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Updated ward-level child and maternal health data available PHE's Local Health tool was updated on 12 October, including updates to indicators relating to the health of mothers, children and young people. These are available for a range of geographical areas including ward and middle layer super output area (MSOA). The Public Health Outcome Framework (PHOF) indicator 2.01: low birth weight of term babies has been included for the first time.
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.
Sepsis in children: advice for health visitors and school nurses This short guide from Public Health England sets out what health visitors and school nurses need to know about sepsis; and is designed to raise awareness of sepsis locally amongst health visitors and school nurses and their teams. This guidance includes: - causes and symptoms of sepsis
- support for parents
additional resources for health visitors and school nurses Child abuse and neglect This guidance from the National Institute for Health and Care Excellence (NICE) covers recognising and responding to abuse and neglect in children and young people aged under 18. It covers physical, sexual and emotional abuse, and neglect. The guideline aims to help anyone whose work brings them into contact with children and young people to spot signs of abuse and neglect and to know how to respond. It also supports practitioners who carry out assessments and provide early help and interventions to children, young people, parents and carers.
Key data on young people 2017 This report from the Association for Young People's Health (AYPH) explores the latest trends in young people's health and lifestyles. This comprehensive data review focuses on the health of 10-24 year olds in the UK. Findings include: - The late teens are a 'peak age' for health risks, with lifelong implications
- Contrary to popular understanding, young people are frequent users of health services
- Despite being frequent users of health services, services are not youth friendly
- Mental health is a huge issue for this age group but resources are very limited·
- Inequality greatly affects young people's lives
Full report Summary Chapter 1: Introduction Chapter 2: Living circumstances, education and employment Chapter 3: health behaviours and lifestyle Chapter 4: Sexual health and identity Chapter 5: Physical health, long term conditions, disability and mortality Chapter 6: Wellbeing and mental health Chapter 7: Health promotion and use of health services Chapter 8: Inequalities in health outcomes Concluding comments
A separate document on AYPH's Recommendations for Action can be downloaded here.
Children's voices: The wellbeing of children with mental health needs in England This report from the Children's Commissioner's Office examines the wellbeing of vulnerable groups of children in England and their relationship with mental health services. Qualitative research explores the limited awareness of mental health issues in young people, focusing on their perception of mental health. Findings: children appeared to have highly negative and stereotyped ideas about mental illness; there is lack of awareness of the types of services and support available for children experiencing mental health problems; children and families delayed or avoided treatment due to anxiety and uncertainty around accessing services. Fear of being seen accessing services and insecurity about the confidentiality of the service also emerged as important barriers to young people's ability to address and overcome mental health needs. Early language development: needs, provision and intervention for preschool children from socio-economically disadvantage backgrounds A new review of the evidence on early language development, commissioned by the EEF in partnership with Public Health England has examined the most effective ways to support young children with delays in their early language development. Researchers looked at the existing evidence to find out which interventions have the greatest potential for boosting toddlers' language skills and reducing inequalities in outcomes.
Findings: The researchers identified a series of intervention studies which have had positive results on developing language skills. They found one of the best ways to improve early language development for this group is through training for teachers in early years settings so that they can deliver cost-effective and evidence based interventions to those children who have fallen behind. In addition to high-quality early years provision, the researchers identify interactions with parents as key. They highlight at need to promote positive interaction between parents and their children before they get to nursery at 2-3 years.
The report also stresses the need for better monitoring of children's progress at different stages of their development, to catch those children falling behind and to identify those who need targeted, specialist support.
