant tables must be avoided.

Technical requirements for tables:

Tables should be constructed using a Microsoft Word program and inserted in numerical order at the end of the manuscript, either within the main Word document following the references or as separate files.

Do not provide tables in scan/image format. Pediatrics cannot accept Excel or PowerPoint files for any part of your submission.

Style for tables:

Tables should be illustrative, illuminative, instructive and self-explanatory.

Avoid abbreviations; define any abbreviations in footnotes to the table.

Avoid excess digits and excess ink in general. Where possible, rows should be in a meaningful sequential order such as descending order of frequency. etc.

Provide units of measurement for all numbers.

In general, only one type of data should be in each column of the table.

Presentation of Numbers and Statistics

Results in the abstract and the paper generally should include estimates of effect size and 95% confidence intervals, not just P values or statements that a difference is statistically significant.

Where possible, focus on absolute and not relative differences.

Measures of clinical impact like the number needed to treat can be especially helpful for our readers.

All statistical methods should be clearly described.

Units of independent variables must be provided in tables and results sections if regression coefficients are provided.

Equations should be typed exactly as they are to appear in the final manuscript.

Percentages

Report percentages to one decimal place (ie, xx.x%) when sample size is greater than or equal to 200.

To avoid the appearance of a level of precision that is not present with small samples, do not use decimal places (ie, xx%, not xx.x%) when sample size is less than 200.

Error Measures

Report confidence intervals, rather than standard errors, when possible.

Use mean (error measures)rather than mean ± error measure notation.

P values

Except when one-sided tests are required by study design, such as in noninferiority trials, all reported P values should be two-sided.

In general, P values larger than 0.01 should be reported to two decimal places, those between 0.01 and 0.001 to three decimal places; P values smaller than 0.001 should be reported as P -is less than sign]0.001.

Notable exceptions to this rule include P values arising in the application of stopping rules to the analysis of clinical trials and genetic-screening studies.

Trends

Use the word trend when describing a test for trend or dose-response.

Avoid the term trend when referring to p-values near but not below 0.05. In such instances, simply report a difference and the confidence interval of the difference (if appropriate) with or without the p-value.

Supplemental Information

Authors may wish to include additional information in an appendix as part of their article. References to any online supplemental information must appear in the main article. Such supplemental information can include but are not limited to additional tables, figures, videos, audio files, slide shows, data sets -including qualitative data, and online appendices.

If your study is based on a survey, consider submitting your survey instrument or the key questions as a data supplement.

Authors are responsible for clearly labeling supplemental information and are accountable for its accuracy.

Supplemental information will be peer reviewed, but not professionally copyedited.

Videos

Some Paediatrics Journals encourage the submission of videos to accompany articles where relevant. Links can be placed in the article for use when it is accessed electronically.

All videos must adhere to the same general permission rules that apply to figures such as parental consent when a patient is identifiable.

All videos should be submitted at the desired reproduction size and length.

To avoid excessive delays in downloading the files, videos should be no more than 6MB in size and run between 30 and 60 seconds in length.

In addition, cropping frames and image sizes can significantly reduce file sizes.

Files submitted can be looped to play more than once, provided the file size does not become excessive.

Video format must be either .mov or .mp4.

Paediatric Authors will be notified if problems exist with videos as submitted and will be asked to modify them if needed.

No editing will be done to the videos at the editorial office—all changes are the responsibility of the author.

Video files should be named clearly to correspond with the figure they represent, such as figure1.mov, figure2.mp4, etc.

Be sure all video files have filenames that are no more than 8 characters long and include the suffix .mov or .mp4.

A caption for each video should be provided, preferably in a similarly named Word file submitted with the videos stating clearly the content of the video presentation and its relevance to the materials submitted.

It is important for Paediatric Authors to note that One to four traditional still images from the video must be provided.

These still images may be published with the article and will act as thumbnail images that will link to the full video file.

Please indicate clearly in your text whether a figure has a video associated with it, and be sure to indicate the name of the corresponding video file.

A brief figure legend should also be provided.

In this interview, since the discussions on the recommendations of writing a world class research article, case reports and review papers could be achieved elsewhere In this section I will like to highlight and discuss some of the other types of articles that are equally published in Paediatric Journal which also make a significant impact on the contextual journals standards etc.,these include article types such as but not confined to:

Original research letter

Original research letters are appropriate for studies with a single research question.

The research letter should contain one paragraph for each of the following (without subheadings: Introduction; Methods; Results; Discussion.

Additional paragraphs are allowed, as long as the word count is not exceeded.

Please note that the editorial process for research letters is the same as for original articles; i.e. open peer review.

Following the lead of the trend of the global trend and its patient partnership strategy, several paediatric journals are encouraging active patient involvement in setting the research agenda. As such, most journals will require authors of Original Research Letters to add a Patient and Public Involvement statement to their letter.

Essence

Word count: up to 600 words

Tables/Figures: maximum 2 tables and/or figures

References: up to 6

Abstract: 100 words unstructured abstract

Historical Perspectives Feature

The historical perspectives Feature of some paediatric journals is intended to attract concise and engaging historical articles of interest to clinicians.

These articles are more akin to a commentary than an original article and cannot be expected to provide the kind of in-depth analysis expected in professional historical journals.

The content may draw from original research or develop a particular insight from existing scholarship.

These articles are typically qualitative and not divided into the conventional sections appropriate for original scientific contributions.

Articles are peer reviewed by professionals with both medical and historical expertise.

Consider the following points as you develop your article:

Frame a clear question or central argument.

Historical articles do not just recite chronologies or lists of persons and dates, they investigate a particular question and develop an argument backed up by sources.

Set your article in historical context—in its own time and place.

Don’t judge the past by the standards of the present.

Secondary sources could be very helpful.

Search for articles or books that can provide historical background.

Will your article be of interest to pediatricians -the main readership for most Pediatrics Journals?

Is the writing clear, organized, and easy to follow?

Is it original? Authors who have completed longer historical projects may wish to submit a short article related to a bigger project that may attract new readers to their other scholarship.

Are assertions in the paper accurate and supported with appropriate references?

Most articles will have about 10 to 20 references.

Follow the International Manual of Style.

Specific references in longer sources may require page numbers to be noted in parentheses.

Primary sources -produced by participants or contemporaries are preferred when possible.

The goal is to provide enough information that a reader could independently confirm the assertions in the text.

Secondary sources (books and reviews written by historians or physician-historians) should be cited to provide context to frame the story in space and time and scholarly background.

Specific questions may be directed to Section Editor.

Pediatrics Perspectives

Essence

Abstract length: no abstract

Article length: 1,200 words max

Author limit: Three (3) authors or fewer

Figure/table: No more than one (1) figure or table allowed

Pediatrics Perspectives are unsolicited opinion pieces that address current topical issues in areas commonly of child’s public health importance such as, but not confined to: child advocacy,child public policy, and population health, or clinical topics related to infant, child, and/or adolescent health etc.

Perspectives pieces should include a clear explanation of the issue and potential measures to address it.

A short synopsis of current or past personal research on the topic is not appropriate. Perspectives pieces cannot exceed 1,200 words, be written by more than 3 authors, or and have more than 7 references.

Pediatrics Perspectives may include 1 figure or 1 table.

The general instructions regarding submission -including cover letter, title page requirements, contributors' statement page, journal style guidance, and conflict of interest statementsalso apply to Paediatrics Perspectives.

It is pertinent for paediatric authors to please note that :

Most PaediatricsJournals receive a lot more Pediatrics Perspectives than the journal can publish.

Authors are encouraged to review the Pediatrics Perspectives that have published to ensure that new submissions are instructive and unique.

Letters to the Editor

Although some Paediatric Journals encourage a direct submission of Letters to the Editor, Some Paediatric Journals expect all Letters to the Editor must first be submitted as online comments and must conform to comment requirements.

Selected comments may then be chosen for publication in the indexed edition of Paediatrics Journal asLetters to the Editor.

The editors may choose to abridge and edit a comment prior to publication as a Letter to the Editor in Paediatrics without notifying or seeking approval from the author.

Only these selected responses will be cited in MedLine.

Any letters submitted through the official manuscript submission site will be withdrawn.

At the time of provisional acceptance, the comment author will receive instructions for submitting an online copyright form.

No comment will be scheduled for an issue’s Letters to the Editor section and move onto production until the copyright form is completed.

Protocol

Word count: up to 2,500 words

Abstract: up to 300 words

Tables/Illustrations: maximum 8 tables and/or figures

References: up to 40

All submissions must contain a box summarising what the article adds to the literature so that readers can gather an overview of the article before reading it.

This should be divided into two sections, each with 1-3 sentences and should have the headings:

What is known about the subject – followed by a maximum of 3 brief statements no more than 25 words per statement.

What this study hopes to add – followed by a maximum of 3 brief statements (no more than 25 words per statement)

Publishing study protocols enables researchers and funding bodies to stay up to date in their fields by providing exposure to research activity that may not otherwise be widely publicized.

This can help prevent unnecessary duplication of work and will hopefully enable collaboration.

Publishing protocols increases transparency, which makes it easier for others -editors, reviewers and readers to see and understand any deviations from the protocol that occur during the conduct of the study.

Protocols should report planned or ongoing studies.

If data collection is complete, we will not consider the manuscript.

For systematic reviews, the search must not have been performed.

The journal will consider protocols for any study design, including observational studies and systematic reviews.

The SPIRIT -Standard Protocol Items for Randomized Trials statement is an evidence-based tool developed through systematic review of a wide range of resources and consensus.

It closely mirrors the CONSORT statement and also reflects important ethics considerations.

Most Paediatric Journals will encourage investigators to adhere to the SPIRIT recommendations when drafting their protocols.

The PRISMA-P -preferred reporting items for systematic review and meta-analysis protocolsis a fairly novel reporting guideline.

An article stating the guideline checklist has now been published.

The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.

Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols.

Various other resources exist that list the ingredients of an authoritative trial protocol, such as the Department of Health/Medical Research Council Clinical Trials Toolkit and the National Institutes for Health provide advice on how to structure a trial protocol.

Some Paediatrics Journals will consider for publication protocols for any study design, including observational studies and systematic reviews.

Some Paediatrics Journals strongly encourage you to register your study.

Prospective registration is mandatory for any clinical trials.

Acceptable registries for trials are itemised and listedonline.

Some Paediatric journals recommend Prospero for registration of systematic reviews.

Some Paediatric journal will consider publishing without peer review protocols that have formal ethical approval and funding from a recognised, open access advocating research-funding body such as those listed by the JULIET project.

Please provide proof that these criteria are met when uploading your protocol.

Any protocols that do not meet both these criteria will be sent for external peer review.

The generic paediatric journals policiesapply on the manuscript formatting, editorial policies, licence forms and patient consent where applicable to study designs.

Protocols should include, as a minimum, the following items.

Protocols should have the following structure:

Title:

This should include the specific study type, e.g. randomised controlled trial and lucidly outline that the article reports a protocol.

Abstract:

This should be structured with the following sections: Introduction; Methods and analysis; Ethics and Dissemination. Registration details should be included as a final section, if appropriate.

Introduction:

Explain the rationale for the study and what evidence gap it may fill.

Appropriate previous literature should be referenced.

Methods and analysis:

Provide a full description of the study design, including the following: how the sample will be selected; interventions to be measured; the sample size calculation -drawing on previous literature- with an estimate of how many participants are needed for the primary outcome to be statistically, clinically and/or politically significant; what outcomes will be measured, when and how; a data analysis plan.

Ethics and dissemination:

Ethical and safety considerations and any dissemination plan (publications, data deposition and curation) should be covered here.

Full references

Authors’ contributions: state how each author was involved in writing the protocol.

Funding statement: preferably worded in one of two ways: ‘

This work was supported by [name of funder] grant number [xxx]’ or ‘This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors’.

Competing interests statement

Following the lead of The global trend and its patient partnership strategy, This contextual Paediatrics Journal is encouraging active patient involvement in setting the research agenda.

As such, we require authors of Protocols to add a Patient and Public Involvement statement in the Methods section. Please see more details above.

Single Centre Audits

Some Paediatrics Journals do not normally routinely publish single centre audits but will consider them for publication when the study has genuine implications on wider practice.

Editorial

Editorials commissioned by the editorial team fall into two general categories: comment on particular research papers and comment on wider child health.

This contexual paediatric journal welcome the submission of Editorials commenting on child health issues in any part of the world.

All Editorials undergo external transparent peer review.

Editorials need to be evidence-based and balanced.

See published Editorials as examples

Word count: up to 1,200 words

No abstract

No Tables/Illustrations

References: up to 5

Annotations and Commentary

Abstract length: no abstract

Article length: 400 to 800 words

Annotations and Commentaries are solicited by the editors.

These contributions usually pertain to and are published concurrently with a specific article; the commentary serves to launch a broader discussion of a topic.

The general submission instructions, including cover letter, title page, contributors' statement page, journal style guidance, and conflict of interest statements also apply to commentaries.

Further instructions will be sent to authors after they are invited to write a commentary. Unsolicited opinion pieces are published as Pediatrics Perspectives.

Responses to published articles should be submitted as online Comments.

Diagnostic Dilemmas and Clinical Reasoning

Abstract length: 250 words or fewer (unstructured: no headings, run in a single paragraph)

Essentials

Abstracts must not reveal the final diagnosis

Article length: 3,500 words or fewer

Author limit: Seven (7) authors or fewer

Diagnostic Dilemmas and Clinical Reasoning articles are interactive case studies with comments inserted by generalists and specialists asked to comment on the case, simulating what might occur in an oral case presentation.

The goal of this feature is to present clinical cases that are diagnostic dilemmas and that involve the input of both generalists and subspecialists who comment as segments of the case are presented, similar to Ethics Rounds feature articles. Each case presented should generate a dialogue about unusual or complicated disease processes and stimulate discussion about clinical reasoning. The initial case description should include the chief complaint and enough information to generate an initial differential diagnosis. Clinical details should alternate with input from generalists and from subspecialists as the case evolves and as the ultimate diagnosis is made. The case should culminate with a brief summary (750–1,000 words) of the key points of the case and of the ultimate diagnosis. Use of media, such as radiology studies, pathology specimens, or video clips as, is encouraged to complement the discussion.

Authors may come from any institution. The case may be one that was discussed in the hospital’s teaching rounds (many hospitals have sessions entitled Case Conference, CPC, Professorial Rounds, or something similar).

Manuscripts will be submitted for peer review, with acceptance contingent on positive peer reviews and input from the editorial board.

All cases should be real cases. On submission, authors must attest that they have written consent from the family. Written consent from the family and from the providers who cared for the patient is also required before a manuscript can be published (the consent can be in the form of an email); upload consent as a Supplemental File and select the internal use only box. Instances where there are extenuating circumstances in which family consent may be problematic will be handled on a case-by-case basis. If a case is published without family consent, enough elements should be changed so that the patient and family are not recognizable. If the case is too unique to be disguised, then those involved in the care of the patient cannot be authors, and the published paper must have no link to the institution where the case took place.

The requirements of local institutional review boards should be followed.

Authorship: All authors must fulfill the ICJME criteria for authorship.

Questions can be addressed to section editor for Diagnostic Dilemmas and Clinical Reasoning, accordingly.

Paediatric Trainees Issues

This section publishes insightful updates and opinion articles on all aspects of paediatrics, written from the unique perspective of the trainee.

The goal of the editorial board of the Journal is to work with trainee authors to develop thoughtful and timely articles related to pediatrics that appeal to everyone from medical students to well-seasoned practitioners. Topic content that focuses on training in paediatric medicine is preferred, but a range of other content areas will be considered. Topics should be relevant to students, residents, and fellows, but also of general interest to the readership of Pediatrics. The issue being discussed must be uniquely viewed from the trainee’s perspective, not from that of the supervisor, educator, or attending.

A few questions to consider when writing include:

Why is the issue important?

What is causing the problem to persist?

How might it be corrected?

How is this issue important to pediatricians in training?

How might it affect pediatric medicine in the future?

This contextual journal is looking for authors who take a stand and support it with evidence from the literature, and for articles which are unique and distinctive.

A narrative thread that engages the reader and includes observations drawn from the author’s clinical and professional experiences is recommended.

Essentials

The first author must be a resident, fellow, or medical student,.

Collaborating authors at any career level are welcome.

Word Limit: 1,200 words

Reference Limit: 15 references

Author limit: 4 authors

Specific questions may be directed to Section Editor.

Ethics Forum and Rounds

Abstract length: 250 words or fewer unstructured: no headings, run in a single paragraph.

Article length: varies

Ethics Rounds present discussions of cases that illustrate ethical dilemmas in patient care, research, or administration.

Authors who have a case that raises ethical issues and who want to submit a paper for Ethics Rounds should email Associate Editor.

Ethics Rounds usually consist of an abstract, brief introduction, a case followed by several commentaries, the outcome of the case, and a conclusion.

The abstract should summarize the commentators’ substantive conclusions in addition to briefly describing the case.

The case can involve clinical, research, or organizational ethics.

It should conclude with an ethical dilemma or conflict, and the need for an individual or group to act. Cases are typically 250 to 300 words in length.

If the case is based on the care of an actual patient, informed consent should be obtained from the adult patient or the parents or guardian of a minor patient, or the case should be sufficiently anonymised that the participants cannot recognize it.

Cases can also be a composite of the care of several actual patients.

The case is usually followed by 2-3 commentaries that are all included in the article.

Each commentary usually has 1-2 authors. The author(s) of the case are typically among the commentators.

If there are 2 commentaries, they should each be 1,200 or fewer words and, if there are 3, each should be 800 or fewer words.

It is preferable that the commentaries’ authors represent different institutions, disciplines, and/or perspectives.

Commentaries should not introduce new information about the case and should not be repetitive. Ethics Rounds generally conclude with a description of the outcome of the case and a brief comment by the Section Editor.

Potential authors are strongly encouraged to review recently published Ethics Rounds to familiarize themselves with the format and topics that have already been covered.

The general submission instructions, including cover letter, title page, contributors' statement page, abstract, journal style guidance, and conflict of interest statements, also apply to Ethics Rounds.

Global Health Issues:

The global health Issues is intended to educate and engage clinicians who might not otherwise be immersed in the global health field.

Submissions should provide information or perspective on issues and initiatives of international interest, including health, nutrition, and medical care in low- and middle-income countries.

Articles may be broad or specific in focus and should include appropriate references.

Paediatric Medical Students Forum.

This publishes articles on topics of relevance to the undergraduate paediatric medical student education. Articles are solicited internally or externally.

The number of authors is limited to 3 to 5 medical students preferably those ones undertaking their paediatric clinical clerkships,rotations,electives,perceptorships and attachments under the direction of residents and consultants in Paediatrics.

Equity, Diversity, and Inclusion Forum

The goal of the Equity, Diversity, and Inclusion Feature is to highlight areas in which bias, discrimination, racism, and inequity have impacted the health of children and their families. Topics discussed should question assumptions of traditionally held beliefs of race and other social constructs and encourage the promotion of health equity. Suggested topics include, but are not limited to: the impact of social or structural factors on health, with respect to housing and geography, health care access, transportation, education, wealth, law, policy, and justice system involvement. Primary research, regardless of scope, should not be submitted to this section.

Reader Comments

Some Paediatrics Journals welcome reader comments on published articles. Some of the comment submission portals are user friendly requiring the author to submit a comment, by clicking on the Comments tab that appears with each article, then click onSubmit a Comment.

Comments submitted via e-mail or regular mail will not be considered for posting or returned.

The editors review all comments submitted online; comments are not peer-reviewed. The decision regarding whether to post a comment is at the sole discretion of the editors, and all editorial decisions are final.

The submitting author will receive an email if the comment is posted, which generally occurs within 3-5 days of submission.

No email notification will be sent if the comment is not posted.

Once a comment has been posted on the website, you will not have the right to have it removed or edited.

These Paediatric journals shall, however, be able to remove any comment at its discretion.

It is pertinent for paediatrics journal article authors to note that comments are online responses only.

They are neither published nor cited in Medline/PubMed.

Comments that raise issues addressed in prior comments are unlikely to be posted.

Be sure to follow all of the consideration criteria below; you will not be able to modify your comment after submission.

Consideration Criteria for Posting of Reader Comments:

To ensure timely discussion, comments are limited to articles published within the previous 6 months.

The editors will consider posting comments that contribute substantially to the discussion of the original article to which the reader is responding.

All editorial decisions are final.

Some contexual paediatric journals will consider posting comments from all readers regardless of professional background.

Decisions about posting are made based on the content, not the professional background of the respondent.

Pediatrics does not allow multiple comment submissions from the same reader for a particular article.

Comments must be in English and not exceed 500 words, not including references.

Comments must have no more than 3 authors.

Comments must have no more than 5 references.

Comments cannot include web links.

Some contexual paediatric journals will remove any web links from responses chosen for posting.;

Tables, figures, and other attachments are not allowed.

Some Paediatrics Journals will not post comments that are, or appear in the opinion of the editor to be, abusive,obscene, libelous, incomprehensible, defamatory, or rude; that include advertising, address personal health questions about the respondent or family members; or that give personal health information about identifiable individuals.

The decision regarding whether to post any comment is at the sole discretion of the editors; all editorial decisions are final.

In general, we do not edit reader comments prior to or after posting. The editors may, at their discretion, modify submitted comments either before or after posting the comment.

How to Submit Reader Comments for Consideration

1. Locate the article online using the Current Issue or e-Archives links.

2. To respond to the article, click theComments tab.

Some Paediatrics Journals may only allow one comment per author per article.

3. Click on the Submit a Comment bar.

4. Compose your comment and add your author information.

It is pertinent for authors to note that no HTML tags are allowed.

Lines and paragraphs are automatically recognized.

The line break, paragraph and close paragraph tags are inserted automatically.

If paragraphs are not recognized simply add a couple of blank lines.

5. Then Click Submit.

How to View Comments

1. To read comments on an article that have been posted, click on the Comments tab.

2. Recent comments also located on the home page in the Recent Comments box.

How to Cite a Comment

Paediatrics authors should do well to glean the information on how to site a comment from the guidelines for authors intending to submit their manuscripts to that contextual journal.

Errata

The corresponding author of an article can request a correction to a published manuscript. The editors will decide if an erratum is in order.

Cover Letter

The cover letter serves to assure the editors that the article and the authors meet the conditions of publication.

A brief paragraph that provides any additional information that may be useful to the editors is welcome, but keep in mind that the need for a long cover letter may indicate that the article does not speak for itself.

Reviewers will not see the cover letter; cover letters are not a Title Page.

All authors must affirm the following in their cover letter before their manuscript is considered:

That the manuscript is being submitted only tothis given contextual Paediatrics Journal , that it will not be submitted elsewhere, while under consideration, that it has not been published elsewhere, and, should it be published inthis given contextual Paediatrics Journals , that it will not be published elsewhere—either in similar form or verbatim—without permission of the editors.

These restrictions do not apply to abstracts or to press reports of presentations at scientific meetings.

That all authors are responsible for reported research.

That all authors have participated in the concept and design, analysis and interpretation of data, and drafting or revising of the manuscript, and that they have approved the manuscript as submitted.

If a manuscript uses the same or similar data contained in previously published articles, the authors must state this in the cover letter and provide citations to the related or possibly duplicative materials.

If the manuscript has been posted on a preprint server, the authors must state this in the cover letter and include a link to the preprint server posting..

Manuscripts should not be submitted to preprint servers while under consideration for publication.

Getting Started with Submitting Your Manuscript

Submission Guide.

The first screen you’ll see is the Submission Guide.

This page provides a description of each article type and guidance on what is required for each section of the submission system. Once you’ve reviewed this page, click Begin Submission at the bottom of the page.

Manuscript Basics.

Select your article type and enter the title, short title, and abstract. Review your article type earlier in the Submission Guide for further details on abstracts.

The Article Summary and the What’s Known/What’s Added summaries are required for Regular Articles only -if this does not apply, input NA to skip.

For published articles, the Article Summary will appear under the author names in the table of contents to give the reader a brief insight into what the article is about.

It should entice the reader to read the full article.

Summarize your article in 25 words or less.

Manuscript Files.

In this step, you will be prompted to upload your files.

The first screen you’ll see includes information on the file types supported for each upload type -manuscript file, image files -which include tables and figures, and supplemental data or additional files.

Click Save/Continue to submit your files.

If you chose double-blind peer review, you will see the link Upload your title page in the middle of the screen.

Click here to upload your Title Page -which should include your Contributors’ Statement Page and Acknowledgments.

Once you’ve uploaded your Title Page separately, you can then upload your manuscript and table/figure files.

The paediatric author’s main manuscript file should be submitted by dragging the file into the green box labeled Drop manuscript files here or by clicking the Select Files link in this box. Labels are preferred, but not required.

Please note that these labels are not a substitute for the required table/figure legends in your manuscript files.

Your table and figure files should be submitted by dragging them into the gray box labeled Drop image and table/figure files here or by clicking the Select Files link in this box.

Supplemental data files should be submitted by dragging them into the blue box labeled Drop supplemental files here or by clicking the Select Files link in this box.

Once you drag a file into this box, you will have the option of checking an Internal Usebox if the file provided is for editor use only and not to be shared with the peer reviewers.

Once you’ve dragged over or selected your files, click Upload Files to complete the upload. Once you are taken to the next screen, use the navigation links on the left-hand side to move to the next step.

Abstract, Cover Letter and Questions.

Enter your abstract and cover letter in the text boxes provided.

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Submission Requirements

To submit the supplement after conceptual approval, you must submit via the manuscript system.

Paediatric authors should note that the supplement files require special organization and file naming conventions as detailed in the supplement submission guide.

Once the supplement is received by the deputy editor, it is sent out in its entirety to reviewers.

If the supplement is provisionally accepted, revisions may be required. If revisions cannot be made to the satisfaction of the editors, the supplement may be rejected.

Most Journals may need up to three months from final acceptance to publication.

However, this timeline can vary depending on the number of other supplements already scheduled for publication.

Supplementary and raw data can be placed online separately from the text, and Some contexual paediatric journals may request that you separate out some material into supplementary data files to make the main manuscript clearer for readers.

It will be worthwhile for the contexual paediatric authors to keep the full contact co-ordinates, the names of responsible personnel, physical address, postal address, E-mail, Telephone, Fax, Social Media and other means of contacts of these key contexual journals administrative and governance staff.

Paediatrics Editorial Offices.

Office of the Editor-in-Chief.

Office of the Deputy Editor.

Publisher’s Office.

Senior Managing Editor.

Publications Editor.

Editorial Staff.

The Equator Network Enhancing the Quality and Transparency Of health Research provides a comprehensive list of reporting guidelines.

Although, publishing is a challenging but crucial endevour, however it is not impossible.

The success with improvements in the standard of paediatric journals depend on the scientific quality of the research studies reported in the journals , but also on knowing how to address details and formalities in the writing,structuring and presentation of the data to be published, that may seem negligible and of minor importance.

For Paediatric Journals to function most effectively and efficiently they will need to be adequately endowed.

Although this may be a daunting task, but overall it appears to be more sustainable if achieved and favours scientific credibility when compared with relying on Authors Article publication charges as the main source of revenue for the Paediatric Journals.

Question: What are your recommendations to improve syllabus of Paediatrics for more creativity, applications and opportunities?

Answer:

Thank you for asking me to proffer my recommendations to improve syllabus of Paediatrics for more creativity,applications and opportunities.

In this discursive activity, I will present this generic progressive curriculum which is recommended as a guide for use by doctors undertaking postgraduate paediatric training in settings where there are no regional Paediatric Post Graduate fellowship or board examinations and the putative trainees intends to be candidates for international paediatric collegiate or intercollegiate examinations.

Although, it is by no means exhaustive, it has been found useful by many successful candidates in the regional paediatric fellowship and board examinations programmes

It is pertinent that all postgraduate paediatric training curriculum an syllabi should be developed in consultation with trainees, consultants, children and adolescents, parents and carers, employers and other professionals, we redeveloped the curricula for General Paediatrics and the sub-specialties.

There appears to be a trend towards a framework that ensures that postgraduate paediatric trainees develop the full range of skills and knowledge they require in their day to day work and for progressing to a specialist consultant post rather than religiously following an algorithm of an itemizations of competences of competencies to be achieved by the Post graduate Paediatric trainee.

I will recommend the development and application of a progressive curriculum and azz

I will encourage the adaptation of a curriculum which ensures that doctors in postgraduate paediatric training develop their knowledge and skills across all key salient practice areas.

In this interview,I will address the pivotal aspects of a Paediatric curriculum and generic syllabi for each of the various training levels, as well as the assessment strategy, procedure for excellent clinical governance and syllabus modifications.

The Putative Generic learning outcomes for the whole training programme in Paediatrics will aim to cover the following thematic areas such as but not confined to:Professional ethic,values and behaviours,professional knowledge;Professional skills: communication and interpersonal skills withcollegues,hospital ,research institutional staff,child patients and their relatives, guardians and care givers.’Professional skills: generic procedures in paediatric practice.;Professional skills: patient management ;Health promotion and illness prevention;Governance,Collegialityand team working ;Patient safety including safe prescribing,safety disposal of sharps etc.;Quality improvement;Safeguarding ;Education and training;Paediatric Research;Paediatric Sub-specialties rotation;Paediatric Assessment strategy;in addition to Effective Clinical Governance in Paediatrics.etc.

A Progressive Paediatric Training programme will consist of several entities such as but not confined to :

Learning Outcomes- The learning outcomes capture the skills, knowledge and behaviours required, including the Generic Professional Capabilities for all doctors in training.

Syllabi - These provide further requirements and guidance on how to demonstrate satisfactory achievement of the learning outcomes. They are flexible, allowing trainees to apply the curriculum to the context in which they are working. The emphasis is on credibility quality rather than quantity of evidence.

Programme of Assessment - This specifies the range of assessment instruments to be used by trainees to develop and demonstrate their knowledge and skills throughout their period in training.

Generic learning outcomes -for first second and third years respectively

These are required for all trainees as they progress through three years of training towards the completion of their specialist training in paediatrics. These are nested to the Generic Professional Capability y and capability building within the curriculum and syllabi.

I will recommend the employment of an audio-visual devices in a trainee couselling, guidance and support sessions , we explain how to assess a particular trainees specific need, this may be quite assistive for the new trainees ,however it may be expedient to employ it throughout a particular trainees training period.to use it as you throughout your training.

I encourage the use of Audio-Videos devices to introduce the trainee to the curriculum, and demonstrate a typical, illustrative and instructive supervisor-trainee scenario.

Aims, objective and Outcomes of the Professional ethics values and behaviours and professional knowledge Training.

Paediatric Training Year One

During this year, in addition to the professional values and behaviours required of all doctors and Medical Professionalism Practice, a paediatric trainee maintains confidentiality but judges when disclosure may be required in relation to safeguarding, taking into account the differing legislation and health services between different circumstances and regions which applies to children and their families as a group.

Paediatric Training Year Two

In this stage, the Paediatric trainees should be able to acts as a role model who guides their junior colleagues in developing professional ethics, values, culture and behaviours in relation to paediatrics, through the creation of an open and supportive working environment.

Paediatric Training Year Three.

During this phase of their training, Paediatric trainees must learn to adhere to current statutory regulatory norms and legislation pertaining to children and their families such as but not confined to child labour, adoption, safeguarding, child abuse, investigation and appearance in court for child maltreatment and suspected non-accidental injuries etc.

In addition it is expected of the senior trainee to be able to adopt a self-regulatory approach to their own behaviour, comportment and mannerisms.

At this point, the senior trainee should be able to demonstrate the professional qualities required by a Paediatrician undertaking independent practice, across several circumstances, regions continentally and globally.

Aims, objective and Outcomes of the - Professional skills: communication Training.

Paediatric Training Year One

At this level of their training, paediatric trainees will be expected to develop effective relationships with children and their families in addition to their colleagues, demonstrating effective collegiality, listening skills, cultural awareness and sensitivity.

In addition to communicating effectively in the written form, by means of clear, legible, and accurate written and digital records

Paediatric Training Year Two.

At this juncture, the Paediatric trainees will be obliged to participate effectively in the engagement with patients and families/carers, facilitating shared decision making.

Also, they will be able to recognises complex discussions and when to seek assistance

Paediatric Training Year Three.

Senior Paediatric trainees at this level explores leadership roles and demonstrates effective communication skills in a range of environments and situations with children, young people and families in challenging and complex circumstances.

In addition, they will be expected to communicate effectively with external third party agencies, including authoring, editing and processing legal documents and child protection reports.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Clinical Procedures.

Paediatric Training Year One.

These Paediatric trainees will be dwelling on adapting clinical examinations to meet the needs of the child and their family or carers in addition to undertaking basic paediatric clinical procedures.

They should be able to recognise a paediatric emergency event, knowing when and how to scale up and monitor interventions appropriately.

More importantly, they should be able to initiate basic life support and able to carry out advanced life support with reasonable guidance.

Paediatric Training Year Two.

Trainees in their Paediatric Training Year Two Supervises and assesses paediatric junior staff when they are undertaking clinical procedures.

They should be able to respond to and manage paediatric emergencies, and be able to perform advanced life support.

Paediatric Training Year Three.

At this level paediatric trainees demonstrates competence in the full range of clinical skills relevant within paediatrics and either General Paediatrics or their chosen sub-specialty and areas of interest and desired expertise.

They will also be privileged to utilise the skills of other health professionals when imperative.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Clinical patient management.

Paediatric Training Year One.

The budding paediatric trainee in this context will be able to conduct a patient assessment and make pausible differential diagnostic considerations.

They should equally be able to plan appropriate investigations and initiates a treatment plan.

Paediatric Training Year Two.

At this intermediate point, the paediatric trainee undertakes refinementsof differential diagnostic considerations and rationalizes management plans in response to the Child’s needs and/orresponses to initial the initial therapeutic interventions.

Paediatric Training Year Three.

At this level the senior level trainee should be able to consider, the full range of therapeutic Intervenions and management options available, including new and innovative therapies, relevant within paediatrics and either general paediatrics or their chosen sub-specialty.

The trainee should at this juncture be able to anticipate and determine the need for transition from paediatric services and plans accordingly.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Health Promotion and Illness Prevention.

Paediatric Training Year One.

The contexual Paediatric trainee at this level of his training should be able to promote healthy behaviour, including giving advice, from early childhood years to adulthood.

Paediatric Training Year Two.

