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The development of child and youth advocacy has been informed by varying theoretical perspectives and in the last decade has been increasingly incorporated into policy and legislation for young people in receipt of welfare services. Through examining the varying perspectives of young people, advocates and commissioners of advocacy services it can be seen that although there is some consensus about how advocacy should be provided, the construction of advocacy by adults may have a significant impact on how it is experienced by young people. This paper draws on material from five advocacy projects to examine how advocacy is constructed by those involved in the provision and receipt of services. It argues that there is a danger that the construction of advocacy in an adult proceduralised way is likely to compromise its potential to challenge the structures that deny young people opportunities to participate in decision making about their lives.

Objective: Studies summarizing the outcome of first-trimester septated cystic hygroma are generally based on small studies or from multiple centers with limited ascertainment. We reviewed the natural history of a large cohort of such cases from a single tertiary referral center, with the aim being to establish contemporary outcome data, particularly in the setting of normal karyotype. Methods: A retrospective cohort study from 2007 to 2017 was conducted at a single tertiary referral prenatal diagnosis center. Data were analyzed from a prospectively collated fetal anomaly database. Search terms were "increased nuchal translucency (NT)," "cystic hygroma," and "septated cystic hygroma." All cases were confirmed to have NT >3 mm with septations. Cases of simple increased NT without septations were excluded. Results: During the study period, over 110,000 pregnancies were delivered at our center, resulting in 410 cases of septated cystic hygroma diagnosed prior to 14 weeks' gestation. Pregnancy outcome was obtained in 99% (405/410) of cases, with detailed pathology outcome available in 92% (378/410). A total of 87% (351/405) underwent invasive prenatal testing, and postnatal chromosome status was established in further 27 cases. A total of 61% (230/378) had abnormal chromosomal status. Of the 39% (148/378) with normal chromosomal status, only 13% (19/148) had a significant structural fetal abnormality, which included 7 cardiac and 12 noncardiac abnormalities. Overall, the perinatal loss was 62% (253/405). The total survival rate in the setting of euploid cystic hygroma without structural abnormality was 84% (108/129). Conclusions: Counseling regarding outcomes in the setting of first-trimester septated cystic hygroma initially focuses on the strong likelihood of an abnormal karyotype, which occurs in 61% of cases. However, once fetal chromosomal abnormality is excluded, our results demonstrate only a 13% incidence of major structural fetal abnormality, which appears significantly less than previously reported. Normal fetuses have a 77% survival rate. These data represent the largest single-center study of first-trimester cystic hygroma with complete outcome data and therefore will be useful for contemporary patient counseling. Such counseling can be more positive than previously expected, once chromosomal abnormality is first excluded. [ABSTRACT FROM AUTHOR]

The emergence of independent advocacy services for children and young people has had an impact on promoting the rights of children and young people. Historically, advocacy has been considered an important social work skill underpinned by principles of human rights and social justice. However, the development of independent advocacy and changes in the delivery of health and social care services have had an impact on how far social workers now feel able to directly advocate for service users. This paper interrogates the tensions faced by social workers in managing their advocacy role through a discussion of advocacy in relation to children and young people. By examining the concepts of 'best interests' and the welfare of the child the paper considers dilemmas for social workers committed to advocating for children and young people. It argues that if principles of social justice are to be upheld practitioners need to actively consider ways to reclaim a culture of advocacy. [ABSTRACT FROM AUTHOR]

The development of child and youth advocacy has been informed by varying theoretical perspectives and in the last decade has been increasingly incorporated into policy and legislation for young people in receipt of welfare services. Through examining the varying perspectives of young people, advocates and commissioners of advocacy services it can be seen that although there is some consensus about how advocacy should be provided, the construction of advocacy by adults may have a significant impact on how it is experienced by young people. This paper draws on material from five advocacy projects to examine how advocacy is constructed by those involved in the provision and receipt of services. It argues that there is a danger that the construction of advocacy in an adult proceduralised way is likely to compromise its potential to challenge the structures that deny young people opportunities to participate in decision making about their lives. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article examines the development of child and youth advocacy through an analysis of the meaning of professionalization and argues that a culture of advocacy is needed to facilitate the development of professional advocacy expertise. Findings: The fragmented development of child and youth advocacy in England and Wales has accelerated within the modernizing agenda of New Labour. While child and youth advocacy competes with other imperatives in the provision of health and social care services, advocates seek to develop professional status in order to ensure effectively the involvement of children and young people in decision making. The nature of advocacy practice creates resistance to traditional models of professionalization but a committed practitioner model, recognizing advocacy expertise, enables advocacy to develop in a way that does not compromise its role. Applications: Debates about the professionalization of child and youth advocacy are ongoing, particularly with the publication of advocacy standards in England and Wales. This article contributes to the discussion and suggests a model for developing the theory and practice of child and youth advocacy. [ABSTRACT FROM AUTHOR]

