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Publication History View all

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    ABSTRACT: This article reports the results of a review of the research evidence related to joint working in the field of adult health and social care services in the UK. It explores whether recent reforms to joint working have met the objectives set by policy-makers. The review followed an established methodology: electronic databases were searched using predetermined terms, abstracts were screened against inclusion criteria, studies that met the criteria were read in full and assessed for inclusion and data were extracted systematically. The findings of the review suggest that there is some indication that recent developments, in particular the drive to greater integration of services, may have positive benefits for organisations as well as for users and carers of services. However, the evidence consistently reports a lack of understanding about the aims and objectives of integration, suggesting that more work needs to be done if the full potential of the renewed policy agenda on integration is to be realised. Additionally, while the review acknowledges that greater emphasis has been placed on evaluating the outcome of joint working, studies largely report small-scale evaluations of local initiatives and few are comparative in design and therefore differences between 'usual care' and integrated care are not assessed. This makes it difficult to draw firm conclusions about the effectiveness of UK-based integrated health and social care services.
    Health & Social Care in the Community 06/2013;
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    ABSTRACT: OBJECTIVE: To identify reasons why eligible families are not accessing free 'Healthy Start' vitamin supplementation (providing vitamins A, C and D) in England. DESIGN: Qualitative study using in-depth interviews. SETTING: 13 primary care trusts in England. PARTICIPANTS: Purposive sample of 15 Healthy Start coordinators, 50 frontline health and children's professionals and 107 parents. RESULTS: Vitamin take-up was low across all research sites, reported as below 10% of eligible beneficiaries for free vitamins. Reasons identified by both parents and professionals included (1) poor accessibility of vitamins, (2) low promotion of the scheme by health professionals, (3) a lack of awareness among eligible families, and (4) low motivation among mothers to take vitamins for themselves during pregnancy or for children under 4 years old. CONCLUSIONS: Low uptake rates can be explained by poor accessibility of vitamins and lack of awareness and motivation to take vitamin supplements among eligible families. Universal provision (at least for pregnant women) and better training for health professionals are identified as potential solutions worthy of further research and evaluation.
    Archives of Disease in Childhood 05/2013;
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    The journal of family health care 05/2013; 23(4):12-5, 17.
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    ABSTRACT: BACKGROUND: Previous research has established that poor diets and eating patterns are associated with numerous adverse health outcomes. This study explored the relationships between two specific eating behaviours (daily junk food consumption and irregular eating) and self-reported physical and mental health of secondary school children, and their association with perceived parenting and child health. METHODS: 10 645 participants aged between 12 and 16 completed measures of junk food consumption, irregular eating, parental style, and mental and physical health through the use of an online survey implemented within 30 schools in a large British city. RESULTS: 2.9% of the sample reported never eating regularly and while 17.2% reported daily consumption of junk food. Young people who reported eating irregularly and consuming junk food daily were at a significantly greater risk of poorer mental (OR 5.41, 95% confidence interval 4.03-7.25 and 2.75, 95% confidence interval 1.99-3.78) and physical health (OR 4.56, 95% confidence interval 3.56-5.85 and 2.00, 95% confidence interval 1.63-2.47). Authoritative parenting was associated with healthier eating behaviours, and better mental and physical health in comparison to other parenting styles. DISCUSSION: A worrying proportion of secondary school children report unhealthy eating behaviours, particularly daily consumption of junk food, which may be associated with poorer mental and physical health. Parenting style may influence dietary habits. Interventions to improve diet may be more beneficial if also they address parenting strategies and issues related to mental and physical health.
