Maternal adversity and variation in the rate of children entering local authority care during infancy in England: a longitudinal ecological study

BackgroundIn England, the rate at which infants enter care varies considerably by local authority, with little evidence on what drives these differences. Decisions instigating infant entry into care may be triggered by child protection concerns arising from parental ill-health or risky behaviour from pregnancy onwards. Main AimWe explored the extent to which adversity indicated within women’s hospitalisation history, pre-delivery, explained differences in rate of infant entry into care between local authorities. Methods/ApproachCombining data from several sources (Office for National Statistics Population Estimates, Public Health England Fingertips, 2011 Census, Children Looked After Return, and Hospital Episode Statistics), we derived population-level predictors for entry into care (i.e. local case-mix) for 131 English local authorities from 2006/07 to 2013/14. Our primary outcome was rate of infant entry into care. We used linear mixed-effects models to analyse the relationship between the outcome and percentage of live births with maternal history of adversity-related hospital admissions (i.e. any admission indicating substance misuse, mental ill-health, or violence, up to 36 months pre-delivery), adjusting for other case-mix measures. ResultsRate of infant entry into care (mean: 85.16 per 10,000 [min-max: 0.00-318.51]) and percentage of live births with maternal history of adversity-related hospital admissions (4.62%, [0.52-16.19%]) varied greatly by local authority. Prevalence of maternal adversity accounted for 24% of variation in rate of entry (95% CI: 14-35%). After adjustment, there was evidence that a percentage point increase in prevalence of maternal adversity - both over time and between local authorities - is associated with an extra 2.56 infants, per 10,000, entering care (1.31-3.82). Conclusion Prevalence of maternal adversity prior to birth helps to explain differing rates of infant entry into care among local authorities. Further research using individual-level linked parent-child data is required to ascertain whether interventions to reduce maternal adversity before birth would decrease rate of infant entry into care.

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Association between health indicators of maternal adversity and the rate of infant entry to local authority care in England: a longitudinal ecological study

BMJ Open ◽

10.1136/bmjopen-2019-036564 ◽

2020 ◽

Vol 10 (8) ◽

pp. e036564 ◽

Cited By ~ 1

Author(s):

Rachel Jane Pearson ◽

Matthew Alexander Jay ◽

Linda Petronella Martina Maria Wijlaars ◽

Bianca De Stavola ◽

Shabeer Syed ◽

...

Keyword(s):

Ecological Study ◽

Mental Health Problems ◽

Hospital Admissions ◽

Health Indicators ◽

Well Being ◽

Specific Rate ◽

Maternal History ◽

Live Births ◽

Percentage Point Increase ◽

History Of

ObjectiveInfants enter care at varying rates across local authorities (LAs) in England, but evidence is lacking on what is driving these differences. With this ecological study, we aimed to explore the extent to which adversity indicated within women’s hospitalisation histories, predelivery, explained the rate of infant entry into care.MethodsWe used two longitudinal person-level data sets on hospitalisations and entries to care to create annual measures for 131 English LAs, between 2006/2007 and 2013/2014 (April–March). We combined these measures by LA and financial year, along with other publicly available data on LA characteristics. We used linear mixed-effects models to analyse the relationship between the outcome—LA-specific rate of infant entry into care (per 10 000 infants in the LA population) — and LA-specific percentage of live births with maternal history of adversity-related hospital admissions (ie, substance misuse, mental health problems or violence-related admissions in the 3 years before delivery), adjusted for other predictors of entry into care.ResultsRate of infant entry into care (mean: 85.16 per 10 000, SD: 41.07) and percentage of live births with maternal history of adversity-related hospital admissions (4.62%, 2.44%) varied greatly by LA. The prevalence of maternal adversity accounted for 24% of the variation in rate of entry (95% CI 14% to 35%). After adjustment, a percentage point increase in prevalence of maternal adversity—both within and between LAs—was associated with an estimated 2.56 (per 10 000) more infants entering care (1.31–3.82).ConclusionsThe prevalence of maternal adversity before birth helped to explain the variation in LA rates of infant entry into care. Preventive interventions are needed to improve maternal well-being before and during pregnancy, and potentially reduce risk of child maltreatment and therefore entries to care. Evidence on who to target and data to evaluate change require linkage between parent–child healthcare data and administrative data from children’s social care.

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11. Child Protection: State Support for Children

10.1093/he/9780198834243.003.0011 ◽

2021 ◽

pp. 705-769

Author(s):

Polly Morgan

Keyword(s):

Social Services ◽

Child Protection ◽

Legal Framework ◽

The State ◽

State Support ◽

Local Authorities ◽

Looked After Children ◽

History Of ◽

Difficult Situations ◽

Or Applications

This chapter considers how the Children Act 1989 provided a legal framework within which the state can support children to remain with their families through difficult situations and intervene to protect them when they face unacceptable risks. The chapter starts by giving a brief history of child protection law. The chapter then looks at the inherent tension in protecting children while aspiring to support their life with their families, before considering local authorities' powers and duties, resources, and the ever-increasing numbers of children who are involved with social services, whether as c hildren in need, looked after children, or as subjects of child protection investigations or applications.