At this point the Paediatric trainee takes into account the potential impact of cultural, social, religious and economic factors on child and family health.

Paediatric Training Year Three.

The senior Paediatrician at this senior level should be able to demonstrate effective governance and leadership skills in the promotion of health and wellbeing practices in the wider community.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Effective Governance, Leadership and team working.

Paediatric Training Year One.

The Postgraduate Paediatric Trainees at this point will be able to recognise why governance, leadership and team workare crucial in the paediatric clinical environment. They should be able to work constructively within a team, valuing the contributions of the others.

They should be able to develop personal governance and leadership skills.

Paediatric Training Year Two.

Paediatric trainees at this intermediate level will be expected to be able to demonstrate an awareness of their own leadership qualities, adjusting their overall approach and strategy to improve and optimise outcomes.

They should be able to participate effectively and constructively in multidisciplinary and inter-disciplinary professional teams.

Paediatric Training Year Three.

Paediatric trainees at this senior level should be able to take up the challenge and responsibility of leading in multi-disciplinary team work in an encompassing and collegiate clinical setting. They should be able to promote a frank and probit culture of learning and accountability by challenging and influencing their colleague’s attitude, behaviour, countenance comportment and demeanour.

In addition they should be able to support the development of the team’s governance and leadership qualities and critical decision-making skills.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Effective - Patient safety including safe prescription proffering skills.

Paediatric Training Year One.

Paediatric Trainees at this year of their training should be to establish the importance and relevance of safe prescription proffering skills, and will be able to prescribe commonly-used pharmacotherapeutics agents in an apposite and professional manner.

They should be able to appreciate and recognises when a patient has been exposed to risk and scalesup his diagnostic and therapeutic interventions accordingly and escalates his closer monitoring and in accordance with the prevailing protocols and standard operating procedures.

Paediatric Training Year Two.

Paediatric post graduate trainees at this level will be able to apply appropriate procedures to direct and guide both their pharmacotherapeutic agent’s prescription skills and clinical care situations interventional aptitude and shall be able to manage risk effectively and optimally.

They should be able to demonstratesthe ability and flair needed to anticipateenvisage and mitigate against apparent or real safety threats and potential risks.

Paediatric Training Year Three.

Paediatric post graduate in this senior level year will be participating in the investigation, reporting, management and resolution ofrisks to patients, including the proffer of appropriate communication channels with their patients, families, relatives and care givers.

They should be able to evaluatesafety mechanisms across a wide range of healthcare settings, applying a mature, methodological and reflective approach to self and team performance and progress.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Effective - Quality Improvement .

Paediatric Training Year One.

Postgraduate paediatric trainees at the first year of their training will be able to apply quality improvement methodologies and techniques such as but not restricted to audit ,quality assurance and quality improvement projects under guidance.and supervision.

Paediatric Training Year Two.

At this intermediate level, the postgraduate trainees in their second year of the training should be able to independently apply knowledge of quality improvement processes to undertake projects and audits to improve clinical effectiveness, patient safety and patient experience.

Paediatric Training Year Three.

At this senior level, the paediatric trainees should be able to identify quality improvement needs and opportunities, supervise healthcare professionals in relation to improvement projects.

They should be able to govern, lead and facilitate reflective evaluation in relation to quality improvement interventions.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Effective - Safeguarding of Children and adolescents

Paediatric Training Year One.

The Paediatric trainees at the first year of their training will be promoting the professional responsibility of safeguarding children and adolescents, and they will also be able to document and record their observations accurately and raise an alarm or concerns in a subtle and professional manner to senior staff.

Paediatric Training Year Two.

Paediatric trainees at this intermediate level should be able to take responsibilities for raising concerns, getting advice and taking appropriate corrective, remedial and preventive actions, with direction, guidance and supervision.

Paediatric Training Year Three.

Paediatric trainee at their third year of post graduate training will be independently leading the full process of safeguarding the interventions and strategic management for children, including effective assessment ,documentation and reporting.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Effective - Education and training

Paediatric Training Year One.

Paediatric Post graduate trainees during the Paediatric Training Year One Period will be able to perform planned teaching, education and learning events under guidance.

Paediatric Training Year Two.

At this intermediate level the contexual Paediatric Postgraduate trainee should be able to Plan and deliver teaching and learning experiences to their co- trainees and other paediatric health and allied health professionals in addition to the provision of appropriate and constructive feedback.

Paediatric Training Year Three.

The paediatric training year three is a senior level, where it is expected that the trainees should be able to demonstrate the required knowledge, skills ,aptitudes and attitudes to provide appropriate teaching, learning opportunities, supervision, assessment and mentorship in a collegiate and challenging multidisciplinary and interdisciplinary paediatric healthcare setting.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Effective - Paediatric Research.

Paediatric Training Year One.

During their first year of Paediatric post graduate training, the trainees will be expected to adopt an evidence-based approach to paediatric health practice and the critical appraisal of relevant existing published scientific research.

Paediatric Training Year Two.

At their second year of training, paediatric trainees will be expected to implement an evidence-based approach to practice to inform decision-making and enhance patient care, interventions, holistic management and optimised overall patient outcomes.

Paediatric Training Year Three.

At this senior paediatric training year three, paediatric postgraduate trainees should be able to demonstrate the competence to undertake an independent development and revision of paediatric interventional guidelines and procedures focused on current ongoing clinical research and evidence-based healthcare to improve overall service delivery.

Aims, objective and Expected Outcomes of the - Professional skills: Training in Effective - Education and training in Paediatric Sub-specialties and Research Investigation demonstrated Through the Attainment of A Dedicated Subspecialty Fellowship Qualification Diploma and Academic Research Fellowship,PhD/DPhil OR Attestation of Academic Research Competenceand demonstration of comparability or equivalence. AT The Doctoral Level

In addition to the generic learning outcomes, all third year paediatric trainees must fulfil the requirements of the paediatric third year Learning Outcomes for generic Paediatrics or their chosen sub-specialty in addition to the attainment of A Dedicated Subspecialty Fellowship Qualification Diploma and Academic Research Fellowship,PhD/DPhil , OR demonstration of equivalence by an Attestation of Academic Research Competence AT The Doctoral Level .

These paediatric subspecialty fellowship trainings and academic research fellowship training and Doctoral level training will see their training periods transiting from the third year into the fourth year ,Fifth year and probably especially with career breaks into the sixth and seventh year or probably more.

Assessment strategy

My recommended assessment strategy will comprise of the rationale, content and style of, that proposed by dedicated international paediatric associations, but this could be modifiable on the basis of the region.The recommended programme of Assessment, will reflect the evolution and positive progress, rather than a revolution, of previous strategies, so, it reinforces the assessment practices that have anecdotaly and experientially worked effectively and ensuresthat these could continue to be deployed appropriately to support the current curriculum and syllabi.

While I will not recommend an assessments guide ,approach,application ,theme,strategy and style that will be much more divergent from the previously recognised international standards,however I will recommend an appraisal and modifications in a non-obtrusive way in their directions and interest, to be consistent and represent the current globally recognised and acceptable curriculum aims,objectives and essence. With trainees now focused on achievement of higher level, holistic learning outcomes, all assessments will demonstrate and/or develop attitude,aptitude,capacity,capability and flair in one of more learning outcomes.

Credible Academic Clinical Governance.

This recommended developmental curriculum and syllabi will serve as guide for paediatric specialty and subspecialty training in regions where there are no prevailing one or where there is need is undergoing modifications or for other reasons there are need to complement and supplement the existing curriculum or syllabi,in addition it may be found useful by those trainees who wish to complement their regional trainings with the other internationally recognised trainings in paediatric specialty and subspecialty trainings ,it will be amenable to modifications and revision following credible and constructive intramural and extramural critique it will be amenable to internationally approval and regulation by international paediatric paediatric associations and societies ,in addition to other relevant regulatory stakeholders.

It could support a curriculum and syllabi for generic paediatrics at up to the third year of paediatric training and for all the very relevant sub-specialties and generic Paediatrics at the third level and beyond in addition to the Pivotal academic research fellowships and doctoral level trainings in the following paediatric subspecialties including but not confined to:

Community child health - sub-specialty

Child mental health - sub-specialty

Neonatal medicine - sub-specialty

Paediatric allergy, immunology and infectious diseases - sub-specialty

Paediatric clinical pharmacology - sub-specialty

Paediatric diabetes and endocrinology - sub-specialty

Paediatric emergency medicine - sub-specialty

Paediatric gastroenterology, hepatology and nutrition - sub-specialty

Paediatric inherited metabolic medicine - sub-specialty

Paediatric intensive care medicine - sub-specialty

Paediatric nephrology - sub-specialty

Paediatric Neurodisability - sub-specialty

Paediatric neurology - sub-specialty

Paediatric oncology - sub-specialty

Paediatric palliative medicine - sub-specialty

Paediatric respiratory medicine - sub-specialty

Paediatric rheumatology - sub-specialty

In the context of education and training, the Paediatric post graduate curriculum and syllabus for paediatric subspecialities should have the following aims:

To Harmonise training programmes across various circumstances, regions, internationaly and globally.

Establish defined standards of knowledge and skills required to practice paediatric subspecialty at the tertiary care level.

To Foster development of an international and global network of competent specialist centres to facilitate collaborative research and training opportunities.

To improve the clinical care of children with acute and chronic paediatric pathologies that cuts across all the relevant pivotal paediatric subspecialties, regionally internationally and globally.

To enhance the paediatric trainees contribution to international scientific progress in the field of paediatric subspecialty.

To promote teaching of paediatric subspecialties at the undergraduate and postgraduate levels to raise awareness about the importance of early diagnosis, prompt referral to specialist care and facilitate potential recruits to fellowship programmes and the future workforce.

Thank You

Question: What is Paediatrics? What are the major branches in Paediatrics?

Answer:

Paediatrics is the branch of medicine that involves the medical care of infants, children, and adolescents.

The accepted upper age limit varies between 18 to 21 on the basis of the contexual region.

Contexually, children were occasionally defined as individuals under nineteen years of age who are not yet engaged in postsecondary tertiary education.

Globally, on the basis of interesting research discoveries, with ongoing research there appears to be an upward trend in the upper age limits of accepting children to be with the age range for paediatrics.

A medical doctor who specializes in paediatrics is known as a paediatrician.

History of Paediatrics

Ethymology.

The word paediatrics and its collates refers to the curer and healer of children ethmyologically, these two words were derived from two Greek words: παῖς (pais -child) and ἰατρός (iatros -doctor,or healer).

Histriographically for a long time, dating back to ancient Greek times, doctors have always provided medical care to people of all ages, including children.

Despite this, however, paediatrics is a relatively new field of medicine.

Early History

It is well known , that from the ancient time, traditional medical doctors cared for patients of any age, including both the young and the old, with little specialization.

Some salient points of histriographic importance throughout early history in relation to paediatrics are outlined in the timeline below.

1552 BC-:-The Ebers Papyrus discussed many topics including breastfeeding, therapy forhelminthes and treatment of ocular diseases etc.

400 BC-:-Hippocrates wrote about several issues relating to pediatric health including asthma, cephalhematoma, clubfoot, congenital dislocation of the hip,diarrhea, hydrocephalus, mumps, scrofula and worms.etc.

100 AD-:-Soranus of Ephesus noted the fingernail test as a means to check the fat content and quality of breast milk.

200 AD-:-Galen described cases of children with ear discharge, pneumonia and intestinal prolapse.etc.

990 AD-:- Avicenna wrote about health conditions such as convulsions, meningitis, tetanus, umbilical abscess and worms.

Middle Ages

The first paediatric hospital in the Western world is generally accepted to be the Hôpital des Enfants Malades, which translates to: the Hospital for Sick Children in English, which was opened in 1802 in Paris, France. The hospital was dedicated and famous for the care of patients only up to 15 yearsofage.

The beginning of the paediatric care centers in France then encouraged and fostered the spread to other countries throughout Europe. Soon afterwards, other pediatric hospitals were opened in Germany, Russia, Austria, Poland and England in the 19th century. The first hospital dedicated specially for childrenin the United States was opened in Philadelphia in 1855.

The Enfants-Trouvés, which translated to a Hospice for Found-Children in English, was founded in the 1600s in Paris, France. This was the first of a gradual transformation to make distinct institutions intended for the care of children with illnesses, earnest attempts were made to separate these child focused health care units from those intended for adults in the hospitals.

George Frederic Still was an instrumental physician from England who devoted his work to pediatrics as a specialty.

He wrote the textbook entitled Common Disorders and Diseases of Children, which went on to guide the practice of many successive physicians who specialized in pediatrics.

Dr. Abraham Jacobi is considered to be the father of pediatrics in America. He was a German pediatrician who came to New York in 1853 and formed several societies devoted to paediatricsand child health, as well as some children’s departments in the hospitals of New York.

History of Paediatrics- The Modern Era

The field of paediatrics as we know it today in the United States originates from the American Pediatric Society and American Academy of Paediatrics, which began in the 1930s.

Although earlier research and recordings included information about children, pediatrics as a separate specialty was distinguished later.

Today, paediatrics as a specialty is certified and regulated by the American Paediatric Society and American Academy of Paediatrics in the United States, and similar bodies in other countries around the world.

Paediatricians can now also train, study and practice a subspecialty of paediatrics, which focuses on specific types of tissues,organs,systems, and their associated ailments and health conditions in children.

This progression began in the 20th century and more and more subspecialties continue to be created as the interest and need in certain areas arises.

Already Hippocrates, Aristotle, Celsus, Soranus, and Galen understood the differences in growing and maturing organisms that necessitated different treatment: Ex toto non sic pueri ut viri curari debent -In general, boys should not be treated in the same way as men.

Some of the oldest traces of paediatrics can be discovered in Ancient India where children's doctors were called kumara bhrtya.

Sushruta Samhita an ayurvedic text, composed during the sixth century BC contains the text on paediatrics.

Another ayurvedic text from this period is Kashyapa Samhita.

A second century AD manuscript by the Greek physician and gynecologist Soranus of Ephesus dealt with neonatal paediatrics.

Byzantine physicians Oribasius, Aëtius of Amida, Alexander Trallianus, and Paulus Aegineta contributed to the field of ancient paediatrics and childhealth.

The Byzantines also built brephotrophia an analogue of the-modern crêches.

Islamic Golden Age writers served as a bridge for Greco-Roman and Byzantine medicine and added ideas of their own, especially Haly Abbas, Yahya Serapion, Abulcasis, Avicenna, and Averroes.

The Persian philosopher and physician al-Razi (865–925) published a monograph on paediatrics entitled Diseases in Children as well as the first definite description of smallpox as a clinical entity.

Also among the first books on paediatrics was Libellus [Opusculum] de aegritudinibus et remediis infantium 1472 -Little Book on Children Diseases and Treatment, by the Italian paediatrician Paolo Bagellardo.

In sequence came Bartholomäus Metlinger's Ein Regiment der Jungerkinder 1473, Cornelius Roelans (1450–1525) no title Buchlein, or Latin compendium, 1483, and Heinrich von Louffenburg (1391–1460) Versehung des Leibs written in 1429 (published 1491), theses together form the Paediatric Incunabula, four great medical treatises on children's physiology and pathology.

The Swedish physician Nils Rosén von Rosenstein (1706–1773) is considered to be the founder of modern pediatrics as a medical specialty, while his work The diseases of children, and their remedies in 1764is considered to be the first modern textbook on the subject.

Paediatrics as a specialized field of medicine continued to develop in the mid-19th century; German physician Abraham Jacobi (1830–1919) is known as the father of American paediatrics because of his many contributions to the field. He received his medical training in Germany and later practiced in New York City.

The first generally accepted paediatric hospital is the Hôpital des Enfants Malades -French Translation: Hospital for Sick Children-, which opened in Paris in June 1802 on the site of a previous orphanage.

From its beginning, this famous hospital accepted patients up to the age of fifteen years, and it continues to this day as the paediatric division of the Necker-Enfants Malades Hospital, created in 1920 by merging with its physically contiguous Necker Hospital, founded in 1778.

In other European countries, the Charité -a hospital founded in 1710- in Berlin-Germany established a separate Paediatric Pavilion in 1830, followed by similar institutions at Saint Petersburg-Russia in 1834, and at Vienna-Austria and Breslau -now Wroclaw-Poland, both in 1837. In 1852 Britain's first paediatric hospital, the Hospital for Sick Children, Great Ormond Street was founded by Charles West.

The first Children's hospital in Scotland opened in 1860 in Edinburgh. In the US, the first similar institutions were the Children's Hospital of Philadelphia, which opened in 1855, and then Boston-Massachusetts Children’s Hospital in -1869.

Subspecialties in pediatrics were created at the Harriet Lane Home at Johns Hopkins University Hospital Maryland by Edwards A. Park.

Other relevant Histriographic Aspects of The Origins of Paediatrics as a Specialty.

Sir James Spence is considered the pioneer of British Paediatrics ,Spence was born in 1892 at a time when paediatrics as a specialty had yet to be born. Undistinguished as an undergraduate, he went on to be one of the leaders of the emerging paediatric discipline and was one of the inspirations behind the formation of the B.P.A, the forerunner of the RCPCH. He is best known for his innovative approaches to them care of children in hospital and in particular that mothers could be an asset when their babies were admitted and should be allowed to room in. One of his great strengths was that there could be no progress without scientific study, the topic of a lecture given in 1953 -The methodology of clinical science. Prior to World War II he was commissioned by the City of Newcastle to undertake a study to determine why the infant mortality rate was so high. This eventually led to the Thousand Families one of the first longitudinal cohort studies with its participants having recently been followed up at the age of 50 years. He was deeply affected by his participation in the First WorldWar,but he never gave up.,where he distinguished himself and was awarded the MC and bar. After the war many prospective paediatricians from not only the UK but elsewhere were to be found working with him in Newcastle up on Tyne. He travelled widely during his paediatric lecture tours and was instrumental in establishing the Australian College of Paediatrics. He died prematurely in 1954 but his important work, and disciples, lived on to greatly influence paediatrics over the next generation. He was a scientist ,educationists and philosopher but above all he was a very inspirational teacher and pprofessor. He was accepted by his contemporaries as a wise moderator and counsellor, moderate in the presentation of his views but nevertheless a practical minded visionary. His whimsical charm and humour made him a most attractive personality.

Histriographic Aspects of Paediatric Nutrition.

BREAST IS BEST? INFANT FEEDING IN THE FOUNDLING HOSPITALS OF LONDON AND FLORENCE IN THE 1740s

In the 18th century, the merits of the mother’s milk were not clearly understood, and many women sent their children away to be nursed.

Infants abandoned to the London Foundling Hospital or the Spedale degl’Innocenti in Florence, faced a yet more ambiguous situation: was it better to send them to be breast fed by a paid nurse who might neglect them, or convey undesirable characteristics to the child though her milk; or to use artificial feeding methods? The director of

the Innocenti in 1742, faced with high mortality rates among foundlings, turned to an eminent Florentine doctor, Antonio Cocchi, to ask his opinion on the effects of dry nursing on infants. The answer was almost entirely in favour of the practice, in sharp contrast to the policy adopted by the contemporary governors of the London Foundling

Hospital. There, dry nursing had been found to raise the risk of death for infants, and as was stated in a letter on the subject to the Innocenti, wet nursing had been almost universally adopted as an accepted standard practice. There were many considerations for the reasons for these different views on infant feeding in several contemporaneous institutions for abandoned children. Although initially it was unclear how artificial feeding was actually adopted at the Innocenti, and the consequences of artificial feeding for infant survival in these settings,This innovative initiative is the very origin of the Baby Friendly Hospital Initiative of Innocenti which has been eagerly accepted and embraced and is still very widely applied and practiced globally in most paediatric units and hospitals till this date.It has equally been extended in the Neonatal Intensive care unirs for preterm and term babies.

Some Histriographic Aspects Of Paediatric Orthopaedica anf Rheumatology.

THE HISTORY OF DIAGNOSTIC SCREENING FOR

CONGENITAL DISLOCATION OF THE HIPS (CDH)

Hippocrates was the first acknowledged scientist to describe CDH. Two thousand years later, Ambroise Paré (1575) added to the knowledge of Hippocrates. But it was Guillaume Dupruytren (1847) who provided the first classic description of the condition, its aetiology and presentation. In 1879 Wilhelm Rosser described neonatal hip instability and suggested the need for early detection and treatment. Pierre Le Damany, a surgeon in Brittany, was the first clinically to screen a cohort of newborn infants (1912). In 1933 Vittorio Putti proposed that all newborn infants should be screened radiologically for CDH at birth using the technique of Hilgenreiner of 1925. Marino Ortolani, a paediatrician in Ferrara, described his clinical test for CDH in 1948. This manoeuvre was improved by the addition of the provocation test of Kurt Palmén of 1953 and Thomas Barlow of 1962.

Ultrasound examination of the neonatal hip, pioneered by R. Graf in 1984, has been used as a screening tool for high-risk infants.Currently the outcome of clinical screening in globally varies from poor to excellent depending on the organisation and efficiency of the local programme.

Why is there the need to make a distinction between the adult and paediatric medicine?

This is because there are differences in the biophysical, biochemical and physiological aspects of children and adults besides the differences in their sizes.

So the practice of Paediatrics is not adult medicine cut to size,for a common example there are several pharmacotherapeutic medications that are commonly prescribed for adults without any considerable adverse or side effect that should not be mentioned in a Paediatric clinic or ward.

More importantly is that amongst children as a group there are equally considerable divergence between the various age subsets from birth to adolescence.

The body size differences are paralleled by maturation changes. The smaller body of an infant or neonate is substantially different physiologically from that of an adult. Congenital defects, genetic variance, and developmental issues are of greater concern to pediatricians than they often are to adult physicians. A common adage is that children are not simply little adults. The clinician must take into account the immature physiology of the infant or child when considering symptoms, prescribing medications, and diagnosing illnesses.

Paediatric physiology directly impacts on the pharmacokinetic properties of drugs that enter the body. The absorption, distribution, metabolism, and elimination of medications differ between developing children and grown adults. Despite completed studies and reviews, continual research is needed to better understand how these factors should affect the decisions of healthcare providers when prescribing and administering medications to the paediatric population.

Absorption

Distribution

Metabolism

Elimination

Educational Requirements.

Globally on the average, aspiring medical students will need four years of undergraduate courses at a college or university, which will get them a BS, BA or other bachelor's degree. After completing college, future pediatricians will need to attend four years of medical school (MD/DO/MBBS) and later do three more years of residency training, the first year of which is called internship. After completing the three years of residency, physicians are eligible to become certified in pediatrics by passing a rigorous test that deals with medical conditions related to young children.

In high school, future pediatricians are required to take basic science classes such as biology, chemistry, physics, algebra, geometry, and calculus. It is also advisable to learn a foreign language and be involved in high school organizations and extracurricular activities. After high school, college students simply need to fulfill the basic science course requirements that most medical schools recommend .Once attending medical school, student courses will focus on basic medical sciences like human anatomy, physiology, chemistry, etc., for the first three years, the second year of which is when medical students start to get hands-on experience with actual patients.

The training of paediatricians varies considerably across the world. Depending on jurisdiction and university, a medical degree course may be either undergraduate-entry or graduate-entry. The former commonly takes five or six years and has been usual in the Commonwealth. Entrants to graduate-entry courses (as in the Americas), usually lasting four or five years, have previously completed a three- or four-year university degree, commonly but by no means always in sciences. Medical graduates hold a degree specific to the country and university in and from which they graduated. This degree qualifies that medical practitioner to become licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for internship or conditional registration.

Paediatricians must undertake further training in their chosen field. This may take from four to eleven or more years depending on jurisdiction and the degree of specialization.

A medical school graduate wishing to specialize in pediatrics must undergo a three-year residency composed of outpatient, inpatient, and critical care rotations. Subspecialties within pediatrics require further training in the form of 3-year fellowships. Subspecialties include critical care, gastroenterology, neurology, infectious disease, hematology/oncology, rheumatology, pulmonology, child abuse, emergency medicine, endocrinology, neonatology, and others.

In most jurisdictions, entry-level degrees are common to all branches of the medical profession, but in some jurisdictions, specialization in pediatrics may begin before completion of this degree. In some jurisdictions, pediatric training is begun immediately following the completion of entry-level training. In other jurisdictions, junior medical doctors must undertake generalist training for anumber of years before commencing pediatric (or any other) specialization. Specialist training is often largely under the control of 'pediatric organizations (see below) rather than universities and depends on the jurisdiction.

The medical branch of paediatrics has emerged into different branches like paediatric oncology, paediatric immunology, paediatric cardiology, paediatric critical care, paediatric dermatology, etc.

Paediatrics could be considered a medical branch for Future Generation.

Paediatrics is a branch of medicine that deals with the medical care of infants, children, and adolescents. The medical branch of paediatrics has emerged into different brancheslike pediatric oncology, pediatric immunology, pediatric cardiology, pediatric critical care, pediatric dermatology, etc.

Paediatrics is playing major role by saving lives of many children who will play major role in the future world. It has become the cornerstone of all the paediatric branches by working towards health care of children and can be regarded as a medical branch for future generation.

Paediatrics is a branch of medicine that deals with the medical care of infants, children, and adolescents. The medical branch of paediatrics has emerged into different branches like paediatric oncology, pediatric immunology, paediatric cardiology, paediatric critical care, etc.

In this discussion, I will itemise, highlight and annotate on some of these paediatric subspecialties.

Paediatric Oncology

Pediatric Oncology is a branch of pediatrics which deals with all cancers and oncological conditions in infants and children.

Paediatric Nephrology

Pediatric Nephrology is a branch of pediatrics which deals with all the kidney pathologies and nephrological conditions of infants and children.

Paediatric Immunology

Pediatric immunology is a branch of paediatrics which deals with all the immunological conditions and pathologies of infants and children.

Paediatric Cardiology

Paediatric cardiology is a branch of pediatrics which deals with heart and heart related disorders of infants. Ventricular Septal Defect is the most common congenital abnormality of the heart.

Paediatrics Therapeutics

Paediatric Critical Care

Pediatric critical care and Intensive is the branch of paediatrics which deals with care of critically and very sick infants and children. Qualitative approaches have rarely been made to synthesize and describe the causes of neonatal deaths in the hospitals following the referral and interventions of these sick neonates and infants . Acute lower respiratory tract infections and over whelming bacterial infections remains one of the most common causes of neonatal, infantile and childhood deaths globally, but especially in developing countries. Children in this situation are provided assistance and support through mechanical ventilatory support and in some cases noninvasive ventilation at the first instance during their admissions and interventions in the neonatal and paediatric intensive care units.

An Itemised and annotated list of Paediatric Subspecialties :This is however a non exhaustive list

Subspecialties of pediatrics include but not confined to:

Paediatric Addiction medicine (multidisciplinary)

Paediatric Adolescent medicine

Child abuse pediatrics

Paediatric Clinical informatics

Developmental-behavioral pediatrics

Paediatric Genetics and Metabolism

Paediatric Headache medicine

Paediatric Hospital medicine

Paediatric Medical toxicology

Neonatology/Perinatology

Paediatric Pain medicine which is a multidisciplinary paediatric subspecialty.

Palliative care which is a multidisciplinary paediatric subspecialty.

Paediatric allergy and immunology

Paediatric cardiology

Paediatric Pulmonology.

Paediatric Infectious Diseases

Paediatric Psychiatry.

Paediatric Intensive Care

Paediatric Dentistry.

Child Public Health

Paediatric Sociology.

Paediatric cardiac critical care

Paediatric critical care

Paediatric Neurocritical care

Paediatric cardiac critical care

Paediatric emergency medicine

Paediatric endocrinology

Paediatric gastroenterology

Paediatric Transplant Hepatology

Paediatric hematology

Paediatric infectious disease

Paediatric nephrology

Paediatric oncology

Paediatric neuro-oncology

Paediatric Pulmonology

Paediatric Primary care

Paediatric Rheumatology.

Paediatric Sleep medicine which is a multidisciplinary paediatric specialty.

Social Paediatrics.

Paediatric Sports medicine.

Other specialties that care for children incude but not confined to.

Paediatric Child Neurology.

Paediatric Addiction medicine which is a multidisciplinary specialty.

Paediatric Brain injury medicine.

Paediatric Clinical neurophysiology.

Paediatric Epileptelogy.

Paediatric Headache medicine.

Paediatric Neurocritical care.

Paediatric Neuroimmunology.

Paediatric Neuromuscular medicine.

Paediatric Neuropsychiatry.

PaediatricPain medicine which is a multidisciplinary paediatric specialty.

PaediatricPalliative care which is a multidisciplinary paediatric specialty.Paediatric neuro-oncology.

Paediatric Sleep medicine which is a multidisciplinary paediatric subspecialty.

Paediatric Child and adolescent psychiatry, subspecialty of psychiatry

PaediatricNeurodevelopmental disabilities.

Paediatric Anesthesiology, subspecialty of anesthesiology

Paediatric Dentistry,also subspecialty of dentistry

Paediatric Dermatology, also subspecialty of dermatology

Paediatric Gynaecology

Paediatric neurosurgery, subspecialty of neurosurgery

Paediatric ophthalmology, subspecialty of ophthalmology

Paediatric orthopedic surgery, subspecialty of orthopedic surgery

Paediatric otolaryngology, subspecialty of otolaryngology

Paediatric plastic surgery, subspecialty of plastic surgery

Paediatric radiology, subspecialty of radiology

Paediatric rehabilitation medicine, subspecialty of physical medicine and rehabilitation

Paediatric surgery, subspecialty of general surgery

Paediatric urology, subspecialty of urology

Conclusion

Thus, although child well-being may have been increasing as a national priority, the policy terrain may be shifting.

Paediatrics and its related sub-specialties has been playing major roles by saving lives of many children who will play major role in the future world thus Paediatrics is serving as one of the leading branches of biology. It has become the cornerstone of all the above discussed paediatric branches by working towards health care of children and can be regarded as a medical branch for future generation.

Question: What are your recommendations to frame guidelines on funding of research projects on Paediatrics?

Answer:

Paediatric research as studies in all categories of biomedical research (basic, clinical, epidemiologic, behavioral, prevention, treatment, and diagnosis, as well as outcomes and health services) that relate to diseases, conditions, or the health/development of neonates, infants, children, and adolescents up to age 18.

The term perinatal refers to the time period just before and after delivery.

The term neonatal period implies within the first twenty eight days of life.

Paediatric research funding refers to the total expenditures used to conduct or support pediatric research, both clinical and basic.

The uncertain fate of the paediatric research funding and portfolio especially in the developing and emerging countries.

Although the amount of funds allocated to improving the health of our paediatric population can serve as an indicator of the priority placed on child well-being.

Admittedly, although several multilateral, bilateral, intergovernmental and voluntary non-governmental organisations in addition to private philanthropic organisations has established novel mechanisms that marginally increase pediatric research funding, the pediatric research portfolio is facing an increasingly uncertain fate globally but more so in the emerging regions.

Several anecdotal and evidence based reports examined pediatric, perinatal and pediatric research networks analysed data collected by the application of novel research, condition and disease categorization system in addition to several policy research on impact highlighted recent ,ongoing and futuristic policy developments in pediatric biomedical research and offers recommendations to insulate the future of Paediatric research funding from future uncertainty.

Several aggregated data produced on this theme suggests that globally support for pediatric research has declined on average annual rates terms compared to development price index growth for both Paediatric experimental biological human biomedical and clinical researches respectively.

Apparently, support for pediatric biomedical research has plateaued in nominal terms but has actually declined significantly in real terms. It is therefore imperative that future multimodal and multifaceted corrected remedial congressional actions will be necessary to protect gains and to expand the capacity of the paediatric research funding and portfolio.

Consistent with previous investigative research efforts, the overall purpose, of my recommendation is not to adduce a comparative analysis of diseases that affect children versus those that impact adults. Rather, I presumed that it is scientifically more credible to assess the paediatric research portfolio over time in relation to the overall contexual sectoral budgets. Given that resolving diseases that emanates at the beginning of life itself has a more enhanced cost –benefit ratio with regards to both improved health and economic productivity to the subjects later on in life, nationally, regionally, continentally and globally especially in the emerging and developing countries children, since a healthy child will grow up to become a healthy adult,I proposed that a promotion of Paediatric research is of critical importance.

Reconciling Public Policy and Paediatric Research

A recommended approach to address the recognized the lack of resources devoted to pediatric research is to propose the request that performance indicators be developed so that various relevant research funding agencies and institutions could report on specifically identified progress and milestones achieved toward strengthening the pediatric research funding portfolio employing an approach that compiles with several diverse research funding agencies reporting requirements extensive discussion of the specific performance indicators to be used. Funding is usually tracked for specific diseases such as childhood diarrhoeal diseases, cancers, infections, asthma ,rickets atopies sickle cell haemoglobinopathies etc., for various conditions such as growth failure, chromosomal aneuploidies etc. and specific areas of research for example ,nutrition,, substance abuse, etc.. in this`way indicated a commitment to effectively measure the funding agencies progress toward a strengthened pediatric research funding portfolio could be indicated, assessed and followed .

In a similarly related endevour,I would equally propose the encouragement of Intersectoral collaborative efforts to be used to mitigate the underinvestment in paediatric research.

In this way, the expansion of pediatric research activities at various paediatric health services delivery levels from the primary, through the secondary to the tertiary and the quaternary levels, several other mechanisms, promoting including the Pediatric scientific Research innovations such as the promulgation and adoption of child health research bills and legislation should be positive paediatric research developmental steps in a right direction.

Research investigations with a comprehensive, and encompassing ontogenic , developmental approach to tracing the influences of genetic and other biological, adaptive, social, environmental, nutritional and behavioral factors on human development, health, and disease from conception onward will be scientifically plausible. .

I will always recommend and propose projects that will expand various aspects of the pediatric research funding portfolio, including research funding, Intersectoral health institutional collaborations across the several Paediatric research networks,institions societies a and research grant and loan repayment programs, as well as to accelerate clinical trials.

Other corrective remedial measures that I might recommend and advice paediatric research units to undertake while addressing the challenges to expand pediatric research portfolio is to achieve this milestone while maintaining constant spending levels, clearly a difficult to impossible task in the absence of some degree research investigational voluntarism.

