Training stress in the absence of adequate recovery has been associated with a decrease in well-being and performance. Thus, there is potential for the high training and competition loads that elite English youth football players experience to have a negative effect on wellbeing and performance. The aim of the thesis was to assess the utility of well-being and physical performance assessments in managing the development of elite English youth football players. The first study (Chapter 4) examined the sensitivity of a subjective well-being questionnaire (WQ; developed ‘in-house’ by sport science practitioners at a category two academy and only taking < 30 s to complete), by comparing the player’s next day responses between two acute training bouts of varied duration; 15 mins (low load) compared to 90 mins (high load) high intensity intermittent exercise (Loughborough intermittent shuttle test, LIST). WQ items showed small to large deteriorations following the high load compared to low load (d=0.4-1.5, P=0.03-0.57). The ability of the WQ to differentiate between responses to high and low training loads indicated that this questionnaire could be used to detect training induced stress prior to training on a daily basis throughout the season. Other modes of monitoring assessment evaluated were either not sensitive to differentiate between high and low loads (countermovement jump; CMJ) or detected differences between high and low training load responses (HR indices) but lacked utility in detecting individual changes. The second study (Chapter 5) applied well-being and physical performance assessments to elite English youth football players during a high intensity, low volume pre-season training period. Trivial changes in perception of WQ items of sleep, recovery, appetite, fatigue, stress and muscle soreness were observed across weeks (P=0.35-0.93, 2 P  =0.02-0.08) with no negative WQ responses evident. Internal training load was lower to a large extent in week 1 (P= < 0.001, 2P  =0.54) yet no differences in internal training load were evident across weeks two, three, four and five. Trivial to small associations (r=-0.21 to 0.19) between internal training load and WQ responses were observed. Small to moderate improvements in aerobic performance were evident post training in comparison with pre training (P < 0.001-0.53, d= 0.33 – 0.94) with a large to moderate improvement in submaximal HR measures (P < 0.001 – 0.09; 2 P  = 0.34 - 0.74) observed across the training weeks. Trivial to moderate impairments in neuromuscular performance were evident post training in comparison with pre training (P < 0.001 – 0.21; d=0.17 – 1.00). Collectively, the preservation of well-being prior to each training session during a pre-season period and improvements in aspects of physical performance were indicative of a balance between stress and recovery. The third study (Chapter 6) examined player perceptions of well-being and physical performance across a season in Elite English youth football players. Increases in training exposure (P < 0.05; 2 P  =0.52) and moderate to large deteriorations in perceptions of well-being (motivation, sleep quality, recovery, appetite, fatigue, stress, muscle soreness P < 0.05; 2 P  =0.30-0.53) were evident as the season progressed. A large improvement in Yo-Yo intermittent recovery test performance (Yo-Yo IRT; P < 0.05; 2 P  =0.93) and a small to moderate impairment in neuromuscular performance (P > 0.05; 2 P  =0.18 - 0.48) was observed as the season progressed. These findings show an imbalance between stress and recovery in English elite youth football players even when players experienced lower training exposure than stipulated by the elite player performance plan (EPPP). In summary, this thesis highlights the potential utility of subjective well-being assessments to inform the management English elite youth football player development. Furthermore, it highlights the high training volumes that English elite youth players are exposed can potentially lead to an imbalance between stress and recovery.

This thesis presents findings from a longitudinal study of young people living in poverty providing a unique insight into their lives. The research set out to explore three themes, namely how young people end contact successfully (or not) from support, their experiences of the ‘transition to adulthood’ and also what triggered, helped and hindered those who were trying to desist from offending. It was revealed that a small number never left Includem’s Transitional Support, a unique service set up in Scotland providing emotional and practical help for vulnerable young people in this age group. For those who did leave, many had limited to no other support in their lives and were reluctant to ask for help again even when they were in real need. They were all acutely aware of their precarious situation. ‘Adulthood’ denoted certainty for them and was not viewed as a feasible destination. Members of the group dealt with this differently. Almost all retained hope of achieving their goals and in doing so suffered a form of ‘cruel optimism’, conversely, a smaller number scaled back on their aspirations, sometimes even to the extent of focusing on their immediate day to day survival. Over the course of the study most participants became more hopeless, isolated and withdrawn. Although they still wanted to achieve their original ambitions of having a job, own place and being settled this appeared less likely over time. A key finding from this study is that those who managed least had accepted the idea that independence was about ‘going it alone’ and proving oneself by oneself, but on the other hand, those who coped better viewed independence as being interdependence and welcomed help from others. It emerged that those who had offended had done so to achieve a sense of belonging, rejected by home and education. By desisting they moved from having some element of status and respect to then living a legitimate but often impoverished existence overshadowed by their past. This study opens up a series of questions about the pains of desistance and the pains of poverty. It is suggested that considering desistance and adulthood in terms of citizenship would emphasise the individual’s and societies interdependence so that rights, responsibilities and potential are recognised. At present, I argue that there is a mutual dismissal. Society dismisses impoverished youth and they in turn do not see that society holds anything for them. I call for renewed hope so that inaction and continued poverty and inequality are not rendered inevitable, and for criminologists to also embrace the idea of interdependence so that this issue is dealt with beyond the parameters of this field.

