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Background: Not much is known about glycaemic‐control trajectories in childhood‐onset type 2 diabetes (T2D). We investigated characteristics of children and young people (CYP) with T2D and inequalities in glycemic control. Methods: We studied 747 CYP with T2D, <19 years of age in 2009‐2016 (from the total population‐based National Pediatric Diabetes Audit [>95% diabetes cases in England/Wales]). Linear mixed‐effects modeling was used to assess socioeconomic and ethnic differences in longitudinal glycated hemoglobin (HbA1c) trajectories during 4 years post‐diagnosis (3326 HbA1c data points, mean 4.5 data points/subject). Self‐identified ethnicity was grouped into six categories. Index of Multiple Deprivation (a small geographical area‐level deprivation measure) was grouped into SES quintiles for analysis. Results: Fifty‐eight percent were non‐White, 66% were female, and 41% were in the most disadvantaged SES quintile. Mean age and HbA1c at diagnosis were 13.4 years and 68 mmol/mol, respectively. Following an initial decrease between diagnosis and end of year 1 (−15.2 mmol/mol 95%CI, −19.2, −11.2), HbA1c trajectories increased between years 1 and 3 (10 mmol/mol, 7.6, 12.4), followed by slight gradual decrease subsequently (−1.6 mmol/mol, −2, −1.1). Compared to White CYP, Pakistani children had higher HbA1c at diagnosis (13.2 mmol/mol, 5.6‐20.9). During follow‐up, mixed‐ethnicity and Pakistani CYP had poorer glycemic control. Compared to children in the most disadvantaged quintile, those in the most advantaged had lower HbA1c at diagnosis (−6.3 mmol, −12.6, −0.1). Differences by SES remained during follow‐up. Mutual adjustment for SES and ethnicity did not substantially alter the above estimates. Conclusions: About two‐thirds of children with childhood‐onset T2D were non‐White, female adolescents, just under half of whom live in the most disadvantaged areas of England and Wales. Additionally, there are substantial socioeconomic and ethnic inequalities in diabetes control. [ABSTRACT FROM AUTHOR]

Background: There is a growing concern about the mental health of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for self-harm and referrals to mental health services. We investigated whether there have been similar recent trends in selected mental health outcomes among CYP in national health surveys from England, Scotland and Wales. Methods: Data were analysed from 140 830 participants (4–24 years, stratified into 4–12, 13–15, 16–24 years) in 36 national surveys in England, Scotland and Wales, 1995–2014. Regression models were used to examine time trends in seven parent/self-reported variables: general health, any long-standing health condition, long-standing mental health condition; Warwick–Edinburgh Mental Wellbeing Score (WEMWBS), above-threshold Strengths and Difficulties Questionnaire Total (SDQT) score, SDQ Emotion (SDQE) score, General Health Questionnaire (GHQ) score. Results: Across all participants aged 4–24, long-standing mental health conditions increased in England (0.8–4.8% over 19 years), Scotland (2.3–6.0%, 11 years) and Wales (2.6–4.1%, 7 years) (all p < 0.001). Among young children (4–12 years), the proportion reporting high SDQT and SDQE scores decreased significantly among both boys and girls in England [SDQE: odds ratio (OR) 0.97 (0.96–0.98), p < 0.001] and girls in Scotland [SDQE: OR 0.96 (0.93–0.99), p = 0.005]. The proportion with high SDQE scores (13–15 years) decreased in England [OR 0.98 (0.96–0.99), p = 0.006] but increased in Wales [OR 1.07 (1.03–1.10), p < 0.001]. The proportion with high GHQ scores decreased among English women (16–24 years) [OR 0.98 (0.98–0.99), p = 0.002]. Conclusions: Despite a striking increase in the reported prevalence of long-standing mental health conditions among UK CYP, there was relatively little change in questionnaire scores reflecting psychological distress and emotional well-being. [ABSTRACT FROM AUTHOR]

Presents the results of a study on suicide and self-harm committed by youth. Incidence of suicide by youth in England and Wales; Claim that many deaths officially listed as having an "undetermined cause" are due to suicide; Impact of gender on suicide risk; Discussion of deliberate self-harm, committed with suicidal or non-suicidal intent; Motivations associated with deliberate self-harm; Risk factors for deliberate self-harm, including experience of abuse, substance misuse, and family dysfunction; Influence of deliberate self-harm on a youth's suicide risk; Methods of prevention; Recommendations for treatment of youth who practice self-harm; Resources available for research on deliberate self-harm.

