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Introduction: The impact of multiple health conditions on bowel cancer screening is currently unknown. We explored the impact of multiple health conditions on bowel cancer screening perceptions, experience and clinical management decisions following a positive stool test. Methods: Semi‐structured qualitative interviews were conducted remotely with Bowel Screening Wales staff (n = 16) stratified by regional location and role and with screening participants (n = 19) stratified by age, gender and comorbidity. Interview topics were guided by the Common‐Sense Model. Results: Screening participants, regardless of comorbidity status, placed great emphasis on the importance of early detection of cancer and completing the bowel screening process. Screening staff emphasised comorbidities in the clinical decision‐making process; however, screening participants had low awareness of the impact that comorbidities can have on bowel screening. Participants describe how the presence of multiple health conditions can mask potential bowel symptoms and influence beliefs about follow‐up. Conclusion: Bowel screening staff try to individualise the service to meet participant needs. The potential mismatch in screening staff and participant awareness and expectations of the bowel screening and diagnostic process needs to be addressed. Clearer and more regular communication with screening participants could support the screening process, particularly for those with significant coexisting health conditions or facing time delays. The possible masking effects and misattribution of symptoms because of comorbidities highlight an opportunity for education and raising awareness for screening participants and a potential area of focus for discussions in clinical consultations and staff training. Patient and Public Contribution: Project funding included costs for patients and public contributors to be compensated for their contributions to the project, in line with current standards. A patient and public contributor was involved in the design of the study, including protocol development, and the interpretation of key findings and implications for patients, which are subsequently reflected within the manuscript. [ABSTRACT FROM AUTHOR]

Background: This paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support underserved populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions. Methods: A type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework. Results: Reach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme. Conclusion: Community-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health. [ABSTRACT FROM AUTHOR]

Background: The UK National Health Service (NHS) is one of the largest employers in the world and employs around 360,000 registered nurses. Following a protracted pay dispute in December 2022 NHS nurses engaged in industrial action resulting in the largest nurse strikes in the 74-year history of the NHS. Initially it appeared these strikes were a direct consequence of pay disputes but evidence suggests that the situation was more complex. This study aimed to explore what the key factors were in driving UK NHS nurses' decision to strike. Methods: A convergent parallel mixed methods design was used. The study was conducted throughout the UK and involved participants who were nurses working for the NHS who voted in favour of strike action. Data collection involved the use of an online survey completed by 468 nurses and 13 semi-structured interviews. Descriptive and inferential statistics were used for quantitative data analysis and a process of inductive thematic analysis for the qualitative data. The quantitative and qualitative data were analysed separately and then integrated to generate mixed methods inferences. Results: The quantitative findings showed that patient safety, followed by staff shortages, pay, and unmanageable work demands were the most important factors encouraging nurses' decision to strike. The qualitative findings served to further the understanding of these factors particularly in relation to participants' perception of the NHS and the consequences of inadequate pay and staff shortages. Three overarching and overlapping themes represented the qualitative findings: Save our NHS, Money talks, and It's untenable. Integration of the findings showed a high level of concordance between the two data sets and suggest that the factors involved are interconnected and inextricably linked. Conclusions: The UK NHS is a challenging and demanding work environment in which the well-being of its patients is dependent on the well-being of those who care for them. Concerns relating to patient welfare, the nursing profession and the NHS played a large part in driving UK NHS nurses' decision to strike. In order to address these concerns a focus on recruitment and retention of nurses in the NHS is needed. [ABSTRACT FROM AUTHOR]

There is clear evidence that university students are experiencing significant mental health difficulties, further exacerbated by the temporary closure of university campuses during the height of the COVID-19 pandemic. Against this backdrop, our study – Student Wellbeing and Experiential Learning Spaces (SWELS) – explored the role of experiential learning spaces in supporting student wellbeing. We adopted a mixed-methods approach, consisting of an online survey and interviews with students from three research intensive UK Universities. The survey results revealed that compared to the national average of 16–25-year-olds from the UK Office for National Statistics' (ONS) wellbeing questionnaire, the sampled students exhibited significantly lower levels of life satisfaction, happiness, perceived worthwhileness and higher levels of anxiety. The qualitative results further confirmed that students perceived their wellbeing to be affected by their university experience and the COVID pandemic. However, the results also suggest that experiential learning spaces (such as museums, collections, libraries, and gardens) hold strong potential to support student mental health. Accordingly, the study indicates that diversifying module content and conscientiously considering both physical and digital learning spaces can positively impact students. In short, curricula that are cognisant of the physical learning environment and embed a focus on wellbeing into their content might help to bolster student wellbeing. [ABSTRACT FROM AUTHOR]

