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Harrington MP, Satherley RM, John M, O'Donnell N, Read R, Wakelin K, Jones CJ. Reliability and validity of a parent-reported screening tool for disordered eating in children and young people with type 1 diabetes. Diabet Med 2024; 41:e15256. [PMID: 37925592 DOI: 10.1111/dme.15256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/08/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND There is a high prevalence and complex overlap between type 1 diabetes (T1D) and disordered eating. However, screening for disordered eating in children and young people (CYP) with T1D is not routinely conducted, with reluctance reported by both professionals and parents. This study aimed to validate a parent-reported version of a validated disordered eating screening tool for CYP with T1D (the Diabetes Eating Problems Survey-Revised; DEPS-R). METHODS The existing DEPS-R was adapted for parental use. Eighty-nine parents of CYP with T1D aged 11-14 years completed the parent-reported DEPS-R and other questionnaires related to demographics, child eating behaviours and parental well-being. CYP of parents were invited to participate, with 51 CYP completing the validated CYP-reported DEPS-R for comparison. RESULTS The parent-reported DEPS-R demonstrated good internal consistency (Cronbach's α = 0.89). Moderate to good inter-rater reliability was found between the parent-reported DEPS-R and CYP-reported DEPS-R (ICC 0.746, 95% CI = 0.554-0.855, p < 0.001), indicating good convergent validity. Construct validity with hypothesised variables, including specific eating behaviours, diabetes-related distress, well-being, CYP BMI, gender and parental worry about CYP disordered eating, suggested validity of the measure. However, some hypothesised variables did not significantly correlate with the parent-reported DEPS-R as expected. CONCLUSIONS The parent-reported DEPS-R has demonstrated good reliability and validity, and it may provide clinical benefit by increasing screening and early detection of disordered eating in CYP with T1D. Whilst novel and providing stepped increase in our knowledge, these findings would benefit from further validation (e.g. in a larger sample and responsiveness).
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Affiliation(s)
- Megan P Harrington
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Rose-Marie Satherley
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Mary John
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, UK
| | - Nicola O'Donnell
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Rebecca Read
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Katherine Wakelin
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health & Medical Science, University of Surrey, Guildford, UK
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Jones CJ, Read R, O'Donnell N, Wakelin K, John M, Skene SS, Stewart R, Hale L, Cooke D, Kanumakala S, Satherley RM. PRIORITY Trial: Results from a feasibility randomised controlled trial of a psychoeducational intervention for parents to prevent disordered eating in children and young people with type 1 diabetes. Diabet Med 2024; 41:e15263. [PMID: 38100228 DOI: 10.1111/dme.15263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 03/16/2024]
Abstract
AIMS Children and young people (CYP) with type 1 diabetes (T1D) are at increased risk of disordered eating. This study aimed to determine the feasibility and acceptability of a novel, theoretically informed, two-session psychoeducational intervention for parents to prevent disordered eating in CYP with T1D. METHODS Parents of CYP aged 11-14 years with T1D were randomly allocated to the intervention or wait-list control group. Self-reported measures including the Diabetes Eating Problem Survey-Revised (DEPS-R), Problem Areas in Diabetes Parent Revised (PAID-PR), Child Eating Behaviour Questionnaire subscales (CEBQ), Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), clinical outcomes (e.g. HbA1c, BMI, medication and healthcare utilisation) and process variables, were collected at baseline, 1-and 3-month assessments. Acceptability data were collected from intervention participants via questionnaire. RESULTS Eighty-nine parents were recruited, which exceeded recruitment targets, with high intervention engagement and acceptability (<80% across domains). A signal of efficacy was observed across outcome measures with moderate improvements in the CEBQ subscale satiety responsiveness (d = 0.55, 95% CI 0.01, 1.08) and child's BMI (d = -0.56, 95% CI -1.09, 0.00) at 3 months compared with controls. Trends in the anticipated direction were also observed with reductions in disordered eating (DEPS-R) and diabetes distress (PAID-PR) and improvements in wellbeing (WEMWBS). CONCLUSIONS This is the first study to have co-designed and evaluated a novel parenting intervention to prevent disordered eating in CYP with T1D. The intervention proved feasible and acceptable with encouraging effects. Preparatory work is required prior to definitive trial to ensure the most relevant primary outcome measure and ensure strategies for optimum outcome completion.
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Affiliation(s)
- Christina J Jones
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Rebecca Read
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Nicola O'Donnell
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Katherine Wakelin
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Mary John
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
- Sussex Partnership NHS Foundation Trust, Research and Development Department, Sussex Education Centre, Hove, UK
| | - Simon S Skene
- Surrey Clinical Trials Unit, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Rose Stewart
- Betsi Cadwaladr University Health Board, Wrexham, UK
| | - Lucy Hale
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Shankar Kanumakala
- Royal Alexandra Children's Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Rose-Marie Satherley
- School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK
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Erwin J, Burns L, Devalia U, Witton R, Shawe J, Wheat H, Axford N, Doughty J, Kaddour S, Nelder A, Brocklehurst P, Boswell S, Paisi M. Co-production of health and social science research with vulnerable children and young people: A rapid review. Health Expect 2024; 27:e13991. [PMID: 38403901 PMCID: PMC10895074 DOI: 10.1111/hex.13991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 01/23/2024] [Accepted: 02/03/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The term 'care-experienced' refers to anyone who is currently in care or has been in care at any stage in their life. A complex interplay of factors leads to care-experienced children and young people (CECYP) experiencing poorer oral health and access to dental care than their peers. A rapid review of the co-production of health and social care research with vulnerable children and young people (CYP) was carried out to inform the development of a co-produced research project exploring the oral health behaviours and access to dental services of CECYP. Here, 'co-production' refers to the involvement of CYP in the planning or conduct of research with explicit roles in which they generate ideas, evidence and research outputs. AIM To learn how to meaningfully involve vulnerable CYP in the co-production of health and social science research. OBJECTIVES To identify: Different approaches to facilitating the engagement of vulnerable CYP in co-production of health and social science research; different activities carried out in such approaches, challenges to engaging vulnerable CYP in co-production of health and social science research and ways to overcome them and areas of best practice in relation to research co-production with vulnerable CYP. SEARCH STRATEGY A rapid review of peer-reviewed articles was conducted in six databases (MEDLINE, Embase, SocINDEX, CINAHL, PsycINFO and Web of Science) and grey literature to identify studies that engaged vulnerable CYP in co-approaches to health and social research. MAIN RESULTS Of 1394 documents identified in the search, 40 were included and analysed. A number of different approaches to co-production were used in the studies. The CYP was involved in a range of activities, chiefly the development of data collection tools, data collection and dissemination. Individual challenges for CYP and researchers, practical and institutional factors and ethical considerations impacted the success of co-production. DISCUSSION AND CONCLUSION Co-production of health and social science with vulnerable CYP presents challenges to researchers and CYP calling for all to demonstrate reflexivity and awareness of biases, strengths and limitations. Used appropriately and well, co-production offers benefits to researchers and CYP and can contribute to research that reflects the needs of vulnerable CYP. Adherence to the key principles of inclusion, safeguarding, respect and well-being facilitates this approach. PATIENT AND PUBLIC CONTRIBUTION Members of our patient and public involvement and stakeholder groups contributed to the interpretation of the review findings. This manuscript was written together with a young care leaver, Skye Boswell, who is one of the authors. She contributed to the preparation of the manuscript, reviewing the findings and their interpretation.
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Affiliation(s)
- Jo Erwin
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Lorna Burns
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Urshla Devalia
- Royal National ENT and Eastman Dental Hospital, London, UK
| | - Robert Witton
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Jill Shawe
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Hannah Wheat
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Nick Axford
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Janine Doughty
- School of Dentistry, Royal Liverpool University Dental Hospital, Liverpool, UK
| | | | | | | | | | - Martha Paisi
- Peninsula Dental School, University of Plymouth, Plymouth, UK
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
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Keetley R, Manning JC, Williams J, Stewart I, Radford K. Child and family health-related quality of life and participation outcomes and goals after acquired brain injury: a cross-sectional survey. Brain Inj 2024; 38:217-226. [PMID: 38363813 DOI: 10.1080/02699052.2024.2309244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/19/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE To explore longer-term health-related quality of life (HRQoL) and participation outcomes and goals of children and young people (CYP) with acquired brain injuries (ABI) and their families in a region of the UK and the impact of the COVID-19 pandemic. METHODS Cross-sectional survey of (5-18 CYP) and their parent-carers 12-43 months following ABI. Included measures of HRQoL, participation, family function and parental wellbeing and demographic and free text questions. RESULTS Ninety-five responses (30% response) were received. 67% of CYP were at risk of impaired HRQoL, 72% had severely impaired participation. 53% of parent-carers reported reduced HRQoL and family functioning, 37% of parent-carers screened positive for anxiety/depression. Relationships exist between CYP participation and HRQoL and parental HRQoL and family functioning. Goals were overwhelmingly activity and participation focused. Participants described the global impact of an ABI on the CYP and family as well as the additional impact of the COVID-19 pandemic on CYP and family wellbeing. CONCLUSION ABI significantly impacts CYP participation and both CYP and parent-carer wellbeing in the long-term, potentially further impacted by the COVID-19 pandemic. Rehabilitation interventions should address both participation and the psychological wellbeing of CYP with ABI and their parent-carers.
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Affiliation(s)
- Rachel Keetley
- Centre of Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, England
| | - Joseph C Manning
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, England
- School of Healthcare, University of Leicester, Leicestershire, England
| | - Jane Williams
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, England
| | - Iain Stewart
- Faculty of Medicine, Imperial College London, London, England
| | - Kathryn Radford
- Centre of Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK
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Abbott-Smith S, Dougall N, Ring N. Suicide prevention: Introducing the Lothian Safekeeping Plan © for parents as a clinical innovation for use alongside safety plans for children and young people. J Child Adolesc Psychiatr Nurs 2024; 37:e12455. [PMID: 38368534 DOI: 10.1111/jcap.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/19/2024]
Abstract
TOPIC Internationally, preventing suicide in children and young people is a priority and there are a range of preventative approaches available for health professionals to use, including brief interventions. Safety planning is one such brief intervention. Safety plans have long been recommended for use with young people who are suicidal but, these were initially developed for adults. A recent scoping review revealed safety plans need to be tailored to children and young people. This review also identified an important practice gap, that parents also require plans supporting them to keep their child safe. PURPOSE This paper highlights how a Scottish clinical child and adolescent mental health setting in the UK's National Health Service developed and implemented evidence-based safety plans for suicidality-the Lothian Safety Plan for young people and the Lothian Safekeeping Plan for parents. This paper outlines both plans and gives recommendations for their use by healthcare professionals. The parental Lothian Safekeeping Plan is discussed in more depth as this is a novel intervention. CONCLUSION The Lothian Safekeeping Plan is a clinically led evidence-based practice innovation. It is a specific suicide prevention plan for use by parents as an additional, complementary, and enhanced resource to the Lothian Safety Plan for young people. It is recommended that healthcare professionals also use a parental safety plan when supporting young people presenting with suicidal crisis. Further research is needed to evaluate the impact of these plans.
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Affiliation(s)
- Susan Abbott-Smith
- Child and Adolescent Mental Health Services, NHS Lothian Royal Hospital for Children and Young People, Edinburgh, UK
| | - Nadine Dougall
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Nicola Ring
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
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Nugawela MD, Pinto Pereira SM, Rojas NK, McOwat K, Simmons R, Dalrymple E, Ford T, Garg S, Hargreaves D, Semple MG, Xu L, Shafran R, Stephenson T. Data Resource Profile: the Children and Young People with Long COVID (CLoCk) Study. Int J Epidemiol 2024; 53:dyad158. [PMID: 37990948 PMCID: PMC10859131 DOI: 10.1093/ije/dyad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023] Open
Affiliation(s)
- Manjula D Nugawela
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Snehal M Pinto Pereira
- Research Department of Targeted Intervention, Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Natalia K Rojas
- Research Department of Targeted Intervention, Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Kelsey McOwat
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, London, UK
| | - Ruth Simmons
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, London, UK
| | - Emma Dalrymple
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Hershel Smith Building Cambridge Biomedical Campus, Cambridge, UK
| | - Shruti Garg
- Division of Neuroscience, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Child and Adolescent Mental Health Services, Royal Manchester Children’s Hospital, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Dougal Hargreaves
- Mohn Centre for Children’s Health & Wellbeing, School of Public Health, Imperial College London, London, UK
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Respiratory Medicine, Alder Hey Children’s Hospital, Liverpool, UK
| | - Laila Xu
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Roz Shafran
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Terence Stephenson
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Oulton K, Gibson F, Kenten C, Russell J, Carr L, Hassiotis A, Kelly P, Kerry S, Tuffrey-Wijne I, Whiting M, Wray J. Being a child with intellectual disabilities in hospital: The need for an individualised approach to care. J Appl Res Intellect Disabil 2024; 37:e13153. [PMID: 37792824 DOI: 10.1111/jar.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 08/08/2023] [Accepted: 08/13/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND There is limited qualitative research focussed specifically on what it is like for children and young people with intellectual disabilities coming into hospital, with much of the evidence-base being about those with Autism Spectrum Condition or adults with intellectual disabilities. AIM To share rich detail of the emotional and physical impact on children and young people with intellectual disabilities of attending hospital, from their own and their parent's perspective. METHODS Talking Mats interviews, sticker survey and photography with children and young people with intellectual disabilities, and in-depth interviews, hospital diaries and photography with their parents. RESULTS AND CONCLUSIONS The multiple and compounding layers of complexity surrounding hospital care of children and young people with intellectual disabilities resulted in challenges associated with loss of familiarity and routine, undergoing procedures, managing sensory overload, managing pain and having a lack of safety awareness. An individualised approach to their care is needed.
