Child health crisis: calls for urgent action must not go unheeded – BMJ

Child health
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Published 20th March 2018

After years of progress the UK is stalling in areas such as infant mortality and immunisation levels and is lagging behind similar countries on mortality, breastfeeding, and the prevalence of obesity.

Several new reports detail the worrying state of the nation’s child health. Health professionals say that the latest figures are cause for alarm and are calling on the government to act urgently to develop a comprehensive child health strategy.

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NIHR Signal: Self-care support for children with long-term conditions may reduce emergency costs

ill child
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Published on 27 March 2018

Helping children and parents to manage long-term conditions like asthma may reduce their need for emergency care, and is unlikely to reduce children’s quality of life.

This NIHR review found that structured professional help with self-care, including online support, provision of care plans, case management and face-to-face education, was linked to small increases in quality of life scores and fewer emergency department visits. However, there was no clear evidence that supported self-care reduced hospital admissions or overall costs.

Most of the 97 studies reviewed included children with asthma (66 studies) or mental health conditions (18 studies). Not all were high-quality studies, and the review covered very different interventions, which makes it hard to compare approaches.

The findings suggest there is little chance of self-care support causing harm to children with long-term conditions, although that could not be definitively ruled out. However, there is also little evidence that supported self-care can make a substantial difference to healthcare costs.

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EARLY REGULATION IN CHILDREN WHO ARE LATER DIAGNOSED WITH AUTISM SPECTRUM DISORDER. A LONGITUDINAL STUDY WITHIN THE DANISH NATIONAL BIRTH COHORT

 

Studies have shown that children later diagnosed with autism spectrum disorders (ASD) in their first years of life might show symptoms in main developmental areas and that these signs might be sensed by the parents. The present study investigated in a large birth cohort if children later diagnosed with ASD had deviations at 6 and 18 months in areas such as the ability to self‐regulate emotions, feeding, and sleeping. The study was based on prospective information collected from 76,322 mothers who participated in the Danish National Birth Cohort. When the children reached an average age of 11 years, 973 children with ASD and a control group of 300 children with intellectual disability (IDnoASD) were identified via Danish health registries.

Associations were found between short periods of breast‐feeding and the children later diagnosed with ASD and IDnoASD as well as associations at 18 months to deviations in regulation of emotions and activity. The similarities in these associations emphasize how difficult it is to distinguish between diagnoses early in life.

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What distinguishes adolescents with suicidal thoughts from those who have attempted suicide? A population‐based birth cohort study

 

Background

Only one‐third of young people who experience suicidal ideation attempt suicide. It is important to identify factors which differentiate those who attempt suicide from those who experience suicidal ideation but do not act on these thoughts.

Methods

Participants were 4,772 members of the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population‐based birth cohort. Suicide ideation and attempts were assessed at age 16 years via self‐report questionnaire. Multinomial regression was used to examine associations between factors that differentiated adolescents in three groups: no suicidal ideation or attempts, suicidal ideation only and suicide attempts. Analyses were conducted on an imputed data set based on those with complete outcome data (suicidal thoughts and attempts) at age 16 years (N = 4,772).

Results

The lifetime prevalence of suicidal ideation and attempts in the sample was 9.6% and 6.8% respectively. Compared to adolescents who had experienced suicidal ideation, those who attempted suicide were more likely to report exposure to self‐harm in others (adjusted OR for family member self‐harm: 1.95, for friend self‐harm: 2.61 and for both family and friend self‐harm: 5.26). They were also more likely to have a psychiatric disorder (adjusted OR for depression: 3.63; adjusted OR for anxiety disorder: 2.20; adjusted OR for behavioural disorder: 2.90). Other risk factors included female gender, lower IQ, higher impulsivity, higher intensity seeking, lower conscientiousness, a greater number of life events, body dissatisfaction, hopelessness, smoking and illicit drug use (excluding cannabis).

Conclusions

The extent of exposure to self‐harm in others and the presence of psychiatric disorder most clearly differentiate adolescents who attempt suicide from those who only experience suicidal ideation. Further longitudinal research is needed to explore whether these risk factors predict progression from suicidal ideation to attempts over time.

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Doctors launch ‘game-changing’ new eLearning tool to help identify muscle degenerative disorders

The new eLearning resource, launched by RCPCH, aims to equip health professionals with the information to identify conditions such as Duchenne muscular dystrophy and spinal muscular atrophy at the earliest opportunity. This will allow treatment to begin much earlier which will in turn, enhance mobility, prolong life and allow family members to be tested to assess the risk of passing the condition on to future generations. Go to RCPCH Compass Online Learning Tool – learn the signs and help improve the quality of a child’s life today Doctors say this new resource, aimed at health visitors, GPs, nurses and physiotherapists will void the gap of knowledge that currently exists and will finally enable awareness to catch up with the science.

Link to RCPCH page here

Share on facebook More Sharing Services share this RCOG/BritSPAG: New booklet empowers young people to understand normal vulva appearance

Vulva

A new resource aimed at educating young people on normal female anatomy – specifically vulva appearance – has been launched by RCOG/BritSPAG. The resource consists of a booklet titled ‘So what is a vulva anyway?‘ and has been developed in response to an increasing number of girls and women with cosmetic genital concerns requesting surgery despite having normal anatomy.

Link to RCOG page here

Safe sleeping – supporting parents. (Public Health England)

sleeping well

Blog report from Wendy Nicholson, Nursing Lead for Children, Young People and Families at Public Health England, about helping parents ensure their baby sleeps well and is safe. PHE have teamed up with Lullaby Trust to develop guidance to help new and expectant parents make safer choices when deciding on sleeping products for their baby. The guidance can be downloaded here https://www.lullabytrust.org.uk/about-us/safer-sleep-week-2018/ . It aims to provide parents with some key pieces of advice when choosing sleeping products.