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Objective : To investigate the relationship between patient-related factors (sex, cleft type, cleft extent, and Robin Sequence [RS]) and speech outcome at 5 years of age for children born with a cleft palate ± lip (CP ± L). Participants : 3157 Children (1426 female:1731 male) with a nonsyndromic CP ± L, born between 2006 and 2014 in England, Wales, and Northern Ireland. Outcome Measure : Perceptual speech analysis utilized the Cleft Audit Protocol for Speech–Augmented (CAPS-A) rating and UK National Speech Outcome Standards: Speech Standard 1 (SS1)—speech within the normal range, SS2a—no structurally related speech difficulties or history of speech surgery, and SS3—speech without significant cleft-related articulation difficulties. Results : Odds of achieving SS1 were lower among boys (aOR 0.771 [CI 0.660-0.901]), those with clefts involving the lip and palate (vs palate only) (UCLP—aOR 0.719 [CI 0.591-0.875]; BCLP—aOR 0.360 [CI 0.279-0.463]), and clefts involving the hard palate (incomplete—aOR 0.701 [CI 0.540-0.909]; complete—aOR 0.393 [CI 0.308-0.501]). Similar relationships with these patient factors were observed for SS3. SS2 was affected by the extent of hard palate involvement (complete; aOR 0.449 [CI 0.348-0.580]). Although those with CP and RS were less likely to meet all 3 standards than those without RS, odds ratios were not significant when adjusting for sex and cleft extent. Conclusion : Sex, cleft type, and extent of hard palate involvement have a significant impact on speech outcome at 5 years of age. Incorporating these factors into risk-adjustment models for service-level outcome reporting is recommended. [ABSTRACT FROM AUTHOR]

Research into how alignment to UK dietary guidelines during childhood affects cardiometabolic health is limited. The association between adherence to UK dietary guidelines during childhood and overall cardiometabolic risk (CMR) in adolescence/early adulthood was explored using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC children with diet diaries completed at 7, 10 and 13 years of age, and data on CMR markers at 17 years (n 1940) and 24 years (n 1957) were included. A children's Eatwell Guide (C-EWG) score was created by comparing dietary intakes at each age to UK dietary guidelines for nine foods/nutrients. Cardiometabolic health at 17 and 24 years was assessed using a composite CMR score. Multivariable linear regression models examined associations between C-EWG scores at 7, 10 and 13 years and the CMR score at 17 and 24 years, adjusting for confounders. C-EWG scores were generally low. However, a higher score (adherence to more dietary guidelines) at 7 years old was associated with a lower CMR score at 17 and 24 years: β −0·13 (95 % CI −0·25, –0·01) and β −0·25 (95 % CI −0·38, –0·13) for a 1-point increase in C-EWG score, respectively. A higher C-EWG score at 10 years was also associated with a lower CMR z-score at 24 years. No clear associations were evident at other ages. Greater adherence to UK dietary guidelines during mid-childhood was associated with a better overall cardiometabolic profile, suggesting that encouraging children to eat in this way has long-term benefits to health. [ABSTRACT FROM AUTHOR]

Asthma is a common chronic and burdensome disease which typically begins in childhood. The aim of this study was to assess perinatal and obstetric factors which may increase the risk of developing asthma in the offspring. Data from five consecutive waves (n=7,073 children, from birth to 15 years old) from a nationally-representative birth cohort of people born in the United Kingdom between 2000 and 2002, the Millennium Cohort Study (MCS), were used. The Kaplan–Meier survival curve was used to graphically display the risk of developing asthma from early childhood to adolescence. The Z-based Wald test was used to prove significant covariate loading. Cox regression analyzing the influence of covariates on asthma development risk showed a significant likelihood ratio test, χ2(18)=899.30, p<0.01. A parent with asthma (OR=2.02, p<0.01), a younger maternal age at delivery (OR=0.98, p<0.05), and the use of assisted reproductive technology (OR=1.43, p<0.05) were associated with an increased risk of developing asthma in the offspring. Perinatal factors (a younger maternal age, assisted reproductive technology) and a parental factor (a parent with asthma) increased the risk for developing asthma in the offspring. [ABSTRACT FROM AUTHOR]

Background : Coronavirus disease 2019 (COVID-19) was officially declared a pandemic by the World Health Organisation (WHO) on 11 March 2020, as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly across the world. We investigated the seroprevalence of anti-SARS-CoV-2 antibodies in pediatric patients on dialysis or kidney transplantation in the UK. Methods: Excess sera samples were obtained prospectively during outpatient visits or haemodialysis sessions and analysed using a custom immunoassay calibrated with population age-matched healthy controls. Two large pediatric centres contributed samples. Results: In total, 520 sera from 145 patients (16 peritoneal dialysis, 16 haemodialysis, 113 transplantation) were analysed cross-sectionally from January 2020 until August 2021. No anti-SARS-CoV-2 antibody positive samples were detected in 2020 when lockdown and enhanced social distancing measures were enacted. Thereafter, the proportion of positive samples increased from 5% (January 2021) to 32% (August 2021) following the emergence of the Alpha variant. Taking all patients, 32/145 (22%) were seropositive, including 8/32 (25%) with prior laboratory-confirmed SARS-CoV-2 infection and 12/32 (38%) post-vaccination (one of whom was also infected after vaccination). The remaining 13 (41%) seropositive patients had no known stimulus, representing subclinical cases. Antibody binding signals were comparable across patient ages and dialysis versus transplantation and highest against full-length spike protein versus spike subunit-1 and nucleocapsid protein. Conclusions: Anti-SARS-CoV-2 seroprevalence was low in 2020 and increased in early 2021. Serological surveillance complements nucleic acid detection and antigen testing to build a greater picture of the epidemiology of COVID-19 and is therefore important to guide public health responses. [ABSTRACT FROM AUTHOR]

UK statutory guidance for practitioners suggests that indebtedness is an area where safeguarding red flags should be raised and action taken to minimize the risk of exploitation. Yet, our research shows that unaccompanied migrant children have complex indebted relationships, which can range from extractive to connective. Drawing on interviews with unaccompanied children, we show that these indebted relationships can include financial debt to smugglers, responsibilities to support transnational families, as well as social obligations to peers and others. Their accounts present a nuanced understanding of the taboo nature of indebted relationships, not to be shared with the practitioners in their lives. This is due, in part, to the potential threat of reporting to the Home Office, which might jeopardize their immigration status. In response to this weaponization of social care, we demonstrate how children turn to peer networks of support, creating their own alternative forms of social protection. In so doing, we complicate critiques of adultification, which traditionally highlight the ways that racially minoritized children may be treated as adults—to their detriment. In so doing, we show that because indebtedness is normatively linked to adulthood, unaccompanied children's hopes and fears may be rendered unsayable and therefore unsupportable in social care, all in the name of safeguarding. [ABSTRACT FROM AUTHOR]