Whether research funds were presumed to be adequate or restricted I will always recommend that paediatric research units must strive earnestly and work very hard to work to work collectively as a team and maintain accountability and transparency ,this becomes most research funding agencies must wish to be brought closer to the activties of the research project by an invitation to examine and be acquainted with the financial and technical activties of the research institutions,this is where the audited annual financial and technical research reports comes in, by detailing the status of the pediatric research funding budget revenue and spending portfolio.

Other considerations ,will include the recommendation and encouragement of the need that during Paediatric training programmes and specific paediatric research programmes that doctors,pharmacists ,laboratory staff,nurses and other allied health workers should be trained in Good Clinical Practice,good laboratory practice,good research practices and good statistical practices ,in addition there should be a dedicated paediatric research financial management team appointed by the paediatric research sponsors that should be responsible for the oversight of any newly appropriated paediatric research funds and regularly report to the sponsors and the relevant research projects stakeholders on the extent of the total funds obligated to conduct or support pediatric research across the contexual paediatric research setting , including the specific support and research awards allocated .in addition to the specific budget allocations and appropriations that been made.

Other Paediatric Research funding initiatives worthy of recommendations aims to improve access to clinical trials for under-represented children

A good paediatric research funding programme will aim to provide the necessary resources to conduct pediatric clinical trials for children with a variety of conditions.

Additional reforms with positive implications for pediatric research will be besides the direct provision of research institutions with greater financial resources, will be to offer them reduced administrative burdens, free or significantly subsided internet and information access and increased access to credible and robust scientific data.

Policies that require that people across the lifespan, including children and older adults, be included in clinical research studies unless a scientific or ethical justification can be provided should equally be encouraged since most international research grants propose that most studies involving human subjects must have a plan describing how participants across the lifespan will be included and justify the proposed age range of participants. Furthermore, grant progress reports will be required to include demographic data that would include age and sex.

Resource Allocation and Paediatric Research

It is worthwhile to recommend that policies that has a transient and tentative boost which expands research capacity, but will not provide sustainable long-term resources should be discouraged, since this will add considerable uncertainty to future research with potentially serious negative impacts on long-term research programs and individual careers of paediatric researchers.

Nevertheless, given the current policy landscape, the future of financial support for biomedical and clinical paediatric research remains a cause for concern.

Assessing the paediatric health research budget : methods and data

The sectoral units, multilaterals, bilaterals and other philanthropic have an obligation to allocate resources commensurate with child public health needs. However, estimating these needs is challenging, as several valid measures of disease burden exist such as point prevalence and incidence etc). Thus these research funding agencies and sponsors NIH considers multiple data types and sources, and each disease or condition is considered on a case-by-case basis.

Several Pediatric research funding agencies have various methods by which it estimates pediatric research funding through systems that utilizes a text data mining program, together with widely accepted definitions to match projects to disease categories. This improves consistency and eliminates variability in category reporting.

A developmental approach to Paediatric Research funding involving significant expansions which includes expanding the existing paediatric research innovations and initiative resources beyond initial commitments and restricted zones should be encouraged when appropriate, these may include strategies such as expanding an existing initiative by adding a paediatric research grant or site, expanding or adding a pediatric population to a current ongoing paediatric research study, establishing an extramural inter-institutional collaboration to enhance pediatric research, capability and capacity , or expanding the pay dates of pediatric research career development grants or loans.

Capturing and reporting new and expanded investigator-initiated pediatric research projects should be encouraged.

There is an interesting inverse trend between the age of the paediatric patient and the capacity of funding available in that paediatric research funding appears to favour the older children more that the ,infants and neonates and indeed perinatal and neonatal research appears appears to be refers to the time period just before and after delivery.

Ideally, paediatric research funding levels should be commensurate with disease burden especially those of public health importance, otherwise investigators’ capacity to conduct research will be significantly diminished.

Although fairly recently research sponsors has focused new attention on the pediatric research portfolio, the increase in spending has been a tip on the ice berg. As the current paediatric research budgetary environment remains elusive and uncertain, the paediatric funding portfolios will become increasingly vulnerable especially in the emerging regions.

Also paediatric researchers and disease advocates need to develop and communicate novel evidence and arguments regarding the benefits of pediatric biomedical research, both in terms of enhanced individual health outcomes for children especially in terms of economic and societal benefits.

Paediatric research funding should be encouraged despite all odds since Indeed, research conducted across several settings reveals a considerable body of evidence showing the benefits to child health. Perhaps even more persuasively, it has been shown that these benefits continue throughout the lifespan of a child.

Moreover, it is circumstantially and scientifically worthwhile that an increased proportion of pediatric research support should be directed toward investigations conducted alongside obstetricians and maternal–fetal medicine specialists. This perinatal approach recognizes that a healthy mother is much more likely to produce a healthy infant, child, adolescent, and, ultimately, adult. As we plan for the future, it is imperative that policymakers support and research study sponsors prioritize investment in lines of inquiry that elucidate the mechanisms of developmental processes, which direct the emergence and progression of disorders both early in life and through adulthood.

In order to improve the capacity of Paediatric research fundings, I will encourage research investigators to always be on the lookout for organisations , soliciting grant applications from institutions/organizations for the creation of Pediatric Research ventures either as individual research entities or Research Consortium to conduct comprehensive translational/basic and clinical research in pediatric specialties with the goal to conduct research that will fill gaps in knowledge that may be responsible for failed efficacy trials or that may prevent regulatory sanctions on drugs in paediatrics. In addition, the Consortium will be expected to adopt a new paradigm of promoting personalized pediatric research and promote a greater understanding of the interrelationship among disease processes, and therapy across the developmental spectrum. Testing of new molecular entities, pediatric formulations, novel therapeutic approaches, new types of delivery systems and development and testing of biomarkers will be priorities for these consortiums of credible scientific characters.

Ideally, each Paediatric research grant application will have an experimental, translational, diagnostic, therapeutic, prophylactic, pharmacometric and a clinical research component and entity in addition to an administrative and research policy unit. It is a provident scientific research practice to ensure that individual research Centers must involve collaborating investigators at two or more different institutions. The Consortium will also be a locus of training future academic and scientific research leaders and researchers in pediatric clinical and developmental translation research and novel drug development.

In the zeal to seek opportunity for grants to fund their scientific research investigation paediatric principal investigators will be obliged to undertake paediatric research grant applications, therefore in framing this guideline, I will like to acquaint them with some of the generic characteristic profile that research funding agencies and sponsors adapt in putting up all a call for grant application.

Although, this is not in itself archtypical, but its algorithmic profile is as outlined below.

Mechanism of Support.to be utilized there should be a specified grant mechanism.

Amount of Funds Available and the Anticipated Number of Awards.

Budget and Project Period.

The total project period for an application submitted in response to this funding opportunity may not exceed five years.

Eligible Institutions/Organizations. Institutions/organizations listed in this gazette are eligible to apply.

Eligible Project Directors/Principal Investigators (PDs/PIs). Individuals with the skills, knowledge, and resources necessary to carry out the proposed research are invited to work with their institution/organization to develop an application. Individuals from underrepresented racial and ethnic groups as well as individuals with disabilities are always encouraged to apply for NIH support.

Number of Applications. Applicants may not submit more than one application.

Resubmissions. Resubmission applications are not permitted in response to this call.

Renewals. Renewal applications are not permitted in response to this call

In most instances, Paediatric Research Projects Sponsors will include the following minimum information in the Application Materials. During a call for Paediatric Research grant applications for the use of the applicant paediatric research investigators.

Funding Opportunity Description

Research Objectives

Award Information

Mechanism(s) of Support

Funds Available

Section on Eligibility Information

Eligible Applicants

Eligible Institutions

Eligible Individuals

Cost Sharing or Matching

Other - Special Eligibility Criteria

Section on Application and Submission Information

Address to Request Application Information

Content and Form of Application Submission

Submission Dates and Times

Receipt, Review and Anticipated Start Dates

Letter of Intent

Sending an Application to the Paediatric Research Sponsors.

Application Processing

Application Assignment

Intergovernmental Review

Funding Restrictions

Other Submission Requirements and Information

Section on Application Review Information

Criteria

Review and Selection Process

Additional Review Criteria

Additional Review Considerations

Resource Sharing Plans

Anticipated Announcement and Award Dates

Section on Award Administration Information

Award Notices

Administrative and National Policy Requirements

Cooperative Agreement Terms and Conditions of Award

Principal Investigator Rights and Responsibilities

Sponsors Responsibilities

Sponsors Collaborative Responsibilities

Arbitration Process

Reporting

Section on. Agency Contact(s)

Scientific/Research Contact(s)

Peer Review Contact(s)

Financial/ Grants Management Contact(s)

Section On Other Information

Full Text of Announcement

Section on Funding Opportunity Description

1. Research Objectives

Purpose

This research sponsoring organisation solicits grant applications from institutions/organizations for the creation of Pediatric Specialties Research Consortium pivotal centres to conduct comprehensive translational/basic and clinical research in pediatric therapeutics. A major goal of the these research consortia will be to conduct research that will fill gaps in knowledge that may be responsible for failed efficacy trials or that may prevent Food and Drug Administration (FDA) labeling of drugs in pediatrics. In addition, the Consortium will be expected to adopt a new paradigm of promoting personalized pediatric therapeutics and promote a greater understanding of the interrelationship among disease processes, and therapy across the developmental spectrum. Testing of new molecular entities, pediatric formulations, novel therapeutic approaches, new types of delivery systems and development and testing of biomarkers will be priorities for the consortium. The Consortium will also be a locus of training future leaders and researchers in pediatric clinical and developmental pharmacology.

This consortia is the result of the need to restructure the pediatric pharmacology research program to address knowledge gaps that may be responsible for failed efficacy trials and to accommodate the research needs of the future, while at the same time profiting from the experience and contributions made by interim studies. A new consortium will be developed according to functional cores rather than a group of units that are similar in structure and function. A major realignment will be the expansion of translational research with linkage to basic research and the continued development of multidisciplinary teams.

Although this consortia stems from the previous initiative, the Pediatric specialty Research Unit Network , the program structure and goals of the current consortia differ substantially from those of the original consortia. Consequently, all responses to this consortia call will be considered new applications. Investigators who are or were members of the previous Network have developed strong collaborations over the years in the therapeutic areas addressed in this consortia and have made substantial contributions to development of pediatric specialty using a multi-investigator approach will be welcomed. Current and/or past members of the Pediatric specialty Network and other experts in pediatric specialty are strongly encouraged to apply as research Centers.

Background

Federal law and the regulations of the FDA require that drugs be tested for safety and efficacy before they are approved for clinical use. This testing must take place in all populations in which the drug will be employed. Since both the qualitative and quantitative aspects of pharmacodynamics and pharmacokinetics are different in immature individuals, studies must be conducted in infants and children before a drug can be approved for their use.

Until three decades ago, most drugs up to three-quarters and four fifths were not labeled as either safe or effective for infants and children and off label use was the norm for these therapeutic orphans. There was little awareness among practitioners that prescribing for children was not evidence-based. Three decades ago, the FDA implemented a regulation the Pediatric Rule of 1994 that allowed labeling of drugs for pediatric use based on appropriate studies in adults and additional pharmacokinetics, pharmacodynamics, and safety studies in pediatric patients if the course of the disease and drug effects is similar in children and adults. This regulation was designed to encourage pediatric labeling.

Performance of these studies uncovered the need to provide the scientific underpinnings of drug trials in children. Along with these regulatory and legislative developments, the explosion of knowledge in pharmacogenomics has provided tools to decipher the mechanisms responsible for changes in drug biodisposition during development and the effects of ontogeny on both drug disposition and drug effects.

Despite the advances in legislation, several practical problems discouraged the testing of drugs in children. These include the unforeseeable nature of some clinical responses in immature individuals; the possibility of catastrophic unanticipated reactions; the threat of effects on growth or health long after completion of the drug administration; the difficulty in predicting dose-response relationships by extrapolation from data obtained in adults; the ethical problems of conducting non-therapeutic research in children; the awkwardness of procedures for obtaining informed parental permission and children's assent; and the lack of a suitable infrastructure for the conduct of pediatric drug studies.

Pediatric labeling of drugs

As a result of several studies conducted , there is an improved understanding of the pharmacokinetics of a number of drugs which has led to significant changes in drug labeling for pediatric patients. There is, however, concern about the significant number of failed pediatric trails because efficacy could not be demonstrated. According to the FDA, up to one half of pediatric effectiveness trials are uninterpretable.

A number of other factors may contribute to the high failure rate, including small sample size, dosing issues, feasibility issues, lack of well-defined endpoints and differences in drug sensitivity between adult and pediatric patients. Because of these factors, there is an important need for model-based advice prior to the design of efficacy trials.

The significant number of failed pediatric trials requires concentrated efforts to address issues of study design, appropriate dosing, development of biomarkers of response to therapy and toxicity across disciplines and therapeutic areas. The need to provide the scientific basis for the performance of efficacy and safety trials applies to both academic research studies and studies to support pediatric labeling.

Molecular Medicine and Personalized Therapeutics

Advances in decoding the genome have led to an expanded understanding of disease pathogenesis and identification of molecular drug targets. Molecular medicine (genomics, proteomics and metabolomics) has emerged as a powerful engine that is providing the tools to characterize changing disease states and uncover pathways for possible individualized therapeutic interventions.

Molecular markers represent a vision for the future that has been incorporated into the FDA’s Critical Path but this approach remains largely unexplored particularly in current clinical pediatric practice. Gene-based molecular diagnostics, however, is changing the practice of medicine. Molecular profiling of various diseases using genomic or proteomic approaches holds great promise. The use of molecular markers as clinical correlates of disease progression, risk quantification and prognostic indicators will form the basis of individualized medicine in years to come.

Completion of the Human Genome Project opened new areas of research and expansion of the fields of functional genomics, bioinformatics, and proteomics and the bioinformatics essential to interpreting the complex information generated by these techniques. These technologies and new areas of knowledge markedly expand the potential of pharmacogenomics, receptor biology, and molecular pharmacodynamics.

The genomic research revolution has resulted in an explosion of knowledge that made the development of multidisciplinary researchers in developmental pharmacology essential. There is a need to form multidisciplinary teams with participation of investigators with expertise in developmental biology, systems biology, bioinformatics, pharmacogenomics, metabolomics, biomarker development and pediatric subspecialists. There is a limited appeal for developmental pharmacology outside the small pediatric pharmacology community. Without an increase in the pool of investigators trained in newpharmacogenomics, technology, the necessary integration and synergistic interaction will not be possible.

Pediatric Therapeutics: a changing discipline

Pediatric pharmacology has been the mainstay of pediatric therapeutics with emphasis on the effect of development on the biodisposition and response to specific drugs in children. The interrelationship between disease processes, development and therapy is beginning to be appreciated. Disease processes in children often differ from those similar disorders in adults, and different phenotypes are being identified in children at various developmental ages. Until recently asthma was considered to be basically similar in adults and children, differing primarily in clinical severity. Therefore, successful treatment was believed to require only different dosage regimens or routes of administration to control the disease. Asthma is now recognized as a heterogeneous disease with a number of distinct phenotypes. The course of asthma may also vary based on age, with marked variations possible between young children, older children, adolescents and adults. While developmental processes can modulate phenotypic expression, the latter may also be influenced by therapy.

The explosion in biomedical knowledge and the growing number of disease targets dictate the need to reevaluate traditional approaches to pediatric pharmacology. There is a pressing need for innovation in pediatric therapeutics and the adoption of disease-oriented and patient-oriented approaches. This new paradigm will require a multidisciplinary approach in which pharmacologic expertise is integrated with knowledge of disease expression in children compared to adults and with in depth knowledge in physiology and pathophysiology of disease processes.

Research Objectives and Scope

The goals of the several paediatric drug developing firms are to:

Perform experimental translational research that characterizes drug disposition and/or action as affected by developmental age, disease, genetics and environment.

Develop and apply methods to study pharmacokinetics and pharmacodynamic modeling, simulation technology and biomarkers to facilitate the investigation of drugs in children.

Identify and fill knowledge gaps that prevent determination of the safety or efficacy of drugs in pediatrics and that may result in failed trials.

Investigate the clinical pharmacology of new molecular entities, biopharmaceuticals, drug delivery systems and drug formulations.

Characterize and uncover adverse drug reactions and develop approaches for their prevention.

Incorporate molecular medicine technologies to uncover the effects of disease and development on drug disposition and effects, and to promote the development of paediatric personalized medicine..

Serve as an educational organization to train researchers in pediatric therapeutics.

General Description and components of the Drug Developing Firms.

Consortia must involve investigators at two or more research sites and at different institutions. Each responding applicant team must include researchers from at least two different institutions. The contexual research centers will work together to develop a consensus-based program in Pediatric subspecialties.

A systems biology approach will be used by forging links and collaborations with basic scientists in developmental biology, pharmacology and informatics.

Each of the consortia centers will include clusters which are programmatic pathways that will focus on only one of the following therapeutic areas:

Neonatology and Newborn Therapeutics

Infectious Diseases

Cardiovascular and Respiratory Therapeutics

Chronic childhood diseases such as bronchial asthma, diabetes)

Neurology/psychiatric therapeutics

Special paediatric populations such as, adolescents, pediatric organ transplant .

General Paediatric therapeutics

Other therapeutic area groupings may be included if adequate rationale for the grouping is provided and the proposed group fulfills the overall goals of the consortium. It is expected that the implementation of programmatic pathways within and across therapeutic areas will maximize knowledge acquisition and generate multi-investigator and interdisciplinary teams to address research knowledge gaps. The programmatic pathways are not limited by, but must be congruent with that of the funding agencies priorities for Paediatric research, drug development programmes and needs in paediatric therapeutics.

Although each consortia research network centre could spearhead research in a specifically defined therapeutic area, all consortia paediatric research centre will be expected to participate in research studies requiring integration and collaboration beyond a single consortia paediatric research centre, such as building a prior knowledge base to determine paediatric dosing or providing the scientific tenets for the study of drugs at different developmental stages.

Whereas, other inter-consortia paediatric research centers studies may pursue the effects of blood groups and genotype on drug bio-availability and disposition, and effect, or the development of methodology applicable to all pediatric clinical trials as a group such as the elucidation of neuro- renal ,pulmonary or hepatic toxicity.

Also I will propose a guideline where cooperation from the consortia paediatric research centers will equally include mechanisms to expedite and scale up patients enrollment in clinical studies originating at individual consortia paediatric research centers.

The establishment of collaborations with established pediatric specialty consortia research networks with established experience in drug efficacy trials is recommended and will be highly desirable.

It is anticipated that the Consortia Paediatric Research network sponsors will provide all its disease-specific pediatric networks and collaborative centres with pharmacologic support in the performance of novel pharmacologic approaches such as but not confined to the development of pharmacodynamic ,pharmacokinetic or biotoxicity markers.

Credible participation and interaction with other pharmacogenetics research networks, pharmacoepidemiology consortia and other related clinical trials network(s) will also encouraged.

In some unusual unforeseen instances such as research investigation involving rare ,but epidemiologically and clinically illustrative, instructive or significant rare childhood disease, when expertise ,capacity or capability may not available in within the paediatric research investigations consortia networks and there is urgent need to address a specific scientific question the Consortia Paediatric Research Steering Committee may recognize affiliate or associate membership of individual investigators or a group of investigators and co-opt them to address the contexual scientific question.

The recommended and awarded Consortia Paediatric Research Network Center will work jointly under the guidance, mentorship and stewardship of the Steering Committee of the Consortia Paediatric Research Network on the design, development, harmonization and prioritization of programmatic pathways within and across several paediatric subspecialty therapeutic areas and pathologies.

The synergy, harmonization and integration of projects will be the responsibility of the Consortia Paediatric Research Network steering committee, and should be designed to have an exponential multiplier effect with various other interrelated research studies nested into it, instead of developing iterative common protocols projects. An overriding consideration will be the interrelationship of projects across programmatic pathways that may become the source of hypothesis generating ideas for consortium studies. These ideas should allow for cross-fertilization of therapeutic areas and conditions, addressing knowledge gaps whose resolution will result in important generalizable knowledge for determining efficacy and safety in all pediatric subpopulations.

Some Recommended Consortia Paediatric Research Network Center Research Activities.

It is recommended that each designated Consortia Paediatric Research Network Center should serve as a springboard for research conception, innovation, hypothesis generation, and testing of proof of concept and hypothesis. In addition the Consortia Paediatric Research Network Centers will address gaps in knowledge and develop new approaches to solve feasibility issues that prevent the determination of safety and efficacy of drugs in pediatric patients.

Each Consortia Paediatric Research Network will consist of a consortium of clinical and translational science investigators, institutions and relevant organizations. The focus ofeach Consortia Paediatric Research Network will be pharmacotherapeutic and disease-oriented research in a specified therapeutic area.

Each Consortia Paediatric Research Network will be designed to perform collaborative research in a synergistic and complementary manner with other Consortia Paediatric Research Network Centers.

The Overall research goals of Consortia Paediatric Research Networks will be to optimise The Research Grants that it is awarded through, the Creation of a consortium of research groups which will link collaborating members to promote intellectual exchange, generate innovative inter- and multi-disciplinary research in all relevant paediatric subspeciaties.

The facilitation of the sharing of scientific advances throughout the translational research spectrum that will ultimately lead to novel interventions such as chemical chaperone therapy, enzyme replacement therapy, gene therapy, stem cell therapy, personalized precision paediatric therapeutics etc.

The establishment ofongoing academic and scientific partnerships to ensure the integration of emerging advances into scientific paediatric clinical practice.

The provision of a training environment that will develop a new generation of scientists grounded in the principles of paediatric multidisciplinary research to address complex paediatric therapeutics translational research challenges etc.

The promotion of academic scientific multisectorial public-private collaborative and corporative partnerships to foster economic growth and employment prospects.

The Promotion of the development and/or adaptation of cutting-edge technology for inter-institutional and industrial collaborations in order to provide a princint for institutions and industry to collaborate on developing new technology in pediatrics;

To encourage the integration and adaptation of new technologies for the use of biomarkers in paediatrics subspecialties research and application in trial design and drug trial simulation.

The facilitation of the development of novel strategies for study design and study endpoints.

The creation of new research synergies;

To encourage the bridging and intersections between basic, translational and clinical researchers.

Ideally my proposed research funding criteria guideline will encourage each Consortia Paediatric Research Network Centers.to have a translational, a pharmacometric and a clinical research pivotal component in addition to an administrative and financial units respectively.

The Remits of the Translational Pivotal Component.

The functional scope of the Translational Pivotal Component.may include but are not limited to:

Trial design/endpoints. Development of novel trial design methods for paediatrics ,neonatology,infancy,orother peculiar pediatric subpopulations)

Identification, definition and testing of endpoints that are closely related to clinically relevant outcomes. Development of validation measures of endpoint assessment.

Biomarker development, adaptation and application to pediatric trials in specific therapeutic areas.

Adverse drug reactions (ADRs) in children.

As guide it is recommended that studies on the mechanisms and the pathogenetic role of pharmacogenetics and epipharmacogenetics in the production of ADR in children could be within the scope of these Paediatric subspecialties research consortia networks.

Ideally as guide it is recommended that these studies should not be stand-alone projects but should be part of programmatic pathways in the specific therapeutic area of the Paediatric Research Network Centers.

Developmental Pharmacology and Toxicology.

These studies should also not be stand-alone projects but should be part of programmatic pathways in the specific therapeutic area of the Paediatric Research Network Centers.

Normally to optimise positive effects, the translational pivotal components of the different Paediatric Research Network Centers.should collaborate to characterize and complete a developmental road map of drug biodisposition and response to drugs at different developmental ages.

Anedotally, on the basis of the need to expand the pool of investigators in Developmental Pharmacology, collaboration with investigators outside the Consortium is strongly encouraged. Non-clinical experimental studies using neonatal, infantile juvenile animals, tissue, in vitro and in silico approaches as well as pharmacogenomics, proteomics, and transcriptomic studies, should be encouraged. These studies should be done in partnership with basic science investigators or with consortium-wide projects targeted to answer high priority research gaps or need to acquire new knowledge across multidisciplinary paediatric subspecialty therapeutic interventional areas.

Paediatric Pharmacometrics Pivotal Component Research.

As a guide, grant applicants Investigators responding to this call must:

Provide bonafide evidence of a well themed unit of a team of highly experienced pharmacometricians to assist with development and analysis of therapeutic studies, construct dynamic developmental models for drug distribution process and reactions, and link novel and existing global databases for employ with study design and analysis;

Use and or develop experimental, mechanistic and physiologic models according to stage of drug development.

Incept, develop or adapt disease progression models to specific therapeutic areas such as`.experimental translational research from rodent models to porcine model and thence to primate models before human models, in addition to age dependent physiological maturational adjustments for extrapolated adult models,

Incorporation and integration of pharmacogenetics as a qualitative and quantitative technique for experiemetal in vivo assessment of the clinical pharmacology of drugs given to paediatric patients.

In silico simulation of the effect(s) of age, disease and/or concomitant drug therapy on dose-concentration-effect, pharmacodynamics and pharmacokinetic relationships.

Clinical Paediatrics Research Pivotal Component.

Projects within the Clinical Paediatrics Research Pivotal Component may include but not confined to :

Early stage proof of concept or safety clinical trials;

Determination of the sensitivity of clinical endpoints to changes in disease severity and determination of the magnitude of changes that are clinically significant and useful in paediatric, infantile and neonatal patients across developmental stages;

Studies designed to investigate dose-concentration, dose response, or concentration-dose response relationships to derive an optimal dosage for efficacy trials;

Studies designed to evaluate a novel pharmacodynamic biomarker.

Studies to assess novel drug delivery systems.

Studies designed to make a choice between two dosing regimens derived from clinical trial simulation in silico to evaluate in subsequent efficacy trials:

The application of molecular imaging biomarkers and other pertinent biomarkers;

The conception and the design of approaches such as genotypic and –phenotypic association in in-born errors of metabolism such as galactosaermia,neonatal,infantie and juvenile onset diabetes mellitis,the congenital anaemias and Fanconi anaemias ,Tay-Sachs syndrome ,the mucopolysaccharidosis etc .The elucidation of genotypic and –phenotypic associations in this context will be necessary to translate pharmacogenetics into the context of patient-oriented clinical decision-making such as but not confined to the development and integration of clinical pharmacogenetics..

In this guide, well monitored and supervised Paediatric efficacy trials could be allowed in the context of , interactions between pharmacometric and translational researchers, pediatric pharmacology investigators of the and pediatric specialists involved in pediatric clinical trials networks, of the Paediatric Research Network Centers will be strongly encouraged.

The proposed research project(s) should address problems in pediatric subspecialty therapeutics within the Paediatric Research Network Centers. therapeutic area that requires substantial collaboration.

For an overall success of their grant applications, Paediatric Research Grant Investigator Applicants will be strongly encouraged to use a multidisciplinary team approach rather than a large number of small projects that can be addressed outside the Paediatric Research Network Centers.cooperative mechanisms. It will be expected that activities may require collaboration with other institutions or other .Paediatric Research Network Centers.

By employing an interdisciplinary approach, the Paediatric Research Network Centers.could conduct activities that are beyond the capabilities of individual investigators or institutions.

It is advisable that the description of the these Paediatrics Research Pivotal Component.must not be unduly lengthy and should be abbreviated as much as would be achievable.

Paediatric Research Administraton For The Optimisation of Grant Awards.

Coventionally, the Paediatrics Research Pivotal Component. Center Administrative Department must be chaired and directed by the Paediatric Research Project Director of the Paediatrics Research Pivotal Component. Centre who will ensure a mutually supportive interaction between scientists conducting translational, pharmacometric or paediatric clinical investigations. The experience and qualifications of the Paediatric Research Project Director for this role and the plan to promote clinical and translational research should be described. As guide for an optimal success of a putative paediatric research grant application, the description of the direction and management of the Paediatric Research administration must not also be unduly lengthy and should ideally be one-half the size of Clinical Paediatrics Research Pivotal Component.

Training, Education and Expansion of the Pool of Researchers in Developmental Pharmacology

Given its acclaim and outlook as a globally and internationally recognized consortia of excellence in pediatric therapeutics, the Consortia Paediatrics Research Network centre Centers will be expected to be a training centre for new researchers in paediatric subspecialties and developmental pharmacology and therapeutics. This program will emphasize multidisciplinary crossing and intersections of training thematic areas.

It will be welcomed, even if there are pedagogic approaches which somewhat differs across several paediatric subspecialties academic and research training programs.

Each Consortia Paediatrics Research Network centre should be expected to develop a training plan in its specific paediatric subspecialty research area. This centre specific plan, will be integrated with those of the other Paediatrics Research Network Centers to provide a training environment for post-doctoral research investigations in the different paediatric subspecialty therapeutic areas.

Also, the, modification, adaptation and utilization of existing training programs in paediatric pharmacology will be encouraged. In addition to academic research fellowships in paediatric sub-specialties, It will be expected that the Consortia Paediatrics Research Network centre should offer rotations for fellows in various pediatric specialties and in adult training programs in clinical research investigation.

Again to eschew and unduly frequent need for revisions, the recommended and proposed plan must be unduly lengthy.

Ideally, for Paediatric research grant applications, Investigators chairing the Translational Pivotal components Cores of Paediatric Research Network Consortia, in cooperation with the Sponsoring agency Program Scientist of the , Paediatric Research Network Consortia will actively promote the expansion of research in developmental pharmacology with emphasis on multidisciplinary collaboration.

In this context, as a useful guide it will be worthwhile for a dedicated website for education and research in developmental pharmacology to be developed by the Coordinating Center in cooperation with consortium investigators and the responsible staff or web editor of the contexual Paediatric Research sponsoring agency. The target audience, in addition to paediatric Paediatric Research Investigators , will include investigators with expertise in developmental biology, systems biology, paediatric pharmaco-epidemiology, metabolomics, transcriptomics, paediatric genetics and bioinformatics as well as obstetric and pediatrics clinical pharmacology and therapeutics.

In addition, pertinently, a regular periodic Web-cast will be organized with the participation of both consortium and extramural investigators. The investigators with active grants in developmental pharmacology and therapeutics who are not active members of the Paediatric Research Network Consortia centres will be invited to join this network.Semi-annual Web casts with participation of developmental pharmacology investigators globally will be jointly planned.

Plan to Monitor Center Progress.

As a guide for the overall success of its Pediatric research grant application, the Paediatric Research Network Consortia must develop a clear and concise plan on how progress will be monitored in meeting its aims, goals and objectives. A section must be included that describes the qualitative and quantitative criteria that will be used to help monitor the Paediatric Research Network Consortia progress. These criteria must incorporate how the Paediatric Research Network Consortia will provide an additional value and generate a new body of knowledge compared to other research mechanisms. Measurable criteria for assisting to assess the progress of every component of the Paediatric Research Network Consortia toward its goals for the entire funding period must be provided.

A Robust Statistics and Data Management and Coordinating Department.

The Statistics and Data Management and Coordinating Department.will be the subject of a distinct and unique consideration. This pivotal, absolutely independent data coordinating center will provide data management and statistical services support for all inter-Consortia clinical protocols in development and for active protocols. In addition, the Statistics and Data Management and Coordinating Department.will be responsible for all statistical and data management services for all intra-Consortia clinical research projects within the Paediatric Research Network Consortia program. The Statistics and Data Management and Coordinating Department.and organize the clinical collaboration between the Paediatric Research Network Consortia Centres and their subordinate clinical sites, and will serve as the primary unit to collect, manage, analyze, and store clinical data obtained from the individual Paediatric Research Network Consortia. This will require the full range of coordinating center activities including: organization of program communications through websites, e-mail listservs, conference calls etc, study design and protocol development; preparation of forms and a Manual of Procedures for collaborative clinical trials; training center staff in data collection procedures; maintaining the study database; monitoring clinical center performance; providing patient accrual reports; performing appropriate analyses of the contexual paediatric research study data; and participating in the preparation of paediatric study publications. Thereafter The Statistics and Data Management and Coordinating Center. will continue to maintain, expand, and improve the existing Data Repository initiated in the prior Paediatric Research Networks Consortia paediatric research grant funding cycle. The registry will ideally contains de-identified, protected clinical, demographic, pharmacometric and pharmacogenetic data collected from patients in the consortium and individual centers studies. The follow-on registry will be used as a tool for the Steering Committee to plan collaborative clinical studies during the funding cycle, to develop a prior knowledge library and to plan studies relating within and across therapeutic groups and conditions. The Paediatric Research Network consortia collaborative Data Registry and Repository will be accessible to any interested investigator outside the Paediatric Research Network consortia program who proposes a legitimate scientific research use following authorised access to its contents. . A separate database may also need to be developed for some collaborative , co-operative inter-center clinical studies carried out within the program, depending on the nature of the study, at the discretion of the Paediatric Research Network consortia’s Steering Committee.

The Statistics and Data Management and Coordinating Department .will have the following additional responsibilities:

The maintenance and update the Consortia Paediatric Research Network website for accessibility to the public originating in the immediate previous years funding cycle of the Consortia Paediatric Research Network and linked to all websites for the individual Consortia Paediatric Research Network centres.

The inception, development and maintenance of a secure Consortia Paediatric Research Network -only website for data entry and analysis, and for other miscellaneous uses to be defined by the Consortia Paediatric Research Network Steering Committee.

The inception, development and maintenance, and support of customized software as needed for Consortia Paediatric Research Network focal Centers applications for inter-Consortia clinical projects which could be used for the remote entry of experimental, clinical or laboratory data, or for specimen tracking.

The inception, execution and implementation of pay study-specific subcontracts for central facilities or patient enrollment or required specialists in inter-or intra-Consortia clinical and/or translational projects.However, patient and laboratory expenses will be negotiated on a capitated system.

The coordination of the shipment of patient and/or animal samples, to be stored at the Paediatric Research Study Sponsors Biological Specimen Repository.

The coordination of the collection and shipment to the Paediatric Research Study Sponsors repository of DNA and plasma samples for all consenting patients entered into the Data Repository Registry. In addition to the coordination of the management of access to samples by the Steering Committee. Coordination of the distribution of Paediatric Research study samples to Consortia Paediatric Research Network focal Centers investigators proposing legitimate research uses.

Coordination, with the Paediatric Research Study Sponsors Project Scientist and the Paediatric Research Study Sponsors Program Officer, the activities of the Steering Committee , independent Protocol Review Committee , and Data and Safety Monitoring Board .

The assistance of Consortia Paediatric Research Network focal Centers staff in the preparation of protocol and consent documents from clinical projects for review . Assume responsibility for writing/revising the data management and statistical sections of the clinical protocol.

