Assessment Of Young People Research Articles

Improving Patient-Centered Care for Young People in General Practice With a Codesigned Screening App: Mixed Methods Study.

BackgroundDespite experiencing a high prevalence and co-occurrence of mental health disorders and health-compromising behaviors, young people tend not to seek professional help for these concerns. However, they do regularly attend primary care, making primary care providers ideally situated to identify and discuss mental health and lifestyle issues as part of young people’s routine health care.ObjectiveThe aim was to investigate whether using a codesigned health and lifestyle-screening app, Check Up GP, in general practice influenced young people’s assessment of the quality of their care (measures of patient-centered care and youth friendliness), and their disclosure of sensitive issues. In addition, this study aimed to explore young people’s acceptance and experience of using a screening app during regular health care.MethodsThis was a mixed methods implementation study of Check Up GP with young people aged 14 to 25 years attending a general practice clinic in urban Melbourne, Australia. A 1-month treatment-as-usual group was compared to a 2-month intervention group in which young people and their general practitioners (GPs) used Check Up GP. Young people in both groups completed an exit survey immediately after their consultation about disclosure, patient-centered and youth-friendly care, and judgment. In addition, participants in the intervention group were surveyed about app acceptability and usability and their willingness to use it again. Semistructured interviews with participants in the intervention group expanded on themes covered in the survey.ResultsThe exit survey was completed by 30 young people in the treatment-as-usual group and 85 young people in the intervention group. Young people using Check Up GP reported greater disclosure of health issues (P<.001), and rated their GP higher in patient-centered care: communication and partnership (P=.01), personal relationship (P=.01), health promotion (P=.03), and interest in effect on life (P<.001). No differences were found on core indicators of youth-friendly care: trust, level of comfort, expectations met, and time to ask questions. In all, 86% (73/85) of young people felt the app was a “good idea” and only 1% (1/85) thought it a “bad idea.” Thematic analysis of qualitative interviews with 14 participants found that Check Up GP created scope to address unmet health needs and increased sense of preparedness, with use moderated by honesty, motivation, app content and functionality, and app administration.ConclusionsIntegrating a health and lifestyle-screening app into face-to-face care can enrich young people’s experience of seeing their GP, create scope to identify and address unmet health needs, and increase patient-centered care. Further research is needed to investigate the effect of using a health and lifestyle-screening app in a diverse range of clinic types and settings, and with a diverse range of GPs and youth.

Practitioners' experiences of adolescent suicidal behaviour in peer groups

Introduction Group suicidal behaviour by young people can have harmful effects; it may be increasing, influenced by online media and reported increasing self-harm rates; new knowledge and understanding to inform interventions is required. Aim To explore how practitioners experience group suicidal behaviour amongst adolescents, how they assess risks/needs, and how these insights inform understanding about these groups. Method Ten practitioners, including Mental Health Nurses, were interviewed in one multidisciplinary CAMHS, in England. Data analysis was by Thematic Analysis (Braun & Clarke 2006). Results Participants described frequently working with suicidal groups. Roles in groups include suicide encouraging and preventing. Practitioners identify risky and protective connections between young people, online and offline. Clinical tensions include living with suicidal risks, emotional and positional challenges, and getting to grips with digital media. Discussion Peer groups appear to have a larger role in adolescent suicide than recognized to date. Practitioners need to assess young people's roles in groups, their diverse motivations and to understand constantly changing digital media. Implications for practice Assessments of suicide risk for young people should routinely include focus on peer relations including the online/digital realm. Maintaining relationships with vulnerable young people facilitates managing fluctuating risks and understanding different group dynamics.

Designing a sexual health risk assessment for young people.

Sexual health nurses working with teenagers from the black and minority ethnic community reflect on fieldwork undertaken for a Mary Seacole leadership award aimed at reducing inequalities.