Young people who are currently or were previously in state care have consistently been found to have much higher rates of mental health and neurodevelopmental difficulties than the general youth population. While a number of high‐quality reviews highlight what research has been undertaken in relation to the mental health of young people with care experience and the gaps in our knowledge and understanding, there is, until now, no consensus, so far as we aware, as to where our collective research efforts should be directed with this important group. Through a series of UK wide workshops, we undertook a consultative process to identify an agreed research agenda between those with lived experience of being in care (n = 15), practitioners, policy makers and researchers (n = 59), for future research regarding the mental health of young people with care experience, including those who are neurodiverse/have a neurodevelopmental difficulty. This consensus statement identified 21 foci within four broad categories: how we conceptualize mental health; under‐studied populations; under‐studied topics; and underused methodologies. We hope that those who commission, fund and undertake research will engage in this discussion about the future agenda for research regarding the mental health of young people with care experience. [ABSTRACT FROM AUTHOR]

The article focuses on the alarming disparities in asthma outcomes for children and young people in the UK, revealing high hospital admission and mortality rates, significant morbidity, and health inequalities, with factors contributing to poor outcomes including inadequate perceptions of asthma, health disparities, delays or inaccurate diagnosis, and inadequate basic care.

Children and young people's (CYP) life chances depend heavily on family resources. This paper reports a rapid review of qualitative/mixed method studies about Universal Credit undertaken with CYP in the UK; subsequently expanded to include additional descriptors of economic disadvantage. Sixteen studies were reviewed; narrative synthesis was used to explore themes. Most recruited CYP with experience of economic disadvantage; none explicitly reported perspectives of CYP experiencing disability or rurality. Findings show growing up in poverty has significant, negative impacts on health and well‐being, causing feelings of exclusion, shame and unfairness; raising important questions about the adequacy of welfare support in the UK. [ABSTRACT FROM AUTHOR]

Oxygen therapy is widely used in the community for patients with chronic hypoxaemia. Although only a small proportion of those are children, more and more paediatric patients are prescribed home oxygen for a variety of indications, most commonly for chronic lung disease related to premature birth. Chronic hypoxaemia in children is diagnosed using pulse oximetry, a method that has limitations, but alternative tests are rarely required. Whilst there are clear advantages in therapy with oxygen outside the hospital setting, clinicians need to be aware of potential impact on family life, housing, school attendance and travel. The process of prescribing is standardised in the UK, and it is crucial for clinicians to understand risks and equipment used to deliver oxygen in the community. Regular follow up is important and input from community-based professionals is hugely beneficial. Some children on long-term oxygen therapy may be able to wean and eventually stop therapy. This process can be supported by a structured protocol. New technologies such as remote monitoring may further improve the care of children with chronic conditions that require long term oxygen therapy. [ABSTRACT FROM AUTHOR]

Background and aims: Children and young people on the autism spectrum frequently report a range of negative educational experiences and face disproportionally high rates of school non-attendance, including school avoidance and permanent exclusion, which can have a significant impact on their well-being as well as educational and broader life outcomes. To date, few studies have examined the full range of proximal (child, parent/family, school levels) and distal (community and society levels) barriers to ensuring the school attendance and the inclusion of autistic pupils. The current study sought to do just that by examining autistic young peoples' school non-attendance and exclusion experiences from the perspectives of multiple informants. Methods: We recruited 12 autistic pupils, who had previously experienced school avoidance and/or exclusion, from one local authority in England, United Kingdom. We conducted semi-structured interviews with the young people themselves, ten of their parents, eight of their current teachers and nine local authority professionals, including six educational psychologists and three specialist autism teachers. We analyzed interviewees' responses using reflexive thematic analysis. Results: Interviewees gave overwhelmingly negative accounts of autistic pupils' school non-attendance and exclusion experiences. Our analysis identified a range of school-related factors they felt led to, or exacerbated, negative experiences in their former mainstream schools, and which ultimately led to their or their children's school non-attendance. It also went further to identify distal factors, including fragmented educational experiences, parents "fighting" against a complex bureaucratic system to secure appropriate education for their children, and limited professional involvement. Conclusions: Our findings emphasize the importance of examining the broader context in which autistic pupils are embedded and demonstrate that such pupils are able to successfully attend—and even enjoy—school when they receive the appropriate care and support. Implications: Schools and local authority professionals should seek to work in partnership with parents and autistic pupils to secure the necessary support for their inclusion in mainstream education. Government policy should support the provision of sufficient local authority professionals to adopt a more proactive approach to mitigate autistic pupils' avoidance of and exclusion from school. [ABSTRACT FROM AUTHOR]

