Understanding and Supporting Young Children’s Transitions into State Care: Schlossberg’s Transition Framework and Child-Centred Practice

There is a growing body of research regarding children and young people in state care that is organised around the concept of transition. Focusing mainly on young people leaving care, the research highlights their experiences of multiple transitions that can contribute to poor long-term outcomes in terms of emotional and psychological well-being, educational attainment and employment prospects. The smaller body of research that focuses on young children shows that their journeys before and when in state care are also marked by multiple and fragmented transitions. Despite the growing knowledge base, there are two areas that remain under-developed—research that draws attention to the lived experiences of young children regarding their transitions into state care; and the development of conceptual frameworks that centralise young children's perspectives to support the development of practice. This article begins to address these gaps by applying Schlossberg's transition framework to a case study of a young child regarding their transition into state care. The article highlights, through the child's perspectives, the multiple impacts of the transition and considers the implications for the development of better child-centred practice.

Constrained adoptive parenthood and family transition: Adopters' experience of unplanned birth family contact in adolescence

Adoption policy in the UK emphasizes its role in providing secure, permanent relationships to children in care who are unable to live with their birth families. Adoptive parents are crucial in providing this life-long, stable experience of family for these vulnerable children. This paper explores the experience of adoptive parenthood in the context of changes to adoptive kinship relationships brought about by new, unplanned contact with birth family during their child's middle adolescence. This contact was initiated via informal social networks and/or social media, with older birth siblings instrumental in negotiating renewed relationships. The contact precipitated a transition in adoptive family life resulting in emotional challenges and changes in parent/child relationships, which were experienced as additional to the normative transitions expected during adolescence. Parental concern as a dominant theme was founded in the child and birth sibling's stage of adolescence, coupled with constraints on adoptive parenthood imposed by the use of social media, by perceived professional attitudes and by parental social cognitions about the importance of birth ties. Adoptive parents' accounts are interpreted with reference to family life-cycle theory and implications are suggested for professional support of adoptive kinship relationships.

Identifying educational needs in end-of-life care for staff and families of residents in care facilities.

AIM: the purpose of this article is to describe educational needs in end-of-life (EoL) care for staff and families of residents in long-term care (LTC) facilities in the province of Ontario, Canada. Barriers to providing end-of-life care education in LTC facilities are also identified. DESIGN, SETTING AND PARTICIPANTS: cross-sectional survey of directors of care in all licensed LTC facilities in the province of Ontario, Canada. RESULTS: directors of care from 426 (76.9% response rate) licensed LTC facilities completed a postal-survey questionnaire. Topics identified as very important for staff education included pain and symptom management and communication with family members about EoL care. Priorities for family education included respecting the residents' expressed wishes for care and communication about EoL care. Having sufficient institutional resources was identified as a major barrier to providing continuing education to both staff and families. CONCLUSION: through examining educational needs in EoL care this study identified an environment of inadequate staffing and over-burdened care providers. The importance of increased staffing concomitant with education is a priority for LTC facilities.

Demographic and psychosocial characteristics of asthmatic children in a Canadian rehabilitation setting

This study investigated the demographic and psychosocial characteristics of patients attending a residential treatment program for children with asthma. Measures of background information and standardized psychosocial variables were administered to 54 inpatients over an 18-month period. Typically, our patients presented with moderate to severe chronic asthma, mostly diagnosed before 3 years of age and often associated with atopic dermatitis. The families exhibited normal levels of emotional bonding and flexibility in response to stress. Psychosocially, most children were experiencing behavioral and school-related problems, with 6-11-year-old boys exhibiting global social competency problems as well. Girls exhibited lower self-esteem. Locus of control was within the normal range for all age groups. Half the children had not previously attended an asthma education program and two-thirds of the family members either smoked and/or had a pet. The treatment implications of these characteristics of our asthma population were considered.

Interventions to optimise prescribing for older people in care homes

There is a substantial body of evidence that prescribing for care home residents is suboptimal and requires improvement. Consequently, there is a need to identify effective interventions to optimise prescribing and resident outcomes in this context.

