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Aims:\ud \ud We investigated which patients with heart failure (HF) should receive specialist palliative care (SPC) by first creating a definition of need for SPC in patients hospitalised with HF using patient‐reported outcome measures (PROMs) and then testing this definition using the outcome of days alive and out of hospital (DAOH). We also evaluated which baseline variables predicted need for SPC and whether those with this need received SPC.\ud Methods and results:\ud \ud PROMs assessing quality of life (QoL), symptoms, and mood were administered at baseline and every 4 months. SPC need was defined as persistently severe impairment of any PROM without improvement (or severe impairment immediately preceding death). We then tested whether need for SPC, so defined, was reflected in DAOH, a measure which combines length of stay, days of hospital re‐admission, and days lost due to death. Of 272 patients recruited, 74 (27%) met the definition of SPC needs. These patients lived one third fewer DAOH than those without SPC need (and less than a quarter of QoL‐adjusted DAOH). A Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score of

Animal abuse by children is common, with 3-44% of children being reported to abuse animals at some point during their childhood. Much of this behaviour may be regarded as an extension of exploratory behaviour in a younger child; however, the apparent link between child and animal abuse is an area of increasing interest; with children who abuse animals being 2-3 times more likely to be directly abused themselves. How concerned should a health professional be that a child who abuses animals could themselves be the victim of abuse? We reviewed the literature on the subject, finding that abuse to an animal that is perpetrated by an older child (>10 years) is more likely to be associated with child abuse. Animal abuse is less common in girls compared with boys and there is some suggestion that child abuse may be more likely in these cases. Some papers have reported a higher prevalence of animal abuse in children with attention deficit hyperactivity disorder, developmental delay and conduct disorder, but the relationship with child abuse in these cases is unknown. Information on both child and animal abuse needs to be shared between the veterinary, medical and social care teams in order to protect both children and animals who are vulnerable.