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The longitudinal Belfast Youth Development Study (BYDS) followed a group of young people from age 11 to 21 years (from 2001 to 2011), charting their experiences of substance use, offending, education, and peer and family relationships. This allowed the investigation of risk and protective factors associated with different types of behavioural patterns and outcomes in adolescence and emerging adulthood. A feasibility study was carried out from 2018 to 2019 to test the success rate of electronically tracing 4,195 participants after almost a decade, in anticipation of carrying out an additional wave of data collection. The projected trace rate obtained using standard and forensic electronic tracing methods was considerably higher (86%) than traditional tracing methods (10%) for getting up-to-date contact details on participants. The electronic tracing methods were also cheaper (£9.72 per person traced) than traditional tracing methods (£20.62 per person traced). These findings will help maximise the potential of longitudinal social research.

BackgroundMinimally invasive and remote access thyroid surgery has been evolving with the transoral endoscopic thyroidectomy vestibular approach (TOETVA) emerging as a true "scarless" thyroidectomy. In this study, we describe a hybrid transoral and submental thyroidectomy (TOaST) technique for thyroid lobectomy.Materials and methodsA TOaST right thyroid lobectomy was performed for a 4 cm cytologically benign right thyroid nodule. Initial incision was made in the submental region with two additional 5 mm lateral ports inserted transorally. Right thyroid lobectomy proceeded via standard TOETVA with intact specimen extraction via the submental incision.ResultsThe patient was discharged home on postoperative day 1. Final pathology showed a 4.2 cm follicular adenoma. Cosmetic results and patient satisfaction were excellent.DiscussionThis is the first reported case of a hybrid TOaST technique. It aims to maintain the principles and advantages of TOETVA while addressing its limitations related to large tumor extraction, mental nerve injury, and chin sensory changes. The shorter distance of dissection required may reduce postoperative pain. This approach may expand the indications for transoral thyroidectomy while maintaining excellent cosmetic outcomes.

ImportanceLaparoscopic adrenalectomy is the gold standard for most adrenal disorders and its frequency in the United States is increasing. While national and administrative databases can adjust for patient factors, comorbidities, and institutional variations, granular disease-specific data that may significantly influence the incidence of perioperative complications and length of stay (LOS) are lacking.ObjectiveTo investigate factors associated with perioperative complications and LOS after laparoscopic adrenalectomy.Design, setting, and participantsThis cohort study was carried out at a single academic medical center, with all patients who underwent laparoscopic adrenalectomy between 1993 and 2017 by the endocrine surgery department. Multivariable linear and logistic regression were used to obtain adjusted odds ratios (ORs).Main outcomes and measuresThe primary outcome was perioperative complications with a Dindo-Clavien grade of 2 or more. The secondary outcome was prolonged length of stay, defined as a stay longer than the 75th percentile of the overall cohort.ResultsWe identified 640 patients who underwent 653 laparoscopic adrenalectomies, of whom 370 (56.7%) were female. The median age was 51 (range, 5-88) years. A total of 76 complications with a Dindo-Clavien grade of 2 or more occurred in 55 patients (8.4%), with postoperative mortality in 2 patients (0.3%). The median hospital length of stay was 1 day (range, 0-32 days). Factors independently associated with increased complications were American Society of Anesthesiologists class 3 or 4 (OR, 2.78 [95% CI, 1.39-5.55]; P

