Search

Introduction: The aim of this study was to gain consensus among young people with a stoma due to inflammatory bowel disease (IBD) on the priorities for the content of an intervention for the self‐management of stoma‐related distress. The current identification and management of distress in young people with a stoma is often suboptimal in clinical settings and there is a need for improved support resources. Methods: Two consensus group meetings were carried out via online video conferencing, using nominal group technique. Participants generated, rated on a Likert scale and discussed, topics for inclusion in a future self‐management intervention. Results: Nineteen young people, aged 19–33, with a stoma due to IBD took part in one of two group meetings. Participants were located across England, Scotland, and Northern Ireland. Twenty‐nine topics were generated by participants, seven of which reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7‐point Likert scale. These were: receiving advice from young people with lived experience of stoma surgery; advice on/addressing concerns about romantic relationships, sex and intimacy; information about fertility and pregnancy related to stoma surgery; stoma 'hacks', for example, useful everyday tips regarding clothing, making bag changes easier and so forth; reflecting on and recognising own emotional response to surgery; tips on managing the stoma during the night; and processing trauma related to the illness and surgery journey. Conclusions: Findings extend previous research on young people's experiences of stoma surgery, by generating consensus on young people's priorities for managing distress related to surgery and living with a stoma. These priorities include topics not previously reported in the literature, including the need for information about fertility and pregnancy. Findings will inform the development of a self‐management resource for young people with an IBD stoma and have relevance for the clinical management of stoma‐related distress in this population. Patient or Public Contribution: Three patient contributors are co‐authors on this paper, having contributed to the study design, interpretation of results and writing of the manuscript. The study's Patient and Public Involvement and Engagement advisory group also had an integral role in the study. They met with the research team for four 2‐h virtual meetings, giving input on the aims and purpose of the study, recruitment methods, and interpretation of findings. The group also advised on the age range for participants. The views of young people with a stoma are the central component of the study reported in this paper, which aims to gain consensus among young people with an IBD stoma on their priorities for the content of a resource to self‐manage distress related to stoma surgery. [ABSTRACT FROM AUTHOR]

Purpose: This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process. Design/methodology/approach: Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software. Findings: This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process. Originality/value: This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge. [ABSTRACT FROM AUTHOR]

Conversation and dialogue are used as a central process within youth work. Whilst much has been written about the micro-skills of conversation, less attention has been paid to the philosophical realm. This paper examines how dialogue in youth work can be deepened when juxtaposed with the philosophies, principles and theories of conversation. Using qualitative and phenomenological methodologies, this study involved 32 youth workers from across Northern Ireland, in focus groups (N = 8) and interviews (N = 24). The findings illustrate how youth workers perceived dialogue in their practice, pointing to the connections with relationship-building, the development of critical consciousness and the equalizing of power. [ABSTRACT FROM AUTHOR]

