178 results found
Blair M, Rigby M, Alexander D, 2019, Issues and Opportunities in Primary Health Care for Children in Europe The Final Summarised Results of the Models of Child Health Appraised (MOCHA) Project, Publisher: Emerald Publishing Limited, ISBN: 9781789733549
This book presents the scientific findings of a three-year project across 30 EU and EEA countries assessing primary care for children throughout the life-course, drawing from 20 academic partners' analysis of evidence produced by agents in ...
Zdunek K, Schröder-Bäck P, Alexander D, et al., 2019, How does societal reaction to children's health issues contribute to health policy in Europe? Results of a survey., Child Care Health Dev, Vol: 45, Pages: 364-370
BACKGROUND: In the European context the awareness of societal responsibility for children's health has increased with greater attention to children's rights and child empowerment processes. Child health issues are considered particularly sensitive; thus, they often provoke strong societal reactions, which, as a consequence, influence national health policies across Europe. Effectiveness of societal influences increases with the involvement of various actors in the context. METHODS: A qualitative approach was used to identify the level of societal involvement in health decision-making. A questionnaire was sent to the Country Agents (CAs) of the Models of Child Health Appraised (MOCHA) project. CAs are contact points in each of the 30 participating in the project countries and were asked to identify strong public and professional discussions related to child health services in their countries. Data collection was undertaken between July and December 2016. RESULTS: Based on 71 case studies, we identified eight thematic patterns, which characterize societal reactions to the currently worrisome child health issues across Europe. We devoted our attention to the three most controversial: child vaccination, child poverty and child abuse. The cases described by the CAs show the broad perspective in the perception of child health problems. Child health issues involve the public and raise nationwide debates. Public concerns were directly or indirectly related to child health and depicted the national overtone. CONCLUSIONS: Concerns in Europe about child health care are twofold: they are devoted to systemic issues (indirect patient orientation) and to child health and well-being (direct patient orientation). The phenomenon of societal responsibility for children's health is important for the support of public acceptance of child health policy.
Hoang U, Liyanage H, Coyle R, et al., 2019, Determinants of inter-practice variation in childhood asthma and respiratory infections: cross-sectional study of a national sentinel network., BMJ Open, Vol: 9
OBJECTIVES: Respiratory infections are associated with acute exacerbations of asthma and accompanying morbidity and mortality. In this study we explore inter-practice variations in respiratory infections in children with asthma and study the effect of practice-level factors on these variations. DESIGN: Cross-sectional study. SETTING: We analysed data from 164 general practices in the Royal College of General PractitionersResearch and Surveillance Centresentinel network in England. PARTICIPANTS: Children 5-12 years. INTERVENTIONS: None. In this observational study, we used regression analysis to explore the impact of practice-level determinants on the number of respiratory infections in children with asthma. PRIMARY AND SECONDARY OUTCOME MEASURES: We describe the distribution of childhood asthma and the determinants of upper/lower respiratory tract infections in these children. RESULTS: 83.5% (137/164) practices were in urban locations; the mean number of general practitioners per practice was 7; and the mean duration since qualification 19.7 years. We found almost 10-fold difference in the rate of asthma (1.5-11.8 per 100 children) and 50-fold variation in respiratory infection rates between practices. Larger practices with larger lists of asthmatic children had greater rates of respiratory infections among these children. CONCLUSION: We showed that structural/environmental variables are consistent predictors of a range of respiratory infections among children with asthma. However, contradictory results between measures of practice clinical care show that a purely structural explanation for variability in respiratory infections is limited. Further research is needed to understand how the practice factors influence individual risk behaviours relevant to respiratory infections.
