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Last chance to tell us what you think - Child health profiles
Earlier this year, we published Child Health Profiles 2017 for each top tier local council in England. They give a picture of child health in each local area and are designed to support local government and health services improve children's health and reduce health inequalities. We are currently reviewing the content to help us develop profiles which continue to provide you with the common core information you need. We are keen to hear from those who have used the profile and what priorities you would like to see them reflect next year. We would be grateful if you could take a few minutes to complete a short survey before Friday 29 September and tell us what information we should give to help you. Annual update to early years indicators
On 5 September, the National Child and Maternal Health Intelligence Network published annual updates to a number of early years indicators (under 5 years old) in the child and maternal health section of PHE's Fingertips tool. As a result, many of the indicators about A&E attendances, elective and emergency admissions will be updated for both this and older age groups. Data is available at county council, unitary authority and clinical commissioning group level.
This eBulletin includes links to content from a range of different organisations. We do not accept responsibility for the availability, reliability or content of the items included in this eBulletin and do not necessarily endorse the views expressed within them.
The multi-agency response to children living with domestic abuse: prevent, protect and repair A report from Ofsted, Care Quality Commission, HM Inspectorate of Constabulary, and HM Inspectorate of Probation examining the multi-agency response to children living with domestic abuse, along with inspections of local area services. The report inspected six areas: Bradford, Hampshire, Hounslow, Lincolnshire, Salford and Wiltshire. The report found that social workers, the police, health professionals and other agencies such as youth offending teams and probation services are often doing a good job to protect victims but that more needs to be done to prevent domestic abuse in the first place, and to repair the damage it causes afterwards. Ofsted recommends that schools in England must prioritise education about healthy relationships. It also calls for a new public information campaign to raise awareness of domestic abuse.
Joint targeted area inspections include a 'deep dive' investigation – an evaluation of children and young people's experiences. This changes periodically to investigate different themes in detail. The theme for September 2016 to March 2017 was the response to children living with domestic abuse.
EIF commissioner guide. Reducing the impact of interparental conflict on children This Guide is a practical planning tool to support local commissioners and leaders of services for children and families to reduce the impact of conflict between parents on children. This resource builds reviews of research conducted by the Early Intervention Foundation (EIF) in collaboration with the University of Sussex, highlighting the latest scientific and intervention evidence on how the interparental relationship affects multiple outcomes for children, including emotional, behavioural, social and academic development. The modular guide explains what 'interparental conflict' means and how it can affect children; discusses how to measure the impact of interparental conflict and understand local need; and offers advice on choosing evidence-based interventions to improve outcomes to match local needs.
Health protection in schools and other childcare facilities A practical guide from Public Health England for staff on managing cases of infectious diseases in schools and other childcare settings. This guidance provides advice on: - preventing the spread of infections
- which diseases to vaccinate for
- how long to keep children away from school
- managing infectious diseases
- cleaning the environment
You're never too young to talk mental health The Anna Freud National Centre for Children and Families has developed a booklet: Supporting mental health and wellbeing in schools and a series of expert advice films which offer practical guidance about what teachers can do in the classroom to support mental health, and what to do if they are concerned about a child. The teaching materials are designed to help children learn the life-long skills to help them talk about 'big' and 'small' feelings, and how to listen to their friends when they need to talk. A leaflet and film for parents and carers offering tips on how to start conversations with their children about mental health has also been made available. Depression in children and young people: identification and management This guideline from the National Institute for Care and Excellence (NICE) was reviewed and updated in August. It covers identifying and managing depression in children and young people aged between 5 and 18 years. Based on the stepped care model, it aims to improve recognition and assessment and promote effective treatments for mild, moderate and severe depression. This guideline includes recommendations on: Baby carries a gene for unusual haemoglobin: description in brief This leaflet, in English, French, Bengali and Urdu, from Public Health England can help healthcare professionals speak with parents about a baby carrying a gene for unusual haemoglobin. This publication explains the consequences of a baby carrying a gene for unusual haemoglobin. The document includes information about: - detection of the sickle cell gene
- what a sickle cell carrier is
- how having the gene affects the baby's health
- how a carrier can pass on sickle cell disease
- what the baby's family should do next
The NHS newborn blood spot (NBS) screening programme can show this trait.
Health economics: evidence resource The Health Economics Evidence Resource (HEER) provides an initial snapshot collection of economic evidence underpinning public health interventions. This tool from Public Health England shows the key cost-effectiveness and return on investment evidence on activities in the public health grant including the Health Child Programme (HCP) 0-5 and the Healthy Child Programme (HCP) 5-19. Each piece of evidence is summarised across over 20 criteria to provide details on how the results were created and to highlight the inputs and assumptions used in the original studies. This allows users to understand the relevance and apply the evidence to their local setting.
Rise Above for Schools programme Public Health England (PHE) has developed a series of new resources for secondary school teachers to use in their lesson plans as part of the Rise Above for Schools programme. The resources will help teachers to engage pupils with coping strategies about 'traditional' health issues, like smoking and alcohol, while also addressing some of the most challenging pressures young people face today in an 'always on' social media generation.
