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Aim A discussion which aims to explore the diversity of decision-making during teenage and young adult cancer treatment. The discussion will be related to the concepts of autonomy, dependence and decision-making in this age group. Background The experience of cancer involves a significant series of treatment decisions. However, other non-treatment decisions also have to be made which can relate to any aspect of everyday life. These decisions occur against the backdrop of young people's disease experience. Design Discussion paper. Data sources A literature search for the period 1990-2013 was undertaken. This included searching the following databases: Cumulative Index for Nursing and Allied Health Literature ( CINAHL), SCOPUS, Medline, DARE, Applied Social Sciences Index and Abstracts ( ASSIA), (Psych Info) and The Cochrane Library. Implications for nursing There is a lack of evidence into the experience of everyday decisions made by young people during cancer treatment. This may affect them in the form of unmet needs that nurses, or other professionals, fail to appreciate. Conclusion Further exploration of how teenagers and young adults experience the range and process of decision-making during cancer treatment could be useful in helping to provide effective supportive care for this age group. [ABSTRACT FROM AUTHOR]

Objectives In line with the aims of this special issue, the purpose of this paper is to forward a position on the concept of sport parenting expertise through the presentation of six key postulates. Design Literature review and position statement. Method By adopting methods associated with an academic position paper, a statement is presented that we believe encapsulates sport parenting expertise. Six key postulates of parenting expertise, formulated from critically reviewing and interpreting relevant literature, are then presented. Results We propose that sport parenting expertise is dependent on the degree to which parents demonstrate a range of competencies; namely that parents, (a) select appropriate sporting opportunities and provide necessary types of support, (b) understand and apply appropriate parenting styles, (c) manage the emotional demands of competitions, (d) foster healthy relationships with significant others, (e) manage organizational and developmental demands associated with sport participation, and, (f) adapt their involvement to different stages of their child's athletic career. Conclusion Expertise in sport parenting requires parents to develop knowledge and utilize a range of intrapersonal, interpersonal, and organizational skills in order to support their child, manage themselves, and operate effectively in the wider youth sport environment. Recommendations for applied researchers to further investigate these postulates and substantiate the components of sport parenting expertise are offered. [ABSTRACT FROM AUTHOR]

Introduction: Dysmenorrhoea affects many adolescents with significant impacts on education and well-being. In the UK, most of the adolescents who seek care (and many never do), will do so through general practice (primary care). Knowing how best to care for adolescents reporting menstrual pain is an area where UK general practitioners would like better guidance and resources. Methods: This mixed-methods narrative synthesis collates community and specialist evidence from 320 papers about adolescent dysmenorrhoea, with a UK general practice community health perspective. Results: We report a narrative summary of symptoms, cause, consequences and treatments for adolescent dysmenorrhoea. We highlight areas of tension or conflicted evidence relevant to primary care alongside areas of uncertainty and research gaps identified through this synthesis with input from lived experience advisers. Discussion: There is little evidence about primary care management of adolescent dysmenorrhoea or specific resources to support shared-decision making in general practice, although there are evidence-based treatments to offer. Primary care encounters also represent potential opportunities to consider whether the possibility of underlying or associated health conditions contributing to symptoms of dysmenorrhoea, but there is little epidemiological evidence about prevalence from within community health settings to inform this. The areas where there is little or uncertain evidence along the care journey for adolescent dysmenorrhoea, including at the interface between experience and expression of symptoms and potential underlying contributory causes warrant further exploration. [ABSTRACT FROM AUTHOR]

Paediatric Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) is a disabling condition. Schools play a key role in adolescents' experiences with managing ME/CFS. However, little is known about the experiences of adolescents with ME/CFS (and their families) in schools. This paper is an incidental qualitative study, which combines data from two independent ME/CFS studies: study 1 researched ethnic minority adolescents with ME/CFS; study 2 explored Acceptance and Commitment Therapy for adolescents with ME/CFS who had not recovered after one year. Participants included: adolescents with ME/CFS; their families; and medical professionals (ME/CFS specialists and non‐specialists). Adolescents, their families, and ME/CFS medical professionals were recruited from a UK specialist paediatric ME/CFS service. Non‐ME/CFS medical professionals were recruited from the same region. Semi‐structured qualitative interviews and focus groups were undertaken. Participants' views on schools from each study were combined and thematic analysis was used to identify themes. Fifteen adolescents with ME/CFS (11–17 years old), sixteen family members, and ten medical professionals (GPs, school nurses and ME/CFS specialists) were interviewed. Four key themes were found: (1) adolescents identified school was important for aiding ME/CFS recovery, especially educationally and socially; (2) families described varying levels of support from schools and local authorities with help managing ME/CFS – some described significant practical and emotional difficulties to accessing education, whereas others recounted examples of positive supportive strategies, particularly when teachers had previous experience or knowledge of ME/CFS; (3) parents thought three‐way communication between schools, healthcare and families could improve support; (4) participants felt schools were an appropriate place for knowledge building and raising awareness of ME/CFS amongst teachers and pupils, to aid improved supportive measures. In conclusion, this paper provides rich data that highlights the importance of education and the realistic fears and hurdles for adolescents with ME/CFS remaining engaged in education and the impact on their future. Some families described positive strategies in school, which were viewed as helpful to manage ME/CFS in the classroom. These strategies could be implemented alongside knowledge building initiatives and improved communication between healthcare and education. There is a need to further investigate useful strategies and determine how teachers can be best supported in implementing them. [ABSTRACT FROM AUTHOR]

This paper aims to explore young people's perspectives of a real-life scenario of child language brokering in a healthcare setting (the doctor's office), when the topic of discussion is sensitive and potentially conflictual. Child Language brokers are migrant young people who translate and interpret for family members, peers and the local community. Often the spaces in which children broker (e.g., healthcare, banks), referred to here as a 'contact zone', are dominated by adults in positions of authority and unequal power differentials. The language broker and those for whom they are brokering may be in a less powerful position because of their migration status and/or age status. Existing research has focused mainly from the view of adults and young people's perspectives on the practice are underexplored. We draw the existing literature to explore how brokers understand the wider societal context and the strategies they employ to manage conflict. Findings are presented from 29 individual qualitative vignette-based interviews with language brokers (aged 13–16) in the United Kingdom which were qualitatively analysed. Findings show how these children play a vital role in protecting those for whom they broker, often navigating sophisticated social interactions and tactics (such as delay and selective modification). Equally, they carry a weight of responsibility trying to manage complicated, perhaps morally questionable, situations. By asking brokers to reflect on a real-life healthcare scenario, we are advancing understanding of migrant youth brokers and the families they support in their day to day lives. Highlights: Child language brokers find themselves brokering in health care settings with unequal power relations. Vignette methodology is a useful way of capturing complex sensitive and conflictual accounts of healthcare brokering in children. Brokering in the doctor's office required children to have knowledge of tri-interactional actors, institutional factors and wider societal norms. Young people used different strategies for managing conflict (e.g., delay tactics and selective modification). Clearer guidelines are needed around child language brokering in medical settings and spaces with contentious power inequalities. [ABSTRACT FROM AUTHOR]