Pandemics threaten world stability; however, spread is mitigated with prevention behaviors. We introduce "personally relevant knowledge" to explain the knowledge–behavior gap (i.e., objective and subjective knowledge on information acquisition and behavioral change). Hypotheses are derived from prior knowledge literature, economic psychology, and relevance theory. Multimethod analysis (survey data, partial least squares structural equation path modeling [PLS-SEM], and an asymmetric information theoretic statistical analysis) is applied to H1N1 data from the USA and Australia. Personally relevant knowledge is an important addition to prior knowledge conceptualizations, and information theory uncovers asymmetric variable relationships concerning the knowledge–behavior gap, not captured by PLS-SEM. [ABSTRACT FROM AUTHOR]

Background: Pelargonium sidoides DC (Geraniaceae) root extract, EPs®7630 or "Kaloba®", is a widely used herbal remedy for respiratory infections, with some evidence of effectiveness for acute bronchitis. However, it is not yet widely recommended by medical professionals in the UK. There is a need to undertake appropriately designed randomised trials to test its use as an alternative to antibiotics. The aim was to assess the feasibility of conducting a double-blind randomised controlled trial of Pelargonium sidoides root extract for treatment of acute bronchitis in UK primary care, investigating intervention compliance, patient preference for dosage form and acceptability of patient diaries. Study design: Feasibility double-blind randomised placebo-controlled clinical trial. Methods: We aimed to recruit 160 patients with cough (≤ 21 days) caused by acute bronchitis from UK general practices. Practices were cluster-randomised to liquid or tablet preparations and patients were individually randomised to Kaloba® or placebo. We followed participants up for 28 days through self-reported patient diaries with telephone support and reviewed medical records at one month. Outcomes included recruitment, withdrawal, safety, reconsultation and symptom diary completion rates. We also assessed treatment adherence, antibiotic prescribing and consumption, mean symptom severity (at days 2–4 after randomisation) and time to symptom resolution. We interviewed 29 patients and 11 health professionals to identify barriers and facilitators to running such a randomised trial. Results: Of 543 patients screened, 261 were eligible, of whom 134 (51%) were recruited and 103 (77%) returned a completed diary. Overall, 41% (41/100) of patients took antibiotics (Kaloba® liquid group: 48% [15/31]; placebo liquid group: 23% [6/26]; Kaloba® tablet group: 48% [9/21]; placebo tablet group: 50% [11/22]). Most patients adhered to the study medication (median 19 out of 21 doses taken in week 1, IQR 18–21 - all arms combined). There were no serious adverse events relating to treatment. Most patients interviewed found study recruitment to be straightforward, but some found the diary too complex. Conclusions: It was feasible and acceptable to recruit patients from UK primary care to a double-blind placebo-controlled trial of herbal medicine (Kaloba®) for the treatment of acute bronchitis, with good retention and low data attrition. Trial registration: HATRIC was registered on the ISRCTN registry (ISRCTN17672884) on 16 August 2018, retrospectively registered. The record can be found at http://www.isrctn.com/ISRCTN17672884. [ABSTRACT FROM AUTHOR]