The 7 Personal, Social, Health and Economic Education (PSHE) lesson plans have been accredited by the PSHE Association and piloted with teachers, ensuring they are robust and of the highest quality. The resources include a range of techniques for teachers to employ to enable pupils to safely learn, explore and discuss coping strategies for dealing with issues, such as: - bullying and cyberbullying
- alcohol use and smoking
- positive relationships and friendships
- exam stress
- online stress and social media
- body image in a digital world
Whooping cough: vaccination in pregnancy programme resources Information leaflet and poster from Public Health England to support the whooping cough vaccination in pregnancy programme. The leaflet provides in-depth information on: - why the vaccine is needed
- how maternal pertussis vaccination helps to protect babies from whooping cough
- when expectant mothers can have the vaccine
- vaccine safety and efficacy.
The poster has been designed to promote the need for maternal pertussis vaccination which is now recommended from week 16 of each pregnancy. It is suitable for GP surgeries, hospitals, maternity units, nurseries, child care centres and libraries.
Covering all bases. Community child health: A paediatric workforce guide The Royal College of Paediatrics and Child Health (RCPCH) and the British Association for Community Child Health (BACCH) have developed a set of resources to support workforce planning for community paediatric services. Their main report of the project, Covering all bases, includes an overview, key findings, a framework for service planning and links to guidance and standards for the components of community child health service. The report raises concerns over the system failing to cope with growing demand and the unprecedented pressures faced by specialist community children's doctors, who have a wide remit from child protection to managing children with disabilities and diagnosing those with conditions such as autism and ADHD. It provides guidance on workforce and clear specifications for commissioners, clinicians and health care organisations. The State of Child Health: Community paediatric workforce summarises the project outputs and its principal findings and conclusions. It also provides a number of recommendations about workforce numbers and service planning. National funding formula for schools and high needs Policy paper explaining changes to the funding system for schools and high needs the Department for Education. New national funding formulae for schools, high needs and the central school services block will be introduced from April 2018. High needs funding is funding for children and young people with special educational needs or disabilities who need extra support at school, college or alternative provision settings. Alternative provision settings are for children who can't go to a mainstream school. The central school services block is funding that local authorities use to provide services for all schools. The policy document sets out the background and principles of the new national funding formulae. The executive summary gives an overview of the formulae. Mental ill-health among children of the new century. Trends across childhood, with a focus on age 14. Researchers from the UCL Institute of Education and the University of Liverpool analysed information on more than 10,000 children born in 2000-01 who are taking part in the Millennium Cohort Study. At ages 3, 5, 7, 11 and 14, parents reported on their children's mental health. Then, when they reached 14, the children were themselves asked questions about their depressive symptoms. Based on the 14-year-olds reporting of their emotional problems, 24 per cent of girls and 9 per cent of boys suffer from depression. The research, published with the National Children's Bureau, also investigated links between depressive symptoms and family income. Generally, 14-year-olds from better-off families were less likely to have high levels of depressive symptoms compared to their peers from poorer homes. Parents' reports of emotional problems were roughly the same for boys and girls throughout childhood, increasing from 7 per cent of children at age 7 to 12 per cent at age 11. However, by the time they reached early adolescence at age 14, emotional problems became more prevalent in girls, with 18 per cent having symptoms of depression and anxiety, compared to 12 per cent of boys. Behaviour problems, such as acting out, fighting and being rebellious decreased from infancy to age 5, but then increased to age 14. Boys were more likely than girls to have behaviour problems throughout childhood and early adolescence. As 14-year-olds' own reports of their emotional problems were different to their parents', this research highlights the importance of considering young people's views on their own mental health.
Ages and stages questionnaire (ASQ-3) analysis: October 2016 to March 2017 This collaborative report between NHS Digital and Ofsted describes the results of exploratory analysis on 24, 27 and 30 month questionnaires – part of the 2 to 2.5 year health check – which were submitted to NHS Digital's Children and Young People's Health Services (CYPHS) Data Set between October 2016 and March 2017. It includes aggregate data about: - children's ASQ-3 scores in 5 domains, broken down by gender, ethnicity, first language and deprivation
- children's ASQ-3 scores compared to Good Level of Development outcomes in the 2015 to 2016 Early Years Foundation Stage Profile (EYFSP)
Under pressure? NHS maternity services in England This briefing note from the Institute for Fiscal Studies (IFS) reviews the evidence on the long-run pressures faced by maternity units (MUs) from changes in the number of maternity admissions and the case mix. While the number of maternity cases has remained largely constant since 2010, the case mix continues to change, with women giving birth later in life and with more complex health conditions. There are implications for MUs if this evolving case mix of mothers requires more care in terms of staffing or other resources.
The report findings include: Pressure on NHS maternity services varies over time and by season. Women giving birth today are much more likely to be older and have more complex health conditions than a decade ago. Short-run fluctuations in admissions place pressure on maternity services where capacity is largely fixed. As a last resort Maternity Units may temporarily close to ensure the safety of mothers and babies. While closures do correlate with busy days, they also vary by day of the week and month in ways that do not correspond to spikes in admissions.
Closures are 30% more likely on Thursdays, Fridays and Saturdays than they are on Mondays to Wednesdays. This is despite the fact that admissions are evenly spread across week days and are lower at weekends. There are 50% more closures in June than January, even though the number of births is roughly the same.
Brief, intensive and concentrated CBT for anxiety disorders in children This Mental Elf blog summarises a recent systematic review of brief, intensive and concentrated cognitive behavioural therapy for anxiety disorders in children, which finds some promising results for this more focused approach to care. The post Brief, intensive and concentrated CBT for anxiety disorders in children appeared first on National Elf Service. Conclusions: These results provide exciting initial support for BIC interventions treating youth with various anxiety disorders. Highlighting the evolving delivery of mental health services outside of the traditional "therapy hour".
