The impact of universal, school based, interventions on help seeking in children and young people: a systematic literature review.

Reviews into universal interventions to improve help seeking in young people focus on specific concepts, such as behaviour, do not differentiate between interpersonal and intrapersonal help seeking, and often report on statistical significance, rather than effect size. The aim of this review was to address the gaps highlighted above, to investigate the impact of universal, school-based interventions on help-seeking in children and young people, as well as to explore longer term impact. Four databases were searched. Data were extracted on country of origin, design, participant, school, and intervention characteristics, the help-seeking concept measured (e.g. knowledge, attitude/intention, behaviour), the duration between baseline and each follow-up (if applicable) and effect sizes at each follow-up. Quality assessment of the studies was undertaken using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Overall, 14 different interventions met inclusion criteria. The majority of the studies were rated low in the quality assessment. Three constructs were most frequently reported a) intrapersonal attitudes towards help-seeking, b) interpersonal attitudes towards help-seeking and c) intrapersonal intended help-seeking. Findings around intervention effect were mixed. There was tentative evidence that interventions impacting interpersonal attitudes produced small effect sizes when measured between 3 and 6 months post intervention and that when effect sizes were initially observed intrapersonal attitudes, this remained at 3-6 month follow-up. Further work should pay attention to implementation factors, understanding the core ingredients needed to deliver effective interventions and whether embedding mental health education could help sustain or top up effect sizes from help-seeking interventions.

Prenatal diagnosis of two fetuses with deletions of 8p23.1, critical region for congenital diaphragmatic hernia and heart defects.

Microdeletions of 8p23.1 are mediated by low copy repeats and can cause congenital diaphragmatic hernia (CDH) and cardiac defects. Within this region, point mutations of the GATA4 gene have been shown to cause cardiac defects. However, the cause of CDH in these deletions has been difficult to determine due to the paucity of mutations that result in CDH, the lack of smaller deletions to refine the region and the reduced penetrance of CDH in these large deletions. Mice deficient for one copy of the Gata4 gene have been described with CDH and heart defects suggesting mutations in Gata4 can cause the phenotype in mice. We report on the SNP microarray analysis on two fetuses with deletions of 8p23.1. The first had CDH and a ventricular septal defect (VSD) on ultrasonography and a family history of a maternal VSD. Microarray analysis detected a 127-kb deletion which included the GATA4 and NEIL2 genes which was inherited from the mother. The second fetus had an incomplete atrioventricular canal defect on ultrasonography. Microarray analysis showed a 315-kb deletion that included seven genes, GATA4, NEIL2, FDFT1, CTSB, DEFB136, DEFB135, and DEFB134. These results suggest that haploinsufficiency of the two genes in common within 8p23.1; GATA4 and NEIL2 can cause CDH and cardiac defects in humans.

A Rose by any Other Name? Using Core Components to Categorize Social and Emotional Learning Provision.

Although social and emotional learning (SEL) benefits children and youth worldwide, classifying a program as SEL is insufficient to capture its variability of content. There is currently little to aid in identifying specific program content so that foci may be identified (e.g., self-management skills vs. social skills). This gap poses a difficulty for researchers attempting to address heterogeneity in SEL research and practitioners who want to select programs best suited for their contexts. This paper begins to address these concerns by extracting and contrasting 'core components' of interventions within an identified shortlist of 13 universal, elementary evidence-based programs through a distillation method using the often cited 'five core competency' model from CASEL (Collaborative for Academic, Social, and Emotional Learning). Results showed that CASEL's core competencies are represented across short-listed programs. However, almost all programs had identifiable foci, targeting a subset of skills. Accordingly, the use of 'core components' is recommended as a method for offering more nuance in SEL classification for programs beyond the current study, with implications for program implementation and the design of future research in SEL evaluation.

'It's scary starting a new school': Children and young people's perspectives on wellbeing support during educational transitions.