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Affiliation(s)
- Kate Oulton
- School of Health Sciences, University of Surrey, Guildford, UK
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Faith Gibson
- School of Health Sciences, University of Surrey, Guildford, UK
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Charlotte Kenten
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Jessica Russell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Lucinda Carr
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Angela Hassiotis
- UCL Division of Psychiatry, University College London, London, UK
| | - Paula Kelly
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Sam Kerry
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Mark Whiting
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hertfordshire, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Sitas Z, Peters K, Luck L, Einboden R. Erasure of the young trans person: A critical discursive review of contemporary health care literature. J Nurs Scholarsh 2024; 56:103-118. [PMID: 37393606 DOI: 10.1111/jnu.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 05/03/2023] [Accepted: 05/23/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Trans youth experience significantly higher rates of societal violence and ill-health compared to their cisgender peers. Although recent clinical guidelines for trans young people in health have paved the way for revolutionizing care, many trans young people still experience adversity in clinical settings. This discursive literature review provides a novel approach in exploring why trans young people experience violence in health care despite the availability of evidence-based resources and guidelines. DESIGN Databases (CINAHL and Scopus) were systematically searched to identify qualitative literature on the experiences of trans young people (<18 years) in health care settings. METHOD Rather than synthesizing and presenting the literature, Fairclough's (2001) CDA methodology was used to critically analyze the literature as texts in a data corpus. The authors engaged with the data from a critical social theory perspective. RESULTS Fifteen qualitative articles and one report (n = 16) on the experiences of trans young people (3-24 years) in health care settings were included. Two key discourses were identified in the literature. First, discourses that constituted the trans young person were identified in the definitions of 'trans' as a pathological incongruence and as alternate, self-determined ways of being. Further discourses were identified in the constitution of trans young people as victims, extra-pathological, and alternatively problematised as socially dysphoric. Second, discourses in health provider responses were identified in dismissive, gatekeeping, regulatory, and respectful practices. DISCUSSION The discursive constitution of the trans young person as incongruent, vulnerable, and pathological is constituted and generated by dismissive, gatekeeping, and regulatory practices of health care providers. The analysis reveals how trans young people are considered pathological and deemed treatable (at the site of the body), in the interest of 'protecting' them from a perceived abject future of trans adulthood. The logic and violence of cisgenderism is uncovered as the foundation of these dominant discourses, whereby growing up cisgender is often presented as the only option in health care settings. The dominant discourses that constitute the trans young person in health care as incongruent, pathological, and vulnerable, alongside the reifying health care responses of dismissal, gatekeeping, and regulation contribute to the erasure of the young trans person. CONCLUSION This paper identified key discourses in the literature in how trans young people are constituted and regulated in health care. This review highlights an urgent need for further critical scholarship in trans health by trans researchers, from critical perspectives. Furthermore, it provides a starting point for critical reflection of health care provider and researcher practices and the re-imagination of trans-futurity for all young people in health care. CLINICAL RELEVANCE Nurses are situated at the forefront of health care delivery and play a crucial role in the advocacy and provision of culturally safe care. With this ideal proximity to clients, nurses can powerfully affect change through better understanding and reflecting on how regulatory practices constitute and position trans young people in health care. Nursing knowledge, such as cultural safety, can offer novel approaches in working towards safer ways of meeting the needs of trans young people.
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Affiliation(s)
- Zoë Sitas
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Lauretta Luck
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Rochelle Einboden
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario (CHEO) and CHEO Research Institute, Ottawa, Ontario, Canada
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Demkowicz O, Bagnall C, Hennessey A, Pert K, Bray L, Ashworth E, Mason C. 'It's scary starting a new school': Children and young people's perspectives on wellbeing support during educational transitions. Br J Educ Psychol 2023; 93:1017-1033. [PMID: 37246444 DOI: 10.1111/bjep.12617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/13/2023] [Accepted: 05/11/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Children and young people experience various transitions throughout their education. Theory and evidence highlight that these can be complex, and poor experiences of transitions can be associated with worsened outcomes, necessitating a need to develop and implement wellbeing support. However, children and young people's views are lacking in the literature, and studies tend to focus on specific transitions rather than on what matters for wellbeing during transitions generally. AIMS We explore children and young people's own perceptions of what would support wellbeing during educational transitions. SAMPLE We engaged with 49 children and young people aged 6-17 years, using purposeful maximum variation sampling to facilitate engagement of a diverse sample across a variety of education setting types. METHODS We undertook focus groups, using creative methods centred around a storybook, asking participants to make decisions as headteachers about wellbeing provision in a fictional setting. Data were analysed using reflexive thematic analysis. ANALYSIS We constructed four themes: (1) helping children and young people understand what to expect; (2) developing and sustaining relationships and support; (3) being responsive to individual needs and vulnerabilities; and (4) managing loss and providing a sense of closure. CONCLUSIONS Our analysis highlights a desire among children and young people for a considered, supportive approach that recognizes their individual needs and their connection to educational communities. The study makes a methodological and conceptual contribution, demonstrating the value of adopting a multifocussed lens to researching and supporting transitions.
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Affiliation(s)
- Ola Demkowicz
- Manchester Institute of Education, The University of Manchester, Manchester, UK
| | - Charlotte Bagnall
- Manchester Institute of Education, The University of Manchester, Manchester, UK
| | - Alexandra Hennessey
- Manchester Institute of Education, The University of Manchester, Manchester, UK
| | - Kirsty Pert
- Manchester Institute of Education, The University of Manchester, Manchester, UK
| | - Lucy Bray
- Nursing and Midwifery, Edge Hill University, Ormskirk, UK
| | - Emma Ashworth
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Carla Mason
- Manchester Institute of Education, The University of Manchester, Manchester, UK
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Forsner M, Cyrén M, Gerdin A, Rullander A. It hurts to get forced: Children's narratives about restraint during medical procedures. Paediatr Neonatal Pain 2023; 5:110-118. [PMID: 38149218 PMCID: PMC10749400 DOI: 10.1002/pne2.12093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 11/08/2022] [Accepted: 01/09/2023] [Indexed: 12/28/2023]
Abstract
According to the UN Convention on the Rights of the Child (UNCRC), children have the right to be involved in decisions about medical procedures affecting them. However, research has shown that healthcare professionals sometimes find this difficult to achieve and those procedures then are performed against the will of the child. The aim was to illuminate restraint from the perspective of children's and young people's experiences of feeling forced during medical procedures. Following the phenomenological hermeneutic method, a secondary qualitative analysis of narrative data from four datasets collected between 2001 and 2020 was performed. Twelve children and young people aged 6-19 years (three male, nine female) from central and northern Sweden narrated their experiences of restraint related to medical procedures in nine narrative interviews and three short written narratives. The analysis revealed that it hurts to get forced, this being illustrated in six themes: bodily misery, emotional rebellion, feeling disregarded, physically limited, desiring escape, and leaving deep traces. From the perspective of children and young people, restraint was interpreted with inspiration from the philosopher Michel Foucault, as being overpowered - not voluntary submission but offering resistance - and according to the theory of caring and uncaring, a relationship in which the healthcare professional is perceived as indifferent to the patient as a person. In conclusion restraint hurts and means powerlessness to the child, leaving deep traces that remain for a long time. The findings call the healthcare profession to take action to support children's self-determination, participation, and integrity in healthcare. How children experience restraint in healthcare merits further investigation from the children's own perspective.
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Newlands F, Goddings AL, Juste M, Boyd H, Nugawela MD, Pinto Pereira SM, Whelan E, Whittaker E, Stephenson T, Heyman I, Chalder T, Dalrymple E, Segal T, Shafran R. Children and Young People with Long COVID-Comparing Those Seen in Post-COVID Services with a Non-Hospitalised National Cohort: A Descriptive Study. Children (Basel) 2023; 10:1750. [PMID: 38002841 PMCID: PMC10670307 DOI: 10.3390/children10111750] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Post-COVID services have been set up in England to treat children with ongoing symptoms of Long COVID. To date, the characteristics of children seeking treatment from these services has not been described. PURPOSE (1) to describe the characteristics of children aged 11-17 referred to the Pan-London Post-COVID service and (2) to compare characteristics of these children with those taking part in the United Kingdom's largest research study of Long COVID in children (CLoCk). DESIGN Data from 95 children seeking treatment from the Post-COVID service between May 2021 and August 2022 were included in the study. Their demographic characteristics, symptom burden and the impact of infection are described and compared to children from CLoCk. RESULTS A high proportion of children from the Post-COVID service and CLoCk reported experiencing health problems prior to the pandemic. Almost all Post-COVID service children met the research Delphi definition of Long COVID (94.6%), having multiple symptoms that impacted their lives. Symptoms were notably more severe than the participants in CLoCk. CONCLUSIONS This study describes the characteristics of children seeking treatment for Long COVID compared to those identified in the largest longitudinal observational study to date. Post-COVID service children have more symptoms and are more severely affected by their symptoms following infection with COVID-19 than children in the CLoCk study. Research to understand predisposing factors for severity and prognostic indicators is essential to prevent this debilitating condition. Evaluation of short- and long-term outcomes of interventions by clinical services can help direct future therapy for this group.
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Affiliation(s)
- Fiona Newlands
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Anne-Lise Goddings
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Maude Juste
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Holly Boyd
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK
| | - Manjula D. Nugawela
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Snehal M. Pinto Pereira
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London WC1E 6BT, UK
| | - Emily Whelan
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK
| | - Elizabeth Whittaker
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London W2 1NY, UK
| | - Terence Stephenson
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Isobel Heyman
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Trudie Chalder
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Emma Dalrymple
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | | | - Terry Segal
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK
| | - Roz Shafran
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
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12
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Lingam R, Smithers-Sheedy H, Hodgson S, Hutchinson K, Meyers Morris T, Hu N, Nassar N, Schroeder EA, Rana R, Dickins E, Bula K, Zurynski Y. Evaluation of RuralkidsGPS; A Novel Integrated Paediatric Care Coordination Model of Care in Rural Australia - a Mixed-Methods Study Protocol. Int J Integr Care 2023; 23:10. [PMID: 38020416 PMCID: PMC10668883 DOI: 10.5334/ijic.7008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The Kids Guided Personalised Service (KidsGPS) is an integrated model of care coordination for children and young people (CYP) living with medical complexity. After successful implementation in an urban setting, the model of care will be rolled-out at scale to four rural regions in New South Wales, Australia to establish RuralKidsGPS. This paper describes the approach and methods for the outcome and implementation evaluation of RuralKidsGPS. Description The evaluation aims to assess health, economic and implementation outcomes and processes whilst identifying barriers and enablers to inform future rollouts. Measures of health service utilisation (primary outcome), child health related quality of life and parent/carer experiences will be assessed. The implementation evaluation will occur alongside the outcomes evaluation and is underpinned by the Consolidated Framework for Implementation Research and informed by validated quantitative measures and qualitative interviews with patients, families, healthcare providers and service managers. An economic analysis will determine incremental cost effectiveness ratios for the new model of care using health service utilisation data. Conclusion RuralKidsGPS, if effective, has the potential to improve equity of access to integrated care for CYP and their families and this protocol may inform other evaluations of similar models of care delivered at scale.
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Affiliation(s)
- Raghu Lingam
- Population Child Health Research Group, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
- The Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Hayley Smithers-Sheedy
- Population Child Health Research Group, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
| | | | - Karen Hutchinson
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Tammy Meyers Morris
- Population Child Health Research Group, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
- Department of Community Paediatrics, Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Nan Hu
- Population Child Health Research Group, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Elizabeth-Ann Schroeder
- Macquarie University Centre for the Health Economy, Australian Institute of Health Innovation, Macquarie University, Sydney NSW 2113, Australia
| | - Rezwanul Rana
- Macquarie University Centre for the Health Economy, Australian Institute of Health Innovation, Macquarie University, Sydney NSW 2113, Australia
| | - Emma Dickins
- The Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Kirsten Bula
- The Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Yvonne Zurynski
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Abbott-Smith S, Ring N, Dougall N, Davey J. Suicide prevention: What does the evidence show for the effectiveness of safety planning for children and young people? - A systematic scoping review. J Psychiatr Ment Health Nurs 2023; 30:899-910. [PMID: 37052321 DOI: 10.1111/jpm.12928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 04/14/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Suicide prevention is an international healthcare priority. There is an urgent need to use approaches that are helpful and follow research evidence. Safety planning is now widely used in suicide prevention; however, it was developed for use with adults, and little is known about its effectiveness for children/young people. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This systematic scoping review brings together all research evidence since 2008 that reported how effective safety planning is for children/young people. Findings highlight that when healthcare professionals help children/young people who are suicidal, they need to ensure that the safety plan is completed collaboratively with healthcare professionals and children/young people and that it is appropriate for their age and development. There is also need for healthcare professionals to better recognize and respond to the needs of parents/carers who are caring for a child/young person with suicidal ideations/behaviours. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is some research indicating that safety planning is effective for use with children/young people, but such evidence has primarily been obtained from females and there is need for more evidence from male study populations. Further research on its use is needed for certain groups of children/young people including those who are care experienced, or identify as lesbian, gay, bisexual and transgender. This review highlighted that healthcare professionals need specific training before they deliver safety planning for children/young people. It was identified that parents/carers have additional needs and should be involved in safety planning. An additional resource specifically for parents/carers should be developed. ABSTRACT INTRODUCTION: Suicide is a leading cause of death for children and young people and its prevention is a global priority. Many Mental Health Services employ safety planning as a brief intervention. There is some evidence of safety planning effectiveness for adults, but little is known about its effectiveness with young people. AIM To synthesize research reporting safety planning effectiveness for children/young people with suicidal ideation and identify good practice recommendations. INCLUSION CRITERIA The review relates to safety planning around suicide prevention for children/young people aged less than 18 years, even if it was within a wider intervention. The review was inclusive of all clinical areas (including mental health, primary care, etc), any geographical location or social economic status and inclusivity around the method of delivery. METHODS A systematic scoping review of literature reporting effectiveness data for the use of safety planning with children/young people with suicidal ideation. The systematic scoping review protocol (pre-registered with Open Science Framework) followed Joanna Briggs Institute conduct guidance and PRISMA-ScR checklist. DATA ANALYSIS AND PRESENTATION Fifteen studies were reported during 2008-2021. Overall, there is promising, but limited, evidence of effectiveness for safety planning for children/young people but with complete evidence gaps for some demographic sub-groups. Evidence determined that healthcare professionals should deliver a safety planning intervention that is completed collaboratively, developmentally appropriate, and recognizes parental/carer involvement. DISCUSSION AND IMPLICATIONS FOR PRACTICE Further research is needed but current evidence suggests safety planning should be a routine part of care packages for children/young people with suicidal ideation proportionate to their needs. Developing/implementing these plans needs bespoke health professional training and additional support and resources for parents/carers should be developed.