Assist Consortia Paediatric Research Network focal Centers staff in the preparation of protocol and consent documents from all funded clinical projects for review ; hold a special training session on Paediatric Research grant approval processes for all Principal Investigators of funded Paediatric Research Study Sponsors intra-Center clinical projects; take responsibility for writing/revising the data management and statistical sections of the clinical protocol; prepare standardize Case Record Forms using common vocabularies in recognised dictionaries, prepare standard protocol and consent form templates to be used for all clinical projects both inter-Center or intra-Center undergoing review, and ensure the timely preparation of all final documents for review; take responsibility for all statistical and data management aspects of all Consortia Paediatric Research Network clinical projects in front of the .Paediatric Research Study Sponsors

Prepare statistical and safety reports for all active Paediatric Research Study Sponsors clinical projects per the set schedule..

Meet all drug regulatory reporting requirements for any inter-Consortia Paediatric Research Study Sponsors clinical projects conducted, including adverse event reporting. For intra-Center clinical projects in a joint effort.

Assume responsibility for adverse event reporting on all Consortia Paediatric Research Study Sponsors clinical studies according to Consortia Paediatric Research Study Sponsors Office of Human Subjects Protections rules and timelines.

Assume responsibility for clinical monitoring of each clinical site participating in each inter-Center clinical study. Develop a monitoring plan for each clinical Consortia Paediatric Research study Network Focal Centres that includes review of compliance with the protocol, compliance with regulatory issues as appropriate, and review of data quality.

Appoint and support as a consultant an independent medical monitor to review adverse event reports in real time.

Maintain a controlled document facility, and a secure data storage facility with data and power backup plans in case of computer failure.

At the direction of the Consortia Paediatric Research Network Steering Committee assist representatives of the new Consortia Paediatric Research Study Sponsors with collaborative activities as needed.

Public briefing

An informational session for investigators representing groups considering submission of applications in response to this call for paediatric research grant application will be held. Details will be announced in the Guide to Grants and Contracts.

Representatives from the Consortia Paediatric Research Study Sponsors Fetal.Perinatal and Pediatric Pharmacology Branch, Grants Management Branch and Division of Scientific Review will provide information and answer questions pertinent to preparing applications in response to this call for paediatric research grant application..

Section on . Award Information

Mechanism of Support

This funding opportunity will use the Cooperative agreement award mechanisms.

The Project Director/Principal Investigator will be solely responsible for planning, directing, and executing the proposed project.

This call for paediatric research grant application uses Just-in-Time information concepts. It also uses non-modular budget formats described in the application instructions.

This funding opportunity will use a cooperative agreement award mechanism. In the cooperative agreement mechanism, the Project Director/Principal Investigator retains the primary responsibility and dominant role for planning, directing, and executing the proposed project, with Consortia Paediatric Research Study Sponsors staff being substantially involved as a partner with the Principal Investigator as described in the Administrative Requirements, Cooperative Agreement Terms and Conditions of Award.

Funds Available

The estimated amount of funds available for the support of Consortia Paediatric Research Study Network Focal Centers awarded as a result of this announcement is for the total cost of …..for this fiscal year . Future year amounts will depend on annual appropriations. The anticipated start date of the awards is -----this year.

Although the financial plans of the Consortia Paediatric Research Study Sponsors provide support for this program, awards pursuant to this funding opportunity are contingent upon the availability of funds and the receipt of a sufficient number of meritorious applications.

Facilities and administrative costs requested by consortium participants are not included in the direct cost limitation as described in the grants policies as described in the Consortia Paediatric Research Study Sponsors Grants Policy Statement.

Other-Special Eligibility Criteria

Applicants are not permitted to submit a resubmission application in response to this call for Paediatric research grant application.

Renewal applications are not permitted in response to this call for Paediatric research grant application.

Applicants may submit more than one application, provided each application is scientifically distinct.

Section on Application and Submission Information

Address to Request Application Information

Content and Form of Application Submission

Applications must be prepared using the most current research grant application instructions and forms.

The title and number of this funding opportunity must be in the specified section of the application form.

Additional information is available in the grant application instructions.

Special requirements

Strategic Planning for this call for Paediatric Research Grant Application.

Applicants who expect to be competitive for this call for Paediatric Research Grant Application. will find it necessary to conduct collaborative strategic planning activities to develop a conceptual framework for the specific therapeutic areas of research proposed in their application. Such a process is key to identifying the most important research gaps and opportunities, identifying the expertise needed to address these gaps, developing a plan of action, adhering to policies and procedures, identifying outcome measures and plans for monitoring progress, developing an administrative structure for efficient management andresearch implementation, developing specific research projects, and maximizing synergy among Consortia Paediatric Research Focal Centers partners, the investigators, and the research projects. This planning is a critical first step in developing essential communication and collaborations among researchers from different disciplines. The planning activities should also include developing training and career development plans for future investigators; disseminating research findings; and developing management strategies for implementation of research that will ultimately result in improved pediatric therapeutics. The resulting strategic plan should include short and long term goals that can be used to help monitor progress. The ways in which input is to be obtained for strategic planning purposes must be documented in the application.

Applications failing to comply with this requirement will be considered non-responsive to the .call for Paediatric Research Grant Application.

Applicants are encouraged to consider the following elements of a strategic planning process as they prepare to respond to this call for Paediatric Research Grant Application.

Identification and prioritization of research gaps and opportunities:

This includes a collaborative process to identify and prioritize research gaps in order to have an impact on clinical practice and a better assessment of efficacy and safety of drugs given to children.

The type and extent of knowledge gaps will vary between therapeutic areas. For example, issues of study design, feasibility and selection of clinical endpoints and measures of efficacy will be prominent in Neonatal subspeciaties pharmacotherapeutics, while development and testing of models and biomarkers of disease progression would be a priority in Paediatric Chronic Disease pharmacotherapeutics such as Juvenile Idipathic Arthritis. The Strategic Plan should include a likely change in emphasis during the funding cycle as gaps in knowledge are filled with a shift toward novel approaches leading to personalized pediatric pharmaco-therapeutics.

Conceptual framework development:

This involves development and adoption of an overall conceptual framework, for addressing the selected therapeutic area and disease(s) in the specific pediatric populations under study.

Strengths of the proposed Consortia Paediatric Research Focal Centers:

This involves identification of strengths in terms of the experience, expertise and resources of the proposed consortium of institutions, organizations, agencies, researchers. A realistic assessment should be made of the available experience and appropriate facilities for Consortia Paediatric Research Focal Centers research.

Opportunities:

This involves identification of opportunities to conduct innovative studies and opportunities for the training and career development of researchers new to pediatric therapeutics. Applicants should explore potential collaborations with a variety of organizations, such as federal agencies, private sector organizations, foundations, and other consortia.

Overarching Consortia Paediatric Research Focal Centers research theme:

A focused research theme for the Consortia Paediatric Research Focal Centers is identified to assure that the proposed studies produce synergy and maximize the body of evidence needed to influence clinical practice, and evolution toward personalized pediatric therapeutics. The Consortia Paediatric Research Focal Centers program must not be a collection of independent, unrelated research projects.

Rather, the Consortia Paediatric Research Focal Centers application must clearly delineate how the research projects, consortium, and investigators will collaborate synergistically to address the research theme that is identified in the strategic planning process.

Evidence of previous collaboration:

It is expected that the key members of each Consortia Paediatric Research Focal Centersteam especially the Project Director, Principal Investigator of Clinical Pivotal Component , Principal Investigator for pharmacometrics, and developmental pharmacologist have a long history of previous collaboration evidenced by joint publications, NIH grants, and participation in joint studies.

The strategic plan must not be unduly lengthy.

Consortia Paediatric Research Focal Centers research theme programmatic pathways in specific therapeutic areas.

While each Consortia Paediatric Research Focal Centers is expected to bring together experts from multiple disciplines to form interdisciplinary collaborations and is expected to undertake a wide range of intervention research, it is not expected to address the entire spectrum of research in a particular therapeutic area. The theme and range of research, training, and career development, must emerge from the strategic planning process. This theme (programmatic pathways) should be used by the Consortia Paediatric Research Focal Centers to focus its activities throughout the funding period.

The formation within Consortia Paediatric Research Focal Centers applications of consortium arrangements between institutions separated by any geographic distance virtual centers is strongly encouraged, so as to facilitate the assembly of the highest quality paediatric therapeutic research.

Consortium arrangements can also be included in the clinical cores to expand patient access. While consortium arrangements are encouraged, it is incumbent upon the applicants to present evidence that the proposed consortium is feasible, and that it can function well as a productive team. At a minimum, a Center’s administrative core should reside at the parent institution. The clinical core can either be located at the parent institution, or at a subcontract site, or both. The assembly of teams with prior collaborative experience is strongly encouraged but not required. Submission of a schedule of planned meetings, and/or a plan to develop web- or e-mail-based electronic communications infrastructure is encouraged.

The administrative core of the application must include the following:

Detailed description of the conceptual framework for the Consortia Paediatric Research Focal Centers and a research theme developed from the strategic plan

Management plan

Leadership plan

Plans to monitor Consortia Paediatric Research Focal Centers progress

Plans for training and career development

Organizational plan

The administrative pivotal component of the application must describe in detail, and by diagram if appropriate, the sequence of responsibility for decision-making and administration. Include to whom the Consortia Paediatric Research Focal Centers Project Directors reports and the administrative structure as it relates to the investigators responsible for the clinical and translational research.

Describe a sound plan for communication (meetings, conference calls, use of SharePoint, webcast etc.)

Plans for dissemination of research findings

The scientific component of the application must include the following:

Description of overall research program

Description of the strategic plan

Outline of the programmatic pathway chosen for therapeutic area

Description of the three cores

Implementation plan in a five year funding cycle

Study proposals

Applicants must submit two proposals to provide reviewers with an idea of the capabilities of the proposed Consortia Paediatric Research Focal Centers:

A demonstration research project geared to fill high priority gaps in knowledge that may be responsible for failed pediatric drug trials or that may prevent the design of academic or labeling studies.

Examples include:

Lack of adequate endpoints

Inability to measure clinical endpoints in pediatric sub-populations in perinates, neonate,.infants and developmentally delayed children.

Need to stratify study population to maximize statistical power in small sample studies

Lack of adequate drug delivery systems

Inability to characterize exposure-response relationships

Need for the development of diagnostic, prognostic or disease progression, toxicity, and/or efficacy biomarkers

The proposed project should be aimed to remove a major obstacle for the study of different drugs for a given indication. This research could include the development of a research strategy that would allow the performance of research studies currently considered infeasible. Here again the proposal should not be unduly lengthy.

An optimised level multi-investigator demonstration proposal should be structured to show interactions between disciplines, investigators and synergy between the different pivotal components such as but not confined to. pharmacometrics, pharmacogenetics, clinical design, and related translational and basic research needs.

The proposal should contain separate but interrelated studies in the Consortia Paediatric Research Focal Centers therapeutic areas such as genomics and predictive and precision therapeutics,:Translational research study, Pharmacometric study, neonatal and paediatric Clinical protocol etc.

The proposed studies may address any of the translational areas of research interest and types of pharmacometrics and clinical types of studies listed under Consortia Paediatric Research Focal Centers research activities.

The studies within the proposal need to be connected and must complement each other within a programmatic pathway. The research demonstration project proposals should be drafts up to twenty pages in length for consideration by other participants in the program, and should include enough detail hypothesis, design, rationale, significance, procedures, resources required, end points, power calculations, and discussion of feasibility) to permit evaluation of the proposals for scientific merit.

SUPPLEMENTAL INSTRUCTIONS

These instructions refer to the Consortia Paediatric Research Focal Centers and all of its cores institutions, and investigators.

The application requirements for all applicants are as follows:

Participants must be based in a Children's Hospital(s) with access to a sufficient number of eligible research subjects in the pediatric age groups: newborn infants (including prematurely born infants), children, preadolescents and adolescents. This is an essential component of the application and must be detailed in the application. Statistical information should contain data for both inpatient and outpatient facilities, including clinics and access to pediatric practices that may contribute research subjects.

Departmental and Institutional commitments to collaborative research must be documented by letters to the applicant and by evidence of past support and history of clinical research productivity.

Evidence of access to pediatric patients with a wide variety of medical conditions who are available for drug studies must be provided. Letters of commitment by pediatric subspecialists and evidence of previous collaborations must be provided.

Evidence of access to pediatric patients in the therapeutic area chosen by the applicant.

Evidence of the ability to recruit patients for pediatric drug studies must be provided. A list of clinical trials performed during the last four years should be provided with the following information: investigator-initiated or pharmaceutical company sponsored; b) single center or multicenter study; number of centers involved and total number of patients studied; d) type of study such as pharmacokinetics, pharmacodynamics, drug metabolism, bioavailability, efficacy or safety; number of patients studied; f) gender and racial/ethnic composition of the study subjects; whether the study was completed; and major findings and results of the study.

Qualifications of the Project Director of the Consortia Paediatric Research Focal Centers and his or her academic productivity must be documented, including history of success in paediatric research grants applications.

The Project Director /Principal Investigators of the Clinical and Pharmacometric pivotal studies, must hold an independent peer-reviewed grant(s) or contract(s), must be actively publishing, and must be familiar with academic and proprietary research in pediatric subspecialty therapeutics etc. Evidence must be provided of the Project Directors and Principal Investigators combined expertise in pharmacokinetics, pharmacodynamics, drug bioavailability and drug metabolism studies, pharmacogenetics, and design of paediatric research drug trials.

In addition, evidence should be provided of the applicant's research in previous or ongoing clinical trials, especially of a multicenter nature. Contributions in key areas such as protocol design, data analysis, and interpretation, disease diagnosis, pathophysiology and biomarker development are important.

A description of current and past research collaborations of the key investigators with members of other pediatric clinical trials networks and other researchers involved in basic and translational research in pediatric pharmacology and therapeutics.

A detailed description of the clinical and research capabilities of the Consortia Paediatric Research Focal Centers should be provided, including a description of pharmacokinetics and pharmacodynamic capabilities, access to a pharmacogenetics and other omics technology (e.g. proteomics, metabolomics), and other strengths in pediatric pharmacology and therapeutics, both in basic and clinical research.

If applicant institution(s) received a previous paediatric research grant award, detail its role in the activities and support oftheConsortia Paediatric Research Focal Centers.

Budget

Each application must allocate a significant effort to support pilot/demonstration projects for short term translational research that take maximum advantage of new or ongoing funding opportunities in paediatric subspecialty therapeutics and developmental pharmacology and therapeutics. Funding of pilot projects is intended to generate feasibility data and to have the most promising research potential for realizing the objectives of the different programmatic pathways. Pilot projects may not exceed a given stated amount. The developmental funds are intended to provide interim support for project development until research grants are awarded or funding from other sources such as but not confined to private-private partnerships, consortiums could equally be obtained.

Developmental projects may be collaborative among scientists with one or more Consortia Paediatric Research Focal Centers or with scientists outside the Consortia Paediatric Research Focal Centers environment. Project/program developmental funds may not exceed a given stated amount per year and must be approved by the External Advisory Committee and .Consortia Paediatric Research Study Sponsors Developmental funding is intended to remain flexible and to support studies of limited duration (two years or less.

It is the intent of this call for Paediatric grant application to provide minimal infrastructure funding support. The use of the resources available at institutions with a Clinical and Translational Science Award or General Clinical Research Center should be available to each .Consortia Paediatric Research Focal Centers

Direct costs to cover tasks assigned to administrative and research cores as needed for each Consortia Paediatric Research Focal Centers must not exceed the following allocation:

Project Director maximum of twenty percent time and effort; Pediatric pharmacometrics Principal Investigators about fifteen percent time and effort, pediatric subspecialist ten percent of time and effort; administrative assistant support maximum twenty percent time and effort.

A number of administrative activities such as monitoring, allocation of research funds, webpage support etc are assigned to the Statistics and Data Management and Development Department. No funds for the activities Statistics and Data Management and Development Department can be included in the Consortia Paediatric Research Focal Centers budget.

No funds for training support must be included in the budget. Consortia Paediatric Research Study Sponsors intends to develop a separate budget to fund training after a Consortia Paediatric Research Focal Centers specific curriculum is jointly developed by the Consortia Paediatric Research Study Sponsors and the Consortia Paediatric Research Focal Centers investigators. In addition institutional and outside support for this program are encouraged.

The Consortium Steering Committee will meet at least three times per year in a designated academic research institute. Applicants should include costs for travel to these meetings in their budget request.

Submission Dates and Times

Applications must be received on or before the receipt date described on the instructions for applications.

Submission times not specified..

Receipt, Review and Anticipated Start Dates

Letters of Intent Receipt Date:

Application Receipt Date:

Peer Review Date(s):

Council Review Date:

Earliest Anticipated Start Date:

Letter of Intent

Prospective applicants are asked to submit a letter of intent that includes the following information:

Descriptive title of proposed research

Name, address, and telephone number of the Principal Investigator

Names of other key personnel

Participating institutions

Number and title of this funding opportunity

Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows Consortia Paediatric Research Study Sponsors staff to estimate the potential review workload and plan the review.

The letter of intent is to be sent by the date as listed in the application guidelines and instructions..

The letter of intent should be sent to:

Program Scientist

Fetal Perinatal and Paediatric Pharmacology and Therapeutics Branch

Paediatric Research Institute of The Consortia Paediatric Research Study Sponsor.

Telephone:

Email:

Sending an Application to the NIH

Applications must be prepared using the forms found in the The Consortia Paediatric Research Study Sponsor instructions for preparing a research grant application. Submit a signed, typewritten original of the application, including the checklist, and three signed photocopies in one package to:

Department for Scientific Review.

The Consortia Paediatric Research Study Sponsor

Personal deliveries of Paediatric Research Grants applications are no longer permitted .At the time of submission, two additional copies of the application and all copies of the appendix material must be sent to:

The Director, Division of Scientific Review

Fetal Perinatal and Paediatric Pharmacology and Therapeutics Branch

Paediatric Research Institute of The Consortia Paediatric Research Study Sponsor.

Telephone:

Email:

Sending an Application to the NIH

Application Processing

Applications must be received on or before the application receipt date) described in the guides and instructions for Paediatric Research Study Grants Applications. If an application is received after that date, the application may be delayed in the review process or not reviewed. Upon receipt, applications will be evaluated for completeness by the Fetal Perinatal and Paediatric Pharmacology and Therapeutics Branch of The Paediatric Research Institute of The Consortia Paediatric Research Study Sponsor.and for responsiveness by the reviewing Institute Incomplete and/or non-responsive applications will not be reviewed.

Sending an Application to theThePaediatric Research Institute of The Consortia Paediatric Research Study Sponsor

The Consortia Paediatric Research Study Sponsor will not accept any application in response to this funding opportunity that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. However, when a previously unfunded application, originally submitted as an investigator-initiated application, is to be submitted in response to a funding opportunity, it is to be prepared as a NEW application. That is, the application for the funding opportunity must not include an Introduction describing the changes and improvements made, and the text must not be marked to indicate the changes from the previous unfunded version of the application.

Information on the status of an application should be checked by the Principal Investigator in the designated given page of the . The Consortia Paediatric Research Study Sponsor Website.

Requirement For Intergovernmental Review

This initiative is not subject to intergovernmental review.

Funding Restrictions

All The Consortia Paediatric Research Study Sponsor awards are subject to the terms and conditions, cost principles, and other considerations described in the The Consortia Paediatric Research Study Sponsor Grants Policy Statement. The Grants Policy Statement can be found at The Consortia Paediatric Research Study Sponsor Grants Policy Statement.

Pre-award costs are allowable.

A grantee may, at its own risk and without The Consortia Paediatric Research Study Sponsor prior approval, incur obligations and expenditures to cover costs up to three months before the beginning date of the initial budget period of a new award if such costs: are necessary to conduct the project, and would be allowable under the grant, if awarded, without The Consortia Paediatric Research Study Sponsor prior approval. If specific expenditures would otherwise require prior approval, the grantee must obtain The Consortia Paediatric Research Study Sponsor approval before incurring the cost. The Consortia Paediatric Research Study Sponsor prior approval is required for any costs to be incurred more than 90 days before the beginning date of the initial budget period of a new award.

The incurrence of pre-award costs in anticipation of a competing award imposes no obligation on The Consortia Paediatric Research Study Sponsor either to make the award or to increase the amount of the approved budget if an award is made for less than the amount anticipated and is inadequate to cover the pre-award costs incurred. The Consortia Paediatric Research Study Sponsor expects the grantee to be fully aware that pre-award costs result in borrowing against future support and that such borrowing must not impair the grantee's ability to accomplish the project objectives in the approved time frame or in any way adversely affect the conduct of the project refer to The Consortia Paediatric Research Study Sponsor Grants Policy Statement at The Consortia Paediatric Research Study Sponsor given and specified webpage.

Other Submission Requirements and Information

Awardees must agree to the Cooperative Agreement Terms and Conditions of Award in the appropriate given Section of Award Administration Information..

Research Plan Page Limitations

In this instance also,the overall research plan including the strategic plan must not be unduly lengthy. The demonstration research project addressing the need to fill gaps in knowledge must be brief. The grantee institutional optimised level demonstration proposal must not be unduly lengthy.

Appendix Materials

All paper applications submitted must provide appendix material on CDs only. Include five identical CDs in the same package with the application. See guidelines and instructions for paediatric research study applications guidelines..

Do not use the Appendix to circumvent the page limitations of the Research Plan component. An application that does not observe the required page limitations may be delayed in the review

Section on Application Review Information

Criteria

Only the review criteria described below will be considered in the review process.

Review and Selection Process

Applications that are complete and responsive to the Call For Paediatric Research Grant will be evaluated for scientific and technical merit by an appropriate peer review group convened by the The Consortia Paediatric Research Study Sponsor and in accordance with The Consortia Paediatric Research Study Sponsor peer review procedures given at the designated section of The Consortia Paediatric Research Study Sponsor peer review wb page using the review criteria stated below.

As part of the scientific peer review, all applications will:

Undergo a selection process in which only those applications deemed to have the highest scientific and technical merit, generally the top half of applications under review, will be discussed and assigned a priority score.

Receive a written critique.

Receive a second level of review by The Consortia Paediatric Research Study Sponsor

Council.

The following will be considered in making funding decisions:

Scientific and technical merit of the proposed project as determined by peer review

Availability of funds to The Consortia Paediatric Research Study Sponsor

Relevance of the proposed project to program priorities considers the following in evaluating Center grant applications:

The scientific and technical merit of the proposed program;

The qualifications and experience of the center director and other key personnel;

The statutory and program purposes to be accomplished;

The extent to which the various components of the proposed program would be coordinated into one multi-disciplinary effort within the center;

The extent to which the center's activities would be coordinated with similar efforts by other organizations;

The administrative and managerial capability of the applicant; and

Other factors which the awarding Institutional Council The Consortia Paediatric Research Study Sponsor considers appropriate in light of its particular statutory mission

The Consortia Paediatric Research Network Focal Center Applications

Each of The Consortia Paediatric Research Network Focal Centre application will receive an overall priority score. Reviewers will assign overall priority scores to nter based on the strategic plan, project scores, the PPTRC specific review criteria listed below, and the reviewer assessment of the quality of the core components of the Consortia Paediatric Research Network Focal Centre .

The administrative unit , the qualifications of the core components (pharmacometrics, translational and clinical), the training plan within a Consortia Paediatric Research Network Focal Centre , the overall clinical research program organization, and capability institutional commitment components of the application will not receive priority scores, but will either be recommended, or not recommended by the review committee.

Review Criteria

Overall Scientific Merit:

What is the composite scientific merit of the overall application, including the scored research projects and Consortia Paediatric Research Network Focal Centre components based on the detailed review criteria listed below?

What is the potential for synergy within the proposed collaborative research program?

Review Criteria of research applications:

Personalized pediatric therapeutics

These studies addressing translational, pharmacometrics, and clinical research, respectively, will be reviewed separately and then as an integrated proposal.

The goals of Consortia Paediatric Research Study Sponsors supported research are to advance our understanding of biological systems, to improve control of disease, and enhance health. In their written critiques, reviewers will be asked to comment on each of the following criteria in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. Each of these criteria will be addressed and considered in assigning the overall score and weighted as appropriate for each application. Note that an application does not need to be strong in all categories to be judged likely to have major scientific impact and thus deserve a high priority score.

Significance:

Does this study address an important problem? If the aims of the application are achieved, how will scientific knowledge or clinical practice be advanced? What will be the effect of these studies on the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field? What is the potential of the proposed study? Does this study address an important aim? What is the likelihood that this study will lead to other synergetic and complementary projects that will close knowledge gaps, remove obstacles and/or move toward personalized pediatric therapy?

In order to better understand the use of drugs in children and the important clinical problems that derive from patient- oriented therapeutics, a more focused use of genomics, proteomics, biomarkers, functional imaging, pharmacogenetics and bench to bedside/bedside-to- bench translational research will be required.

Approach:

Are the conceptual or clinical framework, design, methods, and analyses adequately developed, well integrated, well-reasoned, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics? Does the patient-oriented therapeutics research include the focused use of newer technology (e.g., genomics, proteomics, and pharmacogenetics)?

Innovation:

Is the project original and innovative? For example: Does the project challenge existing paradigms or clinical practice; address an innovative hypothesis or critical barrier to progress in the field? Does the project develop or employ novel concepts, approaches, methodologies, tools, or technologies for this area? Does it take advantage of historical research strengths at the center? Does the project develop or employ novel approaches, drugs, or devices?

Investigators:

Are the investigators appropriately trained and well suited to carry out this work? Is the work proposed appropriate to the experience level of the Principal Investigator and other researchers? Does the PD/PI(s) and investigative team bring complementary and integrated expertise to the project (if applicable)?

Environment:

Does the clinical research infrastructure in which the work will be done contribute to the probability of success? Do the proposed studies benefit from unique features of the scientific environment, or subject populations, or employ useful collaborative arrangements? Is there evidence of institutional support? Are adequate numbers of patients available to answer the questions asked?

Gaps in knowledge research application

In their written critiques, reviewers will be asked to comment on each of the following criteria in order to judge the likelihood that the proposed research will have a substantial impact in preventing failures of efficacy drug trials in pediatrics. These criteria will be addressed and considered in assigning the overall score, and weighted as appropriate for each application. Note that an application does not need to be strong in all categories to be judged likely to have major scientific impact and thus deserve a meritorious priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward.

Significance:

Does the application address an important pharmacologic and/or therapeutic knowledge deficiency that prevents or significantly contributes to failure of efficacy drug trials in pediatrics? Are the results likely to positively impact pediatric drug development?

Approach:

Are the conceptual or clinical framework, design, methods, and analyses adequately developed, well integrated, well reasoned, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics?

Innovation:

Is the project original and innovative? For example does the project propose an innovative biomarker or pharmacodynamic measurement allowing pk-pd correlations and modeling? Does the project develop or employ novel approaches or study designs?

Investigators:

Are the investigators appropriately trained and well suited to carry out this work? Is the work proposed appropriate to the experience level of the Principal Investigator and other researchers?

Environment:

Does the clinical research infrastructure in which the work will be done contribute to the probability of success? Are adequate numbers of patients available at this center to make a significant contribution toward completion of the proposed trial? Do the proposed studies benefit from unique features of the scientific environment, or subject populations, or employ useful collaborative arrangements? Is there evidence of institutional support?

Consortia Paediatric Research Network Focal Centre Administration unit

Are the plans for overall administration of the Nodal Center, coordination of clinical, translational and collaborations presented and sufficient for the requirements of the proposed Consortia Paediatric Research Network Focal Centre? Is the plan for communication of all personnel within the consortium well described?

Pivotal Components

Are the investigators in each core trained and well suited to carry out the work required by this Call For Paediatric Research Grants Applicants ? Does the investigative team in each pivotal component bring complementary and integrated expertise to conduct the type of studies specified in this Call For Paediatric Research Grant Application? Are the investigators committed to the collaborative and nature of this program? Is the investigative team committed to collaborate in projects that involve all three cores and inter-Center studies? Are the plans for integrating the activities of the Consortia Paediatric Research Network Focal Centre clinical, pharmacometrics and/or translational research cores well develop? Are the plans to integrate disease and pharmacologic research with existing institutional resources (e.g., laboratory support including pharmacometrics/pharmacogenomics, and other “omics’ technologies) effective?

Training Pivotal Component

Is the plan for training new investigators adequate and appropriate? Does the proposed plan for the training describe how promising candidates for clinical and translational research in pediatric therapeutics will be selected? Are environments within Consortia Paediatric Research Network Focal Centreappropriate for supporting the training of new investigators? Does the proposed plan address how the investigators will seek out and include qualified women and minorities for participation in the training component of the program

Overall Clinical Research Program Organization and Capability

Research Governance and Leadership:

Are the scientific qualifications and involvement of the Principal Investigator Consortia Paediatric Research Network Focal Centre Director as well as his/her scientific and administrative leadership capabilities and commitment presented and sufficient for the requirements of the proposed Consortia Paediatric Research Network Focal Centre ?

Are the qualifications, experience, and commitment of the key investigators such as the paediatric subspecialist, pharmacometrics and developmental pharmacologist) commensurate with the goals of this call for Paediatric Research Study grants application

Pediatric Research Volunteers population availability:

Is the access to patients in the chosen therapeutic areas and other populations for conducting current and projected clinical/translational research adequate to ensure likely success of the goals of the program?

Institutional Commitment:

Is there institutional commitment to establishing the Consortia Paediatric Research Network Focal Centre as an integral part of its overall clinical research environment? Will the institution align or adjust incentives and rewards to promote the academic mission of collaborative pediatric pharmacology research? Is there commitment from the institutional leadership to protect the time of the investigators to pursue clinical research and mitigate the demands of providing patient care? Will clinical researchers/trainees training be supported? Is the institutional leadership committed to this program and its goals in terms of providing specific assets specifically for the program, such as faculty support, specific equipment, dedicated space, or financial support as a few examples? If a pediatric Statistics and Data Collection,Analysis and Management Department resides in the institution(s) is there evidence of support supporting the goals of the Consortia Paediatric Research Network Focal Centre ?

Performance in Collaborative Clinical Trials:

Does the applicant center have a track record of success enrolling patients in prior multicenter collaborative clinical trials?

Participation and Collaboration: How many collaborative clinical trials has the applicant center participated in during the last ten years? Is the applicant center likely to be a strong team player in the Consortia Paediatric Research Network Focal Centre clinical or translational research component? Does the present overall application reflect a willingness to collaborate on the part of the applicant center working with other institutions and relying on multidisciplinary teams?

Collaboration: Do the investigators state their willingness to participate in joint meetings, share methods and data resources, and embark on collaborative efforts to decide overall research direction? Is the research plan flexible enough to accommodate further refinement and integration with other efforts? While it will be a group decision to actually engage in any particular proposed collaborative activities, do the applicants show an understanding of how joint collaborative activities can be conducted in a consortium of this type?

Additional Review Criteria:

In addition to the above criteria, the following items will continue to be considered in the determination of scientific merit and the rating:

Protection of Human Subjects from Research Risk: The involvement of human subjects and protections from research risk relating to their participation in the proposed research will be assessed refer to the Research Plan section on Human Subjects in the guides and instructions for grant applicants.

Inclusion of Women, Minorities and Children in Research:

The adequacy of plans to include subjects from both genders, all racial and ethnic groups and subgroups, and children as appropriate for the scientific goals of the research will be assessed. Plans for the recruitment and retention of subjects will also be evaluated refer to the Research Plan section on Human Subjects in the guides and instructions to paediatric research grant applications.

Care and Use of Vertebrate Animals in Research: If vertebrate animals are to be used in the project, the five points described in the Vertebrate Animals section of the Research Plan will be assessed.

Biohazards: If materials or procedures are proposed that are potentially hazardous to research personnel and/or the environment, determine if the proposed protection is adequate.

Additional Review Considerations

Budget:

The reasonableness of the proposed budget and the requested period of support in relation to the proposed research. The priority score should not be affected by the evaluation of the budget.

Resource Sharing Plans

When relevant, reviewers will be instructed to comment on the reasonableness of the following Resource Sharing Plans, or the rationale for not sharing the following types of resources. However, reviewers will not factor the proposed resource sharing plans into the determination of scientific merit or priority score, unless noted otherwise in the call for Paediatric Research Grant Applications. Program staff within the Consortia Paediatric Research Network Study Sponsors Institutional Council will be responsible for monitoring the resource sharing.

Data Sharing Plan.

Refer to the appropriate webpage of the Consortia Paediatric Research Network Study Sponsors Centre for the guide and instructions on data sharing plan for paediatric research study grant applicants.

Sharing Model Organisms.

Refer to the appropriate webpage of the Consortia Paediatric Research Network Study Sponsors Centre for the guide and instructions on sharing model animal for paediatric research study grant applicants such as that applicable to Genomic Studies .

Anticipated Announcement and Award Dates

To be communicated in due course.

Section on Award Administration Information

Award Notices

After the peer review of the application is completed, the Project Director/Principal Investigator will be able to access his or her Summary Statement or written critique via a given link in the Refer to the appropriate webpage of the Consortia Paediatric Research Network Study Sponsors Centre for the guide and instructions on Award Administration Information for paediatric research study grant applicants.

If the application is under consideration for funding, Award Administration Information will request just-in-time. information from the applicant. For details, applicants may refer to the Award Administration Information Grants Policy Statement for guides on : Terms and Conditions of Consortia Paediatric Research Network Study Sponsors Grant Awards,

General.Award Information.

A formal notification in the form of a Notice of Award will be provided to the applicant organization. The Notice of Award signed by the grants management officer is the authorizing document. Once all administrative and programmatic issues have been resolved, the Notice of Award will be generated via email notification from the awarding component to the grantee business official as designated in a given itemised number on the Application First Page.

If a grantee is not email enabled, a hard copy of the Notice of Award will be mailed to the official institutional.

Selection of an application for award is not an authorization to begin performance. Any costs incurred before receipt of the Notice of Award are at the recipient's risk. These costs may be reimbursed only to the extent considered allowable pre-award costs. Refer to Section on. Funding Restrictions.

