The effects of neighbourhood social cohesion on preventing depression and anxiety among adolescents and young adults: rapid review

Background: Research suggests that increasing neighbourhood social cohesion can prevent mental health problems, including depression and anxiety. However, it is unknown whether this is the case for adolescents and young adults. Aims: To investigate whether neighbourhood social cohesion can prevent depression and anxiety, and identify interventions that can increase neighbourhood cohesion in young people. Method: We conducted a rapid review for an overview of the available literature. PubMed, Campbell Collaboration, KSR Ltd and grey literature databases were searched from inception up to 10 July 2020. When synthesising the results, we applied a hierarchy of evidence, prioritising study designs that allowed for the most ability to infer causality. Risk of bias was assessed with the ROBIS tool and Joanna Briggs Institute risk-of-bias assessment. A narrative review and two workshops with young people were conducted to inform what future interventions may look like. Results: Forty-two peer-reviewed publications, including two systematic reviews, 13 longitudinal studies and 27 cross-sectional studies, were identified. Prospective longitudinal studies found that neighbourhood social cohesion factors (safety, trust, positive social connections, helping others and a lack of crime and violence) were associated with fewer depressive symptoms. Future interventions to increase neighbourhood cohesion should involve creating safe and attractive community centres, accessible and safe outdoor spaces, community activity groups and online communities. Conclusions: Neighbourhood social cohesion has the potential to protect mental health. The next step is to conduct intervention studies to evaluate the effects on onset prevention. Clinicians should consider the impact cohesion can have on mental health, and signpost to community initiatives

Development of the Huddle Observation Tool for structured case management discussions to improve situation awareness on inpatient clinical wards

Background‘Situation Awareness For Everyone’ (SAFE) was a 3-year project which aimed to improve situation awareness in clinical teams in order to detect potential deterioration and other potential risks to children on hospital wards. The key intervention was the ‘huddle’, a structured case management discussion which is central to facilitating situation awareness. This study aimed to develop an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle.MethodsA cross-sectional observational design was used to psychometrically develop the ‘Huddle Observation Tool’ (HOT) over three phases using standardised psychometric methodology. Huddles were observed across four NHS paediatric wards participating in SAFE by five researchers; two wards within specialist children hospitals and two within district general hospitals, with location, number of beds and length of stay considered to make the sample as heterogeneous as possible. Inter-rater reliability was calculated using the weighted kappa and intraclass correlation coefficient.ResultsInter-rater reliability was acceptable for the collaborative culture (weighted kappa=0.32, 95% CI 0.17 to 0.42), environment items (weighted kappa=0.78, 95% CI 0.52 to 1) and total score (intraclass correlation coefficient=0.87, 95% CI 0.68 to 0.95). It was lower for the structure and risk management items, suggesting that these were more variable in how observers rated them. However, agreement on the global score for huddles was acceptable.ConclusionWe developed an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle. Future research should examine whether observational evaluations of huddles are associated with other indicators of safety on clinical wards (eg, safety climate and incidents of patient harm), and whether scores on the HOT are associated with improved situation awareness and reductions in deterioration and adverse events in clinical settings, such as inpatient wards.</jats:sec

Crossing visual borders and connecting cultures: children’s responses to the photographic theme in David Wiesner’s 'Flotsam'

&lt;i&gt;Flotsam&lt;/i&gt; (2006), the award-winning wordless picturebook by David Wiesner is about the power and mystery of photographs but, at the same time, it plays with many of the techniques of photography to tell its story. This article discusses these themes and techniques and also examines children’s responses to the picturebook, both oral and photographic. It considers photography with children as a research tool for investigating identity, culture, and literacy. The discussion about &lt;i&gt;Flotsam&lt;/i&gt; and the photographs provided an insight into children’s understanding, not only of wordless narrative but also of the techniques and uses of photography. We argue that the photographs increase the children’s control of the way in which their space, as well as their identity, is represented to others; a representation that is particularly important for immigrant pupils. We conclude that Flotsam can act as an incentive to reflect on the idea of looking carefully; to think about artistically complex texts and about the potential of photography. Finally, we suggest that photography is a promising way of exploring the visual image, not only from an investigative but also from a pedagogic point of view, as it can draw attention to the construction and metalanguage of image and thus strengthening comprehension and critical literacy skills