BackgroundPrimary hyperparathyroidism (PHPT) is a common endocrine disorder that predominantly affects patients >60 and is increasing in prevalence. Identifying risk factors for poor outcomes after parathyroidectomy in older adults will help tailor operative decision making. The impact of frailty on surgical outcomes in parathyroidectomy has not been established.MethodsWe performed a retrospective review of patients ≥40 years who underwent parathyroidectomy in the 2005-2010 ACS NSQIP. Frailty was assessed using the modified frailty index (mFI). Multivariable regression was used to determine the association of frailty with 30-day complications, length of stay (LOS), and reoperation.ResultsWe identified 13,123 patients ≥40 who underwent parathyroidectomy for PHPT. The majority of patients were not frail, with 80% with a low NSQIP mFI score (0-1 frailty traits), 19% with an intermediate mFI score (2-3), and 0.9% with a high mFI score (≥4). Overall 30-day complications were rare, occurring in 141 (1.1%) patients. Increasing frailty was associated with an increased risk of complications with adjusted odds ratios (ORs) of 1.76 (95% CI 1.20-2.59; p = 0.004) for intermediate and 8.43 (95% CI 4.33-16.41; p

Over recent decades there has been growing interest in amplifying children and young people's views (CYP) within policy debates. Despite this, they are rarely invited to participate in key policy‐making discussions, and when they are, this tends to be tokenistic. This paper presents an intergenerational methodological framework 'The Causeway Approach', inspired by the mythology of the Giant's Causeway, which addresses the challenge of CYP's voices being drowned out by adult stakeholders. This contextualised approach has significant potential to benefit CYP and communities through capacity building, strengthening of social capital and fostering intergenerational connections. [ABSTRACT FROM AUTHOR]

Children learn through interaction with their surroundings, meaning that their experiences of place directly contribute to their personal development. Despite this, the needs of the youth are rarely factored into development plans. This is a major obstacle to the sustainable and inclusive development of places. Examining potential pathways to correct this issue, this paper presents the findings of research conducted with young people from the Market area of Belfast. The research engaged with two groups (n = 11) in a participatory investigation of how young people engage with the built environment. Using several participatory methods, including narrative walkabouts, mapping exercises and semi‐structured group interviews, the children engaged as co‐researchers. We link to idea of 'third places' to frame our analysis, demonstrating how children in the Market community have strong opinions of how space is, and should be, designed and managed. We reveal interesting dynamics regarding the children's perceived exclusion from the city centre and concerns about how poor planning is harming their community's public health. We conclude by reflecting upon some of the children's proposed solutions, as well as by presenting two outcomes of our study that hint at the potential future role of young people in co‐designing the built environment. [ABSTRACT FROM AUTHOR]

The article explores the concept of "believability" in the context of sexual violence, media, and the politics of doubt. It argues that the current economy of believability is unequal and reinforces existing power structures, with men, whiteness, and wealth having an advantage. The authors emphasize the need for collective action to challenge this economy and create new listening publics that prioritize empowerment, empathy, and justice for survivors. The text also discusses the intersectionality of believability, highlighting the experiences of marginalized groups who face additional barriers to being believed. The book expands on these ideas, examining the dynamics of believability in the context of the #MeToo movement and the crisis of "post-truth" in contemporary culture. It also discusses the rise of reactionary feminism and the challenges faced by marginalized voices in the pursuit of justice. The authors emphasize the potential for transformation within the economy of believability and suggest strategies for feminists to challenge and transform the current media landscape. [Extracted from the article]

Background: Aspects of the school environment, such as school attachment levels, are linked to adolescent offending. Previous research has not clarified whether a school- or individual-level intervention approach to improving pupil school attachment and commitment is most likely to reduce adolescent offending. Aim: The present study assessed the impact of individual- and school-level variables on offending behaviour from ages 14-16 years. Sample: The participants were 4,049 young people from 42 mainstream schools who took part in the Belfast Youth Development Study. Method: Multilevel modelling was used to examine the relative influence of individual- and school-level variables on offending behaviour in adolescence. Results: Pupils who had high levels of school commitment and attachment and were involved in fewer fights at age 13 reported lower levels of offending at age 14 years. Differences between schools accounted for 7% of the variation in offending. Lower individual-level commitment was associated with higher initial levels of offending at age 14 if the school-level ethos was of higher commitment. Lack of safety at the school level appeared to be detrimental for young people not exposed to socio-economic deprivation. Conclusions: Individual-level targeted interventions are likely to be a more cost-effective approach of reducing offending behaviour in adolescence. Additional, albeit smaller, reductions in offending levels could be achieved through school-level interventions in some school types (e.g., deprived areas).