Background Safe assessment of severe underweight in children is important but experience suggests a frequent lack of understanding. Here we sought evidence from a wide spectrum of trainees. Methods Cross-sectional telephone survey of an on-call middle-grade paediatric doctor in hospitals providing acute inpatient general paediatric care in England and Wales. Results Response rate was 100%. Only 50% identified BMI as the appropriate measure for underweight in children. Most did not identify any clinical cardiovascular complications of severe underweight. Only 13% identified corrected QT time (QTc) as an important ECG finding. Knowledge of the refeeding syndrome was poor with 20% unable to define it at all, 21% able to identify some clinical features and 57% aware of potential phosphate abnormalities. Conclusions Knowledge base among middle-grades doctors in England and Wales on this topic is worryingly poor, particularly in relation to several life-threatening features. Existing and new training approaches should recognise this. [ABSTRACT FROM AUTHOR]

The article focuses on the child protection actions related to childhood obesity in Great Britain. It informs about a survey according to which obesity was found in approximately 20 child protection cases in the country in 2009. The Local Government Association, a voluntary lobbying organization in Great Britain, has warned that child protection concerns associated with obesity in children may impose future cost pressure on local councils of the country. As stated, child protection issues usually take place if a child or adolescent is severely obese and has no contact with health and social services since long time. It further suggests a framework for understanding the practice of child protection actions in relation with childhood obesity.

Competing Interests: We declare no competing interests.

Objective: Intergenerational data on mother-offspring pairs were utilized in an instrumental variable analysis to examine the longitudinal association between BMI and sedentary behavior., Methods: The sample included 3,864 mother-offspring pairs from the 1970 British Cohort Study. Height and weight were recorded in mothers (age 31 [5.4] years) and offspring (age 10 years) and repeated in offspring during adulthood. Offspring provided objective data on sedentary behavior (7-day thigh-worn activPAL) in adulthood at age 46 to 47 years., Results: Maternal BMI, the instrumental variable, was associated with offspring BMI at age 10 (change per kg/m 2 , β = 0.11; 95% CI: 0.09 to 0.12), satisfying a key assumption of instrumental variable analyses. Offspring (change per kg/m 2 , β = 0.010; 95% CI: -0.02 to 0.03 h/d) and maternal BMI (β = 0.017; 95% CI: 0.001 to 0.03 h/d) was related to offspring sedentary time, suggestive of a causal impact of BMI on sedentary behavior (two-stage least squares analysis, β = 0.18 [SE 0.08], P = 0.015). For moderate-vigorous physical activity, there were associations with offspring BMI (β = -0.010; 95% CI: -0.017 to -0.004) and maternal BMI (β = -0.007; 95% CI: -0.010 to -0.003), with evidence for causality (two-stage least squares analysis, β = -0.060 [SE 0.02], P = 0.001)., Conclusions: There is strong evidence for a causal pathway linking childhood obesity to greater sedentary behavior., (© 2020 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society (TOS).)

Purpose: Ethnic minority children are at a greater risk for type 2 diabetes (T2D). However, current prevalence of T2D among children and young people is unknown in England and Wales. In addition, little is known on glycemic control in pediatric T2D globally., Methods: Using data from the National Paediatric Diabetes Audit for 2012-2013 with >98% coverage of diabetes cases, we estimated (1) the overall, gender- and ethnic-specific prevalence of T2D in children and young people <16 years and (2) whether ethnicity predicts glycemic control (measured by mean HbA1c) in children and young people <19 years. Ethnicity was self-identified and categorized into white, Asian, black, mixed, other, and "not stated." Multivariable linear regression was used to estimate differences in glycemic control by ethnicity adjusting for socioeconomic status, age, diabetes duration, and gender., Results: A total of 307 children and young people aged <16 years were identified with T2D in the National Paediatric Diabetes Audit for 2012-2013. Overall prevalence of T2D was 2.9/100,000. Females had a higher prevalence of T2D than males (4.3 vs. 1.5/100,000). The highest prevalence was found in Asian (12.2/100,000) followed by mixed ethnicity (4.4/100,000) females. Children of mixed ethnicity had significantly higher mean HbA1c compared with white children (9.7% [83 mmol/mol] vs. 7.8% [62 mmol/mol], p < .001, and adjusted mean difference of 4.2% [22.3 mmol/mol], 95% confidence interval = 3.1%-5.2% [10.9-33.7 mmol/mol]), but there were no significant differences between the other ethnic minority groups., Conclusions: Children of all ethnic minorities particularly females have an increased prevalence of T2D. Those belonging to mixed ethnic backgrounds are at increased risk for poorer glycemic control., (Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)