Pub Date : 2019-03-01DOI: 10.1093/med/9780198788850.003.0006
J. Barlow, N. Axford
This chapter summarizes evidence on (i) the prevalence and effects on the unborn and newborn infant of exposure to teratogenic substances such as tobacco, alcohol, or substances during pregnancy, and (ii) what works during the perinatal period in terms of universal and targeted interventions for smoking cessation, and preventing and treating alcohol and drug misuse. It concludes with recommendations for practice, drawing on the evidence presented and best practice guidance, and focusing on strategies for identification and intervention.
{"title":"Tobacco, alcohol, and substance use in the perinatal period","authors":"J. Barlow, N. Axford","doi":"10.1093/med/9780198788850.003.0006","DOIUrl":"https://doi.org/10.1093/med/9780198788850.003.0006","url":null,"abstract":"This chapter summarizes evidence on (i) the prevalence and effects on the unborn and newborn infant of exposure to teratogenic substances such as tobacco, alcohol, or substances during pregnancy, and (ii) what works during the perinatal period in terms of universal and targeted interventions for smoking cessation, and preventing and treating alcohol and drug misuse. It concludes with recommendations for practice, drawing on the evidence presented and best practice guidance, and focusing on strategies for identification and intervention.","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":"75656866","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/9780198788850.003.0029
H. Bedford
Forms of parent-held records have been in existence for well over 100 years, but it is only relatively recently that they have been introduced on a systematic basis in the UK. As part of the review of Health for all children in 2003, the Personal Child Health Record was reviewed in England and a national standard core record introduced, reflecting the content of the child health programme with flexibility to allow for local details. It is intended as a record of growth and development and health events, but not as a repository of detailed health promotion material. This principle also applies in Scotland, Wales, and Northern Ireland with some variation. Parents value it, but apart from health visitors it is not well used by healthcare professionals. A digital version is in development.
{"title":"Personal child health record","authors":"H. Bedford","doi":"10.1093/MED/9780198788850.003.0029","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0029","url":null,"abstract":"Forms of parent-held records have been in existence for well over 100 years, but it is only relatively recently that they have been introduced on a systematic basis in the UK. As part of the review of Health for all children in 2003, the Personal Child Health Record was reviewed in England and a national standard core record introduced, reflecting the content of the child health programme with flexibility to allow for local details. It is intended as a record of growth and development and health events, but not as a repository of detailed health promotion material. This principle also applies in Scotland, Wales, and Northern Ireland with some variation. Parents value it, but apart from health visitors it is not well used by healthcare professionals. A digital version is in development.","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":"83734257","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/9780198788850.003.0016
H. Bedford, D. Elliman
Immunization is a highly successful public health intervention providing protection against serious infectious diseases. UK vaccine uptake rates are generally high, although pockets of lower uptake and social inequalities remain which compromise herd protection. The child health programme provides health professionals opportunities to introduce immunization to parents, offer ongoing information and advice, and remind them when vaccines are due. Improving and maintaining high vaccine rates depends on multicomponent strategies. In view of their relationship with families, health visitors are the key professionals to work with them to ensure that children are immunized fully and in a timely fashion, although in practice they now do not usually deliver vaccines.
{"title":"Integrating immunizations into the programme","authors":"H. Bedford, D. Elliman","doi":"10.1093/MED/9780198788850.003.0016","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0016","url":null,"abstract":"Immunization is a highly successful public health intervention providing protection against serious infectious diseases. UK vaccine uptake rates are generally high, although pockets of lower uptake and social inequalities remain which compromise herd protection. The child health programme provides health professionals opportunities to introduce immunization to parents, offer ongoing information and advice, and remind them when vaccines are due. Improving and maintaining high vaccine rates depends on multicomponent strategies. In view of their relationship with families, health visitors are the key professionals to work with them to ensure that children are immunized fully and in a timely fashion, although in practice they now do not usually deliver vaccines.","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":"86409376","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/9780198788850.003.0001
A. Emond
The first United Nations Sustainable Development Goal is to ‘ensure that all human beings can fulfil their potential in dignity and equality’. Protecting, promoting, and supporting early childhood development is essential to achieve this goal. The foundations of child health and well-being, and of adult health in later life, are laid down in pregnancy and the early years. So this review of evidence takes a life course approach, starting in pregnancy and extending to the age of 7 years, to include transition into school and to cover the ‘early years’.