Administrative and Institutional Statutory Policy Requirements

All Consortia Paediatric Research Network Study Sponsors Grant Awards, and cooperative agreement awards include the Consortia Paediatric Research Network Study Sponsors Grant Awards, Grants Policy Statement as part of the Notification of Award. For these terms of award, see the Consortia Paediatric Research Network Study Sponsors Grant Awards,

Grants Policy Statement section for guide on I: Terms and Conditions of Consortia Paediatric Research Network Study Sponsors Grant Awards, section on : General Consortia Paediatric Research Network Study Sponsors Grant Awards, pol icy at Consortia Paediatric Research Network Study Sponsors Grant Awards,web page on award policy for applicants guide and the second section on Terms and Conditions of Grant Awards, : Terms and Conditions for Specific Types of Grants, Grantees, and Activities Consortia Paediatric Research Network Study Sponsors web page on grants award policies for the guide of grant policies.

The following Terms and Conditions will be incorporated into the award statement and will be provided to the Principal Investigator as well as to the appropriate institutional official, at the time of award.

Cooperative Agreement Terms and Conditions of Award

Cooperative Agreement Mechanism

These special Terms of Award are in addition to and not in lieu of otherwise applicable administrative guidelines, Consortia Paediatric Research Network Study Sponsors Grant Administration Regulations at Consortia Paediatric Research Network Study Sponsors Grant Administration policy statements.

The administrative and funding instrument used for this program is a cooperative agreement , an assistance mechanism (rather than an acquisition mechanism in which substantial Consortia Paediatric Research Network Study Sponsors scientific and/or programmatic involvement with the awardee is anticipated during performance of the activity. Under the cooperative agreement, the NIH purpose is to support and/or stimulate the recipient's activity by involvement in and otherwise working jointly with the award recipient in a partner role, but it is not to assume direction, prime responsibility, or a dominant role in the activity. Consistent with this concept, the dominant role and prime responsibility for the activity resides with the awardee(s) for the project as a whole, although specific tasks and activities in carrying out the studies will be shared among the awardees and the Consortia Paediatric Research Network Study Sponsors Institutional Council Project Scientist/Coordinator/Collaborator as described below.

Principal Investigator Rights and Responsibilities

The Consortia Paediatric Research Network program will include non-collaborative, intra Center functions, as well as collaborative, inter-focal Center functions involving interactions between individual focal Centers.

The Principal Investigators will be responsible for managing the theConsortia Paediatric Research Network Studyfoca centre This will include ensuring that all components for individual Nodal Centers are in place and functioning and all subprojects and cores are making satisfactory progress.

Each Principal Investigator will have primary responsibility to define objectives and approaches and to plan, analyze, and publish results, interpretations, and conclusions of studies. The Consortia Paediatric Research Network Study Sponsor Program scientist will periodically review the progress of each focal Center and undertake a quality assurance audit process, but will not participate in the design of non-collaborative research.

The Consortia Paediatric Research Network Study Sponsor will be involved in approval and oversight of clinical protocols within no-collaborative intra Center clinical research projects. The External Advisory committee will review non-collaborative research for quality of science and compliance with the theConsortia Paediatric Research Network Study Focal Centres goals and objectives. The reviews will be performed every six months for the first two years of the funding cycle and yearly thereafter. The Consortia Paediatric Research Network Study Sponsor will play an assistive, optional role in the design of non-collaborative focal Centers research, but will be responsible for assisting with the preparation and presentation of all intra Center clinical research protocols before the theConsortia Paediatric Research Network Study.

The awardees will have lead responsibilities in all aspects of research design, including any modification of study design; quality control; data interpretation; preparation of publications and collaboration with other investigators, unless otherwise provided for in these terms or by action of the Steering Committee.

Collaborative research protocols will be review by a protocol review Committee appointed by the Steering Committee. Awardees agree to the governance of all collaborative studies. The awardees retain custody of and primary rights to the data developed under those awards, subject to government rights of access, consistent with current theConsortia Paediatric Research Network Study policies. Awardees must be willing to participate and collaborate with other awardees and with the Consortia Paediatric Research Network Study Sponsor staff.

Awardee(s) are expected to contribute data to the Paediatric Awardee(s) of the Paediatric Research Network Study Sponsor data cases,they are also expected to contribute DNA and plasma samples for all consenting patients specimens to the appropriate repository for studies requiring phenotypic-genotypic correlations or other recognised genomic studies data bases.

Responsibilities

Paediatric Research Network Study Sponsor Program Scientist

The Paediatric Research Network Study Sponsor Program Scientist is responsible for the overall scientific administration of the Paediatric Research Network Study Sponsor.The Paediatric Research Network Study Sponsor Program Scientist will be a member of the Paediatric Research Network Study Sponsor Steering Committee.

The role of the Paediatric Research Network Study Sponsor Program Scientist will be to aid the awardees and the consortium Steering Committee in the following ways:

Assist in the efficient conduct of studies, interventions and trials, including ongoing review of progress,possible redirection of activities to improve performance, and frequent communication with other members of the consortium Steering Committee.

Assist in the development of study protocols.

Assist in the review and evaluation of the program and in the development of new research goals through the funding cycle in conjunction with the Steering Committee and the External Advisory Board.

Assist in reporting results in the community of investigators and health care recipients.

Serve as liaison between the grantees and the other researchers involved in basic and translational research in developmental pharmacology to foster scientific collaboration and interaction.

Coordinate the Paediatric Research Network Study Sponsor activities with other Paediatric Research Network Study Sponsor -funded pediatric clinical trials consortium to facilitate development of joint projects, avoid duplication, and maximize efficiency.

Participate in data analysis, interpretations and, where warranted, co-author publications that report results of studies performed under this call for . Paediatric Research Network Study grant applications

Provide assistance to the consortium Steering Committee in the development of procedures for monitoring the performance of the studies. This includes participation in periodic on-site monitoring with respect to compliance with protocol specifications, quality control and accuracy of data recording, and accrual.

Perform other duties required for normal custodian, governance and stewardship of grants.

Coordinate research efforts across different funding mechanisms and research structures.

Assist in the interaction between awardees and investigators at other institutions, as well as between awardees and other Federal agencies and/or potential commercial sponsors.

Paediatric Research Network Study grant applications Project Officer

The Paediatric Research Network Study grant applications will appoint a Project Officer, apart from the Program Scientist, who will:

Assure the scientific merit of studies, interventions, and trials done under this initiative, including the option to withhold support of a participating Paediatric Research Network Studyfocal Centers if technical performance requirements such as protocol compliance and enrollment targets are not met.

Initiate a decision to modify or terminate a study based on the advice of the Data Safety and Monitoring Committee and the Advisory Board after consultation with the consortium Steering Committee.

The Paediatric Research Network Study grant applications reserves the right to terminate or curtail a study (or an individual award) in the event of substantial shortfall in participant recruitment, follow-up, data reporting, quality control or other major breach of a protocol; if a study reaches a major study endpoint substantially before schedule with persuasive statistical significance; if qualified scientific investigators are not available to participate in the study; if an awardee fails to participate in the committee/group activities; or if there are human subject ethical issues that may dictate a premature termination.

Collaborative Responsibilities

The Paediatric Research Network Study Focal Centres will be managed by a Steering Committee, an Extramural Scientific Advisory Committee and designated Paediatric Research Network Study Focal Centre applications staff.

The Paediatric Research Network Study Sponsors will be substantially involved as a partner in providing overall scientific guidance and support consistent with the cooperative agreement mechanism a designated Paediatric Research Network Study grant applications staff person will monitor study progress and serve in the Steering Committee, and Extramural Scientific Advisory Committee.

The Steering Committee will be composed of the Principal Investigators of each Paediatric Research Network Study Focal Centre. The Chairperson of the Steering Committee will be selected by .the Paediatric Research Network Study Sponsor . All major decisions will be made by the Steering Committee. As needed the Steering Committee may establish subcommittees for special purposes.

Each full member will have one vote. Awardee members of the Steering Committee will be required to accept and implement policies approved by the Steering Committee.

The role of the Steering Committee will be to review, approve, oversee and promote inter nodal centers’ projects and activities and harmonize research across the different therapeutic areas.

As a guide, a Consortium translational science and a pharmacometrics working groups that include Principal Investigators in developmental pharmacology and pharmacometrics investigators from all Paediatric Research Network Study Centers, will integrate results from different programmatic pathways, oversee inclusion in the Paediatric Research Network Study Focal Centres data repository, further development of paediatric prior knowledge base and determine opportunities for expanded research conducted in the Consortium, in collaboration with other networks or with project specific ad hoc groups of investigators.

The External Scientific Advisory Committee will be appointed by the Paediatric Research Network Study and will be composed of experts in the various disciplines involved in the Paediatric Research Network Study Focal Centres projects. The Paediatric Research Network Study Sponsors will conduct at a minimum an annual review of the: interim progress of all research projects of individual Focal Centers and review of accomplishments and progress towards meeting the Paediatric Research Network Study goals for the Consortium as a whole; ; adherence to the Paediatric Research Network Study conceptual framework and theme In addition the Paediatric Research Network Study Sponsors Moderators will advise the Paediatric Research Network Study on scientific merit and synergistic value of requests for developmental funds.

The Paediatric Research Network Study will appoint an independent Data and Safety Monitoring Board for clinical trials.

Communication within each Paediatric Research Network Study Focal Center and between Consortia will be facilitated by using Share Point and Adobe Connect web casts. The Statistics and Data Management and Coordinating Center will set up and coordinate all meetings within the Consortium and with other consortiums, networks or organizations.

During the early program development phase usually the first year of the new Consortium conference calls between components within each Paediatric Research Network Study Focal Center will be held weekly and biweekly thereafter. conference calls will be held monthly.

Arbitration Procedure.

Any disagreements that may arise in scientific or programmatic matters within the scope of the award, between award recipients and the Paediatric Research Network Study Sponsors may be brought to arbitration. An Arbitration Panel composed of an odd number of members usually between three to nine will be convened. It will have designated members: designees of the Steering Committee chosen without Paediatric Research Network Study Sponsors staff voting, Paediatric Research Network Study Sponsors designees, and designees chosen with expertise in the relevant area who are selected and co-opted by the other ; in the case of individual disagreement, the initial members may be chosen by the individual awardee. This special arbitration procedure in no way affects the awardee's right to appeal an adverse action that is otherwise appealable in accordance with the stipulated regulations on good paediatric research practices.

Reporting

Awardees will be required to submit the Non-Competing Continuation Grant Progress Report annually and financial statements as required in the Paediatric Research Network Study Sponsors Grants Policy Statement.

A final progress report, invention statement, and Financial Status Report are required when an award is relinquished when a recipient changes institutions or when an award is terminated.

Agency Contacts

We encourage your inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants. Inquiries may fall into three areas: scientific/research, peer review, and financial or grants management issues:

Relevant Scientific/Research Contacts:

Program Scientist

Perinatal and Pediatric Subspecialty Therapeutics Branch

Paediatric Research Network Study Sponsors

Telephone:

FAX:

Email:

Program Officer

Perinatal and Pediatric Subspecialty Therapeutics Branch

Paediatric Research Network Study Sponsors

Telephone:

FAX:

Email

Peer Review Contacts:

Director, Division of Scientific Review

Perinatal and Pediatric Subspecialty Therapeutics Branch

Paediatric Research Network Study Sponsors

Telephone:

FAX:

Email

Relevant Peer Review Contacts:

Financial/Grants Management Contact(s):

Perinatal and Pediatric Subspecialty Therapeutics Branch

Paediatric Research Network Study Sponsors

Physical/Postal Address.

Telephone:

FAX:

Email

Peer Review Contacts:

Chief Grants Management Officer

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Required Statutory Citations

Use of Animals in Research:

Recipients of Consortium Paediatric Research Network Study Sponsors support for activities involving live, vertebrate animals must comply with Consortium Paediatric Research Network Study Sponsors policy on Humane Care and Use of Laboratory Animals Consortium Paediatric Research Network Study Sponsors grants policy for Laboratory Animals use as mandated by the Health Research Extension Act and the the Animal Welfare Regulations as applicable.

Human Subjects Protection:

Statutory regulations require that applications and proposals involving human subjects must be evaluated with reference to the risks to the subjects, the adequacy of protection against these risks, the potential benefits of the research to the subjects and others, and the importance of the knowledge gained or to be gained.

Data and Safety Monitoring Plan:

Data and safety monitoring is required for all types of clinical trials, including physiologic toxicity and dose-finding studies (phase I); efficacy studies (Phase II); efficacy, effectiveness and comparative trials (Phase III). Monitoring should be commensurate with risk. The establishment of data and safety monitoring boards is required for multi-site clinical trials involving interventions that entail potential risks to the participants please refer to Consortium Paediatric Research Network Study Sponsors Policy for Data and Safety Monitoring, and Guide for Grants and Contracts in the guides and instructions to applicants.

Sharing Research Data

Investigators submitting grant applications to the Consortium Paediatric Research Network Study Sponsors for grant award seeking above the conventionally designated amount or more in direct costs in any single year are expected to include a plan for data sharing or state why this may not be achievable possible refer to Consortium Paediatric Research Network Study Sponsors guides and instructions to applicants on data sharing.

Investigators should seek guidance from their institutions, on issues related to institutional policies and local Institutional Review Boards rules, as well as applicable statutory laws and regulations, including the Privacy Rule. Reviewers will consider the data sharing plan but will not factor the plan into the determination of the scientific merit or the priority score.

Policy for Genome-Wide AssociationStudies :

Since The Consortium Paediatric Research Network Study Sponsors is interested in advancing genome-wide association studies to identify common genetic factors that influence health and disease through a centralized Genomic –Wide Association Studies data repository. For the purposes of this policy, a genome-wide association study is defined as any study of genetic variation across the entire human genome that is designed to identify genetic associations with observable traits -such as blood pressure or weight), or the presence or absence of a disease or condition. All applications, regardless of the amount requested, proposing a genome-wide association study are expected to provide a plan for submission of Genome Wide Association Studies data to the NIH-designated Genome Wide Association Studies data repository, or provide an appropriate explanation why submission to the repository is not possible. Data repository management submission and access is governed by the Policy for Sharing of Data Obtained in Consortium Paediatric Research Network Study Sponsors

Supported or Conducted Genome-Wide Association Studies, For additional information, refer to the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

Access to Research Data through the Freedom of Information Act:

The Office of Management and Budget has been advised to provide access to research data through the Freedom of Information Act under some circumstances. Data that are (1) first produced in a project that is supported in whole or in part with Federal funds and (2) cited publicly and officially by a Federal agency in support of an action that has the force and effect of law or a regulation may be accessed through Freedom of Information Act. It is important for applicants to understand the basic scope of this amendment. The Freedom of Information Act has provided guidance at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards policy for guidance.

Applicants may wish to place data collected under this funding opportunity in a public archive, which can provide protections for the data and manage the distribution for an indefinite period of time. If so, the application should include a description of the archiving plan in the study design and include information about this in the budget justification section of the application. In addition, applicants should think about how to structure informed consent statements and other human subjects procedures given the potential for wider use of data collected under this award.

Sharing of Model Organisms:

The Consortium Paediatric Research Network Study Sponsors .is committed to support efforts that encourage sharing of important research resources including the sharing of model organisms for biomedical research for details refer to the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance. Policy on model organisms. At the same time the theConsortium Paediatric Research Network Study Sponsors .recognizes the rights of grantees and contractors to elect and retain title to subject inventions developed with Statutory funding pursuant to the relevant Act refer to the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance. on Grants Policy Statement . All investigators submitting an application or contract proposal are expected to include in the application/proposal a description of a specific plan for sharing and distributing unique model organism research resources generated using the Consortium Paediatric Research Network Study Sponsors funding or state why such sharing is restricted or not possible. This will permit other paediatric research investigators to benefit from the resources developed with statutory funding. The inclusion of a model organism sharing plan is not subject to a cost threshold in any year and is expected to be included in all applications where the development of model organisms is envisaged.

Inclusion of Women And Minorities in Clinical Research:

It is the policy of theConsortium Paediatric Research Network Study Sponsors.thatwomen and members of minority groups and their sub-populations must be included in all the Consortium Paediatric Research Network Study Sponsors .supported clinical research projects unless a clear and compelling justification is provided indicating that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research.

All paediatric research investigators proposing clinical research should read the theConsortium Paediatric Research Network Study Sponsors .

Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.and do well to undertake continual follow ups for amendments,updates and revisions especially as related to .updated policy incorporates: the use of an standardised definition of clinical research; updated racial and ethnic categories in compliance with the new standards; clarification of language and other pertinent research governance issues.

Good Research Practices continue to require theConsortium Paediatric Research Network Study Sponsors defined Phase III clinical trials consistent with the new standardised Form ; and updated roles and responsibilities of the Consortium Paediatric Research Network Study Sponsors .staff and the extramural community. The policy continues to require for all the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.-defined Phase III clinical trials that: all applications or proposals and/or protocols must provide a description of plans to conduct analyses, as appropriate, to address differences by sex/gender and/or racial/ethnic groups, including subgroups if applicable; and investigators must report annual accrual and progress in conducting analyses, as appropriate, by sex/gender and/or racial/ethnic group differences.

Inclusion of Children as Participants in Clinical Research:

The maintains a policy that children that is individuals under the age of 21 must be included in all clinical research, conducted or supported by the NIH, unless there are scientific and ethical reasons not to include them.

All investigators proposing research involving human subjects should read the theConsortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

Policy and Guidelines on the inclusion of children as participants in research involving human subjects the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance for children.

Required Education on the Protection of Human Subject Participants:theConsortium Paediatric Research Network Study Sponsors policy requires education on the protection of human subject participants for all investigators submitting the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.applications for research involving human subjects and individuals designated as key personnel. The policy is available at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards notice for guidance.

Human Embryonic Stem Cells :

Criteria for federal funding of research on Human Embryonic Stem Cells can be found at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.on stem cells

Only research using Human Embryonic Stem Cell lines that are registered in the theConsortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.Human Embryonic Stem Cell Registry will be eligible for Statutory funding . It is the responsibility of the applicant to provide in the project description and elsewhere in the application as appropriate, the official the Consortium Paediatric Research Network Study Sponsors identifier(s) for the human Embryonic Stem Cell lines to be used in the proposed research. Applications that do not provide this information will be returned without review.

The Consortium Paediatric Research Network Study Sponsors Public Access Policy Requirement:in accordance with the theConsortium Paediatric Research Network Study Sponsors .Public Access Policy refer to the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

Investigators must submit or have submitted for them their final, peer-reviewed manuscripts that arise from the Consortium Paediatric Research Network Study Sponsors grant.funds and are accepted for publication within the last two years to PubMed Central or other designated database , to be made publicly available no later than one year after publication. Investigators must include the PubMed Central or any other designated data base reference number when citing an article in the Consortium Paediatric Research Network Study Sponsors paediatric research grant applications, proposals, and progress reports that fall under the policy, and was authored or co-authored by the investigator or arose from the investigator’s the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.award. For more information,refer to see the Public Access webpage at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

Standards for Privacy of Individually Identifiable Health Information:

Other issues worthy of consideration includes the Privacy of Individually Identifiable Health Information, the Privacy Rule. The Privacy Rule is a statutory regulation under the Health Insurance Portability and Accountability Act which governs the protection of individually identifiable health information, and is administered and enforced by the Office for Civil Rights.

Decisions about applicability and implementation of the Privacy Rule reside with the researcher and his/her institution. the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

On The Office of Civil Rights website provides information on the Privacy Rule, including a complete Regulation Text and a set of decision tools on :Am I a covered entity?Information on the impact of the Privacy Rule on the Consortium Paediatric Research Network Study Sponsors processes involving the review, funding, and progress monitoring of grants, cooperative agreements, and research contracts can be found at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

URLs in the Consortium Paediatric Research Network Study Sponsors and .Grant Applications or Appendices:

All applications and proposals for theConsortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.funding must be self-contained within specified page limitations. For publications listed in the appendix and/or Progress report, internet addresses (URLs) must be used for publicly accessible on-line journal articles. Unless otherwise specified in this solicitation, Internet addresses (URLs) should not be used to provide any other information necessary for the review because reviewers are under no obligation to view the Internet sites. Furthermore, we caution reviewers that their anonymity may be compromised when they directly access an Internet site.

Healthy People 2010:

The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of Healthy People a PHS-led national activity for setting priority areas. This Free Official Access is related to one or more of the priority areas. Potential applicants may obtain a copy of Healthy People at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance. On healthy people.

Authority and Regulations

This program is described in the Catalog of Statutory Domestic Assistance at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.and is not subject to the conventional interstatutory review requirements.

All awards are subject to the terms and conditions, cost principles, and other considerations described in the the Consortium Paediatric Research Network Study Sponsors .Grants Policy Statement. The NIH Grants Policy Statement can be found at the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

The the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.strongly encourages all grant recipients to provide a smoke-free workplace and discourage the use of all tobacco products. In addition, Statutory Public Law , the Pro-Children Act , prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care, or early childhood development services are provided to children. This is consistent with the the Consortium Paediatric Research Network Study Sponsors guidance. mission to protect and advance the physical and mental health of the American people.

Loan Repayment Programs:

The Consortium Paediatric Research Network Study Sponsors encourages applications for educational loan repayment from qualified health professionals who have made a commitment to pursue a research career involving clinical, pediatric, contraception, infertility, and health disparities related areas. The Loan Repayment Plan is an important component of the Consortium Paediatric Research Network Study Sponsors efforts to recruit and retain the next generation of researchers by providing the means for developing a research career unfettered by the burden of research scholars loan debt. Note that an the Consortium Paediatric Research Network Study Sponsors grant is not required for eligibility and concurrent career award and Loan Repayment Programs applications are encouraged. The periods of career award and Loan Repayment Programmes award may overlap providing the Loan Repayment Programmes recipient with the required commitment of time and effort, as Loan Repayment Programmes awardees must commit at least fifty percent of their time at least twent hours per week based on a forty hour week for two years to the research. For further information, please see: the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance. On Loan Repayment Programmes.

.Other guidance tips for grant applicants.

Check Weekly Alerts For Further TOC for this Announcement

Check Funding Opportunities and Notices of the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

Contact the Office of Extramural Research the Consortium Paediatric Research Network Study Sponsors web page on grants and awards for guidance.

Question: How can universities produce revolutionary PhD and Post Doc thesis and dissertations on Paediatrics? What are your recommendations to improve the academic standards?

Answer:

Recommendations

In response to this question,in my key findings, I have identified some initiatives to facilitate greater contribution by university PhD graduates and Post Doctoral Fellows in global scientific development through the production of revolutionary PhD and Post Doc thesis and dissertations on Paediatrics and Child healthin this discussion.

These innovations and initiatives includes but not confined to the formulation of a globally acceptable strategy for doctoral education, driven by the respective sectoral and institutional governance , multifaceted support structures for doctoral graduates and post-doctoral fellows and the alignment of knowledge and skills with employment and entrepreneural prospects.

These initiatives, individually and in combination, would facilitate an environment for current and future PhD graduates and to maximise their contribution to global development through the production of revolutionary PhD and Post Doc thesis and dissertations on Paediatrics and child health.

Formulating a Global Strategy for Doctoral Education

The first key finding of the compromises in this aspect ofthe compromises that needs to be addressed was a lack of interest and eagerness to benefit from the scientific scholarship output of the global PhD graduates and post-doctoral fellows through the scientific application and use of revolutionary PhD and Post Doc thesis and dissertations on Paediatrics and Child health.

A global approach and strategy for doctoral and post-doctoral education may be needed in order to address this issue and allow the global scientific community and the society at large to benefit more from its PhD graduates and post-doctoral fellows.

This could be linked directly with global multilateral plans for numerous sectors, particularly education, child health and national human resource development, to help drive overall global development since a healthy child will give rise to a healthy society and world.

A global strategy will also provide a global action plan for capacity and capability building and assuage youth employment and underemploymewnt challenges.

Formulated in partnership with key stakeholder groups , a global approach and strategy to improve the academic and scientific standards of the revolutionary PhD and Post Doc thesis and dissertations on Paediatrics and Child health, will encourage scientific global community engagement and collaboration, boosting the overall positive developmental outcomes for all.

This global strategy will need commitment from the multilaterals and the national governments in formulating a comprehensive policy for their doctoral and post doctoral education. This will need to include the encouragement of several schemesof postgraduatestudentships, scholarships and fellowships of varied developmental character.

Also to augment the academic and standard outputs of these sets of scholars it will be worthwhile to have a decent, dedicated and specified criteria for research scholarship funding allocations and appropriations.

Also it will be pertinent to establish a competitive tenure track career progression scheme for researchers and academics of rank and files from Graduate Assistanceships to Emeritus Professorships.

At the global and national levels, global scientific bodies,multilaterals and other Paediatric research Sponsors should plan and document priority research areas for Paediatric Research,in this way research associates co-opted as doctoral and post doctoral candidates will be adequately funded and supervised to improve the scientific standards of the revolutionary PhD and Post Doc thesis and dissertations on Paediatrics and Child health which will encourage scientific global development

Other steps in the right direction with regards to achieving this goal will include the creation of a global International PhD graduates and Post Doctoral Fellows Data Aggregation Advisory register adapted through virtual induction programs and interviews in order to keep employers ,sponsors and the other relevant stakeholders informed to facilitate the communication and collaboration between research sponsors, Paediatric PhD graduates and post doctoral fellows supervisors ,paediatric doctoral and post doctoral scholars, universities in these way all the involved parties and relevant stakeholders will be highly motivated to achieve distinction.

Also there may be need for supplementary global policies that will match demand and supply such as doctoral training plans that quantifies the demand for doctoral graduates and aligns their research topics with global ,regional, continental and national goals.

The introduction of a virtual Paediatric PhD graduate and Post Doctoral fellows induction programs to enable the smooth transition of these scholars into employment will further enhance their motivation to complete their dissertations and thesis on time with distinction. It could also serve as a source of relevant information, professional networks, and career pathways for these scholars

The Global press and regular media also have a role to play in demystifying and disseminating a clear message about the value of a PhD qualification, and of post doctoral education and research in general for the global scientific development in all aspects of human endevour such as health,science,education arts ,culture,security etc . They can also provide a valuable spring board for publicizing and celebrating the achievements of these scholars, increasing the visibility of their performance and capacity.

These are all positive attributes that would encourage these scholars to complete their trainings on time with distinction.

Other positive recommendations will include the encouragement of the establishment of a doctoral graduate and post doctoral network, post-PhD and post doc employment and career support systems, incentive schemes for multisectoral engagement and collaboration in addition to a performance-based salary scale.

In this way the PhD graduates and Post Doctoral graduates will be encouraged to connect with and support one another, share their significant research findings, engage in scientific intellectual debates, induct and mentor early-career researchers, organise seminars and conferences , and offer collective interdisciplinary consultancies in their areas of their interests or specializations.

To promote the career progression of the Paediatric PhD graduates, post-doctoral opportunities will need to be created which will facilitate their transition into scientifically productive employment, this will be best achieved by encouraging their participations and mentorships in entrepreneurial projects.

Also in a similar manner,it will be worthwhile for tenure tracks and to be established in the universities ,research institutions and Paediatric Academies, so that Post Doctoral Fellows on completion of their Fellowships could continue their academic and research stints.

The establishment of professorships at the university will open up career prospects for Paediatric PhD graduates and Post Doctoral Fellows as they will aspire to progress. In time, the initiative encouraging the establishment of International Institutes of Child health, biological Sciences and Technologies And Science Academies will be better poised to proffer more research projects and opportunities in addition to more credible mentorship programmes to Paediatric PhD graduates and Post Doctoral Fellows through the encouragement of more innovative and novel Paediatric BioMedical experimental and translational research to direct robust evidence based Paediatric clinical practice .

Other possible incentive schemes to promote stakeholder engagement in doctoral education can be implemented through tax concessions for financing aspiring Paediatric doctoralstudents to pursue research in specific topics relevant to targeted sectors

Given that a PhD thesis and Post-Doctoral Fellowship dissertations are essentially a personal project, it is therefore pertinent that original scientific and technical research reports derived from these the name of the candidate should be the first and the most senior person the last.in the author listing order, in this way the candidate will feel accomplished subject to living up to the standards expected from faculties of these ranks.

Other forms ofengagement include employment, and using the services of Paediatric doctoral graduates and Post Doctoral fellows for further research, teaching, mentorship programmes andadvisory consultancies.etc..

A federal and state government scheme to fund and facilitate start-ups for doctoral graduates to validate their ideas, realise their potential, and improve their prospects of achieving commercial and industrial success will also encourage innovation and entrepreneurship. The participation of other stakeholder groups will add value to the outcomes. Incubator and induction workshops are proposed for developing ideas driving innovation.

PhD graduates can draw on their expertise to apply for research grants in partnership withstakeholder groups. Strategies will be needed to facilitate working rights for Paediatric PhD graduates to work on projects for more thanone employer. This will broaden their options for contributing to variouseconomic sectors and society in general.

It is recommended that remuneration packages of Paediatric PhD graduates and Post Doctoral Fellows be reviewed to ensure transparency and equity with those of PhD graduates and Post Doctoral Fellows working in similar positions in the other disciplines. Salaries should be based on their performance and the quality of their scholarship output, with rewards built in for innovative ideas and outstanding accomplishments. These initiatives may need to be implemented exigently as a proof of appreciation of the Paediatric PhD graduates and Post Doctoral fellow expertise and the human capital value they represent.

Doctoral Expertise Aligned with Employment and Advisory Opportunities

To address the underutilisation of PhD graduates’ knowledge and skills, aligning their

expertise with employment is crucial. Consultancy work, advisory services and national think tanks require specialist expertise to inform discourse and debate. PhD graduates and Post Doctoral Research Fellows possess substantial knowledge that can be used effectively in relevant employment and numerous other forums to contribute to global development in both the academic and non-academic sectors.

Employers andHuman Resource Managers will need to understand the disciplinary

knowledge and generic skills of PhD graduates so that they can effectively recruit, manage and develop their competencies for fulfilling their career prospects. Aspiring paediatric PhD students must ensure alignment of their research topics with national requirements to be identified and articulated in a national plan, from which they can select and pursue appropriate studies for the global context.

To assist effective utilisation of their expertise it is incumbent upon Paediatric PhD and Post-Doctoral Research Fellows qualifies to promote proactively their knowledge and skills using online tools such as personal websites, and global internet bases and social media to increase outreach. They should also participate in scientific debates, televised programs, keynote addresses in academic conferences , and present their work to the national and international community and fellow researchers, with the objective of raising their profiles, promoting their expertise and networking with peers and stakeholders.

Implications for Further Research

One major implication for these recommendations is that eventually the Paediatric PhD graduates and Post Doctoral Fellows who are working in biological sciences will be more satisfied with their contribution than the others.

Their satisfaction will be associated with a high demand for their expertise and alignment of their PhD and Post Doctoral field of research with their employment.

Further research could investigate other these factors , which are amenable to high-

level contributions, with the aim of developing a framework of comprehensive factors that facilitate contribution from doctoral and post doctoral education education. The recommendations could potentially be applied to other employment sectors to help maximise the contribution of doctoral graduates to global development.

A study that examines and assess the demand and supply of doctoral expertise in Paediatrics and Child health could also be valuable for deriving further benefits from doctoral education and align global priorities with global development goals.

Conclusion

These recommendations will provide insights into the current contribution of Paediatric PhD graduates and Post Doctoral Fellows to global development.

Some of these contributions weremade through various leadership, consultancy and specialist advice roles, as well as teaching, research and publishing.

Some Paediatric PhD graduates and Post-Doctoral Fellows made socio-economic andglobal contributions through theirown personal achievements. A more indirect contribution was made in their workplaces, where the spillover effects of their skills and expertise influenced and inspired colleagues and subordinates .

It may well be that despite having substantial knowledge and skills in their fields of study, PhD graduates and Post Doctoral Fellows had limited impact on global development, and had untapped potential to contribute more to advancing research in global settings.

It is possible that the world has not been making full use of the knowledge, skills, capabilities and human capital of the Paediatric PhDgraduates and Post Doctoral Fellows because of

Several key factors which could have negatively influenced the contributions of Paediatric PhD graduates and Post Doctoral Fellows to global development such as but not confined to the global unpreparedness for doctoral education, restricted support for PhD graduates and Post Doctoral Fellows the underutilization of their expertise. These factors not only diminished their contributions to global development, but also prevented the Paediatric PhD graduates from reaching their academic career potentials.

In seeking approaches to maximize the contribution of Paediatric PhD graduates and Post Doctoral Fellows to global development, I have reiterated some initiatives for improving readiness and deriving more benefits from Paediatric PhD graduates and Post Doctoral Fellows. These initiatives includes but not confined to the formulation of a global doctoral and post doctoral research and scholarship funding approaches and strategy, development of support structures for PhD graduates and Post Doctoral Fellows,the alignment of doctoral graduates ’ expertise with employment and advisory services. Such initiatives could boost innovation and enable the contextual institutions to achieve its aspiration of becoming a knowledge-based economy, a knowledge hub for the global scientific community , and to compete in the modern research world.

A global strategy for doctoral education, including a policy and strategic investment, will help strengthen national research capability, harness greater contribution from Paediatric PhD graduates and Post Doctoral Fellows and drive national development. The investment has the potential to yield high returns, since doctoral graduates can help to increase productivity, enhance global development and create global wealth and prosperity.

Thank You

Question: What are your views on Corona Infection in infants and children?

Answer:

The impact of corona infection in children and infants is a very imoportant topical and challenging theme that is worthy of inquiry into several credible knowledge base and resources. In this discussion, I will highlight and comment on the enigmatic and peculiar phenomena associated with corona virus infection in children in comparison and relativity to the corona infection in adults.

Anedotally, although children of all ages could become sick and ill with coronavirus disease 2019 (COVID-19),however apparently ,most children who were infected typically may not look very sick or constitutionally upset when compared to the adults and indeed some may not show any symptomatologies at all,however this enigmatic tonality is deceptive and falsely reassuring ,infact it could be quite deleterious,since this more bening presentation of corona virus infection in children does not prevent them from covert ,subtle progressive downhill course complications,especialy those following unregulated, inflammatory responses with chemokines ,cytokines and other humoural factors liberation, in addition to its associated or related immune responses and immunopathologies which could affect several cell,tissue,organ systems of children with acute, subacute and chronic complications and vita end organ compromise . This said, given this enigmatic features of corona infection in children, it is therefore more important and pertinent to know the signs and symptomatologies of COVID-19 in infants and children, why children might be affected differently by COVID-19 and what measures could be do employed to ensure an effective and utmost prevention of the spread of the corona virus.

