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Talking about death and dying is promoted in UK health policy and practice, from a perception that to do so encourages people to plan for their end of life and so increase their likelihood of experiencing a good death. This encouragement occurs alongside a belief that members of the public are reluctant to talk about death, although surveys suggest this is not the case. This paper describes findings from a research study in which people participated in deliberative discussion groups during which they talked about a range of topics related to death, including talking about death, the good death, choice and planning and compassionate communities. Here we report what they had to say in relation to talking about death and dying. We identified three themes: 1. The difference between talking about death as an abstract concept and confronting the certainty of death, 2. how death and dying presents issues for planning and responsibility, and 3. approaches to normalising death within society. For our participants, planning was considered most appropriate in relation to wills and funerals, while dying was considered too unpredictable to be easy to plan for; they had complex ideas about the value of talking about death and dying. [ABSTRACT FROM AUTHOR]

Purpose: Drawing on survey data (N = 7,826) collected in the United Kingdom, Australia, and the United States, this paper examines whether sexual orientation is a differentiating factor in explaining relationship quality and maintenance. Previous research suggests that sexual orientation is not significant in determining relationship satisfaction; however, these analyses have used traditional variable driven approaches, which do not provide an holistic view of the relationship by considering the unique combination of characteristics. Method: In this study, latent profile analyses were used, which is a person-centered approach that allows for identification of different types of long-term relationships. Results: Data suggested that LGB individuals had marginally higher levels of relationship quality compared to their heterosexual counterparts, and sexual orientation was also associated with differing types of long-term relationships. Discussion: These findings are interrogated in more detail, in particular, how sexual orientation is associated with types of long-term relationships and how everyday practices are associated with relationship quality. [ABSTRACT FROM AUTHOR]

The increasing amount of ‘unhealthy’ food consumed outside the home is thought to be a major contributory factor to growing levels of obesity. To tackle the problem and promote changes in catering and consumption behaviour, initiatives designed to encourage out-of-home caterers to provide healthier menus or adopt healthier cooking practices have been developed. Such voluntary agreements, rather than legislation, are the UK government’s preferred strategy. This paper reports on and explores issues arising from an evaluation of one such initiative – the Healthier Catering Commitment, piloted with over 80 independent businesses in London in the UK. Analysis of data on take-up of the scheme, and interviews with businesses and those involved in assessing them against the scheme’s criteria, suggests the extent to which businesses are prepared to make changes to their catering practices. Operational barriers as well as aspects of the local trading environment are shown to impact on the level of business commitment to the initiative. In considering the degree to which the scheme’s criteria inform, widen or restrict consumer choice, the paper adds to the debate on effective strategies for encouraging behaviour change. It also comments on the extent to which voluntary agreements are likely to be an effective means of ensuring a healthier food environment, and the extent to which government intervention is justified in the interests of improving public health and tackling health inequalities. [ABSTRACT FROM PUBLISHER]

Globally, clinical guidelines for HIV treatment are being altered to reflect new research showing that successful treatment with antiretroviral therapies (ART) can prevent the onward transmission of HIV. As a result, health care services are being challenged to find ways to roll out “treatment as prevention” (TasP) as a public health measure. In theory, TasP requires individuals to start ART as soon as they are diagnosed – for public health reasons – which may be some time before ART for that individual is required for clinical reasons. There is currently little research on the acceptability of TasP from a patient or provider perspective. This paper reports findings from a qualitative study that sought to explore UK nurses' views and experiences of TasP in HIV care. Ten HIV specialist nurses, purposively selected from across the country, were interviewed. Results suggest that, although positive about TasP in principle, nurses hold several reservations about its implementation in practice. Perceived benefits of TasP include reassurance for patients that their loved ones are protected and that immediate care is available. Concerns include the possibility of sexual dis-inhibition or coercion within sexual relationships. In the UK context, decisions around TasP are still being made on a highly individualised patient by patient basis, within a philosophy of holistic care and partnership working. As such, the research participants called for more resources to support information giving, risk assessment and decision-making. The results show that translating a public health treatment approach into individual patient care is complex, potentially time-consuming and may alter traditional provider–patient dynamics. The findings from this study suggest that in-depth research is needed to understand better the patient, community and provider experience as TasP becomes more widely rolled out. [ABSTRACT FROM AUTHOR]

In this article we discuss the findings from a recent study of UK policy and practice in relation to sexual health services for young people, based in - or closely linked with - schools. This study formed part of a larger project, completed in 2009, which also included a systematic review of international research. The findings discussed in this paper are based on analyses of interviews with 51 service managers and questionnaire returns from 205 school nurses. Four themes are discussed. First, we found three main service permutations, in a context of very diverse and uneven implementation. Second, we identified factors within the school context that shaped and often constrained service provision; some of these also have implications for sex and relationships education (SRE). Third, we found contrasting approaches to the relationship between SRE input and sexual health provision. Fourth, we identified some specific barriers that need to be addressed in order to develop 'young people friendly' services in the school context. The relative autonomy available to school head teachers and governors can represent an obstacle to service provision - and inter-professional collaboration - in a climate where, in many schools, there is still considerable ambivalence about discussing 'sex' openly. In conclusion, we identify areas worthy of further research and development, in order to address some obstacles to sexual health service and SRE provision in schools. [ABSTRACT FROM AUTHOR]

Background: Traditional laboratory-based skills training provides mass training that does not match clinical experience and is not tailored to individual needs. This compromises the transfer and retention of skills into clinical practice. Aim: To demonstrate the feasibility of integrating a centralised programme of laboratory-based surgical skills training into a higher surgical training programme and to evaluate its effectiveness and acceptability to trainees. Methods: Laboratory-based skills training was provided at a central site, delivered by consultants and tailored to the trainees' level of clinical experience. Each trainee was expected to attend one session a month for 11 months a year. Evaluation was conducted through attendance records, structured evaluations by participants, independent qualitative questionnaires and web interviews. Results: Forty-two specialist surgical trainees in the North West London higher surgical training programme participated in laboratory-based skills sessions delivered by 19 consultants over a period of two years. The average attendance was 70.5% for trainees and 100% for trainers. All sessions were rated by trainees as well-organised and useful with an average score of more than 4 out of 5. Trainees felt that the Skills Programme can complement surgical training by allowing practice under expert supervision in a safe environment. Conclusions: Centralising laboratory-based skills training and integrating it into a clinical programme is feasible and acceptable and represents a paradigm shift in surgical training. Involvement of trainees in designing the content is valuable. [ABSTRACT FROM AUTHOR]