    Child Care Health and Development 04/2013;
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    ABSTRACT: This paper examined whether a two-year change in fitness, body mass index (BMI) or the additive effect of change in fitness and BMI were associated with change in cardiometabolic risk factors among youth. Cardiometabolic risk factors, BMI group (normal weight, overweight or obese) were obtained from participants at the start of 6th grade and end of 8th grade. Shuttle run laps were assessed and categorized in quintiles at both time points. Regression models were used to examine whether changes in obesity, fitness or the additive effect of change in BMI and fitness were associated with change in risk factors. There was strong evidence (p < .001) that change in BMI was associated with change in cardiometabolic risk factors. There was weaker evidence of a fitness effect, with some evidence that change in fitness was associated with change in total cholesterol, HDL-C, LDL-C and clustered risk score among boys, as well as HDL-C among girls. Male HDL-C was the only model for which there was some evidence of a BMI, fitness and additive BMI*fitness effect. Changing body mass is central to the reduction of youth cardiometabolic risk. Fitness effects were negligible once change in body mass had been taken into account.
    Pediatric exercise science 02/2013; 25(1):52-68.
  • BMJ (online) 05/2012; 344:e3386.
  • Neuromuscular Disorders 03/2012; 22(5):445-6.
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    ABSTRACT: The numbers of children in kinship care in England has been thought to be substantial, but it is only recently that research has begun to illuminate the circumstances and needs of carers and children. This paper describes the findings of an analysis of the 2001 UK Population Census. For the first time, the numbers of children in kinship care were estimated, as was the proportions of children living in formal and informal kinship care. As expected many children were being brought up by grandparents but surprisingly, large numbers of children were living with an older sibling. This group of kinship carers has not been previously identified by researchers or policy makers and their circumstances and needs may differ from grandparent kinship carers.
    Children and Youth Services Review - CHILD YOUTH SERV REV. 01/2012;
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    ABSTRACT: Background  Developmental problems in children can be alleviated to a great extent with early detection and intervention through periodic screening for developmental delays during pre-school ages. Currently, there is no established system for developmental screening of children in Sri Lanka. Although some developmental norms, which are similar to those of Denver Developmental Screening Test-II (DDST-II), have been introduced into the Sri Lankan Child Health Developmental Record (CHDR), those norms have not been standardized to the Sri Lankan child population. The aim of this research was to establish Sri Lankan norms for DDST-II and to test the universal and regional applicability of developmental screening tests by comparing the Sri Lankan norms with the norms of DDST-II and DDST-Singapore norms, the geographically nearest standardization of DDST-II. The norms were also compared with the milestones already available in the CHDR. Methods  DDST-II was adapted and standardized on a sample of 4251 Sri Lankan children aged 0-80 months. Thirteen public health nursing sisters were trained to collect the data as part of their routine work. The 25th, 50th, 75th and 90th percentile ages of acquiring each developmental milestone were then calculated using logistic regression. Results  The Denver Developmental Screening Test for Sri Lankan Children (DDST-SL) was created. Most of the established DDST-SL norms were different to the comparable norms in DDST-II, DDST-Singapore and the CHDR. Conclusions  In view of the results of the study, it is imperative that developmental screening tests are used in context and are adapted and standardized to the populations in question before utilization.
    Child Care Health and Development 10/2011; 38(6):889-99.
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    ABSTRACT: To explore the views of British 10-11 year old children towards reducing their screen-viewing and their screen-viewing reduction strategies. 10 focus groups were conducted with 55 10-11 year old children (30 girls, 25 boys) in Bristol (UK) in 2010. Data were transcribed and transcripts were analysed using thematic analysis. Three main themes were developed: Reaction to Reduction; Reduction: What, when and what else instead?; and Strategies to reduce screen-viewing. Participants reacted largely positively to reducing their screen-viewing although enjoyment, established routines and favourite TV programmes presented barriers. A range of screen-viewing modes were put forward as candidates for reduction and participants believed they would replace screen-viewing with both physically active and non-screen sedentary behaviours. Reduction strategies identified comprised the provision of alternative activities, facilities and after school clubs, peer-led educational interventions, behavioural strategies such as the use of rewards, charts and time limits which involved children's parents and parent-child collaboration. Unexpectedly, participants identified the focus group itself as a means of encouraging self-reflection and initiating change. Children appeared open to screen-viewing reduction and identified the strategies that they may respond to best. This can inform the development of interventions designed to reduce screen-viewing.
    Preventive Medicine 08/2011; 53(4-5):303-8.
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