<p>Children’s participation in their planning in health and social services is important. To make children’s needs more considered they need to be involved in the cision-making processes. Children have the ability to reflect. The aim has been to find ut which knowledge there is about participation of children and youth with disability in meetings with the society and elucidate factors that have an impact on the participation. This study focus on the children’s view on their own participation. The topic was examined with a selective systematic literature review. Forty studies showed that children want to be participating in their own habilitation contacts. The majority studies concern health care, very few social care. This study concerns children’s participation in the aspect how</p><p>• they are listened to</p><p>• they are supported in expressing their views</p><p>• their views are taken into account</p><p>• they are involved in decision-making processes and</p><p>• they participate and have power and responsibility for decision-making.</p><p>Children clearly desired participation in the three first levels and to some extent in the two latter. Time, flexibility, the staff ’s child competence and children’s participation competence, interaction competence (children, parents, staff) etc are important factors on individual and system level. Despite knowledge about children ’s competence the awareness still is low about the importance of children’s participation.</p>

Children’s participation in their planning in health and social services is important. To make children’s needs more considered they need to be involved in the cision-making processes. Children have the ability to reflect. The aim has been to find ut which knowledge there is about participation of children and youth with disability in meetings with the society and elucidate factors that have an impact on the participation. This study focus on the children’s view on their own participation. The topic was examined with a selective systematic literature review. Forty studies showed that children want to be participating in their own habilitation contacts. The majority studies concern health care, very few social care. This study concerns children’s participation in the aspect how • they are listened to • they are supported in expressing their views • their views are taken into account • they are involved in decision-making processes and • they participate and have power and responsibility for decision-making. Children clearly desired participation in the three first levels and to some extent in the two latter. Time, flexibility, the staff ’s child competence and children’s participation competence, interaction competence (children, parents, staff) etc are important factors on individual and system level. Despite knowledge about children ’s competence the awareness still is low about the importance of children’s participation.

No description available.

Public involvement in health services is an area of policy where ostensibly good intentions appear to repeatedly fail in implementation. Since the late 1990s public involvement in the UK NHS has been subject to frequent reforms, and this has continued in Scotland since devolution. Reformers have criticised mechanisms for being subject to manipulation by managers, parochial in their outlook, and crucially, ‘unrepresentative’ of the wider public. Academic literature has responded primarily by seeking to ‘fix’ the problems of public involvement, offering typologies and models of participation intended to apply across a wide range of settings and to the entire ‘public’. Taking a different route focused on the complexity of a single case, this thesis explores the multiple meanings and goals contained within the public involvement agenda in Scotland, and argues that these are far-removed from the way that many individual patients seek to influence their health-care in the everyday. In particular this project illuminates the creative and political potential of citizens’ interactions with public services. Research comprises an interpretive case study of the implementation of public involvement policy within one Community Health Partnership in Scotland, and a nested case study of interviews with ‘ordinary’ young adults in the area. Fieldwork across twelve months included semi-structured interviews with staff, participants, and young adults; observation of public and private meetings of the Community Health Partnership and the Public Partnership Forum; and analysis of local reports and plans for public involvement. Given a low level of awareness or interest in public involvement, interviews with young adults concentrated instead on accounts of using health services. Rather than simply illuminating ‘non-participation’, the resulting data act as a lens through which public involvement policy can be seen anew. Public involvement is depicted as an unevenly embedded assemblage of actors and materials pursuing a range of goals, including the strengthening of public influence and the diversification of the public voice. I argue that many current participants in the Public Partnership Forum seek not to change the NHS, but to serve or assist it, and accordingly that their actions can best be understood as work or volunteering, not as activism. Finally, drawing on the reported experiences of my young adult interviewees, I argue that the transition from individual patient to participant is an unlikely one, revealing a range of alternative (oppositional) tactics available to individuals who feel unhappy with some aspect of their care. I conclude by arguing that NHS staff confront the inherently chimerical nature of participatory projects within public services. By operating without a sense of what amount or degree of participation is ‘good enough’, public involvement re-interprets my young adult interviewees as apathetic nonparticipants, and NHS managers and staff as failed engagers. The thesis uncovers the neglected, often-mundane everyday realities of public involvement as both governmental practice and citizen participation. In doing so it troubles the growing literature on contemporary forms of citizen participation and engagement, demonstrating the need for a critical approach to an ostensibly compelling policy agenda.