Improving lives: Helping workless families - evidence base This analysis and research pack from the Department for Work and Pensions (DWP) sets out the comprehensive evidence base that supports the Improving Lives: Helping Workless Families publication. Part 1 describes the evidence behind some of the issues associated with worklessness, how these disadvantages are often interrelated, and how they impact on children's outcomes. Part 2 sets out the 9 national indicators (7 non-statutory and 2 statutory) which DWP are using to track progress in tackling the disadvantages that affect families and children's outcomes, as shown in our evidence and analysis. These will replace the indicators reported on in the former social justice outcomes framework. The evidence resource on multiple disadvantage in families and its impact on children provides an overview of important milestones of child development from pre-conception to early adulthood, and explores how child development is influenced by multiple disadvantages affecting workless families.
Mental health apps for young people: an evidence-free zone? This Mental Elf blog considers a recent systematic review of mental health apps for young people, which highlights the current dearth of reliable research to support the efficacy and safety of mobile apps. The post Mental health apps for young people: an evidence-free zone? appeared first on National Elf Service. Conclusion: While there are indications that young people find mental health apps acceptable, there is currently no evidence to support their safety and effectiveness. The authors conclude there is an urgent need for methodologically robust, adequately powered research evaluating safety and effectiveness/efficacy. They also recommend including young people and therapists in the app design process to ensure apps are user-friendly and fit for purpose.
Social mobility challenges faced by young Muslims This report from the Social Mobility Commission explores young Muslims' perceptions and experiences of growing up and seeking work in Britain. The research examines: - the perceived causes of low social mobility for young Muslims
- why educational attainment isn't translating into better employment outcomes for young Muslims
- the barriers young Muslims see to social mobility in the UK
- how perceived barriers to social mobility differ based on gender, ethnicity and socio-economic background
The report uncovers significant barriers to improved social mobility for young Muslims from school through university and into the workplace - with many reporting experience of Islamophobia, discrimination and racism. The report recommendations include: - mentoring and other support programmes for young (school aged) Muslims should be established to include sessions or provision for parents to ensure they are provided with support and information about post-16 choices
- the Department for Education should put in place a careers strategy that promotes informed and inclusive choices by pupils, free from stereotypical assumptions. These should be piloted in areas with high rates of unemployment for people from Muslim communities and include routes for involving parents in understanding these choices
- teacher training should include sophisticated and practical diversity training with a focus on religious diversity
- business bodies should promote greater awareness and take-up of good unconscious bias, diversity, religious literacy and cultural competence training by employers
The FEA report card 2016/17 The Fair Education Alliance (FEA) is a coalition of 86 of the UK's leading organisations from business, education and the third sector. The aim of the FEA is to work towards ending the persistent achievement gap between young people from the poorest communities and their wealthier peers. The FEA believes that England must meet five impact goals to be achieved by 2022. Their latest Report Card reports on progress on each impact goal. The report finds that educational inequality remains deeply entrenched in the UK and outlines a number of policy recommendations for improving social mobility.
UK poverty: Causes, costs and solutions This report from the Joseph Rowntree Foundation (JRF) explains what poverty is and what causes it, highlights trends and projections in UK poverty, and makes recommendations including for tackling childhood poverty. JRF's recommendations for solving poverty include strengthening family life, ensuring all citizens have the skills they need to operate in the 21st century, fixing flaws in the benefits system, taking practical action to contain rising costs, and moving to more progressive employment and business practices.
An Inquiry into the impact of cyberbullying on social media on children and young people's mental health Alex Chalk, MP for Cheltenham, in partnership with YoungMinds and The Children's Society, has set up an inquiry into the impact of social media bullying on children and young people's mental health. To inform the inquiry, YoungMinds and The Children's Society, have carried out a survey of children and young people to hear about their views and experiences of bullying online. The survey, taken between March and August 2017, was completed by 1, 089 young people aged 11-25. Experiences of cyberbullying: - 37% of young people reported having personal experience of online bullying in their lifetime, in contrast to 47% who reported experience of off-line bullying.
- 26% of young people reported personal experience of online bullying within the last year.
- 42% of young people reported having seen somebody be harassed or bullied online.
- 83% said that social media companies should do more to tackle cyberbullying on social media, whilst only 6% of young people disagreed with this.
School Ready? A survey of school leaders by NAHT and Family and Childcare Trust This survey from National Association of Head Teachers (NAHT) and the Family and Childcare Trust investigates the current state of children's school readiness and tests the perception amongst school leaders and practitioners that this has declined over recent years. Their report is based on 780 responses from school leaders in England, Wales and Northern Ireland in June and July 2017. Findings: The NAHT and the Family and Childcare Trust's survey confirms that school readiness is an area of concern for school leaders, with 83 per cent of respondents reporting an issue with school readiness and a majority believing this has become worse in the last five years. Respondents identified a number of issues that mean that some children are not ready for school, in particular concern about their speech, language and communication skills were highlighted. The social, emotional and physical development of some children were also cited as areas of concern. Recommendations: Reductions in local authority and health budgets, combined with pressures on school budgets as a whole, would appear to be having a knock-on effect on children's school readiness and schools' abilities to help support their children's transition once in school. Many of these issues had already been identified in NAHT's Breaking Point: A report of the school funding crisis in 2016/17. Support for parents, early years providers and schools is essential to help tackle the issue of school readiness as early as possible, especially for children with special educational needs and disabilities (SEND). Partnerships between early years providers, schools, parents, local authorities, health services and other services need to be adequately funded and well-coordinated to help support all children who may find starting school challenging. Further child and maternal health data can be found on Public Health England's Fingertips tool. The child and maternal health section brings together a range of publicly available data, information, tools and resources. Find guidance on using these statistics and other intelligence resources to help you make decisions about the planning and provision of child and maternal health services on.GOV.UK.
