bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emotional labour and befriending in family support and child protection in Tower Hamlets
Authors: Gray Benjamin 
Published: March 2003

ABSTRACTThis paper describes the emotional labour and befriending of families in East London by Family Support Workers (FSWs). The study is derived from an evaluation of the Family Welfare Association's Tower Hamlets Family Support Service. A key finding is that engaging the emotions of families enables high quality and effective support in the family home. FSWs win trust and elicit narratives from families, particularly from mothers and children. The narratives of families are a rich source of informing better practice. In line with Government objectives, the participatory work of FSWs helps to balance understanding on family support, health and child protection. According to Government and research, the early identification of child protection issues is particularly important in mitigating their worst effects. FSWs gain trust and early disclosure on child protection cases. This prevents child care problems from deteriorating into child protection issues. FSWs also act as informal advocates and help to balance social service assessments with the views of families. FSWs take a proactive, non‐stigmatizing, non‐intrusive approach to families. FSWs are sensitive and responsive to the emotions, ethnicity and specific needs of families.
Child protection social work and men's abuse of women: an Irish study
Authors: Holt Stephanie 
Published: March 2003

ABSTRACTThis paper reports the findings of an exploratory study of the response of social workers within a community care setting, in a large Dublin suburb, to cases involving men's abuse of women. This research aims to focus on what child protection workers do regarding this abuse, and what they say about what they do, thereby giving readers a sense of the action taking place in this social work team. The data, generated from both qualitative and quantitative methodological research, reflects this aim, as it taps into the working model of responses to men's abuse of women held by social workers, and identifies what influences that, thereby reflecting the realities and constraints of everyday work.At the time the research was carried out (2000), the results confirm that the prevalence of cases involving men's abuse of women on this team was in line with international findings. This research revealed an absence of a team policy, an agreed definition of intimate violence in this context and agency practice guidelines, and illuminated how these gaps act as a deterrent to effective intervention. This paper explores some of the ethical and practical dilemmas that may arise for child protection social workers intervening in cases where the abuse of women by men is present. Recommendations arising from this research identify a need for a clear policy and best practice guidelines for social work staff in relation to this abuse.
Children and the city: a summary of recent environmental psychology research
Authors: Spencer C , Woolley H 
Published: March 2003

SummaryThe environmental psychology literature is reviewed as it focuses on children’s needs and experiences of towns and cities. Children are, we argue, the unacknowledged outsiders in the planning and management of urban areas; yet their enjoyment of and contribution to these areas is ignored at our peril. We discuss the importance of place attachment in the child’s developing personal identity; and the rich affordances of towns and cities for the child’s well‐being and development, alongside an assessment of the evidence about the social and physical dangers that are more frequently stressed in popular discussions: these range from strangers and street crime, to traffic and pollution. Other related topics reviewed include: children’s favourite places and their role in the child’s self‐regulation; the role of exploration of the local area as part of the child’s widening social and cognitive world; gender differences in patterns of exploration, and whether these might be changing; and examples of children’s involvement at more than a token level in the planning of their communities. The role of children as consumers in the local economy, and their use of public places, malls and plazas, has often been discussed as if they were inevitably socially problematic, and that their presence inevitably led to conflicts with adult users: yet we argue for a view of cityscapes which bring the different strands of society together. We conclude by discussing those Continental European city designs which foster the participation of children in the city’s social life.
Attention to infants in the first year
Authors: Baildam E M , Hillier V F , Menon S , Bannister R P , Bamford F N , Moore W M O , Ward B S 
Published: March 2003