In recent years, Northern Ireland has seen the introduction and significant growth of the use of restorative justice practice within the criminal justice system. There have been two main drivers behind these developments. First, the desire to better meet the needs of, and provide redress for the harm caused to, victims of crime; and second, to find an effective alternative to punitive responses and establish positive ways of dealing with children, young people and adults when incidents occur. Within the adult criminal justice context, restorative justice is not generally the way in which crime is addressed. Courts will have regard to the Victim Impact Statement to aid sentencing, but victims will not normally have an opportunity to participate in a dialogue with the person who has harmed. Victims of crime have not had the opportunity to ask questions of the person responsible for the crime, about how and why the crime occurred, to share the impact of the offence on them and to share their views on what could be done to repair the harm and reduce the likelihood of further offending. To date, the most extensive, formal application of restorative justice in Northern Ireland has been in the area of youth justice. Some progress has been made in the application and use of restorative practices with adults, through community-based interventions, in particular; but to date this has largely been driven by individual organisations. Until now, there has been no overarching strategic or co-ordinated approach to its development, in spite of the proven benefits of this approach. The Department of Justice (DOJ), in conjunction with the Probation Board for Northern Ireland, the Public Prosecution Service for Northern Ireland, the Police Service of Northern Ireland, the Northern Ireland Prison Service, Victim Support NI, Community Restorative Justice Ireland and Northern Ireland Alternatives, is now developing a strategic approach to the use of restorative justice at all stages of the adult criminal justice system. In June 2020, the DOJ held a full public consultation on the proposed Adult Restorative Justice Strategy for Northern Ireland, and the responses were shared with the Justice Committee on 9 March 2021 (https://www.justice-ni.gov.uk/publications/adult-restorative-justice-strategy). It is anticipated that the strategy will be published later this year. The Probation Board for Northern Ireland (PBNI) has contributed fully to the development of the strategy and is now developing a Restorative Justice Framework, which will flow from the Adult Restorative Justice Strategy for Northern Ireland. This practice piece outlines the origins and development of restorative justice in Northern Ireland; reviews current practice in the Probation context; identifies the core principles in the forthcoming justice strategy, and reflects on the shape and content of the PBNI framework. The paper also draws from the experience of the author as a former facilitator of restorative justice interventions with young people. [ABSTRACT FROM AUTHOR]

Northern Ireland has substantially higher rates of disability and disability benefit receipt than England, despite a common institutional context. This paper exploits newly available data from the NICOLA and ELSA surveys to examine potential health and labour market explanations for this gap, specifically among older working-age people. Observable differences in health and labour markets are sufficient to explain the gap in self-reported activity-limiting disability, but only half of the gap in worklimiting disability and income-replacement disability benefit receipt, and only one-third of the gap in additional costs disability benefit receipt. Possible reasons for these remaining unexplained gaps are discussed. [ABSTRACT FROM AUTHOR]

This paper seeks to obtain the views of student teachers in Northern Ireland as to the benefits and challenges of inclusive education and the key issues that may need to be addressed to ensure they become effective teachers in an inclusive classroom. Because of the system of academic selection that has prevailed in Northern Ireland, issues relating to inclusion have been difficult to resolve mainly because principles of inclusion are at odds with existing structures. By 2008, however, academic selection is to be set aside and it would seem reasonable to believe that more inclusive practices will be adopted by all schools. Positive attitudes towards inclusion by practitioners will be essential in ensuring successful implementation. The majority of students entering Initial Teacher Education (ITE) programmes in Northern Ireland have been traditionally drawn from the academic grammar school sector where classroom contact with pupils who have diverse special educational needs may have been minimal. The results of this study show that while many student teachers claim to support inclusive policies, they believe that lack of appropriate preparation, concerns about class size, resources, managing other adults and coping with increasing numbers of pupils with diverse special educational needs are the key issues to be addressed within ITE in advance of the radical changes planned. Despite claiming to support inclusion, substantial numbers did not believe the removal of academic selection was the best way to ensure equality of provision for all pupils. [ABSTRACT FROM AUTHOR]

Objectives: Eating disorders (ED) are associated with significant morbidity and mortality rates and are most common in young people aged between 15 and 19 years. Large representative surveys on disordered eating in youth are lacking. The main aims were to estimate the prevalence of disordered eating in a representative sample of 11–19 year olds in Northern Ireland and investigate the associations between probable eating disorder and a range of risk factors. Designs and Methods: A large nationally representative household survey was conducted, and the bivariate and multivariate associations between demographic, familial, economic and psychological risk factors and probable eating disorder were assessed. Results: A total of 16.2% (n = 211) of the sample met the SCOFF screening criteria for disordered eating. Probable eating disorder was associated with being female (OR = 2.44), having a parent with mental health problems (OR = 1.68), suffering from certain psychological problems, such as mood or anxiety disorder (OR = 2.55), social media disorder (OR = 2.95), being the victim of physical bullying (OR = 1.71) and having smoked (OR = 2.46). Conclusions: This study provides the first prevalence estimates of probable eating disorder among youth in Northern Ireland. Furthermore, the study identifies unique risk factors for probable eating disorder among this representative sample. [ABSTRACT FROM AUTHOR]