The current study explored the role of pre-existing and pandemic-time child, family or environmental factors in the presentation of mental health symptoms of autistic youth and their parents during the pandemic. Participants were parents/carers of autistic children (Autism Spectrum Treatment and Resilience Cohort, N = 67, M age = 9 years) and adolescents (QUEST cohort, N = 112, M age = 17 years). Parents completed an online survey that asked about child and parental mental health, infection experience, and changes to education arrangements, family life, housing and finances during the pandemic. Pre-existing measures of mental health, autism and adaptive functioning were also utilised. More engagement and enjoyment in education provision and going outside was associated with better child and parental mental health. In multivariate multiple linear regression models, more pre-existing attention deficit hyperactivity disorder symptoms were associated with more behavioural/attention deficit hyperactivity disorder symptoms during the pandemic in the pre-adolescent cohort, and with greater emotional symptoms in the adolescent cohort. More pre-existing parental mental health problems were associated with more parental mental health symptoms during the pandemic in both cohorts. Knowledge of pre-existing mental health and pandemic-related stressors may help care planning. 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. 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. [ABSTRACT FROM AUTHOR]

Previous research has shown that there is a small but significant cumulative private school advantage in terms of educational attainment in Britain. However, research on how school type influences non-educational outcomes is more scarcer. This paper aims to identify the extent to which school type influences satisfaction with life and mental health from adolescence to early adulthood. Using Next Steps, a longitudinal study of young people in England born in 1989/90, the authors use multiple variable regression analyses to address the research questions. They find that for this cohort there is no evidence of a difference for mental health and life satisfaction by school type for either men or women in adolescence or early adulthood. [ABSTRACT FROM AUTHOR]

Since the emergence of the #MeToo and #ChurchToo movements, online tracts have been employed to publicly reveal experiences of sexual abuse and assault among women and men in religious institutions and to shame abusers, which tend to be examined as an issue of women's rights or child protection from adult predators. Drawing on the use of digital reporting platforms to testify against peer offences within religious schools, this paper asks how do such testimonies reveal adolescent agency and provoke policy re/actions about the accountability of religious institutions? Digital revelations submitted anonymously to Everyone's Invited are analysed alongside interviews conducted with educators, parents, and youths in Jewish schools in Britain. Findings indicate how adolescent digital revelations of peer sexual abuse call for accountability by implicating the faith schools in question, which in turn triggers pedagogical and policy debates from educators. Public responses reflect diverging denominational positions on how to balance the protection of young people and safeguard religious self-protectionism. The paper spotlights the agency of youth in shaming peer abusers as much as faith schools and structures of religious authority, and in turn, how online shaming reveals frictions over accountability. [ABSTRACT FROM AUTHOR]

This short paper is a brief exploration of working towards an ending, during the global pandemic, with a young woman who had previously been attending for once-weekly face-to-face psychotherapy. The paper reflects on the shift from face-to-face working, to telephone sessions, and finally to walking outdoors, in the context of an ending. Some thoughts are given on flexibility of working during lockdown and working with the 'movable setting', while maintaining a therapeutic frame and boundary. The young woman described, in her late adolescence, can be seen to have developed in maturity, in her ability to reflect and self-regulate and in her capacity to seek resolution. [ABSTRACT FROM AUTHOR]

Previous research has found that music brings back more vivid and emotional autobiographical memories than various other retrieval cues. However, such studies have often been low in ecological validity and constrained by relatively limited cue selection and predominantly young adult samples. Here, we compared music to food as cues for autobiographical memories in everyday life in young and older adults. In two separate four‐day periods, 39 younger (ages 18–34) and 39 older (ages 60–77) adults recorded their music‐ and food‐evoked autobiographical memories in paper diaries. Across both age groups, music triggered more frequent autobiographical memories, a greater proportion of involuntary memories, and memories rated as more personally important in comparison to food cues. Age differences impacted music‐ and food‐evoked memories similarly, with older adults consistently recalling older and less specific memories, which they rated as more positive, vivid, and rehearsed. However, young and older adults did not differ in the number or involuntary nature of their recorded memories. This work represents an important step in understanding the phenomenology of naturally occurring music‐evoked autobiographical memories across adulthood and provides new insights into how and why music may be a more effective trigger for personally valued memories than certain other everyday cues. [ABSTRACT FROM AUTHOR]

The global surge in adolescent suicide necessitates the development of innovative and efficacious preventive measures. Traditionally, various approaches have been used, but with limited success. However, with the rapid advancements in artificial intelligence (AI), new possibilities have emerged. This paper reviews the potentials and challenges of integrating AI into suicide prevention strategies, focusing on adolescents. Method: This narrative review assesses the impact of AI on suicide prevention strategies, the strategies and cases of AI applications in adolescent suicide prevention, as well as the challenges faced. Through searches on the PubMed, web of science, PsycINFO, and EMBASE databases, 19 relevant articles were included in the review. Results: AI has significantly improved risk assessment and predictive modeling for identifying suicidal behavior. It has enabled the analysis of textual data through natural language processing and fostered novel intervention strategies. Although AI applications, such as chatbots and monitoring systems, show promise, they must navigate challenges like data privacy and ethical considerations. The research underscores the potential of AI to enhance future suicide prevention efforts through personalized interventions and integration with emerging technologies. Conclusion: AI possesses transformative potential for adolescent suicide prevention by offering targeted and adaptive solutions, while they also raise crucial ethical and practical considerations. Looking forward, AI can play a critical role in mitigating adolescent suicide rates, marking a new frontier in mental health care. [ABSTRACT FROM AUTHOR]

