Facilitators and Barriers to Person-centred Care in Child and Young People Mental Health Services: A Systematic Review

Implementation of person-centred care has been widely advocated across various health settings and patient populations, including recent policy for child and family services. Nonetheless, evidence suggests that service users are rarely involved in decision-making, whilst their preferences and goals may be often unheard. The aim of the present research was to systematically review factors influencing person-centred care in mental health services for children, young people and families examining perspectives from professionals, service users and carers. This was conducted according to best practice guidelines, and seven academic databases were searched. Overall, 23 qualitative studies were included. Findings from the narrative synthesis of the facilitators and barriers are discussed in light of a recently published systematic review examining person-centred care in mental health services for adults. Facilitators and barriers were broadly similar across both settings. Training professionals in person-centred care, supporting them to use it flexibly to meet the unique needs of service users whilst also being responsive to times when it may be less appropriate and improving both the quantity and quality of information for service users and carers are key recommendations to facilitate person-centred care in mental health services with children, young people and families

How mothers feel: validation of a measure of maternal mood

© 2019 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd Rationale: Low mood may affect developing relationships with a new baby, partner and family. Early identification of mood disturbance is crucial to improve outcomes for women perinatally. Instruments such as the Edinburgh Postnatal Depression Scale (EPDS) are used routinely, with evidence that some women do not feel comfortable with how they are asked about their mental health. Objective: To develop a mood checklist as a user-friendly, effective measure of well-being in post-partum women, for use by health professionals. Methods: Cognitive interviews with women who had recently given birth assessed response format and face validity of a prototype measure. A cross-sectional survey followed. A random split-half instrument development protocol was used. Exploratory factor analysis determined factor structure with the first sample,. The second sample confirmed factor structure and evaluationof key psychometric variables and known-groups discriminant validity (KGDV), requiring a supplementary between-subjects design with stratification based on case negative/case positive classification using EPDSscreening cut-off criteria. Results: Cognitive interview data confirmed the face validity of the measure. Exploratory factor analysis indicated an 18 item two-factor model with two (negatively) correlated factors. Factor 1 loaded with items reflecting positive mood and factor 2 negative items. Confirmatory factor analysis showed a good fit to the two-factor model across the full spectrum of fit indices. Statistically significant differences between groups were observed in relation to as EPDS caseness classification. Cronbach alpha coefficients for the positive and negative subscales revealed acceptable internal consistency of 0.79 and 0.72, respectively. Conclusion: The outcome checklist may be appropriate for use in clinical practice. It demonstrated effective psychometric properties and clear cross-validation with existing commonly used measures

Risk-shifting Through Issuer Liability and Corporate Monitoring

This article explores how issuer liability re-allocates fraud risk and how risk allocation may reduce the incidence of fraud. In the US, the apparent absence of individual liability of officeholders and insufficient monitoring by insurers under-mine the potential deterrent effect of securities litigation. The underlying reasons why both mechanisms remain ineffective are collective action problems under the prevailing dispersed ownership structure, which eliminates the incentives to moni-tor set by issuer liability. This article suggests that issuer liability could potentially have a stronger deterrent effect when it shifts risk to individuals or entities holding a larger financial stake. Thus, it would enlist large shareholders in monitoring in much of Europe. The same risk-shifting effect also has implications for the debate about the relationship between securities litigation and creditor interests. Credi-tors’ claims should not be given precedence over claims of defrauded investors (e.g., because of the capital maintenance principle), since bearing some of the fraud risk will more strongly incentivise large creditors, such as banks, to monitor the firm in jurisdictions where corporate debt is relatively concentrated

The limits of inter-religious dialogue and the form of football rituals: The case of Bosnia-Herzegovina

The difficulties with interfaith dialogue are linked, at least in part, to the lack of ritual forms (consisting of rules, ceremonial idioms, liturgy, and repertoires of action) designed to unite and integrate the "meta-group "formed by the various religious communities. By means of ethnographic research conducted in Bosnia-Herzegovina, the author studied the mechanisms with which, under particular conditions, some forms of collective ritual were able to create opportunities for the re-integration of the Bosnian population, which had been profoundly divided after the terrible war of 199295. Comparing the forms of religious rituals and those of sports ritualsin particular, of football ritualsthe author develops some considerations that can be applied to the general debate about inter-religious dialogue. The comparison brings to light some of the limits and difficulties that religious institutions encounter in giving life to an interfaith dialogue that directly and concretely involves the members of different communities. © 2007 Social Compass

Law Professor Comment Letter on Harmonization of Private Offering Rules

Comment letter filed on Sept. 24, 2019. File No. S7-08-19 We are fifteen law professors whose scholarship and teaching focuses on securities regulation. We appreciate the opportunity to comment on the U.S. Securities and Exchange Commission’s (“SEC” or the “Commission”) Concept Release on Harmonization of Securities Offering Exemptions (the “Concept Release”)

Phospholipid Composition Modulates Carbon Nanodiamond-Induced Alterations in Phospholipid Domain Formation