Dental erosion among 12-14 year old school children in Khartoum:A pilot study

Objectives: To investigate dental erosion among 12-14 year old Sudanese school children and evaluate the associated risk factors. Basic Research Design: Cross sectional survey in secondary schools in Khartoum city, Sudan. Method and Participants: A sample of 157 school children was obtained from both private and public schools. Erosion on the labial and palatal surfaces of maxillary incisors was measured by criterion based on the Smith and Knight Tooth Wear Index. Dietary intake and other related factors were assessed using a questionnaire. Results: The overall erosion prevalence in this group was 66.9%, of which 45.2% was mild and 21.7% was moderate erosion. A strong association was found between erosion and private schooling (higher socioeconomic groups), carbonated drinks, herbal hibiscus drink and traditional acidic food consumption. Conclusion: There was a high prevalence of dental erosion among Sudanese school children which was mild to moderate in severity and was strongly associated with acidic dietary intake © BASCD 2007.

Environmental Affordances and Children in Post-conflict Belfast

This paper examines the experiences of children in post-conflict Belfast as peace and social change afford new opportunities at the same time as they regulate behaviours and spatial practices. Theoretically and empirically it draws on the concept of environmental affordances in order to map the experiences of 11-year-old children in separate inner-city segregated and middle-class communities. Whilst the recession has affected the pace of urban restructuring, children in the expanding mixed and largely middleclass city extract multiple advantages from their area in ways not available to segregated communities. The paper concludes by highlighting the implications for effective listening strategies in the management of divided communities. © 2011 Taylor & Francis.

Pain in care home residents with dementia: an exploration of frequency, prescribing and relatives' perspectives

Objectives: This study aims to determine pain frequency amongst care home residents with dementia, to investigate variables associated with pain, to explore analgesic use among residents and to seek residents' relatives' views on provision of care and management of pain by the care home. Methods: Structured face-to-face interviews were conducted with residents, nursing staff and relatives from nine dementia care homes in Northern Ireland, between May 2010 and March 2012. Demographic information was collected from participants, neuropsychiatric tests were used to assess residents' cognitive functioning, medication use was determined from care home records and residents' pain was assessed using a verbal descriptor scale. Relatives' views were sought on care provision and management of pain. Results: Forty-two residents, 16 nurses/care assistants and 35 relatives participated; the participation rate of residents was low (27.6%). Most residents were suffering moderate-severe dementia, and some residents (26.2%) were unable to provide a self-report of pain. A significantly higher proportion of relatives (57.1%) deemed residents to be experiencing pain at the time of the interview, compared with residents (23.8%, p = 0.005) and nurses/care assistants (42.9%, p = 0.035). Most residents (88.1%) were prescribed with analgesia; non-opioid analgesics were most commonly prescribed. High proportions of residents were prescribed with psychoactive medications. Antipsychotic drug use was associated with presence of pain (p = 0.046). Conclusions: This study has reinforced the challenge of assessing and managing pain in this resident population and highlighted issues to be addressed by long-term care providers and clinicians. Participation of people with dementia, and their families, in healthcare research needs to be improved.

Deoxynivalenol exposure assessment in young children in Tanzania

Scope: This study assessed deoxynivalenol (DON) exposure in children from three geographic locations within Tanzania, over three time points in 1 year, using a urinary biomarker of exposure.

Methods and results: A total of 166 children aged 6-14 months were studied at a maize harvest and followed up twice at 6-month intervals. On two consecutive days, morning urine was collected from each child and urinary DON was measured using an LC-MS method, with and without beta-glucuronidase hydrolysis in order to assess free DON (fDON) and glucuronide DON. Overall, urinary DON increased significantly along with the three visits (geometric mean 1.1, 2.3, and 5.7 ng/mL, at visits 1, 2, and 3, respectively, p <0.01). fDON was 22% of urinary total DON. Urinary DON excretion rate was 74% in village Kikelelwa based on food DON level and food consumption. Assuming 360 mL of urine excreted per day, 10, 19, and 29% of children at visits 1, 2, and 3, respectively, exceeded the provisional maximum tolerable daily intake of 1000 ng/kg b.w./day.

Conclusion: Young children in Tanzania are chronically exposed to DON due to eating contaminated maize, although exposure levels varied markedly by region and season.