Search

Background: Childhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown. Aim: This study aimed to explore primary care practice nurses' (PNs) use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice. Methods: A questionnaire was developed and distributed to nurses throughout the UK via convenience sampling in paper and online formats. Questions assessed the frequency of pain management intervention use during infant immunisation and barriers to their use. Findings: A total of 255 questionnaire responses were received. Over 90% (n  = 226) of respondents never used topical anaesthetics or sweet solutions during immunisations, while 41.9% advised breastfeeding occasionally (n =  103). Parent-/caregiver-led distraction was the most frequently used intervention, with most nurses using it occasionally (47.9%, n =  116) or often (30.6%, n =  74). Most practices had no immunisation pain management policy (81.1%, n =  184), and most PNs' previous training had not included pain management (86.9%, n =  186). Barriers to intervention use included lack of time, knowledge and resources. Excluding distraction, pain management strategies were infrequently or never used during infant immunisation. Key barriers to using evidence-based strategies were lack of time, knowledge and resources. [ABSTRACT FROM AUTHOR]

This paper examines the ways in which older people's residential and nursing homes can constitute heteronormative environments – social spaces in which the same-sex attractions and desires of residents are disregarded in the provision of everyday care. The aim of this discussion is to examine the synergies and differences between older lesbian, gay and bisexual (LGB) adults' expectations for future care home provision and the expectations of care staff and managers in providing residential services to older people with diverse sexual backgrounds. We present qualitative evidence from research into the provision of care environments in Wales. In this paper, we present findings from two cohorts: first, from five focus groups with care and nursing staff and managers; and second, from 29 semi-structured interviews with older LGB adults (50–76 years) residing in urban and rural locations across Wales. We argue that residential care environments can constitute heterosexualised spaces in which LGB identities are neglected in comparison to the needs and preferences of other residents. To this extent, we discuss how care staff and managers can be more attentive and responsive to the sexual biographies of all residents and argue against the separation of care and sexual orientation in practice. [ABSTRACT FROM PUBLISHER]

ObjectiveTo assess the feasibility of combining short-term and long-term dietary assessment instruments as new concept for improving usual dietary intake assessment on the individual level.DesignFeasibility study of completing three 24 h dietary recalls (24-HDR) and a self-administered food propensity questionnaire (FPQ). The 24-HDR was conducted by monthly telephone interviews, using EPIC-SOFT software. The FPQ was completely standardized across cohorts and offered either as a web-based tool or in paper format.SettingRandom sample derived from five ongoing European cohort studies (EPIC-San Sebastian, EPIC-Florence, EPIC-Potsdam, Estonia Genome Center (EGC) and Norwegian Women and Cancer study (NOWAC)).SubjectsA total of 400 participants.ResultsOverall, the total participation rate for the present study was 65·3 % (n 261). On average, completion of the 24-HDR was highest for the first 24-HDR (63·0 %) and decreased slightly for the second (60·3 %) and third 24-HDR (56·3 %). The proportions of selecting the web-based FPQ varied among the study centres, with the highest in EGC (92·9 %) and NOWAC (70·0 %) and the lowest in EPIC-San Sebastian (25·5 %) and EPIC-Potsdam (33·9 %). Web users rarely requested support and were younger and more highly educated than those who completed the paper format.ConclusionsThe present study supports the feasibility of a combined application of three 24-HDR and an FPQ in culturally different populations. The varying acceptance of the web-based instrument across populations requires a flexible application of assessment instruments. [ABSTRACT FROM PUBLISHER]

The impact of disparities in socio-economic status on the health of older people is an important issue for policy makers in the context of population ageing. As older people live in different types of economic circumstances and because, as people age, their desires and needs are different to those of younger generations, measures of living standards need to be appropriate for older people. This paper reports on the validation of a measure of living standards for older people based on Sen's Capability Approach. Using this approach, living standards are conceptualised as varying from constraint to freedom rather than from hardship to comfort. Using the New Zealand Longitudinal Study of Ageing omnibus survey of 3,923 adults aged 50–87 years, the validity of the measure was assessed. The results indicate that this measure assesses what older people are able to achieve. In addition, this measure discriminates better at the higher end of the living standards spectrum than an existing measure that assesses living standards from hardship to comfort in terms of what people possess. From this, a short form of the measure has been developed which offers a conceptually based and valid measure useful for survey research with older people. This measure of living standards provides future avenues for improved understandings of socio-economic position in later life. [ABSTRACT FROM PUBLISHER]

