Sexual behaviours determined incidence and reinfection, regardless of healthcare setting. Our results suggest annual screening of women aged 16-24 years who are chlamydia negative, or sooner if partner change occurs. Rescreening chlamydia-positive women within 6 months of baseline infection may be sensible, especially if partner change occurs or all partners are not treated.

Objectives: To determine the prevalence and treatment outcomes among young women screened opportunistically for genital Chlamydia trachomatis and to evaluate the impact of screening in those participating. Design: An opportunistic screening programme (1 September 1999 to 31 August 2000) using urine samples, tested by ligase chain reaction (LCR). In-depth interviews were used for programme evaluation. Setting: Screening was offered in two health authorities at general practice, family planning, genitourinary medicine (GUM), adolescent sexual health, termination of pregnancy clinics and women's services in hospitals (antenatal, colposcopy, gynaecology and infertility clinics). Main participants: Sexually active women (16-24 years) attending for any reason. Main outcome measures: Screening data: prevalence of infection by age and healthcare setting; proportion of positive patients attending for treatment. Evaluation data: participants' attitudes and views towards screening and follow up. Results: In total, 16 930 women (16-24 years) were screened. Prevalence was higher in younger women (16-20) than those aged 21-24 years and was highly variable at different healthcare settings (range 3.4%-17.6%). Prevalence was approximately 9% in general practice. The role of the project health advisers in managing results and coordinating treatment of positive individuals was essential; the vast majority of all positives were known to be treated. Women felt that screening was beneficial. Improving awareness and education about sexually transmitted infections is required to alleviate negative reactions associated with testing positive for infection. Conclusions: Prevalence of infection outside GUM clinics is substantial and opportunistic screening using urine samples is an acceptable method of reaching individuals with infection who do not normally present at specialist clinics.T his paper presents data from a large scale pilot of opportunistic screening for genital Chlamydia trachomatis infection at a range of healthcare settings including primary care. Offering opportunistic screening at healthcare settings outside genitourinary medicine (GUM) clinics is likely to detect many infected individuals who may not consider themselves at risk of infection, or who are asymptomatic and so would not normally be diagnosed. The main aim of the pilot, which was undertaken in response to the recommendations of the chief medical officer's expert advisory group on Chlamydia trachomatis, 1 was to assess the feasibility and acceptability of screening in healthcare settings outside GUM clinics. In addition, the study has generated accurate estimates of prevalence in healthcare settings outside GUM clinics, which can be used to inform decision making on the cost effectiveness of screening and which settings should be utilised in a national screening programme. In this paper, we present results on the prevalence of infection, treatment outcomes, and the impact of screening on young people taking part in the programme. METHODSA full description of th...

High parental expressed emotion (EE), reflected by criticism or emotional over-involvement, has been related to poorer outcome in family-based treatment (FBT) for adolescent anorexia nervosa. This study assessed EE in 89 mothers and 64 fathers at baseline and end of treatment in a randomised trial comparing conjoint FBT to parent-focused FBT (PFT). Compared with conjoint FBT, PFT was associated with a decrease in maternal criticism, regardless of adolescent remission. Furthermore, an increase in maternal criticism was more likely to be observed in conjoint FBT (80%) than PFT (20%, p = 0.001). Adolescents of mothers who demonstrated an increase in EE, or remained high in EE, were less likely to remit compared with adolescents for whom EE decreased or remained low (33% and 0% vs. 43% and 50%, p = 0.03). There were no significant effects for paternal EE. The results highlight the importance of considering EE when implementing FBT for adolescents with anorexia nervosa. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Family-based treatment (FBT; Lock & Le Grange, 2013) is currently the most efficacious outpatient treatment for medically stable adolescents with anorexia nervosa (AN) (Lock, 2015) and is considered first-line outpatient treatment (Ciao, Accurso, Fitzsimmons-Craft, Lock, & Le Grange, 2015; Couturier, Kiymber, & Szatmari, 2013). Despite this, FBT is not effective for all patients, thus prompting exploration of factors that might enhance, or hinder, patient recovery. One such factor is expressed emotion (EE).Expressed emotion characterises the quality of interpersonal interactions and the relationship between a caregiver and an unwell relative (Brown & Rutter, 1966;Hodes, Dare, Dodge, & Eisler, 1999;Vaughn & Leff, 1976). Family members characterised as having high EE are generally critical or hostile towards the unwell family member and/or emotionally overinvolved (Rienecke, Accurso, Lock, & Le Grange, 2016). In assessing EE within families, the attitudes, emotions and feelings expressed by family members towards an unwell relative is evaluated (Rein et al., 2006). The most common face-to-face methods used to assess EE are the Camberwell Family Interview (Vaughn & Leff, 1976), Standardised Clinical Family Interview (SCFI;Kinston & Loader, 1984) and the Five Minute Speech Sample (FMSS; Magana, Goldstein, Karno, & Miklowitz, 1986).Early studies have suggested that parental EE predicts treatment response in family therapy for adolescents with AN. Specifically, high parental EE has been associated with treatment dropout (Szmukler, Eisler, Russell, & Dare, 1985) and poor treatment outcomes (Le Grange, Eisler, Dare, & Russell, 1992;van Furth et al., 1996). For instance, in a small (n = 18) randomised clinical trial (RCT) of conjoint family therapy (CFT) versus separated family therapy (SFT), parents of adolescents who had a poor response to treatment made significantly more critical comments during the SCFI (i.e., high EE) at baseline compared with those who had a good or inte...

The American Academy of Paediatrics recommend that parent and children (aged 2–18 years) jointly engage in media yet the impact on interactions is unknown. This systematic review identified joint media engagement (JME) rates, the supports offered by parents and children to each other and the impact of JME on parent–child interactions. A search within six article databases (ProQuest, PsycInfo, Web of Science, Scopus, Pub Med, and CINAHL) from January 2007 to June 2019 found 7,130 results. Included papers involved parent–child dyads engaging in JME with a smartphone or tablet. In the 27 identified papers, most parents engaged in JME sometimes (41–72%) compared to JME use that was frequent (13–38%) and JME refusal (4–8%). Parents and children supported each other with cognitive, physical, technical, and affective techniques. Children were more engaged during JME activities and key elements of language quality was reduced compared to nonmobile device activities (such as toy play). The impact of JME on language quantity, warmth, scaffolding and the overall parent–child relationship was inconsistent, however, several factors that potentially influenced this impact were identified. Research investigating these factors and how apps may foster interactions is needed.