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Affiliation(s)
- Susan Abbott-Smith
- NHS Lothian-CAMHS, Royal Hospital Children and Young People 50 Little France, Edinburgh, UK
- Edinburgh Napier University-Health and Social Care, Edinburgh, UK
| | - Nicola Ring
- Edinburgh Napier University-Health and Social Care, Edinburgh, UK
| | - Nadine Dougall
- Edinburgh Napier University-Health and Social Care, Edinburgh, UK
| | - Jill Davey
- Edinburgh Napier University-Health and Social Care, Edinburgh, UK
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14
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Palmer M, Chandler S, Carter Leno V, Mgaieth F, Yorke I, Hollocks M, Pickles A, Slonims V, Scott S, Charman T, Simonoff E. Factors associated with mental health symptoms among UK autistic children and young people and their parents during the COVID-19 pandemic. Autism 2023; 27:2098-2111. [PMID: 36847345 PMCID: PMC9974376 DOI: 10.1177/13623613231153694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
LAY ABSTRACT What is already known about the topic: The COVID-19 pandemic and the associated restrictions impacted all of society. There is emerging evidence showing a range of impacts on autistic children and young people and their families. Further research that looks at how individuals coped during the pandemic while considering how they were doing before the pandemic is needed.What this paper adds: This article explores whether how well autistic youth were doing before the pandemic influenced how they coped during the pandemic. It also looked at how well their parents were doing during the pandemic and whether any pre-pandemic factors influenced how they coped. Samples of both primary-school-aged autistic children and autistic teenagers and their parents were surveyed to answer these questions. More engagement and enjoyment in education provision during the pandemic and getting outside more were linked with better child and parental mental health during the pandemic. More attention deficit hyperactivity disorder before the pandemic was linked with more attention deficit hyperactivity disorder and behavioural problems during the pandemic in primary-school-aged autistic children, and more emotional problems during the pandemic in autistic teenagers. Parents with more mental health problems during the pandemic had more mental health problems before the pandemic.Implications for practice, research or policy: Encouraging engagement and enjoyment in education and promoting physical exercise are key intervention targets. Ensuring access to attention deficit hyperactivity disorder medication and support is important, especially if this is managed jointly across school and home.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Tony Charman
- King’s College London, UK
- South London and Maudsley NHS Foundation Trust, UK
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15
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Daines L, Bonnett LJ, Tibble H, Boyd A, Thomas R, Price D, Turner SW, Lewis SC, Sheikh A, Pinnock H. Deriving and validating an asthma diagnosis prediction model for children and young people in primary care. Wellcome Open Res 2023; 8:195. [PMID: 37928213 PMCID: PMC10622861 DOI: 10.12688/wellcomeopenres.19078.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 11/08/2023] Open
Abstract
Introduction: Accurately diagnosing asthma can be challenging. We aimed to derive and validate a prediction model to support primary care clinicians assess the probability of an asthma diagnosis in children and young people. Methods: The derivation dataset was created from the Avon Longitudinal Study of Parents and Children (ALSPAC) linked to electronic health records. Participants with at least three inhaled corticosteroid prescriptions in 12-months and a coded asthma diagnosis were designated as having asthma. Demographics, symptoms, past medical/family history, exposures, investigations, and prescriptions were considered as candidate predictors. Potential candidate predictors were included if data were available in ≥60% of participants. Multiple imputation was used to handle remaining missing data. The prediction model was derived using logistic regression. Internal validation was completed using bootstrap re-sampling. External validation was conducted using health records from the Optimum Patient Care Research Database (OPCRD). Results: Predictors included in the final model were wheeze, cough, breathlessness, hay-fever, eczema, food allergy, social class, maternal asthma, childhood exposure to cigarette smoke, prescription of a short acting beta agonist and the past recording of lung function/reversibility testing. In the derivation dataset, which comprised 11,972 participants aged <25 years (49% female, 8% asthma), model performance as indicated by the C-statistic and calibration slope was 0.86, 95% confidence interval (CI) 0.85-0.87 and 1.00, 95% CI 0.95-1.05 respectively. In the external validation dataset, which included 2,670 participants aged <25 years (50% female, 10% asthma), the C-statistic was 0.85, 95% CI 0.83-0.88, and calibration slope 1.22, 95% CI 1.09-1.35. Conclusions: We derived and validated a prediction model for clinicians to calculate the probability of asthma diagnosis for a child or young person up to 25 years of age presenting to primary care. Following further evaluation of clinical effectiveness, the prediction model could be implemented as a decision support software.
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Affiliation(s)
- Luke Daines
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Laura J Bonnett
- Department of Biostatistics, University of Liverpool, Liverpool, L69 3GL, UK
| | - Holly Tibble
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Andy Boyd
- Institute of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Richard Thomas
- Institute of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - David Price
- Observational and Pragmatic Research Institute, Singapore, 573969, Singapore
- Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZG, UK
| | - Steve W Turner
- Child Health, University of Aberdeen, Aberdeen, AB25 2ZG, UK
- Women and Children Division, NHS Grampian, Aberdeen, AB25 2ZG, UK
| | - Steff C Lewis
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
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16
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Daines L, Bonnett LJ, Tibble H, Boyd A, Thomas R, Price D, Turner SW, Lewis SC, Sheikh A, Pinnock H. Deriving and validating an asthma diagnosis prediction model for children and young people in primary care. Wellcome Open Res 2023; 8:195. [PMID: 37928213 PMCID: PMC10622861 DOI: 10.12688/wellcomeopenres.19078.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction: Accurately diagnosing asthma can be challenging. We aimed to derive and validate a prediction model to support primary care clinicians assess the probability of an asthma diagnosis in children and young people. Methods: The derivation dataset was created from the Avon Longitudinal Study of Parents and Children (ALSPAC) linked to electronic health records. Participants with at least three inhaled corticosteroid prescriptions in 12-months and a coded asthma diagnosis were designated as having asthma. Demographics, symptoms, past medical/family history, exposures, investigations, and prescriptions were considered as candidate predictors. Potential candidate predictors were included if data were available in ≥60% of participants. Multiple imputation was used to handle remaining missing data. The prediction model was derived using logistic regression. Internal validation was completed using bootstrap re-sampling. External validation was conducted using health records from the Optimum Patient Care Research Database (OPCRD). Results: Predictors included in the final model were wheeze, cough, breathlessness, hay-fever, eczema, food allergy, social class, maternal asthma, childhood exposure to cigarette smoke, prescription of a short acting beta agonist and the past recording of lung function/reversibility testing. In the derivation dataset, which comprised 11,972 participants aged <25 years (49% female, 8% asthma), model performance as indicated by the C-statistic and calibration slope was 0.86, 95% confidence interval (CI) 0.85-0.87 and 1.00, 95% CI 0.95-1.05 respectively. In the external validation dataset, which included 2,670 participants aged <25 years (50% female, 10% asthma), the C-statistic was 0.85, 95% CI 0.83-0.88, and calibration slope 1.22, 95% CI 1.09-1.35. Conclusions: We derived and validated a prediction model for clinicians to calculate the probability of asthma diagnosis for a child or young person up to 25 years of age presenting to primary care. Following further evaluation of clinical effectiveness, the prediction model could be implemented as a decision support software.
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Affiliation(s)
- Luke Daines
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Laura J Bonnett
- Department of Biostatistics, University of Liverpool, Liverpool, L69 3GL, UK
| | - Holly Tibble
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Andy Boyd
- Institute of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - Richard Thomas
- Institute of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - David Price
- Observational and Pragmatic Research Institute, Singapore, 573969, Singapore
- Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZG, UK
| | - Steve W Turner
- Child Health, University of Aberdeen, Aberdeen, AB25 2ZG, UK
- Women and Children Division, NHS Grampian, Aberdeen, AB25 2ZG, UK
| | - Steff C Lewis
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, EH8 9AG, UK
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17
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Bernard A, de Ossorno Garcia S, Salhi L, John A, DelPozo-Banos M. Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people. Front Psychiatry 2023; 14:1143272. [PMID: 37575580 PMCID: PMC10415812 DOI: 10.3389/fpsyt.2023.1143272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/27/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction The COVID-19 pandemic increased public use of digital mental health technologies. However, little is known about changes in user engagement with these platforms during the pandemic. This study aims to assess engagement changes with a digital mental healthcare service during COVID-19. Methods A cohort study based on routinely collected service usage data from a digital mental health support service in the United Kingdom. Returning users aged 14-25 years that interacted for a maximum of two months were included. The study population was divided into pre-COVID and COVID cohorts. Demographic and usage information between cohorts were compared and usage clusters were identified within each cohort. Differences were tested using Chi-squared, two-sample Kolmogorov-Smirnov tests and logit regressions. Results Of the 624,103 users who joined the service between May 1, 2019, and October 1, 2021, 18,889 (32.81%) met the inclusion criteria: 5,048 in the pre-COVID cohort and 13,841 in the COVID cohort. The COVID cohort wrote more journals; maintained the same focus on messaging practitioners, posting discussions, commenting on posts, and having booked chats; and engaged less in writing journals, setting personal goals, posting articles, and having ad-hoc chats. Four usage profiles were identified in both cohorts: one relatively disengaged, one focused on contacting practitioners through chats/messages, and two broadly interested in writing discussions and comments within the digital community. Despite their broad similarities, usage patterns also exhibited differences between cohorts. For example, all four clusters had over 70% of users attempting to have ad-hoc chats with practitioners in the pre-COVID cohort, compared to one out of four clusters in the COVID cohort. Overall, engagement change patterns during the COVID-19 pandemic were not equal across clusters. Sensitivity analysis revealed varying strength of these defined clusters. Discussion Our study identified changes in user activity and engagement behavior within a digital mental healthcare service during the COVID-19 pandemic. These findings suggest that usage patterns within digital mental health services may be susceptible to change in response to external events such as a pandemic. Continuous monitoring of engagement patterns is important for informed design and personalized interventions.
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Affiliation(s)
| | | | | | - Ann John
- Swansea University Medical School, Swansea, United Kingdom
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18
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Thomson A, Harris E, Peters-Corbett A, Koppel K, Creswell C. Barriers and facilitators of community-based implementation of evidence-based interventions in the UK, for children and young people's mental health promotion, prevention and treatment: rapid scoping review. BJPsych Open 2023; 9:e132. [PMID: 37485912 PMCID: PMC10375901 DOI: 10.1192/bjo.2023.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Community-based organisations continue to take on a greater role in supporting children and young people in the UK with their mental health. However, little evidence exists on the capacity and capability of these settings to effectively implement evidence-based interventions (EBIs). AIMS To identify barriers and facilitators of the implementation of EBIs within community settings in the UK, for children and young people's mental health promotion, prevention and treatment. METHOD A PRISMA-guided, rapid scoping review was conducted, using predefined criteria and a relevant search strategy on eight databases: Ovid EMBASE, Ovid Medline, Ovid PsycINFO, Ovid Global Health: Scopus, Web of Science All Databases, EBSCO CINAHL and EBSCO ERIC. Study characteristics and data on barriers and facilitators were extracted, with results narratively synthesised. RESULTS Five out of 4899 studies met the inclusion criteria, addressing the barriers and facilitators of community-based implementation of EBIs for children and young people's mental health promotion, prevention and treatment. All of the studies that were identified focused on school settings, but we identified no studies that included data on barriers or facilitators of implementing EBIs in other community-based or voluntary sector settings. CONCLUSIONS There is a lack of available evidence on the capacity and capability of community settings in the UK to effectively implement EBIs and adhere to evidence-based practice. However, existing findings within schools have highlighted key barriers and facilitators to implementation, such as the importance of meaningful involvement of stakeholders throughout the research process, and greater allocation of resources to support evidence-based decision-making in these settings.