This evidence review will inform guidance on early years literacy teaching, due to be published later this year. Mental health service models for young people In 2015, the Government committed 5 years of extra funding for Children and Young People's Mental Health Services (CYPMHS). All areas of England were required to submit plans outlining how they will improve their services by 2020. This briefing from the Parliamentary Office of Science and Technology (POST) describes some of the new models of CYPMHS and examines the challenges to their effective implementation. Serious games for mental health: you cannot be serious! This Mental Elf blog explores the results of the first systematic review with meta-analysis of serious games for mental health, which asks: are they accessible, feasible and effective? The post Serious games for mental health: you cannot be serious! appeared first on National Elf Service. Conclusion: The reviewers concluded that serious games are moderately effective in reducing psychiatric disorder-related symptoms. There is potential for games having a positive impact on various age groups and both clinical and non-clinical populations. The results are in-line with previously conducted systematic reviews on serious games (e.g. this review focusing on depression: Fleming et al, 2014). The effect size in this review is comparable to other digital interventions for mental illness in youth or adults, e.g. internet-based or computer-based interventions. #NotWithoutMe: A digital world for all? This report from the CarnegieUK Trust explores the issues of digital exclusion amongst vulnerable young people. The #NotWithoutMe programme challenges the assumption that young people are 'digital natives' and have basic digital skills or access to learning opportunities. The report's main findings are drawn from four, year-long pilot projects run across the UK (two based in England, one in Scotland and one in Northern Ireland). The report provides a range of recommendations to help further develop innovative practice and policy interventions in this area. Vulnerable birth mothers and recurrent care proceedings A study funded by the Nuffield Foundation has found a high number of women, who repeatedly appear before the family courts and lose many children into public care or adoption because of child protection concerns, have been in care themselves. 40% of the mothers had been in foster care or children's homes with a further 14% living in private or informal relationships away from their parents. The research team from Lancaster University read court records relating to a sample of 354 mums who, at the time of the study, had appeared in a total history of 851 first and repeat sets of care proceedings issued by 52 local authorities in England. The study revealed the high levels of abuse and neglect women had suffered in their lives as children. 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.
Local authority public health dashboard As part of a wider government commitment to support greater transparency across the public sector, Public Health England has published a new local authority public health dashboard. The dashboard will support local councillors and senior council officers in making decisions on how they prioritise resources across a range of public health service areas. As a new tool, PHE are publishing an initial version now and seeking suggestions to improve it so that it can be launched in full in the summer of 2018. It uses existing published data and therefore complements the range of tools PHE provides to support local government in their role as the local leaders for the public's health. Service areas on which comparative ranks are available include start in life and child obesity. Please send any comments to PHdashboard@phe.gov.uk by 30 November 2017. Birth characteristics in England and Wales: 2016 Annual birth statistics from the Office for National Statistics, including birthweight, place of birth, multiple births and stillbirths. According to the Royal College of Midwifes (RCM) ONS' latest figures show that in 2016, the stillbirth rate for England and Wales fell to 4.4 per 1000 total births; the lowest rate since 1992 when it was 4.3.
The data also revealed that the percentage of women having home births in 2016 was 2.1% – a small decrease compared with 2012 to 2015 when it was 2.3%.
Of the 696,271 live births in 2016, 7% (48,490) were low birthweight (under 2.5kg), which has remained the same since 2011. Children and young people's health services monthly statistics: Jun 2017 This CYPHS data set from NHS Digital has been developed to help achieve better outcomes of care for mothers, babies and children. This is a patient-level data set 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. Sexual and reproductive health services, England 2016 to 2017 This publication from NHS Digital covers activity taking place in the community at dedicated Sexual and Reproductive Health (SRH) services, including activity at non NHS service providers where available.
SRH services include family planning services, community contraception clinics, integrated GUM and SRH services and young people's services e.g. Brook advisory centres. They provide a range of services including, but not exclusively, contraception provision and advice, sexual health treatment and advice, pregnancy related care, abortion related care, cervical screening, psychosexual therapy, PMS treatment, colposcopy services, fertility treatment and care and gynaecological treatment and care. Maternity services monthly statistics May 2017 This is a report on NHS-funded maternity services in England for May 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 is 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 Public Health: The social determinants of lesbian, gay, bisexual and transgender youth suicidality in England: a mixed methods study Background: Lesbian, gay, bisexual and transgender (LGBT) youth have a higher risk of suicidality and self-harm than heterosexual youth populations but little is known about the underlying mechanisms. This study aimed to investigate the social determinants of this mental health inequality. Conclusions: Public health universal interventions that tackle bullying and discrimination in schools, and selected interventions that provide specific LGBT youth mental health support could reduce LGBT mental health inequalities in youth suicidality. Journal of Pediatric Nursing: Outcomes of depression screening among