Childhood vaccination coverage statistics- England Immunisation coverage statistics from NHS Digital for routine childhood immunisations at 1, 2 and five years as well as coverage statistics for those aged 2, 3 & 4 immunised against seasonal flu. Mental health services monthly statistics final June, provisional July 2017 This series from NHS Digital has replaced the Monthly MHLDS reports. The scope has been broadened to include children and young people's mental health services and restructured to support waiting time measurement for specific services. The Mental Health Services Dataset (MHSDS) covers NHS funded secondary mental health, learning disability and autism services for all ages and this report includes a variety of measures about activity, caseload and patient pathways at national, provider, Clinical Commissioning Group and Council with Adult Social Services Responsibilities level. This month includes the report on final data for June 2017 and provisional data for July 2017. From April 2017 MHSDS is the official source of information about waiting times for Early Intervention in Psychosis services. Children and young people's health services monthly statistics May 2017 This publication from NHS Digital reports information from the CYPHS data set. This is a patient-level dataset providing information relating to NHS-funded community services for children and young people aged 18 years or under. These services can include health centres, schools and mental health trusts. The data collected includes personal and demographic information, diagnoses including long-term conditions and childhood disabilities and care events plus screening activities. Suicides in Great Britain: 2016 Registered deaths in Great Britain from suicide analysed by sex, age, area of usual residence of the deceased and suicide method from the Office of National Statistics. An update will be published later in the year to include UK data. Statistics on women's smoking status at time of delivery: England Quarter 1, Apr to Jun 2017 Results and trends from the women's smoking status at time of delivery (SATOD) data collection in England published by NHS Digital. The results provide a measure of the prevalence of smoking among pregnant women at Clinical Commissioning Group (CCG) and region levels. Maternity services monthly statistics April 2017 This is a report from NHS Digital on NHS-funded maternity services in England for April 2017, using data submitted to the Maternity Services Data Set (MSDS). The MSDS has been developed to help achieve better outcomes of care for mothers, babies and children.
The MSDS is a patient-level 'secondary uses' data set that re-uses clinical and operational data for purposes other than direct patient care, such as commissioning, clinical audit. It captures key information at each stage of the maternity service care pathway in NHS-funded maternity services, such as those provided by GP practices and hospitals. The data collected include mother's demographics, booking appointments, admissions and re-admissions, screening tests, labour and delivery along with baby's demographics, diagnoses and screening tests.
As part of this month's publication, NHS Digital are also publishing an analysis of delivery method by Robson group. (Robson groups are 10 population groups used to classify births based on information relating to women's labour and previous birth history.) The full versions of some of these resources may only be available with a paid subscription. Contact your local library service or Athens account administrator to see if you are able to access them through your organisation.
Journal of Medical Internet Research: Video game intervention for sexual risk reduction in minority adolescents: Randomized controlled trial Background: Human immunodeficiency virus (HIV) disproportionately impacts minority youth. Interventions to decrease HIV sexual risk are needed. Objective: Researchers hypothesized that an engaging theory-based digital health intervention in the form of an interactive video game would improve sexual health outcomes in adolescents. Conclusions: An interactive video game intervention improves sexual health attitudes and knowledge in minority adolescents for at least 12 months. BMC Public Health: Perceived neighborhood safety related to physical activity but not recreational screen-based sedentary behavior in adolescents Background: A growing proportion of adolescents have poor cardiovascular health behaviors, including low levels of physical activity and high levels of sedentary behavior, thus increasing the likelihood of poor heart health in later years. This study tested the hypothesis that low perceived neighborhood safety would be associated with low levels of physical activity and high levels of recreational sedentary behavior in high-school students. Conclusion: These data add to a growing body of work demonstrating the importance of perceived safety with physical activity levels in youth. Sports team participation may be a viable target to reduce screen-based sedentary time. BMC Public Health: The role of self-control and cognitive functioning in educational inequalities in adolescent smoking and binge drinking Background: Large differences in substance use between educational levels originate at a young age, but there is limited evidence explaining these inequalities. The aim of this study was to test whether a) smoking and binge drinking are associated with lower levels of self-control and cognitive functioning, and b) associations between educational track and smoking and binge drinking, respectively, are attenuated after controlling for self-control and cognitive functioning. Conclusions: In this study population, pre-existing variations between adolescents in terms of self-control and cognitive functioning played a minor role in educational inequalities in smoking, but not in binge drinking. Child Abuse & Neglect: School staff members experience and knowledge in the reporting of potential child and youth victimization Background: Victimization has been widely demonstrated to have negative consequences in minors. Most crimes against children go unreported and victims tend to reach adulthood without receiving any of the available specialized support. Studies have highlighted the unique role of school workers in early detection and reporting of possible cases of victimization, and have also found high rates of underreporting by school staff. The present study analyzes the underreporting of child and youth victimization suspicions among school staff and aims to identify variables related to its detection and reporting. Conclusion: In order to increase early reporting of possible cases of victimization, it is necessary to overcome certain misconceptions, raise awareness among school staff, design new training programs or interventions, and adapt the school dynamics in the light of these findings. Child Abuse & Neglect: A fatal review: Exploring how children's deaths are reported in the United States Background: Child death reports are the leading data source used to orchestrate child fatality prevention policy. Therefore, the way in which child death is reported is crucial to how we sustain