Use of methylphenidate in children has increased substantially, despite conflicting evidence regarding efficacy. In this study, prescription data were analyzed in relation to the publication of new evidence regarding efficacy. Incidence rates and prescribed doses of methylphenidate increased, with a decline during the last few years. Duration of use is still increasing. In half of the cases, starting dosages are higher than recommended in guidelines. There was little evidence that publication of new evidence directly influenced the use of methylphenidate. Recent and critical study findings should receive more attention to contribute to the development and use of treatment guidelines for ADHD and evidence-based methylphenidate use.
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Athlete development depends on many factors that need to be balanced by the coach. The amount of data collected grows with the development of sensor technology. To make data-informed decisions for training prescription of their athletes, coaches could be supported by feedback through a coach dashboard. The aim of this paper is to describe the design of a coach dashboard based on scientific knowledge, user requirements, and (sensor) data to support decision making of coaches for athlete development in cyclic sports. The design process involved collaboration with coaches, embedded scientists, researchers, and IT professionals. A classic design thinking process was used to structure the research activities in five phases: empathise, define, ideate, prototype, and test phases. To understand the user requirements of coaches, a survey (n = 38), interviews (n = 8) and focus-group sessions (n = 4) were held. Design principles were adopted into mock-ups, prototypes, and the final coach dashboard. Designing a coach dashboard using the co-operative research design helped to gain deep insights into the specific user requirements of coaches in their daily training practice. Integrating these requirements, scientific knowledge, and functionalities in the final coach dashboard allows the coach to make data-informed decisions on training prescription and optimise athlete development.
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Abstract Background. Fever in children is common and mostly caused by self-limiting infections. However, parents of febrile children often consult in general practice, in particular during out-of-hours care. To improve management, it is important to understand experiences of GPs managing these consultations. Objective. To describe GPs’ experiences regarding management of childhood fever during out-ofhours care. Methods. A descriptive qualitative study using purposeful sampling, five focus group discussions were held among 37 GPs. Analysis was based on constant comparative technique using open and axial coding. Results. Main categories were: (i) Workload and general experience; (ii) GPs’ perceptions of determinants of consulting behaviour; (iii) Parents’ expectations from the GP’s point of view; (iv) Antibiotic prescribing decisions; (v) Uncertainty of GPs versus uncertainty of parents and (vi) Information exchange during the consultation. GPs felt management of childhood fever imposes a considerable workload. They perceived a mismatch between parental concerns and their own impression of illness severity, which combined with time–pressure can lead to frustration. Diagnostic uncertainty is driven by low incidences of serious infections and dealing with parental demand for antibiotics is still challenging. Conclusion. Children with a fever account for a high workload during out-of-hours GP care which provides a diagnostic challenge due to the low incidence of serious illnesses and lacking longterm relationship. This can lead to frustration and drives antibiotics prescription rates. Improving information exchange during consultations and in the general public to young parents, could help provide a safety net thereby enhancing self-management, reducing consultations and workload, and subsequent antibiotic prescriptions.
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