Search

As a specialised intervention, the Newcastle Parent Infant Partnership (NEWPIP) service supports new parents and their babies experiencing issues affecting their relationship and development within the first 1001 critical days. NEWPIP is one of 34 specialised parent–infant psychotherapy teams across England. We aimed to gather in-depth data to understand parent's lived experiences and the effectiveness of the service, to provide recommendations for future practice. With a qualitative approach, this study included ten semi-structured interviews. Guided by narrative methods and open-ended questions, interviews lasted between 30–90 min. Recruitment involved both purposive and convenience sampling. All parents received the service within the past 2 years between March, 2018, and April, 2020. Participants were provided with an information sheet before taking part. All participants electronically signed a consent form and provided verbal consent. Ethics was approved by Newcastle University, Newcastle, UK. Once interviews were complete, researchers transcribed the interviews and analysed the data thematically (NVivo 12), using a three-stage coding method, grounded in the data. 11 parents were involved in the study, including ten women and one man, due to the purpose of referrals being predominantly for mothers. Five overarching themes were discovered on the basis of the parent's own sense of empowerment, narratives of time, reflections on a unique approach, impact on relationships, and public awareness and partnerships. The findings illuminated an approach that supports parents to build a better bond with their baby by providing a safe space for parents to heal relationships, although with differences in expectations from parents around time and support required. Parents also felt there should be increased public awareness and improved partnerships with other health organisations to ensure a smooth transition to long-term support and improved outcomes for children after parents have ended their sessions with NEWPIP. The NEWPIP approach provides unique and flexible support, increasing a parent's confidence, autonomy, and deeply understanding the bond with their baby. There was also an emphasis from parents on how to strengthen the fluidity of the NEWPIP approach to incorporate wider service eligibility for parents and their infants within the 1001 critical days and beyond. Nonetheless, referral times were inconsistent and required more clarification. The service requires increased public awareness to highlight the success of the unique approach while also creating greater opportunities for self-referral to increase empowerment felt by parents. The timing and transition of the parents in receipt of the service is fluid and responsive to individual circumstances but could be improved to ensure that care is provided during the 1001 critical days and beyond. None. [ABSTRACT FROM AUTHOR]

Background: Maternal weight management increases risks for women and babies and is a public health priority. Interventions can substantially improve maternal diet and physical activity behaviours and pregnancy outcomes. Low self-efficacy is a core barrier to midwives' implementation of guidelines. GLOWING used social cognitive theory to address evidence-based barriers to practice, aiming to support midwives' guidelines implementation.Methods: This study was a pilot cluster randomised controlled trial in four UK National Health Service Trusts (clusters) in England. Clusters were randomised to intervention (midwives received intervention) or control (no intervention). Guideline recommendations for midwives' practice were: first, communication-related behaviours (weight-communication and risk-communication); and second, support and intervention-related behaviours (diet and nutrition, physical activity, weight management, and referrals and signposting). Questionnaires were designed using social cognitive theory constructs (eg, self-efficacy, outcome expectancies, intentions, behaviours), higher scores being more positive. Following Consolidated Standards of Reporting Trials guidelines for pilot trials, descriptive statistics were used to compare arms, before and after the intervention.Findings: 100 midwives were randomised to complete questionnaires before and after the intervention. 74% consented, and 68% returned questionnaires. Pre-intervention, self-efficacy for support, and intervention-related behaviours scored lowest. In controls, the difference between pre-intervention and post-intervention scores were negligible. Post-intervention scores were consistently higher in midwives in the intervention group than the control group, particularly for support and intervention self-efficacy (mean 71·4 [SD 17·1] vs 58·4 [20·1]). Self-efficacy was higher after the intervention than before the intervention for all outcomes among intervention midwives: weight-communication (mean 76·3 [SD 16·7] vs 67·2 [21·1]), risk-communication (79·4 [16·4] vs 68·6 [14·9]), diet, nutrition, and physical activity (76·4 [16·0] vs 49·3 [16·5]), weight management (72·1 [18·3] vs 48·3 [19·8]), referrals and signposting (63·3 [26·0] vs 47·9 [17·3]), and consistently higher than controls.Interpretation: Results support the theoretical models used to develop GLOWING: low self-efficacy is a core implementation barrier. Results suggest GLOWING successfully targets self-efficacy, potentially with positive implications for guideline implementation. A strength of this work is the rigorous evidence-based theoretical approach to intervention development, largely absent in maternity-based research. A limitation is that this is a pilot trial. A definitive trial is required to determine effectiveness.Funding: National Institute for Health Research Postdoctoral Fellowship (reference PDF-2011-04-034). [ABSTRACT FROM AUTHOR]