Rigby M, Deshpande S, Blair M, 2019, Credibility in published data sources, LANCET, Vol: 393, Pages: 225-226, ISSN: 0140-6736
Hoang U, James AC, Liyanage H, et al., 2019, Determinants of inter-practice variation in ADHD diagnosis and stimulant prescribing: Cross-sectional database study of a national surveillance network, BMJ Evidence-Based Medicine, ISSN: 2515-446X
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. Early recognition, identification and treatment of children with attention deficit hyperactivity disorder (ADHD) can reduce detrimental outcomes and redirect their developmental trajectory. We aimed to describe variations in age of ADHD diagnosis and stimulant prescribing among general practitioner practices in a nationwide network and identify child, parental, household and general practice factors that might account for these variations. Cross-sectional study of children aged under 19 years registered within a general practice in the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network in 2016, RCGP RSC has a household key allowing parent and child details to be linked. Data from 158 general practices and 353 774 children under 19 were included. The mean age of first ADHD diagnosis was 10.5 years (95% CI 10.1 to 10.9, median 10, IQR 9.0-11.9) and the mean percentage of children with ADHD prescribed stimulant medications among RCGP RSC practices was 41.2% (95% CI 38.7 to 43.6). There was wide inter-practice variation in the prevalence of diagnosis of ADHD, the age of diagnosis and stimulant prescribing. ADHD diagnosis is more likely to be made later in households with a greater number of children and with a larger age difference between adults and children. Stimulant prescribing for children with ADHD was higher in less deprived practices. Older parents and families with more children fail to recognise ADHD and may need more support. Practices in areas of higher socio-economic status are associated with greater prescribing of stimulants for children with ADHD.
Schröder-Bäck P, Schloemer T, Clemens T, et al., 2019, A Heuristic Governance Framework for the Implementation of Child Primary Health Care Interventions in Different Contexts in the European Union., Inquiry, Vol: 56
To adopt and implement innovative good practices across the European Union requires developing policies for different political and constitutional contexts. Health policies are mostly decided by national political processes at different levels. To attain effective advice for policy making and good practice exchange, one has to take different models of governance for health into account. We aimed to explore which concepts of governance research are relevant for implementing child health policies in a European Union context. We argue that taking into account the insights of good intersectoral and multilevel governance in research and practice is essential and promising for future analyses. These governance concepts help to understand what actors and institutions are potentially of relevance for developing and implementing child-centric health care approaches not only within health care but also outside health care. The framework we developed has the potential to advise on and thus support effectively the spreading and implementation of good practices of child-centric health policy approaches across the European Union. With this heuristic framework, the variety of relevant stakeholders and institutions can better be mapped and taken into account in implementation processes. Also, the normative side-particularly stressing values that make governance "good governance"-is to be taken into account.
Rigby M, Deshpande S, Blair M, 2018, Published Mortality Datasets – is Perfection the Enemy of Credibility?, European Journal of Public Health, Vol: 28, ISSN: 1101-1262
Rigby M, Greenfield R, Deshpande S, et al., 2018, Are we Serious – and Ethical – about HPV Vaccination in Europe?, European Journal of Public Health, Vol: 28, ISSN: 1101-1262
Blair M, Rigby M, Alexander D, 2018, Critical Factors for Child Primary: Child-Centricity, Core Principles and Context Sensitivity, European Journal of Public Health, Vol: 28, ISSN: 1101-1262
Brenner M, O'Shea MP, McHugh R, et al., 2018, Principles for provision of integrated complex care for children across the acute-community interface in Europe, LANCET CHILD & ADOLESCENT HEALTH, Vol: 2, Pages: 832-838, ISSN: 2352-4642
Zdunek K, Schröder-Bäck P, Vlasblom E, et al., 2018, European capacity to implement evidence-based child health policy, European Journal of Public Health, Vol: 28, ISSN: 1101-1262
Visser A, Kocken P, Reijneveld SA, et al., 2018, Primary care in Europe: starting points to improve primary care from school health services and adolescent health services for children and adolescents, European Journal of Public Health, Vol: 28, ISSN: 1101-1262
Brenner M, O'Shea MP, Larkin P, et al., 2018, Management and integration of care for children living with complex care needs at the acute-community interface in Europe, LANCET CHILD & ADOLESCENT HEALTH, Vol: 2, Pages: 822-831, ISSN: 2352-4642
Jansen D, Vervoort H, Visser A, et al., 2018, Integrated school health services in Europe: an overview, International Journal of Integrated Care, Vol: 18, Pages: 289-289
