Ties that bind: Young people, community and social capital in the wake of the pandemic.

The connection that young people have to their local neighbourhood and community has been shown to impact on health and wellbeing, particularly for those living in the most deprived areas. We report on a qualitative participatory study using photo elicitation methods undertaken in three deprived neighbourhoods across London exploring concepts of community and social connection, with young people aged 13–24 years, against the backdrop of the COVID-19 pandemic. The construct of social capital, referring to the extent of solidarity and connection between groups, has been shown to impact on pandemic related outcomes, and is used in this study as a lens to enhance understanding of young people's experience of the pandemic. Young people created heterogenous physical social ties across class, ethnicity, and geographical area which were important during the pandemic, although these may be jeopardised by a range of factors including fear of violence, mistrust of those in power, parental control and place-based inequity. The isolation and localism enforced by the pandemic encouraged young people to pay more attention to the value of local connections they built up both with people and place. Place-based research needs to continue a dialogue with young people, acknowledging and drawing on existing networks, community assets and cultural beliefs. The impact of COVID-19 on accentuating existing inequalities means that the need for place-based action, addressing the social determinants of health and involving the experiences and input of the young, is more vital than ever

Peer support for discharge from inpatient mental health care versus care as usual in England (ENRICH): a parallel, two-group, individually randomised controlled trial.

BACKGROUND: High numbers of patients discharged from psychiatric hospital care are readmitted within a year. Peer support for discharge has been suggested as an approach to reducing readmission post-discharge. Implementation has been called for in policy, however, evidence of effectiveness from large rigorous trials is missing. We aimed to establish whether peer support for discharge reduces readmissions in the year post-discharge. METHODS: We report a parallel, two-group, individually randomised, controlled superiority trial, with trial personnel masked to allocation. Patients were adult psychiatric inpatients (age ≥18 years) with at least one previous admission in the preceding 2 years, excluding those who had a diagnosis of any organic mental disorder, or a primary diagnosis of learning disability, an eating disorder, or drug or alcohol dependency, recruited from seven state-funded mental health services in England. Patients were randomly assigned (1:1) to the intervention (peer support plus care as usual) or control (care as usual) groups by an in-house, online randomisation service, stratified by site and diagnostic group (psychotic disorders, personality disorders, and other eligible non-psychotic disorders) with randomly permuted blocks of randomly varying length to conceal the allocation sequence and achieve the allocation ratio. The peer support group received manual-based, one-to-one peer support, focused on building individual strengths and engaging with activities in the community, beginning during the index admission and continuing for 4 months after discharge, plus care as usual. Care as usual consisted of follow-up by community mental health services within 7 days of discharge. The primary outcome was psychiatric readmission 12 months after discharge (number of patients readmitted at least once), analysed on an intention-to-treat basis. All patients were included in a safety analysis, excluding those who withdrew consent for use of their data. The trial is registered with the ISRCTN registry, ISRCTN10043328. The trial was complete at the time of reporting. FINDINGS: Between Dec 1, 2016, and Feb 8, 2019, 590 patients were recruited and randomly assigned, with 294 allocated to peer support (287 included in the analysis after withdrawals and loss to follow-up), and 296 to care as usual (291 in the analysis). Mean age was 39·7 years (SD 13·7; range 18-75). 306 patients were women, 267 were men, three were transgender, and two preferred not to say. 353 patients were White, 94 were Black, African, Caribbean, or Black British, 68 were Asian or Asian British, 48 were of mixed or multiple ethnic groups, and 13 were of other ethnic groups. In the peer support group, 136 (47%) of 287 patients were readmitted at least once within 12 months of discharge. 146 (50%) of 291 were readmitted in the care as usual group. The adjusted risk ratio of readmission was 0·97 (95% CI 0·82-1·14; p=0·68), and the adjusted odds ratio for readmission was 0·93 (95% CI 0·66-1·30; p=0·68). The unadjusted risk difference was 0·03 (95% CI -0·11 to 0·05; p=0·51) in favour of the peer support group. Serious adverse events were infrequent (67 events) and similar between groups (34 in the peer support group, 33 in the care as usual group). Threat to life (self-harm) was the most common serious adverse event (35 [52%] of 67 serious adverse events). 391 other adverse events were reported, with self-harm (not life threatening) the most common (189 [48%] of 391). INTERPRETATION: One-to-one peer support for discharge from inpatient psychiatric care, plus care as usual, was not superior to care as usual alone in the 12 months after discharge. This definitive, high-quality trial addresses uncertainty in the evidence base and suggests that peer support should not be implemented to reduce readmission post-discharge for patients at risk of readmission. Further research needs to be done to improve engagement with peer support in high-need groups, and to explore differential effects of peer support for people from different ethnic communities. FUNDING: UK National Institute for Health Research

