Trauma-informed services and trauma-specific care for Indigenous Australian children

This paper examines how childhood trauma experienced by Indigenous children can be overcome by appropriate interventions.IntroductionWhile many Indigenous and non-Indigenous Australian children grow up in safe homes and live in safe communities, there are some who do not. In the case of Indigenous children, some families and communities are unable to, or are still working to, heal the trauma of past events, including displacement from Country, institutionalisation and abuse. The Stolen Generations also represent a significant cause of trauma. In 2008, an estimated 8% of Indigenous people aged 15 and over reported being removed from their natural family and 38% had relatives who had been removed from their natural family. This trauma can pass to children (inter-generational trauma).Indigenous children may also experience a range of distressing life events including illness and accidents, hospitalisation or death of close family members, exposure to violence, family disintegration (with kin networks fragmented due to forced removals, relationship breakdown and possibly incarceration) and financial stress.Experiencing trauma in childhood can have severe and long-lasting effects; effects that can be overcome by appropriate interventions. This resource sheet examines these effects and explores how they can be tackled. It focuses on the design and delivery of trauma-informed and trauma-specific children’s services and care

Speaking the unspeakable in forbidden places: addressing lesbian, gay, bisexual and transgender equality in the primary school

This paper interrogates the ways in which school is produced as a particular bounded place (or collection of places) where sexuality, and particularly non-heterosexuality, is carefully policed by these boundaries. Drawing upon data generated in primary schools during a nationwide action research project (No Outsiders), we focus on three very different school places: the classroom, the staff room and a school -based afterschool art club. Our analysis engages with the contingency of place-making to show that place is neither a unitary experience nor a neutral stage upon which social relations are enacted. The three vignettes analysed offer insights into the critical potential of consciously and persistently working across (apparently) boundaried spaces within and beyond schools

Guideline for UK midwives/health visitors to use with parents of infants at risk of developing childhood overweight/obesity

A guideline for members of the health visiting team to use with parents of infants at risk of overweight/obesity has been developed. The guideline contains recommendations about identification of infants at risk as well as a number of strategies that could be used for prevention of overweight/obesity. The guideline needs to be applied alongside health visitors’ professional judgement. It is not intended to replace normal UK clinical practice which is guided by the Healthy Child Programme and complements existing guidance such as the Framework for Action for tackling obesity

Development of an evidence-based practice guideline for UK public health nurses (health visitors) to use with parents of infants at risk of obesity

Introduction: Evidence about effective interventions that reduce obesity risk during infancy is needed. This project aimed to systematically review published Randomised Controlled Trials (RCTs) of behavioural and non-behavioural interventions which address potential risk factors for obesity to inform a guideline for UK health visitors. Methods: A multiprofessional Guideline Development Group (GDG) was convened to undertake a systematic review, based on the National Institute for Health and Clinical Excellence (NICE) guidelines. Findings from the review were used to develop a guideline which was subsequently externally reviewed by national experts and practitioners. Results: We identified 28 RCTs reporting behavioural and non-behavioural interventions delivered during infancy with breastfeeding and/or weight outcomes measured during the first two years of life. A number of on-going studies were also identified. Inclusion criteria for intervention studies included parental breastfeeding intentions and first time parents. Good evidence exists for breastfeeding promotion and support interventions. Evidence exists for parental education around responsive feeding, aspects of infant diet and soothing/sleep expectations. These behavioural components informed the guideline. Despite good evidence that infants fed lower protein formula milk gained less weight compared to milk with higher protein levels, it was not possible to incorporate the evidence from the non-behavioural studies into the guideline. Conclusion: Further research is needed to establish clinically effective interventions for obesity prevention during infancy. Continuous dialogue between commissioners, policy makers, health visitors and parents is essential to ensure existing UK policies are not a barrier to implementing obesity prevention strategies in the first year of life

Untargeted metagenomics protocol for the diagnosis of infection from CSF and tissue from sterile sites

Metagenomic next-generation sequencing (mNGS) is an untargeted technique capable of detecting all microbial nucleic acid within a sample. This protocol outlines our wet laboratory method for mNGS of cerebrospinal fluid (CSF) specimens and tissues from sterile sites. We use this method routinely in our clinical service, processing 178 specimens over the past 2.5 years in a laboratory that adheres to ISO:15189 standards. We have successfully used this protocol to diagnose multiple cases of encephalitis and hepatitis

