The link between mental health, social and emotional vulnerability and life chances: school based early identification of socially and emotionally vulnerable adolescents in a deprived urban community

The objectives of this work are to:- Explore the concept of adolescent vulnerability;- Establish easily administered, reliable means of early identification of the most vulnerable; and- Suggest some school level interventions.This research focuses on adolescents in a socially deprived area. The thesis contains two parts:Part I explores the theoretical contexts, examining the social, educational and moral climate, and concludes that potential vulnerability is not being identified early enough in young people's lives for effective interventions to be implemented. The phenomenon and experience of adolescence is explored from a variety of perspectives, and various definitions of adolescence examined. The broad range of experience representing both typical and atypical adolescence is considered.A range of socio-economic factors and psychometric measures are reviewed for potential use as early indicators of vulnerability. The four screening measures chosen from the range reviewed are social deprivation, selfesteem, locus of control (LoC) and coping strategies. Social deprivation indicators establish background levels of life chances and prospects. Selfesteem is used to identify the most vulnerable; locus of control adds information about the nature of their vulnerability, and coping strategies informs potential practical interventions.Part 2 focuses on practical research. The prospects of the subject population are explored using a range of indicators, including the social and educational alienation and dysfunction of its young adolescents. Six hypotheses are defined and the selected psychometric tools piloted and administered on all of Year 7 of the subject school. Pupils are identified as either vulnerable or not identifiably vulnerable. Case studies using semi-structured interviews are conducted, adding a qualitative, experiential dimension to the statistical, psychometric findings.Based on this research conclusions are drawn which have academic application and directly inform practical interventions which, if implemented in early adolescence, would potentially alleviate the identified vulnerability

Integrated landscapes of home and neighbourhood: ageing well in urban Australia

The desire for older people to age in place in an intergenerational community is widely recognised. While the literature has long affirmed the link between the biopsychosocial benefits of nature and well-being, there is a gap in the people-environment literature about the needs and aspirations of older people and the impact that health and functional limitation may have on ageing well in place. As home is integral to and inseparable from the neighbourhood, it is essential that locale be considered in context. This qualitative study explores the perceptions of a group of older Australians living independently in the community. Between 2008 and 2010, 30 self-selected individuals (24 females and six males), 65 to 92 years of age, living in suburbs of Sydney, Australia, participated in semi-structured in-depth interviews at their homes. These interviews encompassed a broad-ranging discussion about their experiences of their local environments, including views to the outside to the transitional areas of the home garden and beyond into the neighbourhood. Following the one-on-one interviews, an optional, open-ended mobile interview into the neighbourhood was conducted with most of the participants, either on foot or by motorised mobility scooter (MMS). In addition, a visual method, still colour photography, was used to capture the features discussed and to document the neighbourhood environment. The overarching theme for ageing well at home was found to encompass amenity of place integrated with neighbourhood landscape affordance, which provides an inclusive landscape in everyday life. Neighbourhood amenity is dependent on a predominance of urban nature which in turn, contributes to scenic landscape. This was found to encourage older people to engage in repeated discretionary or optional activity outside of the dwelling. An unexpected outcome was the identification of four mobility-related personas, which are constellations of characteristics representative of my sample of participants who were the focus of my qualitative research. Use of these four personas will enable future researchers to study landscape in relation to older people and will inform the planning and design of residential environments which support healthy ageing in place

Food provisioning and the domestic food handling practices of the over 60s in the North East of England

PhD ThesisOver the last decade there has been an unexplained increase in cases of listeriosis in the UK observed almost exclusively in those aged over 60 (SSRC, 2009, ACMSF, 2009). Domestic food safety practices have been hypothesised as one contributing factor to this increase (SSRC, 2009), and this research was funded to explore these practices in more detail. Using the North East of England as the geographical focus for the research, a mixed method approach was chosen using a complement of traditional and innovative research methods in a two-phase approach. Phase 1 was a large-scale administered questionnaire (n=213), designed to profile independently residing older adults (aged 60+) based upon their knowledge of, and reported practices associated with, domestic food safety. Factor and cluster analyses revealed a 3-cluster solution, which provided the basis for detailed narrative typologies of the clusters which were labelled i) ‘Independent Self- assessors’ ii) ‘Experienced Dismissers’ and iii) ‘Compliant Minimalists’ These findings highlighted the heterogeneity of the 60+ population with respect to their living and health circumstances, social networks and their food safety knowledge and behavioural practices. The risk of foodborne illness was not identified as linear with age, rather levels of vulnerability to foodborne risks varied across the cohort. Phase 2 purposively sampled 10 households from Phase 1 for an ethnographically inspired study (EIS), which took a Social Practice Theory perspective to observe domestic food handling practices. Data were generated using life-course interviews fridge auditing including microbiological sampling kitchen ‘go-alongs’ food purchase history, activity recognition and video documentation. In addition to confirming the findings of Phase 1, the substantive theoretical contribution of Phase 2 was the concept of ‘Independence Transitioning’. Food provisioning practices were the observed outcome of the value negotiations made by the household to adapt to the incremental changes experienced as part of the ageing process that facilitated independent living. Although food safety issues were XXV implicit within these practices, they were not a salient factor within food provisioning or handling. This was therefore concluded to compound their risk of contracting illness as a result of foodborne disease

