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Background and Aims: Evidence demonstrating an association between parental alcohol use and offspring alcohol use from robust prospective studies is lacking. We tested the direct and indirect associations between parental and young adult alcohol use via early alcohol initiation, parental monitoring and associating with deviant peers. Design Prospective birth cohort study. Path analysis was used to assess the possible association between parental alcohol use (assessed at 12 years) and alcohol use in young adults (assessed at 18 years) via potential mediators (assessed at 14 and 15.5 years, respectively). Setting: South West England. Participants: Data were available on 3785 adolescents and their parents from the Avon Longitudinal Study of Parents and Children. Measurements The continuous Alcohol Use Disorders Identification Test (AUDIT) score was used as the primary outcome measure. Maternal alcohol use was defined as light (< 4 units on any day), moderate (≥ 4 units on 1–3 days) and high‐risk (≥ 4 units on ≥ 4 days in 1 week). Partner alcohol use was also defined as light, moderate and high risk. Socio‐economic variables were included as covariates. Findings There was strong evidence of a total effect from maternal alcohol use to young adult alcohol use [moderate: b = 1.07, 95% confidence interval (CI) = 0.64, 1.49, P < 0.001; high risk: b = 1.71, 95% CI = 1.07, 2.35, P < 0.001]. The majority of this association was explained through early alcohol initiation (moderate: b = 0.14, 95% CI = 0.04, 0.25, P = 0.01; high risk: b = 0.24, 95% CI = 0.07, 0.40, P < 0.01) and early alcohol initiation/associating with deviant peers (moderate: b = 0.06, 95% CI = 0.02, 0.10, P < 0.01; high risk: b = 0.10, 95% CI = 0.03, 0.16, P < 0.01). There was strong evidence of a remaining direct effect (moderate: b = 0.81, 95% CI = 0.39, 1.22, P < 0.001; high risk: b = 1.28, 95% CI = 0.65, 1.91, P < 0.001). A similar pattern of results was evident for partner alcohol use. Conclusions: Young adults whose parents have moderate or high‐risk alcohol consumption are more likely to consume alcohol than those with parents with lower alcohol consumption. This association appears to be partly accounted for by earlier alcohol use initiation and higher prevalence of association with deviant peers. [ABSTRACT FROM AUTHOR]

Background The National Violence Surveillance Network (NVSN) of emergency departments (ED), minor injuries units and walk-in-centres in England and Wales has brought clarity to contradictory violence trends derived from crime survey and police data. Gender, age-specific and regional trends in violence-related injury in England and Wales since 2010 have not been studied. Methods Data on violence-related injury were collected from a structured sample of 151 EDs in England and Wales. ED attendance date and age and gender of patients who reported injury in violence from 1 January 2010 to 31 December 2014 were identified from attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends. Results In total, 247 016 (178 709 males: 72.3%) violence-related attendances were identified. Estimated annual injury rate across England and Wales was 4.4/ 1000 population (95% CI 3.9 to 4.9); males 6.5/1000 (95% CI 5.6 to 7.2) and females 2.4/1000 (95% CI 2.1 to 2.6). On average, overall attendances decreased by 13.8% per year over the 5 years (95% CI -14.8 to -12.1). Attendances decreased significantly for both genders and all age groups (0-10, 11-17, 18-30, 31-50, 51+ years); declines were greatest among children and adolescents. Significant decreases in violence-related injury were found in all but two regions. Violence peaked in May and July. Conclusions From an ED perspective, violence in England and Wales decreased substantially between 2010 and 2014, especially among children and adolescents. Violence prevention efforts should focus on regions with the highest injury rates and during the period May-July. [ABSTRACT FROM AUTHOR]

While neglect is generally associated with poor developmental outcomes, it remains poorly defined. Factor analysis was applied to 39 parental behavior variables on data from the Cambridge Study in Delinquent Development (CSDD) to explore underlying dimensions of parental behavior that were consistent with the concept of neglect. Logistic regression assessed associations between the dimensions of neglect recovered from the CSDD and future adult delinquency. Factor analysis revealed four dimensions; logistic regression revealed significant associations between two of these dimensions--poor supervision and a disorganized, chaotic home environment--and future adult delinquency. Neglect is a viable construct that can summarize aspects of parental behavior and predict future adult delinquency. [ABSTRACT FROM AUTHOR]