SummaryThe time spent by 158 infants in contact with their carers at 6, 13, 26 and 52 weeks was reviewed prospectively. Periods of contact in the categories of (1) physical care, (2) holding the crying or sleeping infant, and (3) playing and interacting with the infant were recorded using 24‐h log diaries completed by the mother. The mean total carer contact time over a 24‐h day did not change significantly in the first year, varying between 6.5 and 7.3 h. Between 6 and 52 weeks, time spent by the mother in physical care declined significantly from 207 to 143 min and in holding the crying or sleeping infant from 61 to 17 min (P< 0.05 and 0.0001 respectively). There were no significant changes in the amount of time spent in playing and interacting with the infant over the first year by the mother and father, the time being on average 52.7 and 25.0 min respectively. Play and interaction with a non‐parental carer increased significantly from 14 to 69 min (P< 0.0001). Relationships between infant size and holding became weaker as the infant became older. Infant gender, socioeconomic status and duration of breast‐feeding did not influence infant contact time.
Adolescent girls and their babies: achieving optimal birthweight. Gestational weight gain and pregnancy outcome in terms of gestation at delivery and infant birth weight: a comparison between adolescents under 16 and adult women1
Authors: Buschman N A , Foster G , Vickers P 
Published: March 2003

SummaryAims Pregnancy amongst under 16s has been reported to result in worse outcomes for the baby, including low birthweight. This study aimed to find out whether the under 16s need to gain more weight during pregnancy to avoid this outcome.Method A retrospective case control study of pregnancy outcomes in girls delivering before the age of 16 and women delivering aged 25–30. Data was collected from medical case notes, including maternal age, pregnancy weight gain and infant birth weight.Results Although weight gain amongst under 16s was similar to that in the control group, average birthweight of babies born to under 16s was less than in the older group. For both girls and older women greater weight gain in pregnancy did result in higher birth weights.Discussion As younger girls are still growing it may be necessary for them to achieve a greater pregnancy weight gain in order to achieve a satisfactory birth weight.
Antenatal inflammation and infection in chronic lung disease of prematurity
Authors: Miralles R. E. , Hodge R. , Kotecha S. 
Published: March 2003

AbstractIn spite of improved neonatal care, chronic lung disease of prematurity (CLD) remains a major cause of morbidity and mortality in extremely preterm infants. Our current understanding is that antenatal infection can trigger intra‐uterine inflammation which then promotes preterm labour. Recent studies suggest that antenatal infection and inflammation can also increase the preterm infant's susceptibility to develop CLD. It may be that exposure of the fetal lung to high concentrations of pro‐inflammatory cytokines is the cause of this increased susceptibility. One candidate for initiating intra‐uterine inflammation is ascending infection by the vaginal commensal Ureaplasma urealyticum (Uu). Antibiotics administered to mothers prior to delivery appear to improve the neonatal outcome in cases of preterm prolonged rupture of membranes, but not in cases of preterm labour with intact membranes. Uu can be transmitted vertically to the airways of the preterm infant, but the role of Uu in causing CLD remains uncertain. Small trials of antibiotics given to preterm infants after delivery have not shown any consistent benefit in reducing CLD. Although CLD remains a significant problem for the extremely preterm infant, it is likely that molecular biology techniques, such as the polymerase chain reaction, will enhance the detection of antenatal infection and further our understanding of the pathogenesis of CLD.
Can maternal depression increase infant risk of illness and growth impairment in developing countries?
Authors: Rahman A. , Harrington R. , Bunn J. 
Published: March 2003

SummaryDespite relative improvement in living conditions and availability of modern healthcare, infant mortality rates continue to be very high in many developing countries. High rates of depression have also been reported in women in these countries. The continuous care and attention of children is a demanding task, and poor physicalormental health in mothers might be expected to have adverse consequences on their children’s health, nutrition and psychological well‐being. Review of published literature reveals very little research in developing countries on the association between poor mental health in mothers and the subsequent physical well‐being of their children. We hypothesize that the level of care provided by mothers with depression may put their infants at higher risk of infection and impaired growth, compared with infants of mothers without depression. We outline approaches to test such a hypothesis in a developing country, and discuss its implications.
Communicating about pupils in mainstream school with special health needs: the NHS perspective
Authors: Mukherjee S. , Lightfoot J. , Sloper P. 
Published: March 2003

