A Qualitative Exploration of Prominent Factors Contributing to the Aetiology of Child and Adolescent Eating Disorder Presentations during the COVID-19 Pandemic: The Perspectives of Patients, Parents and Clinicians.

AIM: The aim of this study was to explore the prominent factors that contributed to the development of child and adolescent eating disorder presentations during the COVID-19 pandemic. METHODS: This was achieved through a qualitative analysis of interviews gathered from (1) adolescent patients diagnosed with an eating disorder (ED) during the COVID-19 pandemic (aged 13-18) (n = 4), (2) parents of patients attending an ED service (n = 7) and (3) clinicians working within a specialist child and adolescent ED support service (n = 7). Reflexive thematic analysis was used to analyse the data and establish the most prominent aetiological factors reported. RESULTS: The most prominent aetiological factors reported were (1) the accumulation of risk factors; (2) seeking control amid increased anxiety, stress and uncertainty; (3) social isolation; (4) an increased focus on exercise and "healthy eating"; (5) increased social media use promoting unhelpful attention towards ED triggers; and (6) a lack of both awareness and support services. CONCLUSION: During the COVID-19 pandemic, the quantity and severity of ED presentations increased. The current study uncovered six themes perceived by patients, parents and clinical staff that contributed to the aetiology of ED presentations during the COVID-19 pandemic. It is hoped that the insight gained through this research study into ED aetiology may act as a basis for further research and support ED awareness, prevention and intervention in the future.

'It's life threatening, it's not life limiting but it's life threatening' - Dyadic framework analysis of adolescent and parent adjustment to a type 1 diabetes diagnosis.

Type 1 diabetes-management can be considered an adolescent-parent collaboration. Given particular adolescent adherence challenges, it is integral that adolescent-parent dyadic relationships are investigated. Therefore, this study aimed to explore dyads' adjustment to type 1 diabetes, while examining the congruence/dissimilarity within these dyads. Semi-structured interviews were conducted with 10 dyads (20 individuals) separately. Interviews were transcribed verbatim and analysed with thematic analysis using a dyadic framework method. Findings suggested complex experiences of adjustment among parents and adolescents which reflect two main themes - Never-Ending Abyss of Management and Diabetes Integration, with three subthemes - A Life of Food Restrictions, Evolving Familial Bonds and Technology as easing the burden of Diabetes. Dyadic analyses revealed dyadic congruence across most themes. This study adds to the adjustment literature by providing a systemic perspective rarely presented in prior paediatric research.

Young people's experience of the therapeutic alliance: A systematic review.

OBJECTIVE: The aim of this systematic review was to synthesise qualitative evidence on young people's conceptualisation, utilisation and experiences of the therapeutic alliance in individual psychotherapy or counselling and its role in bringing about change. METHOD: The thematic synthesis method was used to synthesise data. The methodological quality of included studies was assessed using the CASP checklist for qualitative research. RESULTS: Four superordinate analytical themes were generated: (1) valuable therapist qualities, (2) conditions for the development and maintenance of the therapeutic alliance, (3) therapeutic processes and (4) barriers to the development of the therapeutic alliance. Findings indicate that young people appreciated the uniqueness of the therapeutic relationship that provided a sense of safety, choice and autonomy. Flexibility and accessibility were noted as important elements of therapeutic alliance building as they elicited a sense of agency. Young people emphasised the non-linear nature of therapy and prioritised process variables such as improvement in self-understanding, self-efficacy and self-worth. CONCLUSION: The current systematic review is a comprehensive overview of qualitative studies of experiences of therapy from young people's perspectives. Important practical implications derived from this review as the role of autonomy in the change process and the formation and maintenance of the therapeutic relationship were outlined as important elements in youth therapy.

'I Had It. I Don't Think I Have It But I Do Feel It Will Come Back Somewhere': A Qualitative Investigation of the Experience of People With Non-Muscle Invasive Bladder Cancer.

Very little is known about the impact of living with non-muscle invasive bladder cancer (NMIBC). NMIBC patients' experiences of their illness-in terms of their perceptions, coping strategies and psychological wellbeing-were explored. This study describes an interpretative phenomenological analysis (IPA) of individuals' accounts of living with NMIBC while on routine surveillance for cancer recurrence. Ten individuals took part in face-to-face semi-structured interviews. Three superordinate themes were derived from the data. The first theme, Being Diagnosed and Treated for NMIBC, concerned the observation that participants considered the physical implications, timeline and practicalities of their illness of primary importance and focused less on its psychological aspects. The second theme, Grappling with the Illness, outlined the impact of the doctor-patient relationship. The final theme, 'I don't treat it as a problem. I treat it as an issue', delineated how participants managed difficult emotions in the context of the illness. Findings from this study demonstrated that participants generally found effective ways to cope with their illness and experience of ongoing surveillance, though delay of emotional responses was common. Clinical implications for healthcare professionals are outlined including the importance of high-quality communication with the urology team.