ImportanceFrailty is a measure of decreased physiological reserve that is associated with morbidity and mortality in major elective and emergency general surgery operations, independent of chronological age. To date, the association of frailty with outcomes in ambulatory general surgery has not been established.ObjectiveTo determine the association between frailty and perioperative morbidity in patients undergoing ambulatory general surgery operations.Design, setting, and participantsA retrospective cohort study was conducted of 140 828 patients older than 40 years of age from the 2007-2010 American College of Surgeons National Surgical Quality Improvement Program Participant Use File who underwent ambulatory and 23-hour-stay hernia, breast, thyroid, or parathyroid surgery. Data analysis was performed from August 18, 2016, to June 21, 2017.Main outcomes and measuresThe association between the National Surgical Quality Improvement Program modified frailty index and perioperative morbidity was determined via multivariable logistic regression with random-effects modeling to control for clustering within Current Procedural Terminology codes.ResultsA total of 140 828 patients (80 147 women and 60 681 men; mean [SD] age, 59.3 [12.0] years) underwent ambulatory hernia (n = 71 455), breast (n = 51 267), thyroid, or parathyroid surgery (n = 18 106). Of these patients, 2457 (1.7%) experienced any type of perioperative complication and 971 (0.7%) experienced serious perioperative complications. An increasing modified frailty index was associated with a stepwise increase in the incidence of complications. In multivariable analysis adjusting for age, sex, race/ethnicity, anesthesia type, tobacco use, renal failure, corticosteroid use, and clustering by Current Procedural Terminology codes, an intermediate modified frailty index score (0.18-0.35, corresponding to 2-3 frailty traits) was associated with statistically significant odds ratios of 1.70 (95% CI, 1.54-1.88; P

Hypoparathyroidism is a potential outcome of anterior neck surgery. Commonly it is managed by calcium and vitamin D supplementation in large doses, with attendant side effects. A recombinant human parathyroid hormone (rhPTH) is now available in the USA, offering a potentially more effective treatment. No cost-effectiveness model investigating this new medication versus standard care has yet been published.We constructed a decision analytic model comparing usual care versus rhPTH treatment for postsurgical hypoparathyroidism. Threshold and sensitivity analyses on key parameters were conducted to assess robustness of the model. Costs and health outcomes were represented in US dollars and quality-adjusted life-years (QALYs).The rhPTH strategy was both more costly and more effective than the usual care (UC) strategy. In the base case, UC cost $37,196 and provided 7.54 QALYs. The rhPTH strategy cost $777,224 and provided 8.46 QALYs for an incremental cost-effectiveness ratio of $804,378/QALY. As this was above our willingness-to-pay of $100,000, treatment with rhPTH was not considered cost-effective. The model was robust to all other parameters.To our knowledge, this is the first formal cost-effectiveness analysis of rhPTH in comparison with UC. Our model suggests that although the new treatment is slightly more effective than UC, the modest gain in quality of life for patients who are reasonably well-managed by UC does not justify the cost. However, consideration must be given to rhPTH for patients who have failed UC, as the expenditure may be justified in that context.

BackgroundGuidelines for management of small adrenal incidentalomas are mutually inconsistent. No cost-effectiveness analysis has been performed to evaluate rigorously the relative merits of these strategies.MethodsWe constructed a decision-analytic model to evaluate surveillance strategies for

Enhancing health research capacity in developing countries is a global health priority. Understanding the orthopedic burden of disease in Latin America will require close partnership between more-developed and less-developed countries. To this end, the Osteosynthesis and Trauma Care Foundation assembled a research consortium of Latin-American orthopedic leaders. Prior to the meeting, we surveyed attendees on perceived barriers to conducting research at their institutions. During the event, working groups discussed these barriers, developed strategies for addressing them, and planned future steps for collaboration. The participants established the need for global relationships that allow colleagues from Latin America to access to training and established investigational infrastructure of North American centers to address research questions relevant to their communities. As a result of the discussion, the International Orthopaedic Multicenter Study (INORMUS) in Fracture Care was initiated. Since then, an expanded international working group, Associación de Cirujanos Traumatológicos en las Americas (ACTUAR), has been created with the purpose of promoting increased global partnership for research capacity development.