life. Researchers sought to assess the systematic ways in which death is reported for children. Findings: There are some flaws in our death reporting system for child populations, which have the potential to hinder reliability and accuracy of these death reports, as well as thwart their overall usefulness in prevention policies. Programme Grants for Applied Research: Keeping children safe: a multicentre programme of research to increase the evidence base for preventing unintentional injuries in the home in the under-fives Background: Unintentional injuries among 0- to 4-year-olds are a major public health problem incurring substantial NHS, individual and societal costs. However, evidence on the effectiveness and cost-effectiveness of preventative interventions is lacking. Aim: To increase the evidence base for thermal injury, falls and poisoning prevention for the under-fives. Conclusions: These studies provide new evidence about the effectiveness of, as well as economic evaluation of, home safety interventions. Evidence-based resources for preventing thermal injuries, falls and scalds were developed. Providing such resources to children's centres increases their injury prevention activity and some parental safety behaviours. Future work: Further randomised controlled trials, meta-analyses and NMAs are needed to evaluate the effectiveness and cost-effectiveness of home safety interventions. Further work is required to measure NHS, family and societal costs and utility decrements for childhood home injuries and to evaluate complex multicomponent interventions such as home safety schemes using a single analytical model. Journal of Public Health: Weight gain in mid-childhood and its relationship with the fast food environment Background: Childhood obesity is a serious public health issue. Understanding environmental factors and their contribution to weight gain is important if interventions are to be effective. Aims: The purpose of this research was to assess the relationship between weight gain in children and accessibility of fast-food outlets. Conclusions: This paper supports previous research that fast-food outlets are more prevalent in areas of deprivation and presents new evidence on fast-food outlets as a potential contributor towards weight gain in mid-childhood. The Journal of Pediatrics: Influence of socioeconomic context on the rehospitalization rates of infants born preterm Objective: To investigate the impact of social inequalities on the risk of rehospitalization in the first year after discharge from the neonatal unit in a population of preterm-born children. Conclusions: Despite regional routine follow-up for all children, rehospitalization after very preterm birth was higher for children living in deprived neighborhoods. Families' social circumstances need to be considered when evaluating the health consequences of very preterm birth. ADC Fetal & Neonatal: Survival of very preterm infants admitted to neonatal care in England 2008–2014: time trends and regional variation Objective: To analyse survival trends and regional variation for very preterm infants admitted to neonatal care. Conclusions: Continued national improvement in the survival of very preterm admissions masks important regional variation. Timely assessment of preterm survival is feasible using electronic records. BMJ: Low alcohol consumption and pregnancy and childhood outcomes: time to change guidelines indicating apparently 'safe' levels of alcohol during pregnancy? A systematic review and meta-analyses Objectives: To determine the effects of low-to-moderate levels of maternal alcohol consumption in pregnancy on pregnancy and longer-term offspring outcomes. Conclusion: Evidence of the effects of drinking ≤32 g/week in pregnancy is sparse. As there was some evidence that even light prenatal alcohol consumption is associated with being SGA and preterm delivery, guidance could advise abstention as a precautionary principle but should explain the paucity of evidence. Clinical Psychology and Psychotherapy: What approaches for promoting shared decision-making are used in child mental health? A scoping review Objective: Whilst the benefits of shared decision-making (SDM) have been promoted across different health settings, its implementation is complex, particularly for children and young people with mental health difficulties. The aim of this scoping review was to identify and describe SDM approaches (tools, techniques, and technologies) used in child and youth mental health. Conclusion: Evidence suggests that a range of approaches are being developed to support SDM in child and youth mental health. Rigorous research evaluating the effectiveness of these approaches is urgently needed, particularly from the perspective of children and young people. British Journal of General Practice: Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies Background: Up to 20% of women experience anxiety and depression during the perinatal period. In the UK, management of perinatal mental health falls under the remit of GPs. Aim: This review aimed at synthesising the available information from qualitative studies on GPs' attitudes, recognition, and management of perinatal anxiety and depression. Conclusion: GPs often do not have timely access to appropriate psychological therapies and use several strategies to mitigate this shortfall. Training must focus on these issues and must be evaluated to consider whether this makes a difference to outcomes for patients. British Journal of General Practice: Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis Background: There is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent. Aim: To assess the effectiveness of aerobic exercise on postpartum depressive symptoms. Conclusion: This systematic review provides support for the effectiveness of exercise in reducing postpartum depressive symptoms. Group exercise, participant-chosen exercise, and exercise with co-interventions all may be effective interventions. These results should be interpreted with caution because of substantial heterogeneity and risk of bias. Lancet Public Health: Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis Background: Tobacco smoking and smoke exposure during pregnancy and childhood cause considerable childhood morbidity and mortality. Researchers did a systematic review and meta-analysis to investigate whether implementation of WHO's recommended tobacco control policies (MPOWER) was of benefit to perinatal and child health. Interpretation of findings: Smoke-free legislation is associated with substantial benefits to child health. The majority of studies on other MPOWER policies also indicated a positive effect. These findings provide strong support for implementation of such policies comprehensively across the world. BMC Pregnancy and Childbirth: Maternal body mass index and access to antenatal care: a retrospective analysis of 619,502 births in England Background: Late access to antenatal care increases risks of adverse outcomes including maternal and perinatal mortality. There is evidence that BMI influences patient engagement with health services, such as cancer screening services and delayed access to treatment; this association