Background: Caregivers frequently provide support to people living with long-term conditions. However, there is paucity of evidence of interventions that support caregivers in their role. Rehabilitation EnAblement in Chronic Heart Failure (REACH-HF) is a novel home-based, health-professional-facilitated, self-management programme for patients with heart failure (HF) and their caregivers. Methods: Based on the random allocation of individual adult patients with reduced ejection fraction (HFrEF) and left ventricular ejection fraction <45% within the past five years, the caregiver of patients was allocated to receive the REACH-HF intervention over 12 weeks (REACH-HF group) or not (control group). Caregiver outcomes were generic health-related quality of life (EQ-5D-5L), Family Caregiver Quality of Life Scale questionnaire (FamQol), Caregiver Burden Questionnaire HF (CBQ-HF), Caregiver Contribution to Self-care of HF Index questionnaire (CC-SCHFI) and Hospital Anxiety and Depression Scale (HADS). Outcomes were compared between groups at 4, 6 and 12 months follow-up. Twenty caregivers receiving REACH-HF were purposively selected for qualitative interviews at 4 and 12 months. Results: Compared with controls (44 caregivers), the REACH-HF group (53 caregivers) had a higher mean CC-SCHFI confidence score at 12 months (57.5 vs 62.8, adjusted mean difference: 9.3, 95% confidence interval: 1.8–16.8, p = 0.016). No significant between group differences were seen in other caregiver outcomes. Qualitative interviews showed that most caregivers who received the REACH-HF intervention made positive changes to how they supported the HF patient they were caring for, and perceived that they had increased their confidence in the caregiver role over time. Conclusion: Provision of the REACH-HF intervention for caregivers of HF patients improved their confidence of self-management and was perceived for some to be helpful in supporting their caregiver role. [ABSTRACT FROM AUTHOR]

Background: Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context. Aim: To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom. Design: Exploratory, sequential, mixed-methods design. Methods: Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in palliative care. The 'Ethical Issues in Palliative Care for Nursing Homes' instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015. Ethical considerations: Ethical approval was granted by Queen's University's School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home's manager. Findings: The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress. Conclusion: The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change. [ABSTRACT FROM AUTHOR]

Background: traditional health workforce roles are changing, with existing roles being extended and advanced, while new roles are being created, often undertaking duties previously completed by doctors, sometimes referred to as non-medical practitioners (NMPs). Aim: to investigate which NMP roles exist within the UK, mapping distribution, and explore factors influencing their development and recruitment. Methods: two descriptive, exploratory, online self-completed semi-structured questionnaires were used. One was sent to all NHS acute healthcare providers (n=156) and private/independent healthcare providers in England (n=90). A separate questionnaire collected data, using convenience and snowballing approaches, from NMPs across the UK. Quantitative data were analysed using descriptive and frequency statistics. Qualitative data derived from open questions and comments were analysed using content and thematic analysis. Results: healthcare organisations in England returned 23/246 useable questionnaires; 115 NMPs returned responses, 19 did not meet the criteria, leaving 96 useable responses. Conclusion: seven NMP roles were identified, throughout the UK, with regional variation. Several factors influence the development and recruitment of NMP roles in England such as service delivery and national policies. Inconsistencies were noted in Agenda for Change pay banding. Many practitioners undertook NMP roles to progress their career clinically. [ABSTRACT FROM AUTHOR]

Background The health risks of cigarette smoking are well established. As a result, reducing cigarette smoking is a key concern for public health agencies. Little is known about rates of smoking among adults with disabilities. Methods Secondary analysis of data collected in Waves 2 and 7 of 'Understanding Society', an annual household panel study. Results Age and gender adjusted odds ratios (AORs) of adults with disabilities smoking increased significantly from 1.41 (1.33–1.49) in 2010–12 to 1.57 (1.45–1.70) in 2015–17 (P = 0.032). AORs of adults with disabilities smoking 20 or more cigarettes a day increased non-significantly from 1.83 (1.66–2.02) in 2010–12 to 1.90 (1.65–2.20) in 2015–17. These changes were evident for both men and women and across age groups. Additionally adjusting these estimates to take account of between group differences in socioeconomic position significantly reduced the AORs for both smoking outcomes. Changes over time in AORs reflected a more rapid decline in smoking among participants without a disability. Conclusions Adults with disabilities are more likely than their peers to smoke. Public health agencies and practitioners may wish to consider what reasonable adjustments may need to be made to policies and interventions to ensure that they are effective for adults with disabilities. [ABSTRACT FROM AUTHOR]

The Working Alliance Inventory remains a widely studied measure of quality of therapeutic relationships between the practitioner and client. No prior study has examined the psychometrics and validity of the Working Alliance Inventory–Short (WAI-S) in a sample of families, social workers, and trained observers within child protection services. Surveys were completed by 130 families, social workers concerning 274 cases, and observers following 165 home visits during the first wave of data collected from a randomized controlled trial of child protection services. Confirmatory factor analyses were conducted on three versions of the WAI-S and demonstrated moderate to good model fit. Convergent construct validity was found with other standardized measures. Results support the use of the WAI-S during in child protection services practice and research. Future research into family engagement in child protection social work services should focus on the working relationship. [ABSTRACT FROM AUTHOR]