Purpose: Care leavers are identified as a vulnerable group within UK society and, unsurprisingly, are more susceptible to mental health problems. Research highlights inadequacies among UK Government provisions combined with poorer outcomes for care leavers. This paper aims to measure the effectiveness of provisions on mental health when transitioning from the care system to adulthood. Design/methodology/approach: A systematic review was conducted to identify and highlight the inadequacies of provisions in place to aid a care leaver's transition and the effects on their mental health. Of the 211 studies identified from the search, six studies met the eligibility criteria and were deemed eligible by the researcher for further exploration of themes. Findings: The findings identified feeling isolated, training given to care professionals and caregivers, collaboration, lack of preparation and support and access and gaps in provisions as the five key themes. The overarching theme of interconnectedness and interplay between subthemes, mental health and a care leaver's transition, is strongly presented throughout. Many participants within the individual studies reported negative findings illustrating the weaknesses of provisions and the negative effect on their mental health. Furthermore, the findings emphasise the unique nature of everyone's experience transitioning out of the care system. Research limitations/implications: A limitation of the review is the selection of key words, which may have restricted the results produced during the main search, subsequently affecting the amount of relevant data extracted and synthesised. Finally, less emphasis on grey literature and more on empirical studies reduces the probability of discovering null or negative findings, therefore increasing the chances of publication bias (Paez, 2017). A small number of eligible studies increase the risk of not making important comparisons, prompting a wider search to be conducted in the future. An unequal ratio between national and international research in the systematic review restricts fresh perspectives and strategies concerning the mental health of care leavers. Practical implications: Care leavers are identified as a vulnerable group within society and, unsurprisingly, are more susceptible to mental health problems. The UK Government enforces national and local policies to support young adults leaving the care system and transitioning to independence. However, previous research highlights inadequacies among provisions, combined with poorer mental health outcomes for care leavers. Social implications: Following on from gaps in the current findings, an investigation into regional disparities across provisions aimed at assisting care leavers transitioning to independence would produce useful information for the field and policymakers. Although current research addresses the essence of interplay between mental health and transitioning, further research is required to help build a supporting argument for adaptations and improvements in policies and practice. Originality/value: This study supports the argument for an increase in attention from the UK Government and policymakers to improve the quality and quantity of support for a population often underserved and marginalised, especially in terms of reducing poorer mental health outcomes. [ABSTRACT FROM AUTHOR]

This paper uses a dynamic latent factor model to investigate the determinants of not in education, employment or training (NEET) status among adolescents in the United Kingdom. We bring together within one framework various determinants of NEET status, such as educational achievements, non‐cognitive skills, family socio‐economic factors, aspirations, mental health and local labour market conditions. We model the educational progress over multiple periods through the life of the young person, up to the completion of compulsory schooling. By taking into account this progression, we can determine the direct and indirect impacts of different determinants of NEET status, and the stage in the life of the young person at which each determinant is important. Our findings suggest that cognitive ability (as measured by educational achievements) remains the key predictor of NEET status. Further, while a range of individual and family factors determines NEET status, the impact of most of these factors is largely indirect, through ability formation and not necessarily direct. To gauge the relative contributions of various determinants, we conduct simulations to predict the probability of the young person being NEET under different scenarios and assumptions. The exercise indicates that the effects of aspirations of the young person, their school engagement, and the local youth unemployment rate on the likelihood of the young person being NEET are as large as boosting their cognitive skills. [ABSTRACT FROM AUTHOR]

This paper examines the development of the impact of family background on young people's political engagement during adolescence and early adulthood in order to test a number of hypotheses derived from the impressionable years and family socialization perspectives. The study analyses data of the British Household Panel Study and Understanding Society to assess these hypotheses. Political interest and voting intentions are used as outcomes of political engagement. The study finds parental education to have no effect on initial levels of these outcomes at age 11 but to be positively related to the change in these outcomes between ages 11 and 15. This indicates that the effect of parental education becomes stronger over time and that social disparities in political engagement are widening significantly during early adolescence. In contrast, parental political engagement is positively related to initial levels of voting intentions at age 11 but not related to the change in voting intentions between ages 11 and 15, which supports the hypothesis drawn from the family socialization perspective. Neither parental education nor parental political engagement are related to post-16 changes in political engagement. These results point to early adolescence as a crucial period for the manifestation of social inequalities in political engagement. They provisionally suggest that the influence of parental education runs through educational conditions in lower secondary and that these conditions could play an important role in amplifying the said inequalities. [ABSTRACT FROM AUTHOR]

Abstract: This paper introduces a systemic methodology for reviewing professional responses to abuse between young people. The approach, “contextual case reviewing,” draws upon constructivist structuralism to assess the extent to which safeguarding practices engage with the social and public contexts of abuse. The paper conceptually compares the methodologies of contextual case review and other serious case review methods before drawing upon findings from 2 studies, which used the contextual case review methodology to explore the extrafamilial nature of peer‐on‐peer abuse and the ability of child protection practices to engage with this dynamic. Thematic findings from these studies regarding the practical interpretation of “significant harm” and “capacity to safeguard,” as well as their use within child protection assessments, are used to challenge conclusions of other case reviews, which imply that child protection procedures are sufficient for safeguarding young people. Contextual case reviews suggest that safeguarding practices, and the legislation that underpins them, are culturally, procedurally, and organisationally wedded to the context of the home, whereas insufficiently engaged with extrafamilial contexts of significant harm. The application of these issues require interrogation if social work systems are to provide sufficient mechanisms for safeguarding young people and families at risk of significant harm. [ABSTRACT FROM AUTHOR]

Over the last decade dramatic advances have been made in both the technology and data available to better understand the multifactorial influences on child and adolescent health and development. This paper seeks to clarify methods that can be used to link information from health, education, social care and research datasets. Linking these different types of data can facilitate epidemiological research that investigates mental health from the population to the patient; enabling advanced analytics to better identify, conceptualise and address child and adolescent needs. The majority of adolescent mental health research is not able to maximise the full potential of data linkage, primarily due to four key challenges: confidentiality, sampling, matching and scalability. By presenting five existing and proposed models for linking adolescent data in relation to these challenges, this paper aims to facilitate the clinical benefits that will be derived from effective integration of available data in understanding, preventing and treating mental disorders. [ABSTRACT FROM AUTHOR]

Children and young people's (CYP) life chances depend heavily on family resources. This paper reports a rapid review of qualitative/mixed method studies about Universal Credit undertaken with CYP in the UK; subsequently expanded to include additional descriptors of economic disadvantage. Sixteen studies were reviewed; narrative synthesis was used to explore themes. Most recruited CYP with experience of economic disadvantage; none explicitly reported perspectives of CYP experiencing disability or rurality. Findings show growing up in poverty has significant, negative impacts on health and well‐being, causing feelings of exclusion, shame and unfairness; raising important questions about the adequacy of welfare support in the UK. [ABSTRACT FROM AUTHOR]

Non‐violent resistance (NVR) is a systemic approach to working with young people presenting with aggression and other harmful behaviours. The work draws on the use of personal presence in resistance movements of the twentieth century, focusing on the role of the caregiver to increase their presence through acts of resistance and care. This paper investigates the experiences of professionals using NVR in one UK residential care home. Eight participants took part in semi‐structured interviews, which were analysed thematically. Analysis identified four overarching themes: NVR is both a set of processes and a way of being, NVR and transformation, NVR and the personal–professional divide and NVR and organisational support. The findings suggest that NVR offers an effective and acceptable alternative to behavioural approaches. Further research is required to investigate the liminal role of the professional/parent and the challenge of managing reluctance both within and around the organisation. [ABSTRACT FROM AUTHOR]