It has been observed that while children and adults may experience similar symptomatologies following the COVID-19 virus infection, on the average, the symptomatologies of the childhood age groups tend to be more subtle but not necessarily milder and an influenza infection related flu- cold-like illness has been a frequently observed pattern.

Overall, however it is known that most children infected by the corona virus will achieve an almost complete resolution of their symptomatologies within one to two weeks, but the questions to be asked remains that, is this recovery absolute and complete in every way without unforeseen and unpredictable interval short, medium and long term complications.

Given the favourable efficiency of the cost benefit ratio and positive health economics impact of an earlier timely diagnosis compared to a delayed one ,in this discussion I will itemise, highlight and illuminate on some of the possible symptomatologies of corona virus infection in the paediatric age group, other comparatively more subtle ,but not necessarily milder in children these could include but not confined to :

Fever which could simulate common childhood illnesses such as malaria or enteric fever.

Cough that progressively becomes productive which could mimic respiratory tract infections in children.

New loss of taste or smell which could be consistent with infective causes of congestion of the nose a form of congestive-obstructive rhinitis..

Changes in the colour of the skin, such as discolored areas on the feet and hands

Sore throat which could masquerade as other infective causes of pharyngitis or tonsillitis.

Gastrointestinal symptoms, such as nausea, vomiting, abdominal pain or diarrhoea

Chills and rigors which could falsely suggest acute malaria infection or other common bacteria or viral infections.

Muscle aches and pain which could spuriously be consistent with acute malarious infection or other common bacteria infections, viral infections or dermatomyositis.

Extreme fatigue may be thought to be related to common conditions like anaemia, hypoglycaemia, malnutrition, multiple vitamins or micronutrients deficiencies, excessive unguided child activity and play etc.

New onset severe headache may be thought to be related to acute plasmodium falciparium malaria,entericfever,typhoid fever,or other serious viral or bacterial infections such as meningitis or encephalitis,in other instances,it could be thought to be related to migraine,food allergy or over unduly challenging school academic work related to difficult home work and assignments in mathematics,physics,chemistry,biology calculus etc.

New nasal congestion could be misguidedly attributed to common viral and bacterial infections.

Of a growing scientific interest is the attempts to further elucidate the pathobiology, pathogenic mechanism, pathoimmunophysiology and the natural history of the corona virus infection, this is where the multisystem inflammatory syndrome in children -MIS-C in children came in .

MIS-C- is a serious condition in which some parts of the body — such as but not restricted to the heart, lungs, blood vessels, kidneys, digestive system, brain, skin or eyes — become severely inflamed. Evidence indicates that many of these children were infected with the COVID-19 virus in the past, as shown by positive antibody test results, suggesting that MIS-C is caused by an excessive immune response related to COVID-19.

Given the immediate and remote consequences of MIS-C following COVID-19 virus in this discussion, I will proffer and annotate of some of the possible signs and symptomtologies of the MIS-C which include but not confined to:

Fever that lasts twenty four hours or longer, this pattern of fever could be encountered in several common childhood infestations such as acute plasmodium falciparium malaria, acute, subacute, and chronic bacterial infections such as tuberculosis etc.

Vomiting is a common symptomatology in several common childhood infective illnesses such malaria,bacterial infectons,but also in helminthiasis, in addition to metabolic disorders such as juvenile diabetes mellitus, inborn errors of metabolism, acute and chronic renal failure,in addition to some paediatric surgical conditions such as appendicitis and intestinal obstruction of multiple aetiological factors such congenital hypertrophic pyloric stenosis,obstructed congenital or acquired inguinal hernias, congenital and infantile volvulus etc.

Diarrhea which is a common childhood symptomatology of gastroenteritis and diarrhoeal disease of childhood or acute plasmodium falciparium malaria or with complications choleric malaria which is a dangerous form of malaria that could if unmanaged progress downhill to algid malaria a severe shock like state.

Diarrhoea could also be a common symptomatology of lactose intolerance, Galactosaemia, tropical sprue or it could be due to a miscellenous subsets of causes of intestinal malabsorption.

Abdominal pain is a common symptomatology with diarrhoea and vomiting.

Skin rash which could simulate dermatitis or dermatosis of various aetiological factor which could be falsely thought to be related to exanthemas due to measles, rubella or varicellas ,in addition to allergic dermatitis ,eczema,atopy,systemic lupus erythematosis,dermatomyositis,dermatitishertiformis,erythemanodosum.,erythema marginatum, erythema annulare etc

Fast heartbeat could falsely be thought to be due to heart failure in a child, or related to a common febrile illness besides a corona related cause.

Rapid breathing could be related falsely to pneumonia or heart failure in a child.

Red eyes could be thought to be of an allergic, bacterial or other viral infective conjuctivitis such as adenovirus infectiveaetiological origin.Also the suspicion of trauma or non-accidental injury could be suggested and pursed as a course rather than corona virus related factors.

Redness or swelling of the lips and tongue could be erroneously attributed to an enanthemas due to a measles virus infection other febrile illnesses or an attempt by the child to ingest a common corrosive house hold substance such as caustic soda , bleach,petroleum products etc

Feeling unusually tired could be spuriously attributed to anaemia, hypoglycaemia etc.

Redness or swelling of the hands or feet could be falsely attributed to hands and foots disease of infancy due to parvavo- virus infection or sickle cell dactylitis.

Headache, dizziness or lightheadedness could be mistakenly be thought to be related to acute plasmodium falciparium malaria, meningitis, encephalitis ,other infective causes ,food allergy or migrainouscephalgias of childhood.

Enlarged lymph nodes may be falsely thought to be related to other more common childhood infective conditions such as mumps, rubella, tuberculosis etc.

Having considered this array of miscellenous mutisystemic symptomatologies and signs it is now an axiom that the impact of the corona infection and its complication of MIS-C has with in a very abbreviated period of time grossly and rapidly hiked up diagnostic considerations for common child hood illnesses with its implications for interventional and generac costs in order to eschew unduly high incidence of missed diagnosis and unwarranted multimodal interventions.

Emergency warning signs of MIS-C :

In this discussion, it is also pertinent to itemise and comment on some of the emergency warning and alert symptomatologies for the MIS-C-which include, but not confined to:

Inability to wake up or stay awake or a confusional state of a new onset which may be related to cerebral irritation or depression induced and sustained released by the inflammatory chemokines which has an excitatory or an inhibitory neurotransmitter like effect. These symptomatologies may also be related to very severe febrile responses or cerebral oedema secondary to inflammatory oedema in children.

Difficulty in breathing which may also be due to viral acute laryngotracheobronchitis, interstitial pneumonitis or with lack of interventions, it coud be secondarily cardiogenic in Corona Virus-19 inlammatory response and pneumonitis,which could lead to coronary artery thrombo-embolic infarction or non-cardiogenic pulmonary oedema a form of adult respiratory distress syndrome or shock lung.

Pale, gray or blue-colored skin, lips or nail beds — depending on skin tone is commonly due to central and peripheral cyanosis which is commonly related to cardio-pulmonary failure and shock syndrome.

Severe abdominal pain could be of gastrointestinal tract origin, or other intra-abdominal visceral organs inflammatory origin,it may also be related to intestinal or intrabdominal organ infarction, or in some other instances,it may represent a referred pain.

On the basis of the growing concern on the long time impact of the coronal virus infections in children, I wish to mention the new interest on the development a post-COVID-19 condition and phenomena which on the basis of some research studies on this theme intimate that children with both mild or covert and severe or overt COVID-19 have experienced long-term complications and symptomatologies.

The most common of these symptomatologies in children include but not confined to:

Tiredness and fatigue syndromes

Headache and Cephalgias

Difficulties with falling asleep or waking up after a brief period of non-restful sleep and unable to fall asleep again, this implies that the child will be challenged with early or late insomnias.

Difficulties with concentrating on a task at school and undue inattentiveness or diminished attention span,

Muscle pain known as`myalgia , and joint pain known as arthralgia.

In addition to Coughing.

These symptomatologies could affect the infected child’s ability to attend school, cope orundertake his or her usual academic and physical activities.

Parents whose children are experiencing long-term symptomatologies, which is thought to be related to COVID-19 infections should consider talking to the child’s teachers about their needs with regards to ensuring a full recovery for the child and preventing the affectations of the other children in the same class or stream. .

Although the ongoing debate on the value of administering COVID-19 vaccines to children since they do not have frequent and severe symptomatolgies,and disease and with COVID-19 infection appears to be plausible however,it has been demosnstrated following recent and ongoing investigations that

A COVID-19 vaccine could prevent a child from getting and spreading the COVID-19 virus. and also,If children get COVID-19, a COVID-19 vaccine, it could prevent them from becoming severely ill.

Getting a COVID-19 vaccine may also allow children to start undertaking activties that they might not have been able to partake in because of the pandemic.

Since prevention is always better than cure, COVID-19 prevention is the best approach for both children and adults. This could be achieved through vaccination, improved hygiene such as frequent hands and face washing, improved social distancing avoidance of handshaking and other unnecessary body contact, prevention of unwarranted overcrowding, non-smoky or polluted environment avoidance, ingesting a good and balanced diet ,covering your nose and hands while coughing ,the wearing of a mask to cover the mouth and the nose and adequate management of intercurrent illnesses in children etc.

Thank You

Question: How can medical students seek job and career opportunities in Paediatrics?

Answer:

On the basis of availability and opportunity, Medical students are best adviced to seek job and career opportunities from their Lecturers who are paediatricians,their seniorcollegues in Paediatrics ,and several online sources on this theme which have been developed,produced and are available.

Length of training

Undergraduate study at medical school varies from five to six years 5 - 6 years, in the common wealth countries ,depending on whether an intercalated degree was taken or not before seeking admission to the medical school ,such as a good BSc honours degeees in the biological sciences such as zoology,biology,physiology biochemistry,nursing sciences,pathology,pharmacology,pharmacy etc and whether there was a direct entry to the Anatomy,physiology,biochemistry class ,or for those who have good grades in advanced level A-Levels subjects such as biology, zoology,physics,chemistry , mathematics etc However in North America and its allied regions,every science student who intends to go to the medical school must have achieved a good BSc hounours degee in relevant programmes as indicated above whether In North America,the Graduate Entry Programme into medicine is generally four-4 years in length. Find out more about medical school.

Other students with good ordinary level results in physics,chemistry ,biology,mathematics,english language etc could gain an admission into a 6-year programme commencing with the study of advanced levels physics,chemistry ,biology,mathematics,zoology,botany ,english language,general srudies course etc especialy with emphasis of the applications of these science subjects to the life sciences and health sciences.

After medical school doctors undertake a two-year foundation programme.

Training after the foundation years begins at year one of paediatric postgraduate training. It will usually be completed within about eight years of full-time training, in order to achieve the appropriate academic and clinical fellowships and specialty and/or subspecialty certifications.

The training pathway

The training pathway consists of three years following the foundational programmes. All trainees follow courses lasting one to two years of the general paediatric curriculum. At the third year, they will decide whether to continue in general paediatrics or to apply to complete their training in a chosen sub-specialty.

Following the first two to three years (2-3 years) – provides basic knowledge of paediatrics and child health, with placements in acute general, neonatal and community paediatric posts.

About one to one to two years (1-2 years) – training will be provided mainly in district general hospitals using existing core training posts and rotations including community paediatrics and neonatology. At this point,there will be a greater emphasis on outpatient presentations, and the expectation of a higher level of performance in relation to common paediatric conditions, child development and ,child protection ,safeguarding and advocacy issues.

This is usually between (2-3 years) – trainees may choose to enter subspecialty training in one of the accredited subspecialties or to stay on in general paediatric training.

Those wishing to enter subspecialty training may apply in competition for training in one of the about twenty paediatric subspecialties, with variable years of training depending on the specialty curriculum.

Paediatric trainees who are training in general paediatrics will be matched to year posts by their regional training programme directors and postgraduate deans in accordance with regional availability of training opportunities in the academic educational deanery, in addition to the trainee requirements and preferences.

Several information on the postgraduate training curriculum and requirements for paediatricsspecialty and subspecialty training programmes have been produced and are available online in the contextual postgraduate colleges ,,Associations, Academies and Societies websites.

It is important for the intending paediatric trainee to develop their practical skills and interest in paediatrics as early as is achievable.. This will also give the paediatric tiros valuable experience to add to their CurriculumVitae..

Following the completion of the paediatric specialty and subspecialty academic, educational, clinical and research training programmes ,paediatricians may seek further career and job opportunities in several areas human professional endevours within, around or related to paediatrics,child health, child public health etc the myriads of these opportunities open to the qualified paediatricians includes but not confined to:

Professor of Paediatrics

Consultant Pediatrician

Child Psychologist

Neonatal Nurse

Paediatric Nurse Practitioner

Paediatric Registered Nurse

Below is an overview of some common pediatric subspecialties titles.

Neonatologist. ...

Paediatric Cardiologist. ...

Paediatric Hematologist/Oncologist

Paediatric Surgeon

Paediatric Emergency Medicine and Critical Care Physician.

Paediatric Infectious Diseases Physician

Paediatric Hospice and Palliative Medicine Physician

Paediatric Pulmonologist.

Paediatric Neurologist.

Paediatric Neurologist.

Paediatric Immunologist and Allergist..

Paediatric Rheumatologist.

Child developmentalist.

Paediatric endocrinologist.

Paediatric Pathologist.

Paedaitric Nutritional Scientist.

Individuals who want careers in healthcare and want to spend their time working with children can choose from several medical careers in pediatrics. Pediatrics is the branch of medicine that deals with children of all ages from birth until they become adults. There are various medical programs requiring various degree levels and training requirements. Here are five top medical careers in pediatrics.

Pediatrician

Pediatricians are medical doctors who specialize in the treatment of babies, young children and adolescents. It takes many years to become a pediatrician. The individual must complete four years of undergraduate courses as well as four years of medical school. Once this is finished, the student can obtain a medical license. The aspiring pediatrician must then complete a pediatric residency that can take from three to seven years to complete.

Child Psychologist

Child psychologists are trained medical professionals who provide mental health services to children from toddler age to adulthood. They speak with the children, assess their behavior, research their emotional and behavioral patterns, make diagnoses and initiate treatment. To become a child psychologist, an individual must earn both a bachelor’s and master’s degree in psychology and complete a two-year clinical internship. If the child psychologist wants to work in private practice, the candidate must earn a doctoral degree. The individual must also be licensed to work in all states.

Senior leadership and management positions include:

Chief executive

Medical director

Clinical director.

Examples of educational roles include:

Clinical supervisor

Educational supervisor

College Tutor

Regional Lead

Paediatric Nurse Tutor

Undergraduate/postgraduate associate dean

Faculty on local, regional or national education programmes

Simulation lead

Training Programme Director – for foundation or paediatric training programmes

Life Support course instructor or director.

Dean of Faculty of Medical and Allied Health Sciences.

Dean of Faculty of Health Sciences.

Dean of Faculty of Clinical Sciences.

Provost of College of Health Sciences.

Provost of College of Medical Sciences

Director of Institute Of Health.

Foundational Paediatric doctors

Paediatric Specialty trainees

College Tutors

Regional Advisors

Training Programme Directors

Heads of Paediatric Schools

Deans of Regional Postgraduate Deanries.

Chariman&Adiminstrators of Regional Area Health Authority(Education and Teaching)

Head of Department of Paediatric and ChildHealth.

Paediatric Specilaty and Subspecialty Programmes Director.etc.

Thank You,

Question: Which are the courses available in Paediatrics?

Answer

There are several courses that are available in Paediatrics, additionally there are other courses in other Specialties with significant paediatric content..

These Courses couldprovide extensive programmes of training and are usually taught in a modular form. Also there may be other models of offering taught course modules to non-degree students. These avenues will provide routes for the identification and encouragement of sustained engagement of the best child health students of the future globally.

Common courses available in Paediatrics include but not confined to:

Undergraduate programmes:

Bachelors of Medicine and Bachelors of Surgery-MBBS,MBChB.

Intercalated BSc Paediatrics and Child Health Programme

BSc in Population Health

The Certified Pediatric Nurse Examination courses.

Postgraduate taught programmes at Masters, PG Certificate and PG Diploma levels in the following subjects such as but not confined to.

MSC in Paediatrics

MSc in Tropical Paediatrics

Msc in International Child health

Diploma in Child Health--------------------DCH.

Paediatrics and Child Health with specialized pathways in Advanced Paediatrics,

Advanced certificate in maternal and child health (Distance learning course)

Community Child Health, Global Child

Health, Molecular and Genomic Paediatrics,

Intensive Care and Clinical Practice

Child and Adolescent Mental Health

Cell and Gene Therapy

Infancy and Early Childhood Development

Applied and Clinical Paediatric

Neuropsychology

Physiotherapy Studies -pathways in Cardiorespiratory, Paediatrics and

Neurophysiotherapy

Personalized Medicine and Novel Therapies.

Diploma in Maternal and Childhealth.

Diploma in Child health.

Diploma in Child Psychiatry.

Higher Diploma in Child Health.

MRes and MPhil/PhD degrees

Doctoral Level Courses.

Doctor of the New Born –DNB.

There are also several Fellowshipprogrammess in several Paediatric subspecialties with most of them having some significant academic and research content.

Fellowship in Neonatology, Fellowship in Paediatric Cardiology etc.

Continuing Professional Development Courses etc.

Thank You

Question: What job titles are available in Paediatrics?

Answer:

Thank you for asking me to undertake this crucial and seminal discussion on the job titles thatare available in Paediatrics. I will like to commence this discussion by stating that histriographically for a long time there are several job tiltes available in paediatrics as depicted in the histriographic account of of paediatric medicine and nursing in the past,I will at the first instance chronicle ,what the job titles used to be histriographically, how the different job titles evolved ,developed and revolutionised to what it is today.

When I have accomplished this,I will then go on to itemise ,annotate on and detail what it has been in the recent past and currently.

Inventing Pediatric Medicine and Nursing

Physician Abraham Jacobi, considered by most to be founder of modern paediatrics, offered the first medical lectures on the diseases of childhood in 1860.

Until the onset of the Civil War, paediatrics was considered part of obstetrics globally and in the United States,so most children were taken care of by the midwives who delivered them mcontunued with their care as neonate ,an infant a younger child etc .

This sustainable practice is still the norm in some developing and emerging settings till this day.

Before Jacobi, medical specialties centered on a particular organ of interest and technology rather than age, physiological status or gender of the patient.

Jacobi felt that paediatrics should have a broader, more conceptual and scientific, focus. His vision was that paediatricians should concern themselves with child health well beyond the management od mere disease.

He advocated for the involvement of doctors who treated children in all aspects of child health besides management of diseases including bit not confined to infant feeding, child hygiene, and disease prevention in well children etc .

Jacobi articulated a model for paediatrics with a focus well beyond specific diseases, one that involved disease prevention in healthy children, educating parents about child rearing, and social activism for children’s rights.

In 1880, Jacobi and a few other interested physicians founded the American Medical Association’s section on the diseases of children.

In 1888, they formed a new organization, the American Paediatric Society, which helped to ground and solidify paediatrics as a distinctive branch of medical specialties . Jacobi served as the first president of both groups.

Framers of the American Paediatric Society recruited prominent physicians into their ranks to advance paediatrics’ recognition and acceptance.

Early paediatricians such as Jacobi wrote prolifically in new journals and textbooks that focused exclusively on paediatrics childhood diseases.

They stressed the need for more children’s hospitals, and for the expansion of paediatric content in the undergraduate medical school curricula. By 1900, ten schools of medicine had full-time paediatricians –

The Changing notions of disease causation synergized the development of paediatrics globally and in the United States.

In the 1870s and 1880s, Robert Koch, Louis Pasteur, Joseph Lister, and others forged the germ theory of disease causation. These changes altered and modified the role of the hospital in American life -and reshaped paediatric nursing and medical care in the ensuing decades.

By 1900, the organisms responsible for typhoid, leprosy, malaria, tuberculosis, cholera, diphtheria, and a host of other conditions were identified. Illness—at least infectious illness—left the realm of a superstitious aetiology of morality and religion.

It gradually evolved, at least for infectious diseases, to receive its identity in the laboratory .

In addition to the works of Semmelwies and others an understanding of the bacterial origins of infectious diseases encouraged such advances as the use of surgical gloves and sterilization. When coupled with anesthesia, these interventions made pediatric surgery safer.

Better surgical therapeutics assisted make hospitals more medically oriented. As early as the 1870s, physicians at the Children’s Hospital of Philadelphia, for example, pressured the lay trustees who managed the hospital to increase patient turnover and accept more acutely ill children, especially orthopedic surgical patients who had something to offer physician education and on whom new surgical techniques and therapies could be tried.

This new emphasis on the medical needs of patients and the experimental needs of doctors and nurses conflicted with the social welfare role children’s hospitals saw themselves as previously performing.

The individuals who worked these paediatric hospitals, deservedly prided themselves for providing a social safety net for the ill or abandoned child who needed care.

Moreover, children’s hospitals were also good for the burgeoning specialties of paediatric nursing and medicine -The development of children’s hospitals helped paediatrics to evolve more quickly into a specialty branch of medicine and nursing because of the opportunities it proffered for training, the feeling of shared identity and unity it fostered in its health staff, and the research opportunities indigent hospitalized children provided in an era in which no ethical guidelines governed research.

Over time, the proportion of children admitted for social welfare reasons began to fall while the number of those suffering from chronic medical conditions or requiring surgery rose. More hospitals also began to accept children with infectious diseases for the first time. For example, until the 1890s when the Children’s Hospital of Philadelphia developed accommodations to isolate and quarantine potentially infectious children, the institution avoided admitting children with contagious diseases as well as infants for any reason -. As the hospital began to admit sicker patients, hospital trustees and physicians understood that trained nurses were essential for children to benefit utmostly from the increasibly available diagnostic and therapeutic modalities. The ongoing need for more and well-trained nurses resulted in the long anticipated inauguration of a nurse training school at the hospital in 1895, an advance that the Board notedanswered -a need, long well felt-.

Though the first pediatric nursing textbook was not published until 1923, articles addressing the needs of children were presented in nursing journals much earlier. –

Florence Nightingale herself emphasized children’s nursing care needs in her seminal 1859 book, Notes on Nursing, writing: -It is the real test of a nurse whether she can nurse a sick infant-. Early publications highlighted such practices as foundations of nursing, infant feeding techniques and paediatric nursing procedures etc.

Pioneering pediatric nurses such as Anna Haswell,in 1908 also asserted and stressed the special personality type required for children’s nursing asserting that:

The nursing of young children stands out as a division of our work needing special study. We have no branch that is more important . Let us be willing to do anything which will accomplish the greatest good for the child, and honour our profession by becoming more and more efficient in our ability to care for sick children as a group.

Just what skills were necessary to efficiently care for sick children in those days? Though the early nursing literature recognized that nurses needed educational preparation, the form that training took was different from today’s. Until the twentieth century, nurses who specialized in children’s health trained in exactly or much the same way as their adult-oriented counterparts. Hospitals usually paid student nurses small allowances in addition to room and board, and in return these students worked, often largely unsupervised, on the wards caring for patients.

Students usually worked very hard and toiled twelve hours a day, six days a week for fifty weeks a year. The length of training was variable, ranging anywhere from eighteen months to three years. Nurses who wanted to specialize in child health tried to get their training either at a hospital with a children’s ward or at one of the few children’s hospitals. Once graduated, a few nurses assumed leadership positions in hospitals, but most sought private-duty positions in middle-and upper-class homes.

Over the course of the twentieth century, hospital care for sick children of all classes became more commonplace, especially as new technologies and advances such as antimicrobials made it possible to save the lives of more children. After World War II, an increasing number of subspecialties in children’s health care, such as neonatology and paediatric critical care, emerged from the rapidly expanding body of knowledge being generated.

Public Health Nursing and Children’s Health

Although institutions were central to the development of children’s health care, many advances arose from the early twentieth century public health movement and reformers efforts to publicize the plight of poor children. When Jacob Riis, New York City police reporter turned social reformer, wrote his 1890 book, How the Other Half Lives, his descriptions of the poor, especially the children, appalled people:

Seventy-two dead babies were picked up on the streets last year. Some of them doubtless were put out by very poor parents to save funeral expenses, bodies of drowned children turn up in the rivers right along in summer whom no one seems to know anything about-Riis, 1890, p 180.

Riis’s tales of children dying from starvation and disease, exhausted from overwork, and fending for themselves on the streets, galvanized reformers and helped stimulate the reforms that created our modern child labor laws and systems of juvenile justice, foster care, and government aid to poor families.

These reforms were needed because the United States was experiencing profound social and cultural changes brought by industrialization, urbanization, economic growth, and population increase.

Moreover, people poured into American cities from overseas.

Many of these new immigrants, arriving mostly from Eastern and Southern Europe, were poor, spoke little or no English, and engaged in cultural practices foreign to earlier arrivals and the native-born.

Masses of immigrants ended up in the ghettos of large cities where they faced even more awful conditions than did American migrants to the same urban areas.

Living conditions were usually squalid, and immigrants often were forced to accept jobs so arduous or unsafe that native-born Americans shunned them.

Their language and cultural practices were frequently objects of ridicule and suspicion.

A family of seven in a one room apartment, Starr Centre Association of Philadelphia,- c. 1910.

The incidence of urban poverty exploded as immigrants and native born migrants crammed into tenements. Inadequate living conditions led to overcrowding, poor sanitation, disease, and increased crime -Cravens, 1985.

For reformers such as Riis, -child-saving represented a meaningful venue through which to cure these ills.

Child-savers argued that children were impressionable, possessing the capacity to be uplifted, to rehabilitate their morally questionable parents and other family members, and to be easily Americanized if they were immigrants –Katz- 1986.

As one prominent physician noted: -Anyone who has had practical experience recognizes only too well the almost hopeless task of trying to train and educate in the rules of hygiene and right living, ignorant, stupid people from the slums -Children, however, are easily trained-Hawes, 1910, p 904.

Because of the writing and photography of reformers such as Riis, the plight of vulnerable children became more difficult to ignore in the late nineteenth century. Poor children and those orphaned or abandoned, were highly visible in cities. Children played in the streets, increasingly becoming victims of accidents. Contagious diseases and hunger were rampant.

Poor maternal nutrition helped keep infant mortality high. Record keeping was sporadic until the 1920s and ’30s, but what records that do exist indicate that at the dawn of the twentieth century one in every seven babies died. In some New England industrial towns, the infant death rate was as high as 30 percent. -Klaus, 1993 and Meckel,- 1990.

A New York City nurse, Lillian Wald, pioneered the new nursing specialty of public health nursing, an important engine of child-saving.

In 1893, she and a colleague merged the concepts underlying district nursing and settlement houses by creating the nurse-managed Henry Street Settlement.

Wald believed that bringing subsidized nursing care to the poor in their homes—care similar to that which the middle and upper classes could afford for themselves—both heightened the chances for its success and made treatment more humane.

Wald also strove to improve the daily living experiences of children.

One of Wald’s most significant accomplishments for children was her idea for school nurses. In 1902, Wald convinced the Board of Education to hire a Henry Street nurse to work in the school system. New York City had begun having physicians inspect school children for acute or infectious diseases in 1897.

However, the children physicians identified as sickly were simply barred from attending school. Wald argued that this practice was inhumane and arranged for Lina Rogers, a Henry Street Settlement nurse to provide follow-up and home care to children -Wald, 1915.

Wald’s activism helped spur the creation of the Children’s Bureau, the first government agency to be dedicated solely to children’s welfare, which was established in 1912 -Markel and Golden, 2005.

Wald and other public health nurses throughout the nation worked at health departments to implement Children’s Bureau initiatives such as those aimed at preventing infant mortality.

They also worked through private agencies to secure such health benefits as pure milk for children and families. Their efforts established nurses as a critical societal resource for children’s health.

At the height of the 1930s Depression, nurses again sprung into action, providing health care to children through the Child Health Recovery Program and later through the Social Security Act -.

The importance of nurses to the success of child health programs became clear again in the 1960s through their participation in Medicaid-funded programs and in the new infrastructure needed to support the 1975 legislation that guaranteed a quality education for all children, even those with mental and physical disabilities.

Today, an essential site for children’s health care delivery is the school-based health clinic, where school nurses and pediatric nurse practitioners address epidemics of child obesity, asthma, and mental health and behavioral problems -Halfon, 2007.

In the recent past and currently,available Paediatric Job titles includes,but not confined to:

Professor of Paediatrics

Consultant Pa11ediatrician

Child Psychologist

Neonatal Nurse

Paediatric Psychiatrist.

Child Developmentalist.

Paediatric Nurse Practitioner

Paediatric Registered Nurse

Below is an overview of some common pediatric subspecialties titles.

Neonatologist. ...

Paediatric Cardiologist. ...

Paediatric Hematologist/Oncologist

Paediatric Surgeon

Paediatric Emergency Medicine and Critical Care Physician.

Paediatric Infectious Diseases Physician

Paediatric Hospice and Palliative Medicine Physician

Paediatric Pulmonologist.

Paediatric Neurologist.

Paediatric Neurologist.

Paediatric Immunologist and Allergist..

Paediatric Rheumatologist.

Child developmentalist.

Paediatric endocrinologist.

Paediatric Pathologist.

Paedaitric Nutritional Scientist.

Individuals who want careers in healthcare and want to spend their time working with children can choose from several medical careers in pediatrics. Pediatrics is the branch of medicine that deals with children of all ages from birth until they become adults. There are various medical programs requiring various degree levels and training requirements. Here are five top medical careers in pediatrics.

1. Pediatrician

Pediatricians are medical doctors who specialize in the treatment of babies, young children and adolescents. It takes many years to become a pediatrician. The individual must complete four years of undergraduate courses as well as four years of medical school. Once this is finished, the student can obtain a medical license. The aspiring pediatrician must then complete a pediatric residency that can take from three to seven years to complete.

2. Child Psychologist

Child psychologists are trained medical professionals who provide mental health services to children from toddler age to adulthood. They speak with the children, assess their behavior, research their emotional and behavioral patterns, make diagnoses and initiate treatment. To become a child psychologist, an individual must earn both a bachelor’s and master’s degree in psychology and complete a two-year clinical internship. If the child psychologist wants to work in private practice, the candidate must earn a doctoral degree. The individual must also be licensed to work in all states.

3. Neonatal Nurse

Neonatal nursing, another medical career in pediatrics, involves registered nurses who have been specially trained to work in a neonatal intensive care unit (NICU) where babies who have been with medical conditions requiring additional medical care are treated. To work as a neonatal nurse, the candidate must earn an RN license, work in a neonatal department for at least two years and obtain certification as a neonatal nurse. This can be accomplished by passing the Neonatal Intensive Care Nursing or the Critical Care Neonatal Nursing certification exams.

4. Pediatric Nurse Practitioner

Also known as an advanced practice registered nurse , pediatric nurse practitioners work as specialty and primary care providers in a pediatric department such as a hospital, school or similar medical facility. Their workload is very similar to that of a doctor. Pediatric nurse practitioners have completed a master’s degree in nursing with a concentration in pediatric nursing. After obtaining the nursing license, the individual obtains work experience and obtains certification as a pediatric nurse practitioner. The Pediatric Primary Care Nurse Practitioner-Board Certified and the Certified Pediatric Nurse Practitioner-Primary Care aretwo distinct credentials.

A pediatric registered nurse is an registered nurse who works with children of all ages. This Paediatric registered nurse may work in a hospital, clinic or a private health setting. They often work alongside a licensed pediatrician. Becoming a pediatric RN requires first becoming a licensed RN. To do this, the candidate must complete a nursing bachelor’s degree program and pass the National Nursing CouncilLicencing Examination For A Registered Nurse. The final stages of the program have the RN working in a pediatric internship. Upon completion, the candidate can take the Certified Pediatric Nurse Examination to obtain certification as a pediatric registered nurse.

Senior leadership and management positions include:

Chief executive

Medical director

Clinical director.

Examples of educational roles include:

Clinical supervisor

Educational supervisor

College Tutor

Regional Lead

Paediatric Nurse Tutor

Undergraduate/postgraduate associate dean

Faculty on local, regional or national education programmes

Simulation lead

Training Programme Director – for foundation or paediatric training programmes

Life Support course instructor or director.

Dean of Faculty of Medical and Allied Health Sciences.

Dean of Faculty of Health Sciences.

Dean of Faculty of Clinical Sciences.

Provost of College of Health Sciences.

Provost of College of Medical Sciences

Director of Institute Of Health.

Foundational Paediatric doctors

Paediatric Specialty trainees

College Tutors

Regional Advisors

Training Programme Directors

Heads of Paediatric Schools

Deans of Regional Postgraduate Deanries.

Chariman&Adiminstrators of Regional Area Health Authority(Education and Teaching)

Head of Department of Paediatric and ChildHealth.

Paediatric Specilaty and Subspecialty Programmes Director.

Question: Which are Typical employers in Paediatrics?

Answer

Good day and thanks for asking me to proffer a discussion on which are the typical employers in paediatrics.This is a very pertinent and seminal issue which is of concern for those scholars ,who may wish to pursue a career in paediatrics and its related allied health specialties.A brief overview of the histriographic aspects of the evolution, development and revolution of paediatrics as a scientific clinical specialty in a given context will introduce this topic instructively and expose everyone to the challenges that paediatrics faced as as an offshoot secondary specialty,in addition to the difficult and frustrating course that the pioneers in this specialty encountered in navigating the course that brought the specialty to where it is today with numerous and several employers as I itemised ,highlighted and annotated upon in the latter parts of this discursive activities,

Histriographic Aspects and Perspective.Of Paediatrics .

In the long timeline of medicine, paediatrics is a recent clinical field. The first children’s hospital in the world was established in Paris in 1802, followed by the Hospital for Sick Children on Great Ormond Street in London in 1852

On the basis of this compromise, many ascribe the birth of American paediatrics to the children’s hospitals of the latter half of the nineteenth century. However, a focus on hospitals reveals only an incomplete picture of the development of paediatrics in this context..

Throughout history, children had been cared for in larger general hospitals. For example, New York City’s Bellevue Hospital enrolled about one hundred and twenty six children in its 1809 hospital census.