{"title":"Health for all children: philosophy and principles","authors":"A. Emond","doi":"10.1093/MED/9780198788850.003.0001","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0001","url":null,"abstract":"The first United Nations Sustainable Development Goal is to ‘ensure that all human beings can fulfil their potential in dignity and equality’. Protecting, promoting, and supporting early childhood development is essential to achieve this goal. The foundations of child health and well-being, and of adult health in later life, are laid down in pregnancy and the early years. So this review of evidence takes a life course approach, starting in pregnancy and extending to the age of 7 years, to include transition into school and to cover the ‘early years’.","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":"85125966","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/9780198788850.003.0030
Susan Soar, M. Malone
An increasing body of evidence around the importance of the first 5 years of life has led to rapid development in recent years in services for children of this age, with a policy emphasis on joint working by health visitors and early years practitioners. This coincided with a large expansion in the number of 2-year-old children accessing free early education across the maintained, private, voluntary, and independent sectors. An integrated health and early education review was introduced to review children’s progress at age 2–2½ years, combining the child health programme review at that key contact point and the statutory early years progress check at age 2 years. Carrying out a joint review has placed new demands on the skillsets of both health and early years practitioners, but implementation and follow-up research studies have highlighted some of the potential benefits of joint working for children and families.
{"title":"Health and early years services","authors":"Susan Soar, M. Malone","doi":"10.1093/med/9780198788850.003.0030","DOIUrl":"https://doi.org/10.1093/med/9780198788850.003.0030","url":null,"abstract":"An increasing body of evidence around the importance of the first 5 years of life has led to rapid development in recent years in services for children of this age, with a policy emphasis on joint working by health visitors and early years practitioners. This coincided with a large expansion in the number of 2-year-old children accessing free early education across the maintained, private, voluntary, and independent sectors. An integrated health and early education review was introduced to review children’s progress at age 2–2½ years, combining the child health programme review at that key contact point and the statutory early years progress check at age 2 years. Carrying out a joint review has placed new demands on the skillsets of both health and early years practitioners, but implementation and follow-up research studies have highlighted some of the potential benefits of joint working for children and families.","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":"84436827","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/9780198788850.003.0032
A. Emond, A. Haynes
Five programmes which offer additional services to enhance the child health programmes for families at risk of poorer maternal and child health and development outcomes are being evaluated. Flying Start is a community-based programme targeted on families with children under 4 years of age living in deprived neighbourhoods in Wales. A Better Start is a place-based programme implemented by local partnerships in English wards with high levels of economic deprivation, providing services and support for all families living in the target wards from pregnancy until a child’s fourth birthday. The Family Nurse Partnership is a structured programme of home visits for first-time young mothers. The Maternal Early Childhood Sustained Home-visiting programme is a structured programme of sustained home visiting delivered by health visitors in pregnancy and the first 2 years. The Trial of Healthy Relationship Initiatives for the Very Early-years is comparing two parenting programmes for women with additional mental health or social support needs in pregnancy with outcomes up to 18 months. Early published results are reviewed and links given to the websites to signpost the reader to up-to-date information on the effectiveness of each programme.
{"title":"Enhancements to child health programmes in the UK","authors":"A. Emond, A. Haynes","doi":"10.1093/MED/9780198788850.003.0032","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0032","url":null,"abstract":"Five programmes which offer additional services to enhance the child health programmes for families at risk of poorer maternal and child health and development outcomes are being evaluated. Flying Start is a community-based programme targeted on families with children under 4 years of age living in deprived neighbourhoods in Wales. A Better Start is a place-based programme implemented by local partnerships in English wards with high levels of economic deprivation, providing services and support for all families living in the target wards from pregnancy until a child’s fourth birthday. The Family Nurse Partnership is a structured programme of home visits for first-time young mothers. The Maternal Early Childhood Sustained Home-visiting programme is a structured programme of sustained home visiting delivered by health visitors in pregnancy and the first 2 years. The Trial of Healthy Relationship Initiatives for the Very Early-years is comparing two parenting programmes for women with additional mental health or social support needs in pregnancy with outcomes up to 18 months. Early published results are reviewed and links given to the websites to signpost the reader to up-to-date information on the effectiveness of each programme.","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":"80544283","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/9780198788850.003.0033
M. Blair
This chapter describes the evidence base supporting effective implementation of the child health programme at national and local levels. It reviews the contribution of implementation and improvement science. Training accreditation and the use of learning sets and data feedback loops are described. A key organizational mechanism to ensure local quality assurance and accountability is the formation of a local child health programme steering group. The structure and functions of such are described.