INTRODUCTION The World Health Organization recommends banning all forms of e-cigarette advertising, promotion, and sponsorship. The aims of the present study were to: 1) examine young people's exposure to e-cigarette advertising across a wide range of media in four diverse countries; and 2) identify any association between the number of different types of media exposures and e-cigarette use. METHODS A cross-sectional online survey was administered to approximately 1000 people aged 15-30 years in Australia, China, India, and the United Kingdom (n=4107). The survey assessed demographic characteristics, e-cigarette and tobacco use, numbers of friends and family members who vape, and exposure to multiple forms of e-cigarette advertising (e.g. television, radio, print, and various types of social media). Descriptive analyses were conducted on those who had heard of e-cigarettes (n=3095, significance threshold p<0.001) and a logistic regression analysis was used to identify factors associated with e-cigarette ever use (significance threshold p<0.05). RESULTS The majority (85%) of respondents who had heard of e-cigarettes reported being exposed to e-cigarette advertising on at least one type of media, and the average number of types of media to which respondents were exposed was 5 (range: 0-17). The number of media types was significantly associated with ever use of e-cigarettes (OR=1.05; 95% CI: 1.02-1.08, p=0.001). CONCLUSIONS Despite advertising restrictions in place in all four countries, large majorities of young people reported being exposed to e-cigarette advertising. Social media and advertising on/around vape shops and other retailers appear to be key exposure locations. Urgent attention is needed to address these forms of exposure given their apparent association with e-cigarette use. [ABSTRACT FROM AUTHOR]

Deborah Robertson provides an overview of recently published articles that may be of interest to non-medical prescribers. Should you wish to look at any of the papers in more detail, a full reference is provided [ABSTRACT FROM AUTHOR]

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by hyperactivity, inattention and impulsivity. Up to two thirds of young people with ADHD may experience symptoms into adulthood, yet the limited literature available suggests that many young people with ongoing needs do not transfer from child to adult healthcare services. Although worldwide and NICE guidelines recognise the importance of supported transition, evidence suggests for ADHD that this is poorly managed and variable. Little is known about how transition is experienced by those involved. We aimed to synthesise existing peer‐reviewed literature to understand views and experiences of young people, carers and clinicians on transitioning between child and adult ADHD services. Method: Five databases were searched and all articles published between 2000 and up until January 2017 considered. Four key search areas were targeted; ADHD, Transition, Age and Qualitative Research. Quality appraisal was conducted using Wallace criteria. Findings from included studies were synthesised using thematic analysis. Results: Eight papers, six from the UK and one each from Hong Kong and Italy, were included. Emerging themes centred on difficulties transitioning; hurdles that had to be negotiated, limitations of adult mental health services, inadequate care and the impact of transition difficulties. Conclusions: Healthcare transition for this group is difficult in the United Kingdom because of multiple challenges in service provision. In addition to recommendations in NICE guidelines, respondents identified a need for better provision of information to young people about adult services and what to expect, greater flexibility around age boundaries and the value of support from specialist adult ADHD services. More research is needed into ADHD healthcare transition experiences, especially in countries outside the United Kingdom, including accounts from carers and clinicians. [ABSTRACT FROM AUTHOR]

This paper reports on a multi-phased, mixed-method consensus-based study conducted with young carers in the UK aged 11–18, and health, social care and education professionals from the UK, USA and Canada, to identify priority items for inclusion in a short screening tool for use with young carers of a family member with a progressive or long-term illness or disability. Following ethical approval from University and local Research Ethics Committees, qualitative and quantitative data were collected between 2017 and 2019 from 267 people (107 young carers; 160 professionals), through interviews, a focus group, a Delphi survey, consensus group meetings and consultations. Qualitative data were analysed thematically, and quantitative data were analysed using measures of central tendency, frequency and levels of dispersion. The resulting Carers' Alert Thermometer (CAT-YC) contains an identification question followed by ten areas of need across two themes of 'current caring situation' and 'carer's health and wellbeing,' along with guidance for possible next steps and space for an action plan to be jointly agreed between the screener and young carer. Preliminary piloting of the CAT-YC provides evidence of identifying and monitoring needs, and is expected to be useful for young carers, a wide range of professionals, and organisations that support young carers. [ABSTRACT FROM AUTHOR]

Mental health and well-being in adolescence are associated with many short- and long-term outcomes. The evidence suggests that greenspace may play a role in adolescents' mental well-being, but we do not know much about the specifics of this link. In this paper, we investigated the role of other factors in the association. In a cross-sectional study, we investigated the role of neighbourhood greenspace in emotional and behavioural outcomes in 11-year-old urban adolescents participating in the UK Millennium Cohort Study (n = 4,534). We used linear regression models to test for an association of greenspace with self-esteem, happiness, positive mood, negative mood, and antisocial behaviour. We also investigated effect modification/moderation by garden access, physical activity, and perceived area safety. We did not find a main effect of greenspace, but we did find interaction effects. First, in adolescents without a garden, higher levels of greenspace were associated with lower levels of self-esteem and positive mood. Second, in adolescents who reported lower levels of physical activity, higher levels of greenspace were associated with lower levels of negative mood. Third, in adolescents who perceived their areas to be unsafe, higher levels of greenspace were associated with higher levels of antisocial behaviour. Our findings suggest that merely more greenspace in the neighbourhood may not be sufficient to promote the mental well-being of urban adolescents in the UK. However, greenspace does seem to have an influence under certain conditions which should be investigated further in future studies. [ABSTRACT FROM AUTHOR]

Background: Physical activity has been associated with many benefits throughout the life course. As levels of physical activity appear to be insufficient in large populations, the development of effective interventions to promote or maintain activity levels in young people are therefore of key public health concern. Physical activity intervention research in young people is challenging, but this should not be a reason to continue conducting inferior quality evaluations. This paper highlights some of the key issues that require more careful and consistent consideration to enable future research to achieve meaningful impact. Discussion: This paper critically evaluates, amongst others, current research practice regarding intervention development, targeting, active involvement of the target population, challenge of recruitment and retention, measurement and evaluation protocols, long-term follow-up, economic evaluation, process evaluation, and publication. It argues that funders and researchers should collaborate to ensure high quality long-term evaluations are prioritised and that a trial's success should be defined by its quality, not its achieved effect. Summary: The conduct and publication of well-designed evaluations of well-defined interventions is crucial to advance the field of youth physical activity promotion and make us better understand which intervention strategies may or may not work, why, and for whom. [ABSTRACT FROM AUTHOR]

