Data resource profile: the Edinburgh Child Protection Dataset - a new linked administrative data source of children referred to Child Protection paediatric services in Edinburgh, Scotland.

Introduction: Child maltreatment affects a substantial number of children. However current evidence relies on either longitudinal studies, which are complex and resource-intensive, or linked data studies based on social services data, which is arguably the tip of the iceberg in terms of children who are maltreated. Reliable, linked, population-level data on children referred to services due to suspected abuse or neglect will increase our ability to examine risk factors for, and outcomes following, abuse and neglect. Objective: The objective of this project was to create a linkable population level dataset, The Edinburgh Child Protection Dataset (ECPD), comprising all children referred to the Edinburgh Child Protection Paediatric healthcare team due to a concern about their welfare between 1995 and 2015. Methods: The paper presents the process for creating the dataset. The analyses provide examples of available data from the main referrals dataset between 1995 and 2011 (where data quality was highest). Results: 19,969 referrals were captured, relating to 11,653 children. Of the 19,969 referrals, a higher proportion were girls (54%), although boys were referred for physical abuse more often than girls (41% versus 30%). Younger children were more likely to be referred for physical abuse (35% of 0-4 year olds vs. 27% 15+): older children were more likely to be referred for sexual abuse (48% of 15+ years vs. 18% of 0-4 years). Most referrals came from social workers (46%) or police (31%). Conclusions: The ECPD offers a unique insight into the characteristics of referrals to child protection paediatric services over a key period in the history of child protection in Scotland. It is hoped that by making these data available to researchers, and able to be easily linked with both mother and child current and future health records, evidence will be created to better support maltreated children and monitor changes over time.

Challenging behaviour around challenging behaviour.

INTRODUCTION: The United Kingdom's Department for Education's advice on behaviour focuses on the power of staff and the strength of the policy in challenging behaviour, via rules, sanctions and rewards. We designed a video-feedback intervention for staff teams in a special educational setting who were working with children with intellectual disability and challenging behaviour. The intervention aimed to raise reflective capacity on relational mechanisms that offer new response possibilities in everyday practices within trans-disciplinary teams. METHOD: We conducted research with three teams (between five and seven participants in each). We report findings from two teams who were working with children (aged between 10 and 14) who staff identified as having behaviour that challenged. The intervention consisted of two video-feedback intervention sessions, using clips of good interactions between themselves and the child and a review. These sessions took place over three or four months. Qualitative analysis was conducted to analyse changes to the language and depictions of the children. Changes to the participants' goals during the intervention were also analysed. RESULTS: The staff's focus on the child's challenging behaviour reduced. Children who were originally depicted as isolated became depicted in relationship with peers and staff. Participants became more curious about the child and his interactions in the school and home environment. The participant's personal goals emerged through their understandings of what it meant to be good. CONCLUSIONS: Working with staff teams using video feedback can change the interactions around the child and the relational conceptualisation of the child and family. Further adaptations to the intervention are needed to raise critical reflection on the concepts that circulate around 'behaviour' that structure policy and shape everyday practices.

Fluoride Levels in Saliva and Plaque following the Use of High Fluoride and Conventional Dentifrices- a Triple Blinded Randomised Parallel Group Trial.

CONTEXT: The comparison of fluoride levels in saliva and plaque following the use of conventional, 2800 and 5000 ppm dentifrices for different time intervals up to 24 hours has not been explored. AIM: The aim of the present study was to assess salivary and plaque fluoride levels at different time intervals following the use of high fluoride dentifrices. STUDY DESIGN: This randomised control trial was conducted on sixty adolescents between the age group of 16 and 18 years divided into three groups A, B, and C. INTERVENTION: Subjects were asked to brush the occlusal surfaces of posterior teeth with one of the dentifrices for 2 min. Unstimulated whole saliva and plaque samples were collected at different time intervals. Fluoride levels were determined using SPADNS method. Data was collected and statistically analyzed using SPSS 20 Inc. by mixed repeated measure ANOVA. RESULTS: A significant difference in fluoride levels was observed at different time intervals in both saliva (p=0.048) and plaque (p=0.03). The variance was low with time and concentration of the dentifrice used in saliva, whereas the magnitude of treatment was large for time (>0.25) but small for (<0.09) concentration in plaque. CONCLUSION: A significant difference in fluoride levels was observed at different time intervals in both saliva and plaque among the three groups. There was a positive correlation between fluoride levels in saliva and plaque. Both high fluoride dentifrices were effective in maintaining higher intraoral fluoride levels up to 12 hours and 5000 ppm up to 24 hours compared to conventional dentifrice.

Adult student nurses' experiences of encountering perceived child abuse or neglect during their community placement: Implications for nurse education.