Y dychymyg ôl-fodern: agweddau ar ffuglen fer Mihangel Morgan

Cyfrol arbrofol o feirniadaeth greadigol yw hon, sy’n cynnig golwg ffres ar ffuglen fer y llenor nodedig Mihangel Morgan (1955–). Hon yw’r astudiaeth estynedig gyntaf o’i waith, a rhoddir sylw penodol i’r wyth cyfrol o ffuglen fer a gyhoeddodd rhwng 1992 a 2017 – cyfnod lle gwelwyd datblygiadau arwyddocaol ym maes rhyddiaith Gymraeg. Eir i’r afael â phynciau megis ffurf y stori fer, realaeth, moderniaeth ac ôl-foderniaeth, a thrwy osod gwaith Mihangel Morgan yn ganolbwynt i’r astudiaeth cynigir golwg ehangach ar ddatblygiad a derbyniad ffuglen fer ôl-fodernaidd Gymraeg a’i harwyddocâd i’n diwylliant llenyddol. Arbrofir yma am y tro cyntaf yn y Gymraeg â beirniadaeth lenyddol ar ffurf ffuglen academaidd er mwyn archwilio’r ffin dybiedig rhwng ‘ffaith’ a ‘ffuglen’. Dilynir hynt a helynt y cymeriad ffuglennol Dr Mari Non yn ei swydd brifysgol, law yn llaw â thrafodaeth ar ddarnau o ffuglen fer Mihangel Morgan, gan agor y drws ar ddeongliadau newydd o waith yr awdur. [This is an experimental volume of creative criticism, which offers a fresh look at the short fiction of the famous writer Mihangel Morgan (1955-). This is the first extended study of his work, and particular attention will be given to the eight volumes of short fiction he published between 1992 and 2017 - a period during which significant developments in the field of Welsh prose were seen. Topics such as short story form, realism, modernity and postmodernism are addressed, and by placing Mihangel Morgan's work at the center of the study offers a broader view of the development and acceptance of Welsh postmodern short fiction and its significance to our literary culture. Experiment here for the first time in Welsh and literary criticism in the form of academic fiction in order to explore the presumed boundary between 'fact' and 'fiction'. The adventures of fictional character Dr Mari Non in her university post are followed by discussion of pieces of Mihangel Morgan's short fiction, opening the door to new interpretations of the author's work.

Crefft y Stori Fer Heddiw [Educational Resource]

Educational resource focused on the Welsh short story

Y dychymyg ôl-fodern: agweddau ar ffuglen fer Mihangel Morgan

Cyfrol arbrofol o feirniadaeth greadigol yw hon, sy’n cynnig golwg ffres ar ffuglen fer y llenor nodedig Mihangel Morgan (1955–). Hon yw’r astudiaeth estynedig gyntaf o’i waith, a rhoddir sylw penodol i’r wyth cyfrol o ffuglen fer a gyhoeddodd rhwng 1992 a 2017 – cyfnod lle gwelwyd datblygiadau arwyddocaol ym maes rhyddiaith Gymraeg. Eir i’r afael â phynciau megis ffurf y stori fer, realaeth, moderniaeth ac ôl-foderniaeth, a thrwy osod gwaith Mihangel Morgan yn ganolbwynt i’r astudiaeth cynigir golwg ehangach ar ddatblygiad a derbyniad ffuglen fer ôl-fodernaidd Gymraeg a’i harwyddocâd i’n diwylliant llenyddol. Arbrofir yma am y tro cyntaf yn y Gymraeg â beirniadaeth lenyddol ar ffurf ffuglen academaidd er mwyn archwilio’r ffin dybiedig rhwng ‘ffaith’ a ‘ffuglen’. Dilynir hynt a helynt y cymeriad ffuglennol Dr Mari Non yn ei swydd brifysgol, law yn llaw â thrafodaeth ar ddarnau o ffuglen fer Mihangel Morgan, gan agor y drws ar ddeongliadau newydd o waith yr awdur. [This is an experimental volume of creative criticism, which offers a fresh look at the short fiction of the famous writer Mihangel Morgan (1955-). This is the first extended study of his work, and particular attention will be given to the eight volumes of short fiction he published between 1992 and 2017 - a period during which significant developments in the field of Welsh prose were seen. Topics such as short story form, realism, modernity and postmodernism are addressed, and by placing Mihangel Morgan's work at the center of the study offers a broader view of the development and acceptance of Welsh postmodern short fiction and its significance to our literary culture. Experiment here for the first time in Welsh and literary criticism in the form of academic fiction in order to explore the presumed boundary between 'fact' and 'fiction'. The adventures of fictional character Dr Mari Non in her university post are followed by discussion of pieces of Mihangel Morgan's short fiction, opening the door to new interpretations of the author's work.