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Adverse effects of early exposure to parental mood disturbance on child adjustment have been documented for both mothers and fathers, but are rarely examined in tandem. Other under-researched questions include effects of changes over time in parental well-being, similarities and contrasts between effects of parental mood disturbance on children's internalizing versus externalizing problems, and potential mediating effects of couple relationship quality. The current study involved 438 couples who reported symptoms of depression and anxiety at each of four time points (i.e., last trimester of pregnancy and 4, 14, and 24 months postbirth). Mothers and fathers also rated their couple relationship quality and their child's socioemotional adjustment at 14 months, as well as internalizing and externalizing problems at 24 months. Latent growth models indicated direct effects of (a) maternal prenatal well-being on externalizing problems at 24 months, and (b) paternal prenatal well-being on socioemotional problems at 14 months. Internalizing symptoms at 24 months showed only indirect associations with parental well-being, with couple relationship quality playing a mediating role. Our findings highlight the importance of prenatal exposure to parental mood disturbance and demonstrate that, even in a low-risk sample, poor couple relationship quality explains the intergenerational stability of internalizing problems.
Research suggests that a significant minority of hospital in-patients could be more appropriately supported in the community if enhanced services were available. However, little is known about these individuals or the services they require.
To identify which individuals require what services, at what cost.
A ‘balance of care’ (BoC) study was undertaken in northern England. Drawing on routine electronic data about 315 admissions categorised into patient groups, frontline practitioners identified patients whose needs could be met in alternative settings and specified the services they required, using a modified nominal group approach. Costing employed a public-sector approach.
Community care was deemed appropriate for approximately a quarter of admissions including people with mild-moderate depression, an eating disorder or personality disorder, and some people with schizophrenia. Proposed community alternatives drew heavily on carer support services, community mental health teams and consultants, and there was widespread consensus on the need to increase out-of-hours community services. The costs of the proposed community care were relatively modest compared with hospital admission. On average social care costs increased by approximately £60 per week, but total costs fell by £1626 per week.
The findings raise strategic issues for both national policymakers and local service planners. Patients who could be managed at home can be characterised by diagnosis. Although potential financial savings were identified, the reported cost differences do not directly equate to cost savings. It is not clear whether in-patient beds could be reduced. However, existing beds could be more efficiently used.
This article presents an analysis of challenges and considerations when developing digital mental health innovations. Recommendations include collaborative working between clinicians, researchers, industry and service users in order to successfully navigate challenges and to ensure e-therapies are engaging, acceptable, evidence based, scalable and sustainable.
A characteristic pattern of solar hard X-ray emission, first identified in SOL1969-03-30 by Frost & Dennis (1971), turns out to have a close association with the prolonged high-energy gamma-ray emission originally observed by Forrest et al. (1985). This identification has become clear via the observations of long-duration γ-ray flares by the Fermi/LAT experiment, for example in the event SOL2014-09-01. The distinctive features of these events include flat hard X-ray spectra extending well above 100 keV, a characteristic pattern of time development, low-frequency gyrosynchrotron peaks, CME association, and gamma-rays identifiable with pion decay originating in GeV ions. The identification of these events with otherwise known solar structures nevertheless remains elusive, in spite of the wealth of EUV imagery available from SDO/AIA. The quandary is that these events have a clear association with SEPs in the high corona, and yet the gamma-ray production implicates the photosphere itself, despite the strong mirror force that should focus the particles away from the Sun We discuss the morphology of these phenomena and propose a solution to this problem.
Tschumi’s experimental use of the literary text as part of design briefs for students at the Architectural Association in the late 1970s formed the basis for a preoccupation with what he termed the disjunction between space and the events that happen within it. For Coates, the literary briefs triggered a fixation with what was happening in space – but instead of focusing on its conceptual interaction with events, he moved towards the dramatisation of architecture. Grounded in the architects' shared teaching at the AA, the article discusses the early briefs and projects that shaped the directions they would each take.
Research on paranoia in adults suggests a spectrum of severity, but this
dimensional approach has yet to be applied to children or to groups from
To investigate the structure, prevalence and correlates of mistrust in
children living in the UK and Hong Kong.
Children aged 8–14 years from the UK (n = 1086) and Hong
Kong (n = 1412) completed a newly developed mistrust
questionnaire as well as standard questionnaire measures of anxiety,
self-esteem, aggression and callous–unemotional traits.
Confirmatory factor analysis of the UK data supported a three-factor
model – mistrust at home, mistrust at school and general mistrust – with
a clear positive skew in the data: just 3.4%, 8.5% and 4.1% of the
children endorsed at least half of the mistrust items for home, school
and general subscales respectively. These findings were replicated in
Hong Kong. Moreover, compared with their peers, ‘mistrustful’ children
(in both countries) reported elevated rates of anxiety, low self-esteem,
aggression and callous–unemotional traits.
Mistrust may exist as a quantitative trait in children, which, as in
adults, is associated with elevated risks of internalising and
Advance care planning (ACP) is increasingly prominent in many countries; however, the evidence base for its acceptability and effectiveness is limited especially in conditions where cognition is impaired, as in dementia.
This qualitative study used semi-structured interviews with people with mild to moderate dementia (n = 17) and family carers (n = 29) to investigate their views about planning for their future generally and ACP specifically.
People with dementia and their families make a number of plans for the future. Most people undertook practical, personal, financial, and legal planning. However participants did not make formal advance care plans with the exception of appointing someone to manage their financial affairs. Five barriers to undertaking ACP were identified: lack of knowledge and awareness, difficulty in finding the right time, a preference for informal plans over written documentation, constraints on choice around future care, and lack of support to make choices about future healthcare.
