Ready, set, co(produce): a co-operative inquiry into co-producing research to explore adolescent health and wellbeing in the Born in Bradford Age of Wonder project.

BACKGROUND: Co-production of research with communities and stakeholders is recognised as best practice, but despite this, transparent reporting and reflective accounts on co-producing research is lacking. Born in Bradford Age of Wonder (AoW) is a large longitudinal health research project, following the health trajectories of up to 30,000 young people across the Bradford district; moreover, AoW has been entirely co-produced with teachers, parents, and young people. This paper describes the co-production of the Born in Bradford Age of Wonder (AoW) project and shares general reflections on co-production from peer researchers involved in co-producing AoW. METHODS: A co-operative inquiry (CI) approach was used to gather written reflections on co-production from ten peer researchers (one teacher, one parent, eight young people) involved in co-producing the AoW project. Written reflections were collected and rough "themes" were identified using thematic analysis. RESULTS: Four key 'themes' were identified: (1) promoting young people's voice and views (2) identifying impacts of co-production, (3) fostering a collaborative ethos, and (4) suggested improvements to the co-production work in AoW. Peer researchers' reflections highlighted how co-production can positively impact research projects such as AoW, whilst also holding broader benefits including giving young people a voice, facilitating their personal development, and fostering a collaborative ethos both within AoW and with partner organisations. Suggested improvements to AoW co-production included supporting greater numbers of young people and researchers to engage in co-production, organising more regular sessions, and establishing clearer communication channels. CONCLUSIONS: Peer researchers' reflections highlight positive impacts of engaging in co-production, both for research projects (including AoW) and for peer researchers' personal and professional development. That said, continued efforts are needed in AoW to meet young people's needs and interests, maintain trusting relationships, and foster sustained growth of co-production efforts within and beyond the AoW project. Evaluation of AoW co-production, along with wider partnership building are key to these efforts.

Born in Bradford (BiB) is a large health research programme, working to improve the health and wellbeing of people in Bradford and beyond. BiB Age of Wonder (AoW) is the next stage of the BiB programme and is collecting data on up to 30,000 teenagers across the Bradford district. A key part of BiB research (and AoW) involves working with community members as equal partners, through a process called co-production. Co-production is often seen as the best way to do health research; however, not all researchers agree on important questions such as what co-production really is, or why or how it is done. To answer these questions, we need to better understand the perspectives and experiences of those involved in co-production. This study gathered written reflections on co-production from young people, teachers and parents (described as peer researchers) involved in co-producing AoW. The study looked to capture peer researchers' experiences of doing co-production in general, what possible impact it has, and how co-production in AoW can be improved moving forward.Findings indicated that taking part in co-production can help peer researchers directly impact projects (including AoW), gain useful skills, and encourage collaboration within and beyond AoW. Suggested improvements to AoW co-production included having more regular sessions and having clearer communication with peer researchers. Whilst these findings indicate that AoW co-production is generally working well, an important next step is to evaluate the AoW co-production work and highlight key successes and challenges.

Integrated recovery management model for ex-offenders with co-occurring mental health and substance use disorders and high rates of HIV risk behaviors.

This paper provides outcomes from an evaluation of a federally funded program combining HIV prevention services with an integrated mental health and substance abuse treatment program to a population of primarily African American ex-offenders living with, or at high risk for contracting HIV in Memphis, Tennessee. During the 5-year evaluation, data were collected from 426 individuals during baseline and 6-month follow-up interviews. A subset of participants (n = 341) completed both interviews. Results suggest that the program was successful in reducing substance use and mental health symptoms but had mixed effects on HIV risk behaviors. These findings are important for refining efforts to use an integrated services approach to decrease (a) the effects of substance use and mental health disorders, (b) the disproportionate impact of criminal justice system involvement, and (c) the HIV infection rate in African American ex-offenders in treatment.

