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This study aims to evaluate the quality of transition from child and adolescent services to adult intellectual disability services, using the relevant National Institute for Health and Care Excellence (NICE) standard (QS140). In addition, this study also identifies any differences in transition quality between those young people with intellectual disability with and without autism.

Using routinely collected clinical data, this study identifies demographic and clinical characteristics of, and contextual complexities experienced by, young people in transition between 2017 and 2020. Compliance with the quality standard was assessed by applying dedicated search terms to the records.

The study highlighted poor recording of data with only 22% of 306 eligible cases having sufficient data recorded to determine compliance with the NICE quality standard. Available data indicated poor compliance with the standard. Child and adolescent mental health services, generally, did not record mental health co-morbidities. Compliance with three out of the five quality statements was higher for autistic young people, but this only reached statistical significance for one of those statements (i.e. having a named worker, p = 0.02).

Missing data included basic clinical characteristics such as the level of intellectual disability and the presence of autism. This required adult services to duplicate assessment procedures that potentially delayed clinical outcomes. This study highlights that poor compliance may reflect inaccurate recording that needs addressing through training and introduction of shared protocols.

To the best of the authors’ knowledge, this is the first study to examine the transition process between children’s and adults’ intellectual disability health services using NICE quality standard 140.

Obesity leads to increased mortality and morbidity among children, as well as when they turn adults. Melding marketing theories in social influence and message framing, this study aims to examine how compliance versus conformance social influence, each framed either prescriptively or proscriptively, may guide children’s choice of healthy versus unhealthy food.

This study conducted two experiments in a Pakistani junior school. Experiment 1 exposed children to either a prescriptive or a proscriptive compliance influence. Experiment 2 involved a 2 (prescriptive vs proscriptive compliance influence) × 2 (supportive vs conflicting conformance-influence) between-subjects design. Participants in both studies answered an online survey after being exposed to the social-influence messages.

Experiment 1 showed proscriptive was stronger than prescriptive compliance influence in nudging children to pick fruits (healthy) over candies (unhealthy). However, frequency of fruits dropped as susceptibility to compliance strengthened. Experiment 2 found that a proscriptive compliance influence reinforced by a supportive conformance-influence led to most children picking fruits. However, a conflicting conformance influence was able to sway some children away from fruits to candies. This signalled the importance of harmful peer influence, particularly with children who were more likely to conform.

Childhood is a critical stage for inculcating good eating habits. Besides formal education about food and health, social influence within classrooms can be effective in shaping children’s food choice. While compliance and conformance influence can co-exist, one influence can reinforce or negate the other depending on message framing.

In developing countries like Pakistan, institutional support to tackle childhood obesity may be weak. Teachers can take on official, yet informal, responsibility to encourage healthy eating. Governments can incentivise schools to organise informal activities to develop children’s understanding of healthy consumption. Schools should prevent children from bringing unhealthy food to school, so that harmful peer behaviours are not observable, and even impose high tax on unhealthy products or subsidise healthy products sold in schools.

This study adopts a marketing lens and draws on social influence and message framing theory to shed light on children’s food choice behaviour within a classroom environment. The context was an underexplored developing country, Pakistan, where childhood obesity is a public health concern.

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European Union member states agree to address inequalities in health outcomes and include policies to address the gradient of health across society and target particularly vulnerable population groups. The project sought to understand the contribution of primary care services to reducing inequity in health outcomes for children. We focused on some key features of inequity as they affect children, such as the importance of good health services in early childhood, and the effects of inequity on children, such as the higher health needs of underprivileged groups, but their generally lower access to health services. This indicates that health services have an important role in buffering the effects of social determinants of health by providing effective treatment that can improve the health and quality of life for children with chronic disorders. We identified common risk factors for inequity, such as gender, family situation, socio-economic status (SES), migrant or minority status and regional differences in healthcare provision, and attempted to measure inequity of service provision. We did this by analysing routine data of universal primary care procedures, such as vaccination, age at diagnosis of autism or emergency hospital admission for conditions that can be generally treated in primary care, against variables of inequity, such as indicators of SES, migrant/ethnicity or urban/rural residency. In addition, we focused on the experiences of child population groups particularly at risk of inequity of primary care provision: migrant children and children in the state care system.

The general public and professionals from a range of backgrounds have increasingly become interested in autism spectrum disorders. This interest is particularly relevant to learning disability practitioners. Both autism and learning disabilities are independently associated with increased risk of mental health problems. Thus, when a person has learning disabilities and an autism spectrum disorder, a comprehensive assessment for mental health problems is of paramount importance. This paper provides an overview of the assessment of mental health problems in adults and children with neurodevelopmental disorders. The general assessment principles are outlined followed by assessment issues related to specific conditions such as psychoses, mood disorders and attention deficit hyperactivity disorder. Finally conclusions on the clinical implications are drawn.

