Every report we find, newest first.

Informed, autonomous and safe: a qualitative study describing the views of English adolescents on consent to participate in medical research.

Introduction There is confusion in practice regarding the role of adolescents in consenting to their participation in medical research. There are lack of studies investigating the views of adolescents on the process of consenting to participate in research and what this should look like. This study provides a qualitative account of adolescents' views on this process. Methods Qualitative interviews or written responses were collected from 25 adolescents (aged 14-17 years). Views were explored using a story completion method, where participants were given a stem scenario and asked to state what they thought should happen next. Thematic analysis was undertaken to identify key codes and themes. Results Our participants saw parents as an important source of information and often valued their advice. They wanted to make autonomous, informed decisions and thought their parents would contribute to the process of becoming informed. They assessed the risk of participation based on trust of familiar institutions and processes. Discussion English law sees adolescent medical consent in terms of competence but is not clear about research consent. We may be doing a disservice to adolescents by not providing support to help adolescents attain competence prior to decision-making. This could be provided by a parent or another trusted adult. Conclusion Our participants valued input from their parents and want to be supported in making decisions regarding participation in medical research.

Davies F, Fisher H, Birchley G

A Quality Improvement Project (QIP) Within the Bolton Learning Disability (LD) Team (Greater Manchester Mental Health Trust) Aiming to Enhance Communication Among Multi-Disciplinary Team (MDT) Professionals and Wider Stakeholders, for the Purposes of Enhanced Care Delivery and Improved Patient Outcomes During COVID-19 pandemic. Project Lead: Dr Syeda Hasan

Aims This QIP aims to improve communication and information sharing between the community LD team, administration team, service providers and wider stakeholders, to ensure patient safety. The primary objective is to evaluate local initiatives to improve communication between MDT professionals and wider stakeholders. The secondary objective is to improve patient safety and staff satisfaction. Methods The COVID-19 pandemic created unprecedented communication challenges within the workforce and highlighted areas requiring review; this included information sharing among internal and external teams, collaborative teamworking, support in absence of senior clinical leadership and transition pathways from Child and Adolescent Mental Health Services to adult LD services. The QIP was initiated in March 2021. The discovery process included an initial consultation exploring practitioners’ experiences, areas for development and to share ideas for good practice. We used QI methodology, following ‘plan-do-study-action’ cycles, to analyse change. Change ideas included a single point of contact for internal and external queries, regular complex case management meetings, development of a referral process and clinical review for complex cases along with teaching sessions. Qualitative feedback from the team pre- and post-intervention, at baseline and regular follow-up intervals, in the form of monthly team meetings, emails, focus-groups and semi-structured interviews. Results A full thematic map was created after initial consultation; themes included communication improvement between teams and external agencies, timely support for complex case management, improving transition processes and development of robust clinical review processes. Qualitative feedback has been collated, analysed and final recommendations to be shared with the MDT professionals Conclusion Preliminary results have shown improvements in communication among the MDT, stakeholders, and external agencies. The consultation process highlighted that there is a substantial need for standardisation and consistency within communicative practices to promote enhanced care delivery and improved patient outcomes.

Hasan S, Moir R, Neary J et al.

Beyond the menu: how student agency, cultural acceptability, and equity shape realized sustainability in school food environments.

School food environments influence dietary intake, nutritional inequities, food habits, and exposure to sustainable eating during childhood. A nutritionally adequate, lower-impact meal yields public-health and environmental value only when pupils can access, select, consume, and accept it without disproportionate burden or waste. This structured Mini Review asks how student agency, cultural acceptability, and equity-related conditions shape the translation of sustainable school-food provision into selection, intake, waste, lived experience, and distributional outcomes. Web of Science and Scopus searches returned 1,521 records and 871 unique records. Rule-based prioritization and author-verified source assessment of 85 publications produced a 25-publication analytic set representing 23 study families: 13 Direct-child, two Direct-caregiver, five Direct-service/program, and five Adjacent publications. Study quality was appraised against the strongest available source using design-specific Mixed Methods Appraisal Tool criteria or adapted model-credibility domains; relative support was synthesized at study-family level. Sensory fit showed Moderate support for liking/acceptance only. Menu reform, waste feedback, education/information, agency, affordability/governance, and lower- and middle-income country transferability had Limited support, while identity/commensality and digital influence remained Very limited. In a multicountry non-randomized study, service-level plate-waste tracking was associated with lower measured waste; educational studies reported mixed or null outcomes, precluding comparative causal claims. Evidence for religion, migration, disability, commensality, and decision authority remained sparse. The framework changes the unit of evaluation to a provision-access/selection-intake-waste pathway with a cross-cutting equity audit and identifies governance, cultural recognition, and implementation capacity as conditions of realized sustainability.