Introduction: Overweight and obesity is a global problem incurring substantial health and economic implications. This has also been highlighted by the ongoing COVID-19 pandemic which has disproportionately affected overweight and obese individuals. Most of the interventions have concentrated on promotion of physical activities and healthy eating which may involve current sacrifices for future health gains. The purpose of this study was to explore the relationship between bodyweight and how individuals state they would trade-off immediate income for higher amounts in the future (time preference). Methods: An online survey was conducted targeting adults aged >16 years in the UK (England, Northern Ireland, Scotland, and Wales) from January 1, 2016 to July 31, 2016. Using paid online adverts, as well as personal and professional networks for distribution of links to the online survey, the questionnaire asked respondents to report socio-economic and demographic information, height, and weight and to complete a time preference exercise. Data were analysed using descriptive statistics; associations were explored between BMI and respondents' characteristics and time preference using Spearman rank-order correlation and χ2 tests as appropriate. We adopted STROBE guidelines for the reporting of the study. Results: A total of 561 responses were analysed (female = 293, males = 268). The relationship between time preference and overweight/obesity, using BMI as the measure is highly significant (χ2 = 95.92: p < 0.001). Individuals of normal weight have low time preferences and are more likely to invest in activities in a bid to reap future health benefits. There are also significant relationships between BMI and employment status (χ2 = 37.03; p < 0.001), physical activities (p < 0.0001), income levels (χ2 = 6.68; p < 0.035), family orientation, i.e., with or without children (χ2 = 12.88; p < 0.012), and ethnicity (χ2 = 18.31; p < 0.001). These imply that individuals in employment and with children in their families are less likely to be overweight or obese compared to those who do not. People from black backgrounds are also more likely to be overweight or obese and have higher time preferences compared to people from white backgrounds. Discussions/Conclusions: People's preventive behaviours today can be predicted by their time preference and this understanding could be vital in improving population's uptake and maintenance of overweight and obesity prevention actions. People who have low time preference are more likely to invest time and resources in physical activities and healthy lifestyles to reap future health benefits hence value utilities-in-anticipation. Public health programmes should therefore use the knowledge of the association between time preference and overweight/obesity to inform designs of intervention programmes. [ABSTRACT FROM AUTHOR]

Background: Adults with Barrett's esophagus (BE) are often entered into surveillance for esophageal adenocarcinoma (EAC), although cancer risk is relatively low. BE can be detected in children (< 16 years). Little is known about the epidemiology of pediatric BE, and it is unclear what the optimal surveillance regimes are in children. Aim: To evaluate the demographic and clinical characteristics, and future neoplastic progression risk in all pediatric BE patients diagnosed in Northern Ireland between 1993 and 2010. Methods: Data from the population-based Northern Ireland BE register were matched to the Northern Ireland Cancer Registry for EAC outcomes until end 2013. Age-adjusted incidence of pediatric BE was calculated, and characteristics between pediatric and adult BE patients compared using Chi-square tests. Results: Over 18 years, 42 pediatric BE patients (< 16 years) were identified, equivalent to an age-adjusted incidence of < 2 per 100,000 children. There was a clear age differential, with BE incidence increasing with age within the pediatric population. The majority (85.7%) of patients were male, a significantly higher male/female ratio than adult BE patients (p < 0.001). No pediatric BE patients progressed to high-grade dysplasia (HGD) or EAC, although the eldest patient was aged 34 years by the end of follow-up. Conclusions: This is the largest series of pediatric BE ever reported. It demonstrates that pediatric BE is rare. The male preponderance of this condition is more apparent in childhood compared with adult cases. No children developed HGD/EAC during follow-up, suggesting that regular surveillance is not required, at least until adulthood. [ABSTRACT FROM AUTHOR]

