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Background: There is limited qualitative research focussed specifically on what it is like for children and young people with intellectual disabilities coming into hospital, with much of the evidence-base being about those with Autism Spectrum Condition or adults with intellectual disabilities. Aim: To share rich detail of the emotional and physical impact on children and young people with intellectual disabilities of attending hospital, from their own and their parent's perspective. Methods: Talking Mats interviews, sticker survey and photography with children and young people with intellectual disabilities, and in-depth interviews, hospital diaries and photography with their parents. Results and Conclusions: The multiple and compounding layers of complexity surrounding hospital care of children and young people with intellectual disabilities resulted in challenges associated with loss of familiarity and routine, undergoing procedures, managing sensory overload, managing pain and having a lack of safety awareness. An individualised approach to their care is needed.

Background: Children and young people with learning disabilities experience poor health outcomes and lengthier hospital admissions than those without learning disabilities. No consistently applied, systematic approach exists across the NHS to identify and record this population. This paper describes practices in English hospitals to identify children and young people with learning disabilities. Method: "Interviews"--65 NHS staff. "Questionnaire"--2,261 NHS staff. Conducted across 24 NHS hospitals in England. Results: No standardized approach exists to identify children or young people with a learning disability or for this information to be consistently recorded, communicated to relevant parties within a hospital, Trust or across NHS services. Staff reported a reliance on parents to inform them about their child's needs but concerns about "flagging" patients might be a significant barrier. Discussion: Without an integrated systematic way across the NHS to identify children with learning disabilities, their individual needs will not be identified.

Background: Non‐invasive ventilation (NIV) for sleep‐disordered breathing (SDB) in children and young people (CYP) can result in multiple health outcomes; however, adherence to NIV can be challenging. Suboptimally treated SDB may increase the risk of adverse consequences. Placing children's and parents' goals at the core of their SDB treatment may support adherence to NIV. To identify these health outcomes, it is necessary to gain a greater understanding of CYP's experiences of using NIV, whether they perceive any benefits from NIV use, as well as the outcomes that their parents and NIV staff identify as important. Methods: Semi‐structured qualitative interviews were conducted with nine CYP (aged 4–16 + years), 13 parents and nine healthcare professionals (HCPs); verbatim transcripts were analysed using Framework Analysis. Results: CYP predominantly reported an improvement in levels of energy, focus and ability to concentrate whereas parents also identified outcomes of mood and behaviour. The majority of children showed understanding of the reasons for being prescribed NIV. A subset of children did not notice their SDB. The health outcomes identified by HCPs and parents that could result from improved overnight gas exchange are subjective measures that rely on parent and child report. Measuring these health outcomes focussed on the impact of improved sleep rather than measuring improved sleep itself. Conclusions: It is important for HCPs administering NIV to ascertain whether CYP have noticed any of their sleep‐disordered breathing symptoms and any improvements from using NIV, including the relationship between benefits and side effects. Focussing on promoting understanding for CYP who are unable to link their wellbeing to their previous night's sleep may be futile and HCP strategies should concentrate on the process of tolerating the device. Parents, CYP and HCPs should collaborate to identify treatment goals specifically tailored for the child and monitor any progress against these goals. [ABSTRACT FROM AUTHOR]

The present study examined chaplain reported plans for patient conversations regarding end-of-life (EOL) care through the lens of multiple goals. Chaplains (n = 69) were asked to curate a plan for engaging with a patient about EOL treatment options, including how they would engage in the conversation and what they would plan to discuss. Findings indicated that plans primarily consisted of relational and identity goals, with a majority navigating multiple goal orientations. Content overwhelmingly involved developing rapport with patients, eliciting patient preferences for care, and serving as a patient liaison. The current study addresses the paucity of research around the role a chaplain plays on the interdisciplinary team and their respective approach to EOL conversations. Examination of curated plans affords insight to what content is prioritized and which conversational goals are present. Integration of multiple goals offers preliminary evidence for conversational quality. Awareness of goal approach and content prioritized affords clarity on how chaplains can be called upon to support members of the interdisciplinary care team. [ABSTRACT FROM AUTHOR]

This study investigated a set of messages on a university group's Facebook page intended as advice for first-year college students. Investigators coded 108 different units of advice into three overarching categories focused on academics, the transition to college life, and comprehension of the college campus. Messages transmitted were similar in content to those students reported helped them navigate college life in earlier research studies, suggesting that social networking sites might provide a valuable platform for supporting the initial transition to college. (Contains 1 table.)

The author examined the role of narratives used by unemployed, underemployed, and displaced workers seeking job training assistance through a government-funded One-Stop Career Center. Interviews with employees of a One-Stop Career Center provided insight on client rate of disclosure of personal narratives and how client narratives are used to facilitate the job search process. Specifically, data from the interviews suggest that narratives give career center employees insight on job seekers' background, barriers, and reemployment mind-set. Furthermore, the act of listening was seen as legitimizing job seekers' experiences. Implications of the findings are discussed.

This manuscript details an investigation of memorable messages that help students navigate college life using a control theory framework. Researchers conducted face-to-face interviews with 61 undergraduate students who recalled a specific memorable message that helped them as they navigated college. Results of this formative study show the majority of participants' memorable messages were academic, and approximately 70% reported changing their behavior when recalling the message. Findings include categories of messages, challenges and topics, message sources, and changes in behavior and attitudes as a result of recalling the message. Additionally, the authors discuss responses to the study findings by college personnel that highlight the applicability of the research. (Contains 2 tables.)

Background The UK's National Institute for Health and Care Excellence (NICE) advises GPs to inform patients referred to the Urgent Suspected Cancer (USC) pathway about their impending service and expectations. However, little is known about patient experiences and information needs post-referral. GPs often grapple with conveying the urgency of referrals while offering reassurance. Aim This study explores GP communication regarding cancer and USC referrals. Method A secondary analysis of 23 audio-recorded GP-patient consultations, selected from a larger dataset of 200 consultations in Surrey and London (2017-2018), was conducted, focusing on discussions related to cancer. Results We found that most GPs informed patients that they might have cancer and engaged in reassurance about the patient’s low risk of cancer using personalised risk statements. Some GPs, however, avoided all mention of cancer, using symptom-led language instead. GPs tended to focus on communicating practical rather than support-based information when discussing the referral. While most GPs informed patients that they would be seen by a specialist within two weeks, few discussed patients’ support needs during the referral or specialist appointment. Conclusion This presentation will offer language recommendations for clear communication about cancer referrals. This plays an important role in promoting shared decision-making and driving patient attendance for investigations. The study highlights the need for further research on communication practices around cancer referral to improve patient understanding and experience. Our recommendations for enhanced communication may improve patient outcomes by optimising routes to diagnosis via primary care. [ABSTRACT FROM AUTHOR]

This paper discusses trends in recent academic literature on cumulative effects assessment (CEA) in the field of environmental impact assessment (IA). We performed an inductive, thematic analysis of peer-reviewed literature published between 2008 and 2018. We find that most academic research on CEA originates in North America, and much of it is situated in periodicals other than the leading IA journals. There is agreement that CEA is still not well understood conceptually and there remains a need for procedural guidance as support for practitioners. Support for regional and strategic approaches to CEA remains strong. Our review of the literature also shows that, increasingly, researchers advocate estimating relative ecosystem vulnerability to anthropogenic activities by aggregating stressors and differentiating the most heavily disturbed valued components and impact zones. The paper concludes with our suggestions to strengthen CEA scholarship globally. [ABSTRACT FROM AUTHOR]