Abstract
Aim
To add to previous research carried out with young people, parents and teachers, by investigating health staff’s perspectives on the difficulties, and possibilities for, achieving good communication with school staff with regard to children in mainstream school with a chronic illness or physical disability.
Research design and methods
A qualitative research study was carried out in one NHS Trust. Twenty semi‐structured interviews were carried out with a purposive sample of health staff to cover the spectrum of professionals who have responsibility for meeting the needs of children with a chronic illness or physical disability in mainstream schools (paediatricians, school doctors, school nurses, specialist nurses, health visitors, GPs, speech and language therapists, paediatric occupational therapists, paediatric physiotherapists, clinical psychologists and psychiatrists).
Results
The extent to which health professionals communicated with school staff, and the way in which they went about it, varied widely. Communication was facilitated by joint meetings, shared documentation, and local policy development. Sources of difficulty in communication between health and education staff were: the parent as a conduit of information; the practical difficulties of arranging meetings; and lack of knowledge about other professionals’ roles. The ethos of the school with regard to health matters, and the flow of information within health services, also had an impact on the communication process. Participants’ recommendations focused on two key issues: clarification of the roles of health and education staff with regard to this group of pupils; and how information should flow from health to school staff.
Discussion
Many of the findings parallel the previous research with teachers, indicating agreement between professionals from different agencies about aspects of the communication process which are problematic and require attention. The findings suggest that improving communication requires both joint work between health and education staff, and improvements to practice within each agency.
Is puberty getting earlier? The views of doctors and teachers
Authors: Finlay F. O. , Jones R. , Coleman J. 
Published: March 2003

AbstractAims To determine the views of teachers, general practitioners (GPs) and paediatricians about whether there has been a recent change in the timing of the onset of puberty in children in the UK and in the timing of menarche in girls.Design Questionnaires were sent to a stratified random sample of each professional group.Results In relation to girls, almost 80% of teachers believe that the onset of puberty is occurring earlier, and 73% feel that the menarche is occurring earlier. Those who had been working for longer than 10 years were more likely to say that the age of onset of puberty had decreased. GPs feel that both puberty and menarche are starting earlier, whereas paediatricians were evenly divided between those who thought puberty was starting earlier and those who thought that the timing had not changed. In boys, professionals generally believe that the timing of the onset of puberty has not altered significantly.Conclusion Further study is required to determine whether puberty is really occurring earlier in girls.
Financial effects for families after the death of a disabled or chronically ill child: a neglected dimension of bereavement
Authors: Corden A. , Sloper P. , Sainsbury R. 
Published: March 2003

AbstractAim To investigate the financial circumstances of families whose child had died after a long‐term illness and the factors contributing to financial difficulties.Research methods Qualitative exploration involved semi‐structured interviews with a purposive sample of 16 families whose child had died in the last 2 years and who were in touch with a children’s hospice.Results All parents were affected by loss of or reduction in social security benefits. This could result in an immediate drop in income of as much as 72%. Paying for funerals and headstones could be hard. Financial problems after the child’s death often had origins in the period of care, when parents had reduced incomes but faced extra costs of care. Some families had got into debt. Re‐engaging with employment could be a slow process, and it was not clear where professional responsibility lay in providing financial advice and support. Insensitive treatment by administrative agencies increased problems for parents.Discussion Findings provide further evidence of the financial impact for families of caring for severely disabled children. This study shows how this impact can extend far into the period after death. Findings indicate the need for financial advice and support to families both during the period of care and after bereavement.
The meaning of a multimodal approach for children with ADHD: experiences of service professionals
Authors: Hazelwood E. , Bovingdon T. , Tiemens K. 
Published: March 2003