This article describes the experiences of undergraduate healthcare students taking a module adopting a ‘flipped classroom’ approach. Evidence suggests that flipped classroom as a pedagogical tool has the potential to enhance student learning and to improve healthcare practice. This innovative approach was implemented within a healthcare curriculum and in a module looking at public health delivered at the beginning of year two of a 3-year programme. The focus of the evaluation study was on the e-learning resources used in the module and the student experiences of these; with a specific aim to evaluate this element of the flipped classroom approach. A mixed-methods approach was adopted and data collected using questionnaires, which were distributed across a whole cohort, and a focus group involving ten participants. Statistical analysis of the data showed the positive student experience of engaging with e-learning. The thematic analysis identified two key themes; factors influencing a positive learning experience and the challenges when developing e-learning within a flipped classroom approach. The study provides guidance for further developments and improvements when developing e-learning as part of the flipped classroom approach. [ABSTRACT FROM AUTHOR]

Background: British South Asians have a higher incidence of diabetes and poorer health outcomes compared to the general UK population. Beliefs about diabetes are known to play an important role in self-management, yet little is known about the sociocultural context in shaping beliefs. This study aimed to explore the influence of sociocultural context on illness beliefs and diabetes self-management in British South Asians. Methods: A mixed methods approach was used. 67 participants recruited using random and purposive sampling, completed a questionnaire measuring illness beliefs, fatalism, health outcomes and demographics; 37 participants completed a social network survey interview and semi-structured interviews. Results were analysed using SPSS and thematic analysis. Results: Quantitative data found certain social network characteristics (emotional and illness work) were related to perceived concern, emotional distress and health outcomes (p < 0.05). After multivariate analysis, emotional work remained a significant predictor of perceived concern and emotional distress related to diabetes (p < 0.05). Analysis of the qualitative data suggest that fatalistic attitudes and beliefs influences self-management practices and alternative food 'therapies' are used which are often recommended by social networks. Conclusions: Diabetes-related illness beliefs and self-management appear to be shaped by the sociocultural context. Better understanding of the contextual determinants of behaviour could facilitate the development of culturally appropriate interventions to modify beliefs and support self-management in this population. [ABSTRACT FROM AUTHOR]

Objectives Obsessive-compulsive disorder ( OCD) is often perceived as being difficult to treat. This study aimed to test the hypothesis that treatment non-response in routine clinical practice is often due to failures in the delivery of treatment, and that most patients who are apparently treatment-resistant will respond to treatment if adequately delivered. Design Retrospective cohort data analysis. Methods Forty-three young people with severe, treatment-resistant OCD (defined as Children's Yale-Brown Obsessive-Compulsive Scale [ CY- BOCS] scores ≥30 and non-response to previous cognitive behaviour therapy [ CBT] and selective serotonin reuptake inhibitors) were referred to a specialist clinic and completed a course of manualized CBT, with ( N = 21) or without ( N = 22) optimization of medication. A sub-sample ( N = 15) completed a semi-structured interview to determine characteristics of their previous CBT; quality was assessed according to pre-determined criteria. Results Specialist treatment was associated with significant reductions in OCD symptoms at post-treatment with gains maintained at 3-month follow-up. At the 3-month follow-up, 58% of patients showed a meaningful clinical response (≥35% drop on the CY- BOCS) and 22% were in remission (≤12 on the CY- BOCS). Patients whose medication was optimized tended (non-significantly) to have better responses. The quality of previous CBT was assessed in a sub-group of participants and rated as inadequate in 95.5% of cases. The most common inadequacy was insufficient focus on exposure techniques. Conclusions These findings provide support for the notion that treatment non-response in routine practice may be due to technical treatment failures and highlight the need to disseminate good quality evidence-based treatment among this population. Research is also needed to understand factors that impede outcome to further improve response and remission rates. Practitioner points Among young people with OCD, failure to respond to treatment in routine clinical practice may often reflect the nature of the treatment received., Exposure techniques may often be overlooked in CBT for OCD, potentially resulting in poor therapeutic response., Most young people with severe and apparent treatment-resistant OCD respond to outpatient CBT incorporating E/ RP., Further research is needed to establish effective methods for disseminating good quality CBT for OCD. [ABSTRACT FROM AUTHOR]