Active ageing policies seek to increase the quality of life of older people in three areas: health, security and participation. This paper focuses on a specific type of participation: associations. Its objective is to explore the possible self-selection effects of this type of participation, using global subjective quality of life indicators (satisfaction with life) and domain-specific indicators (satisfaction with leisure, community social integration and emotional resources). For this, a structural equation modelling analysis was conducted, taking into account bi-directional relationships between the variables of interest. The data come from a conditions and quality of life survey conducted in 2008 among a sample of 1,106 individuals aged 60 or over, living in community-dwellings in Spain. The results illustrate a complex model of relationships in which associative participation is not statistically significantly associated with the satisfaction measures used. This highlights the importance of self-selection effects and raises the issue of the effectiveness of associative participation as a tool to enhance the life satisfaction of older adults. [ABSTRACT FROM PUBLISHER]

This paper examines college athletes' perceived support for concussion reporting from coaches and teammates and its variation by year-in-school, finding significant differences in perceived coach support. It also examines the effects of perceived coach support on concussion reporting behaviors, finding that greater perceived coach support is associated with fewer undiagnosed concussions and returning to play while symptomatic less frequently in the two weeks preceding the survey. Coaches play a critical role in athlete concussion reporting. [ABSTRACT FROM AUTHOR]

Previous research has shown that exchanges of support within social networks reduce the loneliness of older adults. However, there is no consistent evidence on how types of support (instrumental and emotional) and the direction of that support (giving and receiving) are related to loneliness, and whether the effects are culture-specific. The aim of this study was to investigate support exchanges and their effects on loneliness in Spain and the Netherlands. We suggest that cultural differences, such as more interdependent cultural values in Southern Europe and more independence-related values in Northern Europe, influence social realities such as the social support exchanged. In Spain relationships with family members are determined by mutual obligations; older people expect to receive instrumental support from them. However, in Northern Europe independence is highly valued and intimacy and closeness are shown primarily by confiding about personal matters. This paper examined data from two comparable surveys, one in Spain (N=646) and one in the Netherlands (N=656). Older adults in Spain provide for, and receive, high amounts of instrumental support and this proved to be a protective factor against loneliness. An alternative pattern was found in the Netherlands where respondents provided more and received more emotional support than Spanish older adults; emotional support is a protective factor in the Netherlands (but only for support received). [ABSTRACT FROM PUBLISHER]

Previous research has shown that mobility and the ability to leave the home are among the essential aspects of older people's quality of life. However, surveys of older people's access to transport resources and the impact of mobility on welfare and wellbeing are few. Many previous studies are based on small samples or qualitative data. The questions addressed in this paper are how transport resources are distributed among different groups of older people, to which degree the transport needs of these groups are met and how this is related to their wellbeing. The empirical analysis is based on a Norwegian nationwide survey among 4,723 respondents 65 years and older. The respondents were asked about their access to transport resources, both private and public, health problems connected to use of transport modes, their daily activities and mobility, their uncovered transport needs and the importance of different activities for their life quality. The analysis reveals great differences between groups; especially between men and women, but also between different age groups and by different place of living. The special transport offered by the local authorities is seen as insufficient, and with increasing age a great deal of older people have low mobility and an uncovered transport need that reduces their life quality. [ABSTRACT FROM PUBLISHER]