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Affiliation(s)
| | - Elinor Harris
- Bodleian Health Care Libraries, University of Oxford, UK
| | - Araminta Peters-Corbett
- Children and Young People's Mental Health Service, Norfolk and Suffolk NHS Foundation Trust, UK
| | - Keili Koppel
- Department of Psychiatry, University of Oxford, UK
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19
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Pinto Pereira SM, Nugawela MD, McOwat K, Dalrymple E, Xu L, Ladhani SN, Simmons R, Chalder T, Swann O, Ford T, Heyman I, Segal T, Semple MG, Rojas NK, Consortium CL, Shafran R, Stephenson T. Symptom Profiles of Children and Young People 12 Months after SARS-CoV-2 Testing: A National Matched Cohort Study (The CLoCk Study). Children (Basel) 2023; 10:1227. [PMID: 37508724 PMCID: PMC10377812 DOI: 10.3390/children10071227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Although 99% of children and young people have been exposed to SARS-CoV-2, the long-term prevalence of post-COVID-19 symptoms in young people is unclear. The aim of this study is to describe symptom profiles 12 months after SARS-CoV-2 testing. METHOD A matched cohort study of a national sample of 20,202 children and young people who took a SARS-CoV-2 PCR test between September 2020 and March 2021. RESULTS 12 months post-index-test, there was a difference in the number of symptoms reported by initial negatives who never tested positive (NN) compared to the other three groups who had at least one positive test (p < 0.001). Similarly, 10.2% of the NN group described five-plus symptoms at 12 months compared to 15.9-24.0% in the other three groups who had at least one positive test. The most common symptoms were tiredness, sleeping difficulties, shortness of breath, and headaches for all four groups. For all these symptoms, the initial test positives with subsequent reports of re-infection had higher prevalences than other positive groups (p < 0.001). Symptom profiles, mental health, well-being, fatigue, and quality of life did not vary by vaccination status. CONCLUSIONS Following the pandemic, many young people, particularly those that have had multiple SARS-CoV-2 positive tests, experience a range of symptoms that warrant consideration and potential investigation and intervention.
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Affiliation(s)
- Snehal M. Pinto Pereira
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London WC1E 6BT, UK
| | - Manjula D. Nugawela
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Kelsey McOwat
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Emma Dalrymple
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Laila Xu
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Shamez N. Ladhani
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
- Paediatric Infectious Diseases Research Group, St. George’s University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Ruth Simmons
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Olivia Swann
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh EH16 4TL, UK
| | - Tamsin Ford
- Department of Psychiatry, Hershel Smith Building Cambridge Biomedical Campus, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Terry Segal
- University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Malcolm G. Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
- Respiratory Medicine, Alder Hey Children’s Hospital, Liverpool L12 2AP, UK
| | - Natalia K. Rojas
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London WC1E 6BT, UK
| | | | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Terence Stephenson
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
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20
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Zahid N, Enam SA, Urooj F, Martins RS, Mårtensson T, Mårtensson A, Mushtaq N, Kausar F, Moochhala M, Mughal MN, Altaf S, Kirmani S, Brown N. Socio-demographic and antenatal risk factors of brain tumor in children and young people: A matched case-control study from Karachi, Pakistan. J Public Health Res 2023; 12:22799036231197185. [PMID: 37700932 PMCID: PMC10493064 DOI: 10.1177/22799036231197185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/26/2023] [Indexed: 09/14/2023] Open
Abstract
Background Brain tumors are a common cause of morbidity, disability, cognitive deterioration and mortality in children, even after treatment. Little is know about the specific causes. The study aimed to assess potential socio-demographic and antenatal factors in primary brain tumor (PBTs) in children and young people (CYP) in Karachi, Pakistan. Designs and methods A single center hospital based matched case control study in Karachi, Pakistan. Cases were defined as CYP aged between 5 and 21 years with any histological type and grade of primary brain tumor of any histology, stage or grade. Data were collected from parents of 244 patients at the selected center between 2017 and 2021 via telephonic interview. Controls were 5-21 years old CYP admitted with non-oncological diagnoses matched on age and sex. Matched Odds Ratios for predictors of brain tumor in children were derived. Those of statistical significance were included in a multivariable logistic regression model. Results In the adjusted model, lower paternal education (matched adjusted odds ratio (maOR) 2.46; 95% CI 1.09-5.55), higher household monthly income (maOR 3.4; 95% CI 1.1-10.2), antenatal paternal use of addictive substances (maOR 19.5; 95% CI 2.1-179.8), and antenatal maternal use of analgesics during pregnancy (maOR 3.0; 95% CI 1.2-7.9) were all independently predictive of brain tumors. Conclusion This matched case-control study found novel associations between maternal use of analgesics, paternal use of addictive substances, higher household income, and lower paternal education and Primary Brain Tumors in Children and Young People. Longitudinal multicenter studies will be required to test these associations prospectively.
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Affiliation(s)
- Nida Zahid
- Department of Surgery, Aga Khan University, Karachi, Pakistan
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Syed Ather Enam
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Faiza Urooj
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Russell Seth Martins
- Center for Clinical Best Practices, Clinical and Translational Research Incubator, Aga Khan University, Karachi, Pakistan
| | - Thomas Mårtensson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Andreas Mårtensson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Naureen Mushtaq
- Department of Pediatric Oncology, Aga Khan University, Karachi, Pakistan
| | - Faiza Kausar
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Mariya Moochhala
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | | | - Sadaf Altaf
- Department of Pediatric Oncology, Aga Khan University, Karachi, Pakistan
| | - Salman Kirmani
- Division of Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Nick Brown
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Pediatrics, Aga Khan University, Karachi, Pakistan
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21
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Kadirvelu B, Bellido Bel T, Wu X, Burmester V, Ananth S, Cabral C C Branco B, Girela-Serrano B, Gledhill J, Di Simplicio M, Nicholls D, Faisal AA. Mindcraft, a Mobile Mental Health Monitoring Platform for Children and Young People: Development and Acceptability Pilot Study. JMIR Form Res 2023; 7:e44877. [PMID: 37358901 DOI: 10.2196/44877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/24/2023] [Accepted: 05/15/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Children and young people's mental health is a growing public health concern, which is further exacerbated by the COVID-19 pandemic. Mobile health apps, particularly those using passive smartphone sensor data, present an opportunity to address this issue and support mental well-being. OBJECTIVE This study aimed to develop and evaluate a mobile mental health platform for children and young people, Mindcraft, which integrates passive sensor data monitoring with active self-reported updates through an engaging user interface to monitor their well-being. METHODS A user-centered design approach was used to develop Mindcraft, incorporating feedback from potential users. User acceptance testing was conducted with a group of 8 young people aged 15-17 years, followed by a pilot test with 39 secondary school students aged 14-18 years, which was conducted for a 2-week period. RESULTS Mindcraft showed encouraging user engagement and retention. Users reported that they found the app to be a friendly tool helping them to increase their emotional awareness and gain a better understanding of themselves. Over 90% of users (36/39, 92.5%) answered all active data questions on the days they used the app. Passive data collection facilitated the gathering of a broader range of well-being metrics over time, with minimal user intervention. CONCLUSIONS The Mindcraft app has shown promising results in monitoring mental health symptoms and promoting user engagement among children and young people during its development and initial testing. The app's user-centered design, the focus on privacy and transparency, and a combination of active and passive data collection strategies have all contributed to its efficacy and receptiveness among the target demographic. By continuing to refine and expand the app, the Mindcraft platform has the potential to contribute meaningfully to the field of mental health care for young people.
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Affiliation(s)
- Balasundaram Kadirvelu
- Brain & Behaviour Lab, Department of Computing and Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Teresa Bellido Bel
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Xiaofei Wu
- Brain & Behaviour Lab, Department of Computing and Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Victoria Burmester
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Shayma Ananth
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Bianca Cabral C C Branco
- Brain & Behaviour Lab, Department of Computing and Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Braulio Girela-Serrano
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Julia Gledhill
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Martina Di Simplicio
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Dasha Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - A Aldo Faisal
- Brain & Behaviour Lab, Department of Computing and Department of Bioengineering, Imperial College London, London, United Kingdom
- Chair in Digital Health, Faculty of Life Sciences, University of Bayreuth, Bayreuth, Germany
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22
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Litchfield I, Barrett T, Hamilton-Shield JP, Moore THM, Narendran P, Redwood S, Searle A, Uday S, Wheeler J, Greenfield S. Developments in the design and delivery of self-management support for children and young people with diabetes: A narrative synthesis of systematic reviews. Diabet Med 2023; 40:e15035. [PMID: 36576331 DOI: 10.1111/dme.15035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/22/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
AIMS Facilitated self-management support programmes have become central to the treatment of chronic diseases including diabetes. For many children and young people with diabetes (CYPD), the impact on glycated haemoglobin (HbA1c ) and a range of self-management behaviours promised by these programmes remain unrealised. This warrants an appraisal of current thinking and the existing evidence to guide the development of programmes better targeted at this age group. METHODS Create a narrative review of systematic reviews produced in the last 3 years that have explored the impact on CYPD of the four key elements of self-management support programmes: education, instruction and advice including peer support; psychological counselling via a range of therapies; self-monitoring, including diaries and telemetric devices; and telecare, the technology-enabled follow-up and support by healthcare providers. RESULTS Games and gamification appear to offer a promising means of engaging and educating CYPD. Psychological interventions when delivered by trained practitioners, appear to improve HbA1c and quality of life although effect sizes were small. Technology-enabled interactive diaries can increase the frequency of self-monitoring and reduce levels of HbA1c . Telecare provided synchronously via telephone produced significant improvements in HbA1c . CONCLUSIONS The cost-effective flexibility of increasing the reliance on technology is an attractive proposition; however, there are resource implications for digital connectivity in underserved populations. The need remains to improve the understanding of which elements of each component are most effective in a particular context, and how to optimise the influence and input of families, caregivers and peers.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Timothy Barrett
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Department of Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Julian P Hamilton-Shield
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The Royal Hospital for Children in Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - T H M Moore
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Parth Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
- Queen Elizabeth Hospital, Birmingham, UK
| | - Sabi Redwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Aidan Searle
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, UK
| | - Suma Uday
- Department of Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, UK
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Jess Wheeler
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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23
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Dedat Z, Hope S, Hargreaves D, Lloyd-Houldey O, Nicholls D, Scott S, Stepanova E, Summerbell C, Viner RM, Hillier-Brown F. Measurement Instruments for Integration within Children and Young People Healthcare Systems and Networks: A Rapid Review of the International Literature. Int J Integr Care 2023; 23:18. [PMID: 37250761 PMCID: PMC10215994 DOI: 10.5334/ijic.7028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 05/09/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Robust measures of integration are essential for assessment of the development, design and implementation of integration within healthcare systems. This review aimed to identify measurement instruments for integration within children and young people's (CYP) healthcare systems (PROSPERO registration number CRD42021235383). Methods We searched electronic databases (PubMED and Ovid Embase) using three main concepts: '(integrated care) AND (child population) AND (measurement)', along with additional searches. Results Fifteen studies describing 16 measurement instruments were eligible for inclusion. The majority of studies were conducted in the USA. There was a diversity of health conditions included in the studies. The most frequent type of assessment used was a questionnaire (11 identified), but interviews, patient data and healthcare records, and focus groups were also used. Integration outcomes assessed were quality of care coordination, quality of collaboration, continuity of care, completeness of care, structure of care, quality of communication, and local implementation of integrated care. Conclusion A variety of instruments for the measurement of integration within CYP healthcare systems were identified. Further work on the standardisation of integrated care measures would be valuable; however, it is important that instruments and measures meet the needs of specific settings, populations and conditions being studied.
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Affiliation(s)
- Zainab Dedat
- Population, Policy & Practice Research & Teaching Department, UCL Great Ormond St. Institute of Child Health, London, UK
| | - Steven Hope
- Population, Policy & Practice Research & Teaching Department, UCL Great Ormond St. Institute of Child Health, London, UK
| | - Dougal Hargreaves
- Mohn Centre for Children’s Health & Wellbeing, School of Public Health, Imperial College London, UK
| | - Oliver Lloyd-Houldey
- Population, Policy & Practice Research & Teaching Department, UCL Great Ormond St. Institute of Child Health, London, UK
| | - Dasha Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, UK
| | - Steph Scott
- Fuse –Centre for Translational Research in Public Health, UK
- Population Health Sciences Institute, Newcastle University, UK
| | - Evgenia Stepanova
- Fuse –Centre for Translational Research in Public Health, UK
- Department of Sport and Exercise Sciences, Durham University, UK
| | - Carolyn Summerbell
- Fuse –Centre for Translational Research in Public Health, UK
- Department of Sport and Exercise Sciences, Durham University, UK
| | - Russell M. Viner
- Population, Policy & Practice Research & Teaching Department, UCL Great Ormond St. Institute of Child Health, London, UK
| | - Frances Hillier-Brown
- Fuse –Centre for Translational Research in Public Health, UK
- Population Health Sciences Institute, Newcastle University, UK
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24
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Roach A, Cullinan S, Shafran R, Heyman I, Bennett S. Implementing brief and low-intensity psychological interventions for children and young people with internalizing disorders: a rapid realist review. Br Med Bull 2023; 145:120-131. [PMID: 36715209 PMCID: PMC10075242 DOI: 10.1093/bmb/ldad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/21/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Many children fail to receive the mental health treatments they need, despite strong evidence demonstrating efficacy of brief and low-intensity psychological interventions. This review identifies the barriers and facilitators to their implementation. SOURCES OF DATA PsycInfo, EMBASE and Medline were searched and a systematic approach to data extraction using Normalization Process Theory highlighted key mechanisms and contextual factors. AREAS OF AGREEMENT Ten interventions from 9 papers, including 371 young people, were included. Studies identified organizational demands, lack of implementation strategy and stigma as barriers to implementation, and clear training and plans for implementation as facilitators. AREAS OF CONTROVERSY No standardized implementation outcomes were used across papers so meta-analysis was not possible. GROWING POINTS Barriers and facilitators have been clearly identified across different settings. AREAS TIMELY FOR DEVELOPING RESEARCH Longitudinal studies can identify methods and processes for enhancing long-term implementation and considers ways to monitor and evaluate uptake into routine practice.