Blair M, Well Child Care and Preventive Services in Europe, International Society for Social Paediatrics and Child Health
Blair M, Assessing Which Models of Child Health Services Provide Best Outcomes for Children and Young People in Europe - MOCHA Evaluation and Key Findings, European Academy of Paediatric Societies
Blair M, What Can European Community Pharmacies Offer Children and Young People? - A MOCHA Survey, European Academy of Paediatric Societies
Blair M, Well Child Care in Europe - A Comparison of 26 Countries - A MOCHA Project, European Academy of Paediatric Societies
Blair M, Early Years Theme of Northwest London, CLAHRC, 1st International Eurasian Congress of Social Pediatrics
Blair M, Menon A, 2018, Community Pharmacy Use by Children across Europe: A Narrative Literature Review, PHARMACY, Vol: 6, ISSN: 2226-4787
Blair M, Which models of primary child health services provide best outcomes for children and young people in Europe? – MOCHA evaluation and key findings, European Forum for Primary Care
Blair M, Children and young people in primary care continue to remain relatively invisible, European Forum for Primary Care
Watson M, Blair M, 2018, Emergency departments and minor illness: Some behavioural insights, Archives of Disease in Childhood, Vol: 103, Pages: 309-310, ISSN: 0003-9888
Boullier M, Blair M, 2018, Adverse childhood experiences, Paediatrics and Child Health (United Kingdom), Vol: 28, Pages: 132-137, ISSN: 1751-7222
© 2018 Elsevier Ltd The long term poor health outcomes in people who have experienced multiple adverse events in childhood have been well documented since the original CDC-Kaiser study in the late 1990's. Those people who have experienced four or more adverse childhood experiences (ACE) are at significantly increased risk of chronic disease such as cancer, heart disease and diabetes as well as mental illness and health risk behaviours. The ACE pyramid is a model that describes the relationship between ACEs, disease and potentially early death. There is growing evidence of the ways in which adversity and toxic stress, cause these poor outcomes. Exposure to adversity has been shown to alter the molecular and genetic makeup of a child as well as changing the way the neurological, immune and endocrine systems develop and function. Adverse events in childhood are of great public health concern given the evidence of their long term impact on health. This article describes the significant impact of ACEs on the health of future generations outlining the research background to ACEs. It also explores how we are finding ways to mitigate their adverse effects by prevention and promotion of resilience against the effects of adversity.
Plumptre I, Tolppa T, Blair M, 2018, G431(P) An audit of vaccination adherence and acceptability of opportunistic vaccination in inpatient paediatrics, British Academy of Childhood Disability and British Association for Child and Adolescent Public Health
Julies P, Lynn RM, Pall K, et al., 2018, I16 Nutritional rickets presenting to secondary care in children (<16 years) – a uk surveillance study, International Network of Paediatric Surveillance Units
Blair M, Poots AJ, Lim V, et al., 2018, Preschool children who are frequent attenders in emergency departments: an observational study of associated demographics and clinical characteristics, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 103, Pages: 19-23, ISSN: 0003-9888
Rigby M, Kühne G, Greenfield R, et al., 2018, Extent of Use of Electronic Records in Children's Primary Care and Public Health in Europe., Stud Health Technol Inform, Vol: 247, Pages: 930-934
EHRs are widely seen as a key resource in modern health care. For children not only is primary care vital, but also case-based public health systems can help ensure that all children receive immunisation and other preventive programmes. A European study showed that in 2016 in the 30 EU and EEA countries, 19 countries had widespread use of EHRs in children's primary care, while 20 countries had case-based child public health systems. However, the results show a bias of disadvantage for poorer or smaller countries. More study is needed in this area.
Liyanage H, Shinneman S, Hoang U, et al., 2018, Profiling Databases to Facilitate Comparison of Child Health Systems Across Europe Using Standardised Quality Markers., Pages: 61-65
Models of child primary health care vary across Europe. There are three categories, primary care paediatricians, general practitioner based, or mixed. This paper describes the metadata schema used in the profiling process of candidate data sources for appraisal for the Models of Child Health Appraised (MOCHA) project using the MOCHA International Research Opportunity Instrument (MIROI). The ten clinical indicators included: asthma, antibiotic stewardship, immunisation, rickets, diarrhea, epilepsy, depression, ADHD, enuresis and care of women during pregnancy. Our metadata allows us to identify data within included data sources concerning any of the 10 clinical indicators identified for comparative analysis within the MOCHA project. From the 30 countries we found a minimum of 5 and a maximum of 36 different databases for each indicator.
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