adolescents accessing school-based pediatric primary care clinic services Purpose: Implementation of routine Patient Health Questionnaires (PHQ-9) screening among adolescents aged 12–18 year, accessing school-based pediatric primary care clinic services for identification of adolescents at potential risk for Major Depressive disorder (MDD). Conclusion: Implementation of PHQ-9 depression screening protocol identified MDD among adolescent accessing pediatric school-based primary care clinic services facilitating referrals to mental health providers, potentially improving morbidity and mortality among adolescents. Journal of Medical Internet Research: The effectiveness of ehealth technologies on weight management in pregnant and postpartum women: systematic review and meta-analysis Objective: The objective of this study was to assess the effectiveness of eHealth technologies for weight management during pregnancy and the postpartum period and to review the efficacy of eHealth technologies on health behaviors, specifically nutrition and physical activity. Conclusions: This review found evidence for benefits of eHealth technologies on weight management in postpartum women only. Further research is still needed regarding the use of these technologies during and after pregnancy. Maternal & Child Nutrition: Relationships of family conflict, cohesion, and chaos in the home environment on maternal and child food-related behaviours Aim: This study examined how food-related behaviours differed in mothers and their preschool children by levels of family functioning (cohesion and conflict) and household disorganization (chaos). Findings: suggest family functioning and household chaos are associated with food-related behaviours. This frequently overlooked component of family interaction may affect intervention outcomes and objectives of educational and interventional initiatives. Journal of Epidemiology & Community Health: Early life socioeconomic determinants of dietary score and pattern trajectories across six waves of the Longitudinal Study of Australian Children Background: Social patterning of dietary-related diseases may partly be explained by population disparities in children's diets. This study aimed to determine which early life socioeconomic factors best predict dietary trajectories across childhood. Conclusion: Child dietary trajectories vary profoundly by family socioeconomic position. If causal, reducing dietary inequities may require researching underlying pathways, tackling socioeconomic inequities and targeting health promoting interventions to less educated families. Child and Adolescent Mental Health: Innovations in practice: using clinician-rated outcomes to support improved service decision making in a Child and Adolescent Mental Health Service Background: Clinical outcomes are now routinely collected in most services. However, there is a need to make full use of the information collected in order to improve the use of limited Child and Adolescent Mental Health Service (CAMHS) resources. This paper describes a method of improving service decision making by making the interpretation of outcomes data accessible to frontline staff. Conclusions: Providing clinicians with accessible information about outcomes promotes the likelihood of outcomes being used in service decision making. Child and Adolescent Mental Health: Can we improve parent attitudes and intentions to access computer-based therapies for their children and adolescents? Background: As gatekeepers, parents can improve the uptake of mental health services among youth. This article asked whether providing parents with a presentation on computer-based therapies is a feasible strategy to improve their knowledge, attitudes and uptake intentions. Conclusions: Information- and demonstration-based presentations are a feasible method for improving attitudes towards computer-based therapies for youth among parents in the community. Journal of Epidemiology & Community Health: Factors across the life course predict women's change in smoking behaviour during pregnancy and in midlife: results from the National Child Development Study Background: Tobacco smoking before, during and after pregnancy remains one of the few preventable factors associated with poor health outcomes for mothers and their children. Researchers investigated predictors across the life course for change in smoking behaviour during pregnancy and whether this change predicts smoking status in midlife. Conclusions: Findings from this population-based birth cohort study lend support for smoking cessation strategies that target those at risk at various stages across the life course. The Journal of Pediatrics: Childhood obesity and physical activity-friendly school environments Objective: Childhood obesity may be related to school environment, but previous studies often focused on food environment only. This study aimed to examine the relationship between school physical activity environment and childhood obesity. Conclusions: A physical activity-friendly school environment is associated with lower risk of obesity. School physical activity environment should be considered in future epidemiologic and intervention studies. Child Abuse Review: Assessing capacity to change in high-risk pregnant women Background: Pre-birth risk assessment is a process by which circumstances affecting an unborn child can be identified and support for mother and infant embedded. This mixed methods study describes a community-based pre-birth assessment and care pathway that utilised the Parents Under Pressure (PuP) programme to assess parenting capacity and provide support pre- and post-birth for 'at risk' women. Conclusion: Qualitative data revealed that the pathway was acceptable and helpful to service users and service providers. International Breastfeeding Journal: Gestational, perinatal, and postnatal factors that interfere with practice of exclusive breastfeeding by six months after birth Background: Despite evidences indicating the superiority of breastfeeding and recent advances in the indicators of breastfeeding in Brazil, exclusive breastfeeding (EBF) during the first six months after birth continues to be an infrequent practice in the country. The objective of the present study was to determine which gestational, perinatal, and postnatal factors of the mother-baby dyad might be associated with the cessation of EBF by six months after birth. Conclusion: The identification of the risk variables associated with cessation of