Xing L, Wu X

2.N. Workshop: Improving perinatal health and reducing inequality: the value of European population comparisons

Abstract   In Europe, maternal and child mortality and morbidity during pregnancy and childbirth have declined markedly since the turn of the 20th century, but recent data suggest this trend may be slowing or reversing. Improvements in perinatal health were due primarily to increases in overall standards of living and clinical advances in obstetrics and neonatology which successfully increased maternal and newborn survival when pregnancy complications arose. However, fewer gains have been made in prevention and, in many countries, preterm birth and low birthweight rates have increased. To further improve perinatal health, a population-level approach focusing on prevention and appropriate use of clinical interventions is required. Prevention strategies include reducing risk factors (e.g., smoking and obesity) and ensuring universal access to high-quality health care due to the key roles played by early antenatal care, regular antenatal appointments and referral pathways in the timely identification and management of pregnancy complications. A population approach is particularly essential because both the burden of disease and the dangers of poor care organization fall disproportionately on socially disadvantaged women and babies, contributing to lifelong health inequalities. A final challenge is to avoid over-medicalising pregnancy and childbirth for the large majority of women with uncomplicated pregnancies. Medical technology has contributed greatly to the decline in maternal and infant mortality and morbidity, but clinical intervention can carry risks and must be used appropriately to optimise health outcomes. Despite commonalties such as universal access to health care and access to scientific knowledge, perinatal health outcomes and approaches to maternity care differ greatly between European countries. In this context, comparisons between different European models can be powerful tools for identifying population risk factors, assessing care practices, setting targets for population policies and for understanding their strengths and weaknesses to provide insight into the efficacy of health and medical policies. Currently, European comparisons are limited by the availability, timeliness and quality of population data on maternal and newborn health. This workshop reports on a new protocol implemented by the Euro-Peristat network to provide comparable perinatal indicators from countries across Europe. Based on select core indicators collected using a common protocol, we provide a proof of concept study for a future health information system and report up-to-date data on perinatal outcomes. The four presentations in this workshop present this protocol, describe most recent trends and disparities between countries, explore social inequalities in perinatal outcomes across Europe and raise questions about approaches which can achieve low mortality and morbidity while keeping intervention rates low. Key messages • A federated analytical approach is an efficient and feasible way to collect timely, high-quality and comparable population data on perinatal health in Europe. • Marked disparities in perinatal health remain between and within European countries. Our results demonstrate a need for targeted policies in many countries and offer data to inform these initiatives.

Direct and Indirect Parental Support for Meeting Physical Activity Recommendations Among Chilean Children and Adolescents.

Introduction Physical activity (PA) is vital during development, yet compliance with the 60-min daily moderate-to-vigorous (MVPA) recommendation remains low in Chile. This study examined direct and indirect support reported by mothers and fathers and their separate associations with children's and adolescents' compliance with MVPA recommendations. Methods A cross-sectional study was conducted with 246 schoolchildren (ages 9-19) from three cities. PA was assessed via the YAP questionnaire, while parental support was measured through a 5-item scale. Logistic regression models identified associations with meeting PA guidelines. Results Only 32.1% of students met PA recommendations, with significant gender disparities (boys 47.7% vs. girls 15.3%). Two paternal instrumental support behaviours were significantly associated with meeting MVPA recommendations: providing transportation (OR = 1.52) and financial support during weekdays (OR = 3.36). None of the maternal support behaviours examined showed statistically significant associations. Conclusions Paternal logistical and financial contributions are decisive for children's PA, whereas mothers reported several support behaviours more frequently than fathers. Paternal transportation and weekday financial support were positively associated with meeting MVPA recommendations. Longitudinal studies are needed to determine whether these forms of support contribute prospectively to children's and adolescents' PA.

Vallejos Cortés I, Espinoza Valdivia K, Quijada-Mateluna N et al.

Setting targets for population health improvements: Trends in perinatal health in Europe over the past five years

Abstract Background The Euro-Peristat network documented disparities in perinatal outcomes between countries in Europe in its reports published every 5 years, but trend analyses were limited because data were not collected annually. Methods Using the Euro-Peristat PHIRI protocol, we estimated rates and assessed trends between 2015 and 2019 for preterm birth, stillbirth, neonatal mortality and caesarean delivery. Country-specific relative risks (RR) for year, modelled as a continuous variable, were estimated and random effects meta-analysis used to generate pooled RRs. Heterogeneity was measured with the I2 statistic (percentage of variability in estimates due to heterogeneity rather than sampling error). Results Stillbirth rates ≥24 weeks of gestational age (GA) varied in 2019 from <2.5 per 1000 births in Denmark, Estonia, Finland and Slovenia to over 4 per 1000 in Belgium, Cyprus, UK Wales and Lithuania. Preterm birth rates ranged from <6% in Lithuania, Finland, Latvia, Estonia and Denmark to 8% or more in Portugal, Belgium, UK Scotland and Cyprus. Fewer than 20% of births were by caesarean in Norway, the Netherlands, Finland, Estonia in comparison to one-third in Cyprus, Ireland, Italy, UK Scotland. Trends over time differed between countries and were not related to the level of the indicator: the pooled RR by year for preterm birth was 0.99 [0.99; 1.00] with five countries having significant decreases and three countries having increases. Caesarean section rates were stable overall (RR: 1.00 [0.99; 1.01]RR:1.00, 95% CI: 0.99-1.01), but with high heterogeneity (I2=99%); in six countries rates increased significantly, whereas in nine rates decreased between 2015 and 2019. Conclusions European countries have varying rates and trends of the principal perinatal health indicators. Investigation of policies in high-performing countries could provide guidance for improvement elsewhere.

