“They had clothes on their back and they had food in their stomach, but they didn\u27t have me”: The contribution of parental mental health problems, substance use, and domestic violence and abuse on young people and parents

\ua9 2024 The AuthorsBackground: The parental risk factors of mental health problems, substance use, and domestic violence and abuse each individually negatively impacts children\u27s health and developmental outcomes. Few studies have considered the lived experience and support needs of parents and children in the real-world situation where these common risks cluster. Objective: This study explores parents\u27 and young people\u27s lived experiences of the clustering of parental mental health problems, parental substance use, and domestic violence and abuse. Methods: Semi-structured interviews were conducted with 18 mothers, 6 fathers, and 7 young people with experiences of these parental risk factors. Transcribed interviews were analysed using reflexive thematic analysis. Results: Four themes were developed, 1) cumulative adversity, 2) the impact of syndemic risk, 3) families navigating risk, and 4) family support. Parents and young people described family situations of stress wherein they experienced cumulative impact of multiple parental risk factors. Parents sought to navigate stressors and parent in positive ways under challenging conditions, often impeded by their own childhood trauma and diminished confidence. Parents and young people spoke of the need for, and benefits of having, support; both as a family and as individuals, to successfully address this trio of parental risks and the related impact. Conclusions: This study highlights the high level of stress families experience and the efforts they go to mitigate risk. Services and interventions need to reflect the complexity of multiple needs and consider both the whole family and individuals when providing support

"They had clothes on their back and they had food in their stomach, but they didn't have me": The contribution of parental mental health problems, substance use, and domestic violence and abuse on young people and parents.

This is the final version. Available from Elsevier via the DOI in this record. Data availability: The data that has been used is confidential.BACKGROUND: The parental risk factors of mental health problems, substance use, and domestic violence and abuse each individually negatively impacts children's health and developmental outcomes. Few studies have considered the lived experience and support needs of parents and children in the real-world situation where these common risks cluster. OBJECTIVE: This study explores parents' and young people's lived experiences of the clustering of parental mental health problems, parental substance use, and domestic violence and abuse. METHODS: Semi-structured interviews were conducted with 18 mothers, 6 fathers, and 7 young people with experiences of these parental risk factors. Transcribed interviews were analysed using reflexive thematic analysis. RESULTS: Four themes were developed, 1) cumulative adversity, 2) the impact of syndemic risk, 3) families navigating risk, and 4) family support. Parents and young people described family situations of stress wherein they experienced cumulative impact of multiple parental risk factors. Parents sought to navigate stressors and parent in positive ways under challenging conditions, often impeded by their own childhood trauma and diminished confidence. Parents and young people spoke of the need for, and benefits of having, support; both as a family and as individuals, to successfully address this trio of parental risks and the related impact. CONCLUSIONS: This study highlights the high level of stress families experience and the efforts they go to mitigate risk. Services and interventions need to reflect the complexity of multiple needs and consider both the whole family and individuals when providing support.National Institute for Health Research (NIHR

Practice effects on the modified Concept Shifting Task (mCST): A convenient assessment for treatment effects on prefrontal cognitive function

<p>Abstract</p> <p>Background</p> <p>Trail-making tests, such as the Concept Shifting Task (CST), can be used to test the effects of treatment on cognitive performance over time in various neuropsychological disorders. However, cognitive performance in such experimental designs might improve as a result of the practice obtained during repeated testing rather than the treatment itself. The current study investigated if practice affects the accuracy and duration of performance on the repeatedly administered Concept Shifting Task modified to make it resistant to practice (mCST). The mCST was administered to 54 healthy participants twice a day, before and after a short break, for eight days. Results. The ANOVA and meta-analysis showed that there was no improvement in the mCST accuracy on the last vs. the first trial (Hedges' <it>g </it>= .14, <it>p </it>= .221) or within the session (after vs. before the break on all days; <it>g </it>= .01, <it>p </it>= .922). However, the participants performed the task faster on the last vs. the first trial (<it>g </it>= -.75, <it>p </it>< .001) and after vs. before the break on all days (<it>g </it>= -.12, <it>p </it>= .002). Conclusions. Repeated administration of the mCST does not affect the accuracy of performance on the test. However, practice might contribute to faster performance on the mCST over time and within each session.</p

It takes a community to conceive: an analysis of the scope, nature and accuracy of online sources of health information for couples trying to conceive