Artful Dodgers: The Role of Unreliable Narrators in the Production of Authorized Histories and Assessments of Young People in Conflict with the Law

ABSTRACTThis article argues that pre-sentence reports for youth courts are co-authored by at least two unreliable narrators: the defendant and the youth justice worker. The production of an objective professional assessment for sentencing purposes is therefore a convenient fiction in which key actors collude. Such reports do not only seek to provide narrative explanations of past actions, but also shape future sentencing decisions and other outcomes that can either be helpful or harmful to service users. Full case files, meanwhile, contain documents that reveal less orderly and more challenging narratives from the margins.

Central Coherence, Organizational Strategy, and Visuospatial Memory in Children and Adolescents With Anorexia Nervosa

The vast majority of studies in anorexia nervosa that have investigated the domains of central coherence, organizational strategy, and visuospatial memory have focused on adult samples. In addition, studies investigating visuospatial memory have focused on free recall. No study to date has reported the association between recognition memory and central coherence or organizational strategy in younger people with this disorder, yet the capacity to recognize previously seen visual stimuli may contribute to overall visuospatial ability. Therefore, we investigate these domains in children and adolescents with anorexia nervosa compared to age- and gender-matched healthy controls. There were no significant group differences in immediate, delayed, or recognition memory, central coherence, or organization strategy. When compared with controls, patients with anorexia nervosa scored significantly higher on accuracy and took significantly longer when copying the Rey Complex Figure Task. Caution must be taken when interpreting these findings due to lower-than-expected scores in memory performance in the control group and because of a potential lack of sensitivity in the measures used when assessing this younger population. For neuropsychological functions where no normative data exist, we need a deeper, more thorough knowledge of the developmental trajectory and its assessment in young people in the general population before drawing conclusions in anorexia nervosa.

Earning Not Learning? An Assessment of Young People in the Jobs without Training (JWT) Group

In recent years, mass participation in post-16 education and training in England has led to a diminishing understanding about young people who leave education at the end of compulsory schooling to enter ‘jobs without training’ (JWT). Drawing on data from three recent studies, this article argues that the JWT group is not homogeneous in its composition. Similar findings led to the development of a common typology across all three studies to define young people's position in the labour market, their motivations and aspirations, and their access to training and development. It concludes with a series of recommendations for addressing the deficit in knowledge about the composition of the JWT group, and the learning and training needs of young workers. This discussion is set in the context of the implementation of the Raising of the Participation Age (RPA) in England for all 17-year olds from 2013 and for all 18-year olds from 2015, although within the Coalition Government's current proposals, its delivery will lack any form of immediate enforcement. Therefore, unless young workers and their employers are committed to the acquisition of accredited qualifications, RPA delivery will be seriously undermined and intervention to support school to work transitions among the JWT group will remain negligible.

Does the assessment of young people attending hospital with self harm meet national standards?

Aims To determine whether young people who self harm are being assessed according to national guidance. Methods A multi-centre retrospective case note audit was undertaken of a random sample of young people (12-18 years) presenting during a six-month period (1st Jan 2010-July 31st 2010) with any form of self harm to a District General and tertiary Children9s Hospital. Standards were derived from NICE guidance CG16: Self Harm and included a comprehensive risk and needs assessments, admission rates and waiting times for mental health assessment. Results 167 episodes (in 160 young people) of self harm were audited - 57% resulted in admission and most patients were female (79%). Mean age was 15.3 years (12-18) with 79 episodes in patients under 16 years. Self poisoning (77%) was the most common method, with cutting seen less often (14%) and both methods were documented in Information about substance use, smoking and education status was rarely recorded and 35% did not have a past medical or social history recorded. Evidence of planning and future intent to self harm was not documented in 12% and 17% of patient episodes respectively. Four young people were assessed as presenting a significant risk to themselves or others. Of those not admitted, 7 were under 16 years with only two being offered admission. 69% of those admitted were seen within 24 hours by mental health services, compared with 61% of those discharged. Waiting times were not clear in 14%, and 16% of patients were not referred for a full mental health assessment. Conclusions The audit shows the assessment of young people with self harm is not meeting national standards. Documentation of adolescent psychosocial factors was often incomplete and not all young people under 16 years were offered admission. Assessment by mental health services was often delayed beyond recommended timescales, and in a small but significant number no referral was made.