AbstractBackground Attention‐Deficit/Hyperactivity Disorder (ADHD) is a childhood mental disorder characterized by inattention, impulsiveness and overactivity. It is also characterized by heterogeneity and ambiguity. Effective intervention is influenced by these two factors. This pervasive disorder impacts various domains of functioning, including academics, peer relations, familial relationships and self‐esteem. A confounding factor is the high rate of comorbidity with diagnoses such as learning disabilities, oppositional defiant disorder or conduct disorder. No one intervention has emerged as maximally effective across all symptoms and domains. Consequently, a multimodal approach is regarded as the favoured method of intervention. However, no clear definition of ‘multimodal’ exists.Method This study explored the meaning of multimodal from the perspective of professionals employed in a tertiary care hospital setting in which children with ADHD are assessed and treated. A qualitative design using a phenomenological approach allowed professionals to speak from their practice experiences.Results and Conclusion Although no clear definition of multimodal emerged, professionals identified issues key to this approach and proposed a model for intervention.
Involving disabled and chronically ill children and young people in health service development
Authors: Sloper P. , Lightfoot J. 
Published: March 2003

AbstractAim   To investigate the extent and nature of involvement of physically disabled or chronically ill children and young people in local health service development.Methods   A postal survey of all health authorities (n = 99) and NHS Trusts (n = 410) in England.Results   Seventy‐six per cent of health authorities and 59% of Trusts responded. Twenty‐seven initiatives involving chronically ill or disabled children and young people in consultation regarding service development were identified. Over half of these were carried out in partnership between health services and other agencies, usually local authorities and/or voluntary organizations. A variety of methods was used for consultation, including child‐friendly methods such as drawing, drama and making a video. Seventeen initiatives reported that children's involvement had resulted in service changes, but only 11 went beyond consultation to involve children and young people in decision making about service development. Only a third of the organizations had someone with designated responsibility for children's involvement.Discussion   The involvement of this group of children and young people in service development in the NHS is at an early stage. The failure of policy documents on user involvement to identify children and young people as a group for whom methods of consultation need to be developed, and the lack of people with designated responsibility for developing children's involvement may be a reason for slow progress in this area. The initiatives identified show that such involvement is possible and can have a positive impact on services.
Mechanisms of acute eosinophilic inflammation in a case of acute eosinophilic pneumonia in a 14‐year‐old girl
Authors: Godding  , Bodart  , Delos  , Sibille  , Galanti  , DE Coster  , Jarjour  , Busse  
Published: March 2003

BackgroundAcute eosinophilic pneumonia (AEP) is characterized by respiratory distress, eosinophilic infiltration in the lung, acute onset, resolution of symptoms with corticosteroids and the absence of relapse. Studies to identify the pathophysiology of AEP in adults have demonstrated eosinophil activation in the BAL fluid, and the presence of high levels of interleukin 5 (IL‐5) in the BAL.ObjectiveTo investigate the pathophysiology of AEP with pleural effusion in a paediatric patient.MethodsECP levels in the BALand pleural fluid was determined by radioimmunoassay. IL‐5 and GM‐CSF concentrations in the BAL and pleural fluid were measured by Elisa. Immunohistochemistry studies performed on open lung biopsy included a specific ICAM‐1 immunostaining and a ECP specific immunostaining (EG2+).ResultsHigh levels of ECP were found in the BAL (5 μg/L) and pleural fluid (750 μg/L) demonstrating eosinophil activation at these sites. Immunohistochemistry illustrated activated (EG2+) eosinophils in the interalveolar septa and alveolar space and detected increased expression of ICAM‐1 on alveolar epithelial cells. High levels of IL‐5 were measured in the BAL (1334 pg/mL) and pleural fluid (7014 pg/mL), while elevated concentrations of GM‐CSF (150 pg/mL) were found in the BAL.ConclusionWe conclude that in this paediatric patient with AEP activated eosinophils were present in the BAL fluid, in the interalveolar septa and in the pleural space while increased ICAM‐1 expression was detected on alveolar epithelial cells, contributing, at least partly, for their adhesive interactions. IL‐5 and GM‐CSF are likely important to the massive eosinophil recruitment and activation in the lung, while IL‐5 is probably related to eosinophil accumulation and activation in the pleural space. Thus, lung generation of eosinophil‐active cytokines is central to the pathophysiology of AEP in paediatric patients.
Exhaled and nasal nitric oxide is increased in laboratory animal allergy
Authors: Adisesh  , Kharitonov  , Yates  , Snashell  , Newman‐Taylor  , Barnes  
Published: March 2003

