This paper aims to contribute to the prevention of future domestic homicide by analysing 141 domestic homicide reviews (DHRs) in England and Wales. All publicly available DHRs (n = 141) were retrieved from Community Safety Partnership websites in England and Wales in June 2016. Utilising a mixed methods approach, we designed templates to extract quantitative and qualitative data from DHRs. Descriptive statistics were generated by SPSS. 54 DHRs were analysed qualitatively, using N-Vivo for data management. The findings revealed that perpetrators were aged: 16-82 years; with a mean average age of 41 years. Victims' ages ranged from 17 to 91 years old; with a mean average age: 45 years. Perpetrators' mental health was mentioned in 65% of DHRs; 49% of perpetrators had a mental health diagnosis. Healthcare services, in particular, mental health services, were most likely to be involved with perpetrators. 'Movement' was identified as a key contextual feature of the 54 DHRs analysed qualitatively and this was found to interact with risk assessment, language barriers and housing problems. In conclusion, domestic violence and abuse risk assessments need to be informed by the knowledge that domestic abuse occurs across the age span. Mental health settings offer an opportunity for intervention to prevent domestic homicide. Domestic Homicide Reviews can provide valuable material for training practitioners. K E Y W O R D Sage, domestic homicide, ethnicity, gender, mental health, review

(BMJ. 2018;363:k4372) As maternal age rises in the United States, the age of fathers is also increasing, with the percentage of births to fathers over age 40 doubling since the 1970s. While the effects of increased maternal age have been studied extensively, there is a lack of conclusive research regarding the effects of increased paternal age on pregnancy outcomes. There have been suggested links between the high number of male germ cell divisions in aging fathers and autism, genetic abnormalities and other adverse outcomes, although previous studies have not been adequately powered. This retrospective population-based cohort analysis aimed to examine associations between paternal age and maternal and neonatal health in the United States.

Early help or early intervention is increasingly recommended for safeguarding children living with domestic violence, but little is known about what is effective. This article discusses findings from an evaluation of a pioneering early help service in North West England. This new service aimed to improve the safety and wellbeing of families (mothers and children) who were assessed as below the level of ‘high risk’ domestic violence and below the threshold for a child protection order. Between January 2014 and March 2015, families (473 mothers and 541 children) were identified within multiagency safeguarding hubs and referred to the early help service. The service that emerged was somewhat different to the service expected. This article discusses findings from qualitative data gathered from 39 participants (mothers, children and service providers) involved in the programme. Three main issues emerged as themes from the interviews: the benefits of having any service at all for children living with domestic violence who slip off the agendas of professionals working with child protection and high‐risk domestic violence; the importance of flexibility of key worker‐led service delivery; and the suitability of current group work and therapeutic models for meeting the varied needs of families affected by domestic violence. Key Practitioner Messages Children, mothers and service providers reported both a perceived need for early help and a positive impact from domestic violence early help services on child health and emotional wellbeing. The ability of services to flex their delivery model in response to the needs of families is important for supporting engagement of, and fostering a sense of control for, families receiving support. Confidentiality, reliability, respect and trust are key factors in developing an effective key worker‐family relationship.

A political competency for leaders is to effectively articulate the evidence behind management best practices. Evidence-based practice requires special skills from the nurse leader, many of which are found in health services research (HSR) methods. This review presents approaches associated with HSR, which can be used by nurse managers for the benefit of their units. HSR methods reviewed are cost analyses, small area analysis, geographic information systems, use of existing databases, quality of care measures, and risk adjustment. This review examines the kind of evidence various HSR methods provide, as well as examples of their use and resources needed to apply them.

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