Utility of self-reported sleep disturbances as a marker for major depressive disorder (MDD): Findings from the World Mental Health Japan Survey 2002–2006

Although major depressive disorder (MDD) is a serious common disease, many depressive patients seek primary care with complaints of sleep disturbances that remain undiagnosed. The purpose of this study was to investigate the utility of self-reported sleep disturbances as a marker for MDD. This study investigated the association between 12-month prevalence of self-reported sleep disturbances and MDD using data from a cross-sectional survey in Japan. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic curve (AUC) of self-reported sleep disturbances as a marker for MDD were 58.9%, 73.4%, 6.9%, 98.1%, and 0.66, respectively. Self-reported sleep disturbances showed highest utility for the youngest group. Among four types of sleep disturbances, the problem of daytime sleepiness was most useful as a marker for MDD. Combined with at least moderate role impairment, self-reported sleep disturbances became more informative with higher specificity (99.6%) and PPV (80.0%) as a marker for MDD. Self-reported sleep disturbances cannot be a marker for MDD in isolation. Comorbid role impairment increases the probability of MDD. Clinicians should be cautious in assessments of young people who have sleep disturbances. Daytime sleepiness should be included among the questions asked when inquiring about sleep disturbances.

Initial assessment of young people in the emergency department

One of the most important aspects of care for children in emergency departments (EDs) is the initial assessment of their conditions and circumstances. Paediatric nurses, or other nurses who have had adequate training and skills in the care of children and younger people, should use the appropriate tools to undertake these assessments so that they can identify and manage children's physical, mental or social problems. This article discusses the use of such tools in the initial assessments of children at Ipswich Hospital NHS Trust ED, and how this use has improved practice while raising the profile of paediatric emergency care.

Linking young homeless people to mental health services: An exploration of an outreach clinic at a supported youth accommodation service

Recent research has indicated that young people experiencing homelessness live with high rates of psychological distress and mental illness, yet often do not access mental health services due to a number of barriers. Access may be enhanced through greater interagency collaboration, adopting principles of early intervention, outreach and youth cultural competence. The St Vincent’s Hospital Program for Early Intervention and Prevention of Disability (PEIPOD) has implemented these recommendations in an innovative outreach clinic being conducted at Oasis Youth Support Network in Sydney (Oasis). The purpose of this article is to describe the clinic and to present the perspectives of Oasis youth workers and the PEIPOD clinical team arising from focus groups regarding the extent to which the clinic has: (i) facilitated access to mental health services for young people; (ii) provided a positive experience of a mental health service for young people; and (iii) enhanced the capacity for Oasis staff to work with young people living with complex needs and mental illness. This article also reports the results of a fi le audit of all case notes and triage forms for the 29 clients who attended the clinic between January 2010 and January 2011. Findings suggest that the highly transient behaviour of the Oasis clients is a key challenge to linking young people to (mental health) services. This article describes several service strengths, including the close partnership between Oasis and PEIPOD staff and access to a mental health assessment for young people at a youth-friendly location. Recommendations arising from the staff interviews include expanding the outreach clinic model to other service sites, improving handover information from the Oasis youth support staff and involving medical staff in the clinic assessment.

The feasibility of videoconferencing for neuropsychological assessments of rural youth experiencing early psychosis

We conducted a pilot study of the feasibility of videoconferencing as a mode of neuropsychological assessment in young people (14-30 years) from a rural area of New South Wales experiencing early psychosis. All participants (n = 11) completed assessments both face-to-face and by videoconference at a bandwidth of 384 kbit/s. Assessments included confirmation of diagnosis, quality of life and neurocognitive functioning. There was a strong correlation between modes of assessment for most instruments. Bland-Altman plots indicated that in general the mean difference between face-to-face and videoconference modes of assessment was close to zero with significant bias only evident for general cognitive functioning (WTAR), where videoconferencing produced higher ratings than face-to-face assessments. Feedback from the participants indicated strong acceptability of assessment by videoconferencing, thus supporting further investigation of use of this mode of assessment for clinical and research purposes.

