Background: Many young people are involved in caring for parents, siblings, or other relatives who have an illness or disability. The aim of this study was to estimate the prevalence of caring by young people in England.Method: A national survey of 925 English young people was conducted using the 18-item survey version of the Multidimensional Assessment of Caring ActivitiesChecklist for Young Carers.Results: Around 7% of young people were identified as doing at least a high amount of caring activity and 3% a very high amount. Most frequently, caring by a young person is for a mother or a sibling, with a physical disability. Caring activity consisted mostly of domestic activities, household management, and emotional care.Conclusion: This study provides the most up to date and methodologically sophisticated survey data on the prevalence of young caring in England, with implications for policy and practice.

Long daytime and overnight shifts remain a major feature of working life for trainees in anaesthesia. Over the past 10 years, there has been an increase in awareness and understanding of the potential effects of fatigue on both the doctor and the patient. The Working Time Regulations (1998) implemented the European Working Time Directive into UK law, and in August 2009 it was applied to junior doctors, reducing the maximum hours worked from an average of 56 per week to 48. Despite this, there is evidence that problems with inadequate rest and fatigue persist. There is no official guidance regarding provision of a minimum standard of rest facilities for doctors in the National Health Service, and the way in which rest is achieved by trainee anaesthetists during their on-call shift depends on rota staffing and workload. We conducted a national survey to assess the incidence and effects of fatigue among the 3772 anaesthetists in training within the UK. We achieved a response rate of 59% (2231/3772 responses), with data from 100% of NHS trusts. Fatigue remains prevalent among junior anaesthetists, with reports that it has effects on physical health (73.6% [95%CI 71.8-75.5]), psychological wellbeing (71.2% [69.2-73.1]) and personal relationships (67.9% [65.9-70.0]). The most problematic factor remains night shift work, with many respondents commenting on the absence of breaks, inadequate rest facilities and 57.0% (55.0-59.1) stating they had experienced an accident or near-miss when travelling home from night shifts. We discuss potential explanations for the results, and present a plan to address the issues raised by this survey, aiming to change the culture around fatigue for the better.

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Several studies have demonstrated higher risks of childbearing in stepfamilies, net of the total number of children stepfamily couples have. Analyzing retrospective data from a nationally representative sample of Swedish adults (Level of Living Survey 2000), we found that the risk of a second or third birth is elevated when it is the first or second child in a new union. We also found a faster pace of childbearing after stepfamily formation than after a shared birth. The risk of a second birth is only somewhat higher in a stepfamily after two years of observation. The risk of a third birth is particularly high early in the stepfamily union and remains higher than that for couples with two shared children for at least five years. The stepfamily effect was reduced after 1980 when the Swedish government introduced parental leave incentives for short birth intervals.