Background: Evidence from the British longitudinal studies on the influence of neighbourhood-level socioeconomic deprivation in older men on developing type 2 diabetes mellitus is scarce. This study investigates the prospective associations of neighbourhood-level deprivation and individual socioeconomic position with type 2 diabetes mellitus incidence in older men.Methods: The British Regional Heart Study comprises a cohort of 4252 men aged 60-79 years in 1998-2000 from 24 towns across the UK. Neighbourhood-level deprivation was based on the country specific 2004-05 Index of Multiple Deprivation (IMD) quintiles for participants' postcode of residence at baseline. Individual socioeconomic position was defined as occupational social class based on longest-held occupation at recruitment. Participants with prevalent diabetes were excluded. The incidence of type 2 diabetes mellitus was ascertained from biannual reviews of primary care records over 18 years of follow-up. Cox proportional hazard models were undertaken to examine associations.Findings: The incidence of type 2 diabetes mellitus cases observed was 368 (9·9%), amongst the 3706 male participants. Age-adjusted rates of type 2 diabetes mellitus increased from IMD quintile 1 (least deprived) to quintile 4 (second most deprived), before decreasing in quintile 5. Compared with quintile 1, the age and individual social class adjusted hazard ratio (aHR) in quintile 4 was 1·52 (95% CI 1·09-2·13), remaining significant after further adjustments for obesity and family history of type 2 diabetes mellitus. Participants in the lowest social class had the highest rates of type 2 diabetes mellitus. The aHR by age and IMD scores for type 2 diabetes mellitus in the lowest social class compared with the highest social class was 2·12 (95% CI 1·15-3·89).Interpretation: Neighbourhood-level and individual-level socioeconomic factors remain important predictors of developing type 2 diabetes mellitus in older men, demonstrating that inequalities persist in later life. Inequalities in diabetes and its underlying modifiable risk factors need to be addressed to reduce the burden of this disease in socioeconomically deprived older-age populations.Funding: None. [ABSTRACT FROM AUTHOR]

Background: There has been a rise in food insecurity in Europe since the 2008 global financial crisis and households with children are particularly vulnerable. We aimed to explore families' experiences of food insecurity and how these experiences affect children's nutritional health and wellbeing.Methods: In this systematic review and meta-ethnography, we searched Medline, Scopus, Web of Science, EMBASE, CINAHL, and ASSIA from Jan 1, 2008, to July 10, 2021, supplemented by grey literature, reference lists, and citation searches. Screening was done in duplicate to ensure consistent application of inclusion criteria and minimise random errors. Following title and abstract screening, full texts were screened against the inclusion criteria (qualitative research focussing on children's nutritional health and wellbeing, with data from 2008 onwards, from high-income European countries). Data extracted included study design, country of origin, caregiver type, gender, age, ethnic group, migration status, accommodation type, measure of food insecurity and other socioeconomic factors. Data were synthesised according to Noblit & Hare's seven phases of meta-ethnography. Our protocol was registered with PROSPERO (CRD42020214159).Findings: We identified 11 589 unique records; 19 were included, involving 813 participants. We identified four key themes: food and eating practices, awareness, fragility, and networks of care. Within the key themes, we identified five subthemes: diet, compromised infant feeding practices, psychological fragility, social fragility, and physical fragility. We found that children with food insecurity were aware of their family's scarce resources, with most active in trying to help their family while also forming their own networks of care. We found that food insecurity adversely affects children's physical, psychological, and social experiences setting them on a trajectory towards sub-optimal health.Interpretation: Children's nutritional health and wellbeing is adversely affected by food insecurity. This meta-ethnography highlights gaps in our knowledge about children's nutritional health relating to a range of sociodemographic factors. There is a need to actively involve children in more research and policy. A strength and limitation of this review is the diverse range of included studies from different European contexts, in which contextual factors could have affected our findings.Funding: The Economic and Social Research Council. [ABSTRACT FROM AUTHOR]

Background: Food insecurity has increased since the 2008 global financial crisis. Particularly vulnerable are mothers with young children, pregnant women, and lone parents (the majority of whom are women). This systematic review and meta-ethnography of qualitative studies aimed to explore women's experiences of food insecurity and how it affects their nutritional health and wellbeing.Methods: Six electronic databases were searched from Jan 1, 2008, to July 10, 2021, with no language restrictions. Search terms included "food insecurity", "women", and "nutrition". This search was supplemented by grey literature, reference list, and citation searches. Screening was done in duplicate. Following title and abstract screening, full texts were screened against the inclusion criteria (ie, qualitative research, focus on women of childbearing age, pregnancy nutritional health or wellbeing, data from 2008 onwards, and high-income European countries). We adhered to PRISMA and eMERGe guidelines for meta-ethnographic reporting. Methodological quality was assessed using the CASP qualitative checklist. Data were synthesised according to Noblit and Hare's seven phases of meta-ethnography.Findings: We identified 11 589 unique records; 23 publications reporting data from 22 unique studies were included, comprising 647 women. We identified two key themes: accessing sufficient food and embodying food insecurity, comprising eight subthemes. Our meta-ethnography provides a progressive storyline of women's experiences of food insecurity. This storyline includes how women attempt to access sufficient food, they are unable to meet their nutritional needs, how this is embedded into their everyday lives, and embodied in unhealthful physical, social, and mental nutritional health and wellbeing.Interpretation: This meta-ethnography concludes a need for greater recognition of the psychosocial impact of food insecurity on vulnerable women, in addition to the impact on their nutritional health and wellbeing. The review demonstrates a lack of change over time, qualitatively for women's experiences. A strength and limitation of this review is the range of studies from different European contexts, where contextual factors could affect the experiences of women.Funding: The Economic and Social Research Council. [ABSTRACT FROM AUTHOR]

The article focuses on a population-based study of 20-year-survival of children born with congenital anomalies. Data for the study were obtained from the United Kingdom (UK) Northern Congenital Abnormality Survey (NorCAS) between 1985 and 2003. The congenital anomalies were categorized by group, subtype and syndrome according to European Surveillance of Congenital Anomalies guidelines. The study observed that those individuals born with at least one congenital anomaly has an 85.5% survival rate, while those with cardiovascular disease has a 79.1% survival rate. It also noted the variation of survival between subtypes within the same congenital anomaly group.

A letter to the editor is presented in response to the article "Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000" by R. J. Berry, Coleen A. Boyle, Arnold Christianson in the June 9, 2012 issue and also includes response from authors regarding the same issue.