The current study explored the role of pre-existing and pandemic-time child, family or environmental factors in the presentation of mental health symptoms of autistic youth and their parents during the pandemic. Participants were parents/carers of autistic children (Autism Spectrum Treatment and Resilience Cohort, N = 67, M age = 9 years) and adolescents (QUEST cohort, N = 112, M age = 17 years). Parents completed an online survey that asked about child and parental mental health, infection experience, and changes to education arrangements, family life, housing and finances during the pandemic. Pre-existing measures of mental health, autism and adaptive functioning were also utilised. More engagement and enjoyment in education provision and going outside was associated with better child and parental mental health. In multivariate multiple linear regression models, more pre-existing attention deficit hyperactivity disorder symptoms were associated with more behavioural/attention deficit hyperactivity disorder symptoms during the pandemic in the pre-adolescent cohort, and with greater emotional symptoms in the adolescent cohort. More pre-existing parental mental health problems were associated with more parental mental health symptoms during the pandemic in both cohorts. Knowledge of pre-existing mental health and pandemic-related stressors may help care planning. Encouraging engagement and enjoyment in education and promoting physical exercise are key intervention targets. Ensuring access to attention deficit hyperactivity disorder medication and support is important, especially if this is managed jointly across school and home. What is already known about the topic: The COVID-19 pandemic and the associated restrictions impacted all of society. There is emerging evidence showing a range of impacts on autistic children and young people and their families. Further research that looks at how individuals coped during the pandemic while considering how they were doing before the pandemic is needed. What this paper adds: This article explores whether how well autistic youth were doing before the pandemic influenced how they coped during the pandemic. It also looked at how well their parents were doing during the pandemic and whether any pre-pandemic factors influenced how they coped. Samples of both primary-school-aged autistic children and autistic teenagers and their parents were surveyed to answer these questions. More engagement and enjoyment in education provision during the pandemic and getting outside more were linked with better child and parental mental health during the pandemic. More attention deficit hyperactivity disorder before the pandemic was linked with more attention deficit hyperactivity disorder and behavioural problems during the pandemic in primary-school-aged autistic children, and more emotional problems during the pandemic in autistic teenagers. Parents with more mental health problems during the pandemic had more mental health problems before the pandemic. Implications for practice, research or policy: Encouraging engagement and enjoyment in education and promoting physical exercise are key intervention targets. Ensuring access to attention deficit hyperactivity disorder medication and support is important, especially if this is managed jointly across school and home. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the cost‐effectiveness of retaining one or more compromised first permanent molars (cFPMs) affected by dental caries or enamel hypomineralization, compared to timely extraction, in children aged 8 years. Methods: A Markov model was developed to simulate the lifetime of a cFPM. Two management strategies were compared: extraction facilitating spontaneous space closure or maintenance of teeth with restorations. Ten health states were utilized to capture long‐term outcomes including various tooth restorations, prostheses or a retained gap at the cFPM site. Outcomes were expressed as Quality Adjusted Tooth‐Years (QATYs). The model was informed by survey data on patient preferences for treatment outcomes and UK data on costs. Discounted costs and QATYs were calculated over 62 years. Results: Regardless of the number of cFPMs, retaining cFPMs was more effective than early removal, generating an additional 2.3 QATYs per cFPM. Early removal of one or two cFPM under general anaesthetic (GA) was more expensive than retention and hence never cost‐effective. Retaining a cFPM was more expensive than early removal under local anaesthesia or where four cFPMs were extracted under GA. In these cases, retaining cFPMs was cost‐effective if a QATY was valued at £100 or £35, respectively. Results were robust to sensitivity analysis. Conclusion: Preserving a cFPM was more cost‐effective than the early loss of one, or two cFPMs under GA. Preservation of four cFPMs was cost‐effective if sufficient value was placed on a QATY. These findings can guide clinical practice on management of cFPMs alongside patient/payer values on maintaining teeth. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore how power dynamics affect research with children, focusing on how the projected and perceived role of the researcher and the use of participative techniques, can mediate power relationships between the researcher and child, and impact children's agency. Design/methodology/approach: The research formed part of a wider study on children's digital device use, with children aged 4 to 11 in a UK school. Eight pairs of children participated in buddy interviews, completing several creative and arts-based activities using a choice of equipment and materials, including PlayDoh, LEGO and most innovatively, Minecraft. Findings: The study found the researcher's projected role, and children's interpretation of this, impacted the power relations in the interviews. A consistent projection was challenging however, and it was necessary for the researcher to adapt their role according to children's needs and behaviour. Offering children a choice of activities was an effective power sharing strategy, and children's absorption in these tasks provided a wealth of data from observations and children's on-task "chatter". Originality/value: Using Minecraft as a participative method enabled the children to use their superior technical abilities to take power in the interview, and show their own personal geographies virtually in 3D, and offers potential for other qualitative researchers in conducting research with the agentic child. [ABSTRACT FROM AUTHOR]

The long-awaited national Paediatric Early Warning Score (PEWS) to pick up deterioration in children has been published by NHS England and will now be rolled out to hospitals across the country. [ABSTRACT FROM AUTHOR]

The Royal College of Psychiatrists' conference was held over four days in Liverpool, in July 2023, with world‐renowned keynote speakers and key opinion leaders in mental health covering a wide range of topics. Joy Ogden reports here on some of the highlights of the conference. [ABSTRACT FROM AUTHOR]

Shumela Ahmed's response to the 21st Kilbrandon Lecture presented by Phil Scraton: Resisting the Marginalisation, Regulation, and Criminalisation of Children and Young People. [ABSTRACT FROM AUTHOR]

Background: In the UK, the population of homelessness and housing insecurity is increasing among families headed by mothers. The unique stressors of housing insecurity and living in accommodations ill-suited to long-term dwellings increase mental distress for mothers and children. Community engagement interventions present a public health opportunity to alleviate adverse outcomes for vulnerable families. Aim: To synthesise and evaluate evidence of the impact of community engagement interventions in supporting the mental well-being of mothers and children living under housing insecure conditions. To synthesise the components of community engagement interventions as a public health intervention in alleviating mental well-being and non-health outcomes of mothers and children living under housing insecurity. Methods: A systematic search of five online bibliographic databases (MEDLINE, EMBASE, PsychINFO, Global Health and Child Development & Adolescent Studies) and grey literature (Carrot2) was conducted in May 2022. Primary studies with community engagement components and housing-insecure single-mother families were included. Intervention data was extracted using the TIDieR checklist and a community engagement keywording tool. The studies' quality was critically appraised using the MetaQAT framework. Results: Ten studies meeting inclusion criteria were identified, across two countries (USA & UK). Data from the studies reported positive significant effects for health and personal maternal outcomes in addition to higher positive effects for child health outcomes (e.g., decrease in depression symptoms). Interventions targeting social support and self-efficacy demonstrated potential to improve maternal and child outcomes via the maternal-child relationship. Community engagement at the design, delivery and evaluation intervention stages increased the level of community engagement, however there were tentative links to directly improving mental well-being outcomes. Conclusion: There is evidence to suggest that community engagement may be applied as an effective intervention in supporting the mental well-being of mothers and children living under housing insecurity. Proposed intervention effectiveness may be achieved via psychosocial pathways such as improved maternal self-efficacy and social support. However, more embedded long-term process evaluations of these interventions are needed to establish maintenance of these observed benefits and to understand to what extent the findings apply to the UK context. [ABSTRACT FROM AUTHOR]

Background: Excess weight and an unhealthy diet are risk factors for many cancers, and in high income countries, both are more prevalent among low income families. Dietary interventions targeting primary-school aged children (under 11) can improve healthy eating behaviours, but most are not designed to support the translation of skills learnt in the classroom to the home setting. This paper assessed attitudes and approaches to cooking and eating at home, and the potential to enhance engagement in healthy eating through the COOKKIT intervention. Methods: COOKKIT is an intervention to deliver weekly cooking classes and supportive materials for low-income families to maintain healthy eating at home. Preliminary qualitative interviews were conducted with teachers and parent–child dyads from a range of primary schools in the UK to explore attitudes, barriers and facilitators for healthy eating and inform the development of COOKKIT. Following implementation, ten children (8–9 y/o) participated in post-intervention focus groups, alongside interviews with teaching staff and parents. Results: Thematic analysis identified five themes under which to discuss the children's experience of food, cooking and the impact of COOKKIT: Involving children in planning and buying food for the family; Engaging children in preparing meals at home; Trying to eat healthy meals together in the midst of busy lives; Role-modelling; and Balancing practicalities, information and engagement when delivering cooking classes. Conclusions: Results suggest COOKKIT provides engaging and easy to follow in-school resources for children and school staff with take-home kits facilitating continued engagement and reinforcing lessons learned in the home environment. Importantly, participants highlighted the combination of healthy eating information, applied practical skills and low costs could support families to continue following the COOKKIT advice beyond the intervention, suggesting further evaluation of COOKKIT is warranted. [ABSTRACT FROM AUTHOR]

