The present study builds on past research that has found support for a conceptual model in which poverty is linked with adolescent psychological symptoms through economic stressors and impaired parenting. The present study examined this model in a sample of urban African American mothers and their adolescent children. In addition, an alternative hypothesis was examined: that exposure to community violence mediates the relation between poverty and psychological symptoms in urban youth. Limited support was found for a model in which poverty is linked with internalizing symptoms through exposure to community violence and with externalizing symptoms through economic stressors and inconsistent discipline. Interpretations, limitations, and directions for future research are outlined.

Objective-To estimate the risks of road traffic accidents over a period of three years in drivers with a history of single seizures or epilepsy, and to compare them with a cohort of drivers followed up by the Transport Research Laboratory (TRL).Design-A retrospective survey of driving and accident experience by self-completion questionnaire. Subjects-16 958 drivers with a previous history of epilepsy responding to the survey and 8888 non-epileptic drivers responding to a TRL survey. Main outcome measures-The risk of any accident, any accident producing an injury, and any accident producing a serious injury, over a three year period. Results-After adjustment for differences in age, sex, drivimg experience, and mileage between the two populations there was no evidence of any overall increase in risk of accidents in the population of drivers with a history of epilepsy. However, there was evidence of an increased risk of more severe accidents in the population with epilepsy. The risk was increased by about 40% for serious injuries and there was evidence of a twofold risk of increase in non-driver fatalities. These increases seem largely explicable by the occurrence of seizures in this population during the three years of driving that the survey covered. Conclusions-The acceptability of driving for people with a history of epilepsy should be determined by an acceptable risk of accidents resulting in injury or serious injury rather than overall accident rates. As people with epilepsy can now drive after a 12 month seizure free period rather than the required two year period when this survey was undertaken, it is important to ascertain whether there is any increased risk of injury associated accidents with this policy.

Transition from child to adult mental health services is considered to be a difficult process, particularly for individuals with neurodevelopmental disorders such as Attention Deficit/Hyperactivity Disorder (ADHD). This article presents results from a national survey of 36 mental health NHS Trusts across England, the findings indicate a lack of accurate data on the number of young people with ADHD transitioning to, and being seen by, adult services. Less than half of Trusts had a specialist adult ADHD service and in only a third of Trusts were there specific commissioning arrangements for adult ADHD. Half of Trusts reported that young people with ADHD were prematurely discharged from CAMHS because there were no suitable adult services. There was also a lack of written transition protocols, care pathways, commissioned services for adults with ADHD and inadequate information sharing between services. The findings advocate the need to provide a better transition service underpinned by clear, structured guidelines and protocols, routine data collection and information sharing across child and adult services. An increase in the commission of specialist adult ADHD clinics is needed to ensure individuals have access to appropriate support and care.

Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.

BackgroundAlthough disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services.MethodsEleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement.ResultsFindings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse.ConclusionsBased upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base.