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Affiliation(s)
- Anna Roach
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Sophie Cullinan
- Institute of Education, UCL's Faculty of Education and Society, University College London, 20 Bedford Way, London WC1H 0AL, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Sophie Bennett
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
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25
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Ashworth E, Jarman I, McCabe P, McCarthy M, Provazza S, Crosbie V, Quigg Z, Saini P. Suicidal Crisis among Children and Young People: Associations with Adverse Childhood Experiences and Socio-Demographic Factors. Int J Environ Res Public Health 2023; 20:1251. [PMID: 36674021 PMCID: PMC9858613 DOI: 10.3390/ijerph20021251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Suicide is a major public health issue and a leading cause of death among children and young people (CYP) worldwide. There is strong evidence linking adverse childhood experiences (ACEs) to an increased risk of suicidal behaviours in adults, but there is limited understanding regarding ACEs and suicidal crises in CYP. This study aims to examine the ACEs associated with CYP presenting at Emergency Departments for suicidal crises, and specifically the factors associated with repeat attendances. This is a case series study of CYP (aged 8-16) experiencing suicidal crisis who presented in a paediatric Emergency Department in England between March 2019 and March 2021 (n = 240). The dataset was subjected to conditional independence graphical analysis. Results revealed a significant association between suicidal crisis and several ACEs. Specifically, evidence of clusters of ACE variables suggests two distinct groups of CYP associated with experiencing a suicidal crisis: those experiencing "household risk" and those experiencing "parental risk". Female sex, history of self-harm, mental health difficulties, and previous input from mental health services were also associated with repeat hospital attendances. Findings have implications for early identification of and intervention with children who may be at a heightened risk for ACEs and associated suicidal crises.
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Affiliation(s)
- Emma Ashworth
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Ian Jarman
- Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Philippa McCabe
- Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Molly McCarthy
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Serena Provazza
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Vivienne Crosbie
- Alder Hey Children’s NHS Foundation Trust, Liverpool L14 5AB, UK
| | - Zara Quigg
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Pooja Saini
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
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26
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Wright B, Tindall L, Scott AJ, Lee E, Cooper C, Biggs K, Bee P, Wang HI, Gega L, Hayward E, Solaiman K, Teare MD, Davis T, Wilson J, Lovell K, McMillan D, Barr A, Edwards H, Lomas J, Turtle C, Parrott S, Teige C, Chater T, Hargate R, Ali S, Parkinson S, Gilbody S, Marshall D. One session treatment (OST) is equivalent to multi-session cognitive behavioral therapy (CBT) in children with specific phobias (ASPECT): results from a national non-inferiority randomized controlled trial. J Child Psychol Psychiatry 2023; 64:39-49. [PMID: 35915056 PMCID: PMC10087411 DOI: 10.1111/jcpp.13665] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND 5%-10% children and young people (CYP) experience specific phobias that impact daily functioning. Cognitive Behaviour Therapy (CBT) is recommended but has limitations. One Session Treatment (OST), a briefer alternative incorporating CBT principles, has demonstrated efficacy. The Alleviating Specific Phobias Experienced by Children Trial (ASPECT) investigated the non-inferiority of OST compared to multi-session CBT for treating specific phobias in CYP. METHODS ASPECT was a pragmatic, multi-center, non-inferiority randomized controlled trial in 26 CAMHS sites, three voluntary agency services, and one university-based CYP well-being service. CYP aged 7-16 years with specific phobia were randomized to receive OST or CBT. Clinical non-inferiority and a nested cost-effectiveness evaluation was assessed 6-months post-randomization using the Behavioural Avoidance Task (BAT). Secondary outcome measures included the Anxiety Disorder Interview Schedule, Child Anxiety Impact Scale, Revised Children's Anxiety Depression Scale, goal-based outcome measure, and EQ-5DY and CHU-9D, collected blind at baseline and six-months. RESULTS 268 CYPs were randomized to OST (n = 134) or CBT (n = 134). Mean BAT scores at 6 months were similar across groups in both intention-to-treat (ITT) and per-protocol (PP) populations (CBT: 7.1 (ITT, n = 76), 7.4 (PP, n = 57), OST: 7.4 (ITT, n = 73), 7.6 (PP, n = 56), on the standardized scale-adjusted mean difference for CBT compared to OST -0.123, 95% CI -0.449 to 0.202 (ITT), mean difference -0.204, 95% CI -0.579 to 0.171 (PP)). These findings were wholly below the standardized non-inferiority limit of 0.4, suggesting that OST is non-inferior to CBT. No between-group differences were found on secondary outcomes. OST marginally decreased mean service use costs and maintained similar mean Quality Adjusted Life Years compared to CBT. CONCLUSIONS One Session Treatment has similar clinical effectiveness to CBT for specific phobias in CYP and may be a cost-saving alternative.
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Affiliation(s)
- Barry Wright
- Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Lucy Tindall
- Leeds and York Partnership NHS Foundation Trust, York, UK
| | | | - Ellen Lee
- University of Sheffield, Sheffield, UK
| | | | | | - Penny Bee
- University of Manchester, Manchester, UK
| | | | | | - Emily Hayward
- Leeds and York Partnership NHS Foundation Trust, York, UK
| | | | | | | | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | | | | | - Amy Barr
- University of Sheffield, Sheffield, UK
| | - Hannah Edwards
- Leeds and York Partnership NHS Foundation Trust, York, UK
| | | | | | | | - Catarina Teige
- Leeds and York Partnership NHS Foundation Trust, York, UK
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27
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Wray J, Abrines Jaume N, Oulton K, Sell D. Talking with children and young people with 22q11DS about their mental health, behaviour, learning and communication. Child Care Health Dev 2023; 49:90-105. [PMID: 35403745 DOI: 10.1111/cch.13013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND 22q11DS11.2 deletion syndrome (22q11DS) is a complex multisystem syndrome characterized by physical abnormalities, psychiatric comorbidities and cognitive deficits. The views of children and young people (CYP) about the challenges associated with their mental health, behaviour, learning and communication difficulties have not been reported. The aim of this study was to address this gap and to understand whether they had help and support with these and their views of this. METHODS A three-phase mixed-methods study was undertaken, involving interviews with CYP with 22q11DS, a follow-up survey for those aged 11-25 years and a stakeholder workshop at which CYP presented their views of living with 22q11DS to health professionals and parents. Interview transcripts were thematically analysed, and non-parametric statistics were used to analyse survey data. RESULTS The interviews (n = 13) and survey (n = 32) indicated a mixed picture, with some CYP not reporting ongoing problems; others who had problems received help but a sizeable proportion had unmet needs and wanted to receive help. Two-thirds reported often experiencing negative feelings, and almost half had difficulties with social interactions. Family members were the main sources of support, with teaching assistants identified as an important support at school. CONCLUSIONS The emotional impact of 22q11DS on CYP can be significant: They often do not understand the consequences of having 22q11DS and are frequently not given strategies to understand and manage their feelings, behaviour or problems. This leads to a range of emotions that manifest in different ways at home and at school. CYP are able to talk about the impact of different aspects of 22q11DS on them, facilitated by the use of creative methods, but they differ in how the condition affects them and their perceptions about that. It is imperative that CYP themselves are asked about their experiences, feelings and needs to ensure tailoring of interventions to their individual requirements.
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Affiliation(s)
- Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Debbie Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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28
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Manning JC, Marufu TC, Carter T, Bolton S, Breedon P, Craven M, Frost K, Harbottle A, Hendron E, Patel J, Rad L, White P, Wood D, Albelbisi Z, Kaltsa A, Stevenson C, Landa P, Coad J. Developing a prototype digital risk mitigation pathway for children and young people admitted to acute paediatric NHS care in mental health crisis: Protocol of the Safety Assessment in Paediatric healthcare Environments (SAPhE) pathway study. Digit Health 2023; 9:20552076231205753. [PMID: 37846405 PMCID: PMC10576941 DOI: 10.1177/20552076231205753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
Background Globally, there are increasing numbers of Children and young people (CYPs) experiencing a mental health crisis requiring admission to acute paediatric inpatient care. These CYPs can often experience fluctuating emotional states accompanied by urges to self-harm or attempt to end their life, leading to reduced safety and poorer experiences. Currently, in the UK National Health Service (NHS) there are no standardised, evidence-based interventions in acute paediatric care to mitigate or minimise immediate risk of self-harm and suicide in CYP admitted with mental health crisis. Objective To outline the protocol for the SAPhE Pathway study which aims to: 1) identify and prioritise risk mitigation strategies to include in the digital prototype, 2) understand the feasibility of implementing a novel digital risk mitigation pathway in differing NHS contexts, and 3) co-create a prototype digital risk mitigation pathway. Methods This is a multi-centre study uses a mixed-methods design. A systematic review and exploratory methods (interviews, surveys, and focus groups) will be used to identify the content and feasibility of implementing a digital risk mitigation pathway. Participants will include healthcare professionals, digital experts and CYP with experience of mental health conditions. Data will be collected between January 2022 and March 2023 and analysed using content and thematic analysis, case study, cross-case analysis for qualitative data and descriptive statistics for quantitative data. Findings will inform the experience-based co-design workshops. Ethics and Dissemination The study received full ethical approval from NHS REC [Ref: 22/SC/0237 and 22/WM/0167]. Findings will be made available to all stakeholders using multiple approaches.
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Affiliation(s)
- Joseph C. Manning
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Centre for Children and Young People's Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
- School of Healthcare, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - Takawira C. Marufu
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Centre for Children and Young People's Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Tim Carter
- Centre for Children and Young People's Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Sarah Bolton
- The Centre for Healthcare Equipment & Technology Adoption (CHEATA), Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Philip Breedon
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Michael Craven
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Kate Frost
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Anthony Harbottle
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Elizabeth Hendron
- Library Services, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Julian Patel
- East Midlands Academic Health Science Network (EMAHSN), University of Nottingham, Nottingham, UK
| | - Laura Rad
- Clinical Research Division, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Peter White
- Digital and Innovation, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Damian Wood
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Zaki Albelbisi
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Aikaterina Kaltsa
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | - Jane Coad
- Centre for Children and Young People's Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
- East Midlands Academic Health Science Network (EMAHSN), University of Nottingham, Nottingham, UK
- Centre for Care excellence, University Hospital Coventry and Warwickshire, NHS Trust, Nottingham, UK
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Valentino C, Daniilidi X, Portnoy S. Evaluating the beads of life groups: hearing from our participants. Clin Child Psychol Psychiatry 2023; 28:70-83. [PMID: 35713310 DOI: 10.1177/13591045221090782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION AND AIMS The Beads of Life (BOL) approach uses a narratively informed methodology 'to enable children and young people to make sense of their cancer journey in ways that make them stronger'. We will share feedback from BOL groups and reflect on changes made over time. METHOD Between 2014 and 2019, we have run 14 groups. Participants were aged 13-25, had received a diagnosis of cancer and were either on or had completed treatment. Quantitative and qualitative feedback was gathered at each workshop and 1 month later, with qualitative data then being analysed using thematic analysis. RESULTS 106 young people attended the groups. Young people reported that sharing experiences of cancer was useful, that they enjoyed the group and that they were highly likely to recommend it to others. Feedback remained consistent a month post-intervention. Qualitative feedback showed the value young people placed on meeting others, sharing their stories and on things they learnt about themselves from the group. DISCUSSION Themes support the intention of the intervention to provide a safe space for young people to share and reflect on their cancer journey, to connect with others and to enable peer support and mutual learning.
