Leading suicide theories and research in adults suggest that pain may exacerbate an individual's suicidal risk. Although pain and suicidality both increase in prevalence during adolescence, their relationship remains unclear. We aimed to systematically review the empirical evidence for an association between pain and suicidality in adolescence (PROSPERO: CRD42018097226). In total, 25 observational studies, published between 1961 and December 2018, exploring the potential pain-suicidality association in adolescence (10-19 years) were included. Across various samples and manifestations of pain and suicidality, we found that pain approximately doubles adolescents' suicidal risk, with a few studies suggesting that pain may predict suicidality longitudinally. Although depression was an important factor, it did not fully explain the painsuicidality association. Evidence on associations between pain characteristics and suicidality is sparse and inconclusive, potentially hiding developmental differences. Identification of psychological mediators and moderators is required to develop interventions tailored to the needs of adolescents in pain.

Background Electronic Health Records (EHRs) can help clinicians to plan, document and deliver care for patients in healthcare services. When used consistently, EHRs can advance patient safety and quality, and reduce clinician’s workload. However, usability problems can make it difficult for clinicians to use EHRs effectively, which can negatively impact both healthcare professionals and patients. Objective To improve usability of EHRs within a mental health service in the UK. Methods This was a feasibility study conducted with two mental health teams. A mixed-methods approach was employed. Focus group discussions with clinicians identified existing usability problems in EHRs and changes were made to address these problems. Updated EHR assessment forms were evaluated by comparing the following measures pre and post changes: (1) usability testing to monitor time spent completing and duplicating patient information in EHRs, (2) clinician’s experience of using EHRs, and (3) proportion of completed EHR assessment forms. Results Usability testing with clinicians (n = 3) showed that the time taken to complete EHR assessment forms and time spent duplicating patient information decreased. Clinician’s experience of completing EHR assessment forms also significantly improved post changes compared to baseline (n = 71; p < 0.005). There was a significant increase in completion of most EHR forms by both teams after EHR usability improvements (all at p < 0.01). Conclusions Usability improvements to EHRs can reduce the time taken to complete forms, advance clinician’s experience and increase usage of EHRs. It is important to engage healthcare professionals in the usability improvement process of EHRs in mental health services.

We conducted a scoping review of the current knowledge about autism in Baltic States: Lithuania, Latvia and Estonia. The aim was to identify publications about autism and potential gaps of knowledge in this region. The search was conducted on March 31, 2016 using PubMed, PsycINFO and EMBASE databases. The search was updated on August 31, 2016; a total of 47 studies were analysed. Current research on autism in Baltic States is still in its beginning. Areas studied were education, medicine, parenting, autism in adulthood, treatments and epidemiology. Education sector is the most researched discipline about autism in Baltic countries especially addressing issue on schooling practices for autistic children. The prevalence of autism is unclear as only one outdated epidemiological study was found. Further epidemiological, clinical intervention research need to be conducted in this region.

This review aimed to determine: whether EF is affected in children and adolescents (2-24-years-old) with perinatal HIV infection, perinatal HIV exposure without infection, and behaviourally acquired HIV. A systematic review (PROSPERO number: *) was conducted using 11 electronic databases (01.01.1981-09.07.2019) and 8 conference websites. Primary quantitative studies with EF scores on cognitive tasks and/or behavioural report measures were included. Meta-analyses were performed by EF subtype and subpopulations compared. 1789 records were found. Sixty-one studies were included in the narrative synthesis; 32 (N = 7884 participants) were included in meta-analyses. There was a distinct pattern of reduced EF in those with perinatal HIV infection on antiretroviral therapy compared to controls: pooled effect sizes were largest for verbal and visuospatial working memory, with smaller effects on planning, inhibitory control and set-shifting. Data were limited for other HIV-affected subpopulations. Perinatal HIV infection is associated with reduced EF with varying effect sizes for the different EF subtypes.

Introduction: Child Safeguarding Services intervene in situations where a child is at risk of serious emotional or physical harm. The response will vary according to the level of risk, but in serious cases, a child may need to be removed from danger and cared for by foster parents either temporarily or permanently. The number of children being taken into care has increased markedly in recent years in the United Kingdom. Oxfordshire County Council (OCC) is implementing a new approach to the welfare of children (Family Solutions Plus; FSP) in which the focus is to support the whole family and ideally reduce the need for foster care.In this paper, we describe a proposed programme of evaluation to examine the impact of FSP on the time children are in contact with services, the nature of the support provided, experience of children and families, the experience of staff, and longer term outcomes for children, particularly whether they remain within the family or need to be cared for outside the home. Methods and analysis:A mixed methods approach will be taken in an observational retrospective study of children's social care services. Quantitative research will include descriptive analysis on data routinely collected by OCC, examining the effect on time spent in services, outcomes for children and how these outcomes are mediated by family characteristics and circumstances. Qualitative research will be carried out using individual interviews and focus groups with children, families and staff in the teams providing family safeguarding services to capture their experiences with the new model. Ethics and dissemination:This project has been registered with the OCC as a service evaluation. The qualitative studies will seek ethical approval from Oxford University Ethics Committee. A local data sharing agreement will govern the transfer of quantitative data. Results will be disseminated through newsletters, community forums, professional publications and conference presentations to national and international audiences.

ObjectivesTo describe the current work of the Patient Advice and Liaison Service (PALS) and assess the service’s potential to resolve concerns and contribute to organisational learning.DesignA qualitative study using semistructured interviews.SettingFour mental health trusts and four acute trusts in the English National Health Service, a total of eight PALS across different trusts.ParticipantsTwenty-four participants comprising of PALS staff and clinicians working with PALS teams.MethodsSemistructured interviews were undertaken with participants using video conferencing software. The framework method was used for the analysis of the large qualitative dataset, which is a conventional method of analysis, similar to thematic or qualitative content analysis.ResultsPALS teams fulfil their core responsibilities by acting as point of contact for patients, providing information and resolving a variety of recurrent problems, including PALS staff communication, staff attitudes and waiting times. The remit and responsibilities of each PALS has often broadened over time. Barriers to resolving concerns included a lack of awareness of PALS, limited to no policies informing how staff resolve concerns, an emphasis on complaints and the attitude of clinical staff. Senior management had widely differing views on how the PALS should operate and the management of complaints is a much higher priority. Few PALS teams carried out any analysis of the data or shared data within their organisations.ConclusionsPALS teams fulfil their core responsibilities by acting as point of contact for patients, providing information and resolving concerns. PALS staff also act as navigators of services, mediators between families and staff and, occasionally, patient advocates in supporting them to raise concerns. PALS has the potential to reduce complaints, increase patient satisfaction and provide rapid organisational feedback. Achieving this potential will require more awareness and support within organisations together with updated national policy guidance.

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This paper presents the findings from a qualitative study that sought to understand the experiences of frontline staff working in Oxfordshire County Council (OCC) Children's Social Care Services and their views on a new family safeguarding model (Family Solutions Plus). Focus group interviews were conducted with 20 frontline staff and managers in different teams across OCC Children's Social Care Services using video conferencing software. Thematic analysis identified three overarching themes: Preparation for the implementation of Family Solutions Plus, staff views on the implemented model, and challenges to its implementation. Staff voiced strong support for the new model, which places a much greater emphasis than previous practice on supporting the whole family, developing parenting skills and keeping children safe with their families. The challenges associated with the transition to a new model were considerable in the short term, partly due to the COVID‐19 pandemic, but there was optimism that the new model could be sustained and stabilized over time.