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At a time of increased demand for specialist mental health services, a more nuanced understanding of how adolescents navigate systems of care and support is essential. We mapped ‘networks of care’ to explore patterns of mental health help-seeking alongside the perceived helpfulness of support accessed.
Methods
We examined data from 23 927 adolescents aged 11–18 years who participated in the 2023 OxWell Student Survey, an English school-based, repeated cross-sectional survey of mental health and wellbeing. Students self-reported past-year access to 18 types of support across informal (e.g. friends and family), semi-formal (e.g. school and charities), and formal (e.g. health and social care) domains, alongside how helpful they found the support. We used a network approach to explore interconnections between sources of support accessed and perceived helpfulness.
Results
One in four (27.0%, 6449/23927) adolescents reported past-year access to mental health support, of which 56.7% (3658/6449) reported accessing multiple types. Informal networks were the most commonly accessed (23.1%, 5523/23927), followed by semi-formal (9.7%, 2317/23927) and formal (6.8%, 1623/23927) supports. Informal sources had high acceptability, with around 80–90% reporting them as helpful, whereas child and adolescent mental health services (CAMHS), helplines, and online supports were perceived to be the least helpful. The networks also identified groups who might not be optimally served by current systems, including gender diverse adolescents and adolescents who found mental health support from their parents unhelpful.
Conclusions
Adolescents are accessing mental health support across informal, semi-formal, and formal sources of care. Services can no longer be developed, delivered, or evaluated in isolation from these networks.
US legislators show a remarkable variation in how many bills and resolutions they sponsor and cosponsor to support Taiwan. I argue that legislators’ perception of China and their partisan identity play a crucial role in shaping their support for Taiwan. To test my hypotheses, I conducted a quantitative analysis of all Taiwan-specific bills and resolutions introduced from the 110th to 116th House of Representatives. The results indicate that legislators who view China as a security threat to the US or a non-democracy and a human rights violator exhibit a higher level of support for Taiwan. However, seeing China as an economic challenger has the least significant effect. Furthermore, although there is a general consensus that Taiwan is a bipartisan issue in Congress, my research demonstrates that Republicans display a greater level of interest in supporting Taiwan compared to Democrats.
Based on a range of detailed case studies, this innovative book presents a model for early career language teacher development. It showcases the lived experiences of English language teachers in their training years, as well as the reflections of two more experienced English language teachers, and uses these case studies to provide practical guidelines on early career needs and development. It outlines four essential and highly connected conditions that will enable teachers to survive and thrive in the profession: reflection, support, resilience, and well-being. Using an innovative, evidence-based, data-informed approach to reflective practice, the book covers teachers' philosophy, principles, theory, practice, and critical reflection beyond practice. Each chapter contains practical reflection activities, to encourage reflection throughout from the reader on what the research reveals. It is essential reading for graduate students who are training to become language teachers, as well as language teacher trainers and lecturers.
Preparation is key and hopefully this book will have provided useful information to allow you to link with key people and develop a strategy. The emotional and practical impact on the professional and personal lives of those involved cannot be underestimated. This chapter considers the psychological and practical impact and provides some advice on managing often conflicting emotions.
Many nurses will be asked to give evidence at a coroner’s inquest during their nursing career. Being asked to give evidence can feel incredibly daunting and generate complex feelings. It’s important to remember that the coroner is looking for your help with the inquiry. The coroner can also seek an expert opinion by a nursing professional on the care of the person who has died. This chapter provides advice on how best to fulfil your duty.
Workplace violence and aggression toward healthcare staff has a significant impact on the individual, causing self-blame, isolation and burnout. Timely and appropriate support can mitigate harm, but there is little research into how this should be delivered. We conducted multi-speciality peer groups for London doctors in postgraduate training (DPT), held over a 6-week period. Pre- and post-group burnout questionnaires and semi-structured interviews were used to evaluate peer support. Thematic analysis and descriptive statistical methods were used to describe the data.