In 1846 Amos Lawrence established in Boston the nation’s first children’s infirmary, and the New York Nursing and Child Hospital opened in 1854; however, both were closed down after brief existences. The first permanent US children’s hospital is thus widely acknowledged to be the Children’s Hospital of Philadelphia -CHOP, founded in 1855 and inspired by Great Ormond Street’s Hospital for Sick Children. Other children’s hospitals followed—including Boston Children’s Hospital in 1869—and about two dozen existed by 1900.

During this era, paediatrics was typically a division in the department of medicine.

At Johns Hopkins, the Harriet Lane Home for Invalid Children opened in 1912, and this full-time department of paediatrics-distinct from adult medicine would later become the prototype for modern academic pediatric departments.

However structures and buildings alone do not make a specialty; but people do.

Until the middle of the nineteenth century, most paediatric medical practice was unsound and unscientific.

The fathers of American paediatrics are considered to be Abraham Jacobi and Job Lewis Smith.

Jacobi emigrated from Germany and would introduce the term paediatrics to unify the fields of childhood therapeutics, pathology, and physiology. He is credited with the establishment of bedside teaching in the US but was foremost an advocate for children. Quieter than the more outspoken Jacobi but easily as capable, Smith worked primarily at the Bellevue Medical School.

Smith’s appointment in 1861 as Clinical Professor of Diseases of Children was believed to have been the first time that a professorship in a first-class medical school was designated for pediatrics alone, antedating by some nine years the analogous appointment of Jacobi at Columbia.

Among Smith’s significant accomplishments were his textbook of paediatrics—first published in 1869 and so much esteemed to the extent that it went through eight editions—and his founding of the American Pediatric Society in 1888.

The first pediatricians focused much of their energy on diseases and conditions associated with poverty, poor sanitation, and deplorable living conditions.

At Babies Hospital in New York, L. Emmett Holt is credited with establishing a scientific -biochemical basis for the field of paediatrics in the US, and appropriately also played a key role in founding the Rockefeller Institute.

Holt was always immaculately dressed, he rarely smiled or laughed and appeared to be driven by a stern sense of duty.

Hard working, efficient, thorough and meticulous in his work, he also possessed sound judgment, intellectual honesty, and a total dedication to the welfare of his patients, he is considered the Osler ofpaediatrics.

Devoted clinicians, advocates, gifted teachers, keen investigators, and prolific writers, name all of them, it is notable that even these first American paediatric leaders did not necessarily devote their full-time efforts to the care of children.

It was not until 1912 that John Howland -whose mentor was Holt arrived at Johns Hopkins to lead the first full-time department of paediatrics in the US, establishing the second scientifically-based academic department in the US at the Harriet Lane Home.

Beginning in the 1930s, paediatric subspecialty care emerged through the vision of Edwards A. Park., Paediatric cardiology -Helen Taussi, paediatric endocrinology-Lawson Wilkins, and child psychiatry -Leo Kanner were among the earliest paediatric medical subspecialties. Yet even decades before, hospitals had already naturally subspecialized, the physical separation of medical and surgical patients already documented at CHOP in 1874. Paediatric surgery saw its beginnings in the early twentieth century, founded by disciples of William Halsted and including William Ladd in Boston.

In the late 1880s, American paediatrics in any organized sense was in the doldrums, but its evolution as a medical specialty would soon lead to dedicated professional organizations.

The first American journal devoted solely to pediatrics was the Archives of Paediatrics, initially published in 1884. Some forty years after the American Paediatric Society, the American Academy of Pediatrics -AAP was founded in 1930 with a focus on education, public health, and social issues affecting children.

To bestow certification by establishing specific training requirements and an examination, the American Board of Pediatrics was founded in 1933.

As compared to buildings and people, surprisingly little is written about the evolution of training in paediatrics.

The first formal medical school course and the first faculty appointment in the diseases of children in the US were at Yale in the early 1800s.

CHOP’s medical staff added its first resident physician in 1872; by 1877 its clinics were made accessible to students for medical and surgical instruction.

House officers were appointed as internes and externes starting in 1882 at Boston Children’s Hospital.

Naturally, the first residency programs trained clinicians simply by providing patients as clinical material, under the longstanding apprenticeship model. Howland’s training program at the Harriet Lane Home was still based on an apprenticeship model but critically, academic rigour guided clinical care and producedscientific practitioners.

A master clinician and exceptionally gifted teacher, Howland could also be conservative in accepting new clinical ideas, was known to be sarcastic with students, and controlling within departmental hierarchy. Nevertheless, Howland was the life and inspiration of the clinic.

His great drive was motivated and powered by his faith in the investigative approach, both clinical and experimental.

The importance of such academic training is highlighted by the career paths of Howland’s trainees: most would go on to become heads of departments around the country.

Research and investigation as a core mission of a paediatrics department began with Holt at Columbia and Howland at Hopkins, and blossomed in the early twentieth century. The establishment of the NIH’s National Institute for Child Health and Development -NICHD in 1962 underscored the importance of investigating human development throughout the entire life process, starting even before birth and with a critical role of health in childhood.

Robert Cooke, of Johns Hopkins and the Harriet Lane Home, were instrumental in founding this unusual institute, which did not focus on a particular disease or group of diseases.

The NICHD’s broad mission is reflected in the now-widely-accepted and embraced tenet that maternal-fetal health, paediatric care, and child health, and adult health and disease, all constitute a continuum and continuum..

Within a few short decades of the birth of American paediatrics, the US would itself make extraordinary contributions to paediatrics—encouraged by advances in clinical care, modernization of paediatric facilities, specialized paediatric training, and research—and continues to do so to this day.

Late-Nineteenth and Early-Twentieth Century Paediatrics:

Donations were a necessity for supporting the childrens hospitals , since the health institutions received financial support wholly through private funds.

The writer may have also wanted to publicize the hospital’s existence since the idea of an institution devoted to the needs of children was a new concept. Until the mid-nineteenth century, there were no facilities dedicated to the care of sick children in the United States.

If they could not be cared for at home, children, like their parents, went to municipal almshouses, also known as poorhouses. Orphaned or abandoned babies often ended up in infant asylums, which had been patterned after similar British institutions where the mortality rate approached 100 percent.

By the 1860s in the United States, special hospitals for children were becoming a necessity, since many of the newly founded general hospitals simply refused to admit them children with both social and health compromise..

The earliest children’s hospitals admitted indigent or abandoned children, some of whom but by no means all—were equally ill.

Since sickness and poverty often appeared together, providing spiritual guidance and moral uplift to the ill, in addition to offering food, clothing, and whatever other material provisions were needed, was supposed to help the poor rise above their condition and facilitate better health. Stratifying the needy into deserving versus undeserving categories helped charitable organizations and hospitals decide which individuals to aid.

Because indigent children were considered the innocent victims of their parents’ bad choices or unsuitable lifestyles, they were, by definition, always deserving of assistance, and aiding them engendered little controversy -.

Hospitalized children often resided at the institutions for months, and beyond fresh air and food, they were given very litte therapeutics, at least according to today’s standards.

Those in charge of children’s institutions considered one of the most important interventions for the children to be their exposure to the wealthy trustees who ran the institutions.

These individuals, usually socially prominent, were presumed to have better characters than the children’s indigent parents, and they hired staff who they felt could help imbue the children with the qualities the trustees felt were important. Staff and trustees often discouraged or made it difficult for parents to visit their children, hoping that prolonged contact with staff would facilitate Americanization in immigrant children, and inculcate middle class behaviors and health practices among the native-born

: While there, the sick children in addition to their medical treatment and nursing, they are carefully taught cleanliness of habit, purity of thought and word, and as much regard is paid to their moral training as can be found in any cultivated family. Think what a widespread influence this becomes when the children return to their homes.

Having now taken this histriographic over view to who the employers of paediatricians were and are still are, with evolution,development and revolution of the specialty and the global society as a whole,several other employers of paediatricians emerged to address the miscellenous needs of all multifaceted endevours aimed to improve the health of children,their welfare and the overall outklook of children in their wider community and the society at large globally.

The typical employers in Paediatric includes but not confined to:

Hospitals, teaching, general, district or dedicated paediatric specialty or subspecialty hospitals.

Health centres.

Medical centres.

Clinics,

Nursing-and-Residential-Homes,

Primary and secondary Schools,

Security-and-armed forces,Airforce,Infantry,Navy etc

Creches, Kindergartens and Nursery schools

Regional/Area Health Authorities as chaiman,administrator,director etc.

Respite, homes.

Orphanages

Foundling Homes.

Hospices.

Infirmaries.

Pharmacies .

Pharmaceuticalcompanies as Pharmaceutical stock analyst ,Scientific Director ,

Vaccines and Biologicals manufacturing companies as Scientific Director,Scientific Officer, Senior Medical Writers etc.

Baby and Infant Feeds and Formular manufacturing companies as Scientific Health Nutritionists.Medical Writers etc.

Neonatal,Infantile and paediatrics and medicine of childhood assistive health devices and instrumentations manufacturing companies as Scientific Director,Scientific Officer, Senior Medical Writers etc.

Scientific Officer,Senior .Medical Writer or Communicator etc.

Researchinstitutions,

Universities

Colleges,

Polytechnics.

Public Health Schools.

Allied Health Science schools.

Paediatrics .and its Allied Health Academies ,Societies,Associations as volunteers,elected officers,memers at large .etc.

Paediatric Books and Journals Publications Houses as Authors of regular contents,scientific Editors ,pubishers etc.

Airlines and Aviation Companies

Maritime companies.

Railway companies.

Coach services and other transport companies.

Industrial ,Factory and Company Clinics and Sick bays.

.

School Health Programmes.

General practice surgeries and Family medicine doctors offices.

Ambulatory Emergency and Domestic and Domiciliary services.

Hotels,Motels and Inns.

International,Regional and National Non-Governmental organisations,

International,Regional and National Civil Society Organisations.

Community Based Organisations.

Grass Root Programmes.

Industries ,

academia,

Assurance and Insurance companies

,Health Institutional Administrations,

Regional and Area Health Authorities and Directorates.

Ministries and Departments of Health .

Reformatories and Juvenile, Reformatories or correctional homes or Penitentiary .

Ministries and Departments of Children and womens affairs.

Media houses as Television , Radio or Internet Consulatnts, directing and acting in paediatrics and childhealth related soap operas advertisements etc.

Film and movies industries as legendary actors, editors and directors of paediatrics and childhealth related soap operas ,movies, advertisements etc.

Contract Research organisations: Reserchers,Scientists,Scientific auditor,Quality assurance manager or director , senior medical writer and communicator etc.

Institutional Review Boards and Ethics committees members and chairmanship etc.

Multilaterals as volunterrs, consultants,programme officers,Directors,Managers etc

Bilaterals asvolunterrs, consultants,programme officers,Directors,Managers etc

Intergovernmental organisations etc.

Diplomatic Missions ,Embassies,High Commisions,Consulates,Ligation etc.

Religious Organisations ,Chaplaincies and Missions as. Chaplains etc.

Maternity ,Nursing Homes and Lying in and confinement homes etc.

Pychiatric and mental Hospitals.

Regional Academic Postgraduate Deaneries as Post graduate deans,educational advisors etc.

However most paediatricians are entrepreneurial and on completion of their residency anf fellowship trainings employ themselves in a sole or group practice also they employ other allied and ancilliaryworkers ,so overall Paediatricians are rather job providers rather than job seekers.

Thank You.

Question: Please provide comprehensive list of journals in Paediatrics?

Answer

On the basis of the available archival records, of scientific writings in theEbers Papyrus during the ancient Egyptian dynasties, although there were several documented records of scientific discoveries from several Histriographicscientific scholars such as Hippocrates,Galen,Galeleo ,Archimedes ,Plato,Morgagni,Verselius etc however these were thought to be more representative of case reports etc of today.

However, the official publication of 1665, by the Royal Society which commenced its scientific publication series through the publication of its Philosophical Transactions, the first scientific periodical and one of the most seminal and significant scientific journals within the British Isles, European continent and beyond .

The Philosophical Transactions of the Royal Society was second to none globally, untilwell into the 19^th century, when this scientific governance position was shared with other specialized scientificpublications in biological and health, sciences, physics, mathematics, medicine etc.

Theacademic scientific correspondence between the Society and the whole of the scientific worldwas co-ordinated and supervised Henry Oldenburg who was the first secretary-General appointed to have an administrative and governance oversight over the philosophical transactions publications of the Royal Society.

While in this role,Henry Oldenburgacquitted himself excellently well and generally encouraged the exchange of scientific ideas to such an extent that he was regarded as the inventor of the present day scientific article.

In this capacity, Oldenburg anglicized German, Dutch, Greek, French and Italian letters facilitated and supported his and advanced his role as the scientific correspondent of the Philosophical Transactions, although the communications in Latin was equally achieved and archived.

The Philosophical Transactions initially published news, correspondences, letters and descriptions of experimental reports without a standardized format, structure or style. As Hyland pointed out, essentially, scientific papers evolved as a way of offering a vivid account of experimental performances toa distantreadership.

An extensive and in-depth appraisal, examination and evaluation of the Philosophical Transactions of the Royal Society undertaken byBazermanfrom 1665 upto 1800 depicted a representative overview of the salient aspects of the dynamic development and progression of the histriographic experimental reports intothe current research articles.

At the first instance, Bazermans earlier and histriographic reviews of the archives of the Philosophical Transactions of the Royal Society has a lot of implications for not other scientific endevours and discipline especially geography, chemistry and physics as a group, but also particularly for Paediatrics, Neonatology , Perinatology and Fetal Medicine as a theme, since experimental and observational report articles on these subjects such asthat of unexpected natural events of earthquakes or abnormal, atypical and unusual fetuses were overwhelmingly represented in the first four of every five volumes of the Transactions compared to experimental reports, which merely occupied one of every twenty to one of every five of each volume.

Bazerman also bemoaned theoverarching growth and dynamism in the roles of the contexual scientists who frequently migrated frombeing just mere observers of the events to dedicated and real investigators of experiments as the essence and understanding of experiments revolves between any completed task, finished process or undertaken procedures, to an empirical investigation, an assertion,to a test of a theory and to eventually a proof of, or evidence for, a claim, examination of hypothesis etc.

Contexually, the consequences and impact of this histriographic scientific appraisal and evalutions undertaken byBazerman on the Philosophical Transactions of the Royal Society encouraged a heightened attention to be proffered to the descriptions of the experiments, particularly with relevance to the methodologies employed, the outcome and the results obtained ,in addition to their overall relevance.

The cryptic, slow but steady and regular modifications to the principles of the experimental report were also reflected in the structuring and presentations of the articles published in the Philosophical Transactions of the Royal Society of London.

At the first instance, it was observed that the submitted and published articles got lengthier due to an increase warranted by the compulsion toundertake a number of sequential experiments more often instead of employing only sole activities or events for the evaluation of research hypotheses.

Also, articlesfrom authors took over from editorials featuring and dominated by the opinion and view of the editor that had welcomed and presented the reports at the first instance, a need ,the necessity purpose, aims and objectives section would antecede the experiments and trials, results of earlier, previous experiment and trials would be tested later in due course with other experiments and, in with controversial, contentious and debatable experiments or trials, the report would be commenced with a statement about thecontentious ,debated, controversial and disputed topics and a discussion of the opponent’s position or work.

This was followed by the author’s own view point, opinion and position, then the presentation of methodological concepts and issues and then the outcome and results, in this way, in a timely manner, the hypothesis would have been stated before the experiment even in the absence of contention or controversy. These subtle, but consistent sustained non-rapid modifications contexuallly demonstrates how the acceptance or denial of another scientific author or scholars research work, view points, opinionsassertions ,standing or position and claims has frequently and regularly founded ,grounded and underpinned the pivotal component influencing the structuring, modification, development ,progression and advancement of the ancient extant research article to a current scientific modern research article histriographically since the past to the present.

Bazerman summed up the histriographic developmental, progressive, typological and structural course of the experimental reports published in the Philosophical Transactions by identifying four distinct periodic stages: simple reports of events was the norm between 1665–and --1700, arguments, debates and critiques over the results was frequent from1700–to---1760, discovery accounts for explaining atypical and unusual events was the trend between 1760–and 1780 and reports containing claims and experimental proofs was the rule from 1790–to 1800

As more ambiguous, ambivalent, equivocal, enigmatic, elusive complexand complicated issues were submitted for publication, the Philosophical Transactionsof The Royal Society’s structuring, organization and presentations of articles also underwent some significant modifications.

The published and presented articles would commence with an introduction ,proffering accounts and overviews of previous unsuccessful experiments, followed by the chronicles of sequential series of experiments and their conclusions based on the author’s ingenuity and reasoning, which would culminate ,sum-up and yield ultimate conclusions.

As the year 1800 approached, philosophic statements were used to introduce the problem, which was presented through a paradoxical and surprising result or by indicating and pointing out a research gap, much like the present day Create a Research Space–CARS model for structuring and presenting the Introduction sections of research articles identified and proposed by Swales.

Accounts of the experiments would then be followed by conclusions, which also discussed the consequences and implications of the stated assertions and claims for future experiment, research and practice.

In the initial one- half of the 18^th century, communications, correspondences and letters on medical topical themes were equally publishedin the Philosophical Transactions of The Royal Society ,in several original and translated languages such as English,Walsh,Scottish,Irish,German, Latin, and Greek , Dutch and French and also some still in Latin, although the immediate and direct import or relevance of the clinical contributions was not very optimal.

Following a retrogression in scientific endevours by mid 18^th century, a suggestion by the Earl of Macclesfield, future president of the Royal Society was aimed to enhance, the overall quality of the articles published in the Royal Society’s Philosophical Transactions proffered the inception and establishment of a committee for the review of all article papers prior to publication, the committee membership is inclusive of an medical scholar named William Heberden, whose initiatives, innovations and ingenuity led to an overall development and enhancement in the credibility and qualitative improvements in the medical and biological papers featured in thePhilosophical Transactions of the Royal Society.

Two salient and principally significant modifications positively drived the fundamental rapid evolution and revolution of the Philosophical Transactions in the 19^th century: at the first instance is the splitting of the journal in 1887 into two categorically distinctive sections, one dealing with mathematical and physical topics and themes the other with biological papers, and the introduction in 1896 of sectional committees for peer review processes, which twenty four months later developed and progressed to an anonymous an anonymous peer review committee and process.

Other 19^th century developments included the gradual inclusion of not only amateur scientists and learned gentlemen in the Royal Society but of what would be currently referred to as trained and certified scientists, as well as the infusion of government sponsorship and funds into an initially autonomous and free-thinking voluntary organization.

The development of the experimental report was also linked with the increased professionalism, critical attitude and research interest of both contributors and target readers, which encouraged a shift from scientific reports characterized by narrative structure, personal involvement and author-centered norms of courteous conduct, towards a reporting format with greater emphasis on methodology and experimental description under the aegis and purview of non-obstrusive ethical an professional regulations.

In the lack of or paucity of a conventional and standardized means of converting assertions,empiricisms, speculations and claims into frequently acknowledged and recognized forms of scientific knowledge, the authors and contributors would mainly rely on sensational observations , reproducibility of the results for re-affirmation purposes and reciprocal confidence and trust.

Therefore, histriographically, thescientific experiments were recorded and represented with extensive itemized encyclopedic character and undertone in such a manner that the interested readership could apparently reconstruct,reinvent and rework those itemized details in their cognitive intellect as well as in their own scientific laboratories, and thus verify the accuracy and representativeness of the reported results. In time, as the scientific discipline revoutionised, these detailed descriptions were replaced by today’s usually concise Materials and Methodologies section of research articles.

Contexually, with regards to theform, mode and pattern of sternographic and topographical presentation of the experimental facts,apart from an encyclopaedic factual and probit tendency, and trend,there was also an inclination by the scientists to report their experiments with astonishing degrees of honesty and probity, and even with unaccomplished and unsuccessful experiments were extensively detailed, there was also the need to eschew unfounded ,ungrounded and unwarranted idiosyncratic anticipatory idiosynchratic, ideological imaginary sentimental approach to scientific experiments on the basis of individual principles and scientific piety was emphasized through the need to protect and promote a cordial and professional interpersonal relationships, and exudation of untested ,untried and unpiloted scientific views.

To buttress the need and importance of employing the non-obtrusive and polite linguistic character in their experimental reports, eminent scientists such as Robert Boyle, himself a foundational fellow of the Royal Society

Concurred to often using tentative words of politeness such as but not confined to: it may well be, perhaps, it seems, it is not improbable,it is possible, it is probable ,in addition to other forms of algorithmic certainty classifiers etc, to convey lack of absolute confidence in the facts and veracity of propositions and opinions, thus recording the first use in scientific writing of what is now acknowledged as hedges.

Hedges are linguistic devices such as more or less, as far as we know, we admit,we propose,for now assume that ,relatively, approximately, may, it is assumed, it is believed, if I may beg to differ,to our knowledge, reason with us,from our point of view, which are often used by research article authors in order to present anecdotal,hypothetical and propositional content as accurately,lucidly and reliably as possible, eschew the assumption of direct individual responsibilitites for the some parts of the reported material or convey the sense of undue and inordinate assertiveness over scientific ingenuity as individualized views and therefore eschew delayed disclaimers and promote the peer readership engagement and participation.

Indeed in scientific writings, these approaches have been employed by eminent and erudite scientific research article authors to achieve a distinction between factual robust statements , established ,founded and grounded on rigorous observational, methodological techniques and its credibly derived results from those with anecdotal, guarded and restricted view points.

The reports published in the early issues of the Philosophical Transactions were also written using active-voice verbs and first-person pronouns such as I am reporting that ,he is reporting that, she is reporting that, we are reporting that, they are reporting that but not that It was reported that etc -for increased credibility and attached responsibility. Experimental reports from some scientific authors and scholars were thought to have been punctuated by verbosities, tautologies, undue elegance, in addition to esoteric and rhetoric undertones, linguistic and semantic structures which were thought to be fashionable and was aimed to engage the interest and acclaim of its peerreadership, in addition to harnessing the contexual author’s scientific prowess.

This early record of the use of undue elegance,esoterics, hedges and other rhetorical devices suggests that besides the bare facts, scientists have always relied on linguistic and rhetorical resources for convincing the scientific community of the accuracy, credibility and robustness of the assertions in their scientific research articles report, for harnessing, grounding and re-affirming their dignifying and respectable designated roles in the context of their affiliated institutional academic and professional societies with the overall aim of inventing a new body of applicable, extrapolatable,credible ,illustrative,illuminative instructive and reproducible and sustainable body of scientific knowledge.

Since hedges generally modify and regulate author commitment and promote writer-reader interaction, they are currently regarded as recommendable rhetorical,but guarded means of restrictivelyintroducing new body of knowledge assertions, or filling in the gaps in some existing knowledge base, especially in its discussion sections where they are commonly employed profusely, until such assertions are recognised and accredited by the global medical scientific societies.

It is recognised that hedges have dynamic, multimodal, and very frequently interesecting roles , and can occur under numerous linguistic forms including epistemiologic lexical verbs, adverbs, adjectives, modal verbs and nouns, in addition to paraphrases, phrases or sentences referring to restricted knowledge, restrictions of model, theory or methodology, in addition to/or experimental limitations.

Apart from the Philosophical Transactions, the history of medical journals is connected with the Edinburgh Medical School and their Medical Essays and Observations which was published from 1731, which then became the Edinburgh Medical Journal, peer-reviewed since 1733. A detailed analysis of the evolution of medical research writing as reflected in Edinburgh Medical Journal articles published between 1735 and 1985 was conducted by Atkinson. According to this histriographic study, the initial interest in case studies ,which was based on the observation of single patients changed so that by the end of the 18^th century ,the disease and pathological entity became the focus of attention and the main criterion for categorizing ,characterizing and describing patients. In addition, a trend towards impersonal, non-narrative texts was conspicuous in conjunction with the beginnings of public medicine.

Other important events in the evolution of the English-language medical research article are connected with the emergence of two journals with remarkable tradition and influence in the international medical community. Thus, the Lancet first appeared in 1823 with the purpose of publishing the lectures of medical men working in London medical schools and of advancing and promoting case reports written by the medical and surgical intelligence of the time, thereafter three decades later, in 1857, the British Medical Journal was founded following the creation of the British Medical Association and the merging in 1853 of the Provincial Medical and Surgical Journal with the London Journal of Medicine to form the Association Medical Journal. The outstanding and remaining part of the 19^th century and beginning of the 20^th century witnessed the appearance of specialist British journals that reflected developments in fields such as physiology, pathology, bacteriology, tropical medicine, hygiene, or surgery etc.

The constant efforts to improve the structure and content of research papers continued throughout the 20^th century, which proves the dynamic and migratory character and nature of the research article in response to scientific and disciplinary changes.

The main developments were generated by the standardization of experimental procedures, which led to a less-detailed, shorter Methodological sections and greater emphasis on contextualizing and discussing results in order to demonstrate their relevance. The way methodologies are presented in research articles has changed to such an extent that the concept of replicability turned into a myth due to the insufficient amount of information provided in this section, which thus prevents the independent replication of the experiments by other peer scientist investigators. However, some journals still require that enough information be revealed for replication purposes. For instance, inadequate presentation of the methodologies used in research articles was listed among the top ten reasons why manuscripts are not accepted for publications, as stated by the journal’s editors and reviewers.

The need to present, situate and position, results in a wider context also encouraged frequent references to other publications and citations, thus increasing the space allotted to Discussion sections and creating cross-referencing and intertextuality among the articles published.

Discussion sections of medical research articles are meant to highlight the importance and relevance of a study in connection with the most up-to-date research in the respective field, at the same time mentioning the limitations of the reported research and the further studies required in order to provide adequate solutions to unanswered or controversial issues. However, given the current abundance of references to research reported in other publications, the current ongoing present-day Discussion sections seem to mainly rely on the presentation of data rather than on the use of esoteric and rhetorical strategies aimed at convincing the target peer audience of the validity and usefulness of the findings. Besides decreasing author responsibility, this practice heavily narrows down the target audience and restricts it to fellow colleagues from the same specialty or sub-specialty, who would have to be familiar with all the most recent and currently ongoing research studies listed as references in order to correctly usefully and validly assess all the knowledge claims introduced by their peers.

Other 20^th century developments included the growing use of audio-visual videos and other multimodal visuals as means of supplementing and supporting the written text, an increase in multiple authorship, the use of simpler semantics and syntax structure, and the clear division of papers into sections signaled by headings and sub-headings in order to facilitate modular reading. As far as the format is concerned, until 1945 articles rather resembled book chapters with headings connected with the main topic. The Introduction, Methods, Results and Discussion (IMRAD) structure of research articles recommended by many journal editors after World War II for the purpose of standardization spread quickly and became a uniform technical requirement in 1978, following the meeting of several biomedical journal editors who formed the Vancouver Group, which later transformed into the International Committee of Medical Journal Editors (ICMJE). Since then, the requirements underwent several revisions, including the adoption of abstracts structured according to seven sub-headings in papers that report clinical investigations. The IMRAD structure and its slight variations, such as additional subheadings for Discussion sections or alternative names for Methodologies -Materials and Methodologies, Patients and Methodologies etc continues to be required by most scientific and medical journals.

The creation and consistent use of this structure was attributed to journal editors who insisted on clear formatting for a more uniform and standardized peer review process.

Although this ;ist is by no means exhaustive,however on the basis of availability and opportunity,

A comprehensive list of Peaditric Journals includes but not confined to:

Acta Pediatrica.

Archives of Diseases in Childhood.

BMC Pediatrics.

Clinical Pediatric Emergency Medicine.

Current Problems in Pediatric and Adolescent Health Care.

European Journal of Pediatrics.

JAMA Pediatrics.

JAMA Pediatrics

Journal Language

AAP Policy & Collections English

Acta Pediátrica de México Spanish

Adolescent Health, Medicine and Therapeutics English

Adolescents English

Adolescere Spanish

Advances in Pediatric Research English

American Journal of Pediatrics English

Anales de Pediatría Spanish

Anales de Pediatría (English Edition) English

Andes Pediatrica Spanish/English

ArchivosArgentinos de Pediatría Spanish/English

Archivos de Pediatríadel Uruguay Spanish

ArchivosVenezolanos de Puericultura y Pediatría Spanish

BMC Pediatrics Free site English

BMJ Paediatrics Open English

Boletín de Pediatría Spanish

BoletínMédicodel Hospital Infantil de México Spanish/English

Case Reports in Pediatrics English

Caspian Journal of Pediatrics English

Children English

Clinical and Experimental Pediatrics English

Clinical Medicine Insights: Pediatrics English

Clinical Pediatrics: Open Access English

Contemporary Pediatrics English

Current Pediatric Research English

Egyptian Pediatric Association Gazette English

Evidencias en Pediatría Spanish

Frontiers in Pediatrics English

Global Pediatric Health English

Hong Kong Journal of Paediatrics English

Indian Journal of Neonatal Medicine & Research English

Indian Journal of Youth and Adolescent Health English

Integrative Pediatrics and Child Care English

International Journal of Adolescence and Youth English

International Journal of Clinical Pediatrics English

International Journal of Neonatal Screening English

International Journal of Paediatrics and Geriatrics English

International Journal of Pediatrics English

International Journal of Pediatrics & Adolescent Medicine English

Iranian Journal of Neonatology English

Iranian Journal of Pediatrics English

Italian Journal of Pediatrics English

JMIR Pediatrics and Parenting English

Jornal de Pediatria Portuguese&English

Journal of Applied Research on Children English

Journal of Child English/Turkish

Journal of Clinical Neonatology English

Journal of Neonatal Biology English

Journal of Nepal Paediatric Society English

Journal of Paediatrics and Neonatal Disorders English

Journal of Pediatric and Neonatal Individualized Medicine English

Journal of Pediatric Care English

Journal of Pediatric Pharmacology and Therapeutics English

Journal of School and University Medicine English

Journal of Transition Medicine English

Kinderärztliche Praxis German

Korean Journal of Pediatrics English

La Pediatria Medica e Chirurgica English

Medicina Infantil Spanish

Molecular and Cellular Pediatrics English

Nascer e Crescer Portuguese/English

Neonatal and Pediatric Medicine English

Neonatal Medicine English

Nigerian Journal of Paediatrics English

Open Journal of Pediatrics English

Open Pediatric Medicine Journal English

PaediatriaCroatica English/Croatian

Paediatric and Neonatal Pain English

Paediatrica German/French

Paediatrica Indonesiana English

PagineElettroniche di Qacp Italian

Pediatria Italian

Pediatria i MedycynaRodzinna English/Polish

Pediatric Anesthesia and Critical Care Journal English

Pediatric Health, Medicine and Therapeutics English

Pediatric Investigation English

Pediatric Oncall Journal English

Pediatric Quality & Safety English

Pediatric Reports English

Pediatrics & Health Research English

Pediatrics & Neonatology English

Pediatrics & Therapeutics English

PediatríaAsunción Spanish

Pediatría Integral Spanish

Polish Journal of Paediatrics English

Portuguese Journal of Pediatrics English

Pädiatrie German

Quaderni ACP Italian

Research and Reports in Neonatology English

Paediatric Endocrinology Reviews English

Residência Pediátrica Portuguese/English

RevistaCubana de Pediatría Spanish

Revistadel Hospital de Niños de Buenos Aires Spanish

Revista Mexicana de Pediatría Spanish

RevistaPaulista de Pediatria Portuguese/English

Revistapediatricadel Hospital de Niños de Buenos Aires Spanish

RevistaPediatría de AtenciónPrimaria Spanish

Romanian Journal of Pediatrics English/Romanian

South African Journal of Child Health English

Sri Lanka Journal of Child Health English

Sudanese Journal of Paediatrics English

Translational Pediatrics English

Turkish Archives of Pediatrics English

Turkish Journal of Pediatrics English

Vox Paediatrica Spanish

World Journal of Clinical Pediatrics English

Paediatrics journals included in the Directory of Open Access Journals database (DOAJ).

Acta Pediátrica de Mexico

International Journal of Pediatrics and Adolescent Medicine

Pediatric Hematology Oncology Journal

Adolescent Health, Medicine & Therapeutics

International Journal of Pedodontic Rehabilitation

Pediatric Investigationa

African Journal of Pediatric Surgery

Iranian Journal of Neonatology

Pediatric Neurology Briefs

Annals of Pediatric Cardiology

Iranian Journal of Pediatric Surgery

Pediatric Quality &Safety

Annals of Pediatric Endocrinology &Metabolism

Italian Journal of Pediatrics

Pediatric Reports

Annals of Pediatric Surgery

JCRPE Journal of Clinical Research in Pediatric Endocrinology

Pediatric Rheumatology Online Journal

Archivos de PediatríadelUruguay

JMIR Pediatrics and Parenting Pediatrics and Neonatology

BMC Pediatrics

Jornal de Pediatria

Pediatria

BMJ Paediatrics Open

Jornal de Pediatria (in Portuguese)

Perinatal Journal

Case Reports in Pediatrics

Journal of Children’s Orthopaedics

Portuguese Journal of Pediatrics

Child Development Research

Journal of Early Hearing Detection and Intervention

Research and Reports in Neonatology

Child Neurology Open

Journal of Indian Association of Pediatric Surgeons

Residência Pediátrica (in Portuguese)

Child and Adolescent Psychiatry and Mental Health

Journal of Maternal and Child Health

RevistaCubana de Pediatría

Children

Journal of Neonatal Surgery

RevistaPaulista de Pediatria

Clinical Medicine Insights: Pediatrics

Journal of Nepal Paediatric Society

RevistaPediatría de AtenciónPrimaria

Clinical Medicine: Pediatrics

Journal of Pediatric Clinical Care

RevistaRomana de Pediatría

Clinical Pediatric Hematology-Oncology

Journal of Pediatric Emergency and Intensive Care Medicine

Revista del Hospital de Niños de Buenos Aires (in Spanish)a

Clinical and Experimental Pediatrics

Journal of Pediatric Nephrology Russian Bulletin of Perinatology and Pediatrics (in Russian)

DetskieInfekcii (Moskva) (in Russian)

Journal of Pediatric Research

Sari Pediatri (in Indonesian)

Ecos do Minho (in Portuguese)

Journal of Pediatric Sciences

SlovenskaPediatrija (in Slovene)

Egyptian Pediatric Association Gazzette

Journal of Pediatric Surgery Case Reports

South African Journal of Child Health

European Journal of Pediatric Surgery Reports

Journal of Pediatric and Neonatal Individualized Medicine

Sri Lanka Journal of Child Health

Fertility Research and Practice Journal of Pediatrics Reviews

The Journal of Pediatrics

Frontiers in Paediatrics

La Pediatria Medica e Chirurgica

VoprosySovremennojPaediatriia

Global Paediatric Health

Maternal and Child Nutrition

World Journal of Paediatric Surgery

Indian Journal of Neonatal Medicine and Research

Nascer e Crescera Child's Health

Indian Journal of Paediatric Dermatology

Neonatal Medicine

Actual Problems of Pediatry, Obstetrics and Gynecology

International Breastfeeding Journal

Paediatrica Indonesian

Mother and Baby in Kuzbass (in Russian)

International Journal of Neonatal Screening

Pediatric Orthopaedics, Traumatology and Reconstructive Surgery

Russian Journal of Woman and Child Health (in Russian)

International Journal of Pediatric Endocrinology

Pediatric and Neonatal Pain

Pediatric Surgery

International Journal of Pediatrics (Iran)

Pediatric Anesthesia and Critical Care Journal

Mustansiriy Medical Journal

International Journal of Pediatrics

Pediatric Health, Medicine & Therapeutics

Table lists the paediatrics journals included in this database. The journal Anales de Pediatría is not included in the DOAJ, but the DOAJ website includes a link to apply for inclusion in the database in its home page, which can be used by any open-access journal. Table lists the open-access paediatrics journals with an index factor indexed in the Journal Citation Reports (JCR)® database.