INTRODUCTION: While child nursing students may expect to encounter child abuse and neglect and assume a safeguarding role when they qualify, those undertaking adult nursing courses may not expect to come into contact with children and may be even less likely to expect to encounter child abuse or neglect. This paper presents the findings of an interpretative phenomenological analysis (IPA) study. Students learn through experience and reflection and Mezirow's Transformational Learning Theory (TLT) was used to explain the various ways in which nine adult nursing students attempted to make sense of and learn from their experiences of encountering perceived child abuse and neglect during their community placement. STUDY AIM: The study aimed to examine the learning journeys of undergraduate adult nursing students who encountered perceived child abuse and neglect during their community placement. DESIGN: The research was located within an interpretative philosophical paradigm. Interpretative phenomenological analysis (IPA) provided an in-depth insight into participants' individual lived experiences. SETTING AND PARTICIPANTS: The fieldwork was undertaken at a Higher Education Institution in the North East of England. Participants were in the first year of an undergraduate nursing programme. METHOD: Data were collected using semi-structured face-to-face interviews and analysed using IPA. FINDINGS: The nine participants underwent a process of transformational learning after encountering perceived child abuse and neglect. They found the initial experience disorientating because it challenged their pre-conceived ideas about families and communities. They experienced a range of negative emotional responses, including anger and some expressed judgmental views towards parents. However, their frames of reference changed as they began to critically reflect on and process their experiences and they were able to recognize, albeit to varying degrees, that they had enhanced their knowledge and learnt from the experience. Their understanding of the role of the adult nurse changed and they recognised they had an important role to play alongside other professionals in safeguarding children. CONCLUSIONS: The findings highlight there is a need for HEIs to ensure students on adult nursing programmes understand they have a role to play in protecting children; they also highlight a need for more effective preparation and support.

The health and well-being of children and young people who are looked after: Findings from a face-to-face survey in Glasgow.

Evidence suggests children and young people who are looked after (LACYP) may have poorer health outcomes than children and young people in the general population, particularly in relation to mental health. This paper discusses findings from a survey of the health and well-being of LACYP in Glasgow. A structured questionnaire used in the 2010 Glasgow Schools Survey (GSS) was adapted and administered in face-to-face interviews with 130 young people aged 11-18 in 2014-2015 to investigate various aspects of health and well-being including physical activity, diet and sleep, smoking, alcohol and drugs, health feelings and worries, behaviours, attitudes and expectations. LACYP were more likely to report that they had tried drugs, slightly more likely to have scores indicating a high level of difficulties on the Strengths and Difficulties Questionnaire (SDQ) and less likely to report that they ate fruit and vegetables, used active transport methods to get to school and expected to go on to further or higher education; however, reported rates of physical activity, smoking and drinking were similar. LACYP were less likely to report that they had engaged in antisocial behaviour, truancy or bullying or been exposed to environmental tobacco smoke, less likely to worry or have low self-esteem, and more likely to rate their health positively. There were some variations according to placement type. The findings of this study present a more positive picture of the health and well-being of LACYP in Glasgow than might have been expected but should be treated with caution due to small sample size. Further research is needed to identify differences in relation to placement type and to determine whether being looked after might be associated with improved health and well-being outcomes for some children and young people.

The impact of Hurricane Katrina upon older adult nurses: an assessment of quality of life and psychological distress in the aftermath.

The primary purpose of the current study was to evaluate the impact of Hurricane Katrina upon older nurses using cross sectional data from 291 respondents. Collected data served as the numerical predicate for the evaluation of quality of life and psychological distress among nurses who were affected by Hurricane Katrina. While the focus for the present study was upon older nurses, cross sectional data was reflected for the plenary sample as well. Predictors of Katrina's impact upon older nurses were identified through multinomial regression analyses and included the physical function subscale (OR=0.954), the fatigue subscale (OR=0.961), the arousal subscale (OR=4.190), average to poor health (OR=2.040), married (OR=2.769) and the MSPSS (OR = 0.780). Significant associations between age and storm impact (F=10.707, ñ=.001), depression (F=15.782, ñ< .001), social support (F=5.869, ñ=.016), health status (F=29.004, ñ<.001), anxiety (F=5.583, ñ=.019) and posttraumatic distress disorder (F .032, fñ= .46) remained after adjustment for other risk factors. These associations, as reflected in their respective mean scores, indicated that older nurses experienced greater storm impact (2.880 vs. 2.511), depressive symptoms (11.250 vs. 9.080), anxiety (77.800 vs. 75.430), posttraumatic distress (72.830 vs. 70.860) and lower health status (68.891 vs. 73.569). Accordingly, a more robust public policy paradigm for addressing the growing labor shortages in the medical community is needed. Heightened Congressional interest and increased resourcing is required in order to affect necessary programmatic, educational and institutional remediation. Furthermore, given the increasing role of older nurses in the work place, extensive studies are needed to evaluate their status and independent risk factors for sustaining quality of life and psychological well being among these contributors of health care.