Participatory methods for engaging children and young people in research are becoming more popular and innovative in social research. One example of this is the inclusion of participant photography. Drawing on an ethnographic study conducted in Northern Ireland, this article explores the application of participant photography to research drug use and antisocial behavior among youth. Findings highlight issues surrounding implementation when in the field, building on the existing knowledge base and focusing on recruitment, continuous engagement, image presentation, and analysis. This is followed by an overview of ethical considerations including specific issues relating to researcher and participant safety.

There is increasing recognition regarding the potential of Higher Education Institutions (HEIs) to be significant Anchor institutions capable of impacting the wellbeing of the local communities where they are situated. Subsequently, more universities are prioritising their social and civic responsibility by embedding a research ethos based on closer engagement with their locality, within their key institutional processes. However, demonstrating the social value of community engagement in a meaningful way is difficult, particularly the type of intangible benefits such as relationship building and co-production of knowledge that are forged through collaboration. We present results of a pilot study which applied a Socially Modified Economic Valuation (SMEV) approach to three very different case study projects within a University-Community partnership initiative situated in Belfast, Northern Ireland, to help evaluate how well the university's civic and social obligations are being fulfilled. Two sets of potential social weights were derived. The first was based on the official Deprivation Index and the second on a combination of desirable 'social' and 'strategy' goals. Findings showed that the social valuation element of SMEV may potentially be crucially important in assisting with nuanced interpretation of social value across different communities in different places. [ABSTRACT FROM AUTHOR]

Serving as a key delivery mechanism for Queen’s University Belfast’s (UK) strategic commitment to social and civic responsibility and economic prosperity, Queen’s Communities and Place is a research initiative based on engagement and partnership between communities, policy makers and academics. Combining academic expertise and experiential knowledge from the community, Queen’s Communities and Place uses a ‘place-based’ approach to co-create new solutions to address persistent physical, economic and social challenges, as well as to strengthen the engagement between Queen’s University and its surrounding communities. Queen’s Communities and Place launched in November 2021 with our anchor partner in the Market community in inner south Belfast. We are also working collaboratively with projects and communities in the north, west and east of Belfast across a range of sectors and academic disciplines. We have sought to challenge existing frameworks, with evidenceled, data-driven approaches to build interventions and practices together to identify what might work better here for communities to thrive. Capturing three perspectives – academic, community and local government – this co-written reflective article details the experience of establishing a working partnership with our pilot community, and provides some examples of how our approach is working to address the challenges on the ground to date. [ABSTRACT FROM AUTHOR]

Objective: To examine whether students' school engagement, relationships with teachers, educational aspirations and involvement in fights at school are associated with various measures of subsequent substance use. Methods: Data were drawn from the Belfast Youth Development Study (n = 2968). Multivariate logistic models examined associations between school-related factors (age 13/14) and substance use (age 15/16). Results: The two factors which were consistently and independently associated with regular substance use among both males and females were student-teacher relationships and fighting at school: positive teacher-relationships reduced the risk of daily smoking by 48%, weekly drunkenness by 25%, and weekly cannabis use by 52%; being in a fight increased the risk of daily smoking by 54%, weekly drunkenness by 31%, and weekly cannabis use by 43%. School disengagement increased the likelihood of smoking and cannabis use among females only. Conclusion: Further research should focus on public health interventions promoting positive relationships and safety at school. (Contains 4 tables.)