Results
We found four themes: (a) the experience and impact of workplace violence and aggression on DPT, (b) the experience of support following incidents of workplace violence and aggression, (c) the impact and experience of the peer groups and (d) future improvements to support. DPTs showed a reduction in burnout scores.
Clinical implications
Peer groups are effective support for DPT following workplace violence and aggression. Embedding support within postgraduate training programmes would improve access and availability.
Au cours du vieillissement, les adultes ayant une déficience intellectuelle (DI) vivent de nombreux changements susceptibles d’influencer leurs possibilités d’exercer leurs activités quotidiennes et leurs rôles sociaux. Une bonne connaissance de leurs points de vue sur le sujet apparaît cruciale pour mieux adapter l’offre de services à leurs besoins. Cette recherche a pour but de mieux comprendre les points de vue des personnes ayant une DI à l’égard de leurs possibilités de participation sociale à travers l’avancée en âge. Des entrevues individuelles et un atelier participatif ont été réalisés avec des adultes âgés de 40 à 75 ans dans la ville de Québec. L’analyse de leurs propos a permis d’identifier leurs points de vue relatifs à trois thèmes, soit leurs capacités, les possibilités d’exercer leur participation sociale et les soutiens reçus. Pour conclure, des recommandations sont proposées afin que les pratiques soutiennent réellement leur participation sociale à travers l’avancée en âge.
Convex polytopes, or simply polytopes, are geometric objects in some space $\R^{d}$; in fact, they are bounded intersections of finitely many closed halfspaces in $\R^{d}$.The space $\R^{d}$ can be regarded as a linear space or an affine space, and its linear or affine subspaces can be described by linear or affine equations. We introduce the basic concepts and results from linear algebra that allow the description and analysis of these subspaces. A polytope can alternatively be described as the convex hull of a finite set of points in $\R^{d}$, and so it is a convex set. Convex sets are therefore introduced, as well as their topological properties, with emphasis on relative notions as these are based on a more natural setting, the affine hull of the set. We then review the separation and support of convex sets by hyperplanes. A convex set is formed by fitting together other polytopes of smaller dimensions, its faces; Section 1.7 discusses them.Finally, the chapter studies convex cones and lineality spaces of convex sets; these sets are closely connected to the structure of unbounded convex sets.
Wagner and money is a cantus firmus of his biography. Notoriously broke, he is often regarded as a ‘pump genius’. He always demanded financial generosity from anyone who wanted to call themselves his friend. His pre-March criticism of capitalism has its origins in his completely underdeveloped economic mind. In King Ludwig II of Bavaria, he gained his most powerful and significant patron from 1864 onwards. But contrary to the widespread prejudice, it was by no means excessive sums that the king spent on Wagner. Moreover, in times without copyright and regulated royalty payments, artists were always dependent on patrons and gainful employment. Under today’s legal conditions, Wagner would have been a millionaire.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
This chapter introduces the notion of identifying primary and secondary stressors as a way of drawing attention to the many sources of stress that arise either as a consequence of disastrous events of long or short duration, or because they frame the context in which those disastrous events occur. The events that we include in this approach are broad in nature; they include emergencies of all kinds, major incidents, outbreaks of high consequence infectious diseases (HCIDs), terrorist attacks, and conflicts. We begin by outlining the context in which the circumstances that cause stress operate. Then we define primary and secondary stressors. This approach helps us to understand sources of stress in all kinds of adverse and disastrous events. We conclude that the sources of stress that we have researched in these differing emergencies differ, but also have much in common.
The proportion of the population living into old age has been increasing worldwide. For the first time in history, there are more older people than children under 5 years of age. The task for public health is to understand the relationships between ageing, health and the environment (physical, social and economic) in which people live, to promote healthy ageing and prevent the disability and subsequent dependency that is often associated with growing old.