Preadolescent children's perception of power imbalance in bullying: A thematic analysis

Bullying in schools is associated with an extensive public health burden. Bullying is intentional and goal oriented aggressive behavior in which the perpetrator exploits an imbalance of power to repeatedly dominate the victim. To differentiate bullying from aggressive behavior, assessment must include a valid measure of power imbalance as perceived by the victim. And yet, to date, there remains no agreement as to how to most accurately measure power imbalance among preadolescent children. This qualitative study explored children's (age 9 to 11) understanding of power imbalance through thematic analysis of focus group discussions. Subthemes that emerged as influencing power imbalance include: Age of victim, peer valued characteristics, and group membership and position. Subthemes of empathy and peer valued characteristics emerged as protecting against the negative impact of power imbalance

Tl’azt’en Learning Circle: Information Technology, Health and Cultural Preservation

A Community Learning Centre (CLC) is an innovative model of delivering health care and health information based firmly on the idea of community engagement. It has two interrelated components: 1) a community-based facility with Internet-linked computers accessible to all community members; and 2) community developed web-based resources relevant to community defined needs and priorities. This article describes a pilot CLC implementation in a remote British Columbia First Nations community. A CLC supports the acquisition of health information as well as research and technology skills by facilitating access to, and uptake of, relevant resources developed by and for community members

Developing generic online tutorials as a strategy for extending the use of WebCT

This paper is a progress report on the design and delivery of two short WebCT tutorials for students, as part of a wider strategy to encourage further use of online learning within the University. The tutorials address issues of concern to the Department and to the Higher Education community as a whole: the indiscriminate use of Internet resources by students, poor acknowledgement of sources and inaccurate citation practice. The various stages of design and delivery, as informed by guidance in action research methods are described. Issues surrounding the use of WebCT, including interactivity and accessibility, are discussed and some preliminary results of student evaluations and learning experiences are presented

Perinatal risk factors for Developmental Coordination Disorder

The aetiology of mild motor disability (MMD) is a complex issue and as yet is poorly understood. The aim of this study was to identify the prevalence of perinatal risk factors in a cohort of 10-year-old boys and girls with (n = 362) and without (n = 1193) MMD. Among the males with MMD there was a higher prevalence of postpartum haemorrhage, caesarean section, low birth weight and stressful first year of life. Among the females with MMD, there was a higher prevalence of essential hypertension, anaemia, and threatened pre-term. Multivariable logistic regression revealed gender (male), anaemia, threatened pre-term birth (if female), and hypertension (if female) weakly explained MMD at 10 years. These results underscore the importance of considering gender differences in order to better understand the multiple influences on motor development

Evaluating the use of a population measure of child development in the Healthy Child Programme Two Year Review

Aims and Objectives The overall aim of this study was to inform the use of ASQ-3™ and of ASQ:SE in the Healthy Child Programme two year review which in turn is intended to contribute to overall improved outcomes for children and their families. Aim To explore the acceptability and understanding of the ASQ-3 and ASQ:SE as measures of child development as part of the Healthy Child Programme two year review among health professionals and parents. Objectives 1. To determine the acceptability of ASQ-3 and ASQ:SE among parents of children who have had a HCP a two year review. 2. To investigate parents’ understanding of ASQ-3 and ASQ:SE used as part of the 2 year review. 3. To determine the acceptability of ASQ-3 and ASQ:SE among health professionals using the measures as part of the HCP two year review. 4. To investigate health professionals’ understanding of ASQ-3 and ASQ:SE as part of the two year review. Methods Four study sites known to be currently using ASQ-3 as part of the HCP two year review were selected to reflect differences in geography and in socio-demographic characteristics of the population. A mixed methods approach was taken and data were collected from 153 parents of children who were due their HCP two year review and 126 health professionals conducting two year reviews using survey questionnaires. Twelve focus groups involving 85 health professionals were conducted, 40 parents interviewed individually and 12 HCP two year reviews observed. Findings The key findings were: ? In general, most parents and HPs accepted the ASQ-3 as a measure that provides useful information about a child’s development at two years. ? Parents and HPs were less certain that ASQ:SE could provide an accurate assessment of social and emotional development. ? Parents enjoyed and found it valuable to observe their own child and make their own observations prior to an assessment visit either in a clinic or at home. ? Parents and HPs were positive about the opportunity to work in partnership in relation to the child’s development. ? There was wide variation both across and within the areas studied as to how the ASQ-3 was used (home, clinic, with parents, put to one side, scored differently, health visitor or community nursery nurse, referrals and re-reviews etc.) ? There was considerable variation around the preparation and training for the ASQ-3 and ASQ:SE amongst HPs. ? There was some evidence of confusion about the purpose of the ASQ-3, namely whether it was for screening developmental delay or for use as an assessment tool. ? There was misunderstanding and criticism of some of the individual questions, especially where there was use of American vocabulary or activities that did not make sense to parents or HPs and also misunderstanding of the possible responses. ? There was evidence of misunderstanding of the scoring of the ASQ-3, potentially leading to over- or under- reporting of developmental delay. ? There were problems in the reporting of the scores and the assessment related to time availability, access to a suitable electronic record system such as RIO, access to computers and internet, over-reliance on hard copy and reporting scores in the Personal Child Health Record (PCHR). ? There was some evidence of variation in practice in making referrals for speech and language or paediatric assessment