Abstract Medium secure units are one component of secure mental health care for young people across the UK. No research has previously examined the appropriateness of admissions. This is a retrospective cohort study of all patients admitted to one unit by examining clinical notes for demographic, mental health and criminological variables. Descriptive data was statistically analysed to then characterise the cohort, audit against admission criteria and examine changes over time. There were 149 admissions. All patients admitted were male, most were 17 years old and from racialized groups. Most were detained under forensic sections with a primary diagnosis of psychosis. Four of five admissions met all 4 admission criteria. There were notable changes in use of forensic sections and risk over time. Our cohort differs from previous historical and contemporaneous cohorts in terms of diagnosis, legislation determining admission and ethnic breakdown. Our analysis relies on an interpretation of existing admission criteria but it suggests that not all admissions were appropriate, raising important practical, ethical and cost benefit questions. We suggest greater transparency about admission decisions to ensure that patients are admitted to the least restrictive setting needed and that national service planning is responsive to changes in demand. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to provide an overview of the evidence surrounding the design and delivery of adolescent-specific health services for young people aged 14-25. This aims to make recommendations for National Health Service (NHS) senior management teams on the available literature relating to service design for children's and young people's services within the UK. Design/methodology/approach -- This paper presents a mini-review carried out in Spring 2013 using EMBASE, BNI, PSYCHinfo, MEDLINE and Google Scholar to systematically search available published and unpublished research papers. Systematic reviews, meta-analyses and evaluations of service models were included within this review. Adapted "GRADE" criteria were used to appraise the evidence. Findings -- Of 70 papers found, 22 met the inclusion criteria. There were five main service designs found within the literature: hospital-based; school-linked or school-based; community based; combination and integrative; and other methods which did not fit into the four other categories. Research limitations/implications -- This review is limited to the literature available within the inclusion criteria and search strategy used. It intends to inform management decisions in combination with other parameters and available evidence. Originality/value -- There is range of research and evidence syntheses relating to adolescent services, but none of these have been conducted with a focus on the UK NHS and the information needs of managers re-designing services in the current climate within England. [ABSTRACT FROM AUTHOR]

The engagement of young people has been a neglected area in youth justice and drug policy and practice. This paper explores the concept of 'engagement' in relation to drug interventions in custodial and community settings in different European countries. Interviews were undertaken with young people (aged 14–25 years) in contact with the criminal justice system who use illegal drugs and with practitioners involved in the delivery of interventions for our target group in Denmark, Italy, Poland, and the UK. The key techniques to engage young people were described in similar terms across the countries. These included forming relationships based on trust, honesty, and empathy, setting goals collaboratively, and employing practitioners with lived experience and understanding. The objectives and activities on offer are often constrained by criminal justice contexts. Despite the differences between the countries in terms of criminal justice systems and the structure of drug interventions, there were remarkable similarities in the ways young people and practitioners described effective engagement. Strong emphasis on operational engagement to ensure positive relationships between young people and practitioners was important in the design and delivery of interventions. Practitioners working in criminal justice contexts need to have flexibility and autonomy to work creatively to find ways to engage, connect, and inspire young people. [ABSTRACT FROM AUTHOR]

Based on research undertaken as part of the EU funded EPPIC project, this paper aims to update and elaborate on the relationship between drug use and offending behaviours by exploring variations within a cross-national sample of drug-experienced young people in touch with criminal justice systems. Adopting a trajectory-based approach, interviews were undertaken with 198 young people aged 15–25 in six European countries (Austria, Denmark, Germany, Italy, Poland, and UK). Data were analysed by applying the Bennett and Holloway categorization of the drugs-crime link, with a focus on the concept of social exclusion as developed by Seddon. Three main types of mechanisms (economic, pharmaceutical, and lifestyles) are used to interpret the data, showing how the relationship between drugs and offending can vary according to type of substances and over time. Furthermore, it can be associated with very different degrees of social exclusion and needs. The results suggest that while economic inequalities still play key roles in explaining drug use and offending, both behaviours can originate from a state of relative deprivation, resulting from the contradictions inherent in 'bulimic societies' that raise aspirations and desires while providing young people scarce opportunities for self-realisation and social recognition. [ABSTRACT FROM AUTHOR]

Symptoms of depression are common in adolescents and have negative impacts on academic engagement and achievement, as well as on future mental health and functioning. A number of psychological therapies are effective for the treatment of adolescent depression but there are barriers to young people accessing treatment promptly. Providing treatment in school may help improve access to mental health care; school-based mental health care is routinely provided in some parts of the world and is currently a policy priority in the UK. However, introducing mental health services into schools will require services to adapt. This paper illustrates how a short-term psychological therapy can be delivered successfully in schools. It describes the treatment and outcomes for two young people with symptoms of depression. Both received Brief Behavioural Activation (Brief BA) which has been adapted specifically for adolescents. Brief BA focuses on helping young people engage with valued activities in different areas of their life, thus increasing rewards and reducing symptoms of depression. The two cases highlight a range of educational and clinical benefits of Brief BA for young people with depression symptoms and illustrate how the treatment and service delivery were adapted for schools. [ABSTRACT FROM AUTHOR]

Background Adolescence is a period of increased risk for the development of depression. Epidemiological and clinical studies suggest that the phenomenology of depression may differ during childhood and adolescence. However, participants in these studies may not reflect depressed young people referred to routine clinical services. The aim of this paper was to describe referrals for depression to a UK routine public healthcare service for children and adolescents with mental health difficulties. Method This paper describes a consecutive series of adolescents ( N = 100, aged 12-17 years), referred for depression to a routine public healthcare child and adolescent mental health service, in the south of England. Young people and their caregivers completed a structured diagnostic interview and self-report measures of anxiety and depression. Results Fewer than half of young people referred for depression met diagnostic criteria for a depressive disorder. The key symptoms reported by those with depression were low mood or irritability, cognitive disturbances, sleep disturbances and negative self-perceptions. Suicidal ideation was common and was considerably higher than reported in other studies. Caregiver and young person's accounts of adolescent symptoms of depression and anxiety were uncorrelated. Caregivers also reported fewer symptoms of depression in their child than adolescents themselves. Conclusions These data have direct relevance to the design and delivery of public mental health services for children and adolescents. However, we do not know how representative this sample is of other clinical populations in the UK or in other countries. There is a need to collect routine data from other services to assess the needs of this group of high-risk adolescents. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the authors discuss various reports within the journal on topics including the regulation of alcoholic beverage marketing, the evolution of international marketing laws as of 2017, and the history of alcohol-related laws.