Objective: Parental mental illness can affect the well-being of parents and their children; various initiatives have been developed to support professionals to be family focused. The Champions' Model was introduced in Health and Social Care Trusts in Northern Ireland to promote professionals' capacity to engage in Family Focused Practice, however there has been limited research into this initiative. This article aims to explore the activities undertaken by Champions in one Health and Social Care Trust, with a focus on making recommendations for service development. Method: A brief questionnaire was used to collect quantitative and qualitative data. The questionnaire contained five, tick box questions relating to activities of Champions and a sixth open ended question seeking examples of good practice. The questionnaire was distributed to all individuals (N = 65) who were listed as Champions in one Health and Social Care Trust. Results: Of 65 questionnaires distributed 29 were returned. Participants described carrying out some activities of the Champions' role. Twenty six respondents provided examples of how the Initiative positively influenced their own and other colleagues' practice, including promoting communication and collaboration between Adult Mental Health and Children's Services. Lack of time and organisational support to carry out the role emerged as barriers. Discussion: Results suggest the Champions' Initiative has a positive influence on promoting Family Focused Practice across the Adult Mental Health and Children's services interface and contributes to addressing barriers identified in the literature. Views of Line Managers, colleagues and service users on the effectiveness of the Initiative require exploration. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to co-create of an interview schedule exploring mental health recovery in collaboration with young adult service users. Background Service user involvement in research has been increasingly recognized as providing a vital authentic insight into mental health recovery. Engagement and collaboration with service users have facilitated the exploration of inaccessible or under-investigated aspects of the lived experience of mental health recovery, not only directing the trajectory of research, but making it relevant to their own contextual experience. Design A qualitative content analysis framework was employed in the co-creation of a semi-structured interview schedule through an engagement process with service users. Methods Two separate engagement groups took place at the premises of the service user organizations, between January - February 2014. Miles and Huberman's analysis framework was chosen for this phase as it enabled the visual presentation of factors, concepts or variables and the established relationship between them. Results The lived experience of mental ill health in young adulthood and how this was understood by others was a particularly relevant theme for participants. Further themes were identified between the impact of painful experiences at this developmental life stage leading to a deeper understanding of others through finding meaning in their own mental health recovery journey. Conclusion Our findings identified that suffering painful experiences is an integral aspect in the process of mental health recovery. This understanding has particular relevance to mental health nursing practice, ensuring the care delivered is cognizant of the suffering or painful experiences that young adults are encountering. [ABSTRACT FROM AUTHOR]

Background Understanding the causes of poor mental health in early childhood and adolescence is important as this can be a significant determinant of mental well-being in later years. One potential and relatively unexplored factor is residential mobility in formative years. Previous studies have been relatively small and potentially limited due to methodological issues. The main aim of this study was to investigate the relationship between early residential instability and poor mental health among adolescents and young adults in Northern Ireland. Methods A Census-based record linkage study of 28% of children aged 0-8 years in 2001 in Northern Ireland (n=49 762) was conducted, with six monthly address change assessments from health registration data and self-reported mental health status from the 2011 Census. Logistic regression models were built adjusting for socioeconomic status (SES), household composition and marital dissolution. Results There was a graded relationship between the number of address changes and mental ill-health (adjusted OR 3.67, 95% CIs 2.11 to 6.39 for 5 or more moves). This relationship was not modified by SES or household composition. Marital dissolution was associated with poor mental health but did not modify the relationship between address change and mental health (p=0.206). There was some indication that movement after the age of five was associated with an increased likelihood of poor mental health. Conclusions This large study clearly confirms the close relationship between address change in early years and later poor mental health. Residential mobility may be a useful marker for children at risk of poorer mental health in adolescence and early adulthood. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present research was to investigate mothers' experiences from the perspective of one to two years after they had completed the Incredible Years Parenting programme (IYP). Rationale/Method: A substantial body of research indicates that the IYP is an effective way of tackling behavioural problems in children. Outcomes for parents have been less thoroughly investigated. Individual, semi-structured interviews were conducted with parents (N=7), followed by thematic analysis of their responses. Findings: Results indicated that the overarching theme was change in the mother. The other themes were change in the child, change in approach to parenting, change in relationships, and increased access to social support. This research indicates that the IYP can be a powerful intervention for parents. The mothers valued the social support provided by the IYP and there was some suggestion that the IYP helped mothers who were experiencing mental health difficulties. According to the mothers interviewed, the father-child relationship could be enhanced even when the father did not attend the IYP. The research found that in some circumstances implementation of the IYP could cause mother-partner friction as the maternal way of parenting began to change. It was also found that the participants disseminated information gathered from the IYP to their family and friends. Conclusions: Evidence from the present study suggests that further changes to the delivery of the IYP and the support structures which are in place for participants, both during and following participation, could be considered, to further increase the effectiveness of the programme. [ABSTRACT FROM AUTHOR]

