Objectives. To provide baseline cohort descriptives and assess change in health behaviours since the UK COVID-19 lockdown.Design. A prospective cohort (N = 1,044) of people recruited online, purposively targeting vulnerable populations.Methods. After a baseline survey (April 2020), participants completed 3 months of daily ecological momentary assessments (EMA). Dietary, physical activity, alcohol, smoking, vaping and substance use behaviours collected retrospectively for the pre-COVID-19 period were compared with daily EMA surveys over the first 30 days during early lockdown. Predictors of behaviour change were assessed using multivariable regression models.Results. 30% of the cohort had a COVID-19 at risk health condition, 37% were classed as deprived and 6% self-reported a mental health condition. Relative to pre-pandemic levels, participants ate almost one portion of fruit and vegetables less per day (vegetables mean difference À0.33, 95% CI À0.40, À0.25; fruit À0.57, 95% CI À0.64, À0.50), but showed no change in high sugar portions per day (À0.03, 95% CI À0.12, 0.06). Participants spent half a day less per week doing ≥30 min of moderate to vigorous physical activity (À0.57, 95% CI À0.73, À0.40) but slightly increased days of strength training (0.21, 95% CI 0.09, 0.34), increased alcohol intake (AUDIT-C score change 0.25, 95% CI 0.13, 0.37), though did not change smoking, vaping or substance use behaviour. Worsening health behaviour change was associated with being younger, female and higher body mass index.Conclusions. The cohort reported worsening health behaviours during early lockdown. Longer term changes will be investigated using further waves of data collection.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Analyses revealed a mixed picture of benefit and apparent disbenefit. This study illustrated the challenges of evaluating a complex intervention in which the evaluators had less control than is usual in randomized trials over recruitment, eligibility checking and implementation. If the impact of new policy initiatives is to be assessed using the most robust forms of evaluation, social policy needs to be organized so that evaluations can be constructed as experiments. This is likely to prove most difficult where the perceived value of implementing an intervention rapidly is high.

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Thresholds into and between services emerged as a significant theme in the biennial analysis of cases of child death and serious injury through abuse and neglect ‘serious case reviews’ carried out in England for the (then) Department for Education and Skills between 2003–05. The preoccupation with thresholds was one of a number of interacting risk factors and many children's cases were on the boundary of services and levels of intervention. In most cases child protection did not come ‘labelled as such’ which reinforces the need for all practitioners, including those working with adults to be alert to the risks of significant harm. Policy makers should acknowledge that staff working in early intervention are working within the safeguarding continuum and not in a separate sphere of activity. The emotional impact of working with hostility from violent parents and working with resistance from older adolescents impeded engagement, judgement and safeguarding action. In the long term neglect cases that were reviewed, the threshold for formal child protection services was rarely met and some agencies and practitioners coped with feelings of helplessness by adopting the ‘start again syndrome’. Adequate resources are essential but not sufficient to redress the problems. Effective and accessible supervision is crucial to help staff to put into practice the critical thinking required to understand cases holistically, complete analytical assessments, and weigh up interacting risk and protective factors. Copyright © 2008 John Wiley & Sons, Ltd.

Although there is improved recognition of the pernicious long-term harm that stems from living with neglect during childhood, neglect is rarely associated with child fatality. This article offers a re-analysis of neglect in serious case reviews (cases of child death or serious injury related to maltreatment) in England (2003-11) from four consecutive government-commissioned national two-yearly studies. It draws on anonymised research information from 46 cases out of a total of over 800 cases. Each case was examined in depth using an ecological transactional approach, grounded in the child's experience, which promotes a dynamic understanding and assessment of the interactions between children and their families and the helping practitioners. The qualitative findings reported explore how circumstances came together when neglect had a catastrophic impact on the child and family presenting in six different ways (deprivational neglect, medical neglect, accidents with elements of forewarning, sudden unexpected deaths in infancy, physical abuse combined with neglect and young suicide). Each of the six categories raised particular issues over and above a common core of concerns around the relationship between the child and his or her parent or carer, and between parents/carers and professionals.