305 research outputs found
Developing a model of mental health self-care support for children and young people through an integrated evaluation of available types of provision involving systematic review, meta-analysis and case study
Background
The mental health of children and young people (CYP) is a major UK public health concern. Recent policy reviews have identified that service provision for CYP with mental health needs is not as effective, responsive, accessible or child-centred as it could be. Following on from a previous National Institute for Health Research (NIHR) study into self-care support for CYP with long-term physical health needs, this study explored self-care support’s potential in CYP’s mental health.
Objectives
To identify and evaluate the types of mental health self-care support used by, and available to, CYP and their parents, and to establish how such support interfaces with statutory and non-statutory service provision.
Design
Two inter-related systematic literature reviews (an effectiveness review with meta-analysis and a perceptions review), together with a service mapping exercise and case study.
Setting
Global (systematic reviews); England and Wales (mapping exercise and case study).
Participants (case study)
Fifty-two individuals (17 CYP, 16 family members and 19 staff) were interviewed across six sites.
Main outcome measures (meta-analysis)
A measure of CYP’s mental health symptomatology.
Data sources (literature reviews)
MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, All Evidence-Based Medicine (EBM) Reviews, Applied Social Sciences Index and Abstracts (ASSIA) and Education Resources Information Center (ERIC).
Review methods
Titles and abstracts of papers were screened for relevance then grouped into studies. Two independent reviewers extracted data from studies meeting the inclusion criteria. A descriptive analysis and meta-analysis were conducted for the effectiveness review; descriptive analyses were conducted for the perceptions review. These analyses were integrated to elicit a mixed-methods review.
Results
Sixty-five of 71 included studies were meta-analysable. These 65 studies elicited 71 comparisons which, when meta-analysed, suggested that self-care support interventions were effective at 6-month [standardised mean difference (SMD) = −0.20; 95% confidence interval (CI) −0.28 to −0.11] and 12-month (SMD = −0.12; 95% CI −0.17 to −0.06) follow-ups. However, judged against Cochrane criteria, the studies were mostly low quality. Key elements of self-care support identified in the perceptions review were the acquisition of knowledge and skills, peer support and the relationship with the self-care support agent; CYP also had different perceptions from adults about what is important in self-care support. The mapping exercise identified 27 providers of 33 self-care support services. According to the case study data, effective self-care support services are predicated on flexibility; straightforward access; non-judgemental, welcoming organisations and staff; the provision of time and attention; opportunities to learn and practise skills relevant to self-care; and systems of peer support.
Conclusions
Mental health self-care support interventions for CYP are modestly effective in the short to medium term. Self-care support can be conceptualised as a process which has overlap with ‘recovery’. CYP and their families want choice and flexibility in the provision of such interventions and a continued relationship with services after the nominal therapy period. Those delivering self-care support need to have specific child-centred attributes.
Future work
Future work should focus on under-represented conditions (e.g. psychosis, eating disorders, self-harm); the role of technology, leadership and readiness in self-care support; satisfaction in self-care support; the conceptualisation of self-care support in CYP’s mental health; and efficacy and cost-effectiveness
Taking Action Together: A YMCA-based protocol to prevent Type-2 Diabetes in high-BMI inner-city African American children
<p>Abstract</p> <p>Background</p> <p>Associated with a tripling in obesity since 1970, type 2 diabetes mellitus (T2DM) in children has risen 9-10 fold. There is a critical need of protocols for trials to prevent T2DM in children.</p> <p>Methods/Design</p> <p>This protocol includes the theory, development, evaluation components and lessons learned from a novel YMCA-based T2DM prevention intervention designed specifically for high-BMI African American children from disadvantaged, inner-city neighborhoods of Oakland, California. The intervention was developed on the basis of: review of epidemiological and intervention studies of pediatric T2DM; a conceptual theory (social cognitive); a comprehensive examination of health promotion curricula designed for children; consultation with research, clinical experts and practitioners and; input from community partners. The intervention, <it>Taking Action Together</it>, included culturally sensitive and age-appropriate programming on: healthy eating; increasing physical activity and, improving self esteem.</p> <p>Discussion</p> <p>Evaluations completed to date suggest that <it>Taking Action Together </it>may be an effective intervention, and results warrant an expanded evaluation effort. This protocol could be used in other community settings to reduce the risk of children developing T2DM and related health consequences.</p> <p>Trial registration</p> <p>ClinicalTrials.gov NCT01039116.</p
Beam-target helicity asymmetry for γ→n→→π−p in the N*resonance region
We report the first beam-target double-polarization asymmetries in the γ þ nðpÞ → π− þ pðpÞ reaction
spanning the nucleon resonance region from invariant mass W ¼ 1500 to 2300 MeV. Circularly polarized
photons and longitudinally polarized deuterons in solid hydrogen deuteride (HD) have been used with the
CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab. The exclusive final state has been
extracted using three very different analyses that show excellent agreement, and these have been used to
deduce the E polarization observable for an effective neutron target. These results have been incorporated
into new partial wave analyses and have led to significant revisions for several γnN* resonance
photocouplings
First measurement of direct photoproduction on the proton
We report on the results of the first measurement of exclusive
meson photoproduction on protons for GeV and GeV. Data were collected with the CLAS detector at the Thomas
Jefferson National Accelerator Facility. The resonance was detected via its
decay in the channel by performing a partial wave analysis of the
reaction . Clear evidence of the meson
was found in the interference between and waves at GeV. The -wave differential cross section integrated in the mass range of
the was found to be a factor of 50 smaller than the cross section
for the meson. This is the first time the meson has been
measured in a photoproduction experiment
A Precise Measurement of the Neutron Magnetic Form Factor GMn in the Few-GeV2 Region
The neutron elastic magnetic form factor GMn has been extracted from
quasielastic electron scattering data on deuterium with the CEBAF Large
Acceptance Spectrometer (CLAS) at Jefferson Lab. The kinematic coverage of the
measurement is continuous from Q2=1 GeV2 to 4.8 GeV2. High precision was
achieved by employing a ratio technique in which many uncertainties cancel, and
by a simultaneous in-situ calibration of the neutron detection efficiency, the
largest correction to the data. Neutrons were detected using the CLAS
electromagnetic calorimeters and the time-of-flight scintillators. Data were
taken at two different electron beam energies, allowing up to four
semi-independent measurements of GMn to be made at each value of Q2. The dipole
parameterization is found to provide a good description of the data over the
measured Q2 range.Comment: 14 pages, 5 figures, revtex4, submitted to Physical Review Letters,
Revised version has changes recommended by journal referee
Could Direct Killing by Larger Dingoes Have Caused the Extinction of the Thylacine from Mainland Australia?
Invasive predators can impose strong selection pressure on species that evolved in their absence and drive species to extinction. Interactions between coexisting predators may be particularly strong, as larger predators frequently kill smaller predators and suppress their abundances. Until 3500 years ago the marsupial thylacine was Australia's largest predator. It became extinct from the mainland soon after the arrival of a morphologically convergent placental predator, the dingo, but persisted in the absence of dingoes on the island of Tasmania until the 20th century. As Tasmanian thylacines were larger than dingoes, it has been argued that dingoes were unlikely to have caused the extinction of mainland thylacines because larger predators are rarely killed by smaller predators. By comparing Holocene specimens from the same regions of mainland Australia, we show that dingoes were similarly sized to male thylacines but considerably larger than female thylacines. Female thylacines would have been vulnerable to killing by dingoes. Such killing could have depressed the reproductive output of thylacine populations. Our results support the hypothesis that direct killing by larger dingoes drove thylacines to extinction on mainland Australia. However, attributing the extinction of the thylacine to just one cause is problematic because the arrival of dingoes coincided with another the potential extinction driver, the intensification of the human economy
Twenty important research questions in microbial exposure and social equity
Social and political policy, human activities, and environmental change affect the ways in which microbial communities assemble and interact with people. These factors determine how different social groups are exposed to beneficial and/or harmful microorganisms, meaning microbial exposure has an important socioecological justice context. Therefore, greater consideration of microbial exposure and social equity in research, planning, and policy is imperative. Here, we identify 20 research questions considered fundamentally important to promoting equitable exposure to beneficial microorganisms, along with safeguarding resilient societies and ecosystems. The 20 research questions we identified span seven broad themes, including the following: (i) sociocultural interactions; (ii) Indigenous community health and well-being; (iii) humans, urban ecosystems, and environmental processes; (iv) human psychology and mental health; (v) microbiomes and infectious diseases; (vi) human health and food security; and (vii) microbiome-related planning, policy, and outreach. Our goal was to summarize this growing field and to stimulate impactful research avenues while providing focus for funders and policymakers
Momentum sharing in imbalanced Fermi systems
The atomic nucleus is composed of two different kinds of fermions, protons
and neutrons. If the protons and neutrons did not interact, the Pauli exclusion
principle would force the majority fermions (usually neutrons) to have a higher
average momentum. Our high-energy electron scattering measurements using 12C,
27Al, 56Fe and 208Pb targets show that, even in heavy neutron-rich nuclei,
short-range interactions between the fermions form correlated high-momentum
neutron-proton pairs. Thus, in neutron-rich nuclei, protons have a greater
probability than neutrons to have momentum greater than the Fermi momentum.
This finding has implications ranging from nuclear few body systems to neutron
stars and may also be observable experimentally in two-spin state, ultra-cold
atomic gas systems.Comment: Published in Science. 10 pages, 3 figure
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