Pub Date : 2019-03-01DOI: 10.1093/med/9780198788850.003.0025
A. M. Kemp
In order for children to develop, achieve their potential, and be healthy, they must be safe. Child safeguarding is entrenched in the policy, legislation, and statutory guidance of each UK country. All NHS organizations are accountable for the commissioning and provision of services designed to safeguard and promote the welfare of children. Where possible, child safeguarding is informed by scientific evidence and good practice incorporates the lessons from statutory reviews and child abuse inquiries. This chapter describes the epidemiology of maltreatment, summarizes the legal framework, and addresses the roles and responsibilities of healthcare practitioners in safeguarding children, with a focus on child protection and the prevention of child maltreatment.
{"title":"Safeguarding","authors":"A. M. Kemp","doi":"10.1093/med/9780198788850.003.0025","DOIUrl":"https://doi.org/10.1093/med/9780198788850.003.0025","url":null,"abstract":"In order for children to develop, achieve their potential, and be healthy, they must be safe. Child safeguarding is entrenched in the policy, legislation, and statutory guidance of each UK country. All NHS organizations are accountable for the commissioning and provision of services designed to safeguard and promote the welfare of children. Where possible, child safeguarding is informed by scientific evidence and good practice incorporates the lessons from statutory reviews and child abuse inquiries. This chapter describes the epidemiology of maltreatment, summarizes the legal framework, and addresses the roles and responsibilities of healthcare practitioners in safeguarding children, with a focus on child protection and the prevention of child maltreatment.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84331220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/med/9780198788850.003.0012
A. Chalkley, L. Sherar
Physical activity is beneficial to children’s health and well-being. Evidence suggests that physical activity declines with age from childhood through adolescence and into adulthood, with boys being more active than girls at all ages. Physical activity participation in childhood is affected by the social support and role modelling provided by family, peers, friends, and teachers. Marginalized groups are disadvantaged in terms of access to opportunities to be physically active. From a population perspective, the greatest gains in public health will be achieved by helping those who are most inactive to become moderately active. Physical activity promotion efforts for children have predominantly focused on school-based programmes, but multisectoral approaches are needed with transformative and enlightened public policy regarding many facets of children’s lives such as school curricula, active travel, safe play areas, and enhanced sports opportunities for all.
{"title":"Promoting physical activity","authors":"A. Chalkley, L. Sherar","doi":"10.1093/med/9780198788850.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780198788850.003.0012","url":null,"abstract":"Physical activity is beneficial to children’s health and well-being. Evidence suggests that physical activity declines with age from childhood through adolescence and into adulthood, with boys being more active than girls at all ages. Physical activity participation in childhood is affected by the social support and role modelling provided by family, peers, friends, and teachers. Marginalized groups are disadvantaged in terms of access to opportunities to be physically active. From a population perspective, the greatest gains in public health will be achieved by helping those who are most inactive to become moderately active. Physical activity promotion efforts for children have predominantly focused on school-based programmes, but multisectoral approaches are needed with transformative and enlightened public policy regarding many facets of children’s lives such as school curricula, active travel, safe play areas, and enhanced sports opportunities for all.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85110464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/MED/9780198788850.003.0026
L. Condon, J. Mytton
Children living in special circumstances due to migration or refugee status, or being of Gypsy, Roma, or Traveller ethnicity, have extra health needs and difficulty in accessing universal and specialist health services. Migrant, refugee, and Traveller children belong to diverse ethnic and social groups, but share characteristics which increase their need for targeted health promotion. All groups are subsections of the population with poor self-reported health and access to health services, and higher numbers of dependent children. It is well recognized that they experience discrimination and social exclusion which adversely impacts health. There is overlap between groups, for example, refugees are migrants who have left their country of origin to avoid persecution, and Roma are migrants who are of Gypsy ethnicity. This chapter identifies the reasons why children from these groups require focused health promotion; it summarizes their health needs, describes interventions to improve their physical and mental health through the child health programmes, and discusses factors that influence their ability to access preventive services.