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17. Public Law Proceedings Concerning Children

10.1093/he/9780198806691.003.0017 ◽

2021 ◽

pp. 626-662

Author(s):

N V Lowe ◽

G Douglas ◽

E Hitchings ◽

R Taylor

Keyword(s):

Child Protection ◽

Local Authority ◽

Legal Framework ◽

Public Law ◽

Child Assessment ◽

Local Authorities ◽

The Public ◽

General Duty ◽

Protection Orders ◽

Police Protection

This is the first of two chapters discussing child protection issues—what is often called the public law concerning children. Chapter 17 begins with a consideration of the basic dilemmas of child protection followed by an overview of the development of local authority powers. It explains the current basic legal framework and provisions for local authorities to provide services for families; specific duties and powers; accommodating children in need; and secure accommodation. The chapter ends by focusing on the local authorities’ investigative powers and duties. It covers the general duty of investigation under s 47 of the Children Act 1989; co-operating with other agencies to discharge investigative duties; emergency protection orders; child assessment orders; and police protection.

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Local authorities: Powerhouses or scapegoats?

Rescaling Urban Governance ◽

10.1332/policypress/9781447350774.003.0005 ◽

2020 ◽

pp. 99-122

Author(s):

John Sturzaker ◽

Alexander Nurse

Keyword(s):

Local Government ◽

Urban Governance ◽

Local Authority ◽

Local Level ◽

Local Authorities ◽

History Of ◽

The Uk

Some have argued that reforms to urban governance in the UK in recent years have “hollowed out” the local level, emphasising the levels “above” and “below” it. This reflects a broader perceived loss of focus on cities themselves, but a great deal of power and responsibility still remains at the local authority level. This chapter considers how local government autonomy has changed in recent years, within the context of a broader history of local government in the UK. It then reflects upon the “entrepreneurial turn” in local government, for some a consequence of reduced funding for local authorities, and considers recent evidence of a return to “municipal socialism” in England and beyond.

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The Antonov rebel detachments in the territory of the Balashov uyezd of the Saratov gubernia (1920–1921)

Vestnik of North-Ossetian State University ◽

10.29025/1994-7720-2020-4-45-51 ◽

2020 ◽

pp. 45-51

Author(s):

Sergei V. Lyovin

Keyword(s):

Civil War ◽

Local Population ◽

Local History ◽

Local Authorities ◽

Archival Material ◽

History Of ◽

The Way

The Civil War is one of the largest tragedies in the history of our country. One of its dramatic episodes is the rebel movement led by A.S. Antonov which took place in the Tambov gubenia in 1920–1921 and was brutally suppressed by the Bolsheviks. Its scope is evidenced by the fact that it went beyond the borders of the Tambov gubernia. Separate detachments of Antonovites from the autumn of 1920 to the summer of 1921 raided the territory of the Balashov uyezd of the neighboring Saratov gubernia. The paper attempts to consider the way the uyezd authorities fought the rebels and the way civilians treated them. On the basis of an analysis of the local archival material most of which has not yet been put into scientific circulation, periodicals and the local history literature the author comes to the following conclusion: every time the invasions of Antonov’s detachments into the territory of the Balashov uyezd were so rapid that the local authorities did not manage to organize a proper rebuff, and the peasants, for the most part, supported the rebels since they saw spokesmen and defenders of their interests in them. Only frequent requisitions of peasants’ property by Antonovites as well as the replacement of the surplus appropriation system (Prodrazvyorstka) by the tax in kind (Prodnalog) led to the fact that since the spring of 1921 the support of the rebels by the local population ceased.

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The Implementation Approach of LCCF Checklist in Development Control: Challenges for policymakers

Environment-Behaviour Proceedings Journal ◽

10.21834/e-bpj.v4i12.1910 ◽

2019 ◽

Vol 4 (12) ◽

Author(s):

T B A

Keyword(s):