The article reports findings from a study of negative and harmful experiences of children participating in organised sport in the UK focusing in particular on emotional harm. A convenience sample of 6124 young people (age 18–22) completed an online survey about their experiences of sport as children (up to age 16); 89 follow-up telephone interviews were conducted. The article provides information about the emotional harm of children in sport and the context within which it occurs. It provides some evidence of a sporting culture where emotional harm is widespread at all levels of sport and commonly experienced by children of all ages. [ABSTRACT FROM PUBLISHER]

Background and aims British alcohol consumption and abstinence rates have increased substantially in the last 3 decades. This study aims to disentangle age, period and birth cohort effects to improve our understanding of these trends and suggest groups for targeted interventions to reduce resultant harms. Design Age, period, cohort analysis of repeated cross-sectional surveys using separate logistic and negative binomial models for each gender. Setting Great Britain 1984-2009. Participants Annual nationally representative samples of approximately 20 000 adults (16+) within 13 000 households. Measurements Age (eight groups: 16-17 to 75+ years), period (six groups: 1980-84 to 2005-09) and birth cohorts (19 groups: 1900-04 to 1990-94). Outcome measures were abstinence and average weekly alcohol consumption. Controls were income, education, ethnicity and country. Findings After accounting for period and cohort trends, 18-24-year-olds have the highest consumption levels (incident rate ratio = 1.18-1.15) and lower abstention rates (odds ratio = 0.67-0.87). Consumption generally decreases and abstention rates increase in later life. Until recently, successive birth cohorts' consumption levels were also increasing. However, for those born post-1985, abstention rates are increasing and male consumption is falling relative to preceding cohorts. In contrast, female drinking behaviours have polarized over the study period, with increasing abstention rates accompanying increases in drinkers' consumption levels. Conclusions Rising female consumption of alcohol and progression of higher-consuming birth cohorts through the life course are key drivers of increased per capita alcohol consumption in the United Kingdom. Recent declines in alcohol consumption appear to be attributable to reduced consumption and increased abstinence rates among the most recent birth cohorts, especially males, and general increased rates of abstention across the study period. [ABSTRACT FROM AUTHOR]

The UK prevalence of parent-reported autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) were estimated from the Millennium Cohort Study. Case definition was if a doctor or health care professional had ever told parents that their child had ASD and/or ADHD. Data were collected in 2008/2009 for 14,043 children. 1.7 % of children were reported as having ASD (95 % CI 1.4-2.0) at mean age 7.2 years (SD = 0.2; range = 6.3-8.2). 1.4 % reportedly had ADHD (95 % CI 1.2-1.7), and 0.3 % had both ASD and ADHD (95 % CI 0.2-0.5). After adjusting for socio-economic disadvantage, only male sex ( p < 0.001 for both conditions) and cognitive ability, p = 0.004 (ASD); p = 0.01 (ADHD) remained strongly associated. The observed prevalence of parent-reported ASD is high compared to earlier UK and US estimates. Parent-reported ADHD is low compared to US estimates using the same measure. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal conditions are a common cause of sickness absence and work disability. Little is known about the work-related advice and support that occupational therapists provide to this client group and their employers. The purpose of this study was to report on current occupational therapy practice in this area in the United Kingdom. Method: A questionnaire survey was conducted, of United Kingdom occupational therapists treating employed clients with musculoskeletal conditions in community or outpatient settings. Questionnaires were posted to 960 hospitals or units, identified through National Health Service websites to reach as many respondents as possible, and the survey was also available online. Findings: 257 respondents reported on their provision of work-related advice and support. Of these, over 30% (n = 82) reported that this involved a moderate amount of their time; 60% (n = 154) had experience of contacting employers and 21% (n = 55) had met with clients' employers in the previous year. Time and resources, concern about legal implications, and having the appropriate skills had an impact on communication between therapists and employers. Conclusion: The findings demonstrate considerable variations in service delivery, interventions, and the contact made with employers. These need urgent attention if the profession is to meet the challenges of the government's agenda for improving health at work. [ABSTRACT FROM AUTHOR]