Becoming, Being and Having Been: Practitioner Perspectives on Temporal Stances and Participation across Children’s Services

This article is based on a study of the changing meanings and experiences of citizenship and participation for young people in transition from primary to secondary school. One of the primary concerns of the study is to better understand how different professional practices impact upon young people’s uptake of participation and adoption of civic identity. To gain some insight into this area the article first looks at the contexts in which participation work is developing and the interrelationships between these developments across children’s services. How different practitioner’s conceptualise participation is tied into different assessments of young people’s or children’s capacity. Recasting questions of capacity as dialogues across differing temporal stances can offer practitioners new ways to reflect upon the power negotiations within their relations with young people. The key role temporality plays in configuring power relationships and transactions is explored as it arises within practitioner life history interviews. The shifts between temporal stances that young people experience as they interact with different practitioners are illustrated through fieldwork data.

“You're an American Rapper, So What Do You Know?” The Political Uses of British and US Popular Culture by First-Time Voters in the UK

This paper addresses the question of whether and how contemporary forms of popular culture engage young people with the wider world, in particular with respect to the formation of their political identity. Drawing on the result of focus groups and interviews with seventeen-to-eighteen-year-olds, it examines how regional, national and global identities emerge in talk about US and UK popular culture. This empirical focus is set against the background of existing research into the various dimensions of popular culture's relationship to politics. The authors conclude that popular culture can act as a device in the construction of collective, political identities, albeit indirectly, by way of young people's assessment of the source, authenticity and legitimacy of multiple media representations.

Assessment of the Refined Aging Semantic Differential: Recommendations for Enhancing Validity

The Aging Semantic Differential (ASD) by Rosencranz and McNevin (1969) is the most widely used instrument in gerontological and geriatric education to assess the stereotypic attitudes young people have toward older adults. Polizzi (2003) updated the ASD with current adjectives and reduced the instrument to a single latent factor, attitude. We examine the validity of this major instrument and describe the strengths and shortcomings. The instrument was administered to 199 medical students that participated in a national pilot project, Vital Visionaries, funded by National Institute on Aging. Confirmatory factory analysis using structural equation modeling (SEM) was used. Qualitative data captured stereotypic attitudes young people have toward older adults. SEM indexes suggest that a one-factor structure has poor fit. Qualitative analyses suggest medical students hold multiple dimensions of stereotypic attitudes toward older adults. We suggest that the latent factor, attitude, can be assessed with fewer observed items, thereby creating room for the additional latent factors. The resulting instrument could be just as short, but offer a more comprehensive assessment of young people's stereotypic attitudes toward older adults.

Dusty discos and dangerous desires: community perceptions of adolescent sexual and reproductive health risks and vulnerability and the potential role of parents in rural Mwanza, Tanzania

This paper presents villagers' assessments of young people's sexual and reproductive health vulnerability and of community-based interventions that may reduce both vulnerability and risk in rural Mwanza, Tanzania. The primary methods used were 28 group discussions and 18 in-depth interviews with representatives of various social groups in four villages. The majority of participants attributed young people's sexual and reproductive health risks to a combination of modernisation (and its impact on family and community life), socioeconomic conditions, social norms in rural/lakeshore communities and the difficulties parents and other adults face in raising adolescents in contemporary Tanzania. Community life has limited opportunities for positive development but contains many risky situations. Young and old agreed that parents have a strong influence on young people's health but are failing in their parental responsibility. Parents acknowledged the multiple influences on sexual risk behaviour. They expressed a need for knowledge and skills related to parenting so that they can address these influences both through family- and community-based strategies.