This chapter examines the factors that lead to ageing populations and explores the health, social and economic consequences of the change in the population structure. It then goes on to outline strategies that can lead to healthy ageing and other public health actions that could help to manage the challenges posed – and the opportunities afforded – by the relative and absolute increase in the number of older people.
This chapter focuses on early literacy acquisition as embedded in specific social contexts such as the child's home environment. During the last three decades, the role of parental support, or family support when those other than parents are involved in promoting children's literacy at home was broadly examined within a monolingual context. Concerning a bilingual context, numerous studies have shown that literacy acquisition in minority languages in a home or community setting might serve as a springboard for literacy acquisition in the second language. However, less is known on parental support of biliteracy among language-minority children. Thus, together with home support in the monolingual context, this chapter addresses research evidence on literacy practices in different languages provided by family members to children growing up in bilingual or multilingual homes. A brief overview of prominent theoretical frameworks is provided that outlines parental support and literacy development among children. In addition, drawing mainly on examples from North America, Israel, and other high-income-country contexts, research on parental support in a monolingual context is explored.
The WHO has urged member states to develop preparedness plans for infant and young child feeding (IYCF) during emergencies. Ireland has no such plan. We aimed to identify the needs of caregivers in Ireland with regards IYCF during the COVID-19 pandemic.
Design:
Online survey conducted in May–June 2020.
Setting:
Ireland, during the first period of severely restricted movement due to COVID-19 (lockdown).
Participants:
Respondents (n 745) were primary caregivers of a child under 2 years; they were primarily well educated and likely of higher socio-economic status.
Results:
Among those who breastfed, being unable to access breast-feeding support groups and being unable to access in-person, one-to-one breast-feeding assistance were the biggest challenges reported. Nearly three quarters of those who had their babies during lockdown reported these challenges: 72·8 % and 68·8 %, respectively. For those using formula, the main challenges were structural in nature; approximately two-thirds of those who had their baby prior to lockdown feared there would be formula shortages and a third were unable to purchase formula due to shortages.
Conclusions:
Regardless of how their babies were fed, parents in Ireland experienced multiple challenges with infant feeding during the COVID-19 crisis. Breast-feeding should be protected, supported and promoted, particularly during an infectious disease pandemic. Additionally, assurances around supply of infant formula could reduce parental stress during a pandemic or emergency. An IYCF in emergencies plan would clearly set out how we could best support and protect the nutrition of the most vulnerable members of our population.
This chapter offers an empirically informed approach that utilizes the Internet and social media to provide support and resources for health concerns. The topic of self-injury will be used as a case illustration throughout. To this end, initiatives aimed at supporting and offering outreach for people with lived experience of self-injury as well as key stakeholders who can play key support roles will be presented. By the end of the chapter, readers will be able to reflect on how these various considerations can be drawn upon when planning their own outreach efforts aimed at providing support and informational resources for a range of health concerns via the Internet.
General palliative care (PC) is provided more at home, leading to increased involvement of relatives. Although support for relatives is a fundamental component of PC, there are deficiencies in the support provided to relatives when general PC is provided at home. This study aimed to describe the support provided by health professionals before and after a patient’s death to relatives involved in general PC at home.
Methods
A cross-sectional register study was implemented, with data from the Swedish Register of Palliative care. The sample consisted of 160 completed surveys from relatives who had been involved in general PC at home, with 160 related surveys answered by health professionals. Only the questions about support to relatives were used from the surveys.
Results
The findings showed that although many relatives appear to receive support in general PC at home, not all relatives receive optimal support before or after a patient’s death. The findings also indicated differences in whether relatives received some support before and after a patient’s death depending on the type of relative. There were also differences in responses between health professionals and relatives regarding if relatives received counseling from a doctor about whether the patient was dying.
Significance of results
There is potential for improvements regarding support for relatives, especially after a patient’s death, which has been confirmed in previous studies. The differences in whether relatives received support before and after a patient’s death depending on the type of relative highlight the need for future research on how to support different types of relatives before and after a patient’s death when general PC is provided at home.