This document is the Accepted Manuscript version of a Published Work that appeared in final form in Langmuir, copyright © American Chemical Society after peer review and technical editing by the publisher. To access the final edited and published work see http://doi.org/10.1021/la504923j.The focus of this work is to elucidate how phospholipid composition can modulate lipid nanoparticle interactions in phospholipid monolayer systems. We report on alterations in lipid domain formation induced by anionically engineered carbon nanodiamonds (ECNs) as a function of lipid headgroup charge and alkyl chain saturation. Using surface pressure vs area isotherms, monolayer compressibility, and fluorescence microscopy, we found that anionic ECNs induced domain shape alterations in zwitterionic phosphatidylcholine lipids, irrespective of the lipid alkyl chain saturation, even when the surface pressure vs area isotherms did not show any significant changes. Bean-shaped structures characteristic of dipalmitoylphosphatidylcholine (DPPC) were converted to multilobed, fractal, or spiral domains as a result of exposure to ECNs, indicating that ECNs lower the line tension between domains in the case of zwitterionic lipids. For membrane systems containing anionic phospholipids, ECN-induced changes in domain packing were related to the electrostatic interactions between the anionic ECNs and the anionic lipid headgroups, even when zwitterionic lipids are present in excess. By comparing the measured size distributions with our recently developed theory derived by minimizing the free energy associated with the domain energy and mixing entropy, we found that the change in line tension induced by anionic ECNs is dominated by the charge in the condensed lipid domains. Atomic force microscopy images of the transferred anionic films confirm that the location of the anionic ECNs in the lipid monolayers is also modulated by the charge on the condensed lipid domains. Because biological membranes such as lung surfactants contain both saturated and unsaturated phospholipids with different lipid headgroup charges, our results suggest that when studying potential adverse effects of nanoparticles on biological systems the role of lipid compositions cannot be neglected

Childhood trauma and cognitive functioning in individuals at clinical high risk (CHR) for psychosis

Evidence suggests that early trauma may have a negative effect on cognitive functioning in individuals with psychosis, yet the relationship between childhood trauma and cognition among those at clinical high risk (CHR) for psychosis remains unexplored. Our sample consisted of 626 CHR children and 279 healthy controls who were recruited as part of the North American Prodrome Longitudinal Study 2. Childhood trauma up to the age of 16 (psychological, physical, and sexual abuse, emotional neglect, and bullying) was assessed by using the Childhood Trauma and Abuse Scale. Multiple domains of cognition were measured at baseline and at the time of psychosis conversion, using standardized assessments. In the CHR group, there was a trend for better performance in individuals who reported a history of multiple types of childhood trauma compared with those with no/one type of trauma (Cohen d = 0.16). A history of multiple trauma types was not associated with greater cognitive change in CHR converters over time. Our findings tentatively suggest there may be different mechanisms that lead to CHR states. Individuals who are at clinical high risk who have experienced multiple types of childhood trauma may have more typically developing premorbid cognitive functioning than those who reported minimal trauma do. Further research is needed to unravel the complexity of factors underlying the development of at-risk states

Interview investigation of insecure attachment styles as mediators between poor childhood care and schizophrenia-spectrum phenomenology

Background Insecure attachment styles have received theoretical attention and some initial empirical support as mediators between childhood adverse experiences and psychotic phenomena; however, further specificity needs investigating. The present interview study aimed to examine (i) whether two forms of poor childhood care, namely parental antipathy and role reversal, were associated with subclinical positive and negative symptoms and schizophrenia-spectrum personality disorder (PD) traits, and (ii) whether such associations were mediated by specific insecure attachment styles. Method A total of 214 nonclinical young adults were interviewed for subclinical symptoms (Comprehensive Assessment of At-Risk Mental States), schizophrenia-spectrum PDs (Structured Clinical Interview for DSM-IV Axis II Disorders), poor childhood care (Childhood Experience of Care and Abuse Interview), and attachment style (Attachment Style Interview). Participants also completed the Beck Depression Inventory-II and all the analyses were conducted partialling out the effects of depressive symptoms. Results Both parental antipathy and role reversal were associated with subclinical positive symptoms and with paranoid and schizotypal PD traits. Role reversal was also associated with subclinical negative symptoms. Angry-dismissive attachment mediated associations between antipathy and subclinical positive symptoms and both angry-dismissive and enmeshed attachment mediated associations of antipathy with paranoid and schizotypal PD traits. Enmeshed attachment mediated associations of role reversal with paranoid and schizotypal PD traits. Conclusions Attachment theory can inform lifespan models of how adverse developmental environments may increase the risk for psychosis. Insecure attachment provides a promising mechanism for understanding the development of schizophrenia-spectrum phenomenology and may offer a useful target for prophylactic intervention

The politics of performance: transnationalism and its limits in former Yugoslav popular music, 1999–2004

This paper examines transnational relations between the Yugoslav successor states from the point of view of popular music, and demonstrates how transnational musical figures (such as Djordje Balaševi?, Mom?ilo Bajagi?-Bajaga and Ceca Ražnatovi?) are interpreted as symbolic reference points in national ethnopolitical discourse in the process of identity construction. Another symbolic function is served by Serbian turbofolk artists, who in Croatia serve as a cultural resource to distance oneself from a musical genre associated by many urban Croats with the ruralization (and Herzegovinization) of Croatian city space. In addition, value judgements associated with both Serbian and Croatian newly composed folk music provide an insight into the transnational negotiation of conflicting identities in the ex-Yugoslav context. Ultimately the paper shows how the ethnonational boundaries established by nationalizing ideologies created separate cultural spaces which themselves have been transnationalized after Yugoslavia's disintegration