Background Suicidal behaviour among young people is one of the major public health problems in low-income countries; it is estimated that every year 70,000 young people take their lives and maybe 40 times as many attempt suicide. Nicaragua has the highest suicide rate among young people of all Latin and Central American countries. This thesis aims at examining: (1) suicidal expressions and their determinants among school adolescents in Nicaragua, (2) cross-cultural aspects on suicidal expressions comparing Nicaragua and Cambodia, (3) pathways to suicide attempts among young men, and (4) primary health care professionals’ perceptions of suicidal behaviour and mental health problems among young people. Method Paper I is a cross-sectional study of 368 school adolescents in Nicaragua using self-report instruments (Youth Self Report and Attitudes Towards Suicide). Paper II compares data from Paper I with corresponding data from a study of 316 adolescents in Cambodia using the same methodology. Paper III is a qualitative study based on interviews with 12 young men who have recently attempted suicide. Paper IV is a qualitative study with 12 primary health care professionals. Results Paper I: Among adolescents, suicide ideation during recent year was reported by 22.6%, suicide plans 10.3%, and suicide attempts 6.5%. Girls were significantly more likely to report suicidal ideation. Multivariate analyses showed that anxious/depressed syndrome (YSR), somatic complaints syndrome (YSR) and exposure to attempted or completed suicide in significant others were significantly associated with their own serious suicidal expressions. Paper II: There was no significant difference in serious suicidal expressions (plans and attempts) between countries, but milder suicidal expressions during past year were more common among Nicaraguan young people. Overall, mental health problems were more commonly reported in Cambodia, where adolescents scored significantly higher on almost all YSR-syndromes as compared to Nicaraguan adolescents, except for withdrawn/depressed syndrome among boys. The pattern of association between mental health problems and suicide plans/attempts differed between countries. In Nicaragua, all eight YSR-syndromes were significantly associated with serious suicidal expressions for both genders compared to only one syndrome among girls and two syndromes among boys in Cambodia. Paper III: A model of the pathways leading to suicide attempts among young men was constructed based on the informants’ experiences. Structural conditions such as poverty or single-headed families, along with normative expectations within a framework of hegemonic masculinity, were all involved to create a sense of failure and an inability to cope. Subsequent increased drinking and drug abuse as well as exposure to attempted and completed suicide among friends and family acted as triggers to their own suicide attempt. Paper IV: Primary health care professionals felt themselves that they lacked knowledge and competence when approached by young people with mental health problems. Misconceptions were common. They felt frustrated which made them either ignore signs of mental health problems or reject help-seeking young people. In practice, a common response from health care professionals was to refer the patient over to someone else, the “hot potato” strategy. Conclusions The prevalence of serious suicidal expressions among young people in Nicaragua is within the range reported from Western high-income countries. Health care professionals need to be aware that somatic complaints as such are related to an increased risk of serious suicidal behaviour among young people, and that those who have been exposed to the attempted or completed suicide of someone close are at increased risk of serious suicidal expressions also when there are no warning signs in terms of mental distress. The cross-cultural comparison lends support to the notion that both cultural specificity and universality characterize serious suicidal expressions, as suggested by several researchers. Whereas prevalence shows less variation between cultures, associated factors might behave differently as shown in the present study, calling for different preventive approaches. The interviews with young men who had attempted suicide tell us that not only difficult socio-economic conditions but also the normative expectations on young men need to be addressed to decrease their risk of suicide. Health care professionals need to be alerted that sometimes serious mental health problems are hidden behind help-seeking for more trivial reasons. There is a necessity of a more integral approach towards mental health problems in PHC, including integral training of staff. The continued involvement of the community, family and other institutions would be essential to develop the care further.

No description available.

No description available.

My research investigates young people's stories of sexual practice. I focus on the questions: How do young people construct their sexual practices and their use of `safer' sex and, in particular, how important are `conventional' notions of gender and heterosexuality in these constructions? To answer these questions I collected and transcribed in-depth interviews from 25 young people aged between 16 and 19 from schools and youth groups in a London borough. Using a discourse analytic approach (Edley and Wetherell 1997) I draw my analysis directly from the participants' talk and how they construct a sexual story rather than framing the analysis through assumptions of gender inequality. Previous feminist literature, and in particular that of Holland et al. (1998), suggests that sexual experiences are constructed predominantly through a 'traditional' framework of gender. In this literature masculinity is said to be dominant in the heterosexual relationship, whereas femininity is seen as collaborative and submissive. In my thesis I question whether young people construct their intimate experiences through such `conventional' gendered patterns of behaviour and heteronormative values. I suggest an alternative analysis of young people's sex talk through focusing on discursive scripts emerging from the data in three areas: diversity, time/life plan, and trust. I argue that these scripts, for example the time and life plan scripts, are important features of young people's talk about sexual practices and are used as justifications for the use or non-use of 'safer' sex. The participants' talk that I call the 'children-older-with-a-platform' life plan script legitimises the use of condoms and/or pill as a method of protecting their plan. The 'children-now' script is a justification for the non-use of 'safer' sex. My research concludes that there are diverse stories of intimate experiences told in certain contexts by young people that have not previously been noted by researchers.