Timely prevalence data of psychiatric morbidity among adolescents in small areas remains vital for mental health policy planning at the regional and local levels. Furthermore, effective regional policy planning also requires the measurement of psychiatric morbidity using clinically validated instruments. The K6 scale was therefore included on the 2012 administration of the Kentucky Incentives for Prevention Survey as a measure of serious emotional disturbance in the past 30 days. Principal axis and confirmatory factor analyses were performed to determine the unidimensional structure of the K6 in a school-based sample of Kentucky students (n = 108,736). The documented cutoff of 13 on the K6 was then used to screen Kentucky students for serious emotional disturbance, estimate the state prevalence, and define epidemiologic correlates. Overall, the K6 performed well, with factor analyses confirming the 1-factor solution of the K6. Based upon the established cutoff, the prevalence of serious emotional disturbance was 13.9% in Kentucky. Grade, gender, race and ethnicity, and family structure emerged as significant predictors in a multivariable logistic regression model. Substance abuse, antisocial behavior, role impairments, and peer victimization were significantly higher among students with a positive screen. These results indicate the K6 is particularly useful for inclusion in large epidemiologic surveys that have limited space and logistics that demand timely administration.

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Objectives To identify whether psychiatric disturbance in parentally bereaved children and surviving parents is related to service provision. Design Prospective case-control study. Setting Two adjacent outer London health authorities. Participants 45 bereaved families with children aged 2 to 16 years. Main outcome measures Psychological disturbance in parentally bereaved children and surviving parents, and statistical associations between sample characteristics and service provision. Results Parentally bereaved children and surviving parents showed higher than expected levels of psychiatric difficulties. Boys were more affected than girls, and bereaved mothers had more mental health difficulties than bereaved fathers. Levels of psychiatric disturbance in children were higher when parents showed probable psychiatric disorder. Service provision related to the age of the children and the manner of parental death. Children under 5 years of age were less likely to be offered services than older children even though their parents desired it. Children were significantly more likely to be offered services when the parent had committed suicide or when the death was expected. Children least likely to receive service support were those who were not in touch with services before parental death. Conclusions Service provision was not significantly related to parental wishes or to level of psychiatric disturbance in parents or children. There is a role for general practitioners and primary care workers in identifying psychologically distressed surviving parents whose children may be psychiatrically disturbed, and referring them to appropriate services.

Background:In 1999, 270 000 cases of cancer were registered in the United Kingdom, placing a large burden on the NHS. Cancer outcome data in 1999 suggested that UK survival rates were poorer than most other European countries. In the same year, a Department of Health review noted that clinical trials accrual was poor (<3.5% of incident cases) and hypothesised that increasing research activity might improve outcomes and reduce the variability of outcomes across England. Thus, the National Cancer Research Network (NCRN) was established to increase participation in cancer clinical research.Methods:The NCRN was established in 2001 to provide a robust infrastructure for cancer clinical research and improvements in patient care. Remit of NCRN is to coordinate, support and deliver cancer clinical research through the provision of research support staff across England. The NCRN works closely with similar networks in Scotland, Wales and the Northern Ireland. A key aim of NCRN is to improve the speed of research and this was also assessed by comparing the speed of study delivery of a subset of cancer studies opening before and after NCRN was established.Results:Patient recruitment increased through NCRN, with almost 32 000 (12% of annual incident cases) cancer patients being recruited each year. Study delivery has improved, with more studies meeting the recruitment target – 74% compared with 39% before NCRN was established.Conclusion:The coordinated approach to cancer clinical research has demonstrated increased accrual, wide participation and successful trial delivery, which should lead to improved outcomes and care.

Evidence based health care should apply to the way that services are delivered as much as it does to treatments