While there has been some focus on physical abuse in the general child abuse literature, there have been few studies examining the physical abuse of children in sport. This article focuses mainly on peer physical harm in sport. However, we argue that to fully understand physical harm between young people in sport requires understanding: (1) the 'sporting ethos' prevalent in sport where training and competing to the limits of physicality are part of the culture; and (2) the physical harm that occurs between coaches and young people as a context for understanding physical harm between young people. Results are based on a convenience sample of 6124 young people (age 18-22) who completed an online survey about their experiences of participating in sport as children; 89 follow-up interviews were conducted with a sub-set of these young people. Findings suggest that in sport, where training and competing to the limits of physicality are inherent to sporting achievement, physical harm is common and takes on a different form to physical harm of children in other settings. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Sport practitioners and sport bodies should put in place policies, procedures, training and practice which enable adults to systematically tackle harm occurring in sport settings including between peers., Practitioners involved in working with children and young people in sport settings should take steps to promote a more positive sporting and coaching ethos and build upon what children and young people value about sport participation. [ABSTRACT FROM AUTHOR]

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]

Background. Common mental disorders (CMDs) are associated with occupational impairment and the receipt of disability benefits (DBs). Little is known about the relationship between personality disorders (PDs) and work disability, and whether the association between CMDs and work disability is affected by the presence of co-morbid PDs. The aim of this study was to examine the association between DB and individual categories of PDs, with special attention to the effect of co-morbid CMDs on this association. Method. The association between DB and PD was examined using data from the 2000 British National Survey of Psychiatric Morbidity. Probable PD caseness was identified using the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) screening questionnaire. The impact of CMDs, assessed with the revised version of the Clinical Interview Schedule (CIS-R), was examined as a covariate and in a stratified analysis of co-morbidity. Other covariates included sociodemographic factors, long-standing illnesses and substance use. Results. Probable PD was associated with DB, with the strongest associations found for borderline, dependent and schizotypal PD. Antisocial PD was not associated with DB. The relationship between PD and DB was strongly modified by CMD, reducing the association from an odds ratio (OR) of 2.84 to 1.34 [95% confidence interval (CI) 1.00-1.79)]. In the stratified analysis, co-morbid PD and CMD showed a stronger association with DB than PD without CMD but, when fully adjusted, this effect was not significantly different from the association between CMD without PD. Conclusions. Individuals screening positive for PD are more likely to experience severe occupational outcomes, especially in the presence of co-morbid CMD. [ABSTRACT FROM AUTHOR]

Workplace violence is a serious occupational hazard for many social care staff. In this paper, we detail the results of an investigation into the levels of client violence experienced by a sample of 363 social care staff working in a UK Shire County Department. We also explore the consequences of such violence upon job satisfaction and self-reported stress symptoms. The results reported show that levels of client violence differ across areas of social care work, with residential staff being the most at risk and home care workers the least at risk. The data presented also show that, as exposure to violence increases, job satisfaction diminishes and the reporting of stress symptoms increases. Fear, or feeling vulnerable, is found to be both an important consequence of client violence and a mediator of its association with diminished job satisfaction and elevated stress symptom reporting. It is concluded that theory and practice in tackling violence in social care should more fully address the important role played by fear. [ABSTRACT FROM AUTHOR]

ABSTRACT People who inject substances are at high risk of many physical health problems. The Blood-Borne Virus Programme (BBVP) is a nurse-led health screening programme for blood-borne conditions in substance misusers. The aim of this study was to evaluate the service delivery, organization, and outcomes of the BBVP. The researchers used a case study with three units of analysis: BBVP clinical activities during 1 year using a prospective audit; service users' (n = 20) and professional stakeholders' (n = 10) experiences of the BBVP using semistructured interviews; and service users' (n = 132) satisfaction with the BBVP using a satisfaction measure. The BBVP conducted 4450 consultations with 1940 service users; 847 of whom were new, and presented with many health problems compromising their physical health. The BBVP provided a range of interventions meeting its users' physical health needs. Users and other stakeholders were very satisfied with the service, and suggested ways in which the service might improve. The BBVP appeared to meet the physical health-care needs of people dependent on drugs. Nurse-led services, such as the BBVP, offer a solution that, in the view of users and professional stakeholders, is impacting significantly on the physical health and well-being of people dependent on drugs. [ABSTRACT FROM AUTHOR]