{"title":"Delivering and managing an effective child health programme across the UK","authors":"M. Blair","doi":"10.1093/med/9780198788850.003.0033","DOIUrl":"https://doi.org/10.1093/med/9780198788850.003.0033","url":null,"abstract":"This chapter describes the evidence base supporting effective implementation of the child health programme at national and local levels. It reviews the contribution of implementation and improvement science. Training accreditation and the use of learning sets and data feedback loops are described. A key organizational mechanism to ensure local quality assurance and accountability is the formation of a local child health programme steering group. The structure and functions of such are described.","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":"78615886","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/9780198788850.003.0017
D. Elliman
Screening can be a very important means to reduce the morbidity and mortality of conditions that cannot currently be prevented. However, it also has the capacity to do harm by incorrectly labelling people as having a condition, when in reality they do not, thus causing anxiety and sometimes resulting in unnecessary interventions. The UK National Screening Committee recommends national policy on screening on the basis of the evidence of the overall effects of a potential programme and its cost-effectiveness. Once a programme is introduced, it should be carefully monitored to ensure that it lives up to expectations, coverage is appropriately high, the expected outcomes are delivered, and that it does not increase inequality. More detail can be found on the UK National Screening Committee website.
{"title":"Secondary prevention: principles and good practice/screening tests","authors":"D. Elliman","doi":"10.1093/MED/9780198788850.003.0017","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0017","url":null,"abstract":"Screening can be a very important means to reduce the morbidity and mortality of conditions that cannot currently be prevented. However, it also has the capacity to do harm by incorrectly labelling people as having a condition, when in reality they do not, thus causing anxiety and sometimes resulting in unnecessary interventions. The UK National Screening Committee recommends national policy on screening on the basis of the evidence of the overall effects of a potential programme and its cost-effectiveness. Once a programme is introduced, it should be carefully monitored to ensure that it lives up to expectations, coverage is appropriately high, the expected outcomes are delivered, and that it does not increase inequality. More detail can be found on the UK National Screening Committee website.","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":"76636473","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/9780198788850.003.0008
C. Adams, S. Cowley
This chapter begins by offering some definitions and an explanation of why prevention needs to start with early child development. Then, it considers some of the practicalities of providing primary prevention services, using examples to show the processes of assessing needs and delivering services. Next, key principles and practice approaches that have been found helpful to the preventive effort are explained. Finally, there is a discussion of some effective approaches to health promotion for families and promoting effective parenting.
{"title":"Primary prevention and health promotion in childhood","authors":"C. Adams, S. Cowley","doi":"10.1093/MED/9780198788850.003.0008","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0008","url":null,"abstract":"This chapter begins by offering some definitions and an explanation of why prevention needs to start with early child development. Then, it considers some of the practicalities of providing primary prevention services, using examples to show the processes of assessing needs and delivering services. Next, key principles and practice approaches that have been found helpful to the preventive effort are explained. Finally, there is a discussion of some effective approaches to health promotion for families and promoting effective parenting.","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":"73645953","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/9780198788850.003.0020
D. Elliman
Universal newborn hearing screening has meant that babies with significant congenital hearing impairment can be identified soon after birth and management instituted to ameliorate resultant problems, that is, minimize disability and handicap and optimize life chances. Evidence for the value of school entry screening is lacking and there is some evidence it is neither effective nor cost-effective. Further research is needed on this. Otitis media with effusion can cause significant long-lasting effects and may need surgical intervention or the provision of hearing aids. Parents and professionals should be aware of the symptoms that are indicative of possible hearing loss. Parents’ concerns should always be taken seriously.
{"title":"Identification of hearing impairment","authors":"D. Elliman","doi":"10.1093/MED/9780198788850.003.0020","DOIUrl":"https://doi.org/10.1093/MED/9780198788850.003.0020","url":null,"abstract":"Universal newborn hearing screening has meant that babies with significant congenital hearing impairment can be identified soon after birth and management instituted to ameliorate resultant problems, that is, minimize disability and handicap and optimize life chances. Evidence for the value of school entry screening is lacking and there is some evidence it is neither effective nor cost-effective. Further research is needed on this. Otitis media with effusion can cause significant long-lasting effects and may need surgical intervention or the provision of hearing aids. Parents and professionals should be aware of the symptoms that are indicative of possible hearing loss. Parents’ concerns should always be taken seriously.","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":"88850979","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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