“We should keep what makes us different”: youth reflections on Turkish maintenance in Australia

This article reports on a study of Turkish immigrants, a group that has resisted the rapid shift to English throughout their four decades in Australia. The study sought to identify the unique set of sociohistorical reasons for continued Turkish use and youth perspectives on Turkish vitality. Study participants were students and graduates of secondary Turkish programs in the state of Victoria (n = 16). Information on their language biographies, bilingual achievements, and language orientations were collected in large-scale surveys (n = 858) and follow-up interviews (n = 177). Participating youth expressed an overwhelmingly positive attitude toward Turkish maintenance yet were not confident in their Turkish skills. They recognized that the future of Turkish depended on their commitment to learn and use Turkish and pass it on to the next generation. Young people's assessment of the available Turkish language programs revealed that additional support is needed to sustain Turkish bilingualism beyond the second generation, including a relevant and coherent curriculum to teach Turkish as a second language, well-prepared bilingual teachers, and Turkish classes in universities to upgrade teachers' language skills.

Psychodynamic Consultation and the Rorschach with Adolescents

This article presents a comparative pilot study using the Rorschach Test and a four-session psychodynamic consultation for adolescents attending an outpatient clinic. The study used a comparative qualitative approach to look at how both approaches can help in the assessment of young people experiencing psychological and emotional difficulties. Specifically, the study assessed whether the Rorschach might be useful for engaging young people in the assessment process and explored whether it could add anything to this process, above and beyond the standard four-session psychodynamic consultation.

The use of mobile phones in dietary assessment in young people with Type 1 diabetes

Background: Food is often a contentious issue for people with diabetes (Nutrition Sub‐Committee of Diabetes Care Advisory Committee of the UK, 2003) and being an adolescent with Type 1 diabetes (T1DM) can be extremely challenging (Cartwright et al., 2003). Tailoring interventions to engage with adolescents is essential for maintaining an effective and productive relationship with the healthcare team (Hampson et al., 2000). The use of modern technology, such as mobile phone cameras, may be a way of engaging with this client group. Food diaries are routinely used for dietary assessment in this group, although there may be difficulties with patient recall, establishing portion sizes and compliance with completion (Tefft &amp; Boniface, 2000). This study aimed to assess the effect of mobile phones in dietary assessment in adolescents with T1DM.Methods: Fifteen adolescent patients with T1DM attending the Tayside Paediatric Diabetic Clinics were recruited. Participants were asked to complete food diaries for 4 days and to photograph (using the mobile phones provided) all food and drink consumed during that period. Photographs were downloaded to a computer using Bluetooth technology®. A dietitian estimated portion sizes from the diaries and photographs. The number of items ovn each day for each method was recorded. Dietary intake information was analysed for total energy intake and percent energy from carbohydrate, fat and protein using the dietary analysis package Dietplan 6 (Forestfield Software Ltd, Horsham, West Sussex, UK). Dietary recommendations for this client group (Hanas et al., 2006) are shown in Table 1. The dietary analyses with and without the use of mobile phones were compared using paired Student's t‐tests. Results are expressed as mean (SD) and range, as appropriate.Results: Eight participants [14.3 (1.8) years; duration of diabetes 8.4 months–11.2 years; HbA1C 9.5% (2.0%)] returned completed diaries and full sets of photographs. No statistically significant differences were seen in the number of items recorded by using food diaries 27.8 (7.8) and mobile phones 24.2 (9.6). Dietary analysis of the food diaries is shown in Table 1; there were no significant differences between the two groups. The effect of photographs taken by mobile phone on the dietary analysis of food diaries [mean (SD)] Food diary Food diary with photos Recommended intakes Protein (% total energy) 17.3 16.7 15 Fat (% total energy) 35.2 34.9 35 Carbohydrate (% total energy) 46.9 48.3 40 Discussion: Although there were no significant differences in macronutrient intake as recorded in food diaries with and without the use of mobile phones, photographs provided additional information that facilitated the estimation of portion sizes in this client group. The almost ubiquitous use of mobile phones may provide a perfect medium for engaging young people in diabetes self‐management issues (Franklin et al., 2006), although their use in dietary assessment requires further exploration.Conclusions: Photographs taken using mobile phones may be a useful tool in the dietetic management of T1DM in adolescents.References Cartwright, M., Wardle, J., Steggles, N., Simon, A.E., Croker, H., &amp; Jarvis, M.J. (2003) Stress and dietary practices in adolescents. Health Psychol. 22, 362–369.Franklin, V., Waller, A., Pagliari, C. &amp; Greene, S. (2006) A randomized controlled trial of ‘Sweet Talk’, a text‐messaging system to support young people with diabetes. Diabet. Med.23, 1332–1338.Hampson, S.E., Skinner, T.C., Hart, J., Storey, L., Gage, H. &amp; Foxcroft, D. (2000) Behavioural interventions for adolescents with type 1 diabetes: how effective are they? Diabetes Care23, 1416–1422.Hanas, R., Donaghue, K., Klingensmith, G. &amp; Swift, P.G. (2006) International Society for paediatric and Adolescent Diabetes. ISPAD Clinical Practice Consensus Guidelines. Paediatr. Diabetes 7, 341–342.Nutritional SubCommittee of Daibetes Care Advisory Committee of the UK (2003) The dietitians challenge: the implementation of nutritional advice for people with diabetes. J. Hum. Nutr. Diet. 16, 421–452.Skinner, H., Biscope. S., Poland, B. &amp; Goldberg, E. (2003) How adolescents use technology for health information: implications for health professionals from focus group studies. J. Med. Internet Res.5, E32.Tefft, M.E. &amp; Boniface, D.R. (2000) Estimating food and nutrient intake from food frequency questionnaire data by reference to a standard weighed diet survey. J. Hum. Nutr. Diet.13, 219–224.