Purpose: Despite the potentially devastating and permanently disabling effects of paediatric arteriovenous malformations (pAVMs), there is a paucity of studies reporting long-term quality-of-life (QoL) outcomes in AVM patients. We aim to evaluate the management strategies for paediatric intracranial pAVMs in the UK and long-term QoL outcomes using a validated paediatric quality-of-life outcome measure. Methods: In this single-centre case-series, we retrospectively reviewed a prospectively maintained database of all paediatric patients (i.e. 0–18 years old) with intracranial AVMs, who were managed at Alder Hey Children's Hospital from July 2007 to December 2021. We also collected the PedsQL 4.0 score for these patients as a measure of QoL. Results: Fifty-two AVMs were included in our analysis. Forty (80%) were ruptured, 8 (16%) required emergency intervention, 17 (35%) required elective surgery, 15 (30%) underwent endovascular embolisation, and 15 (30%) patients underwent stereotactic radiosurgery. There was an 88% overall obliteration rate. Two (4%) pAVMs rebled, and there were no mortalities. Overall, the mean time from diagnosis to definitive treatment was 144 days (median 119; range 0–586). QoL outcomes were collected for 26 (51%) patients. Ruptured pAVM presentation was associated with worse QoL (p = 0.0008). Location impacted psychosocial scores significantly (71.4, 56.9, and 46.6 for right supratentorial, left supratentorial, and infratentorial, respectively; p = 0.04). Conclusion: This study shows a staged multi-modality treatment approach to pAVMs is safe and effective, with superior obliteration rates with surgery alone. QoL scores are impacted by AVM presentation and location regardless of treatment modality. [ABSTRACT FROM AUTHOR]

This paper reports on the evaluation of an integrated violence and abuse prevention programme for children aged 5–11, focusing on children with special educational needs and disabilities (SEND). The Speak Out Stay Safe (SOSS) programme was delivered in mainstream primary schools across the UK. A small‐scale study of children with SEND nested within the larger evaluation captured their understandings of abuse and harm and readiness to seek help. A specially adapted survey was completed by 76 children with SEND (aged 6–7 and 9–10) at baseline (31 intervention; 45 comparison schools), 12 in intervention schools post‐programme and 37 (four intervention; 33 comparison schools) six months post‐baseline. Qualitative data was captured through 16 teacher interviews. Whilst this nested study was compromised by the COVID‐19 pandemic, it provides important evidence that with appropriate adaptations, a survey approach to investigating the learning of children with SEND can be effective. Findings indicate that awareness of abuse and help seeking strategies may improve over time, whilst interview data suggests that adapting the programme to be inclusive of those children may have a better effect. However, a much larger sample of children with SEND is required to confidently measure the effects of such programmes for this population. [ABSTRACT FROM AUTHOR]

Documentation of learning through narration and imagery is part of everyday early childhood education. Recently, technology has generated enthusiasm for digital and mobile documentation, where mobility indicates reciprocal communication between home and school using mobile devices. The present paper asks the question of what mobile documentation is doing within the boundaries of a teacher's personal and professional public–private timespace-materialities. By focusing on documentation of young children's playful learning shared through social media platforms, I put to work posthuman, feminist materialist theories. What becomes illuminated is that mobile documentation performs within the porous boundaries between a teacher's personal and professional subjectivities. These actions flow between reproduction, generation, and rupture, with hidden labours and affective costs materialised in the liveliness of timestamps, spatialities, and hashtag entanglements. Whilst mobile documentation practices raise ethical questions, they offer potentialities for accessible ways for teachers to operationalise digital doings that offer hopeful, bite-size, and accessible storytelling. [ABSTRACT FROM AUTHOR]

Background: There are few identified risk factors that may contribute to the increased risk of hospital admission for children and young people with intellectual disabilities. This qualitative study aimed to identify the key risk factors that precipitate admissions to Tier 4 child and adolescent mental health services (CAMHS) inpatient services for young people with an intellectual disability living in the North East of England in accordance with the Transforming Care programme. Methods: This qualitative study captures the narrative of five young people admitted to hospital following a crisis period. Semi‐structured interviews were carried out with two adolescents with an intellectual disability and five caregivers of a young person with an intellectual disability to identify challenges from those with lived experience. Findings: The findings were analysed using interpretative phenomenological analysis and indicated pathological, interpersonal, social, education and intervention challenges. Nine re‐emerging central themes highlighted that young people experienced particular difficulties before admission such as behaviours which challenge, comorbid diagnoses, isolation, insufficient crisis planning, care coordination problems, familial stressors, availability of community service provision, school placements and late intervention. Conclusions: These results have contributed to developing the children's Tier 4 CAMHS Learning Disability pathways within a large NHS Foundation Trust as practitioners and professionals are mindful of these areas exacerbating risks and challenges that a young person with an intellectual disability and their family may experience. Findings could be considered when nationally reviewing services following the Transforming Care programme, aiming to provide care as close to home as possible. This may contribute to future research developing "At Risk" screening tools and formal "At Risk" registers for those with an intellectual disability. Accessible summary: This project looked at possible reasons why young people with a learning disability need to stay in a mental health inpatient service.Young people and their caregivers were interviewed and asked about their experiences.Difficulties before hospital included: behaviours that challenge, mental health problems, bullying, accessing help and problems at home. [ABSTRACT FROM AUTHOR]

Background: This study aimed to establish whether histology tonsillectomy is justified for unilateral tonsil enlargement. Methods: A retrospective review was conducted of histology tonsillectomies in three health organisations over five years, with strict exclusion criteria, focusing on benign-appearing unilateral tonsil enlargement. Results: Ninety paediatric and 233 adult cases were included. No paediatric cases and five adult cases of malignancy were detected. All malignant cases presented with other symptoms. Using binary logistic regression, a history of rapid unilateral tonsil enlargement was the only factor found to be significantly associated with malignant outcome. Thirty-three per cent of subjectively larger tonsils were smaller on post-operative histological measurement. Of the cases, 12.1 per cent re-presented with post-tonsillectomy bleeding. Conclusion: The authors recommend avoiding histology tonsillectomy for unilateral tonsil enlargement unless 'red flag' signs of malignancy are present, with particular attention to rapid unilateral tonsil enlargement. This study demonstrated discrepancy between clinical examination findings and true tonsil asymmetry; there may be a role for cross-sectional imaging prior to histology tonsillectomy in high-risk patients. [ABSTRACT FROM AUTHOR]

This pilot study explored effects of hearing loss on deaf children's reading comprehension in an online context. Eighteen deaf secondary students, ages 12–14 years (11 with British Sign Language as their dominant language, seven with English as their dominant language) engaged in an online research comprehension task. Six age-matched hearing spoken language bilingual students served as a comparison group. All participants were identified as confident readers by their teachers. Participants were asked to "think aloud" during an online search task to provide insights into their strategies. Additionally, participants completed a battery of assessments related to reading comprehension, vocabulary, non-verbal IQ, and working memory. Overall results showed similar use of strategies across all students. Strategies applied by the most skilled readers involved drawing on prior knowledge sources, e.g. informational websites or search engines, prior knowledge of the topic, and taking the time to read and evaluate website headings before deciding which one to use as source. Participants also made use of working memory skills. Findings highlight the importance of teaching online search and evaluation skills as part of the reading curriculum in schools. [ABSTRACT FROM AUTHOR]

