Specialist rehabilitation for neurobehavioural disability produces comprehensive and sustainable improvements in the life of individuals with brain injury. The initial costs associated with neurobehavioural rehabilitation are offset by savings in costs of support in the medium and longer term.

Long-term outcome from severe brain injury can be compromised by enduring disturbance of arousal, most commonly evidenced as sleep disorder. Treatment should be based on judicious use of medication (beyond hypnotic drugs) and greater emphasis on non-pharmacological management.

Background: Reunification of looked-after children with their birth parents is the most common route to permanency for looked-after children in the United Kingdom.Previous research evidence, mainly from American studies, suggests numerous factors that contribute to successful reunification outcomes (Biehal, 2007). Less is known about the current evidence base for reunification practice in the United Kingdom.Objective: This review aimed to identify, appraise, and synthesize published literature concerned with the reunification of looked-after children with their birth parents in the United Kingdom. Methods:A systematic search of the literature identified eight peer-reviewed studies conducted between 2005 and 2017 exploring reunification practice in the United Kingdom. Studies were critically appraised and thematically synthesized according to the Thomas and Harden (2008) approach.Results: Eight articles met eligibility criteria. Descriptive themes were support, case management, oscillation, parenting, and reoccurrence of abuse. Analytic themes were lack of guidance and risks associated with return. Conclusions:A pattern of oscillation between home and care was common for many looked-after children, and remaining in care produced relatively better outcomes. Difficulties arise when comparing studies on reunification, due to methodological variation. Further research is needed to explore the views of reunited children themselves.

Background Self-harm usually begins during adolescence and adolescents that self-harm most commonly confide in friends, yet to date, there is little research from the friend's perspective.Objective This qualitative study explores adolescents' experiences of what it is like to have a friend who self-harms by cutting and what this experience means for friendship, the wider peer group and psychological well-being. Methods Semi-structured interviews were conducted face-to-face with a community sample of eight females aged between 13 and 18 years, living in England. Interpretative Phenomenological Analysis was used to analyse the data. Results Four superordinate themes emerged: desperately searching for meaning, I will be there at all costs, too hot to handle and identification. Adolescents were concerned about escalations in their friends' behaviours and felt a sense of duty to help, but the majority experienced a dilemma as to whether to disclose to others and all reported some form of distress. Conclusions The results highlight the important, yet complex nature of friendship in this context. Friends play a key role in supporting adolescents who self-harm but need greater support managing this role and the effects. Schools/colleges should educate young people about self-harm to increase their knowledge and skills in relation to supporting a friend with this issue. Furthermore, they should promote environments for talking about mental health openly to give young people increased opportunities for help-seeking.

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