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Affiliation(s)
| | - Xeni Daniilidi
- 8964University College London Hospitals NHS Foundation Trust, London, UK
| | - Sara Portnoy
- 8964University College London Hospitals NHS Foundation Trust, London, UK
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Lewis G, Milnes L, Adams A, Schwarze J, Duff A. Influences on indoor environmental trigger remediation uptake for children and young people with asthma: A scoping review. Health Expect 2022; 26:87-97. [PMID: 36478049 PMCID: PMC9854302 DOI: 10.1111/hex.13670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/21/2022] [Accepted: 11/06/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Children and young people (CYP) with asthma can benefit from reduced exposure to indoor environmental allergens and triggers but may not consistently have avoidance strategies implemented. To inform future interventions to increase trigger and allergen avoidance and enhance asthma control, a greater understanding of the influences on avoidance behaviours is necessary. METHODS A systematic scoping review was selected to summarize evidence on what influences family uptake of indoor environmental asthma trigger avoidance strategies for CYP with asthma and identify research gaps. Primary studies of any design, including CYP (≤18 years) with asthma, and/or parent-carers, available in English and conducted since 1993, were eligible. Searches included nine databases, hand-searching reference lists and citation searching. FINDINGS Thirty-three articles were included and are summarized narratively due to heterogeneity. Influences appear complex and multifactorial and include barriers to strategy uptake, health beliefs and personal motivation. Research specifically related to family understanding of allergic sensitisation status and exposure risks, and how these may inform avoidance implementation is required. Patient and public involvement (PPI) was not reported in included articles, although two studies used participatory methods. CONCLUSION There is limited research on family asthma trigger management, particularly what influences current management behaviours. Variation in families' ability to identify important triggers, understand exposure risk and consistently reduce exposures warrants further exploratory research to explain how families reach avoidance decisions, and what future interventions should aim to address. Further PPI-informed research to address such gaps, could enable theory-based, person-centred interventions to improve the uptake of asthma trigger remediation. PATIENT OR PUBLIC CONTRIBUTION An asthma-specific PPI group contributed to the decision-making for the funding for the wider project this review sits within. The findings of this scoping review have informed the subsequent phases of the project, and this was discussed with PPI groups (both adult and CYP groups) when proposing the next phases of the project.
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Affiliation(s)
- Grace Lewis
- School of Healthcare, Faculty of Medicine and HealthUniversity of LeedsLeedsUK,Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK
| | - Linda Milnes
- School of Healthcare, Faculty of Medicine and HealthUniversity of LeedsLeedsUK,Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK
| | - Alexandra Adams
- Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK,Paediatric Respiratory UnitLeeds Children's HospitalLeedsUK
| | - Jürgen Schwarze
- Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK,Child Life and Health, Centre for Inflammation ResearchThe University of EdinburghEdinburghUnited Kingdom
| | - Alistair Duff
- School of Healthcare, Faculty of Medicine and HealthUniversity of LeedsLeedsUK,Asthma UK Centre for Applied Research, USHER InstituteUniversity of EdinburghEdinburghUK,Paediatric Respiratory UnitLeeds Children's HospitalLeedsUK
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Chambers S, Haughton D, Mabelis J, Brown J, Inchley J. Feasibility of using health and wellbeing data for school planning: the SHINE pilot in Scotland. Health Promot Int 2022; 37:6849499. [PMID: 36440898 PMCID: PMC9703801 DOI: 10.1093/heapro/daac149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Child and adolescent mental health and wellbeing (MHWB) have received greater attention in recent years due to increases in mental ill health and reports of decreasing subjective wellbeing. The School Health and Wellbeing Improvement Research Network (SHINE) was established to create a national infrastructure to support Scottish schools to collect and use health and wellbeing (HWB) data to inform school improvement action planning. This study aimed to evaluate a pilot of SHINE's provision of school-level HWB data reports from the Health Behaviour in School-aged Children survey and their impact on school action planning. Using a qualitative case study design, we collected data in four local authorities across Scotland via pupil and school staff focus groups (n = 23 groups), and from interviews with senior leaders, school SHINE Leads, other relevant school-level stakeholders, local authority (LA) HWB and data leads (n = 30 interviews). Data analysis was supported using Normalisation Process Theory as a guiding framework. Implementation was at an early stage. Participants indicated that the data reports were an accessible and valuable source of local information to support the improvement agenda. SHINE's expertise supported the lack of research capacity and strengthened HWB data literacy skills in schools. At the point of interview, data reports had not been shared widely within the school community, but there was some limited use of the reports to inform action planning around HWB. Through close working and further engagement with schools, SHINE has the potential to support them to deliver national commitments to improving HWB.
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Affiliation(s)
| | - Dawn Haughton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Judith Mabelis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Judith Brown
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jo Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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von Werthern M, Grigorakis G, Sweet R, Soon K. The Continuity of Cancer: Children and Adolescent's Experiences of Ending Cancer Treatment - A Systematic Review. Qual Health Res 2022; 32:2006-2018. [PMID: 36190313 DOI: 10.1177/10497323221128860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
As the research and treatment of childhood cancer steadily progresses, so has the interest in children's needs, not only throughout such treatment but also following completion. Whilst there is increased literature focussing on the long-term psychosocial impact of treatment completion, little is currently known about how children and young people (CYP) experience the more immediate end of their cancer treatment. The current review seeks to examine CYP's experiences of the end of their cancer treatment. Sixteen studies were retrieved using a systematic search strategy across five databases, all of which used qualitative methodology. Thematic synthesis was chosen to analyse the data. Four overarching themes were generated, which encompassed 'the continuity of cancer', 'ambivalence of needs', 'making sense of the cancer experience' and 'sense of self following the ending'. The end of treatment is a time of complexity for CYP, yet it is currently largely overlooked. In order to scaffold these endings for CYP, increased emphasis and thought needs to be placed on the end of treatment and the support that is provided within it.
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Affiliation(s)
| | | | | | - Kristina Soon
- 4919University College London, London, UK
- 4956Great Ormond Street Hospital, London, UK
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Bennett V, Gill C, Miller P, Lewis P, Ypag N, Hamilton-Giachritsis C, Lavi I. Developing a novel co-produced methodology to understand 'real-world' help-seeking in online peer-peer communities by young people experiencing emotional abuse and neglect. Health Expect 2022; 25:3124-3142. [PMID: 36210766 DOI: 10.1111/hex.13621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Recent systematic reviews suggest mediating factors (barriers and facilitators) of help-seeking for children and young people (CYP) with a range of mental health problems but highlight the need for a more robust methodology underpinned by theoretical frameworks. Emotional abuse and neglect is the most prevalent and pervasive form of abuse, with many CYP remaining unknown to professional services. These CYP are underrepresented in help-seeking research yet seek help from their peers via anonymous online publicly available message communities. OBJECTIVES To sensitively co-develop qualitative methodology to explore 'real-world' data to inform our understanding of help-seeking for these CYP, and define potential mediators (barriers and facilitators) and mechanisms of change associated with online peer support. METHODS Co-production with 10 young co-researchers (YCoR; aged 14-18 years) from the NeurOX Young People's Advisory Group (YPAG) included co-development and triangulation to apply different research methods (i.e., interpretative phenomenological, thematic and conversation analyses) to analyse rich ethnographic material from 20 publicly available online message conversations between help-seekers experiencing or questioning emotional abuse and neglect. A theoretical model of adolescent help-seeking proposed by Rickwood et al. was used as a conceptual framework to guide methodological development. RESULTS The methodological approach facilitated the identification of barriers and facilitators of help-seeking contextualized to the lives of these CYP: understanding and validating of abuse, emotional competence, fears and uncertainties around disclosure, knowledge, motivational factors and connection/trusted relationships. Notably, positive changes in expressed or perceived 'psychological state' and/or intention to seek help were noticed in 9 of 10 message threads that included a 'conversation' (≥3 posts). Themes associated with change related to connection with supportive peers; compassionate responding and the safeness of the online community. The existing adolescent help-seeking model was found to be too simplistic to account for help-seeking associated with emotional abuse and neglect. CONCLUSION The novel methodological approach offers a meaningful way to explore 'real-world' data with YCoR, for a population underrepresented in help-seeking research. Proposed relational mechanisms involve connection, compassion and online communities. Further research coproduced with YCoR with diverse care experiences and characteristics is required to upscale the methodology and further validate and extend the findings. PUBLIC CONTRIBUTION The core study was co-produced with 10 YCoRs from the NeurOX YPAG who have been involved in over 135 h on and offline work. Their roles involved co-deciding the direction of the study, evolving methodology, detailed co-analysis and reflective processes throughout all aspects of the study, interpretation, presentation and discussion of the findings with the NSPCC and Childline, and involvement in all communications. Additional consultation and involvement included further interested members of the NeurOX YPAG for the final online workshop and dissemination outputs.
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Affiliation(s)
- Vanessa Bennett
- Neuroscience, Ethics and Society Group, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Chloe Gill
- Research and Evidence Team, NSPCC, London, UK
| | | | - Peter Lewis
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - NeurOX Ypag
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Iris Lavi
- Department of Psychiatry, University of Oxford, Oxford, UK
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Bennett V, Gill C, Miller P, Wood A, Bennett C, Ypag N, Singh I. Co-production to understand online help-seeking for young people experiencing emotional abuse and neglect: Building capabilities, adapting research methodology and evaluating involvement and impact. Health Expect 2022; 25:3143-3163. [PMID: 36210767 DOI: 10.1111/hex.13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Involving young people (YP) as co-researchers (YCoR) in mental health research is important for ethical and epistemological reasons. However, approaches to involve and evaluate 'meaningful involvement' in complex qualitative mental health research, and how to evaluate impacts (or change) for the co-researcher and the research is less well defined. OBJECTIVES This co-produced research explored the experiences of YP seeking help for emotional abuse and neglect via an online, peer-peer message board. This practical case study aims to evidence the meaningful role and impacts associated with YCoR involvement in sensitive and complex mental health research using a flexible approach to co-production. METHODS During the Covid-19 pandemic, we explored on- and off-line approaches and adapted research methodology to build relationships, knowledge, skills, and confidence with YCoR. The virtual involvement was evaluated against the five principles of co-production. Anonymous, continuous digital feedback, reflective practices and multiple dissemination outputs are used to evaluate the impact of the study on those involved and the research. RESULTS Ten members of NeurOX Young People's Advisory Group were involved in the core project. Additional members were invited at later stages and in the dissemination of outputs. We describe a supportive, scaffolded learning approach to build capabilities and embed the lived experience of YCoR in complex qualitative research. A digital blended approach was acceptable to YCoR, principles of co-production were met and the impact/benefits of involvement are described. To demonstrate the epistemological value of involving YP we evidence YPs capabilities for involvement and the 'change' or contribution YCoR made to the research through reflective practices. CONCLUSIONS This case study demonstrates how flexible approaches co-production with YCoR can be robust and responsive to balance ethical and epistemological impact in complex mental health research. Supportive, scaffolded practices and safe environments helped build the confidence and capacity of YCoRs to demonstrate valuable phenomenological insights in the analysis. YP's perspectives on how they describe 'meaningful' and impactful involvement illustrate the reciprocal benefits gained through working together. PUBLIC CONTRIBUTION This case study describes the YCoR involvement throughout the research and dissemination of outputs. YCoR co-authors were involved in developing the outline and reviewing the draft stages of the manuscript.
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Affiliation(s)
- Vanessa Bennett
- Neuroscience, Ethics and Society Group, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Chloe Gill
- NSPCC, Research and Evidence Team, London, UK
| | - Pam Miller
- NSPCC, Research and Evidence Team, London, UK
| | - Asher Wood
- Neuroscience, Ethics and Society Group, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Cassia Bennett
- Neuroscience, Ethics and Society Group, Department of Psychiatry, University of Oxford, Oxford, UK
| | - NeurOX Ypag
- Neuroscience, Ethics and Society Group, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ilina Singh
- Neuroscience, Ethics and Society Group, Department of Psychiatry, University of Oxford, Oxford, UK
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Thomson A, Peasgood E, Robertson S. The Youth Patient and Public Involvement Café-A youth-led model for meaningful involvement with children and young people. Health Expect 2022; 25:2893-2901. [PMID: 36065124 DOI: 10.1111/hex.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION There are few meaningful frameworks or toolkits that exist for involvement with young people. Coproduction is a more recent patient and public involvement (PPI) approach that emphasizes the importance of power-sharing, to set young people as equal partners in the research process. This paper explores the successes and challenges encountered by one coproduced PPI space for young people. METHODS This paper is written by a team of young people who developed and worked on the Youth PPI Café over a period of 18 months. It explores how we developed a youth-led space for involvement in research. The authors have reflected on their experiences, providing examples of how youth PPI and coproduction were delivered in the NHS, in practice. RESULTS By working 'with' young people, rather than 'for' them, we offer insights into the successes and challenges of an entirely youth-led involvement space. Despite being effective in shaping mental health research for children and young people, we faced challenges with tokenism, resourcing and diversity and inclusion. CONCLUSIONS Involving youth meaningfully in research has the potential to inform studies at a macro- and microlevel, enabling positive change within research and within the systems that support young people. PATIENT OR PUBLIC CONTRIBUTION Young people aged 16-24 years with lived experience were included at every stage of this project, from formulation to the delivery and development of the group, to the preparation of this manuscript and its dissemination. Sussex Partnership NHS Foundation Trust's charity 'Heads On' provided funding for this study.