INTRODUCTION Although e-cigarettes can be an effective form of nicotine substitution for adults attempting to quit smoking, their use among children and young people is a concern. Accurate data about this are needed to inform debates over policy and regulation in the UK and elsewhere. METHODS Using data from an online survey of 2613 youth aged 11-18 years, conducted by the market research company YouGov in March 2022, we present prevalence estimates of e-cigarette and tobacco use. We use logistic regression models to assess differences in e-cigarette use, tobacco use and use of disposable e-cigarettes across a range of covariates including age, sex, tobacco smoking status, social class, and country. RESULTS Among the 18.0% of those surveyed who reported ever having smoked a cigarette, 83.9% were not regular (at least once per week) smokers and 16.1% were (15.1% and 2.9% of the total sample, respectively). Among the 19.2% of those surveyed who had ever used an e-cigarette, 79.2% were not regular users, while 20.8% were (15.2% and 4.0% of the total sample, respectively). Regular e-cigarette use was more common than regular tobacco smoking (4.0% vs 2.9%). E-cigarette use was more common among those who also smoked tobacco, with 9.0% of never e-cigarette users ever smoking tobacco, compared with 89.4% of regular e-cigarette users. Both smoking and e-cigarette use were associated with increasing age and use by others within the home, but not with social class. Use of disposable e-cigarettes was reported by 53.8% of those who have ever used an e-cigarette, and more common among females than males. CONCLUSIONS Regular e-cigarette use is now more common than smoking in children and youth, though the majority of this is among those who have also smoked tobacco. Measures to reduce the appeal of both e-cigarettes and tobacco to children and young people are warranted. [ABSTRACT FROM AUTHOR]

Purpose: Experiencing bereavement in childhood can cause profound changes to developmental trajectories. This paper aims to evaluate the feasibility of implementing a public health intervention in schools to encourage pupils aged 12-15 years to independently explore ideas of death, dying, loss and end of life care in a structured and creative format. Design/methodology/approach: A co-produced storytelling intervention was implemented in an independent school in Norwich, UK. Pupils wrote up to 1,000 words in response to the title, "I Wish We'd Spoken Earlier". Their participation was voluntary and extra-curricular. Stakeholder feedback was used in addition to the submissions as a measure of acceptability, appropriateness, adoption and feasibility. Findings: In total, 24 entries were submitted. Pupils demonstrated their ability to engage thoughtfully and creatively with the subject matter. Feasibility for the storytelling intervention was demonstrated. Importantly, the intervention also prompted family conversations around preferences and wishes for end of life care. Research limitations/implications: To determine whether the intervention has psychological and social benefits will require further study. Practical implications: Educational settings can be considered as anchor institutions to support a public health approach to end of life care. Originality/value: The positive response from all stakeholders in delivering and supporting the intervention indicates that schools are a community asset that could be further empowered to support children and families affected by death, dying and loss. [ABSTRACT FROM AUTHOR]

Young people aged between 12 and 17 across three major British cities — London, Leeds and Nottingham — were invited to play the role of 'jurors' on a case where 'the Internet was put on trial'. The recommendations reported in this paper are intended to improve digital experience and online safety as contributions to policy. These recommendations derive from the 'youth jurors' policy deliberations designed to encourage young people to reflect on their digital experience and collectively develop their own problem definitions and solutions. [ABSTRACT FROM AUTHOR]

Background: There is evidence that mental health problems are increasing and substance use behaviours are decreasing. This paper aimed to investigate recent trends in mental ill health and health-related behaviours in two cohorts of UK adolescents in 2005 and 2015.Methods: Prevalences in mental health (depressive symptoms, self-harm, anti-social behaviours, parent-reported difficulties) and health-related behaviours (substance use, weight, weight perception, sleep, sexual intercourse) were examined at age 14 in two UK birth cohorts; Avon Longitudinal Study of Parents and Children (ALSPAC, N = 5627, born 1991-92) and Millennium Cohort Study (MCS, N = 11 318, born 2000-02). Prevalences and trend estimates are presented unadjusted and using propensity score matching and entropy balancing to account for differences between samples.Results: Depressive symptoms (9% to 14.8%) and self-harm (11.8% to 14.4%) were higher in 2015 compared with 2005. Parent-reported emotional difficulties, conduct problems, hyperactivity and peer problems were higher in 2015 compared with 2005 (5.7-8.9% to 9.7-17.7%). Conversely, substance use (tried smoking, 9.2% to 2.9%; tried alcohol, 52.1% to 43.5%, cannabis, 4.6% to 3.9%), sexual activity (2% to 0.9%) and anti-social behaviours (6.2-40.1% to 1.6-27.7%) were less common or no different. Adolescents in 2015 were spending less time sleeping (<8 h 5.7% to 11.5%), had higher body mass index (BMI) (obese, 3.8% to 7.3%) and a greater proportion perceived themselves as overweight (26.5% to 32.9%). The findings should be interpreted bearing in mind limitations in ability to adequately harmonize certain variables and account for differences in attrition rates and generalizability of the two cohorts.Conclusions: Given health-related behaviours are often cited as risk factors for poor mental health, our findings suggest relationships between these factors might be more complex and dynamic in nature than currently understood. Substantial increases in mental health difficulties, BMI and poor sleep-related behaviours highlight an increasing public health challenge. [ABSTRACT FROM AUTHOR]

This article uses a socio‐material approach, social practice theory, to provide new insights into the self‐management of chronic illness. It demonstrates how this theory can bridge arguments about the respective roles of social and individual influences, and how it can foreground an oft‐overlooked aspect of the issue – the demands of self‐care technologies and consequences for participation in social life. Drawing on interviews and focus groups with 25 young type‐1 diabetes outpatients in London, UK, the study points to the conflicts that occur when disease management technologies compete for time and space with the social practices of everyday life, and when self‐care tasks threaten to interrupt the flow of social life and make people feel 'left behind'. The paper concludes that young people are disabled by the contingent position of self‐care activities in daily life, which oblige them to compromise either their physical health or their immersion in the social world. This disabling effect would be mitigated if social practices were reorganised to make them more amenable to the time‐space requirements of disease management. A social practice theory lens can help throw light onto this issue and make a valuable contribution to the study of the self‐management of chronic illness. [ABSTRACT FROM AUTHOR]

Child and adolescent mental health services psychiatric intensive care units (CAMHS PICU) are a small, specialised, but important component of the portfolio of child and adolescent mental health service delivery in the UK. There has been no published research in relation to nursing care provision within CAMHS PICU and little or nothing is known about nursing identity and intervention within these settings. This research study investigated the nature of mental health nursing in a CAMHS PICU setting, to propose a conceptual model of CAMHS PICU mental health nursing. A qualitative conceptual text analysis from an externally facilitated psychodynamic work discussion group over a period of six months was undertaken using a theoretically informed inductive content analysis method. This, the first of a two part paper, investigates the context of CAMHS PICU and the nursing interventions developed within it. Findings indicate that CAMHS PICU nursing contains elements that are unique from either general adolescent mental health inpatient settings and adult PICU settings. The primary nursing task of enabling developmental growth and reparation, for young people who are experiencing acute psychiatric disturbance during a critical phase of their maturation against a back drop of chronic adversity, complex trauma and learning difficulties, manifests as a series if irresolvable tensions within the clinical environment. Interventions are required that explicitly engage with young people's dependency and the inherently dialectic nature of adolescent development. Part 2 of this research explores nursing staff experience of their work and of the clinical environment, and their support needs. [ABSTRACT FROM AUTHOR]