BackgroundAllergens from rats, mice, guinea pigs or rabbits cause up to 30% of exposed persons to develop specific immunoglobulin E (IgE) responses. Laboratory animal allergy (LAA) is among the highest occupational risks for asthma in the UK. Elevated levels of nitric oxide (NO) are found in exhaled breath in asthma. In LAA symptoms may progress from conjunctivitis, rhinitis to asthma. Health surveillance aims to detect early sensitization.ObjectiveTo assess whether an association exists between LAA and exhaled NO.MethodsA cross‐sectional study was performed in 39 laboratory workers undergoing LAA health surveillance. Volunteers completed two health questionnaires, had skin‐prick tests, spirometry, total IgE and RAST tests. Exhaled and nasal NO was measured by chemiluminescence analyser (LR2000, Logan Research, Rochester, UK).ResultsThere were 23 asymptomatic subjects (mean age 29.53 yearss) and 16 symptomatic subjects (29.63 yearss, P = 0.95); 9 early LAA, seven LAA asthma. Exhaled NO was raised in those with LAA symptoms 17.97 ppb ± 1.24 (mean ± SEM) compared with asymptomatics 6.08 ppb ± 1.15, P < 0.05. A trend of increased NO by allergic status was observed; asymptomatic, to early LAA, to asthma. One‐way analysis of variance compared differences between groups (F ratio 13.93, P < 0.001). Symptomatic subjects also had raised nasal NO, vs asymptomatic subjects (mean difference 378 ppb, P < 0.05). A trend was again observed by allergic status (F ratio 5.28, P = 0.01).ConclusionRaised NO levels in LAA increasing with symptom severity suggest NO may prove a useful additional tool in monitoring for LAA, and possibly the response to exposure reduction or allergy due to other respiratory sensitizers.
Intranasal salmeterol inhibits allergen‐induced vascular permeability but not mast cell activation or cellular infiltration
Authors: Proud  , Reynolds  , Lichtenstein  , Kagey‐Sobotka  , Togias  
Published: March 2003

BackgroundSalmeterol is a long‐acting β2‐adrenergic agonist that is widely used in the treatment of asthma. It has been suggested that non‐bronchodilator actions of salmeterol may contribute to its efficacy.ObjectiveTo further evaluate the potential non‐bronchodilator actions of salmeterol in vivo, using a model of nasal challenge with allergen.MethodsTwelve asymptomatic subjects with seasonal allergic rhinitis participated in a randomized, double‐blind, placebo‐controlled crossover trial of the effects of a single dose of 100 μg of salmeterol on the response to allergen challenge. Sneezing and symptom scores, and levels of histamine and albumin in nasal lavages, were measured throughout the protocol. Concentrations of tryptase, prostaglandin D2 and lysozyme were measured during the acute allergic response, while levels of IL‐3, IL‐5 and IL‐8 were measured at later time points. Numbers of eosinophils and of total white blood cells were also recorded.ResultsSalmeterol did not affect sneezing or symptom scores at any point. During the immediate response to allergen challenge, mast cell activation, reflected by concentrations of histamine, tryptase and prostaglandin D2, and serous glandular secretion, assessed by measurements of lysozyme, were unaffected by salmeterol treatment but vascular permeability, reflected by concentrations of albumin in nasal lavages, was significantly reduced. At later time points, salmeterol had no effect on levels of histamine or albumin and did not affect cellular infiltration. Concentrations of IL‐3, IL‐5 and IL‐8 were not increased by allergen challenge in these subjects, so the effects of salmeterol could not be evaluated.ConclusionsTreatment with a single dose of salmeterol had no effect on activation of mast cells or cellular infiltration but inhibited vascular permeability. The ability of salmeterol to inhibit antigen‐induced vascular permeability may contribute to its therapeutic efficacy in asthma.