Open-access journals with an impact factor included in the pediatrics category of the Journal Citation Reports (JCR)

Journal name Impact factor

Frontiers in Pediatrics 2.634

Pediatric Rheumatology 2.595

International Breastfeeding Journal 2.545

Italian Journal of Pediatrics 2.185

Children-Basel 2.078

Child and Adolescent Psychiatry and Mental Health 2.061

Jornal de Pediatria 2.029

BMC Pediatrics 1.909

Journal of Clinical Research in Pediatric Endocrinology 1.803

Pediatrics and Neonatology 1.773

Anales de Pediatría 1.313

Journal of Children’s Orthopaedics 1.075

Question: What are your recommendations to write a world class research article in Paediatrics? What essential components and factors must be there?

Answer

Research Articles are original research contributions that aim to inform clinical practice or the understanding of a disease process. Research Articles include but are not limited to clinical trials, interventional studies, cohort studies, case-control studies, epidemiologic assessments, and surveys. Components of a Regular Article include:

The primary goal ofpaediatric research articles has always been, at least in the first instance technically speaking, to contribute to the progress of science. However, within the current academic environment, articles are also published so that authors could achieve individualized gratifications such as but not confined to attaining higher positions in the clinical, research and academic tenure, and therefore attracting research study grants funding through sponsored regionally or internationally funded research programs, etc. which thereafter are rewarding to the academic research institutions in which the contextual authors operate from, such rewards include but not confined to,higher international rankings, improvedvisibility, better funding opportunities, enhanced enrollment of tuition-fee paying scholars, etc).

Given these numerous rewards, original research articles papers remain the utmost determinant and impactful means of not only disseminating but of principally creating a new body of knowledge, as well as of establishing academic research and professional tenure at both the faculty, institutional, regional international and global levels.

Lessons From The Past –The Histriographic Aspects and Perspectives on the Origins and development of the Research Article.

Henry Oldenburg (also Henry Oldenbourg) FRS (c. 1618 as Heinrich Oldenburg – 5 September 1677). was a German theologian, linguist,diplomat, educator,Tutor and natural philosopher, known as one of the creators of modern scientific peer review. He had an initial very firm grasp of the German, Latin, and Greek languages. He equally worked as a tutor in England for much of the decade. He spent some time in Leiden and Utrechtin the Dutch Republic, where he became conversant in the Dutch language.

He was one of the foremost intelligencers of 17th-century Europe, with a network of correspondents to compare and rival those of Fabri de Peiresc, Marin Mersenne, and Ismaël Boulliau etc..

Settling then in England of the Interregnum, he forged a strong relationship with his lifelong patron Robert Boyle, and with John Milton, who wrote of him approvingly that he had learnt to speak our language more accurately and fluently than any other foreigners I have ever known. Oldenburg eventually became the tutor to Boyle's nephew, the politician Richard Jones, and travelled with him through France from 1657 to 1660. Here Oldenburg also added to his intellectual baggage the French language, the last European language in which he was completely conversant.

Oldenburg gained entry to several seminal academic scientific and intellectual circles, including Samuel Hartlib, whose extensive web of correspondents Oldenburg was to take over.

Amongst Oldenburg's correspondents at this time was Baruch Spinoza, whom he was introduced to on a trip to the Netherlands, and to whom he presented a volume of writings on scientific topics by Boyle.

At the foundational meeting of the Royal Society in London, he took on the task of foreign correspondence, as the first Secretary.

After the Restoration he became an early member-original fellow of the Royal Society which was founded in 1660, and served as its first secretary along with John Wilkins, maintaining an extensive network of scientific contacts through Europe and beyond. He also became the founding editor of the Philosophical Transactions of the Royal Society. Oldenburg began the practice of sending submitted manuscripts to experts who could judge their quality before publication. This was the beginning of both the modern scientific journal and the practice of peer review. The Philosophical Transactions of the Royal Society continues till today and is the longest and oldest functioning scientific journal in the world.

He was briefly imprisoned in the Tower as a suspected spy in 1667, during the Second Anglo-Dutch War.Oldenburg's correspondence was linked to support from the politician Sir Joseph Williamson; in part Oldenburg supplied Williamson with intelligence information.

The first public institution dedicated to experimental scientific research and learning was The Royal Society of London for Improving Natural Knowledgewhich in 1660 becamethe pioneer public institution dedicated to experimental scientific research, learning and studies.

Some of this institutions foundational members were prominent pioneer scientists such as but not limited to Robert Hooke, Robert Boyle, John Wilkins, Christopher Wren, and John Evelyn.etc.

This initial full name of The Royal Society of London for Improving Natural Knowledge was later usually abbreviated toRoyal Society of London a name which has stood the test of time to date.

The Royal Society of London, is the institution where the initial scientific publications were developed, read and published more often than not by its scientific members.The history of the scientific research article is closely connected with the academic and scientific activities of these foundational members who almost always were accomplished, cerebrated, seasoned and recognized in their areas of interest and specializations.Robert Hooke in physics and mathematics, Robert Boyle in chemistry etc.

This eminent and erudite scientific membership and fellowship of the parent Royal Society and its off spring of the other regional Royal Societies and the Royal Societies in several other branches of sciences and Arts, Commerce and Manufactures etc continued to have been fostered and continued till date, indeed the nomination,admission and election criteria for the Royal Society and its off spring Royal Societies fellowship is comparable and somewhat equivalent to that required for Nobel Prize Laureateships or other similar awards of distinction, excellence and honourin Medicine or Physiology etc.

On the basis of the available archival records, of scientific writings in the Papyrus Ebersduring the ancient Egyptian dynasties, although there were several documented records of scientific discoveries from several Histriographicscientific scholars such as Hippocrates,Galen,Galeleo ,Archimedes ,Plato,Morgagni,Verselius etc however these were thought to be more representative of case reports etc of today.

However, the official publication of 1665, by the Royal Society which commenced its scientific publication series through the publication of its Philosophical Transactions, the first scientific periodical and one of the most seminal and significant scientific journals within the British Isles, European continent and beyond .

The Philosophical Transactions of the Royal Society was second to none globally, untilwell into the 19^th century, when this scientific governance position was shared with other specialized scientificpublications in biological and health, sciences, physics, mathematics, medicine etc.

Theacademic scientific correspondence between the Society and the whole of the scientific worldwas co-ordinated and supervised Henry Oldenburg who was the first secretary-General appointed to have an administrative and governance oversight over the philosophical transactions publications of the Royal Society.

While in this role,Henry Oldenburgacquitted himself excellently well and generally encouraged the exchange of scientific ideas to such an extent that he was regarded as the inventor of the present day scientific article.

In this capacity, Oldenburg anglicized German, Dutch, Greek, French and Italian letters facilitated and supported his and advanced his role as the scientific correspondent of the Philosophical Transactions, although the communications in Latin was equally achieved and archived.

The Philosophical Transactions initially published news, correspondences, letters and descriptions of experimental reports without a standardized format, structure or style. As Hyland pointed out, essentially, scientific papers evolved as a way of offering a vivid account of experimental performances toa distantreadership.

An extensive and in-depth appraisal, examination and evaluation of the Philosophical Transactions of the Royal Society undertaken byBazermanfrom 1665 upto 1800 depicted a representative overview of the salient aspects of the dynamic development and progression of the histriographic experimental reports intothe current research articles.

At the first instance, Bazermans earlier and histriographic reviews of the archives of the Philosophical Transactions of the Royal Society has a lot of implications for not other scientific endevours and discipline especially geography, chemistry and physics as a group, but also particularly for Paediatrics, Neonatology , Perinatology and Fetal Medicine as a theme, since experimental and observational report articles on these subjects such asthat of unexpected natural events of earthquakes or abnormal, atypical and unusual fetuses were overwhelmingly represented in the first four of every five volumes of the Transactions compared to experimental reports, which merely occupied one of every twenty to one of every five of each volume.

Bazerman also bemoaned theoverarching growth and dynamism in the roles of the contexual scientists who frequently migrated frombeing just mere observers of the events to dedicated and real investigators of experiments as the essence and understanding of experiments revolves between any completed task, finished process or undertaken procedures, to an empirical investigation, an assertion,to a test of a theory and to eventually a proof of, or evidence for, a claim, examination of hypothesis etc.

Contexually, the consequences and impact of this histriographic scientific appraisal and evalutions undertaken byBazerman on the Philosophical Transactions of the Royal Society encouraged a heightened attention to be proffered to the descriptions of the experiments, particularly with relevance to the methodologies employed, the outcome and the results obtained ,in addition to their overall relevance.

The cryptic, slow but steady and regular modifications to the principles of the experimental report were also reflected in the structuring and presentations of the articles published in the Philosophical Transactions of the Royal Society of London.

At the first instance, it was observed that the submitted and published articles got lengthier due to an increase warranted by the compulsion toundertake a number of sequential experiments more often instead of employing only sole activities or events for the evaluation of research hypotheses.

Also, articlesfrom authors took over from editorials featuring and dominated by the opinion and view of the editor that had welcomed and presented the reports at the first instance, a need ,the necessity purpose, aims and objectives section would antecede the experiments and trials, results of earlier, previous experiment and trials would be tested later in due course with other experiments and, in with controversial, contentious and debatable experiments or trials, the report would be commenced with a statement about thecontentious ,debated, controversial and disputed topics and a discussion of the opponent’s position or work.

This was followed by the author’s own view point, opinion and position, then the presentation of methodological concepts and issues and then the outcome and results, in this way, in a timely manner, the hypothesis would have been stated before the experiment even in the absence of contention or controversy. These subtle, but consistent sustained non-rapid modifications contexuallly demonstrates how the acceptance or denial of another scientific author or scholars research work, view points, opinionsassertions ,standing or position and claims has frequently and regularly founded ,grounded and underpinned the pivotal component influencing the structuring, modification, development ,progression and advancement of the ancient extant research article to a current scientific modern research article histriographically since the past to the present.

Bazerman summed up the histriographic developmental, progressive, typological and structural course of the experimental reports published in the Philosophical Transactions by identifying four distinct periodic stages: simple reports of events was the norm between 1665–and --1700, arguments, debates and critiques over the results was frequent from1700–to---1760, discovery accounts for explaining atypical and unusual events was the trend between 1760–and 1780 and reports containing claims and experimental proofs was the rule from 1790–to 1800

As more ambiguous, ambivalent, equivocal, enigmatic, elusive complexand complicated issues were submitted for publication, the Philosophical Transactionsof The Royal Society’s structuring, organization and presentations of articles also underwent some significant modifications.

The published and presented articles would commence with an introduction ,proffering accounts and overviews of previous unsuccessful experiments, followed by the chronicles of sequential series of experiments and their conclusions based on the author’s ingenuity and reasoning, which would culminate ,sum-up and yield ultimate conclusions.

As the year 1800 approached, philosophic statements were used to introduce the problem, which was presented through a paradoxical and surprising result or by indicating and pointing out a research gap, much like the present day Create a Research Space–CARS model for structuring and presenting the Introduction sections of research articles identified and proposed by Swales.

Accounts of the experiments would then be followed by conclusions, which also discussed the consequences and implications of the stated assertions and claims for future experiment, research and practice.

In the initial one- half of the 18^th century, communications, correspondences and letters on medical topical themes were equally publishedin the Philosophical Transactions of The Royal Society ,in several original and translated languages such as English,Walsh,Scottish,Irish,German, Latin, and Greek , Dutch and French and also some still in Latin, although the immediate and direct import or relevance of the clinical contributions was not very optimal.

Following a retrogression in scientific endevours by mid 18^th century, a suggestion by the Earl of Macclesfield, future president of the Royal Society was aimed to enhance, the overall quality of the articles published in the Royal Society’s Philosophical Transactions proffered the inception and establishment of a committee for the review of all article papers prior to publication, the committee membership is inclusive of an medical scholar named William Heberden, whose initiatives, innovations and ingenuity led to an overall development and enhancement in the credibility and qualitative improvements in the medical and biological papers featured in thePhilosophical Transactions of the Royal Society.

Two salient and principally significant modifications positively drived the fundamental rapid evolution and revolution of the Philosophical Transactions in the 19^th century: at the first instance is the splitting of the journal in 1887 into two categorically distinctive sections, one dealing with mathematical and physical topics and themes the other with biological papers, and the introduction in 1896 of sectional committees for peer review processes, which twenty four months later developed and progressed to an anonymous an anonymous peer review committee and process.

Other 19^th century developments included the gradual inclusion of not only amateur scientists and learned gentlemen in the Royal Society but of what would be currently referred to as trained and certified scientists, as well as the infusion of government sponsorship and funds into an initially autonomous and free-thinking voluntary organization.

The development of the experimental report was also linked with the increased professionalism, critical attitude and research interest of both contributors and target readers, which encouraged a shift from scientific reports characterized by narrative structure, personal involvement and author-centered norms of courteous conduct, towards a reporting format with greater emphasis on methodology and experimental description under the aegis and purview of non-obstrusive ethical an professional regulations.

In the lack of or paucity of a conventional and standardized means of converting assertions,empiricisms, speculations and claims into frequently acknowledged and recognized forms of scientific knowledge, the authors and contributors would mainly rely on sensational observations , reproducibility of the results for re-affirmation purposes and reciprocal confidence and trust.

Therefore, histriographically, thescientific experiments were recorded and represented with extensive itemized encyclopedic character and undertone in such a manner that the interested readership could apparently reconstruct,reinvent and rework those itemized details in their cognitive intellect as well as in their own scientific laboratories, and thus verify the accuracy and representativeness of the reported results. In time, as the scientific discipline revoutionised, these detailed descriptions were replaced by today’s usually concise Materials and Methodologies section of research articles.

Contexually, with regards to theform, mode and pattern of sternographic and topographical presentation of the experimental facts,apart from an encyclopaedic factual and probit tendency, and trend,there was also an inclination by the scientists to report their experiments with astonishing degrees of honesty and probity, and even with unaccomplished and unsuccessful experiments were extensively detailed, there was also the need to eschew unfounded ,ungrounded and unwarranted idiosyncratic anticipatory idiosynchratic, ideological imaginary sentimental approach to scientific experiments on the basis of individual principles and scientific piety was emphasized through the need to protect and promote a cordial and professional interpersonal relationships, and exudation of untested ,untried and unpiloted scientific views.

To buttress the need and importance of employing the non-obtrusive and polite linguistic character in their experimental reports, eminent scientists such as Robert Boyle, himself a foundational fellow of the Royal Society

Concurred to often using tentative words of politeness such as but not confined to: it may well be, perhaps, it seems, it is not improbable,it is possible, it is probable ,in addition to other forms of algorithmic certainty classifiers etc, to convey lack of absolute confidence in the facts and veracity of propositions and opinions, thus recording the first use in scientific writing of what is now acknowledged as hedges.

Hedges are linguistic devices such as more or less, as far as we know, we admit,we propose,for now assume that ,relatively, approximately, may, it is assumed, it is believed, if I may beg to differ,to our knowledge, reason with us,from our point of view, which are often used by research article authors in order to present anecdotal,hypothetical and propositional content as accurately,lucidly and reliably as possible, eschew the assumption of direct individual responsibilitites for the some parts of the reported material or convey the sense of undue and inordinate assertiveness over scientific ingenuity as individualized views and therefore eschew delayed disclaimers and promote the peer readership engagement and participation.

Indeed in scientific writings, these approaches have been employed by eminent and erudite scientific research article authors to achieve a distinction between factual robust statements , established ,founded and grounded on rigorous observational, methodological techniques and its credibly derived results from those with anecdotal, guarded and restricted view points.

The reports published in the early issues of the Philosophical Transactions were also written using active-voice verbs and first-person pronouns such as I am reporting that ,he is reporting that, she is reporting that, we are reporting that, they are reporting that but not that It was reported that etc -for increased credibility and attached responsibility. Experimental reports from some scientific authors and scholars were thought to have been punctuated by verbosities, tautologies, undue elegance, in addition to esoteric and rhetoric undertones, linguistic and semantic structures which were thought to be fashionable and was aimed to engage the interest and acclaim of its peerreadership, in addition to harnessing the contexual author’s scientific prowess.

This early record of the use of undue elegance,esoterics, hedges and other rhetorical devices suggests that besides the bare facts, scientists have always relied on linguistic and rhetorical resources for convincing the scientific community of the accuracy, credibility and robustness of the assertions in their scientific research articles report, for harnessing, grounding and re-affirming their dignifying and respectable designated roles in the context of their affiliated institutional academic and professional societies with the overall aim of inventing a new body of applicable, extrapolatable,credible ,illustrative,illuminative instructive and reproducible and sustainable body of scientific knowledge.

Since hedges generally modify and regulate author commitment and promote writer-reader interaction, they are currently regarded as recommendable rhetorical,but guarded means of restrictivelyintroducing new body of knowledge assertions, or filling in the gaps in some existing knowledge base, especially in its discussion sections where they are commonly employed profusely, until such assertions are recognised and accredited by the global medical scientific societies.

It is recognised that hedges have dynamic, multimodal, and very frequently interesecting roles , and can occur under numerous linguistic forms including epistemiologic lexical verbs, adverbs, adjectives, modal verbs and nouns, in addition to paraphrases, phrases or sentences referring to restricted knowledge, restrictions of model, theory or methodology, in addition to/or experimental limitations.

Apart from the Philosophical Transactions, the history of medical journals is connected with the Edinburgh Medical School and their Medical Essays and Observations which was published from 1731, which then became the Edinburgh Medical Journal, peer-reviewed since 1733. A detailed analysis of the evolution of medical research writing as reflected in Edinburgh Medical Journal articles published between 1735 and 1985 was conducted by Atkinson. According to this histriographic study, the initial interest in case studies ,which was based on the observation of single patients changed so that by the end of the 18^th century ,the disease and pathological entity became the focus of attention and the main criterion for categorizing ,characterizing and describing patients. In addition, a trend towards impersonal, non-narrative texts was conspicuous in conjunction with the beginnings of public medicine.

Other important events in the evolution of the English-language medical research article are connected with the emergence of two journals with remarkable tradition and influence in the international medical community. Thus, the Lancet first appeared in 1823 with the purpose of publishing the lectures of medical men working in London medical schools and of advancing and promoting case reports written by the medical and surgical intelligence of the time, thereafter three decades later, in 1857, the British Medical Journal was founded following the creation of the British Medical Association and the merging in 1853 of the Provincial Medical and Surgical Journal with the London Journal of Medicine to form the Association Medical Journal. The outstanding and remaining part of the 19^th century and beginning of the 20^th century witnessed the appearance of specialist British journals that reflected developments in fields such as physiology, pathology, bacteriology, tropical medicine, hygiene, or surgery etc.

The constant efforts to improve the structure and content of research papers continued throughout the 20^th century, which proves the dynamic and migratory character and nature of the research article in response to scientific and disciplinary changes.

The main developments were generated by the standardization of experimental procedures, which led to a less-detailed, shorter Methodological sections and greater emphasis on contextualizing and discussing results in order to demonstrate their relevance. The way methodologies are presented in research articles has changed to such an extent that the concept of replicability turned into a myth due to the insufficient amount of information provided in this section, which thus prevents the independent replication of the experiments by other peer scientist investigators. However, some journals still require that enough information be revealed for replication purposes. For instance, inadequate presentation of the methodologies used in research articles was listed among the top ten reasons why manuscripts are not accepted for publications, as stated by the journal’s editors and reviewers.

The need to present, situate and position, results in a wider context also encouraged frequent references to other publications and citations, thus increasing the space allotted to Discussion sections and creating cross-referencing and intertextuality among the articles published.

Discussion sections of medical research articles are meant to highlight the importance and relevance of a study in connection with the most up-to-date research in the respective field, at the same time mentioning the limitations of the reported research and the further studies required in order to provide adequate solutions to unanswered or controversial issues. However, given the current abundance of references to research reported in other publications, the current ongoing present-day Discussion sections seem to mainly rely on the presentation of data rather than on the use of esoteric and rhetorical strategies aimed at convincing the target peer audience of the validity and usefulness of the findings. Besides decreasing author responsibility, this practice heavily narrows down the target audience and restricts it to fellow colleagues from the same specialty or sub-specialty, who would have to be familiar with all the most recent and currently ongoing research studies listed as references in order to correctly usefully and validly assess all the knowledge claims introduced by their peers.

Other 20^th century developments included the growing use of audio-visual videos and other multimodal visuals as means of supplementing and supporting the written text, an increase in multiple authorship, the use of simpler semantics and syntax structure, and the clear division of papers into sections signaled by headings and sub-headings in order to facilitate modular reading. As far as the format is concerned, until 1945 articles rather resembled book chapters with headings connected with the main topic. The Introduction, Methods, Results and Discussion (IMRAD) structure of research articles recommended by many journal editors after World War II for the purpose of standardization spread quickly and became a uniform technical requirement in 1978, following the meeting of several biomedical journal editors who formed the Vancouver Group, which later transformed into the International Committee of Medical Journal Editors (ICMJE). Since then, the requirements underwent several revisions, including the adoption of abstracts structured according to seven sub-headings in papers that report clinical investigations. The IMRAD structure and its slight variations, such as additional subheadings for Discussion sections or alternative names for Methodologies -Materials and Methodologies, Patients and Methodologies etc continues to be required by most scientific and medical journals.

The creation and consistent use of this structure was attributed to journal editors who insisted on clear formatting for a more uniform and standardized peer review process.

Although by facilitating modular reading this format is regarded as beneficial, especially for today’s extremely busy scientists, it was however,also on the other hand seriously criticized by Peter Brian Medawar, winner of the Nobel Prize in Physiology or Medicine for turning the research article into a fraud by providing a totally misleading narrative of the processes of thought that go into the making of scientific discoveries. Medawar blamed this already traditional inductive format for heavily relying on the formulation of hypotheses, which are largely generated by guesswork and inspiration and which must then undergo rigorous testing. Consequently, he suggested that Discussion sections should open articles up and be followed by the presentation of scientific acts and facts. A similar view was expressed by Knorr-Cetina, who drew attention to the fact that although the purpose of scientific papers is that of reporting research, authors intentionally omit -much of what happened in the laboratory, do not respect the actual sequence of events and resort to literary strategies for convincing readers of assertions, claim, reliability and importance.

The Evolution To The Current Trend Of Research Article Writing.

The serialdevelopmental processes that matured into the current format, structure and main features of the research article, is as a result of the dedication of several eminent who were devoted to attaining a revolutionized scientific model to foster the growth of science and all scientific human endevours in other to attain an optimized and utmost developmental goals for scientific paediatrics and the society at large.

These remarkable developmental milestones have epitomized theaspirations of the academic, scientific and professional readerships, the scientific journal editors, peer-reviewers, publishers and referees, especially given the growing interest in scientific publications and the exponential increases in the article submission frequency and volume of articles submitted for publication, in addition to the heightened levels of ambitiousness ,eagerness and zeal amongst paediatric academics,scholars,professionals and researchers in attaining tenure progressions, international recognition and reward.

The writing and publication of credible and qualitative research articles in Paediatrics are important competencies that should be mastered by the paediatric faculty professionals. It provides an opportunity for paeditricians to develop numerous skills including communication, collaboration, time management, and teamwork.

Although there appears to be a considerable variation amongst paediatric journals, but for all intents and purposes, most paediatric journals still follow the traditional structure that research articles in paediatrics have been known with.

Indeed the structure used for the writing and presentation of the other article types such as case report, review articles are somewhat modifications of these basic original article structure.In this part of the discussion for this interview, I will outline some of the recommended steps for writing a research article in paediatrics. With overallobjectives of providing guidelines for potential paediatric journal authors of research article on how to improve the chances of their manuscript being accepted, with a review on focusing on writing an original medical article.

This review reflects my personal experience in this interview, as a scholar who has extensive experience as an author, reviewer and editor of paediatric original research articles journals.

To write an original article successfully, there are some basic and essential requirements, the of an original article.

These are subjects worth reporting, knowledge of the basic structure of an article, and knowledge of the essential mechanics of good writing. This review details each of the these items.

Writing, like every other art, cannot be learned wholly from books or lectures, but can be learned largely by experience. The best training is to commence the task and persevere. The act of writing, like surgical techniques, must be learned the hard way, by practice and perseverance. Anyone can start writing but only a dedicated good writer .could accomplish the work.

For a very long time over several decades now, a lot of efforts have directed towards achieving an improvement in research article writing and paediatric research article writing is not an exception.

Several paediatric journals editorsask for the minor or major revision of the submitted articles manuscripts with any content component compromise, where as in some instances the abysmally compromised manuscriptswere rejected outright, the criteria for the overall acceptance of manuscripts by paediatric journal editors appear to be getting more and more stringent in an attempt to improve the overall scholarship outlook of the contextual paediatric journals.

Also similarly, some paediatric journals ask their reviewers and referees to proffer a documented comprehensive critique and criticism of the content of review article papers submitted to them for review and offer their expert opinion, inspite of the work load implications of aiming to achieve these high standards most journal management aims to work very hard to excel and sustain this excellence.

The onus is now on the authors to ensure that they conduct their experiments and research with diligence and bonafide intent by giving appropriate amount of time, effort and resources that the conduct of the research study and its writing and dissemination are adequate and satisfactory.

However, despite these opportunity and the relevance of the publication of a credible and qualitative article to the paediatric authors academic and professional progression, more often than not several authors are still not committed, patient and painstaking enough to undertake the writing, production and publication of a research article masterpiece that will be emulable, despite even having carried out a rigorous experiment and research study in paediatrics.

Even amongst those who persevere, write and wants to get published there are clear evidence that their work will need variable degrees of support for it to go places.

Theoverall aim of this discursive recommendation is to proffer guidelines for potential paediatric review article authors on how to enhance their chances of having their review article manuscript appropriately written, thereby enhancing its clarity, readability and comprehensiveness to facilitate its editorial reviews, peer reviews ,referring and acceptance.

In this review I focus only on the writing of original articles for publication in a peer-reviewed paediatric journals.

To write an original article successfully, there are some essential requirements, the fundamentals of an original article, including a subject worth reporting, knowledge of the basic structure of a peer-reviewed article, and knowledge of the essentials of good writing.

The subject

There should be a subject matter and topical theme worthy of reporting, that would be a useful addition to the existing literature and body of knowledge . The author should have read the relevantprevious reports carefully and ensure that he or she is not repeating what has been done successfully before. As an author, one should not expend undue time in writing a research articlemanuscript whichcould neverattain publication standards.

The basic structure of aresearch article.

The following guidelines are recommended to be used in the structuring of research articles:

Introduction: introduction to the clinical problem and the research question being studied.

Methodologies: should be as in the original protocol for the study, which should be submitted as a supplementary file. Where there have been deviations from the original protocol, this needs to be justified and stated.

Methodologies should also include a patient participation statement. If the study involved a questionnaire, please either add this as a supplementary file or reference it, if previously published.

Results: should include all the relevant findings from the research investigation.

Any data presented in tablesshould be summarised, however, all the information in the tables should notbe repeated.

Discussion: Most paediatric journals recommend that on the average that the discussion section should not be longer than five paragraphs and should more less be unstructured but themes around the following thematic points such as but not confined to : a statement of the principal findings; strengths and weaknesses of the study; strengths and weaknesses in relation to other similarly themedstudies, discussion important differences in results; the meaning of the outcome of the study: possible explanations and implications for clinicians and policymakers; and unanswered questions and future research.

Authors should eschew stating ‘This is the first study.,however they could make a factual but tentative statement as an expression of modesty and politeness, and use algorithmic certainty classifiers such as ,as far as we know ,to the best of our knowledge ,this is probably ,possibly - the first published study on this context on this theme,in this region

A funding statement: preferably worded as follows. Either: ‘This research article study and work was supported by -name of funder grant number [xxx]’ or ‘This research received no specific grant from any funding agency in the public, commercial or not-for-profit domain or sectors’. Authors must ensure that the, correct details of their funder(s) and any relevant grant numbers are includedin full.

For the competinginterest’s statement: contexual paediatric journal authors see this advice from the contexual paediatric journals authors guidelines on what to include.

Paediatric Research Articles Journals usually insist that the author’s team should list each author’s contribution individually at the end; this section may also include contributors who do not qualify as authors.

Please Paedaitric authors should do well to visit the ICMJE website for more information on the criteria for authorship.

Any checklist and flow diagram for the appropriate reporting statement, e.g. STROBE could beassessed at the guideline to authors section.

Patient consent form: any research article that contains personal medical information about an identifiable living individual requires the patient’s explicit consent before this contexual paediatric journal can publish it.

Patients would be required to sign the contexual paediatric journal consent form, which requires the patient to have read the article. This form is available in multiple relevant languages and there is translatable version to any other language available.

Please provide a data sharing statement such as: Technical appendix, statistical code, and dataset available from the Dryad repository, Digital Object Identifier-DOI: include DOI for dataset where appropriate.

Following the lead of The Pioneer Paediatric Journals and its patient partnership strategy, some paediatric journals are encouraging active patient involvement in setting the research agenda. As such, these paediatric journals require authors of Research Articles to add a Patient and Public Involvement statement in the Methodology section.

Where applicable, it is pertinent to include and state the clinical trials registrationdata: registry and number for clinical trials and, if available, for observational studies and systematic reviews.

As a minimum standard, an original article should contain the following components and items: A title page, an Abstract, Introduction, Patients (or materials) and methodologies, Results, Discussion, Summary or Conclusion, Recommendation, Implications for future research direction.The References, Tables, Figures, legends to Figures and any acknowledgements.

An algorithmic rapid checklist of the main items is provided for the author in and, to assist the potential authors to understand the demands of the contexual paediatric journal, the criteria used by the reviewer and referees aimed at facilitating and expediting the peer review process and the likelihood of the submitted research articles attaining publications standardsn a qualitative journal.

The Research Article Title Page

The research article title should include the research question and the study design. Titles should however, not declare the results of the study.

Title Page

Most paediatric journal recommend that the Title Page should appear first in the authors manuscript document if they are selecting for a single-blind peer review process, or as a separate file if they are opting for a double-blind peer review process.

If the author has selecteda double-blind peer review and are including acknowledgments, then these should appear at the end of the Title Page file. On the basis of the individual requirements and characteristics of a given research article, the title page may be more comprehensive and encompassing thereby warranting the use of more than one page.

The Title pages for all research article submissionsto this contexual paediatric journal must include the following items as depicted in the sample Title Page:

Title -100 characters including spaces or less.

Author listing.Full names for all authors, including degrees, and institutional/professional affiliations. These affiliations should list the institution where the research presented in the article took place; if the affiliation has changed, add a note indicating the additional affiliation. If published, author names and affiliations will appear as seen in the submitted manuscript Word document and the final typeset proofs; all authors must ensure that their information is correct. This contexual Paediatrics Journal permits a statement of equal contribution for two first authors and two senior authors; on the title page, include asterisks by each name and a statement that reads: * Contributed equally as co-first authors or * Contributed equally as co-senior authors.etc.

Corresponding Author.Contact information for the Corresponding Author -including: name, address, telephone, and e-mail. Note that the affiliation should list the institution where the research presented in the article took place; if the affiliation has changed, add a note indicating the additional affiliation. This contexual Paediatric journal allows one Corresponding Author only; the position of Corresponding Author should not be misconstrued to imply form seniority or any other status as such.

Short title -60 characters -including spaces or less. Please note: The short title may be used on the cover of the print edition of this research article.

Conflict of Interest Disclosures for all authors. This includes any potential conflicts of interest, any relevant financial relationships, and any other relationships or activities that could be perceived to have influenced the work. If none, the authors should say The authors have no conflicts of interest relevant to this article to disclose.

Funding/Support. Research or project support, including internal funding, should be listed here; if the project was done with no specific support, please note that here. Technical and other assistance should be identified stated in Acknowledgments section.

Open Access. Some Paediatrics journals proffer Green OA and Gold OA options. If the authors funding body has open access requirements, he Editorial Office should be contacted prior to the research article manuscript submission.

Where applicable, Clinical Trial registry name, registration number, and data sharing statement. This contexual paediatric journal adhere to ICMJE guidelines, which require that all trials must be registered with ClinicalTrials.gov or any other WHO Primary registry. All articles reporting results of clinical trials must also include the Data Sharing Statement.

Abbreviations. List and define abbreviations used in the text. If none, say Abbreviations: none.

Article Summary. All articles with abstracts require this summary. This brief summary is limited to 25 words. For accepted manuscripts, this will appear under the author names in the table of contents to give the reader a brief insight into what the article is about. It should entice the reader to read the full article. For example: Through linkage of Nephrotic syndrome and congestive cardiac failure in Childhood diagnostic and therapeutic interventions this study captures similarities and differences in aetiology,pathogenesis,pathophysiology ,clinical features and management of the oedematous child based on a history of acites and oedema of childhood etc

For Regular Article submissions, include both the What’s Known on This Subject and the What This Study Adds. These are not usually needed for any other article type.

If a title page does not include all of the above items, the submission may be returned to the authors for completion.