Family Group Conferences are being used in a range of decision making forums around the world. They operate with an empowering methodology that enables service users to participate in decision making. For children and young people however the empowering potential may be minimised by the fact that it is an adult decision making forum. The need for advocates to support children and young people in these meetings has been recognised and this paper uses the experiences of a Barnardos Family Group Conference Project in Wiltshire to identify the benefit of advocacy support. It argues that all children and young people involved in Conferences should have the right of access to an independent advocate to enable them to participate. [ABSTRACT FROM PUBLISHER]

The notion of independent advocacy does not sit easily with the principles of Family Group Conferences (FGC). The integrity of conferencing is in the competence of family members to make their own decisions. The challenge of enabling the voice and agency of children and young people within their own family networks however is formidable. The familial nexus can be as institutionally excluding as any other adult forum. This paper focuses on the work of a FGC project in Wiltshire, England, which used a small grant to provide independent advocacy for children and young people involved in conferences. Drawing on an evaluation of the project, the article argues that distinguishing children and young people's power from parental and professional power permits their empowerment through the use of advocacy. [ABSTRACT FROM AUTHOR]

Sharing information needlessly is an invasion of privacy. Adults are justly indignant if something that they have talked about in confidence is passed on without their consent. However, information between professionals is often shared without the consent of the young people concerned. Many are already distrustful of adults when it comes to sharing confidential information and this is confirmed when something young people have expected to be treated confidentially is shared between adults without permission being sought For those working in agencies providing services for children and young people, attitudes to confidentiality can vary from those who have clear policies or codes of conduct to those who are totally unaware of the legal position. This then creates tensions between professionals and can often make working together difficult for many and impossible for some. In 1996 the Stratford District Children's Services Development group decided to consider issues of confidentiality as they affected different agencies working with young people. Two years on they launched 16 principles for sharing information that are acceptable to all the agencies and to the young people using them, based on shared good practice. This paper presents an account of the process of establishing those principles with particular reference to the part played by young people. [ABSTRACT FROM PUBLISHER]

This article is based on the experiences of social work staff and students involved in the Self-Assessment in Professional and Higher Education Project (SAPHE), funded by the Higher Education Funding Council for England through the Fund for the Development to Teaching and Learning. The rationale for self-assessment is explored, together with its links to reflective learning and the core competence in the requirements for the Diploma in Social Work 'Develop professional Competence'. Work in progress on the project is described and analysed across three sites (the DipSW programmes at the Universities of Briston, Bath and the West fo England). The focus here is on the use of self-assessment in university work; self-assessment in relation to practice learning is considered in parallel article. The centrality of self-assessment to social work education is confirmed, and some preliminary themes emerging from the project are identified. [ABSTRACT FROM AUTHOR]

Practice teachers in partnership with academic sites have the task of ensuring that students have an understanding of anti-oppressive practice. This can be a daunting task. In this article the authors use fictional dialogue between a practice teacher and a student to demystify the principles of anti-oppressive practice and offer practice teachers ideas that can be used to develop a planned programme of learning. [ABSTRACT FROM PUBLISHER]

Objective With the recognition of the role of fetoscopic laser ablation for twin to twin transfusion syndrome (TTTS), there is a requirement for auditable standards for this technically challenging and specialized treatment. The purpose of this study is to report on the perinatal and medium-term neurodevelopmental outcomes following an 8-year national single center experience in the management of TTTS using the selective fetoscopic laser ablation technique. Study design An audit of all cases of TTTS treated with selective laser ablation by a single national fetal medicine team was performed. Overall perinatal survival and medium-term neurodevelopmental outcomes were reported and correlated with gestational age at diagnosis, placental location, volume of amnio-reduction, Quintero staging and percentage inter-twin growth discordance. Procedure-related complications were recorded. Results The overall fetal survival for the first 105 consecutive cases of TTTS was 61% (128/210 fetuses). Dual survival occurred in 47% (49/105) of cases, and with a single survival rate of 28% (30/105), perinatal survival of least one infant was achieved in 75% (79/105) of cases. No correlation was found between any clinical or sonographic marker and perinatal outcome, although dual survival was noted to be significantly decreased with increasing Quintero stage ( p = 0.041). Currently, 86% of survivors have been reported to have a normal medium-term neurological outcome. Conclusion Fetoscopic laser ablation is the established optimal treatment for severe twin to twin transfusion syndrome (TTTS). We report comparable short and medium-term outcomes following the selective fetoscopic technique comparing results from our national program with internationally published single-center outcomes, supporting the efficacy and safety of this treatment at our center. [ABSTRACT FROM AUTHOR]