Women experience a triple burden of ill-health spanning non-communicable diseases (NCDs), reproductive and maternal health conditions and human immunodeficiency virus (HIV) in sub-Saharan Africa. Whilst there is research on integrated service experiences of women living with HIV (WLHIV) and cancer, little is known regarding those of WLHIV, diabetes and/or hypertension when accessing integrated care. Our research responds to this gap.

The INTE-AFRICA project conducted a pragmatic parallel arm cluster randomised trial to scale up and evaluate “one-stop” integrated care clinics for HIV-infection, diabetes and hypertension at selected primary care centres in Uganda. A qualitative process evaluation explored and documented patient experiences of integrated care for HIV, diabetes and/or hypertension. In-depth interviews were conducted using a phenomenological approach with six WLHIV with diabetes and/or hypertension accessing a “one stop” clinic. Thematic analysis of narratives revealed five themes: lay health knowledge and alternative medicine, community stigma, experiences of integrated care, navigating personal challenges and health service constraints.

WLHIV described patient pathways navigating HIV and diabetes/hypertension, with caregiving responsibilities, poverty, travel time and cost and personal ill health impacting on their ability to adhere to multi-morbid integrated treatment. Health service barriers to optimal integrated care included unreliable drug supply for diabetes/hypertension and HIV linked stigma. Comprehensive integrated care is recommended to further consider gender sensitive aspects of care.

This study whilst small scale, provides a unique insight into the lived experience of WLHIV navigating care for HIV and diabetes and/or hypertension, and how a “one stop” integrated care clinic can support them (and their children) in their treatment journeys.

Perinatal health is a good indicator of both maternal health status and the level of socioeconomic status attained in any community. This article presents part of the findings of a research project conducted in 1997 by the author to look at the determinants of maternal and perinatal health in Kisumu district of Kenya. Data were collected from four health facilities within the district which were selected through purposive sampling to act as sentinel centres. In total, 1,455 obstetric cases were enumerated and those with perinatal complications were isolated. Perinatal health status was measured by the frequency of low birth weights, neonatal deaths, still‐births, and early neonatal morbidity. Cross‐tabulations and multivariate analysis have been used to identify the major risk factors of the perinatal health problems identified in the study area. Among other things, the study reveals that the risk of most perinatal complications is significantly increased by maternal and environmental factors. These include poor pregnancy care, malaria and anaemia during pregnancy, poor socioeconomic conditions of the mother and poor sanitary conditions in the household. Any policy measure aimed at promoting perinatal health should seek to address all these factors.

The main purpose of this paper is to increase the level of knowledge pertaining to nutritional status of preschoolers and to identify/quantifying the relative importance of various socioeconomic and environmental factors which may have significant role in determining nutritional status of preschoolers in Pakistan.

Household food availability, childcare practices, and child health status being focused as proximate determinants of child nutritional status pose problems for the simple regression analysis. An ordinary least squares (OLS) estimation of the regression with nutrition as an outcome and these three proximate variables as determinants could be biased for two reasons. First, there may be unobserved variables that are relegated to the error term but are correlated with the variables included on the right side. Second, explanatory variables may exit that are endogenous or codetermined with the outcome variable and hence are correlated with the error term. The approach to address these problems is to use instrumental variables (IV) approach. The credibility of the IV approach will rest on the ability to find variables that are correlated with the suspected endogenous explanatory variables but that do not affect the outcome variable (other than through the explanatory variable being instrumented).

The results from empirical analysis shows that factors on the maternal and household level are more important determinants of child nutritional status. Food availability, childcare practices and child health (diarrhea) are significantly related to child nutritional status. Household size has negative and significant impact on child nutritional status. Household income has an important and significant impact on child nutritional status. Childcare practices are negatively and significantly related to child nutritional status. This may suggest that as childcare practices improve, they may complement the need for other sources of improved energy for preschooler's nutritional status. The findings suggest that women's education plays a very important role in improving children's nutritional status and that the nutrition status among children depends on both better sanitary conditions and on dietary intake.

Owing to data limitation present analysis employed child calorie adequacy ratio (CCAR) as a proxy of child nutritional status. For that to estimate, commonly used measures are nutrient intake, caloric adequacy ratio and relative caloric allocation.

A key message of this research is that significant achievement could be made toward reducing malnutrition through actions in sectors that have not been the traditional focus of nutritional interventions like improved hygiene conditions.

This could be the first ever effort in describing child nutritional status with the help relative more robust analytical technique for Pakistan.

The European Union‐supported Child and Adolescent Mental Health in an Enlarged Europe (CAMHEE) project aimed to provide an overview of the challenges, current practice and guidelines for developing effective mental health promotion and mental illness prevention policy and practice across Europe. As part of this work, an analysis was undertaken of the situation in England, making use of a bespoke data collection instrument and protocol.Our analysis suggests that there has been significant effort and investment in research, needs assessment, policy, human resource and service developments in CAMHS over the last 20 years, leading to a more detailed understanding and availability of services. Much of the emphasis has been on assessment and management of difficulties, however in recent years attention has begun to focus on mental health promotion. National standards and programmes such as Every Child Matters (Department for Education and Skills, 2004) have acted as catalysts for a number of national initiatives.