Heart defects and ocular anomalies in children with Down's syndrome

Aims: To investigate whether ocular anomalies are associated with congenital heart defects in children with Down’s syndrome. Methods: 58 children with Down’s syndrome were entered into a retrospective observational study. Children were assigned to heart defect groups based on medical records. Optometric tests had previously been carried out at the homes of the children. Results: A relation between congenital cardiac defects, myopia, and nystagmus was observed. Heart problems were not related to accommodative insufficiency, hyperopia, or strabismus. Conclusion: In children with Down’s syndrome heart defects were associated with both myopia and nystagmus

An ethical approach to resolving value conflicts in child protection

Child protection professionals working in diverse societies are regularly faced with value conflicts. Recognising these, and resolving them in the best interests of children, is a task that requires child protection specialists to make complex judgements and decisions. In this paper the philosophical concepts of absolutism and relativism to child abuse are applied, and it explores how this approach has practical relevance to solving ethical dilemmas in child protection. Children’s interests are best served by erring towards an absolutist approach to the diagnosis and recognition of maltreatment and towards a relativistic approach in determining how services respond to a harmful incident or situation. Absolutism and relativism are not alternatives, but part of a continuous process of recognising and negotiating ever-changing community, national and global norms. At the service level the dichotomy transpires into the need to be culturally competent in handling the conflicting needs, rights and values of children, families, communities and professionals, whilst retaining the skill of child advocacy

Residential area as proxy for socio-economic status, paediatric mortality and birth weight in Lusaka, Zambia

Systems of socio-economic classification comparable to the Registrar General's Social Classification or post codes are not readily available in many developing countries. Thus health data from developing countries are usually presented without a refined geographical focus. The hierarchical urban residential classification system in Zambia was used as a socio-economic proxy to explore the relationship with mass measures of paediatric health in Lusaka, Zambia. This study shows that the Zambian urban residential classification system appears to be a valid proxy of socio-economic status, revealing residential gradients with respect to birth weight and paediatric mortality rates in Lusaka

The voices of children and young people in health: where are we now?

Universal children's day on 20 November 2014 marked the 25th anniversary of the UN Convention on the Rights of the Child (UNCRC,1989)2 and the 55th anniversary of the Declaration of the Rights of the Child (1959).3 Twenty-five years after the UNCRC, this article explores the rights of children and young people (CYP) to participate in decisions about their healthcare, and the benefits of doing so; we then examine where we are now with respect to the voices of CYP in health. This article addresses this final question through three aspects: first, by celebrating the progress made over the last quarter of a century—particularly with respect to policy development—both in the UK and internationally; second, by identifying ongoing areas of concern, with suggestions as to where to focus our efforts next; and finally, by calling for a change in culture. This change of culture is suggested through four positive concrete steps: a greater dissemination of guidance and examples of good practice, greater evaluation of the participatory process, appropriate training and procedures in place to support CYP participation and finally encouraging increased involvement of CYP in improving their own health. Through these steps, we aim towards a culture where CYP are valued, heard, understood and, ultimately, their rights are respected

Burden and consequences of child maltreatment in high-income countries

Child maltreatment remains a major public-health and social-welfare problem in high-income countries. Every year, about 4–16% of children are physically abused and one in ten is neglected or psychologically abused. During childhood, between 5% and 10% of girls and up to 5% of boys are exposed to penetrative sexual abuse, and up to three times this number are exposed to any type of sexual abuse. However, offi cial rates for substantiated child maltreatment indicate less than a tenth of this burden. Exposure to multiple types and repeated episodes of maltreatment is associated with increased risks of severe maltreatment and psychological consequences. Child maltreatment substantially contributes to child mortality and morbidity and has longlasting eff ects on mental health, drug and alcohol misuse (especially in girls), risky sexual behaviour, obesity, and criminal behaviour, which persist into adulthood. Neglect is at least as damaging as physical or sexual abuse in the long term but has received the least scientifi c and public attention. The high burden and serious and long-term consequences of child maltreatment warrant increased investment in preventive and therapeutic strategies from early childhood