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Affiliation(s)
- Abigail Thomson
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton, UK.,Department of Experimental Psychology, The University of Oxford, Oxford, UK
| | - Edward Peasgood
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton, UK.,East Sussex Community Voice CIC, Eastbourne, UK.,East Sussex County Council (Children's Services), Eastbourne, UK
| | - Sam Robertson
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton, UK
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Babbage CM, Jackson GM, Davies EB, Nixon E. Self-help Digital Interventions Targeted at Improving Psychological Well-being in Young People With Perceived or Clinically Diagnosed Reduced Well-being: Systematic Review. JMIR Ment Health 2022; 9:e25716. [PMID: 36018675 PMCID: PMC9463613 DOI: 10.2196/25716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 06/29/2021] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Levels of well-being are declining, whereas rates of mental health problems remain high in young people. The World Health Organization defines mental health as not merely the absence of mental disorder but also includes social and psychological well-being as integral to positive mental health, highlighting that mental health is applicable to young people with mental health conditions and those without a diagnosis of a mental health condition. Reduced mental well-being have been identified in studies of young people with clinical populations, as well as in populations consisting of nonclinical young people. Self-help digital interventions can be delivered at mass at a low cost and without the need for trained input, thereby facilitating access to support for well-being. Self-help interventions are effective in young people with mental health conditions, but systematic reviews of such studies have been limited to randomized controlled trials, have not included reduced well-being as an inclusion criterion, and do not consider engagement factors such as retention. OBJECTIVE The objective of this study was to systematically review all controlled studies of digitally delivered, self-administered interventions for young people aged 9 to 25 years, with perceived or clinically diagnosed reduced psychological well-being. Participant retention and effectiveness of the interventions were also explored. METHODS A systematic search of the PsycInfo, EMBASE, Cochrane, Scopus, and MEDLINE databases from inception to 2021, reference searches of relevant papers, and gray literature was carried out for digitally controlled studies conducted with young people with perceived or clinically diagnosed reduced well-being, aimed at improving psychological well-being. Data were extracted to identify the effectiveness and retention rates of the interventions and the quality of the studies. RESULTS Overall, 1.04% (12/1153) of studies met the inclusion criteria: 83% (10/12) of studies were randomized controlled trials and 17% (2/12) were controlled pre-post studies. Most (6/12, 50%) studies aimed to improve symptoms of depression; 3 interventions aimed at both anxiety and depressive symptoms and 2 studies aimed at improving social functioning difficulties. Owing to the high risk of bias across interventions and lack of similar outcome measures, a meta-analysis was not conducted. Retention rates across studies were regarded as good, with moderate to high retention. Overall, the findings indicated that predominantly self-administered self-help interventions improved well-being in the areas targeted by the intervention and identified additional areas of well-being that were positively affected by interventions. Few interventions supported psychological well-being that was different from those used by young people with a clinical diagnosis of mental illness or young people from neurodiverse backgrounds. CONCLUSIONS The findings, along with the advantages of self-help interventions, highlight the need for upscaling self-help interventions to better support vulnerable populations of young people who experience poor psychological well-being. TRIAL REGISTRATION PROSPERO CRD42019129321; https://tinyurl.com/4fb2t4fz.
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Affiliation(s)
- Camilla M Babbage
- National Institute for Health and Care Research (NIHR) MindTech Medtech Co-operative, Mental Health & Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Georgina M Jackson
- Institute of Mental Health, Mental Health & Clinical Neurosciences, University of Nottingham, Nottingham, United Kingdom
| | - E Bethan Davies
- National Institute for Health and Care Research (NIHR) MindTech Medtech Co-operative, Mental Health & Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Elena Nixon
- Institute of Mental Health, Mental Health & Clinical Neurosciences, University of Nottingham, Nottingham, United Kingdom
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Bunting L, McCartan C, Davidson G, Grant A, Mulholland C, Schubotz D, McBride O, Murphy J, Shevlin M. Rationale and methods of the 'Northern Ireland Youth Wellbeing Survey' and initial findings from the Strengths and Difficulties Questionnaire. Clin Child Psychol Psychiatry 2022; 27:670-685. [PMID: 35232265 PMCID: PMC9234773 DOI: 10.1177/13591045221075525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Backgrounds and Aims: The Northern Ireland Youth Wellbeing Survey (NIYWS) was commissioned by the Health and Social Care Board (NI) with the aim of providing reliable prevalence estimates of the mental health problems of children and young people aged 2-19 years. Method: The NIYWS used a random probability design, stratified by deprivation decile and county, to ensure even geographical distribution and representation. The survey used a broad range of validated measures to identify children and young people who met established clinical criteria for common mood, anxiety and behaviour disorders, trauma related disorders, as well as those at risk of autism spectrum disorder, eating disorders, future psychotic illness, self-injury or suicide. Results: Data were collected on 3074 children and young people aged 2-19 years, as well as over 2800 parents. The survey achieved a high response rate (67%) and initial findings indicated that 11% of the sample were at risk of emotional or behavioural problems. Conclusions: The NIYWS was the first large scale nationally representative survey of the mental health of children and young people in NI. Despite the legacy of political violence the initial findings show comparable levels of emotional and behavioural problems to England.
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Affiliation(s)
- Lisa Bunting
- 1596Queen's University Belfast, Northern Ireland
| | | | | | - Anne Grant
- 1596Queen's University Belfast, Northern Ireland
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Abstract
The mental health consequences of the war in Ukraine will be enormous. Mental health professionals who are providing care for people in Ukraine, or those resettled elsewhere, may require access to standardized and validated assessment tools. We have developed a repository of mental health measures that are available in Ukrainian, Russian and English and can be accessed at www.traumameasuresglobal.com/ukraine.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, 2596Ulster University (Coleraine), Northern Ireland
| | - Philip Hyland
- Department of Psychology, 8798Maynooth University, Ireland
| | - Thanos Karatzias
- School of Health and Social Care, 3121Edinburgh Napier University, Ireland
| | - Nino Makhashvili
- Global Initiative on Psychiatry, Tbilisi, Georgia, 132043Ilia State University, Georgia
| | - Jana Javakhishvili
- Global Initiative on Psychiatry, Tbilisi, Georgia, 132043Ilia State University, Georgia
| | - Bayard Roberts
- Department of Health Services Research and Policy, 4906London School of Hygiene and Tropical Medicine, UK
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Barratt M, Bail K, Paterson C. Children living with long-term conditions and their experiences of partnership in nursing care: An integrative systematic review. J Clin Nurs 2022. [PMID: 35768938 DOI: 10.1111/jocn.16429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/01/2022] [Accepted: 06/09/2022] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVE To describe the experiences of nursing care and partnership nursing as expressed by children living with long-term conditions. BACKGROUND Children with long-term conditions have higher rates of hospitalisations and adverse events in hospital, yet little is known about their experiences of nursing care. How children perceive partnership in care with their families and nurses is of interest in the achievement of safe and effective care DESIGN: An integrative review following Joanna Briggs Institute protocols for systematic reviews. METHOD An integrative review was chosen following Joanna Briggs Institute protocols for systematic reviews. A total of 5150 articles were screened, with 251 full-text publications reviewed. A total of 21 studies were included, three mixed-method studies and 18 qualitative studies. This review has been reported as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Four integrated findings were identified: "Children are aware of their surroundings and needs," "Children value positive communication," "Children want to be recognised as an individual in the triadic relationship, and this can be done through nurses using tailored play;" and "Children seek a shared decision-making process." DISCUSSION Children wanted to be seen as an individual in Children and Young People's nursing as well as a child who craves security, fun and comfort, both from their families and nursing staff. Children described observing partnership between nursing staff and parents but felt uninvolved, with some children craving more knowledge and power to better understand their long-term condition. RELEVANCE TO CLINICAL PRACTICE Further research is required on how Children and Young People's nursing staff can better support children and empower them to be active members in the shared decision-making process if the child wishes to be involved.
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Affiliation(s)
- Macey Barratt
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia.,Prehabilitation, Activity, Cancer Exercises and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia.,Robert Gordon University, Aberdeen, UK
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Smith JG, Bartlett A, Hales H. Exploration of adverse patterns of placement of young people in secure care: The unwanted child? Crim Behav Ment Health 2022; 32:212-226. [PMID: 35962767 PMCID: PMC9545529 DOI: 10.1002/cbm.2233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/04/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Emerging evidence suggests that distant placements and multiple moves may be detrimental to young people in care settings. Less is known about the characteristics of young people in secure care most affected by these processes. AIMS This study examined distance from home and number of previous placements in English young people detained in secure care and their relationships with organisational and individual characteristics. METHODS Data were derived from the (2016) cross-sectional National Adolescent Study census of English young people in secure care, which included 1322 young people across secure mental health, welfare and Youth Justice establishments. Associations were described with odds ratios/95% confidence intervals (OR/CI). RESULTS Overall, 285 young people (26.4%) were in secure placements over 100 miles from their family/local authority while 54 (5.6%) had 10 or more previous placements. These rates were higher in secure welfare than other settings (73.8%; OR (CI) = 9.62 (5.72, 16.18), 12.7%; OR (CI) = 2.76 (1.29, 5.91) respectively), and there was significant overlap between long-distance placement and multiple placements (n = 22; OR (CI) = 2.26 (1.27, 4.04)). Younger age and presence of neurodevelopmental disorder were also associated with long-distance placements while psychiatric diagnosis, previous secure placement, and previous service contact were linked to multiple placements. CONCLUSIONS Distant and/or multiple placements in young people in secure care appear common, particularly for those who are placed in secure welfare and who are younger and/or present with a psychiatric disorder. Multi-agency evaluations that capture the longitudinal experience of these vulnerable young people are needed to understand how undesirable patterns of placement in secure care occur and prevent future instances.
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Affiliation(s)
- Jared G. Smith
- Population Health Research InstituteSt George’s, University of LondonLondonUK
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Eilert N, Wogan R, Leen A, Richards D. Internet-Delivered Interventions for Depression and Anxiety Symptoms in Children and Young People: Systematic Review and Meta-analysis. JMIR Pediatr Parent 2022; 5:e33551. [PMID: 35551071 PMCID: PMC9136650 DOI: 10.2196/33551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/23/2022] [Accepted: 02/07/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Mental health difficulties in children and adolescents are highly prevalent; however, only a minority receive adequate mental health care. Internet-delivered interventions offer a promising opportunity to increase access to mental health treatment. Research has demonstrated their effectiveness as a treatment for depression and anxiety in adults. This work provides an up-to-date examination of the available intervention options and their effectiveness for children and young people (CYP). OBJECTIVE In this systematic review and meta-analysis, we aimed to determine the evidence available for the effectiveness of internet-delivered interventions for treating anxiety and depression in CYP. METHODS Systematic literature searches were conducted throughout November 2020 using PubMed, PsycINFO, and EBSCO academic search complete electronic databases to find outcome trials of internet-delivered interventions treating symptoms of anxiety and/or depression in CYP by being either directly delivered to the CYP or delivered via their parents. Studies were eligible for meta-analysis if they were randomized controlled trials. Risk of bias and publication biases were evaluated, and Hedges g between group effect sizes evaluating intervention effects after treatment were calculated. Meta-analyses used random-effects models as per protocol. RESULTS A total of 23 studies met the eligibility criteria for the systematic review, of which 16 were included in the meta-analyses, including 977 participants in internet-delivered treatment conditions and 1008 participants in control conditions across 21 comparisons. Random-effects models detected a significant small effect for anxiety symptoms (across 20 comparisons; Hedges g=-0.25, 95% CI -0.38 to -0.12; P<.001) and a small but not significant effect for depression (across 13 comparisons; Hedges g=-0.27, 95% CI -0.55 to 0.01; P=.06) in favor of internet-delivered interventions compared with control groups. Regarding secondary outcomes, there was a small effect of treatment across 9 comparisons for impaired functioning (Hedges g=0.52, 95% CI 0.24-0.80; P<.001), and 5 comparisons of quality of life showed no effect (Hedges g=-0.01, 95% CI -0.23 to 0.21; P=.94). CONCLUSIONS The results show that the potential of internet-delivered interventions for young people with symptoms of anxiety or depression has not been tapped into to date. This review highlights an opportunity for the development of population-specific interventions and their research to expand our current knowledge and build an empirical base for digital interventions for CYP. TRIAL REGISTRATION PROSPERO CRD42020220171; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=220171.
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Affiliation(s)
- Nora Eilert
- e-Mental Health Group, School of Psychology, University of Dublin Trinity College, Dublin, Ireland.,SilverCloud Science, SilverCloud Health, Dublin, Ireland
| | - Rebecca Wogan
- SilverCloud Science, SilverCloud Health, Dublin, Ireland
| | - Aisling Leen
- SilverCloud Science, SilverCloud Health, Dublin, Ireland
| | - Derek Richards
- e-Mental Health Group, School of Psychology, University of Dublin Trinity College, Dublin, Ireland.,SilverCloud Science, SilverCloud Health, Dublin, Ireland
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Abstract
Background There are few opportunities for undergraduate nurses to undertake experiential learning about research design and conduct. The project aim was to implement and evaluate a placement to support the development of research knowledge and skills. Methods Establishment of a four-week placement, with allocation to a registered quality improvement/service evaluation project. Evaluation was obtained through questionnaires; student experience (pre, post and one year), supervisor experience and organisational impact (presentations, conference and grant submissions). Results 24 students (five cohorts) were allocated to 17 projects (2017-2019). 100% of students enjoyed the placement, gained research knowledge and insight into clinical care. At one year (n = 15), 88% of students would consider undertaking a service evaluation and 65% (n = 11) would consider further post-graduate study. All supervisors (n = 20) reported the initiative valuable for student development. All project results were shared with relevant local teams to enable service planning and results from five projects been presented at eight national and international conferences. Three projects have contributed directly to further research grant submissions. Conclusion The programme supports the development of undergraduate nurses to be research ready and facilitates organisations to address high-priority safety and quality topics. Further resources are required to be able to increase placement capacity.