Cash-for-care schemes offering cash payments in place of conventional social services are becoming commonplace in developed welfare states; however, there is little evidence about the impact of such schemes on older people. This paper reports on the impact and outcomes for older people of the recent English Individual Budget (IB) pilot projects (2005–07). It presents quantitative data on outcome measures from structured interviews with 263 older people who took part in a randomised controlled trial and findings from semi-structured interviews with 40 older people in receipt of IBs and with IB project leads in each of the 13 pilot sites. Older people spent their IBs predominantly on personal care, with little resources left for social or leisure activities; and had higher levels of psychological ill-health, lower levels of wellbeing, and worse self-perceived health than older people in receipt of conventional services. The qualitative interviews provide insights into these results. Potential advantages of IBs included increased choice and control, continuity of care worker, and the ability to reward some family carers. However, older people reported anxieties about the responsibility of organising their own support and managing their budget. For older people to benefit fully from cash-for-care schemes they need sufficient resources to purchase more than basic personal care; and access to help and advice in planning and managing their budget. [ABSTRACT FROM PUBLISHER]

Migrant care workers make a substantial contribution to older adult care in Ireland and the United Kingdom (UK). However, little is known about the relational aspects of care involving migrant care workers and older people. Given that the care relationship is closely linked to quality of care, and that the Irish and UK sectors are increasingly restricted by economic austerity measures, this lack of information is a concern for care practice and policy. Our paper explores the relationship between migrant care workers and older people in Ireland and the UK and draws on data collected in both countries, including focus groups with older people (N = 41), interviews with migrant care workers (N = 90) and data from a survey of and interviews with employers. The findings illustrate the complexity of the migrant care worker–older person relationship; the prevalence of need orientated, friendship and familial-like, reciprocal, and discriminatory interlinking themes; and the role of individual, structural and temporal factors in shaping these relationships. [ABSTRACT FROM PUBLISHER]

BackgroundThis study examined the prevalence of major depressive disorder (MDD), and the correlations and co-morbid conditions associated with MDD, in the adult Taiwanese population, which a previous estimate in the 1980s had found to be at the lower end of the spectrum worldwide. Possible explanations for the reported low prevalence of MDD were evaluated.MethodAs part of a survey of common psychiatric disorders in a nationally representative sample of individuals aged ⩾18 years who were non-institutionalized civilians in Taiwan, a face-to-face interview using the paper version of the World Mental Health Survey of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI) was conducted between 2003 and 2005. Functional impairment and help-seeking behaviors were compared between Taiwanese subjects with MDD and their counterparts in the USA.ResultsAmong the 10 135 respondents, the lifetime prevalence of MDD was 1.20% [standard error (s.e.)=0.2%]. Individuals who were divorced or widowed, aged ⩽40 years, and female were at increased risk, whereas rural residents were at lower risk for MDD. The proportion of MDD cases co-morbid with other psychiatric disorders in this study was much lower than in the US study. Only one-third of Taiwanese individuals with MDD sought help despite having twice the number of lost workdays compared with the US sample.ConclusionsDespite the low prevalence of MDD in Taiwanese adults, the pattern of low help-seeking behavior and profound functional impairment indicates much room for improvement in the early detection of and intervention in major depression in this population. [ABSTRACT FROM PUBLISHER]

BackgroundEvidence for an effect of work stressors on common mental disorders (CMD) has increased over the past decade. However, studies have not considered whether the effects of work stressors on CMD remain after taking co-occurring non-work stressors into account.MethodData were from the 2007 Adult Psychiatric Morbidity Survey, a national population survey of participants ⩾16 years living in private households in England. This paper analyses data from employed working age participants (N=3383: 1804 males; 1579 females). ICD-10 diagnoses for depressive episode, generalized anxiety disorder, obsessive compulsive disorder, agoraphobia, social phobia, panic or mixed anxiety and depression in the past week were derived using a structured diagnostic interview. Questionnaires assessed self-reported work stressors and non-work stressors.ResultsThe effects of work stressors on CMD were not explained by co-existing non-work stressors. We found independent effects of work and non-work stressors on CMD. Job stress, whether conceptualized as job strain or effort–reward imbalance, together with lower levels of social support at work, recent stressful life events, domestic violence, caring responsibilities, lower levels of non-work social support, debt and poor housing quality were all independently associated with CMD. Social support at home and debt did not influence the effect of work stressors on CMD.ConclusionsNon-work stressors do not appear to make people more susceptible to work stressors; both contribute to CMD. Tackling workplace stress is likely to benefit employee psychological health even if the employee's home life is stressful but interventions incorporating non-work stressors may also be effective. [ABSTRACT FROM PUBLISHER]