Bullying Experiences of Child and Adolescent Mental Health Service-users: A Pilot Survey

Victims and perpetrators of bullying experience a variety of psychological problems. The aim of the current pilot study was to explore the bullying experiences of Child and Adolescent Mental Health (CAMHS) service-users. The investigation was conducted as a cross-sectional survey at a community-based specialist CAMH service. A modified version of the Revised Olweus Bully/Victim Questionnaire was used to assess bullying experiences. Participants comprised an opportunity sample of 26 adolescent male and female CAMH service-users. Results indicated that 61.5% of participants reported being bullied. Clear links were made between being bullied and the mental health of participants, with 62.5% of bullied participants reporting that being bullied was a ‘‘moderately importantvery important’’ reason for their attendance at the CAMH service. Therapists at the CAMH service made appropriate enquiries about young people being victims of bullying, but more enquiries could be made about young peoples’ experiences as perpetrators. Service-users favoured therapist-led bullying interventions such as assertiveness training, therapy and/or psychological coping strategies, and social skills training. These findings underline the need for ecological approaches to dealing with bullying, and suggest that CAMH services could play an important role in establishing and supporting such interventions.

Selection of the most appropriate roadside vehicle restraint system – the SAVeRS project

Run Off Road (ROR) crashes are road accidents that often result in severe injuries or fatalities. To reduce the severity of ROR crashes, “forgiving roadsides” need to be designed and this includes identifying situations where there is a need for a Vehicle Restraint System (VRS) and what appropriate VRS should be selected for a specific location and traffic condition. Whilst there are standards covering testing, evaluation and classification of VRS within Europe (EN1317 parts 1 to 8), their selection, location and installation requirements are typically based upon national guidelines and standards, often produced by National Road Authorities (NRA) and/or overseeing organisations. Due to local conditions, these national guidelines vary across Europe.
The European SAVeRS project funded by CEDR has developed a practical and readily understandable VRS guidance document and a user-friendly software tool which allow designers and road administrations to select the most appropriate solution in different road and traffic conditions.
This paper describes the main outcomes of the project, the process to select the most appropriate roadside barrier, and the user friendly SAVeRS tool.

Substance Use and Misuse : Adolescent Substance Use in the context of the family ; a qualitative study of young people's views on parent child attachments , parenting style and parental substance use

Introduction and Aims. While the role of the family in adolescent substance use has been well documented, few studies have attempted to explore in-depth youth perceptions of how these familial processes/dynamics influence teenage substance use. This paper reports the findings from a study exploring risk and protective factors for teenage substance use within the context of the family as perceived by young people with a view to informing current and future family based prevention and education interventions.
Design and Methods. Data collection took place in nine post-primary schools across Northern Ireland. Nine focus groups using participatory techniques were facilitated with a purposive sample of sixty-two young people (age 13-17 years). Data were transcribed verbatim and analysed using a content/thematic analysis.
Results. Three broad themes/aspects of the family emerged from the data, which may serve to protect or attenuate the risk of substance use among young people. Parent-child attachment was a major theme identified in protecting adolescents from substance use in addition to effective parenting particularly an authoritative style of parenting supplemented by parental monitoring and good parent-child communication to encourage child disclosure. Family substance use was deemed to impact on children’s substance use if exposed at an early age and the harms associated with PSM were discussed in detail.
Discussion and Conclusions. The qualitative approach provides insight into current understanding of youth perceptions of substance use in the context of family dynamics. A number of recommendations are outlined. Family based (preventive) interventions/parenting programmes may benefit from components on effective parenting including authoritative styles, parental monitoring, effective communication, spending time together (building attachments), parent-child conflict, adolescent development and factors which impact on parenting. Parenting programmes tailored to mothers and fathers may be beneficial. School based interventions targeting children/adolescents may be best placed to target children living with parental substance misuse.
Keywords: substance/substance related disorders, focus groups, young people/adolescent,

Efficacy and Acceptability of Reduced Intensity Constraint-Induced Movement Therapy for Children Aged 9–11 years with Hemiplegic Cerebral Palsy: A Pilot Study

OBJECTIVE: Assess efficacy and acceptability of reduced intensity constraint-induced movement therapy (CIMT) in children with cerebral palsy (CP).

METHODS: Single-subject research design and semi-structured interviews. Children (9-11y) with hemiplegia underwent five baseline assessments followed by two weeks CIMT. Six further assessments were performed during treatment and follow-up phases. The primary outcome was the Melbourne Assessment of Unilateral Upper Limb Function (MUUL). Quantitative data were analysed using standard single-subject methods and qualitative data by thematic analysis.

RESULTS: Four of the seven participants demonstrated statistically significant improvements in MUUL (3-11%, p < .05). Two participants achieved significant improvements in active range of motion but strength and tone remained largely unchanged. Qualitative interviews highlighted limitations of the restraint, importance of family involvement, and coordination of treatment with education.

CONCLUSIONS: Reduced intensity CIMT may be effective for some children in this population; however it is not suitable for all children with hemiplegia.

Handbook of Disabled Children's Childhoods: Building Understandings: Child, Youth, Family and Disability. Palgrave Macmillan:Disabled Children in Out-of-Home Care: Issues and Challenges for Practice Kelly, B., Sandra, D. & Winter, K. 2016

This chapter provides an overview of some of the key findings from a large mixed methods study regarding disabled children in care in Northern Ireland

Child-focused psychosocial interventions for anger and aggression in children under 12 years of age (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows:

To evaluate the effectiveness of child-focused psychosocial interventions for anger and aggression in children under 12 years of age.

