Think child, think parent, think family

This is an introductory update to the Mental Health and Children's Services Project of the HSCB

Managing Climate Insecurity by Ensuring Continuous Capital Accumulation : 'Climate Refugees' and 'Climate Migrants'

Numerous recent reports by non-governmental organisations (NGOs), academics and international organisations have focused on so-called 'climate refugees'. This article examines the turn from a discourse of 'climate refugees', in which organisations perceive migration as a failure of both mitigation and adaptation to climate change, to one of 'climate migration', in which organisations promote migration as a strategy of adaptation. Its focus is the promotion of climate migration management, and it explores the trend of these discourses through two sections. First, it provides an empirical account of the two discourses, emphasising the differentiation between them. It then focuses on the discourse of climate migration, its origins, extent and content, and the associated practices of 'migration management'. The second part argues that the turn to the promotion of 'climate migration' should be understood as a way to manage the insecurity created by climate change. However, international organisations enacts this management within the forms of neoliberal capitalism, including the framework of governance. Therefore, the promotion of 'climate migration' as a strategy of adaptation to climate change is located within the tendencies of neoliberalism and the reconfiguration of southern states' sovereignty through governance.

Healthy child, healthy future: speech and language therapy for children

This resource is designed to reinforce a collaborative approach between speech and language therapists, referrers and parents in the identification and management of children with developmental speech and language and communication needs (including children with feeding and/or swallowing difficulties). It includes a comprehensive key skills section, which provides details on the communication-related skills a child should have acquired at each stage in his/her early years development. It also includes specific criteria and guidelines for referral, should there be concern about whether the child has a significant problem. The resource provides additional guidance on: • communication and child play; • speech sound development; • dummies; • stammering; • dysphonia; • bilingualism; • feeding and swallowing difficulties. Lists of supplementary leaflets, handouts and websites, as well as a bibliography, are also included.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 1. Does my child speak clearly?

This factsheet describes how parents can help their child speak more clearly.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 2. Helping your young non-fluent child

This factsheet outlines how parents can help their child speak more fluently, without stammering.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 4. Dummies and talking

This factsheet gives advice to parents on the use of dummies and their effect on a child's speech.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 5. Does my child have a voice problem?

This factsheet describes voice disorders such as 'hoarseness' in children and what parents can do to help their child with a voice problem.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 6. Tips for talking: children aged 4 to 5 years

This factsheet highlights simple ideas to encourage speech in children around 4 to 5 years old.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 3. Talk to your child in your own language

This factsheet encourages non-English speaking parents to talk to their children in their own language.

Healthy child, healthy future - Speech and language therapy aide memoire for health visitors

This card outlines the key skills, causes for concern and management options for children aged 24 months and 30 months.

Healthy child, healthy future - Information on the child health programme (0-4 years)

This booklet provides parents with information on the first four years of the child health programme for all families in Northern Ireland.

www.fevertravel.ch : an online study prototype to evaluate the safety and feasibility of computerized guidelines for fever in returning travellers and migrants

Résumé Suite à la publication des recommandations de pratiques cliniques sur la prise en soins de patients fébriles au retour des tropiques, nous avons développé un site internet de consultation www.fevertravel.ch qui comprend un arbre décisionnel et des caractéristiques diagnostiques spécifiques fournissant une assistance diagnostique aux médecins de premier recours. Nous avons ensuite intégré une composante de recherche afin d'évaluer l'implémentation de ces recommandations de pratiques cliniques informatisées. De plus, le site est capable d'enregistrer : (1) le chemin parcouru par le médecin au travers de l'arbre décisionnel, (2) les tests diagnostics effectués, (3) les diagnostics initial et final ainsi que les devenirs des patients et (4) les raisons de non-adhérence lorsque les médecins divergent de l'attitude proposée. Nous croyons que la technologie internat est un moyen puissant pour atteindre des médecins provenant de différents horizons dans leur propre environnement et qu'il pourrait se montrer être un outil de recherche efficace pour disséminer les recommandations de pratiques cliniques et évaluer leur justesse-adéquation. Dans cet article, nous décrivons le design, le contenu, l'architecture et l'implémentation du système de ce prototype d'étude interactive qui vise à intégrer une recherche opérationnelle en médecine de premier recours.

Loss to follow-up of HIV-infected women after delivery : The Swiss HIV Cohort Study and the Swiss Mother and Child HIV Cohort Study

INTRODUCTION: HIV-infected pregnant women are very likely to engage in HIV medical care to prevent transmission of HIV to their newborn. After delivery, however, childcare and competing commitments might lead to disengagement from HIV care. The aim of this study was to quantify loss to follow-up (LTFU) from HIV care after delivery and to identify risk factors for LTFU. METHODS: We used data on 719 pregnancies within the Swiss HIV Cohort Study from 1996 to 2012 and with information on follow-up visits available. Two LTFU events were defined: no clinical visit for >180 days and no visit for >360 days in the year after delivery. Logistic regression analysis was used to identify risk factors for a LTFU event after delivery. RESULTS: Median maternal age at delivery was 32 years (IQR 28-36), 357 (49%) women were black, 280 (39%) white, 56 (8%) Asian and 4% other ethnicities. One hundred and seven (15%) women reported any history of IDU. The majority (524, 73%) of women received their HIV diagnosis before pregnancy, most of those (413, 79%) had lived with diagnosed HIV longer than three years and two-thirds (342, 65%) were already on antiretroviral therapy (ART) at time of conception. Of the 181 women diagnosed during pregnancy by a screening test, 80 (44%) were diagnosed in the first trimester, 67 (37%) in the second and 34 (19%) in the third trimester. Of 357 (69%) women who had been seen in HIV medical care during three months before conception, 93% achieved an undetectable HIV viral load (VL) at delivery. Of 62 (12%) women with the last medical visit more than six months before conception, only 72% achieved an undetectable VL (p=0.001). Overall, 247 (34%) women were LTFU over 180 days in the year after delivery and 86 (12%) women were LTFU over 360 days with 43 (50%) of those women returning. Being LTFU for 180 days was significantly associated with history of intravenous drug use (aOR 1.73, 95% CI 1.09-2.77, p=0.021) and not achieving an undetectable VL at delivery (aOR 1.79, 95% CI 1.03-3.11, p=0.040) after adjusting for maternal age, ethnicity, time of HIV diagnosis and being on ART at conception. CONCLUSIONS: Women with a history of IDU and women with a detectable VL at delivery were more likely to be LTFU after delivery. This is of concern regarding their own health, as well as risk for sexual partners and subsequent pregnancies. Further strategies should be developed to enhance retention in medical care beyond pregnancy.