Summary: Background: Between 1 June 2012 and 31 December 2020, there were 49 cases considered by the Medical Practitioners Tribunal Service where a doctor's misconduct involved child pornography. The determinations concerning these cases provided the data for analysis. Findings: In 47/49 (96%) the regulatory outcome was erasure from the GMC's Medical Register, ending the doctor's career. 12 doctors had been imprisoned for 1 to 20 years, and 19 given suspended prison sentences. In 33/49 (67%) cases the indecent images of children included one or more video recordings. Some of these were of children (including very young infants) being raped, sometimes for prolonged periods, the video recordings sometimes indicating that the child could be seen to be in extreme pain. Interpretation: The high proportion of erasures reflected the gravity of these cases, coupled with the fundamental incompatibility of sexual misconduct involving children with a career in medicine. [ABSTRACT FROM AUTHOR]

Background: Children of South Asian (SA) origin in the UK have lower levels of physical activity (PA), compared to their White counterparts. Parents play an important role in establishing PA habits among young children. The aim of this study was to compare PA and television (TV) viewing parenting practices for young children between SA British (SAB) and White British (WB) parents living in the UK. Methods: We conducted a secondary analysis of the Born in Bradford (BiB) 1000 study, using survey data at child ages 24 and 36 months. The study sample included three groups of mothers (n = 1,149): foreign-born SAB (n = 458), UK-born SAB (n = 276), and WB (n = 455). Mothers completed a survey about parenting practices (i.e., PA supports, PA restrictions, TV viewing restrictions) at child age 24 months and child PA and TV viewing behaviors at child ages 24 and 36 months. Parenting practices were compared among the three groups. Multivariable linear regression analyses compared children's weekly walking frequency and daily TV viewing hours by parenting practices in the three groups. Results: The foreign-born SAB group showed the lowest frequencies of PA-supportive parenting practices (verbal encouragement: 3.7 ± 3.1 times/week; logistic support: 1.5 ± 1.8 times/week) and the highest frequencies of PA-restrictive parenting practices (7.8 ± 7.7 times/week) among the three groups (p < 0.01). Children of Foreign-born SAB mothers had the most frequent TV watching during a mealtime (4.0 ± 3.1 times/week) among the three groups (p < 0.01). Less frequent PA-supportive parenting practices and SA ethnicity were associated with lower walking frequency at 24 and 36 months of age among children (p < 0.01). More frequent exposure to TV at mealtimes and SA ethnicity were associated with higher TV viewing time at 24 and 36 months of age among children (p < 0.01). Conclusions: This study demonstrated that SAB parents, particularly those who are foreign-born, apply parenting practices for their young children that are less supportive of PA and more supportive of TV viewing, and their children have lower PA and higher TV viewing time, compared with their WB counterparts. [ABSTRACT FROM AUTHOR]

Adaptive functioning of autistic children is traditionally measured through informant-report, often from parents. Behaviour varies across settings though, and context-specific reports should be considered. Limited and inconsistent results show low parent-education professional concordance, but no research has yet explored item level response variation. We investigated Vineland Adaptive Behaviour Scales-II concordance using 233 lower ability autistic children from the PACT-G sample. Domain and item level agreement was low, but better on objectively measured behaviours. Higher child nonverbal ability improved concordance. Where disagreements occurred, education professionals identified emergent skills more and parents were more likely to rate present/absent. Parents and education professionals view the adaptive abilities of autistic children differently and both should be considered when developing personalised interventions and support. [ABSTRACT FROM AUTHOR]

Background: As a nutritious food‐providing protein, essential fatty acids, vitamin D, iodine and choline eggs have historically been central to an infant weaning diet. However, food poisoning scares and allergy concerns have contributed to low consumption among infants aged 6–12 months. Methods: This paper presents a secondary data analysis of infant egg exposure and intake using three weaning data sets: a 7‐day food frequency questionnaire (n = 297), a 24‐h recall (n = 180) and a 3‐day weighed food diary (n = 71). Egg introduction, frequency of consumption and intake in grams were analysed for infants aged 6–8, 9–10 and 11–12 months). Comparisons were made by whether infants were following a baby‐led approach to weaning (where infants self‐feed family foods) or a traditional approach where pureed foods are given alongside finger foods. Data were collected in the United Kingdom between 2015 and 2018. Results: Our data showed that despite introduction being recommended from the start of weaning at 6 months of age by the Department of Health, just 54% of infants aged 6–8 months had ever been offered eggs. Average egg intake was one to two times per week, increasing with age. However, in terms of frequency and grams consumed, our data suggest a small increase in consumption compared with previous research, although limitations of our smaller sample size should be noted. Finally, a baby‐led approach was associated with increased exposure and consumption; baby‐led infants consumed eggs twice as frequently as spoon‐fed infants. Conclusions: The findings have important implications for public health messaging and for supporting families in introducing solid foods. Key points: Despite introduction being recommended from the start of weaning at age 6 months, just 54% of infants aged 6–8 months had ever been offered eggs.Only 40% of infants aged 6–8 months and about two‐thirds of those aged 9–12 months had consumed eggs in the last week. Those who had consumed eggs most commonly did so once or twice a week.Infants following a baby‐led weaning approach who self‐feed family foods were introduced to eggs at an earlier stage of weaning and consumed eggs twice as frequently as spoon‐fed infants. [ABSTRACT FROM AUTHOR]

An untimely sudden or violent death is a risk for those serving in the armed forces and can result in unique challenges for surviving military family members. This research considered how bereavement affects a range of relationships for military bereaved families in the UK and how they impact the reconstruction of a new identity in civilian life. A two-phase exploratory sequential design, involving semi-structured interviews (n = 15) and a mixed methods survey (n = 264) of military family members, was conducted. Findings revealed changing relationships with friends and family over time, reconstruction of identity, long-term impact on children, and loneliness. [ABSTRACT FROM AUTHOR]