EBF by six months postpartum, such as previous experience with exclusive breastfeeding, may contribute to the effectiveness of EBF intervention and support measures during the first six months after birth. Journal of Adolescent Health: The association of harsh parenting, parent-child communication, and parental alcohol use with male alcohol use into emerging adulthood Purpose: This study investigates the association between mother and father harsh parenting, and parent-child communication, and parental alcohol use on males' alcohol use from early adolescence into emerging adulthood. Conclusion: This study offers unique insights into how mother- and father-son dyads differ in communication and parenting styles, as well as how these associations influence adolescent male alcohol use continuing into emerging adulthood. Multiple informants utilized in the current study provide a more complex understanding of how each parent uniquely contributes to the role of their adolescent's alcohol use in late adolescence into emerging adulthood. PLOS ONE: Nutrition after preterm birth and adult neurocognitive outcomes Background: Preterm birth (<37 gestational weeks) poses a risk of poorer neurocognitive functioning. Faster growth after preterm birth predicts better cognitive abilities and can be promoted through adequate nutrition, but it remains unknown whether variations in nutrient intakes translate into long-term benefits for neurodevelopment. Conclusion: In preterm neonates with very low birth weight, higher energy and human milk intake predict better neurocognitive abilities in adulthood. To understand the determinants of these infants' neurocognitive outcome, it seems important to take into account the role of postnatal nutrition, not just as an isolated exposure, but as a potential mediator between neonatal illness and long-term neurodevelopment. Journal of Child Health Care: Mental health screening of fathers attending early parenting services in Australia Background: Paternal perinatal depression and anxiety is a common, though under-recognized mental health condition experienced by men during their transition to fatherhood. An opportunity to screen for paternal mental health issues occurs when parents present for assistance with the care of their baby at early parenting services (EPSs). Conclusion: EPSs provide a unique opportunity to address the mental health needs of fathers. Results from this study point to the need for a national approach to the development of father-specific screening guidelines for EPSs to improve family well-being, in parallel to those informing the Australian National Perinatal Mental Health Initiative for mothers. Journal of Child Health Care: Behavioural correlates of energy drink consumption among adolescents: a review of the literature Background: Despite regulatory measures on the labelling of energy drinks (EDs), their consumption among adolescents continues to grow in popularity, but teachers increasingly report significant behavioural concerns among students who disclose habitual ED consumption. A review of papers published between January 2010 and October 2016 was undertaken to determine whether an association between adverse behaviour and consumption of ED exists. Findings: indicate that ED consumption among adolescents is associated with alcohol and substance use, risky behaviours and psychological states including sensation seeking, depression and anxiety symptoms. ED consumption impacts negatively on executive functions and increases hyperactivity/inattention symptoms among adolescents. An inverse association between ED consumption and sleep duration exists. The findings highlight the need for greater awareness of the potential risk of ED consumption among adolescents. Maternal & Child Nutrition: A qualitative study exploring midwives' perceptions and knowledge of maternal obesity: reflecting on their experiences of providing healthy eating and weight management advice to pregnant women Background: Midwives are responsible for providing advice regarding the complex issues of healthy eating and weight management during pregnancy. This study utilised an inductive data-driven thematic approach in order to determine midwives' perceptions, knowledge, and experiences of providing healthy eating and weight management advice to pregnant women. Conclusions: Midwives Normalised Obesity. The midwives recognised the importance of providing healthy eating advice to pregnant women and the health risks associated with poor diet and obesity. However, they reported the normalisation of obesity in pregnant women and suggested that this, together with their high workload and lack of expertise, explained the reasons why systematic advice was not in standard antenatal care. In addition, the current lack of UK clinical guidance, and thus, possibly lack of clinical leadership are also preventing delivery of tailored advice. Implementation literature on understanding the barriers to optimal health care delivery and informing clinical practice through research evidence needs to be further investigated in this field. This study has recommendations for policy makers, commissioners, service providers, and midwives. Maternal & Child Nutrition: Children concurrently wasted and stunted: a meta-analysis of prevalence data of children 6–59 months from 84 countries Background: Children can be stunted and wasted at the same time. Having both deficits greatly elevates risk of mortality. The analysis aimed to estimate the prevalence and burden of children aged 6–59 months concurrently wasted and stunted. Conclusion: This analysis represents the first multiple country estimation of the prevalence and burden of children concurrently wasted and stunted. Given the high risk of mortality associated with concurrence, the findings indicate a need to report on this condition as well as investigate whether these children are being reached through existing programmes. Cochrane Database of Systematic Reviews: Interventions for increasing fruit and vegetable consumption in children aged five years and under Background: Consuming not enough fruit and vegetables is a considerable health burden in developed countries. Eating fruit and vegetables is associated with a reduced risk of future chronic disease. Early childhood represents a critical period for the establishment of dietary habits. Interventions to increase consumption of fruit and vegetables in early childhood may therefore be an effective strategy in reducing this disease burden.