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Affiliation(s)
- Julie C Menzies
- Nurse Researcher, Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, UK
| | - Karl Emms
- Lead Nurse for Patient Safety, Birmingham Women's and Children's NHS Foundation Trust, UK
| | - Tracey Valler
- Senior Lecturer, School of Nursing, University of Birmingham, UK
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Toma M, Anderson J, Forster S, Shiels P, Windsor S, Gray NM. Perceived impact of formulating, implementing and enacting national mental health policies recommendations in practice: An exploratory qualitative study within child and adolescent mental health services in Scotland. J Health Serv Res Policy 2022; 27:203-210. [PMID: 35225039 PMCID: PMC9277320 DOI: 10.1177/13558196211072472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To understand the process of formulating, implementing and enacting national recommendations into practice, by exploring the interactions between government policymakers and national and local organisations supporting and delivering policy implementation within a Child and Adolescent Mental Health Service (CAMHS) context in Scotland. METHODS Data collection involved 16 semi-structured individual and four focus group interviews with a purposeful sample of policymakers, national health and social care stakeholders and local outpatient and inpatient CAMHS teams representing three NHS health boards in Scotland. RESULTS Study participants highlighted the challenges of navigating through evolving and often conflicting policy agendas, seen to not acknowledging the current evidence base or experiential learning from services and prior evaluations. Accounts of transformation fatigue often emerged from increased expectations for staff to adopt new approaches to accommodate constantly changing recommendations. Participants also reported a lack of integration and implementation support from national health and social care organisations, leading to duplication of effort and gaps in provision or waste. Policy recommendations were perceived as sometimes vague, lacking clarity about how to deliver service transformation using a whole-system approach. The collective narratives reflected increased tension between the need for local autonomy to innovate and the limitations created vertically by the relative inflexibility of policy recommendations, and horizontally by the proliferation of national organisations delivering the same transformation aims using different approaches in a resource-constrained environment. CONCLUSION The findings contribute to the wider literature by offering an exploration of importance of evaluation and evidence uptake in policy formulation; the roles and remits in supporting the implementation of policy recommendations; and how the dynamics of central control and local autonomy might impact on the local enactment of policy recommendations.
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Affiliation(s)
- Madalina Toma
- NIHR Applied Research Collaboration (ARC) Kent Surrey Sussex, Personal Social Service Research Unit (PSSRU), School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, UK
| | - Julie Anderson
- Performance, Planning and Quality Manager, 130121NHS National Services Scotland, Edinburgh, UK
| | - Sarah Forster
- Head of Service Design and Transformational Change, 102585Aberlour Childcare Trust, Stirling, UK
| | - Paula Shiels
- Senior Nurse Mental Health, 1442NHS Ayrshire & Arran, Crosshouse, Kilmarnock, UK
| | - Shirley Windsor
- Organisational Lead Public Mental Health (Implementation), 578987Public Health Scotland, Edinburgh, UK
| | - Nicola M Gray
- Scottish Improvement Science Collaborating Centre (SISCC), School Health Sciences, 3042University of Dundee, Dundee, UK
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Whittenbury K, Kroll L, Dubicka B, Bull ER. Exploring barriers and facilitators for mental health professionals delivering behavioural activation to young people with depression: qualitative study using the Theoretical Domains Framework. BJPsych Open 2022; 8:e38. [PMID: 35118935 PMCID: PMC8867899 DOI: 10.1192/bjo.2022.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression prevalence among young people is increasing, with growing pressures on specialist mental health services. Manualised behavioural activation therapy may be effective for young people, and can be delivered by a range of mental health professionals (MHPs). This study explored clinician perspectives of barriers and facilitators to implementing behavioural activation with young people in routine practice. AIMS We conducted a qualitative study with individual semi-structured interviews with MHPs, as part of a wider feasibility study. METHOD Participants were mental health professionals (therapists and supervisors) from two UK NHS sites delivering manualised behavioural activation for young people. Data were analysed with an inductive followed by deductive approach, applying the Theoretical Domains Framework (TDF) to understand key influences on practice change. Identified domains were mapped onto possible behaviour change techniques (BCTs) to support implementation, using the Theory and Techniques Tool (TTT). RESULTS Nine MHPs were interviewed. Thirteen of fourteen TDF domains were relevant, including perceived professional identity, beliefs about own capabilities and perceived positive or negative consequences of using manualised behavioural activation, social influences, memory and attention, and environmental resources. Fourteen theory-linked BCTs were identified as possible strategies to help clinicians overcome barriers (e.g. integrating behavioural practice/rehearsal, prompts and persuasive communications within training, and supervision). CONCLUSIONS Behavioural science approaches (TDF, TTT) helped conceptualise key barriers and facilitators for MHPs delivering manualised behavioural activation with young people. Interventions using BCTs to address identified barriers could help the implementation of new therapies into routine practice, working to bridge the research-practice gap in clinical psychology.
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Affiliation(s)
- Kate Whittenbury
- Faculty of Health and Education, Manchester Metropolitan University, UK
| | - Leopold Kroll
- Young People's Mental Health Research Unit, Pennine Care NHS Foundation Trust Headquarters, UK
| | - Bernadka Dubicka
- Young People's Mental Health Research Unit, Pennine Care NHS Foundation Trust Headquarters, UK; and Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Eleanor R Bull
- Faculty of Health and Education, Manchester Metropolitan University, UK; and Department of Anaesthesia, Manchester University NHS Foundation Trust, UK
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Renwick L, Pedley R, Johnson I, Bell V, Lovell K, Bee P, Brooks H. Conceptualisations of positive mental health and wellbeing among children and adolescents in low- and middle-income countries: A systematic review and narrative synthesis. Health Expect 2022; 25:61-79. [PMID: 34904773 PMCID: PMC8849250 DOI: 10.1111/hex.13407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 11/08/2021] [Accepted: 11/25/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mental illnesses are the leading causes of global disease burden. The impact is heightened in low- and middle-income countries (LMICs) due to embryonic care systems and extant barriers to healthcare access. Understanding children and adolescents' conceptualisations of mental health wellbeing in these settings is important to optimize health prevention and promotion initiatives. OBJECTIVE To systematically review and synthesize children and adolescents' conceptualisations and views of mental health and wellbeing in LMICs. DESIGN Ten databases were systematically searched from inception to July 2020 and findings from included studies were synthesized. RESULTS Twenty papers met eligibility criteria comprising qualitative, quantitative and mixed methods studies. Children and adolescents identified aspects of mental health and wellbeing, including positive affect and outlook and having sufficient personal resources to face daily challenges. Identified factors recognized the importance of activating both kin and lay networks in supporting and maintaining wellbeing. Conceptualisations of mental health and wellbeing were varied and influenced by culture, developmental stage and gender. DISCUSSION AND CONCLUSIONS Irrespective of environmental and sociocultural influences on concepts of wellbeing and mental health, children and adolescents in LMICs can conceptualise these constructs and identify how they pursue positive mental health and wellbeing important for developing age and culture-appropriate community mental health strategies. Our review highlights the need to extend inquiry to wider developmental stages and both across and within specific populations in LMICs. PATIENT AND PUBLIC INVOLVEMENT Initial results were presented at stakeholder workshops, which included children, adolescents, parents and health professionals held in Indonesia in January 2019 to allow the opportunity for feedback.
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Affiliation(s)
- Laoise Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Isobel Johnson
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Vicky Bell
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health SciencesUniversity of ManchesterManchesterUK
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health SciencesUniversity of ManchesterManchesterUK
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Brettell M, Fenton C, Foster E. Linking Leeds: A Social Prescribing Service for Children and Young People. Int J Environ Res Public Health 2022; 19:1426. [PMID: 35162458 DOI: 10.3390/ijerph19031426] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/12/2021] [Accepted: 01/05/2022] [Indexed: 02/01/2023]
Abstract
The use of social prescribing interventions for common mental health issues is expanding as clinicians seek to diverge from the traditional medical model of treatment. This intervention allows for the referral of patients to a nonclinical social activity via a link worker. Evidence for the benefits of social prescribing is growing. Most evidence is based on adults; however, a smaller number of studies involving children and young people have produced encouraging results. This evaluation reports on data routinely collected by the Linking Leeds service between 9 January 2019–11 January 2020. Linking Leeds provides Social Prescribing for people aged 16 years and above; however, the current paper focuses on service users aged between 16 and 25. Their aim is to connect people to services and activities in their community in order to benefit overall health and mental wellbeing. This evaluation of the Linking Leeds program supports the growing body of evidence to support the benefits social prescribing can have on young people’s mental health. Two main mechanisms were identified which underpin social prescribing in young people: social connectedness and behavioural activation.
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47
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Helyar S, Jackson L, Patrick L, Hill A, Ion R. Gender Dysphoria in children and young people: The implications for clinical staff of the Bell V's Tavistock Judicial Review and Appeal Ruling. J Clin Nurs 2021; 31:e11-e13. [PMID: 34888970 DOI: 10.1111/jocn.16164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/25/2021] [Indexed: 11/28/2022]
Abstract
In the past few years, there has been a very significant rise in the number of children and young people seeking treatment for gender dysphoria This area is the subject of much discussion, as evidenced in a recent court case in the UK which examined competence and capacity of young people to consent to potentially irreversible interventions. Clinicians involved in gaining consent to puberty blockers for gender dysphoric young people, must understand the evidence in this area and be aware of the heavy burden of accountability placed upon them.
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Affiliation(s)
| | | | | | | | - Robin Ion
- University of the West of Scotland, Scotland, UK
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Ng SM, Evans ML. Widening health inequalities related to type 1 diabetes care in children and young people in the UK: A time to act now. Diabet Med 2021; 38:e14620. [PMID: 34109677 DOI: 10.1111/dme.14620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/20/2021] [Accepted: 06/07/2021] [Indexed: 01/11/2023]
Abstract
In this recent 2019-2020 audit, 96% (168/173) of paediatric diabetes teams submitted data and included a total of 29,242 children and young people (CYP) up to the age of 24 years, and type 1 diabetes consisted of 27,653 CYP. One of the key findings was that CYP with type 1 diabetes from minority ethnic communities have higher HbA1 compared to white ethnicity and that significantly lower use of insulin pumps or real-time continuous glucose monitoring systems was used among black children. There has been an increasing trend of widening health inequalities reported the past 6 years. As chairs of Diabetes UK Diabetes Research Study Groups, the authors urge that research into barriers of access to technology for T1D in CYP in the UK specifically looking at provider bias, systemic issues within the health system, and individual and family factors are conducted with urgency.
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Affiliation(s)
- Sze May Ng
- Paediatric Department, Southport and Ormskirk NHS Trust, Ormskirk, UK
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Mark L Evans
- Wellcome Trust/ MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
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Yates S, Dickinson H, Smith C, Tani M. Flexibility in individual funding schemes: How well did Australia's National Disability Insurance Scheme support remote learning for students with disability during COVID-19? Soc Policy Adm 2021; 55:906-920. [PMID: 33362318 PMCID: PMC7753504 DOI: 10.1111/spol.12670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/30/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
Individualized funding schemes are designed to offer people with disability greater choice and control over the services they receive. In this research, we report on a survey of over 700 families to explore how Australia's National Disability Insurance Scheme (NDIS) supported children and young people and their families to learn remotely during COVID-19. NDIS funding to support education during the first COVID-19 lockdown period forms an important case study of the flexibility of individualized funding schemes. Our results suggest that participant experiences varied widely, with some people able to make the changes they required and others left with a significant service gap. This shows that individual funding schemes are not necessarily more flexible than traditional systems in an emergency situation-useful flexibility depends on many factors, such as clarity of information giving, all actors having a shared message, proactive support of flexibility initiatives, and participants' ability to quickly navigate a complicated system. This research also highlights problems with the interface between the NDIS and mainstream services such as education.
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Affiliation(s)
- Sophie Yates
- Public Service Research Group, School of BusinessUNSW CanberraCanberraAustralian Capital TerritoryAustralia
| | - Helen Dickinson
- Public Service Research Group, School of BusinessUNSW CanberraCanberraAustralian Capital TerritoryAustralia
| | - Catherine Smith
- Melbourne Graduate School of EducationUniversity of MelbourneMelbourneVictoriaAustralia
| | - Massimiliano Tani
- Public Service Research Group, School of BusinessUNSW CanberraCanberraAustralian Capital TerritoryAustralia
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50
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Stynes H, Lane C, Pearson B, Wright T, Ranieri V, Masic U, Kennedy E. Gender identity development in children and young people: A systematic review of longitudinal studies. Clin Child Psychol Psychiatry 2021; 26:706-719. [PMID: 33827265 DOI: 10.1177/13591045211002620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Children are presenting in greater numbers to gender clinics around the world. Prospective longitudinal research is important to better understand outcomes and trajectories for these children. This systematic review aims to identify, describe and critically evaluate longitudinal studies in the field. METHOD Five electronic databases were systematically searched from January 2000 to February 2020. Peer-reviewed articles assessing gender identity and psychosocial outcomes for children and young people (<18 years) with gender diverse identification were included. RESULTS Nine articles from seven longitudinal studies were identified. The majority were assessed as being of moderate quality. Four studies were undertaken in the Netherlands, two in North America and one in the UK. The majority of studies had small samples, with only two studies including more than 100 participants and attrition was moderate to high, due to participants lost to follow-up. Outcomes of interest focused predominantly on gender identity over time and emotional and behavioural functioning. CONCLUSIONS Larger scale and higher quality longitudinal research on gender identity development in children is needed. Some externally funded longitudinal studies are currently in progress internationally. Findings from these studies will enhance understanding of outcomes over time in relation to gender identity development in children and young people.
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Affiliation(s)
- Hannah Stynes
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Chloe Lane
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Beth Pearson
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Talen Wright
- Division of Psychiatry, University College London, UK
| | - Veronica Ranieri
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Una Masic
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Eilis Kennedy
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, UK
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