This chapter considers the range of possible education support roles in the mathematics classroom that a teacher may work with. This chapter presents effective ways of working collaboratively with education support workers and explores positive planning of learning experiences which considers the affordances of various education support workers’ roles.
This study investigated the challenges and support needs of adults aged 75 and older during and after treatment for a blood cancer to aid targeted supportive resource development.
Methods
Adults aged 75 and older with a blood cancer participated in in-depth, semi-structured interviews about challenges and unmet support needs. Participants recruited through The Leukemia & Lymphoma Society were (1) in treatment or previously in treatment for a blood cancer at age 75 or older and (2) living in the United States or its territories. A thematic analysis was conducted with findings compared between 2 groups: (1) chronic -living with a chronic blood cancer; (2) acute -living with an acute blood cancer or both an acute and chronic blood cancer.
Results
Participants (n = 50) ranged from 75 to 91 years old. Both groups described similar experiences and identified 5 challenges and support needs: (1) socioemotional impact, (2) activities of daily living and instrumental activities of daily living (ADLs/iADLs), (3) uncertainty management, (4) treatment-related stressors, and (5) COVID-19-related strain. Properties for these themes illustrate challenges and support needs, with some differences between groups. For instance, those living with a chronic blood cancer highlighted financial strain with treatment-related stressors, while those with an acute blood cancer focused more on iADLs.
Significance of results
Findings inform an agenda for targeted resource development for older adults with a blood cancer nearing the end of the life span. Results demonstrate the need for supportive services and family communication interventions to help patients manage iADLs and navigate socioemotional needs and challenges.
Edited by
Fiona Kelly, La Trobe University, Victoria,Deborah Dempsey, Swinburne University of Technology, Victoria,Adrienne Byrt, Swinburne University of Technology, Victoria
More and more donor-conceived people are interested in, and in contact with, same-donor offspring. Moreover, donor-conceived people can find large numbers of same-donor offspring, enabled by more openness regarding donor conception, social media, donor registers and (online) DNA testing. The impact of meeting large numbers of same-donor offspring has not yet been explored. At Fiom, a Dutch organisation providing independent support in the search for biographical information, we conducted a qualitative study interviewing 19 donor-conceived people who participated in same-donor offspring group meetings. Data showed that while relationships between same-donor offspring are commonly experienced as more beneficial than connecting with the donor, they also come with challenges such as how to integrate these new relations into their lives, how to manage group dynamics and a continuously growing network. Data revealed a need for counselling tailored to the context of multiple same-donor offspring contact. Lastly, challenges for regulators are discussed.
Social mentalizing informs the theory and practice of mentalization-based treatment for adolescents (MBT-A). Adolescence is, among other things, a time for establishing a self-identity and learning about how to interact effectively with a peer group. A focus on balancing mentalizing in peer and family interactions is crucial, with special attention to hypermentalizing and the alien self. Involvement of families and schools in treatment is necessary. MBT-A includes individual, family, and group therapy, and its overall aim is to develop the patient’s independence. Crucial aspects of achieving this goal include building up relational stability and supporting the patient’s sense of agency and autonomy within their relational networks.
Why do ordinary citizens believe in an autocratic ideology? Why do people follow their autocratic leader? How can autocrats win the hearts and minds of their people, securing their support? This chapter seeks to absorb the manifold responses that have been given to these questions in the last decades. It theorizes the role of ordinary citizens in autocratic regimes, illuminating the legitimacy claims of autocratic rulers on the one hand and the popular beliefs in these legitimacy claims on the other hand. Drawing on a rich repository of previous research, it highlights the two strategies of autocracies to deal with their people. Autocracies might either overwhelm their citizens through mass-level political indoctrination or systematically underwhelm them, keeping them satisfied and apolitical. While the former relies on ideational legitimation, the latter refers to socioeconomic performance and a managerial, technocratic style of rule. Both strategies share the goal of thwarting the risk of public protest.