Conclusion: The evidence for effective interventions to increase eating of fruit and vegetables by children aged five and under remains sparse. Child-feeding interventions appear to increase the eating of vegetables by children (by 4.03 grams), but this conclusion is based on very low-quality evidence and is very likely to change when future research is undertaken. Journal of Adolescent Health: Implications of pubertal timing for romantic relationship quality among heterosexual and sexual minority young adults Purpose: Relative to on-time or late-maturing peers, girls who begin puberty early typically begin romantic and sexual experiences earlier; however, advanced pubertal status does not necessarily coincide with commensurate interpersonal skills necessary for healthy romantic relationships. Research is limited on the long-term implications of early puberty for relationship quality, and virtually nothing is known about the social implications of early timing for sexual minority females. Conclusions: Early maturation is associated with lower romantic relationship quality in young adulthood. However, evidence of the association varies by measure of pubertal timing, and the processes by which pubertal timing is linked to later relationship quality may be different for sexual minority and heterosexual females. Potential explanations and public health implications are discussed. Journal of Pediatric Nursing: Parenting practices of African immigrants in destination countries: a qualitative research synthesis Problem: While studies have discussed the parenting practices and challenges of African immigrants, no paper has synthesized the results of these qualitative studies. Conclusion and Implications: This study identifies a need for culturally appropriate policies and practices that build on the strengths of African immigrants in destination countries while addressing their unique challenges. Journal of Adolescent Health: Transgender youth substance use disparities: results from a population-based sample Purpose: The purpose of this study was to examine rates of substance use between transgender and nontransgender youth using a representative population-based sample and to examine mediating risk factors. Conclusions: Using data from the first representative study of youth to include a measure of gender identity, the study showed that transgender youth are at heightened risk for substance use compared with nontransgender peers. Future research is needed to identify the structural and psychosocial mechanisms that drive these disparities The Journal of Pediatrics: Leisure time physical activity in young adults born preterm Objective: To evaluate the amount of self-reported physical activity in young adults born prematurely compared with those born at term. Conclusions: Young adults born early preterm engage less in leisure time physical activities than peers born at term. This finding may in part underlie the increased risk factors of cardiometabolic and other noncommunicable diseases in adults born preterm. Low physical activity is a risk factor for several noncommunicable diseases and amenable to prevention. BMJ: Childhood onset inflammatory bowel disease and risk of cancer: a Swedish nationwide cohort study 1964-2014 Objective: To assess risk of cancer in patients with childhood onset inflammatory bowel disease in childhood and adulthood. Conclusion: Childhood onset inflammatory bowel disease is associated with an increased risk of any cancer, especially gastrointestinal cancers, both in childhood and later in life. The higher risk of cancer has not fallen over time. Archives of Disease in Childhood: Specialist paediatric palliative care services: what are the benefits? Background: The number of children and young people (CYP) living with life-limiting and life-threatening conditions is rising. Paediatric palliative care is a relatively new aspect of healthcare, the delivery of which is variable, with a wide range of healthcare and voluntary sector providers involved. Policy recommendations are for Specialist Paediatric Palliative Care (SPPC) services to be supported by a physician with specialist training. Aim: To examine the research evidence regarding the distinct benefits of SPPC services, with 'Specialist Paediatric Palliative Care' defined as palliative care services supported by a specialist physician. Conclusions: Current evidence indicates that SPPC services contribute beneficially to the care and experience of CYP and their families, but is limited in terms of quantity, methodological rigour and generalisability. Further research is necessary given the significant workforce and resource implications associated with policy recommendations about the future provision of SPPC and to address the need for evidence to inform the design and delivery of SPPC services. Archives of Disease in Childhood: Early-life exposures predicting onset and resolution of childhood overweight or obesity Objectives: To determine which of multiple early-life exposures predict onset or resolution of overweight/obesity during a 9-year period. Conclusions: Readily available baseline information (child/maternal BMI, maternal age, education and child health) were the strongest predictors of both onset and resolution of overweight/obesity between the primary school and adolescent years. Perinatal, breastfeeding and lifestyle exposures were not strongly predictive. Results could stimulate development of algorithms identifying children most in need of targeted prevention or treatment. Academic Pediatrics: Chronic school absenteeism and the role of Adverse Childhood Experiences Objective: To examine the association between chronic school absenteeism and adverse childhood experiences (ACEs) among school-aged children. Conclusions: ACEs exposure was associated with chronic school absenteeism in school-aged children. To improve school attendance, along with future graduation rates and long-term health, these findings highlight the need for an interdisciplinary approach to address child adversity that involves pediatricians, mental health providers, schools, and public health partners. | 
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