Szamotulska K, Loghi M, Weber G et al.

Participation of Children With Developmental Language Disorders in Educational Settings-Parents' Perspectives on Patterns, Environmental Influences and Support Strategies.

Background Participation in educational settings is essential for children's development, learning and well-being. Although access to (pre)school is a fundamental right, participation often depends on children's language abilities. Developmental language disorder (DLD) is among the most common childhood conditions, yet little is known about age- and institution-related differences in participation among children with DLD. This study explores parental perspectives on participation of children with DLD in preschool and primary school settings, considering environmental influences and strategies used to support participation. Methods Parents of preschool-aged (n = 45; Mage = 6.3) and primary school-aged children (n = 56; Mage = 8.5) with DLD in Germany completed the Participation and Environment Measure for Children and Youth. Mann-Whitney U tests and chi-squared analyses were used to examine group differences, whereas an inductive content analysis was applied to identify categories in the responses to open-ended questions. Results According to parental reports, primary school children showed slightly higher average participation, but only two activities differed significantly, indicating largely similar participation patterns across groups. Despite high overall involvement, participation frequency varied, with almost a third of children never taking part in school-sponsored teams or holding special roles. Classroom activities showed the highest participation frequency but also the lowest involvement and the strongest parental desire for change. Environmental supports outweighed barriers, but sensory and cognitive demands remained key challenges across both groups. Strategies of preschool parents focused on daily routines, planning and logistics, whereas parents of school-aged children emphasized academic support and collaboration with educators. Across both groups, emotional and motivational support was the most reported strategy. Conclusion Parental reports highlight that participation among children with DLD is shaped more by environmental demands and available supports than by educational stage alone. These findings underscore the importance of context-sensitive, family-informed approaches to fostering meaningful engagement in everyday school activities.

Kuhlmann K, Licandro U

The use of an electronic form to register play observation of a child with anxiety: A study case at a university clinical practice in Brazil

Introduction The modality of assessment used at a University Clinical Practice in Brazil is interventive psychodiagnosis in which the active participation of children and families is considered. Orientation is given following the input provided by children and their parents. Objectives Evaluating the use of an electronic form to be fulfilled during the observation of a child’s play in psychological session. Methods A child at the age of 5yrs 4m was brought for psychological assessment with the complaint of aggressiveness and irritability. His parents answered the Child Behavior Checklist (CBCL -1 1/12 5 yrs) and the Psychology interns had to observe the child’s play and fulfill an electronic form in which the choice of toys and plays, motricity, creativity, symbolic abilities, frustration tolerance, adequation with reality were verified. Results The results of CBCL indicated that the child was within the clinical range regarding anxiety and depression along with somatic complaints. The indicators observed in the electronic form such as rigidity in the modality of play, the lack of adequate ability of impersonating in role-playing, the difficulty of using creativity during play unless he was guided by peers or the Psychology interns and the constant anguish of separating himself from his parents were crucial for parents’ orientation. The psychological treatment lasted five months and benefited from the information obtained through the form once the symptoms of irritability and aggressiveness were reduced. Conclusions This modality of assessment can be instructional for parents and may also reduce financial and time costs once provides specific indicators to observe during play.

Silva G, Soares J, Brandão T et al.

Assessment the functioning and disability in children with mental disorders

Introduction Despite youth’s high Global Burden of Disease there is a substantial service delivery gap between this population’s urgent needs and their access to health services. Because attention has remained under-prioritized (Babatunde et al., 2019), youth typically do not receive the treatment they require, i.e., they present an unmet need (Barwick et al., 2013). This is particularly problematic given that untreated mental disorders (MD) are associated with short-term and long-term functional deterioration. Objectives To determine the level of functioning of children who receive mental healthcare in the selected psychiatric hospitals of Mexico. Methods A cross-sectional study was conducted during 2018-2020. Sample of children who received mental healthcare at the time of the study. Questionnaire for the evaluation of disability WHODAS 2.0 (World Health Organization-Disability Assessment Schedule) was applied. T test and analysis of variance were applied to know the differences of means of the variables and indicators. Results Sample (n= 397), 63% were boys. Mean (SD) for Age: 12 (3.6) and schooling: 5.8 (3.6). 51% (n =202) of children reported having a generic diagnosis for hyperkinetic disorders and 34% depressive disorder. WHODAS scores: significant differences in the functioning domains (Do). Mean and (SD) for Do5 Life activities domestic: 45 (26.7); Do6 Social participation:37 (20.6); and Do1 cognition: 36.6 (19.3). Figure 1. Conclusions The children with MD are more vulnerable due to the associated disability and it requires specific heath interventions adapted to their mental health care needs. References: 1) Babatunde et al. (2021). Glob.Soc.Welfare 8, 29–46. 2) Barwick et al. (2013). J.evid.based.soc.work, 10(4), 338–352. Disclosure No significant relationships.

Díaz-Castro L, Cabello-Rangel H