Community support in the post-discharge period is of importance, as difficulties managing at home can lead to readmission to hospital (Strunin et al, 2007; Arbaje et al, 2009). There is evidence that support from family in the community is perceived to be the best option by older people (McCann and Evans 2002; Themessl-Huber et al, 2007). However, during the transition from hospital to home gaps may occur in the continuity of support, with the potential for poor outcomes. Knowledge about how older people interact with supports in their communities is therefore important to inform health and social care policy and provision. This article presents the results of a southern Irish study to examine the use of informal and formal supports and services by older people in the post discharge period. Recommendations for practice and further research are included. [ABSTRACT FROM AUTHOR]

BackgroundCognitive skills programmes have been associated with improvements on psychometric measures and reductions in antisocial behaviour in mentally disordered offenders (MDOs). However, to date there have been no randomized controlled trials (RCTs) of such programmes with this population. In the first RCT of a cognitive skills programme with MDOs we aimed to determine if participation in the Reasoning and Rehabilitation (R&R) programme was associated with improvements in social–cognitive skills and thinking styles.MethodA total of 84 men with a primary diagnosis of psychotic disorder and a history of violence were recruited from medium-secure forensic units and allocated to receive R&R (n=44) or treatment as usual (TAU; n=40). At baseline and post-treatment interviews, participants completed questionnaires to assess social problem-solving, criminal attitudes, anger experience, blame externalizing and perspective-taking. Researchers were not blind to group status.ResultsThe R&R group demonstrated significant improvements on measures of social problem-solving relative to the TAU group, some of which were maintained at 12 months post-treatment. Only half of those allocated to receive R&R completed the full programme. In post-hoc analyses programme completers showed improvements in social problem-solving at the end of treatment and changes in criminal attitudes at 12 months post-treatment.ConclusionsAmong male MDOs, R&R participation was associated with improvements in social–cognitive skills, some of which were maintained for up to 12 months post-treatment. Our finding that programme completers do better may reflect pre-treatment patient characteristics. This study establishes that multi-site RCTs can be conducted in medium-secure forensic units. [ABSTRACT FROM PUBLISHER]

ABSTRACT Personality disorder (PD) is an important indicator of future recidivism, and a brief assessment of PD would be of great value to those working in the criminal justice system. There is insufficient research on PD among probation populations. We examined the concurrent validity of a mini-interview for PD, the Standardised Assessment of Personality-Abbreviated Scale (SAPAS), by comparing its performance with that of the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) in a sample of 40 individuals on probation in Lincolnshire, UK. The SCID-II identified 30/40 (75%) of the sample as having a PD. The most common category was antisocial PD, for which 20/40 (50%) were positive. A cut score of 3 on the SAPAS produced a good balance of sensitivity (0.73) and specificity (0.9) for case identification. We conclude that the SAPAS is a valid screening tool for PD among those on probation and is of potential value to those working in the criminal justice system. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose. This study examined whether the affective responses pre-, mid- and post- a single bout of Interactive Video Game Technology (IVGT), as well as the amount of energy expended, were comparable to those experienced during traditional physical activity. Methods. The randomised cross-over design saw each participant (n = 16 undergraduate students) engage in 30-minutes of Nintendo Wii ™ Tennis and 30-minutes of Hardcourt Tennis. Measurements of affect were taken pre-, mid- and post-activity, and estimates of energy expenditure calculated. Two post-experiment focus group interviews were also used to explore participants’ affective responses. Results. Repeated measures analyses of variance revealed both valence and activation to be higher during Hardcourt Tennis at all time intervals. A paired t-test also indicated that energy expenditure was greater during Hardcourt Tennis. However, the IVGT condition was still associated with low-activation pleasant affect. The interview data supported and partially explained the quantitative findings from a self-determination perspective. Conclusions. These findings demonstrate that traditional physical activity elicits greater psycho-physiological benefits than IVGT physical activity. Applications. The efficacy of IVGT-based physical activity may reside in its ability to operate as a motivational entry point for inactive populations, making the initial process of physical activity an enjoyable means to displace sedentary behaviour. [ABSTRACT FROM AUTHOR]