Young people's use of technology has been extensively explored in the literature. However, there has been less work theorising their technology-enabled behaviours, integrating understandings of adolescence into explanations of technology use. The study reported here begins to address this gap. It explores the digital lives of 15 young women in the United Kingdom over one year, using the tools and conceptual categories of social cognition in novel ways. An adaptation of Valsiner's Zones makes it possible to offer an account of technology use which avoids romanticism and pessimism, and enables us to: (i) recognise choice and agency; (ii) articulate technology-mediated development across disciplines and paradigms; and (iii) locate physiological development within the broader social, psychological and socio-technical realms. The paper concludes by applying the adapted framework to a single case, Megan, illuminating unresolved issues for future studies and theorising technology as shaping, rather than defining, adolescent perspectives, behaviours and relationships [ABSTRACT FROM AUTHOR]

Adolescents exhibit remarkable heterogeneity in the structural architecture of brain development. However, due to limited large-scale longitudinal neuroimaging studies, existing research has largely focused on population averages, and the neurobiological basis underlying individual heterogeneity remains poorly understood. Here we identify, using the IMAGEN adolescent cohort followed up over 9 years (14–23 y), three groups of adolescents characterized by distinct developmental patterns of whole-brain gray matter volume (GMV). Group 1 show continuously decreasing GMV associated with higher neurocognitive performances than the other two groups during adolescence. Group 2 exhibit a slower rate of GMV decrease and lower neurocognitive performances compared with Group 1, which was associated with epigenetic differences and greater environmental burden. Group 3 show increasing GMV and lower baseline neurocognitive performances due to a genetic variation. Using the UK Biobank, we show these differences may be attenuated in mid-to-late adulthood. Our study reveals clusters of adolescent neurodevelopment based on GMV and the potential long-term impact. Longitudinal analysis of neuroimaging data are useful for analysing heterogeneity in adolescent brain development. Here the authors cluster adolescent participants of the IMAGEN study into groups based on gray matter volume developmental patterns and investigate genome-wide and epigenome-wide associations with these groups. [ABSTRACT FROM AUTHOR]

Purpose: This study examines the association between mental health problems in adolescence and general practice (GP) costs during adulthood up to age 50 in the UK. Methods: We conducted secondary analyses of three British birth cohorts (individuals born in single weeks in 1946, 1958 and 1970). Data for the three cohorts were analysed separately. All respondents who participated in the cohort studies were included. Adolescent mental health status was assessed in each cohort using the Rutter scale (or, for one cohort, a forerunner of that scale) completed in interviews with parents and teachers when cohort members were aged around 16. Presence and severity of conduct and emotional problems were modelled as independent variables in two-part regression models in which the dependent variable was costs of GP services from data collection sweeps up to mid-adulthood. All analyses were adjusted for covariates (cognitive ability, mother's education, housing tenure, father's social class and childhood physical disability). Results: Adolescent conduct and emotional problems, particularly when coexisting, were associated with relatively high GP costs in adulthood up to age 50. Associations were generally stronger in females than males. Conclusion: Associations between adolescent mental health problems and annual GP cost were evident decades later, to age 50, suggesting that there could be significant future savings to healthcare budgets if rates of adolescent conduct and emotional problems could be reduced. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Childhood long‐term conditions are usually diagnosed in infancy or early childhood. Little is known about the particular experiences and needs of young people who receive a chronic illness diagnosis during adolescence or late childhood. This paper will examine this experience in relation to multiple sclerosis (MS), which is increasingly being diagnosed before adulthood. Aims: To explore how young people experience an MS diagnosis. Methods: Qualitative study using a grounded theory approach. In‐depth interviews were conducted with 21 young people diagnosed with MS. Participants were recruited through health service and voluntary sector organizations in the United Kingdom. Results: Young people's pre‐illness normality was disrupted by the diagnosis of a chronic illness (MS). Participants experienced their body as changed physically, cognitively, and emotionally and as changeable due to symptom unpredictability. This influenced how participants perceived and presented their identity, disrupted their relationships, and altered their future biography. Young people developed strategies to manage their condition and identities in order to incorporate MS into their current and future lives, which required continual illness and identity work in response to changing symptoms, social contexts, and relationships. Conclusions: Although young peoples' experience of living with chronic illness has been widely explored, the aftermath of diagnosis has been underresearched from their perspective. This study contributes to this knowledge gap by illuminating how young people experience a chronic illness diagnosis and negotiate the resulting changes to their identity, relationships, and future. The findings suggest that young people need preparation and support in disclosing their diagnosis to others. Professionals supporting young people with long‐term conditions need to work closely with specialist mental health services to ensure that they receive appropriate emotional support. Schools have an important role in ensuring young people with long‐term conditions achieve their academic potential and receive appropriate careers advice. [ABSTRACT FROM AUTHOR]

Young people's sexting is an area of increasing concern amongst parents, educationalists and policy makers, yet little research has been conducted with young people themselves to explore their perspectives on the support they need to navigate relationships in the new digital media landscape. To address this absence, an inter-disciplinary team of researchers undertook a participatory study with students, aged 13 to 15, in a UK secondary school. This paper outlines key study findings, including young people's views on sexting, their recommendations for improved education around sexting in schools, their preferred sources of support, and their perspectives on the way adults should respond to young people's sexting. Findings indicate that sexting education needs to be developed within the context of wider relationship issues, such as gender, power dynamics and trust between peers, and improved communication between students and teachers or other responsible adults. Findings may be used to consider ways of designing and communicating messages around sexting to young people within and beyond educational settings. [ABSTRACT FROM AUTHOR]

• Trauma-informed practice is being trialled in response to extra-familial risks and harms. • An institutional ethnography found sources of knowledge impact this innovation. • Professionals may say young people are 'known-to-services' but be distant from them. • Being proximal to young people and advocating for their needs helps to know them. • To be trauma-informed, professionals must relationally know those they support. Efforts to shift from criminal justice to welfare-based responses to exploitation and other forms of extra-familial risks and harms, have centred relational approaches. In particular, the role that relationships between professionals and young people can play in providing a sense of safety as well as a route to wider support services when young people come to harm beyond their families is under consideration. In parallel, trauma-informed practice is increasingly promoted as a tool for creating service conditions in which relational practice can thrive. In this paper we present data from an institutional ethnography of two social care organisations in the UK which are endeavouring to adopt trauma-informed responses to extra-familial risks and harms. We use observation, focus group, and case file data collected in two time periods, to illustrate a relationship we identified between the nature and source of knowledge that guided professional responses, the ability of professionals to form relationships with young people affected by extra-familial risks and harms, and the capacity for their organisations to be trauma-informed. In doing so we trouble an established discourse in many social care organisations, that young people subject to intervention are 'known-to-services' and call for more responses in which young people are 'known-by-professionals' who are supporting them. Far from being a matter of semantics, we discuss how these two ways of knowing about young people, and the situations they face, potentially facilitate or undermine key pillars of trauma-informed practice, and the relational approaches that make such practice possible. [ABSTRACT FROM AUTHOR]