has not been fully explored in the context of antenatal care. This study investigated the association between the stage of pregnancy women access antenatal care, BMI, and other socio-demographic factors. Conclusions: There are significant and complex socio-demographic inequalities associated with the stage of pregnancy women access maternity care, particularly for women with obesity accessing care very late in their pregnancy, and among BME groups, teenagers, deprived and unemployed women. These populations are at increased risk of adverse maternal and fetal outcomes and require support to address inequalities in access to antenatal care. Interventions to facilitate earlier access to care should address the complex and inter-related nature of these inequalities to improve pregnancy outcomes among high-risk groups. BMC Pregnancy and Childbirth: Vaginal delivery: how does early hospital discharge affect mother and child outcomes? A systematic literature review Background: There is an international trend to shorten the postpartum length of stay in hospitals, driven by cost containment, hospital bed availability and a movement toward the 'demedicalization' of birth. The aim of this systematic literature review is to determine how early postnatal discharge policies from hospitals could affect health outcomes after vaginal delivery for healthy mothers and term newborns. Conclusions: Because of the lack of robust clinical evidence and full economic evaluations, the current data neither support nor discourage the widespread use of early postpartum discharge. Before implementing an early discharge policy, Western countries with longer length of hospital stay may benefit from testing shorter length of stay in studies with an appropriate design. The issue of cost containment in implementing early discharge and the potential impact on the current and future health of the population exemplifies the need for publicly funded clinical trials in such public health area. Finally, trials testing the range of out-patient interventions supporting early discharge are needed in Western countries which implemented early discharge policies in the past. Journal of Pediatric Nursing: Does access to green space impact the mental well-being of children: A systematic review Problem: An increasing body of research is showing associations between green space and overall health. Children are spending more time indoors while pediatric mental and behavioral health problems are increasing. A systematic review of the literature was done to examine the association between access to green space and the mental well-being of children. Eligibility Criteria: Articles were limited to English language, ages 0–18 years, and publish date 2012–2017. Conclusions: Access to green space was associated with improved mental well-being, overall health and cognitive development of children. It promotes attention restoration, memory, competence, supportive social groups, self-discipline, moderates stress, improves behaviors and symptoms of ADHD and was even associated with higher standardized test scores. Journal of Medical Internet Research: Social media for the dissemination of Cochrane child health evidence: Evaluation study Background: Health care providers value ready access to reliable synthesized information to support point-of-care decision making. Web-based communities, facilitated by the adoption of social media tools such as Facebook, Twitter, and YouTube, are increasingly being used for knowledge dissemination, bridging the gap between knowledge generation and synthesis and knowledge implementation. Objective: Our objective was to implement and evaluate a structured social media strategy, using multiple platforms, to disseminate Cochrane Child Health evidence to health care providers caring for children. Conclusions: This study provides empirical evidence on the use of a coordinated social media strategy for the dissemination of evidence to professionals providing health services to children and youth. The results and lessons learned from our study provide guidance for future knowledge dissemination activities using social media tools. Academic Pediatrics: Prioritizing possibilities for child and family health: An agenda to address Adverse Childhood Experiences and foster the social and emotional roots of well-being in pediatrics Objective: A convergence of theoretical and empirical evidence across many scientific disciplines reveals unprecedented possibilities to advance much needed improvements in child and family well-being by addressing adverse childhood experiences (ACEs), promoting resilience, and fostering nurturance and the social and emotional roots of healthy child development and lifelong health. In this article researchers synthesize recommendations from a structured, multiyear field-building and research, policy, and practice agenda setting process to address these issues in children's health services. Conclusions: Efforts to address the high prevalence and negative effects of ACEs on child health are needed, including widespread and concrete understanding and strategies to promote awareness, resilience, and safe, stable, nurturing relationships as foundational to healthy child development and sustainable well-being throughout life. A paradigm-shifting evolution in individual, organizational, and collective mindsets, policies, and practices is required. Shifts will emphasize the centrality of relationships and regulation of emotion and stress to brain development as well as overall health. They will elevate relationship-centered methods to engage individuals, families, and communities in self-care related to ACEs, stress, trauma, and building the resilience and nurturing relationships science has revealed to be at the root of well-being. Findings reflect a palpable hope for prevention, mitigation, and healing of individual, intergenerational, and community trauma associated with ACEs and provide a road map for doing so. Academic Pediatrics: ACE, place, race, and poverty: Building hope for children Background: Adverse childhood experiences research has focused attention on the importance of family safety, stability, and nurturing in ensuring healthy development. This safety, stability, and nurturing can be compromised by family poverty, discrimination and marginalization, and geographic location. Findings: Drawing upon census data, this report shows that place, race, and poverty are intertwined concepts with particular implications for young children. Examining census tracts according to their levels of poverty shows that the poorest census tracts also: 1) are the "richest" in the proportion of young children, 2) have the least realized social, physical, and educational, as well as economic capital, and 3) are highly racially segregated and separated from many sources of economic opportunity. The implications are that the country's poorest neighborhoods require substantially more supports for young children but currently have many fewer. This includes individual services to young children and their families but also publicly available services and voluntary supports, such as parks, playgrounds, and libraries. These data suggest that improving