Reliability of health-related physical fitness tests in European adolescents. The HELENA Study

To examine the reliability of a set of health-related physical fitness tests used in the European Union-funded Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study on lifestyle and nutrition among adolescents. A set of physical fitness tests was performed twice in a study sample, 2 weeks apart, by the same researchers. A total of 123 adolescents (69 males and 54 females, aged 13.6+/-0.8 years) from 10 European cities participated in the study. Flexibility, muscular fitness, speed/agility and aerobic capacity were tested using the back-saver sit and reach, handgrip, standing broad jump, Bosco jumps (squat jump, counter movement jump and Abalakov jump), bent arm hang, 4 x 10 m shuttle run, and 20-m shuttle run tests. The ANOVA analysis showed that neither systematic bias nor sex differences were found for any of the studied tests, except for the back-saver sit and reach test, in which a borderline significant sex difference was observed (P=0.044). The Bland-Altman plots graphically showed the reliability patterns, in terms of systematic errors (bias) and random error (95% limits of agreement), of the physical fitness tests studied. The observed systematic error for all the fitness assessment tests was nearly 0. Neither a learning nor a fatigue effect was found for any of the physical fitness tests when repeated. The results also suggest that reliability did not differ between male and female adolescents. Collectively, it can be stated that the reliability of the set of physical fitness tests examined in this study is acceptable. The data provided contribute to a better understanding of physical fitness assessment in young people.

Protocol for the assessment of self-harm in young people: initial audit and training implications

Aims and MethodsThis paper describes the development and initial audit of a protocol for the assessment of young people up to the age of 18 years who presented to the accident and emergency department (A&amp;E) with self-harm. A key part of the project was education and training.ResultsRegular training of senior house officers (SHOs) in A&amp;E may have contributed to an increase in young people being admitted to a bed for proper assessment (as per the protocol), but psychosocial assessments undertaken by SHOs in A&amp;E were still only partial, and there was no apparent use of the mental state examination.Clinical ImplicationsChild and adolescent mental health services have an important role to play in liaising with local A&amp;E departments in training of junior staff in psychosocial assessment and the use of the mental state examination. This is especially relevant in the light of the new training requirements of the foundation years.