Health and social care professionals can build on people's preferences for informal planning by exploring the assumptions underlying them, providing information about the possible illness trajectory and discussing the options of care available. Health and social care professionals also have a role to play in highlighting the aspects of ACP which seem to be most relevant to the wishes and aspirations of people with dementia.
Background: Childhood worry is common, and yet little is known about why some children develop pathological worry and others do not. Two theories of adult worry that are particularly relevant to children are Davey's problem-solving model in which perseverative worry occurs as a result of thwarted problem-solving attempts, and Wells’ metacognitive model, in which positive and negative beliefs about worry interact to produce pathological worry. Aims: The present study aimed to test hypotheses that levels of worry in young children are associated with poor or avoidant solution generation for social problems, and poor problem-solving confidence. It also aimed to explore beliefs about worry in this age group, and to examine their relationships with worry, anxiety and age. Method: Fifty-seven young children (6–10 years) responded to open ended questions about social problem-solving situations and beliefs about worry, and completed measures of worry, anxiety and problem-solving confidence. Results: Children with higher levels of worry and anxiety reported using more avoidant solutions in social problem situations and children's low confidence in problem solving was associated with high levels of worry. Children as young as 6 years old reported both positive and negative beliefs about worry, but neither were associated with age, gender, or level of anxiety or worry. Conclusions: Results indicate similarities between adults and children in the relationships between problem-solving variables and worry, but not in relationships between beliefs about worry and worry. This may be due to developmental factors, or may be the result of measurement issues.
The formation of nanocrystal-molecule-nanocrystal nanostructures via controlled mixing of Au nanocrystals and bifunctional Re linkers is reported. UV-visible absorbance data, coupled with histogram analysis of nanostructures measured using Scanning Electron Microscopy has shown a characteristic optical response at wavelengths close to 600 nm following formation of dimer and trimer nanostructures. Directed assembly processes based on dielectrophoretic trapping have also been developed for electrical interfacing of these nanostructures between top-down nanoelectrode pairs for electrical characterization.
To evaluate a mentoring circle workforce development intervention among a group of public health nutrition novices.
The mentoring circle intervention focused on facilitating practice-based public health nutrition competence development and supporting reorientation of practice from clinical services to preventive services. A retrospective post-intervention qualitative semi-structured interview was used to explore the experiences of those participating in the mentoring circle and to make evaluative judgements about intervention attributes and effectiveness.
Thirty-two novice public health nutrition practitioners employed in the state public health system.
Key evaluative theme categories relating to the mentoring circle intervention were identified, including the structure and function of the group, the utility of using advanced-level competency items to guide planning, having a safe and supportive environment for learning and the utility of learning via mentoring and on-the-job experiences. These qualitative evaluation data identify the attributes of the mentoring circle intervention contributing to intervention effectiveness.
This qualitative evaluation indicates that mentoring circles can be an effective workforce capacity-building intervention, particularly in novice workforces characterised by professional isolation and split function roles.
The idea of participation has been central to many policy developments in recent years. Both Conservative and Labour governments have used notions of participation and involvement in attempts to justify and implement their social policies. Yet, despite a plethora of initiatives and guidance around ‘participation’ emerging from all levels of government, and a substantial academic literature, there remains a major, and potentially damaging, lack of clarity over many aspects of participation, while the secret of achieving ‘real’ participation appears to continue to remain elusive.
Faced with reduced numbers choosing to study foreign languages (as in England and Wales), strategies
to create and maintain student interest need to be explored. One such strategy
is to create ‘taster’ courses in languages, for potential university applicants. The findings presented arise
from exploratory research, undertaken to inform the design of a selection of web-based taster courses for less widely taught
languages. 687 school students, aged 14-18, were asked to identify a web site that they liked and to state their main reason for
liking it. They were invited to include recreational sites and told that their answers could help with web design for the
taster courses. To explore the reasons, two focus groups were conducted and student feedback on the developing taster course
site was collected. Students nominated search engines and academic sites, sites dedicated to hobbies, enthusiasms, youth
culture and shopping. They liked them for their visual attributes, usability, interactivity, support for schoolwork and for
their cultural and heritage associations, as well as their content and functionality. They emerged as sensitive readers of web
content, visually aware and with clear views on how text should be presented. These findings informed design of the taster course
site. They are broadly in line with existing design guidelines but add to our
knowledge about school students’ use of the web and about designing web-based learning materials. They may also be relevant
to web design at other levels, for example for undergraduates.
This chapter will focus on the origins of individual differences in young children's understanding of mind. While several recent studies have documented the importance of individual differences in understanding mind for children's social development, these studies have been purely phenotypic. The study presented in this chapter is the first to adopt a genetically sensitive design in order to explore both genetic and environmental influences on theory-of-mind performance. The findings suggest a strong genetic influence upon individual differences in theory of mind, and also highlight the importance of ‘non-shared’ environmental influences. The implications of these findings for the modularity of mind-reading are discussed.
Recent research into children's development of a ‘theory of mind’ has highlighted the importance of individual differences in this domain for children's early social relationships. For example, differences in young children's understanding of mind are strongly linked with differences in their shared pretence (Astington and Jenkins, 1995; Hughes and Dunn, 1997; Taylor and Carlson, 1997; Youngblade and Dunn, 1995), communication (Dunn and Cutting, 1999; Hughes and Dunn, 1998; Slomkowski and Dunn, 1996), as well as self-judgements and sensitivity to criticism (Dunn, 1995). Given that individual differences in understanding mind appear pivotal to young children's ability to adapt to their social worlds, an important new question for research is: how should these individual differences be explained?
Ultimately, all individual differences are explained by either genetic or environmental factors (or their interaction).