A critical analysis of Child and Adolescent Mental Health Services policy in England, 2000‐2015

Policy in Child and Adolescent Mental Health (CAMH) in England has undergone radical changes in the last 15 years, with far reaching implications for funding models, access to services and service delivery. Using corpus analysis and critical discourse analysis, we explore how childhood, mental health, and CAMHS are constituted in 15 policy documents, 9 pre‐2010, and 6 post 2010. We trace how these constructions have changed over time, and consider the practice implications of these changes. We identify how children’s distress is individualised, through medicalising discourses and shifting understandings of the relationship between socioeconomic context and mental health. This is evidenced in a shift from seeing children’s mental health challenges as produced by social and economic inequities, to a view that children’s mental health must be addressed early to prevent future socio‐economic burden. We consider the implications CAMHS policies for the relationship between children, families, mental health services and the state. The paper concludes by exploring how concepts of ‘parity of esteem’ and ‘stigma reduction’ may inadvertently exacerbate the individualisation of children’s mental health.

Mothers, Fathers, Families and Child Development

Summary This chapter reviews the main tenets of attachment theory—one of the most popular and traditional approaches to conceptualising the relationship between caregivers and child development—in the light of recent research evidence. It highlights the limitations of attachment theory in achieving a holistic understanding of child development in current societal structures and considers the advantages of taking an ecological approach to the development of practice and policy. An ecological perspective that is child-centred contributes to a holistic understanding of how families, in all their variety of forms, influence child development and support child-centred practice and policy. The quality of the family environment is a key factor for the healthy adjustment, development and wellbeing of children.

Why are we Waiting? Research, Policy and Practice in Recruiting and Supporting Same Gender Couples in Child Adoption

The adoption process is renowned for its difficulties, however gay and lesbian couples face unique, additional challenges when choosing parenthood through adoption. The Adoption and Children’s Act (2002), Equality Act (2006) and the Sexual Orientation Regulations act (2007) are some of the recent policy changes aimed at ‘smoothing out’ the adoption process for same-gender couples (Cosis-Brown & Kershaw, 2008). Resultantly, there appear to be more cases of gay adoption than ever before (Equality Britain, 2005), however, anecdotal evidence suggests that across the UK the practice of recruiting and supporting gay and lesbian adopters is inconsistent. Whilst some local authorities encourage and emphasise the importance of stability and high quality care for vulnerable looked after children regardless of parental sexuality (Mallon, 2007); yet case studies of gay and lesbian couples seeking adoption demonstrate the unique challenges they encounter in the adoption process because of religious views (Hicks, 2005) or the attitudes towards same gender parenting of adoption panels and social workers within an unspoken hierarchy (Ahmed, 2008; Dennis, 2006). Government’s drive towards adoption (Unwin and Misca, 2013) of children in care as a favoured alternative should lead to recognition of same-gender couples as an under-utilised resource of potential adopters to be used in the best interest of the children who are looked after. The poster will present the results of research undertaken by the authors during 2012-13 highlighting how research on same-gender parenthood over the past decades has influenced the recent developments in the adoption policy and practice in the UK and worldwide. The poster will identify areas of potential barriers encountered in translating these policy changes in the current practice of adoption with a particular focus on professionals’ attitudes towards same-gender couples as potential adopters.

The Activity of Breast Milk and Monoclonal HIV-specific Antibodies in Mother-to-Child Transmission

Mother-to-child transmission of HIV is a unique setting that allows us to explore both the correlates of protective immunity and the characteristics of transmitted variants. This thesis first describes the levels and functional capacity of breast milk HIV-specific antibodies in 19 women with high plasma viral loads. Neutralizing antibodies (Nabs) were detected in breast milk supernatant (BMS) of 4 of 19 women examined, were of low potency and were not associated with infant infection. The low NAb activity in BMS was reflected in binding antibody levels with HIV envelope specific IgG titers being 2.2 log10 lower in BMS versus plasma. In contrast, non- neutralizing antibodies (nNAbs) capable of antibody dependent cell-mediated cytotoxicity (ADCC) were detected in the BMS from all 19 women. BMS ADCC activity was associated with envelope-specific IgG titers (p = 0.014) and was inversely associated with infant infection risk (p = 0.039). Our data indicate that BMS has limited HIV neutralizing activity, however, BMS ADCC activity is a correlate of transmission that may impact infant infection risk. In the second part of this thesis the neutralization sensitivity of 111 variants of diverse subtypes obtained from mothers and infants was determined against 7 HIVspecific broadly neutralizing monoclonal antibodies (mAbs) (NIH45-46w, VRC01, PGT128, PGT121, PG9 PGT145 and b12). Maternal and infant variants did not differ in their neutralization sensitivity to these mAbs and neither did variants from transmitting versus those from non-transmitting women. However, subtype A viruses were iii significantly more sensitive to neutralization by NIH45-46w and VRC01 (p= 0.0001 in both cases) and PGT145 (p=0.03) compared to non-subtype A viruses. Together, NIH45- 46w and PGT128 neutralization profiles resulted in 100% coverage of the variants tested. These data suggest that the epitopes targeted by these mAbs are present and accessible in both circulating and transmitted variants and that a combination of antibodies would provide maximum coverage against diverse subtypes commonly found in HIV endemic regions. Overall, this data suggest that an antibody based HIV vaccine capable of eliciting antibodies of multiple specificities that can mediate ADCC and/or neutralizing activity can provide protection and conquer the genetic diversity displayed by HIV.