Parental involvement: a grounded theory of the role of parents in adolescent help seeking for mental health problems

There is a high prevalence of mental health problems within adolescent populations, but they are unlikely to seek help. Adults, including parents are important within this help seeking process. The study therefore aimed to develop a theory of the influence of parents upon adolescent help seeking. Eighteen semi-structured interviews were conducted with adolescents, their parents and clinicians working within Child and Adolescent Mental Health Services (CAMHS). A grounded theory analysis allowed for the in-depth exploration of participants’ experiences. A model was developed identifying help seeking as a family journey. Parents were highly influential, and parents who were able to be more available to their adolescents tended to be more involved in the help seeking process. Other adults were utilised within the help seeking process. Once adolescents were engaged with the help seeking process they were often able to then seek further help independently. The findings suggest that consideration should be given to making services accessible to adolescents. CAMHS services should explore ways with adolescents to give control over parental involvement, and ways with parents to develop availability. Future research should consider the experiences of older and younger adolescents separately, and the transition into adult services

Supported discharge service versus Inpatient care Evaluation (SITE): a randomised controlled trial comparing effectiveness of an intensive community care service versus inpatient treatment as usual for adolescents with severe psychiatric disorders: self-harm, functional impairment, and educational and clinical outcomes.

Background: Clinical guidelines recommend intensive community care service treatment (ICCS) to reduce adolescent psychiatric inpatient care. We have previously reported that the addition of ICCS led to a substantial decrease in hospital use and improved school re-integration. Aim: To undertake a randomised controlled trial (RCT) comparing an inpatient admission followed by an early discharge supported by ICCS with usual inpatient admission (treatment as usual; TAU). In this paper, we report the impact of ICCS on self-harm and other clinical and educational outcomes. Method: 106 patients aged 12-18 admitted for psychiatric inpatient care were randomised (1:1) to either ICCS or TAU. Six months after randomization, we compared the two treatment arms on the number and severity of self-harm episodes, the functional impairment, severity of psychiatric symptoms, clinical improvement, reading and mathematical ability, weight, height and the use of psychological therapy and medication. Results: At six-month follow-up, there were no differences between the two groups on most measures. Patients receiving ICCS were significantly less likely to report multiple episodes (5 or more) of self-harm (OR=0·18, 95% CI: 0·05 to 0·64). Patients admitted to private inpatient units spent on average 118.4 (95% CI: 28·2 to 208.6) fewer days in hospitals if they were in the ICCS group compared to TAU. Conclusion: The addition of ICCS to TAU may lower the risk of multiple self-harm and may reduce the duration of inpatient stay, especially in those patients admitted for private care. Early discharge with ICCS appears to be a viable alternative to standard inpatient treatment

What can managers learn online? Investigating possibilities for active understanding in the online MBA classroom

Online MBAs have become integral to business schools’ portfolios and the number of MBA students opting for an online version looks set to grow. In the wake of well documented critiques of traditional MBA formats, this expansion prompted us to examine the potential for critically reflexive learning ideals in asynchronous MBA learning environments. Building the Community of Inquiry (CoI) model we elaborate elements of Bakhtin and Shotter’s dialogism to develop the notion of ‘active understanding’ as a means to study an online MBA classroom. We present two illustrative episodes to show how aspects of active understanding may unfold and we point to the role of infrastructure, curriculum and instructor interventions in developing more genuine dialogical exchanges. Our findings suggest that online MBA course designers can learn from CoI approaches to which we add that critically reflexive learning is situationally sensitive; requiring the capacity to create and recognize nuance and difference in the written communication; making the other the focus of learning. We conclude with implications for pedagogy and technology infrastructure

Search for Anisotropy of Ultra-High Energy Cosmic Rays with the Telescope Array Experiment

