Barriers and facilitators to parents seeking and accessing professional support for anxiety disorders in children: qualitative interview study

Anxiety disorders are among the most common mental health disorders experienced by children, but only a minority of these children access professional help. Understanding the difficulties parents face seeking support for child anxiety disorders could inform targeted interventions to improve treatment access. The aims of the study were to identify barriers and facilitators to seeking and accessing professional support for child anxiety disorders, and ways to minimise these barriers. A qualitative interview study was conducted with parents of 16 children (aged 7–11 years) with anxiety disorders identified through screening in schools. Barriers and facilitators were identified in relation to four distinct stages in the help-seeking process: parents recognising the anxiety difficulty, parents recognising the need for professional support, parents contacting professionals, and families receiving professional support. Barriers and facilitators at each stage related to the child’s difficulties, the role of the parent, and parent perceptions of professionals and services. Findings illustrate the need (1) for readily available tools to help parents and professionals identify clinically significant anxiety in children, (2) to ensure that families and professionals can easily access guidance on the help-seeking process and available support, and (3) to ensure existing services offer sufficient provision for less severe difficulties that incorporates direct support for parents

The Environmental Context and Function of Burnt-Mounds : New Studies of Irish Fulachtaí Fiadh

The authors acknowledge funding from The Leverhulme Trust (F/00144/AI) and assistance from a large number of individuals including; Margaret Gowen (access to sites and assistance throughout),A. Ames, H, Essex (pollen processing), S. Rouillard & R. Smith (illustrations), C. McDermott, S. Bergerbrandt, all the staff of Margaret Gowen & Co. Ltd, TVAS Ireland and CRDS. Excavation works and some post-excavation analysis was paid for my Bord Gáis and the National Roads Authority (now Transport Infrastructure Ireland). Thanks also to David Smith for access to the Maureen Girling collection and assistance with identifications.Peer reviewedPostprintPostprin

Early Days in Custody

The Early Days in Custody (EDiC) project is a prison-based crisis intervention delivered by NEPACS providing targeted support to prisoners and family members during the critical first two weeks of custody. The aim is to prevent (or soften) the shock of entering custody, and to avoid an escalation of negative emotions into further problems including self-harm and suicide. EDiC was established as a pilot project in response to specific concerns from prisoners, family members and some prison staff about high numbers of men and women in custody reporting distress and exhibiting risky behaviours during their time on induction wings. Funded by The Big Lottery Community Fund, the EDiC project was delivered in HMP Durham and HMP Low Newton between April 2020 – June 2023. The funding paid for one full-time family support worker (FSW) at HMP Durham and a part-time FSW at HMP Low Newton. The EDiC project was externally evaluated using a mixed methods approach and ran alongside delivery of the service

Cultural policy:Critical concepts in media and cultural studies

Introductio

Parental Rights in Prison Project

The aim of the Parental Rights in Prison Project (PRiP) was to support incarcerated parents who wished to sustain their relationship with their children who are in the care of the local authority, care of family and significant others or adopted and to provide them with legal advice and support around their rights as parents. The project was funded by HMPPS and took place from January 2021 – December 2022. Initially established in HMP Low Newton prison, the project expanded to also support fathers in HMP Kirklevington and HMP Durham in year two. The funding paid for one full-time project coordinator (PRiPC) who provided ongoing specialist family support following intervention from the family support workers, Drug and Recovery Team (DART) family support worker or HMPPS prison family support worker. Her role was to undertake complex core family work. She also supports mothers in custody with additional issues such as safeguarding, looked after children, social care involvement, care proceedings, the perinatal pathway, post-adoption support and liaising with professionals including schools, social workers, family law solicitors as well helping maintain family ties. The PRiP Project was externally evaluated using a mixed methods approach and ran alongside delivery of the intervention. The evaluation focused on mothers only, and delivery of the PRiP Project at HMP Low Newton. We engaged with a total of 23 mothers2 during the evaluation period which ran for eighteen months. Underpinning the evaluation were indepth interviews with 18 mothers and 7 prison staff members, analysis of 10 case-studies written by the PRiPC and impact data collected by the PRiPC; and a participatory theatre project involving 7 mothers which is ongoing

The environmental context and function of Burnt-Mounds: new studies of Irish Fulachtaí Fiadh

Burnt mounds, or fulachtaí fiadh as they are known in Ireland, are probably the most common prehistoric site type in Ireland and Britain. Typically Middle–Late Bronze Age in age (although both earlier and later examples are known), they are artefact-poor and rarely associated with settlements. The function of these sites has been much debated with the most commonly cited uses being for cooking, as steam baths or saunas, for brewing, tanning, or textile processing. A number of major infrastructural development schemes in Ireland in the years 2002–2007 revealed remarkable numbers of these mounds often associated with wood-lined troughs, many of which were extremely well-preserved. This afforded an opportunity to investigate them as landscape features using environmental techniques – specifically plant macrofossils and charcoal, pollen, beetles, and multi-element analyses. This paper summarises the results from eight sites from Ireland and compares them with burnt mound sites in Great Britain. The fulachtaí fiadh which are generally in clusters, are all groundwater-fed by springs, along floodplains and at the bases of slopes. The sites are associated with the clearance of wet woodland for fuel; most had evidence of nearby agriculture and all revealed low levels of grazing. Multi-element analysis at two sites revealed elevated heavy metal concentrations suggesting that off-site soil, ash or urine had been used in the trough. Overall the evidence suggests that the most likely function for these sites is textile production involving both cleaning and/or dyeing of wool and/or natural plant fibres and as a functionally related activity to hide cleaning and tanning. Whilst further research is clearly needed to confirm if fulachtaí fiadh are part of the ‘textile revolution’ we should also recognise their important role in the rapid deforestation of the wetter parts of primary woodland and the expansion of agriculture into marginal areas during the Irish and British Bronze Ages