Using data from a 2007 survey in Northern Ireland (representative sample, N = 1036), we replicate and extend the US-based findings of Lacey et al. (Journal of Happiness Studies 7:167-182, ). Consistent with Lacey et al., we find that young people mispredict happiness levels in old age, believing-wrongly-that happiness declines with age. We explore the possible implications of this under-estimation of happiness in old age for the risky health behaviours of young people. We find that young male binge drinkers are particularly prone to thinking that happiness declines with age. [ABSTRACT FROM AUTHOR]

Background: Genome-wide and clinical studies have linked the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR) with hypertension, whilst limited evidence shows that intervention with riboflavin (i.e. the MTHFR co-factor) can lower blood pressure (BP) in hypertensive patients with the variant MTHFR 677TT genotype. We investigated the impact of this common polymorphism on BP throughout adulthood and hypothesised that riboflavin status would modulate the genetic risk of hypertension.Methods: Observational data on 6076 adults of 18-102 years were drawn from the Joint Irish Nutrigenomics Organisation project, comprising the Trinity-Ulster Department of Agriculture (TUDA; volunteer sample) and the National Adult Nutrition Survey (NANS; population-based sample) cohorts. Participants were recruited from the Republic of Ireland and Northern Ireland (UK) in 2008-2012 using standardised methods.Results: The variant MTHFR 677TT genotype was identified in 12% of adults. From 18 to 70 years, this genotype was associated with an increased risk of hypertension (i.e. systolic BP ≥ 140 and/or a diastolic BP ≥ 90 mmHg): odds ratio (OR) 1.42, 95% confidence interval (CI) 1.07 to 1.90; P = 0.016, after adjustment for antihypertensive drug use and other significant factors, namely, age, male sex, BMI, alcohol and total cholesterol. Low or deficient biomarker status of riboflavin (observed in 30.2% and 30.0% of participants, respectively) exacerbated the genetic risk of hypertension, with a 3-fold increased risk for the TT genotype in combination with deficient riboflavin status (OR 3.00, 95% CI, 1.34-6.68; P = 0.007) relative to the CC genotype combined with normal riboflavin status. Up to 65 years, we observed poorer BP control rates on antihypertensive treatment in participants with the TT genotype (30%) compared to those without this variant, CT (37%) and CC (45%) genotypes (P < 0.027).Conclusions: The MTHFR 677TT genotype is associated with higher BP independently of homocysteine and predisposes adults to an increased risk of hypertension and poorer BP control with antihypertensive treatment, whilst better riboflavin status is associated with a reduced genetic risk. Riboflavin intervention may thus offer a personalised approach to prevent the onset of hypertension in adults with the TT genotype; however, this requires confirmation in a randomised trial in non-hypertensive adults. [ABSTRACT FROM AUTHOR]