We study the anisotropy of Ultra-High Energy Cosmic Ray (UHECR) events collected by the Telescope Array (TA) detector in the first 40 months of operation. Following earlier studies, we examine event sets with energy thresholds of 10 EeV, 40 EeV, and 57 EeV. We find that the distributions of the events in right ascension and declination are compatible with an isotropic distribution in all three sets. We then compare with previously reported clustering of the UHECR events at small angular scales. No significant clustering is found in the TA data. We then check the events with E>57 EeV for correlations with nearby active galactic nuclei. No significant correlation is found. Finally, we examine all three sets for correlations with the large-scale structure of the Universe. We find that the two higher-energy sets are compatible with both an isotropic distribution and the hypothesis that UHECR sources follow the matter distribution of the Universe (the LSS hypothesis), while the event set with E>10 EeV is compatible with isotropy and is not compatible with the LSS hypothesis at 95% CL unless large deflection angles are also assumed. We show that accounting for UHECR deflections in a realistic model of the Galactic magnetic field can make this set compatible with the LSS hypothesis.Comment: 10 pages, 9 figure

Synthetic Biology Open Language Visual (SBOL Visual) Version 2.0

People who are engineering biological organisms often find it useful to communicate in diagrams, both about the structure of the nucleic acid sequences that they are engineering and about the functional relationships between sequence features and other molecular species. Some typical practices and conventions have begun to emerge for such diagrams. The Synthetic Biology Open Language Visual (SBOL Visual) has been developed as a standard for organizing and systematizing such conventions in order to produce a coherent language for expressing the structure and function of genetic designs. This document details version 2.0 of SBOL Visual, which builds on the prior SBOL Visual 1.0 standard by expanding diagram syntax to include functional interactions and molecular species, making the relationship between diagrams and the SBOL data model explicit, supporting families of symbol variants, clarifying a number of requirements and best practices, and significantly expanding the collection of diagram glyphs

The Utility of Video Diaries for Organizational Research

This article assesses the utility of video diaries as a method for organization studies. While it is frequently suggested that video-based research methodologies have the capacity to capture new data about the minutiae of complex organizational affairs, as well as offering new forms of dissemination to both academic and professional audiences, little is known about the specific benefits and drawbacks of video diaries. We compare video diaries with two established and “adjacent” methods: traditional diary studies (written or audio) and other video methods. We evaluate each in relation to three key research areas: bodily expressions, identity, and practice studies. Our assessment of video diaries suggests that the approach is best used as a complement to other forms of research and is particularly suited to capturing plurivocal, asynchronous accounts of organizational phenomena. We use illustrations from an empirical research project to exemplify our claims before concluding with five points of advice for researchers wishing to employ this method

Intensive community care services for children and young people in psychiatric crisis: an expert opinion.

BACKGROUND: Children and young people's (CYP) mental health is worsening, and an increasing number are seeking psychiatric and mental health care. Whilst many CYPs with low-to-medium levels of psychiatric distress can be treated in outpatient services, CYPs in crisis often require inpatient hospital treatment. Although necessary in many cases, inpatient care can be distressing for CYPs and their families. Amongst other things, inpatient stays often isolate CYPs from their support networks and disrupt their education. In response to such limitations, and in order to effectively support CYPs with complex mental health needs, intensive community-based treatment models, which are known in this paper as intensive community care services (ICCS), have been developed. Although ICCS have been developed in a number of settings, there is, at present, little to no consensus of what ICCS entails. METHODS: A group of child and adolescent mental health clinicians, researchers and academics convened in London in January 2023. They met to discuss and agree upon the minimum requirements of ICCS. The discussion was semi-structured and used the Dartmouth Assertive Community Treatment Fidelity Scale as a framework. Following the meeting, the agreed features of ICCS, as described in this paper, were written up. RESULTS: ICCS was defined as a service which provides treatment primarily outside of hospital in community settings such as the school or home. Alongside this, ICCS should provide at least some out-of-hours support, and a minimum of 90% of CYPs should be supported at least twice per week. The maximum caseload should be approximately 5 clients per full time equivalent (FTE), and the minimum number of staff for an ICCS team should be 4 FTE. The group also confirmed the importance of supporting CYPs engagement with their communities and the need to remain flexible in treatment provision. Finally, the importance of robust evaluation utilising tools including the Children's Global Assessment Scale were agreed. CONCLUSIONS: This paper presents the agreed minimum requirements of intensive community-based psychiatric care. Using the parameters laid out herein, clinicians, academics, and related colleagues working in ICCS should seek to further develop the evidence base for this treatment model