The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness

Background: It is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or not dipstick testing should be used to inform antibiotic treatment.Objectives: To develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or not dipstick urinalysis provides additional diagnostic information; and model algorithm cost-effectiveness.Design: Multicentre, prospective diagnostic cohort study.Setting and participants: Children &lt; 5 years old presenting to primary care with an acute illness and/or new urinary symptoms.Methods: One hundred and seven clinical characteristics (index tests) were recorded from the child’s past medical history, symptoms, physical examination signs and urine dipstick test. Prior to dipstick results clinician opinion of UTI likelihood (‘clinical diagnosis’) and urine sampling and treatment intentions (‘clinical judgement’) were recorded. All index tests were measured blind to the reference standard, defined as a pure or predominant uropathogen cultured at ? 105 colony-forming units (CFU)/ml in a single research laboratory. Urine was collected by clean catch (preferred) or nappy pad. Index tests were sequentially evaluated in two groups, stratified by urine collection method: parent-reported symptoms with clinician-reported signs, and urine dipstick results. Diagnostic accuracy was quantified using area under receiver operating characteristic curve (AUROC) with 95% confidence interval (CI) and bootstrap-validated AUROC, and compared with the ‘clinician diagnosis’ AUROC. Decision-analytic models were used toidentify optimal urine sampling strategy compared with ‘clinical judgement’.Results: A total of 7163 children were recruited, of whom 50% were female and 49% were &lt; 2 years old. Culture results were available for 5017 (70%); 2740 children provided clean-catch samples, 94% of whom were ? 2 years old, with 2.2% meeting the UTI definition. Among these, ‘clinical diagnosis’ correctly identified 46.6% of positive cultures, with 94.7% specificity and an AUROC of 0.77 (95% CI 0.71 to 0.83). Four symptoms, three signs and three dipstick results were independently associated with UTI with an AUROC (95% CI; bootstrap-validated AUROC) of 0.89 (0.85 to 0.95; validated 0.88) for symptoms and signs, increasing to 0.93 (0.90 to 0.97; validated 0.90) with dipstick results. Nappy pad samples were provided from the other 2277 children, of whom 82% were &lt; 2 years old and 1.3% met the UTI definition.‘Clinical diagnosis’ correctly identified 13.3% positive cultures, with 98.5% specificity and an AUROC of 0.63 (95% CI 0.53 to 0.72). Four symptoms and two dipstick results were independently associated with UTI, with an AUROC of 0.81 (0.72 to 0.90; validated 0.78) for symptoms, increasing to 0.87 (0.80 to 0.94; validated 0.82) with the dipstick findings. A high specificity threshold for the clean-catch model was more accurate and less costly than, and as effective as, clinical judgement. The additional diagnostic utility of dipstick testing was offset by its costs. The cost-effectiveness of the nappy pad model was not clear-cut.Conclusions: Clinicians should prioritise the use of clean-catch sampling as symptoms and signs can cost-effectively improve the identification of UTI in young children where clean catch is possible. Dipstick testing can improve targeting of antibiotic treatment, but at a higher cost than waiting for a laboratory result. Future research is needed to distinguish pathogens from contaminants, assess the impact of the clean-catch algorithm on patient outcomes, and the cost-effectiveness of presumptive versus dipstick versus laboratory-guided antibiotic treatment.Funding: The National Institute for Health Research Health Technology Assessment programme.<br/

A fluctuating, intermediate warp: a micro-ethnography and synthetic philosophy of fibre mathematics

This project explores the inventive worlds of artists who engage with weaving technologies in the production of their work. It aims to understand the mathematical practices of these textile practitioners, without reifying or subsuming their work within a closed teleology. Side-lining approaches to both mathematics and artistic production that fetishize individual genius or the imposition of form on passive matter, I approach both artistic and mathematical activities as making practices. The project draws on the philosophy of Gilbert Simondon to (re)theorise the role of technique and technology in artistic and mathematical creation. This focus foregrounds fibres and looms, diagrams and models as participants in material modes of reasoning. Exploring how the practices of both novice and expert weavers exceed the sovereign subject in ways that open up mathematical and weaverly tools as experimental forms, the project uses a micro-ethnographic analysis to examine how materials, machines, and humans improvise “algorhythmically” – a concept developed to describe both the regulation and excess of creative processes. Three case studies explore how the loom serves as a generative form/ground for engagement with mathematico-weaverly problems. Placing these material experimentations in the context of historical encounters between disciplines, the dissertation attempts to give contours to an emergent field of fibre mathematics

Exploring masculinities, sexual health and wellbeing across areas of high deprivation in Scotland: the depth of the challenge to improve understandings and practices

Within and across areas of high deprivation, we explored constructions of masculinity in relation to sexual health and wellbeing, in what we believe to be the first UK study to take this approach. Our sample of 116 heterosexual men and women age 18–40 years took part in individual semi-structured interviews (n = 35) and focus group discussions (n = 18), across areas in Scotland. Drawing on a socio-ecological framework, findings revealed experience in places matter, with gender practices rooted in a domestically violent milieu, where localised, socio-cultural influences offered limited opportunities for more egalitarian performances of masculinity. We discuss the depths of the challenge in transforming masculinities in relation to sexual health and wellbeing in such communities