BACKGROUND: Children and young people experience various transitions throughout their education. Theory and evidence highlight that these can be complex, and poor experiences of transitions can be associated with worsened outcomes, necessitating a need to develop and implement wellbeing support. However, children and young people's views are lacking in the literature, and studies tend to focus on specific transitions rather than on what matters for wellbeing during transitions generally. AIMS: We explore children and young people's own perceptions of what would support wellbeing during educational transitions. SAMPLE: We engaged with 49 children and young people aged 6-17 years, using purposeful maximum variation sampling to facilitate engagement of a diverse sample across a variety of education setting types. METHODS: We undertook focus groups, using creative methods centred around a storybook, asking participants to make decisions as headteachers about wellbeing provision in a fictional setting. Data were analysed using reflexive thematic analysis. ANALYSIS: We constructed four themes: (1) helping children and young people understand what to expect; (2) developing and sustaining relationships and support; (3) being responsive to individual needs and vulnerabilities; and (4) managing loss and providing a sense of closure. CONCLUSIONS: Our analysis highlights a desire among children and young people for a considered, supportive approach that recognizes their individual needs and their connection to educational communities. The study makes a methodological and conceptual contribution, demonstrating the value of adopting a multifocussed lens to researching and supporting transitions.

Social and emotional learning in primary schools: A review of the current state of evidence.

BACKGROUND: There is a plethora of reviews that summarize much of the evidence base in Social and Emotional Learning (SEL). However, there are criticisms around variability of quality and focus of those reviews, meaning there is little strategic overview of the current state of the field. Further, there are rising concerns as to systemic gaps in the evidence base itself. An overview of reviews provides an opportunity for a comprehensive classification and corresponding critique of evidence. AIMS: The study sought to examine a-priori concerns regarding (1) variation in the rigour and quality of the meta-analytic and systematic evidence base, (2) comparatively less conclusive evidence for whole school approaches when compared to class-based curricula, and (3) an assumed universality of effect (i.e., lack of examination of any differential gains for sub-groups). METHOD AND RESULTS: A systematic search of the systematic and meta-analytic literature identified a total of 33 reviews examining SEL interventions. Papers were subject to a quality assessment in order to examine methodological rigour and were collated in line with the study's objectives. CONCLUSIONS: We maintain the prevailing consensus that SEL programmes have an important role in education. However, variation in evidence quality remains high and there appear ambiguities regarding what constitutes whole school approaches. The review also highlights a novel and concerning lack of data for differentiating any subgroup effects. The review concludes with recommended novel directions for future research, including adoption of more complex trial architecture in evaluation alongside a move towards a wider plurality in methodological approach.

'Shall We Send a Panda?' A Practical Guide to Engaging Schools in Research: Learning from Large-Scale Mental Health Intervention Trials.

The substantial time that children and young people spend in schools makes them important sites to trial and embed prevention and early intervention programmes. However, schools are complex settings, and it can be difficult to maintain school engagement in research trials; many projects experience high levels of attrition. This commentary presents learning from two large-scale, mixed-methods mental health intervention trials in English schools. The paper explores the barriers and challenges to engaging schools in promotion or early intervention research and offers detailed recommendations for other researchers.

Comprehensive Paired Tumor/Germline Testing for Lynch Syndrome: Bringing Resolution to the Diagnostic Process.

PURPOSE: The current diagnostic testing algorithm for Lynch syndrome (LS) is complex and often involves multiple follow-up germline and somatic tests. We aimed to describe the results of paired tumor/germline testing performed on a large cohort of patients with colorectal cancer (CRC) and endometrial cancer (EC) to better determine the utility of this novel testing methodology. MATERIALS AND METHODS: We retrospectively reviewed a consecutive series of patients with CRC and EC undergoing paired tumor/germline analysis of the LS genes at a clinical diagnostic laboratory (N = 702). Microsatellite instability, MLH1 promoter hypermethylation, and germline testing of additional genes were performed if ordered. Patients were assigned to one of five groups on the basis of prior tumor screening and germline testing outcomes. Results for each group are described. RESULTS: Overall results were informative regarding an LS diagnosis for 76.1% and 60.8% of patients with mismatch-repair-deficient (MMRd) CRC and EC without and with prior germline testing, respectively. LS germline mutations were identified in 24.8% of patients in the group without prior germline testing, and interestingly, in 9.5% of patients with previous germline testing; four of these were discordant with prior tumor screening. Upon excluding patients with MLH1 promoter hypermethylation and germline mutations, biallelic somatic inactivation was seen in approximately 50% of patients with MMRd tumors across groups. CONCLUSION: Paired testing identified a cause for MMRd tumors in 76% and 61% of patients without and with prior LS germline testing, respectively. Findings support inclusion of tumor sequencing as well as comprehensive LS germline testing in the LS testing algorithm. Paired testing offers a complete, convenient evaluation for LS with high diagnostic resolution.