This study examined the nature and accuracy of information available across online platforms for couples trying to conceive. A consumer simulation-based investigation of English websites and social media (Facebook, Twitter, Instagram) was undertaken using common search terms identified in a pilot study. Claims about fertility and pregnancy health were then extracted from the results and analysed thematically. The accuracy of each claim was assessed independently by six fertility and conception experts, rated on a scale of 1 (not factual) to 4 (highly factual), with scores collated to produce a median rating. Claims with a medianscoreb3 were classified as inaccurate. The use of the terms 'trying to conceive' and '#TTC' were common identifiers on online platforms. Claims were extracted predominantly from websites (n= 89) rather than social media, with Twitter and Instagram comprising commercial elements and Facebook focused on community-based support. Thematic analysis revealed three major themes among the claims across all platforms: conception behaviour and monitoring, lifestyle and exposures, and medical. Fact-checking by the experts revealed that 40% of the information assessed was inaccurate, and that inaccuracies were more likely to be present in the conception behaviour and monitoring advice, the topics most amenable to modification. Since online information is a readily accessible and commonly utilized resource, there is opportunity for improved dissemination of evidence-based material to reach interested couples. Further cross-disciplinary and consumer-based research, such as a user survey, is required to understand how best to provide the 'trying to conceive' community with accurate information.Sophie G.E. Kedzior, Tina Bianco-Miotto, James Breen, Kerrilyn R. Diener, Martin Donnelley, Kylie R. Dunning Megan A.S. Penno, John E. Schjenken, David J. Sharkey, Nicolette A. Hodyl, Tod Fullston, Maria Gardiner, Hannah M. Brown, Alice R. Rumbol

A Discourse Analysis of Pilgrimage Reviews

This paper is the first to provide an account of the discursive features of online consumer reviews of pilgrimage sites. Drawing from pilgrimage studies and narrativity theory in consumer research, we explore how consumers communicate the spiritual and material aspects of pilgrimage experiences by examining a corpus of 833 consumer reviews on TripAdvisor of the most sacred pilgrimage sites of the world’s major five faith groups. Pilgrims include analytical discursive features to communicate the material aspect of their consumption experience. They reserve narration for spiritual transformation and the experience of strong emotions. Moreover, review ratings are only reflective of the spiritual aspect of their consumption experience. As such, our research complements previous studies by highlighting the material, physical aspect of this extraordinary consumption experience

Regional health inequalities in Australia and social determinants of health: analysis of trends and distribution by remoteness

Rural and remote areas have a higher burden of disease, leading to inequalities in health between regional and urban areas. This article compares trends in health status and social determinants of health (SDH) in capital cities and the remaining areas of (rest of) states and territories in Australia, and examines the distribution of health and social determinants between metropolitan, inner regional, outer regional, rural and remote areas. Methods: We conducted an ecological analysis of Public Health Information Development Unit data for Australian capital cities, the rest of states and territories, and local government areas (LGAs). Trends in inequalities in capital cities and the rest of states and territories (regional, rural and remote) from 1986 to 2018 were assessed using the slope index of inequality. Data for 538 LGAs were classified into remoteness categories and scatterplots produced to assess differences in health and SDH both between and within remoteness categories. Results: Our analysis of trends found that premature and avoidable mortality and infant mortality decreased in all socioeconomic quintiles outside of capital cities. However, inequality in socioeconomic area disadvantage increased for premature and avoidable mortality. There were mixed trends in terms of SDH: higher increases in full-time participation in secondary education and internet access in the most disadvantaged quintiles led to decreases in inequality in urban and non urban areas. Inequality increased outside capital cities for income indicators, rental stress and labour force participation due to higher proportional gains for areas within the least disadvantaged quintile of area disadvantage. Inequality was higher in capital cities compared to the rest of states and territories in 2016 for rental and mortgage stress, welfare-dependent families and participation in tertiary education. It was higher in the rest of states and territories compared to capital cities for premature and avoidable mortality, labour force participation and internet access. We found that while rural and remote areas had worse health and SDH on average, there was heterogeneity in premature and avoidable mortality and SDH for outer regional, remote and very remote LGAs. Conclusion: Increasing inequality in health and SDH in outer regional, rural and remote areas underscores the ways in which health inequalities strongly correlate with inequalities in SDH. Variation in health and SDH within non-metropolitan areas suggests it may not be appropriate to clump regions and towns together when conducting analysis in Australia. Policies to improve rural and remote health need to enhance existing provisions of social and health infrastructure, with context-specific measures to reduce these health inequalities.Joanne Flavel, Sophie GE Kedzior, Vivian Isaac, Darryl Cameron, Fran Bau