Objective: The school food environment (SFE) is an ideal setting for encouraging healthy dietary behaviour. We aimed to develop an instrument to assess whole-SFE, test the instrument in the school setting and demonstrate its use to make food environment recommendations. Design: SFE literature and UK school food guidance were searched to inform instrument items. The instrument consisted of (i) an observation proforma capturing canteen areas systems, food presentation and monitoring of food intake and (ii) a questionnaire assessing food policies, provision and activities. The instrument was tested in schools and used to develop SFE recommendations. Descriptive analyses enabled narrative discussion. Setting: Primary schools. Participants: An observation was undertaken at schools in urban and rural geographical regions of Northern Ireland of varying socio-economic status (n 18). School senior management completed the questionnaire with input from school caterers (n 16). Results: The instrument captured desired detail and potential instrument modifications were identified. SFE varied. Differences existed between food policies and how policies were implemented and monitored. At many schools, there was scope to enhance physical eating environments (n 12, 67 %) and food presentation (n 15, 83 %); emphasise healthy eating through food activities (n 7, 78 %) and increase parental engagement in school food (n 9, 56 %). Conclusions: The developed instrument can measure whole-SFE in primary schools and also enabled identification of recommendations to enhance SFE. Further assessment and adaptation of the instrument are required to enable future use as a research tool or for self-assessment use by schools. [ABSTRACT FROM AUTHOR]

Whilst research suggests that yoga can positively impact physical and psychological wellbeing, understanding of youth's experiences is limited with no non-clinical studies in the UK. Ten focus groups explored perceptions and experiences of yoga among 35 youth (10–18 years). Inductive thematic analysis revealed that yoga was viewed as a holistic mind-body practice cultivating greater awareness and enhanced physical performance. Youth described yoga as providing tools that developed confidence, stress-management and emotional self-regulation. Social and relational impacts of yoga were highly valued. Despite the perceived biopsychosocial benefits of yoga, gendered and media representations of yoga may serve as a barrier to uptake. [ABSTRACT FROM AUTHOR]

Objective : To delineate the indications, referral sources and outcomes of radical muscle dissection palate repair in the first 4 years of life for patients with submucous cleft palate (SMCP). Design : This study presents a retrospective analysis of a single surgeon's management. Setting : All children were treated at Great Ormond Street Hospital, United Kingdom. Patients : Twenty-three children with nonsyndromic SMCP were included in this study. Interventions : All participants underwent radical muscle dissection repair before their fourth birthday. Outcome Measured : Parameters analyzed included: referral sources, indications for referral, extent of anatomical abnormality, and postoperative outcomes. Results : Paediatricians provided the largest proportion of referrals to the cleft lip and palate clinic (39%) due to the presence of cleft lip/palate on prenatal scans or during neonatal examination. Over half (n = 12, 52%) of patients had severe anatomical anomalies being in grade IV (score 8-9), with the classical triad present to some extent in all but 2 of the patients. The main indication for surgery was nasal regurgitation of food and liquid (n = 9, 35%) followed by hypernasality (n = 6, 21%), difficulty feeding (n = 3, 8%), and severe anatomical defect (n = 2; 4%). Postoperatively, the presenting complaint improved in the majority of cases. Conclusion : Nonsyndromic SMCP is often missed, though may present with nasal regurgitation, feeding problems, and/or hypernasality, though may be missed in nonsyndromic children. Early radical muscle dissection repair in the first 4 years of life is safe and effective, facilitating normal speech development. [ABSTRACT FROM AUTHOR]

This study analyzes the previous literature on the online safety of children and youth under "the 4Cs risk framework" concerning contact, content, conduct, and contract risks. It then conducts a comparative study of Australia, Canada, and the UK, comparing their institutions, governance, and government-led programs. Relevant research in Childhood Education Studies is insufficient both in quantity and quality. To minimize the four major online risks for children and youth in cyberspace, it is necessary to maintain a regulatory approach to the online exposure of children under the age of 13. Moreover, the global society should respond together to these online risks with "multi-level" policymaking under a "multi-stakeholder approach". At the international level, multilateral discussion within the OECD and under UN subsidiaries should continue to lead international cooperation. At the domestic level, a special agency in charge of online safety for children and youth should be established in each country, encompassing all relevant stakeholders, including educators and digital firms. At the school and family levels, both parents and teachers need to work together in facilitating digital literacy education, providing proper guidelines for the online activities of children and youth, and helping them to become more satisfied and productive users in the digital era. [ABSTRACT FROM AUTHOR]

Body weight regulation may be influenced by the timing of food intake. The relationship between children's BMI and their daily pattern of energy consumption was investigated using data from the UK National Diet and Nutrition Survey 2008–2019. The sample included 6281 children aged 4–18 years. Linear and logistic regression models investigated the timing of energy intake (103 kJ) as a predictor of BMI (kg/m2) and healthy weight status. The models showed that children aged 4–10 years who consume more energy content after 20:00, in comparison with less energy content, had a significantly higher BMI (young girls: β = 0·159; 95 % CI 0·003, 0·315; P = 0·05; young boys: β = 0·166; 95 % CI 0·028, 0·304; P = 0·02). Similar findings were also present for boys aged 11–18 years (β = 0·091; 95 % CI 0·003, 0·180; P = 0·04), though logistic regression findings were contradictory (OR = 0·9566; 95 % CI 0·926, 0·989; P = 0·009). However, older girls who consumed more energy content in the morning had a significantly lower BMI (β = –0·464; 95 % CI –0·655, –0·273; P < 0·001) and a lower probability of non-healthy weight (OR = 0·901; 95 % CI 0·826, 0·982; P = 0·02). Physical activity reduced the likelihood of unhealthy weight status. The data suggest that food consumption later in the day in childhood and into adolescence may increase the risk of a higher BMI, especially for less active children. Developing guidance on appropriate meal timings and recommended energy distribution throughout the day could promote healthier lifestyles. Doing so may help increase parental awareness of timing of food intake and its potential impact on BMI. [ABSTRACT FROM AUTHOR]

Background: Few whole-school physical activity programmes integrate implementation science frameworks within the design, delivery, and evaluation. As a result, knowledge of the key factors that support implementation at scale is lacking. The Creating Active Schools (CAS) programme was co-designed and is underpinned by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the Consolidated Framework for Implementation Research (CFIR). The study aims to understand the initial impact and implementation of CAS in Bradford over 9 months using McKay's et al.'s (2019) implementation evaluation roadmap. Methods: Focus groups and interviews were conducted with school staff (n = 30, schools = 25), CAS Champions (n = 9), and the CAS strategic lead (n = 1). Qualitative data were analysed both inductively and deductively. The deductive analysis involved coding data into a priori themes based on McKay et al's implementation evaluation roadmap, using a codebook approach to thematic analysis. The inductive analysis included producing initial codes and reviewing themes before finalising. Results: Identified themes aligned into three categories: (i) key ingredients for successful adoption and implementation of CAS, (ii) CAS implementation: challenges and solutions, and (iv) the perceived effectiveness of CAS at the school level. This included the willingness of schools to adopt and implement whole-school approaches when they are perceived as high quality and aligned with current school values. The programme implementation processes were seen as supportive; schools identified and valued the step-change approach to implementing CAS long-term. Formal and informal communities of practice provided "safe spaces" for cross-school support. Conversely, challenges persisted with gaining broader reach within schools, school staff's self-competence and shifting school culture around physical activity. This resulted in varied uptake between and within schools. Conclusions: This study provides novel insights into the implementation of CAS, with outcomes aligning to the adoption, reach, and sustainability. Successful implementation of CAS was underpinned by determinants including acceptability, intervention complexity, school culture and school stakeholders' perceived self-efficacy. The combination of McKay's evaluation roadmap and CFIR establishes a rigorous approach for evaluating activity promotion programmes underpinned by behavioural and implementation science. Resultantly this study offers originality and progression in understanding the implementation and effectiveness of whole-school approaches to physical activity. [ABSTRACT FROM AUTHOR]