Clinicians' Experience of Collaboration in the Treatment of Suicidal Clients Within the Collaborative Assessment and Management of Suicidality Framework.

INTRODUCTION: There is little known about the clinicians' experience of collaboration using the Collaborative Assessment and Management of Suicide (CAMS) framework. This study aimed to give voice to the clinician experience. METHOD: A qualitative design utilised semi-structured interviews with ten psychologists who worked in a Suicide Assessment and Treatment Service (SATS) in Ireland which utilises the CAMS framework. RESULTS: An Interpretative Phenomenological Analysis (IPA) approach revealed several important findings. The superordinate themes included 'Finding Safety', 'Regulation of the Self', 'Connecting', and 'Systemic Challenges'. DISCUSSION: The CAMS framework plays an important role in providing a safe base for the clinician (in terms of understanding suicidality, in addition to the structures of the framework). It provides a mechanism in which to process difficult emotions, and a way of communicating a formulation of suicide to the treating team. Importantly, the CAMS emerged as facilitating a collaborative, therapeutic way of working.

"Blacklists" and "whitelists": a salutary warning concerning the prevalence of racist language in discussions of predatory publishing.

This commentary addresses the widespread use of racist language in discussions concerning predatory publishing. Examples include terminology such as blacklists, whitelists, and black sheep. The use of such terms does not merely reflect a racist culture, but also serves to legitimize and perpetuate it.

'Greenwashing' tobacco products through ecological and social/equity labelling: A potential threat to tobacco control.

There has been significant growth in ecological/environmental labelling of products and services internationally in recent years. Such efforts have become an integral element of the marketing strategies used by many firms. Concerns have been raised, however, that for some companies, this is little more than 'greenwashing', i.e. a cynical attempt to boost sales without any meaningful underlying sensitivity or change, in practice. Given the extremely negative track record of the global tobacco industry (Big Tobacco), it is essential that health policy makers and anti-smoking campaigners closely monitor this industry's attempts to exploit both growing environmental concerns among consumers and gaps in legislation. Although there is relatively strong legislation in some countries, to prohibit suggestions that cigarettes may be environment friendly, a further tightening of legislation is required.

Positive parenting: a randomised controlled trial evaluation of the Parents Plus Adolescent Programme in schools.

BACKGROUND: The aim of this study was to evaluate the Parents Plus Adolescents Programme (PPAP)-a parent training course specifically targeting parents of young adolescents (aged 11-16 years)-when delivered as a preventative programme in community school settings. METHODS: A sample of 126 parents (mean age of children = 12.34 years; range = 10-16 years) were randomly assigned to either a treatment (PPAP; n = 82) or a waiting-list control condition (WC; n = 44). Analyses are based on a study-completer sample post-treatment (n = 109 parents: PPAP n = 70; WC n = 39) and sample at 6 month follow up (n = 42 parents). RESULTS: Both post-treatment (between groups) and 6-month follow-up comparisons of study completers (within PPAP group) revealed significant positive effects of the parenting intervention with respect to adolescent behaviour problems and parenting stress. The post treatment comparisons demonstrated large effect sizes on global measures of child difficulties (partial eta squared = 0.15) and self-reported parent stress (partial eta squared = 0.22); there was a moderate effect size on the self-reported parent satisfaction (partial eta squared = 0.13). CONCLUSIONS: This study provides preliminary evidence that PPAP may be an effective model of parent-training implemented in a community-based setting. The strengths and limitations of the study are discussed.

Therapeutic micro-environments in the Edgelands: A thematic analysis of Richard Mabey's The Unofficial Countryside.