HTLV-I infections in Barbados: results of a 20-year follow-up study - abstract

Human T-cell lymphotrophic virus type I(HTLV-1) infection is known to be associated with adult T-cell leukaemia/lymphoma (ATL), tropical spastic paraparesis, polymyositis, arthritis, alveolitis, uveitis, and infective dermatitis. Examination of stored sera from Barbados previously identified 41 HTLV-1 seropositives among 1012 participants in a 1972 survey. We have followed up this cohort: (1) to determine the long-term persistence of antibody, (2) to ascertain the risk of seroconbersion in household contacts, and (3) to identify long-term clinical sequelae of HTLV-1 infection. There were 79 HTLV-1 seronegative household contacts from 1972. Subjects were seen without knowledge of their serostatus and those who could be traced completed a questionnaire, had a clinical examination, serological, skin and stool tests. All 16 of the initially identified HTLV-1 seropositive sujects, whowere studied, remained seropositive and all 22 of the identified seronegative household contacts remained uninfected. Of the 22 household contacts, 10 were children of HTLV-1 seropositive mothers. In conclusion, we have confirmed persistence of HTLV-1 infection over 20 years' follow-up. There was no evidence of household transmission or of occult infection with late antibody expression in this study. Many HLTV-I infections are asymptomatic but we identified HLTV-I-associated clinical disorders in 4 cases: chronic dermatitis (2), hepatosplenomegaly (1), and hepatomegaly alone (1); the latter subject also had smouldering ATL (AU)

Intelligence in adolescents with homozygous sickle cell (SS) disease

Strokes occur in approximately 8 percent of children with SS disease most commonly below age 15 years. The cause is generally cerebral infraction secondary to occlusion of major cerebral vessels. Less extensive cerebral lesions might also occur producing subtle defects of cerebral function. This hypothesis has been tested using the Wechsler Intelligence Scales-Revised (WISC-R) adjusted to Jamaican conditions in SS children and controls followed from birth in the Jamaican cohort study. The first 125 children with SS disease were each matched with 2 children of the same sex and age but with a normal haemoglobin (AA) genotype. IQ scores in 60 age/sex matched pairs (1SS; 1AA) of cohort children aged 15-18 years were normally distributed in both genotypes but average IQ was significantly lower in SS disease (p<0.01). The possible mechanism of this defect are being explored. (AU)

A survey of epilepsy management and control in a hospital out-patient setting - abstract

The majority of patients with a diagnosis of epilepsy, attending the medical or paediatric outpatient clinics or the Casualty Department of the QEH in the three months, August 5 to November 5, 1987, were identified and interviewed by a research nurse. Data were collected on employment, diagnosis, fit frequency, drug regime, and alcohol use. A venous plasma sample was taken for anti-epileptic drug analysis. Two hundred and seventy-nine patients were seen (54 percent male and 46 percent female) aged 26ñ12 years meanñSD). Sixty-two per cent of adults were unemployed, nearly four times the national figure of 18 percent. There had been no attempt to qualify or label the type of epilepsy in 61 percent of patients. Specific diagrams of grand mal, complex partial and focal seizures were made in 19 percent, 18 percent and 4 percent respectively. Petit mal (1 case) appeared to be grossly under-diagnosed. Twenty-nine per cent of patients had had their last fit in the previous week, 20 percent between one week and one month, 25 percent between one and six months, and 22 percent more than six months before. Thus, half were unsatisfactorily and half well controlled. Phenytoin was the most frequently prescribed drug (in 44 percent alone, plus 13 percent in combination) followed by carbamazepine (30 percent and 13 percent) and phenobarbitone (8 percent and 6 percent). Eighty-two per cent of patients were treated with one drug, 17 percent with two and only 1 percent with three. There was a clear positive correlation between drug dose and plasma concentration for phenobarbitone, a less good one for carbamazepine and a poor one for phenytoin. Concentrations fell at high doses, showing poor compliance. More careful dose titration is necessary, using plasma monitoring. This is essential for good epilepsy control. Both doctor and public re-education is needed if patients with epilepsy are to be given a "fair deal" in health-care and employment (AU)