Research involving both children's problems and those of their parents who experienced displacement, war, civil strife, and multiple traumas or distress while living in unfamiliar environments (dissimilar host culture) is extremely limited. This study has examined the relationship between psychological well-being and adjustment (in the host culture) of samples of both parents and children of exiled and traumatized Iraqi refugees in London. Participants included in this study were Arab and Kurdish Iraqi refugees; 61 families (mainly adult participants) with a total number of 162 children. The sample consisted of both parents and children who were, at the time of conducting this research (2003-2004), residing in various boroughs of London. The 30-item version of General Health Questionnaire (GHQ) and a short and modified version of the Child Behavioral Checklist (CBCL) questionnaire were used. Both of these measures have been translated and used in different cultures with success. Parents were asked to complete both the GHQ and the CBCL; on the latter, parents were asked to reflect on any problems (including psychosocial and behavioral symptoms of ill health) which may have manifested themselves in the recent past among their children. The main results of this study appear to indicate that the estimated level of distress among parents who completed the GHQ was very high, with 52.46% of the sample reaching the threshold level. It also suggests that parents or adult refugees in this study manifested poor mental health and this, in turn, was found to be associated positively with children's poor adjustment in the host culture. Further results of t tests revealed that there were no significant differences found between male and female scores on the GHQ. Educational background was not a significant factor in determining the adjustment or the level of distress among the population of this study. Larger family size and refugee parents who had more than one child at home appeared to show vulnerability to distress more than those who had smaller families. Newly arrived refugees seemed to score higher on the GHQ than participants who had been in the host culture for a longer period of time. The major findings of this study were discussed in relation to culture learning theory, acculturation paradigm, U-curve theory, and the multidimensional model of adjustment. The latter seem to reflect on several factors associated with adjustment problems, including the prearrival phase and the new demands of the new host culture. Finally, the results of this investigation suggest that emotional and adjustment problems manifested among children of refugee families will not disappear without proper intervention programs or proper consideration of all risk factors, including family circumstances and previous parental psychopathology. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Injury records from Emergency Departments (EDs) have been studied over the last decade as part of the work of the National Violence Surveillance Network (NVSN) and provide information about local, regional and national violence levels and trends in England and Wales. The purpose of the current study is to evaluate overall, gender, age-specific and regional trends in community violence in England and Wales from an ED perspective from January 2005 to December 2009. Methods: Violence-related injury data were collected prospectively in a stratified sample of 77 EDs (Types 1, 3 and 4) in the nine Government Office Regions in England and in Wales. All 77 EDs were recruited on the basis that they had implemented and continued to comply with the provisions of the 1998 Data Protection Act and Caldicott guidance. Attendance date, age and gender of patients who reported injury in violence were identified using assault-related attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends. Results: In total 221,673 (163,384 males: 74%) violence-related attendances were identified. Overall estimated annual injury rate was 6.5 per 1000 resident population (males 9.8 and females 3.4 per 1000). Violence affecting males and females decreased significantly in England and Wales over the 5-year period, with an overall estimated annual decrease of 3% (95% CI: 1.8–4.1%, p <0.05). Attendances decreased significantly for both genders across four out of the five age groups studied. Attendances were found to be highest during the months of May and July and lowest in February. Substantial differences in violence-related ED attendances were identified at the regional level. Conclusions: From this ED perspective overall violence in England and Wales decreased over the period 2005–2009 but increased in East Midlands, London and South West regions. Since 2006, overall trends according to Crime Survey for England and Wales (CSEW), police and ED measures were similar, though CSEW and ED measures reflect far greater numbers of violent incidents than police data. Causes of decreases in violence in regions need to be identified and shared with regions where violence increased. [Copyright &y& Elsevier]

Background: Alcohol intoxication management services (AIMS) provide an alternative care pathway for alcohol-intoxicated adults otherwise requiring emergency department (ED) services and at times of high incidence. We estimate the effectiveness and cost-effectiveness of AIMS on ED attendance rates with ED and ambulance service performance indicators as secondary outcomes., Methods: A controlled longitudinal retrospective observational study in English and Welsh towns, six with AIMS and six without. Control and intervention cities were matched by sociodemographic characteristics. The primary outcome was ED attendance rate per night, secondary analyses explored hospital admission rates and ambulance response times. Interrupted time series analyses compared control and matched intervention sites pre-AIMS and post-AIMS. Cost-effectiveness analyses compared the component costs of AIMS to usual care before with results presented from the National Health Service and social care prospective. The number of diversions away from ED required for a service to be cost neutral was determined., Results: Analyses found considerable variation across sites, only one service was associated with a significant reduction in ED attendances (-4.89, p<0.01). The services offered by AIMS varied. On average AIMS had 7.57 (mean minimum=1.33, SD=1.37 to mean maximum=24.66, SD=12.58) in attendance per session, below the 11.02 diversions away from ED at which services would be expected to be cost neutral., Conclusions: AIMSs have variable effects on the emergency care system, reflecting variable structures and processes, but may be associated with modest reductions in the burden on ED and ambulance services. The more expensive model, supported by the ED, was the only configuration likely to divert patients away from ED. AIMS should be regarded as fledgling services that require further work to realise benefit., Trial Registration Number: ISRCTN63096364., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)