{"title":"Gypsy/Traveller, migrant, and refugee children","authors":"L. Condon, J. Mytton","doi":"10.1093/MED/9780198788850.003.0026","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0026","url":null,"abstract":"Children living in special circumstances due to migration or refugee status, or being of Gypsy, Roma, or Traveller ethnicity, have extra health needs and difficulty in accessing universal and specialist health services. Migrant, refugee, and Traveller children belong to diverse ethnic and social groups, but share characteristics which increase their need for targeted health promotion. All groups are subsections of the population with poor self-reported health and access to health services, and higher numbers of dependent children. It is well recognized that they experience discrimination and social exclusion which adversely impacts health. There is overlap between groups, for example, refugees are migrants who have left their country of origin to avoid persecution, and Roma are migrants who are of Gypsy ethnicity. This chapter identifies the reasons why children from these groups require focused health promotion; it summarizes their health needs, describes interventions to improve their physical and mental health through the child health programmes, and discusses factors that influence their ability to access preventive services.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89285827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/MED/9780198788850.003.0027
D. Simkiss
Looked after children are a vulnerable group with significant health promotion needs. They are at risk of attachment difficulties and unidentified physical and mental health needs. They often have developmental and educational concerns. This chapter introduces the legal and human rights framework and describes what looked after children tell us is important. It outlines the evidence for looked after children having health promotion, attachment, mental, and physical health needs and concludes with some recommendations on the most effective interventions.
{"title":"Looked after and adopted children","authors":"D. Simkiss","doi":"10.1093/MED/9780198788850.003.0027","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0027","url":null,"abstract":"Looked after children are a vulnerable group with significant health promotion needs. They are at risk of attachment difficulties and unidentified physical and mental health needs. They often have developmental and educational concerns. This chapter introduces the legal and human rights framework and describes what looked after children tell us is important. It outlines the evidence for looked after children having health promotion, attachment, mental, and physical health needs and concludes with some recommendations on the most effective interventions.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91438000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/MED/9780198788850.003.0034
M. Blair, A. Spencer
This chapter outlines how the child health programme should be appraised and the issues of classification and coding, staff awareness of information systems, and data flows are highlighted. Sentinel event analysis is used to describe how safety and effectiveness of the programme might be enhanced. Various international examples of quality dashboards are also described including how they are used for information feedback to parents, health and other professionals, as well as policymakers in the pursuit of continuous quality improvement.
{"title":"Quality assurance and data requirements of the child health programme","authors":"M. Blair, A. Spencer","doi":"10.1093/MED/9780198788850.003.0034","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0034","url":null,"abstract":"This chapter outlines how the child health programme should be appraised and the issues of classification and coding, staff awareness of information systems, and data flows are highlighted. Sentinel event analysis is used to describe how safety and effectiveness of the programme might be enhanced. Various international examples of quality dashboards are also described including how they are used for information feedback to parents, health and other professionals, as well as policymakers in the pursuit of continuous quality improvement.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87720254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/MED/9780198788850.003.0004
V. Glover, R. Reynolds, N. Axford, J. Barlow
The effect of the environment on a child’s development starts in the womb. Many studies have shown that if the mother is stressed, anxious, or depressed during pregnancy, this increases the risk of a range of physical and neurodevelopmental problems for the child, even after allowing for relevant confounders. There is also strong evidence concerning the impact of both maternal and paternal anxiety and depression on parent–infant interaction in the postnatal period. Although there is good evidence for interventions that reduce depression and anxiety during the perinatal period for women, less is currently known about effective interventions for men or effective methods of prevention more generally. Overall, the evidence points to the importance of starting interventions in pregnancy.
{"title":"Perinatal parental mental health problems","authors":"V. Glover, R. Reynolds, N. Axford, J. Barlow","doi":"10.1093/MED/9780198788850.003.0004","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0004","url":null,"abstract":"The effect of the environment on a child’s development starts in the womb. Many studies have shown that if the mother is stressed, anxious, or depressed during pregnancy, this increases the risk of a range of physical and neurodevelopmental problems for the child, even after allowing for relevant confounders. There is also strong evidence concerning the impact of both maternal and paternal anxiety and depression on parent–infant interaction in the postnatal period. Although there is good evidence for interventions that reduce depression and anxiety during the perinatal period for women, less is currently known about effective interventions for men or effective methods of prevention more generally. Overall, the evidence points to the importance of starting interventions in pregnancy.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81449862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/MED/9780198788850.003.0010
J. Barlow
Mental health in the early years is underpinned by the capacity of young children for emotion regulation, and the child’s early relational context (i.e. the parenting that they receive) has been identified as being key to the development of this ability. However, many children show signs of regulatory difficulties including sleeping and crying difficulties, and emotional and behavioural problems in the early years; this is as such an important window of opportunity to intervene to optimize parenting, and prevent early parent–child relationship problems using a range of primary and secondary preventive approaches. This chapter provides an overview of the nature and prevalence of early regulatory problems, and some of the main universal and targeted intervention approaches that have been developed to address such problems, alongside the evidence about their effectiveness in improving outcomes for both parents and children.