Mapping habitat indices across river networks using spatial statistical modelling of River Habitat Survey data

Freshwater ecosystems are declining faster than their terrestrial and marine counterparts because of physical pressures on habitats. European legislation requires member states to achieve ecological targets through the effective management of freshwater habitats. Maps of habitats across river networks would help diagnose environmental problems and plan for the delivery of improvement work. Existing habitat mapping methods are generally time consuming, require experts and are expensive to implement. Surveys based on sampling are cheaper but provide patchy representations of habitat distribution. In this study, we present a method for mapping habitat indices across networks using semi-quantitative data and a geostatistical technique called regression kriging. The method consists of the derivation of habitat indices using multivariate statistical techniques that are regressed on map-based covariates such as altitude, slope and geology. Regression kriging combines the Generalised Least Squares (GLS) regression technique with a spatial analysis of model residuals. Predictions from the GLS model are ‘corrected’ using weighted averages of model residuals following an analysis of spatial correlation. The method was applied to channel substrate data from the River Habitat Survey in Great Britain. A Channel Substrate Index (CSI) was derived using Correspondence Analysis and predicted using regression kriging. The model explained 74% of the main sample variability and 64% in a test sample. The model was applied to the English and Welsh river network and a map of CSI was produced. The proposed approach demonstrates how existing national monitoring data and geostatistical techniques can be used to produce continuous maps of habitat indices at the national scale

Early years' prevention of childhood obesity: the challenges facing UK health visitors

Objectives A number of modifiable risk factors are associated with the development of childhood obesity. These are lower breast feeding duration, early weaning onto solid foods, parental response to infant temperament and parental control over food intake. This study explored parents’ beliefs concerning their infant’s size and growth and their receptiveness to intervention aimed at reducing the risk of childhood obesity. Method Six focus groups were undertaken in a range of different demographic areas, with parents of infants less than one year old. The focus groups were audio-recorded, transcribed verbatim and subjected to thematic analysis using an interpretative, inductive approach. Results 38 parents (n=36 female, n=2 male), age range 19-45 years (mean 30.1 years, SD 6.28) participated in the focus groups. Half the sample were overweight (n=12) or obese (n=8). Five main themes were identified. These were a) rationalisation for infant’s larger size, b) parents’ understanding of breastfed infants’ growth and age-related behaviour; c) parents’ understanding of infant growth, developmental norms and feeding practices, d) belief that nothing can be done about overweight/obese infants and e) intentions and behaviour in relation to a healthy diet. Conclusions Some risk factors for childhood obesity are potentially modifiable. Parents are receptive to prevention prior to weaning and need better support with best practice in infant feeding. This should focus on helping them understand the physiology of breast feeding, the rationale around weaning at 6 months and how to recognise that hunger is only one explanation for infant distress and behaviour change

Different trajectories of decline for global form and global motion processing in ageing, Mild Cognitive Impairment and Alzheimer’s disease

The visual processing of complex motion is impaired in Alzheimer's disease (AD). However, it is unclear whether these impairments are biased toward the motion stream or part of a general disruption of global visual processing, given some reports of impaired static form processing in AD. Here, for the first time, we directly compared the relative preservation of motion and form systems in AD, mild cognitive impairment, and healthy aging, by measuring coherence thresholds for well-established global rotational motion and static form stimuli known to be of equivalent complexity. Our data confirm a marked motion-processing deficit specific to some AD patients, and greater than any form-processing deficit for this group. In parallel, we identified a more gradual decline in static form recognition, with thresholds raised in mild cognitive impairment patients and slightly further in the AD group compared with controls. We conclude that complex motion processing is more vulnerable to decline in dementia than complex form processing, perhaps owing to greater reliance on long-range neural connections heavily targeted by AD pathology

Using interactive digital technology to predict and prevent childhood overweight

Special Issue: 27th congress of the European Childhood Obesity Group, ECOG abstracts in 2017, 15–17 November 2017, Rome, Ital