Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Remote measurement technology (RMT) offers the opportunity to provide insight and support for self-management of health in real-time. These methods could augment healthcare by providing personalised, precise and pre-emptive interventions. However, for successful implementation users need to be engaged in its use. Objective: This paper provides an overview of the key barriers and facilitators to engagement and use. It is timely as mobile technology such as wearable devices and smartphone applications are becoming increasingly available. Methods: A systematic review using PRISMA guidelines involving original studies dating back to the last systematic review published in 2014. They were included if they met the following PICOS entry criteria. Population: people using RMT approaches to aid management of health; Intervention: RMT system; comparison group: no comparison group specified; outcomes: qualitative and or quantitative evaluation of the barriers and facilitators to engagement with this system; study design: randomized controlled trials (RCT), feasibility studies, and observational studies. Five databases were searched: Ovid MEDLINE, IEEE Xplore, EMBASE, Web of Science and the Cochrane Library, from January 2014 to May 2017). Articles were screened by two researchers, independently. Study characteristics were extracted and a content analysis conducted to define emerging themes to synthesise findings. Formal quality assessments were performed to address risk of bias. Results: Thirty-three publications met inclusion criteria, employing either quantitative, qualitative or mixed-methods designs. Studies were conducted in 10 countries, included men and women, ranging from 8-95 years and included both active and passive remote monitoring systems for a diverse range of physical and mental health conditions. However, they were relatively short and had small sample sizes and reporting of usage statistics was inconsistent. Acceptability of RMT according to the average percentage of time used (64-86.5%) and dropout rates (0-44%) were variable. The barriers and facilitators from the content analysis related to: health status, perceived utility and value, motivation, convenience and accessibility, and usability. These led to the development of a model of barriers and facilitators of engagement with RMT. Conclusions: The hypothesised model of processes that could facilitate RMT engagement may drive the development of more person-focussed RMT, especially if it involves co-design with the target audience. However, it needs further testing through carefully designed experimental studies.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Access to internet-enabled technology and online services has grown exponentially in recent decades. This growth potentially excludes some communities and individuals with mental health difficulties, who face a heightened risk of digital exclusion. But it is unclear what factors may contribute to digital exclusion in this population. Objective: To explore in detail the problems of digital exclusion in mental health service users and potential facilitators to overcome it. Methods: Semi-structured interviews were conducted with twenty mental health service users who were deemed to be digitally excluded. Participants were recruited from a large secondary mental health provider in South London, UK. Thematic analysis was employed to identify themes and sub-themes relating to historical and extant reasons for digital exclusion, and methods of overcoming it. Results: Three major themes appeared to maintain digital exclusion:(i) a perceived lack of knowledge, (ii) being unable to access the necessary technology and services due to personal circumstances, and (iii) the barriers presented by mental health difficulties. Specific facilitators for overcoming digital exclusion included intrinsic motivation, and a personalised learning format which reflects the individual’s unique needs and preferences. Conclusions: Multiple factors contribute to digital exclusion among mental health service users, including material deprivation and mental health difficulties. This means that efforts to overcome digital exclusion must address the multiple deprivations individuals may face in the offline world, in addition to their individual mental health needs. Additional facilitators include fostering an intrinsic motivation to overcome digital exclusion, and providing a personalised learning format tailored to the individual’s knowledge gaps, and preferred learning style.

Summary: This review considers juvenile delinquency and justice from an international perspective. Youth crime is a growing concern. Many young offenders are also victims with complex needs, leading to a public health approach that requires a balance of welfare and justice models. However, around the world there are variable and inadequate legal frameworks and a lack of a specialist workforce. The UK and other high-income countries worldwide have established forensic child and adolescent psychiatry, a multifaceted discipline incorporating legal, psychiatric and developmental fields. Its adoption of an evidence-based therapeutic intervention philosophy has been associated with greater reductions in recidivism compared with punitive approaches prevalent in some countries worldwide, and it is therefore a superior approach to dealing with the problem of juvenile delinquency.

Objectives: To assess whether there are shared or divergent (a) cognitive and (b) emotion processing characteristics among violent individuals with antisocial personality disorder and/or schizophrenia, diagnoses which are commonly encountered at the interface of mental disorder and violence. Cognition and emotion processing are incorporated into models of violence, and thus an understanding of these characteristics within and between disorder groups may help inform future models and therapeutic targets. Methods: Relevant databases (OVID, Embase, PsycINFO) were searched to identify suitable literature. Meta-analyses comparing cognitive function in violent schizophrenia and antisocial personality disorder to healthy controls were conducted. Neuropsychological studies not comparing these groups to healthy controls, and emotion processing studies, were evaluated qualitatively. Results: Meta-analyses indicated lower IQ, memory and executive function in both violent schizophrenia and antisocial personality disorder groups compared to healthy controls. The degree of deficit was consistently larger in violent schizophrenia. Both antisocial personality disorder and violent schizophrenia groups had difficulties in aspects of facial affect recognition, although theory of mind results were less conclusive. Psychopathic traits related positively to experiential emotion deficits across the two disorders. Very few studies explored comorbid violent schizophrenia and antisocial personality disorder despite this being common in clinical practice. Conclusion: There are qualitatively similar, but quantitatively different, neuropsychological and emotion processing deficits in violent individuals with schizophrenia and antisocial personality disorder which could be developed into transdiagnostic treatment targets for violent behaviour. Future research should aim to characterise specific subgroups of violent offenders, including those with comorbid diagnoses.