The concept of therapeutic landscapes, as introduced by Gesler, has had a significant impact on what has become a reformed geography (or geographies) of health. Research in this field has developed the number and type of sites that have been characterised as therapeutic landscapes. A wide range of environments have now been explored through the analytical lens of the 'therapeutic landscape'. This research further expands current descriptions of such environments by exploring Edgelands as therapeutic micro landscapes. Edgelands refer to the neglected and routinely ignored interfacial zone between urban and rural that are a routine characteristic of the urban fringe resulting from dynamic cycles of urban development and decay. Using a hybrid method of thematic analysis incorporating both inductive and deductive approaches, this research explores Richard Mabey's seminal work on this topic, The Unofficial Countryside. Previous examinations of the features of therapeutic environments are therefore scrutinised to explore both scale and the possibility of further extending the kind of environments that may be described as therapeutic to include Edgelands. This approach is informed, in part, by principles of mindfulness, a historically Eastern, but increasingly Western approach to exploring oneself and the environment. This research identifies that these overlooked and neglected landscapes are in fact vibrant, resilient and enthralling environments teeming with life, renewal and re-birth. Examination reveals that there are three crucial outcomes of this research. The first relates to the issue of scale. Mabey's book provides evidence of the importance of micro environments in providing a therapeutic environmental focus. Secondly, this research explores the potential of mindfulness as an approach in Geography. Lastly, this research also identifies Edgelands as therapeutic sites and calls for an increased understanding and appreciation of their potential.

Children's awareness of alcohol sponsorship of sport in Ireland: Munster Rugby and the 2008 European Rugby Cup.

OBJECTIVES: Examined children's awareness of sport sponsorship in Ireland, focussing on the 2008 European Rugby Cup win by Munster Rugby. METHODS: Following the Munster Rugby win in 2008, a cross-sectional sample of 1,175 children (7-13 years) in 11 National Schools in Ireland were asked which company sponsored "the cup that Munster won" and were then asked to name the product made by that company. RESULTS: Significantly higher level of awareness of the sponsor by children in Munster (69.9 %) to those outside Munster (21.5 %). No significant difference in the level of awareness of their product (alcohol) by location (inside Munster 75.9 %, outside Munster 83.6 %). CONCLUSIONS: These findings support the view for an immediate introduction of legislation banning the sponsorship of sport.

Children's depression, gender and age norms for an Irish national (primary) school population.

OBJECTIVES: To provide normative data for older national (primary) school children, broken down by age and gender, for the Children's Depression Inventory-Short version (CDI-S) and revised norms for the Children's Depression Inventory-Parent version (CDI-P) and its subscales. METHOD: Forty-three randomly selected national schools took part in this study. Participants were 1,255, fifth and sixth class, Irish national school children who completed the Children's Depression Inventory Short Form (CDI-S). In total 1,018 parents completed the corresponding parent form, the Children's Depression Inventory-Parent version (CDI-P). RESULTS: Norms for the CDI-S and the CDI-P subscales were produced. Revised norms for the CDI-P are proposed. Results revealed no significant age or gender difference in depressive symptomatology as measured by respondent's CDI-S and total CDI-P scores. Parent's ratings of their children's depression levels (CDI-P) and children's self-reported depression levels (CDI-S) were significantly correlated. The CDI-S and CDI-P displayed good internal reliability. CONCLUSION: Results indicate the utility of both the CDI-S and the CDI-P for assessing depressive symptoms in national school children in Ireland. This study confirms that national school children do display symptoms of depression. School based policies, materials and services supporting and promoting positive mental health should be developed, implemented and resourced.

Prevalence of psychiatric disorder and the need for psychiatric care in Northern Ireland. Population study in the District of Derry.

BACKGROUND: This is the first report on the epidemiology of psychiatric disorders and needs for psychiatric treatment in the District of Derry, Northern Ireland. AIMS: To assess the prevalence of psychiatric disorder and the needs for treatment in the general population of Derry. METHOD: The sample was drawn at random with a two-phase design using the General Health Questionnaire (GHQ-28) during the first phase, and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) with the Needs for Care Assessment (NFCAS-C) in the second phase. RESULTS: The second phase (n=307) gave a weighted 1-month prevalence of hierarchically ordered ICD-10 psychiatric disorders of 7.5% and a 1-year prevalence of 12.2%. The equivalent prevalences for depressive disorders were 2.4% and 6.0%, respectively, and those for anxiety states were 3.5% and 3.7%. Only a quarter of needs for treatment were met, with the situation being better for depression than for anxiety. CONCLUSIONS: The rates of psychiatric disorder in Derry were even higher than those reported by a similar survey in inner London. This almost certainly reflects the very high levels of social deprivation in the District. Needs for treatment were often unmet.