child health trajectories and reducing health disparities according to race and socioeconomic status therefore will require concerted individual service as well as community-building efforts directed to poor and usually racially segregated neighborhoods and communities. Academic Pediatrics: Methods to assess Adverse Childhood Experiences of children and families: Toward approaches to promote child well-being in policy and practice Background: Advances in human development sciences point to tremendous possibilities to promote healthy child development and well-being across life by proactively supporting safe, stable and nurturing family relationships (SSNRs), teaching resilience, and intervening early to promote healing the trauma and stress associated with disruptions in SSNRs. Assessing potential disruptions in SSNRs, such as adverse childhood experiences (ACEs), can contribute to assessing risk for trauma and chronic and toxic stress. Asking about ACEs can help with efforts to prevent and attenuate negative impacts on child development and both child and family well-being. Many methods to assess ACEs exist but have not been compared. The National Survey of Children's Health (NSCH) now measures ACEs for children, but requires further assessment and validation. Conclusions: Although important variations exist, available ACEs measurement methods are similar and show consistent associations with poorer health outcomes in absence of protective factors and resilience. All methods reviewed appear to coincide with broader goals to facilitate health education, promote health and, where needed, to mitigate the trauma, chronic stress, and behavioral and emotional sequelae that can arise with exposure to ACEs. Assessing ACEs appears acceptable to individuals and families when conducted in population-based and clinical research contexts. Although research to date and neurobiological findings compel early identification and health education about ACEs in clinical settings, further research to guide use in pediatric practice is required, especially as it relates to distinguishing ACEs assessment from identifying current family psychosocial risks and child abuse. The reflective as well as formative psychometric analyses conducted in this study confirm use of cumulative risk scoring for the NSCH-ACEs measure. Even if children have not been exposed to ACEs, assessing ACEs has value as an educational tool for engaging and educating families and children about the importance of SSNRs and how to recognize and manage stress and learn resilience. Academic Pediatrics: Health conditions and racial differences among justice-involved adolescents, 2009 to 2014 Objective: Providers can optimize care for high-risk adolescents by understanding the health risks among the 1 million US adolescents who interact with the justice system each year. We compared the prevalence of physical health, substance use, and mood disorders among adolescents with and without recent justice involvement and analyzed differences according to race/ethnicity. Conclusions: Adolescents involved at all levels of the justice system have high-risk health profiles compared with the general adolescent population, although these risks differ across racial/ethnic groups. Policymakers and health care providers should ensure access to coordinated, high-quality health care for adolescents involved at all levels of the justice system. BMC Pregnancy and Childbirth: Demand-side financing for maternal and newborn health: what do we know about factors that affect implementation of cash transfers and voucher programmes? Background: Demand-side financing (DSF) interventions, including cash transfers and vouchers, have been introduced to promote maternal and newborn health in a range of low- and middle-income countries. These interventions vary in design but have typically been used to increase health service utilisation by offsetting some financial costs for users, or increasing household income and incentivising 'healthy behaviours'. This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health. Conclusions: Evaluations spanning more than 15 years of implementation of DSF programmes reveal a complex picture of experiences that reflect the importance of financial and other social, geographical and health systems factors as barriers to accessing care. Careful design of DSF programmes as part of broader maternal and newborn health initiatives would need to take into account these barriers, the behaviours of staff and the quality of care in health facilities. Research is still needed on the policy context for DSF schemes in order to understand how they become sustainable and where they fit, or do not fit, with plans to achieve equitable universal health coverage. BMC Public Health: Process evaluation results of a cluster randomised controlled childhood obesity prevention trial: the WAVES study Background: Increasing prevalence of childhood obesity and its related consequences emphasises the importance of developing and evaluating interventions aimed at prevention. The importance of process evaluation in health intervention research is increasingly recognised, assessing implementation and participant response, and how these may relate to intervention success or failure. A comprehensive process evaluation was designed and undertaken for the West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study that tested the effectiveness of an obesity prevention programme for children aged 6-7 years, delivered in 24 UK schools. The four intervention components were: additional daily school-time physical activity (PA); cooking workshops for children and parents; Villa Vitality (VV), a 6-week healthy lifestyle promotion programme run by a local football club; and signposting to local PA opportunities. Conclusions: The WAVES study model provides a rigorous and replicable approach to undertaking and analysing a multi-component process evaluation. Challenges to implementing school-based obesity prevention interventions have been identified which can be used to inform future trials. BMC Public Health: "I would rather be told than not know" - A qualitative study exploring parental views on identifying the future risk of childhood overweight and obesity during infancy Background: Risk assessment tools provide an opportunity to prevent childhood overweight and obesity through early identification and intervention to influence infant feeding practices. Engaging parents of infants is paramount for success however; the literature suggests there is uncertainty surrounding the use of such tools with concerns about stigmatisation, labelling and expressions of parental guilt. This study explores parents' views on identifying future risk of childhood overweight and obesity during infancy and communicating risk to parents. Conclusion: This is the first study to explore the use of obesity risk tools in clinical practice, the findings suggest that identification, and communication of future overweight and obesity risk is acceptable to parents of infants. Despite this positive response, findings suggest that parents' acceptance to identification of risk and implementation of behaviour change is time specific. The