Climate Change ◽

Sustainable Development ◽

Carbon Emissions ◽

Local Authority ◽

Survey Methods ◽

Local Level ◽

Control Process ◽

Low Carbon ◽

Local Authorities ◽

Development Control

Global warming, climate change is now affecting the world. The effort of the leaders to achieving the sustainable development is from New Urban Agenda (NUA), Sustainable Development Goals (SDG’s) and local level is local authorities. SDG’s goal number 13 takes urgent action to combat climate change and its impact also SDG’s number 11 to sustainable cities and communities. The gap of this paper Different cities face different challenges and issues. Local authorities will play a significant role in undertaking policy initiatives to combat carbon emissions of the city. Low Carbon Cities (LCC) is to reduce carbon emissions in all human activities in cities. The objective of this paper is by applying the LCCF Checklist in planning permission for sustainable development. The methodology of this research is a mixed-method, namely quantitative and qualitative approach. The survey methods are by interview, questionnaire, and observation. Town planners are the subject matter expert in managing the planning permission submission for the development control of their areas. Descriptive statistical analysis will be used to show the willingness of the stakeholders, namely the developers and planning consultants in implementing of the LCCF. The contribution of this research will gauge readiness at the local authorities level. The findings of the LCCF checklist are identified as important in planning permission into the development control process. Surprisingly, that challenges and issues exist in multifaceted policy implementation the LCCF Checklist in a local authority. Finally based on Subang Jaya Municipal Councils, the existing approach in the application of the LCCF Checklist in the development control process will be useful for development control in a local authority towards sustainable development.

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Maternal History of Child Sexual Abuse and Maladaptive Outcomes in Sexually Abused Children: The Role of Maternal Mental Health

Journal of Interpersonal Violence ◽

10.1177/08862605211013963 ◽

2021 ◽

pp. 088626052110139

Author(s):

Rachel Langevin ◽

Martine Hébert ◽

Audrey Kern

Keyword(s):

Mental Health ◽

Sexual Abuse ◽

Psychological Distress ◽

Sexually Abused ◽

Maternal Mental Health ◽

Ptsd Symptoms ◽

Abused Children ◽

Maternal History ◽

History Of ◽

Sexually Abused Children

The effects of child sexual abuse (CSA) have been found to surpass generations as maternal history of CSA is associated with increased difficulties in sexually abused children. However, little is known about the mechanisms underlying this association. The present study aimed to test maternal mental health symptoms including psychological distress, post-traumatic stress disorder (PTSD) symptoms, and dissociation as mediators of the relationship between maternal CSA and children’s internalizing, externalizing, and dissociation symptoms in a large sample of sexually abused children. A total of 997 sexually abused children aged 3-14 years old and their mothers were recruited at five specialized intervention centers offering services to sexually abused children and their families. The children were divided into two groups depending on their mothers’ self-reported history of CSA. Mothers completed a series of questionnaires assessing their mental health and children’s functioning. Maternal history of CSA was associated with increased maternal psychological distress, PTSD symptoms, and dissociation following children’s disclosure of CSA. In turn, maternal psychological distress and maternal dissociation were associated with increased child internalizing, externalizing, and dissociation symptoms. Maternal PTSD symptoms were associated with child internalizing symptoms. Maternal mental health difficulties mediated the association between maternal CSA and sexually abused children’s maladaptive outcomes. Clinicians should assess for possible history of CSA in mothers of sexually abused children and determine how best to support them to cope with the aftermaths of their child’s disclosure and with their own traumatic past.

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Clinical Profile of Acute Poisoning in Children at a Teaching Hospital in Lalitpur

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v34i2.10139 ◽

2014 ◽

Vol 34 (2) ◽

pp. 100-103 ◽

Cited By ~ 2

Author(s):

Ajaya Kumar Dhakal ◽

D Shrestha ◽

A Shakya ◽

SC Shah ◽

H Shakya

Keyword(s):

Teaching Hospital ◽

Hospital Admissions ◽

Acute Poisoning ◽

Childhood Mortality ◽

Age Group ◽

Common Cause ◽

Mortality And Morbidity ◽

History Of ◽

The Common ◽

Poisoning In Children

Introduction: Acute poisonings are one of the common cause of emergency visits and hospital admissions and is potentially preventable cause of childhood mortality and morbidity. The objectives of this study were to identify the common type of poisoning in children, to determine types of poisoning according to age and to find out the common age group in which the incidence of poisoning was high.Materials and Methods: It was a descriptive observational study done in a teaching hospital in Lalitpur, Nepal in patients aged 1 month to 18 years who visited the emergency department and were admitted to hospital with history of alleged poisoning from 2009 July to 2014 January.Results: Fifty patients were included. Drugs, kerosene and organophosphorus were most common cause of poisoning. Drugs and kerosene below 10 years of age and organophosphorus and drugs above 10 years of age were common types of poisoning. Maximum numbers (50%) of children with poisoning cases were below five year of age. Mean duration of hospital stay was 2.1days and mean age of poisoning was 7.8 years with a male(54%) predominance. Majority of poisoning occurred at home (84%) and 68% of patients were symptomatic at presentation to hospital with 84% of patients presenting to hospital within six hours.Conclusion: This study showed that drugs, kerosene and organophosphorus were most common forms of poisoning. Young children were most vulnerable for acute poisoning.DOI: http://dx.doi.org/10.3126/jnps.v34i2.10139J Nepal Paediatr Soc 2014;34(2):100-103

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