Little is known about cultural variation in perceptions about the age when youngsters should be regarded as competent to make decisions. This is of particular importance as research has shown the significant effect of parental influence on their children’s decision-making. A public survey of 400 adults from diverse socio-cultural backgrounds in the UK and Spain was carried out. Their attitudes regarding adolescents’ ability with regard to common areas of decision-making were assessed using case vignettes including discontinuing family traditions and religious practice. It was found that White British adults agreed for younger adolescents to make decisions about themselves compared with the other ethnic groups. High religious practice was associated with later age to make decisions. The paper argues that there is socio-cultural variation in adults’ attitudes regarding the age when youngsters should make decisions about themselves and for the need of professionals to take this into account. [ABSTRACT FROM AUTHOR]

Women with Tourette's syndrome (TS) continue to be under-researched, despite female sex being associated with increased tic-related impairment in adulthood. Existing literature indicates that individuals with TS are more likely than the general population to report self-stigma, but little is known about the subjective identities of women with TS and how this relates to psychological wellbeing. Semi-structured interviews were conducted via Zoom with a purposive sample of 11 females. All were diagnosed with TS and aged 18–28. Data was transcribed verbatim and thematic analysis applied. Five themes were established: "I'm not normal", "I just want to be me", I'm a "people pleaser", seeing oneself as an "outsider", and "it's just part of me...it's not going anywhere". Difficulties with self-acceptance and the autonomy to be one's true self were noted and appeared to be intensified by stereotypical gender roles and attempts to conceal tics. Findings also suggested that personal growth and feelings of mastery can be achieved through embracing TS as part of one's identity, or recognising it as just one aspect of the self. Psychological support focused on accepting and living with tics rather than reducing them may benefit this population and is currently difficult to access. Consideration should also be given to improving the availability of support groups where women with TS can meet others like themselves. [ABSTRACT FROM AUTHOR]

Infants, children and young people with life-limiting or life-threatening conditions often experience acute, transient pain episodes known as breakthrough pain. There is currently no established way to assess breakthrough pain in paediatric palliative care. Anecdotal evidence suggests that it is frequently underdiagnosed and undertreated, resulting in reduced quality of life. The development of a standardised paediatric breakthrough pain assessment, based on healthcare professionals' insights, could improve patient outcomes. This study aimed to explore how healthcare professionals define and assess breakthrough pain in paediatric palliative care and their attitudes towards a validated paediatric breakthrough pain assessment. This was a descriptive qualitative interview study. Semi-structured interviews were conducted with 29 healthcare professionals working in paediatric palliative care across the UK. An inductive thematic analysis was conducted on the data. Five themes were generated: 'the elusive nature of breakthrough pain', 'breakthrough pain assessment', 'positive attitudes towards', 'reservations towards' and 'features to include in' a paediatric breakthrough pain assessment. The definition and assessment of breakthrough pain is inconsistent in paediatric palliative care. There is a clear need for a validated assessment questionnaire to improve assessment, diagnosis and management of breakthrough pain followed by increased healthcare professional education on the concept. [ABSTRACT FROM AUTHOR]

The prevalence of mental health difficulties among children and adolescents is rising. This study aimed to explore early adolescents' lived experiences of a school- and community-based prevention program, including what helps, why, and when. Seventy-eight semi-structured interviews were conducted with early adolescents (aged 10 to 13) as part of the evaluation of HeadStart, a UK-based program. A reflexive thematic analysis was conducted and a typology was developed to facilitate comparisons between participants' experiences. The typology consisted of five groups, including early adolescents who described positive or helpful experiences of HeadStart support, those who wanted more support, those who described more mixed or unhelpful experiences of support, and those who did not report receiving much or any support. Cross-group themes highlighted the 'bridges' that interventions can build to promote mental health and wellbeing, e.g. learning new coping or problem-solving skills. There was more variation between the groups in terms of the 'walls' (e.g. issues with intervention content, timing, or location) that may limit intervention effectiveness. There were also some group differences in terms of the other sources of social support that participants had access to and the level of difficulties that they were facing in their lives. The findings suggest that intervention developers should tailor design and delivery according to different profiles of early adolescents who may be more or less able or willing to accept help, and who may experience different formats, structures, and content of support as either more or less useful. [ABSTRACT FROM AUTHOR]

Background: Children and young people with life-limiting and life-threatening conditions have multidimensional needs and heterogenous cognitive and communicative abilities. There is limited evidence to support clinicians to tailor their communication to each individual child. Aim: To explore the language children and young people use to describe their own condition, to inform strategies for discussing needs and priorities. Design: Positioned within a s ocial constructivist paradigm, a secondary discourse analysis of s emi-structured interview data was conducted incorporating the discourse dynamics approach for figurative language. Setting/participants: A total of 26 children and young people aged 5–17 years with life-limiting or life-threatening conditions (6 cancer; 20 non-cancer) were recruited from nine clinical services (six hospitals and three hospices) across two UK nations. Results: The language children and young people use positions them as 'experts in their condition'. They combine medical terminology with their preferred terms for their body to describe symptoms and treatments, and use comparatives and superlatives to communicate their health status. Their language depicts their condition as a 'series of (functional and social) losses', which single them out from their peers as 'the sick one'. Older children and young people also incorporate figurative language to expand their descriptions. Conclusion/discussion: Children and young people can provide rich descriptions of their condition. Paying attention to their lexical choices, and converging one's language towards theirs, may enable more child-centred discussions. Expanding discussions about 'what matters most' with consideration of the losses and differences they have experienced may facilitate a fuller assessment of their concerns, preferences and priorities. [ABSTRACT FROM AUTHOR]

Adolescence is a period of increased vulnerability for low well-being and mental health problems, particularly for girls and older adolescents. Accurate measurement via brief self-report is therefore vital to understanding prevalence, group trends, screening efforts, and response to intervention. We drew on data from the #BeeWell study (N = 37,149, aged 12–15) to consider whether sum-scoring, mean comparisons, and deployment for screening were likely to show bias for eight such measures. Evidence for unidimensionality, considering dynamic fit confirmatory factor models, exploratory graph analysis, and bifactor modeling, was found for five measures. Of these five, most showed a degree of non-invariance across sex and age likely incompatible with mean comparison. Effects on selection were minimal, except sensitivity was substantially lower in boys for the internalizing symptoms measure. Measure-specific insights are discussed, as are general issues highlighted by our analysis, such as item reversals and measurement invariance. [ABSTRACT FROM AUTHOR]