Introduction: The Social Communication Questionnaire is used to identify children and young people (CYP) who may require formal ASD assessment. However, there is a paucity of research on its utility in Children and Adolescent Mental Health Services. This evaluation aimed to determine the sensitivity and specificity of the Social Communication Questionnaire (SCQ) in a UK, Midlands CAMHS service. Method: Forty young people (mean age 13.75 years) were screened using the caregiver reported SCQ before completing 'gold standard' assessment. Results: The SCQ had a sensitivity of 80% and a specificity of 25.7%. ROC curve analysis indicated low diagnostic accuracy. Differences in predictive accuracy of SCQ and diagnostic standard were statistically significant (p < 0.0001). Conclusion: This evaluation builds on previous research suggesting that the SCQ may not be an efficient screening tool in CAMHS settings. [ABSTRACT FROM AUTHOR]

We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-analyses to map the available research describing verbal pragmatic skills development and problems in school-age children with primary language impairments and children with language-learning disabilities. A total of 112 reports met inclusion criteria for our review. Many studies were published in journals focused on communication disorders between the years 2000 and 2019 and targeted K-12 children in the United States or the United Kingdom with developmental language disorder who were most often compared with age-matched typically developing peers using a group comparison research design. Over 60% of the studies had fewer than 25 participants in the target group. Nearly two thirds of study participants were boys, and most were Caucasian from middle- to upper-income families. The majority of studies used multiple outcome measures in data analyses, most often norm-referenced and researcher-designed tests, language sample analysis, and rating scales. A third of studies omitted information about outcome measure reliability and nearly all studies omitted validity data. Several studies are described in detail as examples and a summary of the major findings from the reviewed studies is presented. [ABSTRACT FROM AUTHOR]

Introduction: Perinatal palliative care services are increasingly available globally, offering a range of clinical and psychological support services to families during pregnancy, in the neonatal period and following the death of a baby with a life‐limiting or life‐threatening condition. Little is understood about the role of children's hospice care and how it contributes to effective perinatal palliative care. Design: The study aims to answer the question "what is the role of children's hospices in the provision of perinatal palliative care and advance care planning in the United Kingdom?" Methods: An electronic survey was sent to all 54 children's hospices in the United Kingdom between May and June 2022. Results: Thirty hospices responded, representing 54% of the sector. All regions of all four counties are represented. Numbers of referrals to hospices for perinatal palliative care have increased significantly over the last 5 years. Hospices provide a range of services for families and babies, usually from the point of diagnosis or recognition of a life‐limiting or life‐threatening condition, underpinned with counseling and emotional support. Hospices worked with a range of professionals and services, most commonly fetal medicine and neonatal services. Advance care plans were an important element of effective perinatal palliative care, strengthening parent–professional and interprofessional relationships. Conclusion: Children's hospice services play an important and growing role in the perinatal care of babies and families following the diagnosis or recognition of a life‐limiting or life‐threatening condition. The family‐centered approach to care, from a broad, biopsychosocial perspective means that hospices make a unique and meaningful contribution to both the clinical and psychological needs of families. Clinical relevance: The family‐centered approach to care, from a broad, biopsychosocial perspective means that hospices make an important contribution to both the clinical needs of babies, and psychological needs of families antenatally, in the neonatal period and after death. [ABSTRACT FROM AUTHOR]

Children's media use increased during the COVID‐19 lockdowns. Here, we present a thematic analysis of online survey responses from 69 parents (of children aged 0–11 years) who described their family media use after the first UK lockdown. Data highlight an increased reliance on media use driven by the challenges of managing time, work, leisure and social connection. Parents reported the additional work of regulating family media use amidst concerns about harmful effects. We draw on an ecological systems approach to discuss how the role of media in family functioning is determined by societal institutions and discourses around parenting and screens. [ABSTRACT FROM AUTHOR]

Children's lives in the Covid‐19 pandemic were subject to unparalleled restrictions on and disruption to their daily lives. This paper explores the day‐to‐day relational, social participation and activities of young children in one East London borough in early 2021, as told through qualitative interviews with their parents. We adopt a social‐ecological model of children's development, a child rights focused understanding of well‐being, underpinned by an agentic view of both parents and children. We find that for some children, parents had additional time to spend with them and new activities were possible. But for others, particularly those living 'compressed lives' in low‐income households and over‐crowded accommodation with no outside space of their own, all three aspects—relational, participatory and activities—were significantly diminished. [ABSTRACT FROM AUTHOR]

Background: Between 90% and 95% of deaf children are born to hearing parents who often need support with how to adapt their communication. Parent–child interaction (PCI) is an important predictor of deaf children's future language development. It is therefore necessary for professionals to assess parents' strengths and needs to identify areas for intervention. Qualified teachers of the deaf (QToDs), speech and language therapists (SLTs), psychologists, and national deaf child and adolescent mental health (NDCAMHS) professionals regularly support families with deaf children. With no current evidence‐based tool available to assist with the assessment of PCI in deafness, it is important to gather information on current professional practice as this may differ from known practices within research. Aims: To survey the practices of UK‐based professionals in the assessment of PCI where the deaf infant is aged 0–3 years. Professionals were QToDs, SLTs, psychologists or psychiatrists and professionals working at NDCAMHS services. Methods & Procedures: After a pilot phase, an 85‐item survey was distributed electronically through a range of professional and social media networks. Survey items were based on a systematic review of PCI with deaf infants. Survey questions were focused on parent behaviours that were assessed, methods of assessment, goal planning and service provision. Analysis was conducted using descriptive and inferential statistics. Outcomes & Results: A total of 190 professionals from across the UK completed part 1 of the survey; this decreased to 148 in part 4. Respondents were primarily female, hearing, used spoken English and had 16 years or more experience. Results indicate that PCI is routinely assessed by a large proportion of professionals and there is a substantial overlap in which parent behaviours are assessed. Some parent behaviours are assessed that do not feature in the research. Methods of assessment are informal and predominantly consist of observation and note making, with professionals using their own skills and experience to analyse interaction. Goal setting practices were largely similar between professionals, with many jointly deciding goals with parents. Conclusions & Implications: This survey highlights the range of parent behaviours assessed by UK professionals in PCI with deaf children aged 0–3. This survey provides valuable information about and for professionals who assess PCI and set intervention goals with parents. Information from research and professional practice is important to consider in the design of a future PCI assessment. Implications are included for future research in this area. What This Paper Adds: What is already known on this subject: Parental involvement is one of the greatest predictors of deaf children's language outcomes. With many deaf children born to hearing parents, parents often need guidance with how to facilitate effective communication. A recent systematic review identified the range of parent behaviours and methods used to analyse PCI in international research studies, but little evidence or guidance exists on how professionals assess this phenomenon in practice. What this study adds: This is the first survey to generate large, valuable practice‐based evidence for the assessment of parents' communication behaviours as they interact with their deaf infants aged 0–3. The survey recruited a range of multidisciplinary professionals working on interaction within this field: SLTs, qualified teachers of the deaf, psychologists or psychiatrists, and professionals working within deaf child and adolescent mental health services. The study reports on which behaviours these professionals assess and how, and includes information on the goal setting behaviours of practitioners. Most respondents were highly experienced; the survey, therefore, reveals expert practice within the field. What are the potential or actual clinical implications of this work?: We recommend the following practice: (1) incorporate a range of parent‐based behaviours in PCI assessments, including establishing joint engagement and parental sensitivity, as well as communication‐focused behaviours; (2) video record PCI assessments where possible to enable professionals and parents to watch and reflect together; (3) following assessment, set parent‐focused goals in collaboration with families, ensuring parents' skills, particularly their strengths, are considered. All primary caregivers should be included in the process where possible; and (4) reassess PCI regularly (at least termly) to monitor and encourage families' progress. The timing of reviews should be discussed between parent and professional. [ABSTRACT FROM AUTHOR]