apparent level of parental responsibility, fear of judgement and self-blame also highlights the importance of health professionals approach to personalised risk communication so feelings of self-blame are negated and stigmatisation avoided. Journal of Child Health Care: What makes parents act and react? Parental views and considerations relating to 'child health' during infancy Background: Lifestyle factors and behaviours are adopted very early in life and tend to persist throughout life. Considering that the parents are the primary gatekeepers for their child's health, there is a need to gain more knowledge and deeper understanding about what causes parents to act and react in order for early preventive efforts to have any effect. The aim was to explore the parental views and considerations concerning 'child health' among parents with infants 8–10 months old. Findings: Three categories emerged during data analysis: developing a sixth sense, being affected by perceptions and believing health and ill health as a continuum. The parents perceived food and feeding issues as one of the most worrying aspects and a significant indicator of 'child health'. In order to meet the parents on their turf, the 'healthy health message' conveyed needs to take the parental perspective into consideration rather than attempting to educate the parents from predetermined assumption, belief and values. Child Abuse & Neglect: Childhood adversity and cognitive functioning in patients with major depression Objective: Major depression is often accompanied by deficits in cognitive functioning and lowered executive functions. However, not all depressed patients show impairments in these domains. The aim of this study was to examine whether different kinds of childhood adversity might account for cognitive deficits in patients with major depression. Conclusion: A higher number of childhood adversities may influence general knowledge, processing speed and executive functions in patients with major depression. In addition, physical abuse and neglect seemed to be associated with verbal learning deficits and poorer executive functions. Child Abuse & Neglect: Adverse family experiences and flourishing amongst children ages 6–17 years: 2011/12 National Survey of Children's Health Background: Adverse Childhood Experiences (ACEs) are prevalent in the population and linked to various negative long-term health and social consequences. However, due to the retrospective nature of most studies on the topic, little is currently known regarding ACEs' immediate health impact. This study aims to provide insight into this area by examining the association between a new measurement, Adverse Family Experiences (AFEs), and flourishing amongst children ages 6–17 years in the United States. Data from the 2011/12 National Survey of Children's Health were analyzed. Conclusions: Findings show significant differences in flourishing by number of AFEs and suggest that social connectedness may play a role in determining flourishing amongst children with 3/3+ AFEs. Furthermore, the results highlight the potential importance of identifying children with high AFE counts and helping them build resilience outside of the home. Child Abuse & Neglect: Improving outcomes for babies and toddlers in child welfare: A model for infant mental health intervention and collaboration Background: Children under three comprise a sizable and growing proportion of foster care placements. Very young children who enter the child welfare system experience disruptions of critical attachments that are essential to this formative stage of brain development, as well as other traumatic events, leaving them at great risk for lifelong impairments. To reverse these concerning outcomes, babies who have been removed from their homes require intensive, relationship-based interventions that promote secure attachment to a primary caregiver and holistic attention the child's developmental needs. Child welfare decision-makers must be informed of infant brain development and knowledgeable about the particular needs and circumstances of each child. This article describes a model with these features that has been developed and tested in the Bronx, New York, one of the nation's poorest urban counties with high rates of foster care. Findings: Results indicate improvement in parenting interactions, positive child welfare outcomes (including increased rates of reunification, fewer returns to foster care), and improved safety and wellbeing. Results highlight the need for child welfare practices to be more closely aligned with the current science of infant brain development, and to incorporate a specialized approach to address the unique needs of infants. Journal of Epidemiology and Community Health: Alcohol consumption in a general antenatal population and child neurodevelopment at 2 years Background: Prenatal alcohol exposure (PAE) is a community health problem with up to 50% of pregnant women drinking alcohol. The relationship between low or sporadic binge PAE and adverse child outcomes is not clear. This study examines the association between PAE in the general antenatal population and child neurodevelopment at 2 years, accounting for relevant contributing factors. Conclusion: Early binge exposure, followed by lower-level PAE, demonstrated an increase in sensation-avoiding behaviour. There were, however, no significant associations between PAE and neurodevelopment following adjustment for important confounders and modifiers. Follow-up is paramount to investigate subtle or later onset problems. Child and Adolescent Mental Health: Exploring the feasibility and acceptability of a school-based self-referral intervention for emotional difficulties in older adolescents: qualitative perspectives from students and school staff Background: Adolescents with emotional difficulties need accessible, acceptable and evidence-based mental health interventions. Self-referral workshops (DISCOVER workshops) were offered to stressed 16- to 19-year olds in 10 Inner London schools. Conclusions: Findings are discussed in relation to increasing the feasibility of implementing school-based psychological interventions and the value of providing access to mental health support in schools. Journal of Epidemiology and Community Health: Is atmospheric pollution exposure during pregnancy associated with individual and contextual characteristics? A nationwide study in France Background: Exposure to atmospheric pollutants is a danger for the health of pregnant mother and children. The objective of this study was to identify individual (socioeconomic and behavioural) and contextual factors associated with atmospheric pollution pregnancy exposure at the nationwide level. Conclusion: Researchers highlighted social inequalities in atmospheric pollutants exposure according to contextual characteristics such as urbanisation level and social deprivation and also according to individual characteristics such as education, being in a relationship and smoking status. In French urban areas, pregnant women from the most deprived neighbourhood were those most exposed to health-threatening atmospheric pollutants. | 
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