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For the most part, looked-after children have poorer physical and mental health than other children, and do less well educationally. Their employment prospects are poorer and they are over-represented amongst young offenders. But this is changing for the better in Northern Ireland, where research at Queen's has helped to improve the stability and quality of placements provided to looked-after children, and the support given to them when they leave care. The 2010 Demos report on children in state care in the UK used illustrations of best practice from Northern Ireland.
Research by the UCL Dental Public Health Group has led the international field in the development and validation of quality of life (QoL) measures associated with oral health. Tsakos and Sheiham instigated the development of the Oral Impacts on Daily Performances (OIDP) measure in 1996 followed by the Child Oral Impacts on Daily Life (Child-OIDP) in 2004. Both of these outcome measures have been employed in epidemiological surveys of needs assessment by local health providers in London resulting in enhanced use of resources, better staff training, and improved patient care and health care access. These measures have been employed in the most significant NHS surveys of oral health of adults and children in the UK as well as used by health organisations across the globe. The outcomes of Tsakos' research on oral epidemiology and QoL, together with engagement with policy makers in the UK and Europe, have raised the profile of oral health and is influencing health care policies nationally and internationally.
Research at Strathclyde has focused on the abuse of children in residential care, both historical and contemporary abuse, and drawn out the implications for improving current policy and practice. These research conclusions have been central in informing local, national and international policy and practice developments, impacting on interventions for adults who have experienced abuse in care, training and education of residential child care professionals, and current residential child care services. This impact has been delivered through the research directly informing the evidence base for the Shaw Review (2007) in Scotland into lessons to be learnt from historical abuse. This Review drew upon the published research alongside commissioned accounts by the Strathclyde researchers to identify actions by the Scottish Government in this area which have been implemented by government since 2008.
Research conducted by Peter Elfer has shown the significance of attention to babies and under threes' emotional well-being in nursery if early learning is to be effective. Children who are continually anxious or distressed do not learn well. A sensitive, responsive and consistent relationship with mainly one or two members of nursery staff (now known as the child's `key-person') has been shown to promote in young children feelings of safety and security. The research has underpinned the development of the key-person role in nurseries, as the means for enabling individual attention to children. This research has had a significant impact in the following areas:
1) UK Government curriculum guidance and requirements
2) Training of the early years workforce and continuing professional development
3) The evolution of UK Coalition Government policy and public discourse
The reach of the research is extensive, providing the underpinning for attachment practice in English nurseries. The above developments have strengthened the expectation in national standards of greater attention to the emotions of babies and young children in nursery and have provided the detailed guidance on how this can be achieved in practice.
Research by Dr Una Convery and Dr Linda Moore (respectively Lecturer and Senior Lecturer in Criminology) has significantly influenced rights-compliance in policy, legislation and practice regarding youth custody in Northern Ireland and beyond. Most notably, it impacted decisively on the development of innovative regimes and policies at NI's only custodial centre for children and improved their conditions. It also influenced decisions on reduced custodial levels and the removal of children from the penal system. By providing a solid evidence base, utilised by lobbyists and political representatives, the research influenced the inclusion of independent reviews of the penal and youth justice systems within the multi-party Hillsborough Agreement (2010). Its findings also assisted the Northern Ireland Human Rights Commission (NIHRC) in its successful campaign for enhanced investigatory powers.
The ability of healthcare professionals to empathise with patients has been shown to enhance patient satisfaction, improve symptoms and promote well-being. Research at University of Glasgow has developed the Consultation and Relational Empathy (CARE) Measure — the first validated, patient-rated questionnaire developed in a primary care setting that measures patient perceptions of healthcare professionals' empathy and quality of care. The CARE Measure is formally embedded into healthcare professional training standards through its inclusion in Scottish General Practitioner (GP) appraisals and the Royal College of General Practitioners Membership (MRCGP) and Interim Membership by Assessment of Performance (iMAP) processes; through these means more than 8,000 GPs are using the CARE Measure. It has also been incorporated into the Scottish Government's policy on Healthcare Quality and adopted by the General Medical Council and the Chartered Society of Physiotherapy.
Research conducted at UEL on the protection, participation and welfare of children living in difficult circumstances in the aftermath of conflict and in contexts of urban and rural poverty has had wide-ranging impacts on international policy and practice. Benefits have arisen particularly from its influence on national policies for orphans and vulnerable children in Rwanda; on international professional standards and `best practice'; and on legal asylum in the USA. It has been used directly by governmental policymakers in Rwanda and Bangladesh and aid organisations in Africa and Asia, and has formed the basis for the development of new learning and advocacy resources used to improve the services offered by social work professionals in Africa, Asia and the UK. Through its direct impact on these individuals and organisations, the research has delivered indirect benefits to millions of children and adults around the world.
Loughborough University's Improving Outcomes of Services for Children in Need research is a programme of interlinked studies that has had a substantial impact on the development of national and international policy and professional practice for the most vulnerable children. It has influenced the development of government policy on safeguarding children from abuse and neglect, placement in out-of-home care, and adoption throughout the United Kingdom and in Australia, Canada and countries in Western and Eastern Europe. The researchers have translated a number of findings into tools designed to shape professional practice: these include a computer application that introduces transparency into the comparison of costs and outcomes of services.
We have developed the first ever physiotherapy guidelines (2008-) for contracted (frozen) shoulder (CFS). CFS is painful and disabling, affects c.9% of the UK working-age population,1 and costs the NHS > £13.5 million annually.2 Appropriate physiotherapy could improve outcomes and reduce costs by up to £2,000 per case.b
Endorsed by the Chartered Society of Physiotherapy (CSP), the guidelines have generated great interest and already influenced practice and will improve the quality and cost-effectiveness of clinical management, as well as patients' experiences. They will also provide a better framework for research into the condition and, as a `live', electronic document, will evolve with future research.
Cancer treatment for children is one of the success stories of medical care in the twentieth century. Survival increased from almost zero in the 1950s to today, when treatment for some child cancers results in over 90% survival. These improved survival rates have, however, been achieved through use of highly aggressive treatment protocols, with adverse implications for the child's cognitive, emotional and social development and the burden of care on families. Nationally, researchers at Sheffield were among the first to identify the extent to which children continued to show psychological and behavioural problems, even long after the end of treatment. As such, they contributed significantly to discussions about how to balance medical treatment to control the cancer while taking into account the immediate and longer-term impacts on child quality of life and parents' psychological well-being. The work has had direct implications for both national and international clinical guidelines, and assessment of quality of life in national clinical trials. It has also resulted in user-friendly information for schools and families.