{"title":"Promoting infant and child mental health through support for parenting","authors":"J. Barlow","doi":"10.1093/MED/9780198788850.003.0010","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0010","url":null,"abstract":"Mental health in the early years is underpinned by the capacity of young children for emotion regulation, and the child’s early relational context (i.e. the parenting that they receive) has been identified as being key to the development of this ability. However, many children show signs of regulatory difficulties including sleeping and crying difficulties, and emotional and behavioural problems in the early years; this is as such an important window of opportunity to intervene to optimize parenting, and prevent early parent–child relationship problems using a range of primary and secondary preventive approaches. This chapter provides an overview of the nature and prevalence of early regulatory problems, and some of the main universal and targeted intervention approaches that have been developed to address such problems, alongside the evidence about their effectiveness in improving outcomes for both parents and children.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83955057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/med/9780198788850.003.0007
J. Barlow
For first-time parents, the ‘transition to parenthood’ is a significant period, not only in terms of changes for the parents and the related stress that such changes may involve, but also in terms of the needs of the unborn/newborn baby. This reflects the fact that the perinatal period is now recognized to be a ‘sensitive’ developmental period in terms of the baby’s neurodevelopment and thereby a significant window of opportunity to equalize the life chances of all children. This chapter examines some of the key changes that can occur during the ‘transition to parenthood’ and the potential impact in terms of long-term well-being of the infant and child. Innovative and evidence-based methods of working to support the couple in the transition to parenthood are described, and the effectiveness of such programmes reviewed in terms of both parental and infant well-being.
{"title":"Transition to parenthood programmes","authors":"J. Barlow","doi":"10.1093/med/9780198788850.003.0007","DOIUrl":"https://doi.org/10.1093/med/9780198788850.003.0007","url":null,"abstract":"For first-time parents, the ‘transition to parenthood’ is a significant period, not only in terms of changes for the parents and the related stress that such changes may involve, but also in terms of the needs of the unborn/newborn baby. This reflects the fact that the perinatal period is now recognized to be a ‘sensitive’ developmental period in terms of the baby’s neurodevelopment and thereby a significant window of opportunity to equalize the life chances of all children. This chapter examines some of the key changes that can occur during the ‘transition to parenthood’ and the potential impact in terms of long-term well-being of the infant and child. Innovative and evidence-based methods of working to support the couple in the transition to parenthood are described, and the effectiveness of such programmes reviewed in terms of both parental and infant well-being.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79665119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/MED/9780198788850.003.0009
J. Law, A. Emond
Recent evidence emphasizes the interconnectedness of different aspects of young children’s development, the variability of development, and the way that it unfolds in the context of the family. This chapter describes the role of primary prevention in promoting child development, particularly the cognitive aspects of child development. Parental awareness about child development is central to any child health programme. Professionals have a key role in providing appropriate information about child development to families and also in mediating what is available on the Internet. This highlights the need for regular monitoring with a common understanding of development across professionals and the use of appropriate outcomes which are meaningful to parents. A range of different interventions have been tested, many with positive results, but effective service delivery needs to be multifaceted and systemic. The outcome of promoting early child development should be seen in terms of improving school readiness, and enhancing children’s well-being.
{"title":"Promoting child development","authors":"J. Law, A. Emond","doi":"10.1093/MED/9780198788850.003.0009","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0009","url":null,"abstract":"Recent evidence emphasizes the interconnectedness of different aspects of young children’s development, the variability of development, and the way that it unfolds in the context of the family. This chapter describes the role of primary prevention in promoting child development, particularly the cognitive aspects of child development. Parental awareness about child development is central to any child health programme. Professionals have a key role in providing appropriate information about child development to families and also in mediating what is available on the Internet. This highlights the need for regular monitoring with a common understanding of development across professionals and the use of appropriate outcomes which are meaningful to parents. A range of different interventions have been tested, many with positive results, but effective service delivery needs to be multifaceted and systemic. The outcome of promoting early child development should be seen in terms of improving school readiness, and enhancing children’s well-being.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79007487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1093/MED/9780198788850.003.0028
Alison Burton
Each nation in the UK has a child health programme, based on the principle of proportionate universalism. This chapter covers the common shared themes and principles, and summarizes the four individual programmes and their policy context. An appraisal of the evidence underpinning the programmes is not included.
{"title":"Recommended universal components by age across the UK","authors":"Alison Burton","doi":"10.1093/MED/9780198788850.003.0028","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0028","url":null,"abstract":"Each nation in the UK has a child health programme, based on the principle of proportionate universalism. This chapter covers the common shared themes and principles, and summarizes the four individual programmes and their policy context. An appraisal of the evidence underpinning the programmes is not included.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73671516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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