Dental caries prevalence in children is high and inequalities are significant, with a major burden for children, families and the health system. Community water fluoridation (CWF) has been shown to be effective and it may reduce inequalities. Despite concerns, there is no evidence that CWF has any major side effects. CWF can cause mild fluorosis of the teeth, but this can be associated with an improvement in quality of life. Economic evaluations of CWF have consistently shown that CWF is cost-saving. Despite the positive evidence, implementation is limited in the UK, and this appears to be due an inconducive political environment, although this is improving. CPD/Clinical Relevance: Dental professionals should be aware of the benefits of CWF in order to be able to effectively advocate for its implementation. [ABSTRACT FROM AUTHOR]

Emotionally Unstable Personality Disorder (EUPD) is a complex and often stigmatising diagnosis. Although falling under the remit of mental health services, it is not always seen as a mental health need, and research suggests that if parents or carers are not provided with more holistic support, parental mental health will deteriorate with children likely to have poorer outcomes, placing them at an increased risk of harm. This likelihood of harm increases with compounding factors such as substance misuse and domestic abuse. One organisation alone cannot effectively address the complex difficulties that people with this diagnosis may experience, thus inter-agency working is necessary. This article explores the barriers and facilitators to inter-agency working to support parental care-givers with a diagnosis of EUPD between Children's Social Care and a Community Mental Health Team within the same English area. Five mental health care coordinators and two children and families' social workers who had experience working with this client group were interviewed. Participants identified the challenges and benefits of working with their partner agency around communication, knowledge, stigmatisation and resources. The research provides suggestions to develop current inter-agency working relationships and to enhance care and support available to people experiencing the diagnosis. [ABSTRACT FROM AUTHOR]

There has been substantial investment by governments and charities in the UK in the development, diffusion and evaluation of innovative practice models and systems to safeguard and support vulnerable children, young people and families. However, understandings of the processes of innovation within the sector are still at a relatively early stage—for example, in relation to what might be expected or planned for at each stage of an innovation journey. As a result, best use may not always be made of opportunities to address deficiencies in provision. To inform this knowledge gap, the literature was reviewed regarding innovation processes and trajectories within children's social care (statutory and voluntary settings) and within the field of social innovation more widely. Ten modellings of the stages of innovation were identified and synthesised into a directional map of six stages that might be commonly expected: mobilising, designing, developing, integrating, growing and system change. This trajectory framework poses key questions for innovators to consider at each stage to inform planning and determine if, when and how an innovation should progress further. [ABSTRACT FROM AUTHOR]

From dry skin in the newborn to atopic eczema in the infant and child, health professionals in primary care play a crucial role in supporting families in the care of skin, and the treatment and management of skin conditions in children. The evidence base can be conflicting and guidance changes frequently. With so much information to share with new parents, baby skincare is often seen as a lower priority when imparting health promotion advice than other areas such as safe sleep or infant feeding. It has been argued that, with the rising prevalence of atopic eczema in the UK population, advice to parents about what to be concerned about and when to seek medical advice is imperative. This article explores the evidence on general skincare from the newborn period to the treatment and management of common skin conditions, including atopic eczema and seborrheic dermatitis. [ABSTRACT FROM AUTHOR]

A critical discussion of the Brook Traffic Light Tool (TLT) is provided. The TLT supports professionals assessing sexual behaviour in children and young people (CYP). This critical commentary formed part of a wider evaluation of the TLT. The approach taken uses evidence-based, policy transfer and policy success frameworks. Conceptually, questions were raised about empirical research that underpins the TLT. The transfer of the TLT to the UK gave varied results with questions raised in relation to the suitability of the TLT for the UK context. Both successes and failures were evident within the UK. The findings suggest that more work needs to be done on TLT. Rigorous planning needs to be conducted when transferring to differing contexts. A more robust evidence base is required for the UK context and continuous evaluation is required. Yet the TLT exists where no other tool related to CYP and sexual behaviours is available for professionals. This article raises awareness around evidenced based policy, and how tools are introduced, to assess sexual behaviours in children and young people with very little consideration given to the context into which they are being introduced and how their success will be measured. [ABSTRACT FROM AUTHOR]

Fundamental movement skills (FMS) are basic movements in children that represent the building blocks for more complex motor skill development and act as a prerequisite for enduring sport and physical activity (PA) engagement and positive health-related behaviours. The FMS proficiency is currently inadequate worldwide, and consequently there are alarming levels of inactivity and childhood obesity. However, parents are role models to their children and possess the power to influence their PA behaviour. This review investigated if parent-focused interventions could improve FMS in 2–7-year-old children and evaluated which setting and method of parent engagement was most impactful. Keyword searches were conducted via Scopus, Web of Science, SPORTDiscus, PubMed, Science Direct, and Google Scholar. Only nine articles met the inclusion criteria. No research originated from the United Kingdom, highlighting the urgent need for further FMS interventions involving parents. The FMS improved in all nine studies, with significant changes in seven of the articles (p < 0.05). Parent–child co-activity, the education and empowerment of parents, and the provision of clear FMS guidance, messaging, and structure can positively influence children's FMS. Recently, smartphone apps have increased the feasibility and accessibility of FMS practice at home and may be integral to future interventions. Further research with direct parental involvement is clearly warranted. [ABSTRACT FROM AUTHOR]