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Background: Cardiovascular disorders (CVD) are the single greatest cause of mortality worldwide. In the UK, the National Health Service (NHS) has launched an initiative of health checks over and above current care to tackle CVD. However, the uptake of Health Checks is poor in disadvantaged communities. This protocol paper sets out a UK-based study (Sussex and Nottingham) aiming to co-produce a community delivered CVD risk assessment and coaching intervention to support community members to reduce their risk of CVD.The overall aim of the project is to implement a tailored-to-context community engagement (CE) intervention on awareness of CVD risks in vulnerable populations in high, middle and low-income countries. The specific objectives of the study are to enhance stakeholder' engagement; to implement lifestyle interventions for cardiovascular primary prevention, in disadvantaged populations and motivate uptake of NHS health checks., Methods: This study uses both qualitative and quantitative methods in three phases of evaluation, including pre-, per- and post-implementation. To ensure contextual appropriateness the 'Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research' (SPICES) project will organize a multi-component community-engagement intervention. For the qualitative component, the pre-implementation phase will involve a contextual assessment and stakeholder mapping, exploring potentials for CVD risk profiling strategies and led by trained Community Health Volunteers (CHV) to identify accessibility and acceptability. The per-implementation phase will involve healthy lifestyle counselling provided by CHVs and evaluation of the outcome to identify fidelity and scalability. The post-implementation phase will involve developing sustainable community-based strategies for CVD risk reduction. All three components will include a process evaluation. A stepped wedge cluster randomised trial of the roll out will focus on implementation outcomes including uptake and engagement and changes in risk profiles. The quantitative component includes pre and post-intervention surveys. The theory of the socio-ecological framework will be applied to analyse the community engagement approach., Discussion: Based on the results ultimately a sustainable community engagement-based strategy for the primary prevention of CVD risk will be developed to enhance the performance of NHS health care in the UK. The Trial Registration number is ISRCTN68334579., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)

This paper addresses ways in which mathematics pedagogy can benefit from insights gleaned from counselling. Person-centred counselling stresses the value of genuineness, warm empathetic listening and minimal intervention to support people in solving their own problems and developing increased autonomy. Such an approach contrasts starkly with the much more directive and leading interventions often made by mathematics teachers in the classroom. In this position paper I argue that minimal teacher interventions are a powerful way to support students in their learning of mathematics. Drawing on the interplay between a mathematics teacher's responsibility to teach mathematics and their duty to support students pastorally, I argue that such an approach builds on skills that teachers already possess and has considerable potential to enhance students' healthy mathematical development.

This paper attempts to compare the availability, quality, similarities and differences of students' support services in United Kingdom Open University (UKOU) and Sri Lanka Open University (SLOU) and also to identify and enlist the deficiencies that SLOU students are facing in the student support services. To get the desired end four hundred students (two hundred from each university) were taken as sample and a thirty eight items questionnaire on (Likert Scale) was constructed and pilot tested, the reliability of the research tool was 0.957 (Cronbach's Alpha) after getting the data independent sample t-test was run by using SPSS XII. The study found out that student support services of SLOU are quantitatively developing rapidly on teh lines of UKOU. Though the media support services of both the institutions have almost the same status in the provision of student support services, yet the UKOU students have better services in general services, regional office services, tutorial services, guidance and counselling services and overall student support services. The conclusions lead to the recommendations that SLOU should improve student support services in all the parameters, but more emphasis should be given on guidance and counselling; library and modern communication facilities like toll free, auto answer may be provided at SLOU regional campuses.

The article discusses the effectiveness of counseling of clients in general practice in Great Britain. There are some major problems associated with the effort to assess effectiveness and improvement. It is also difficult to conduct a cost effective analyses. The number of counsellors recruited into general practice is growing.

This article reports and reflects on an element of a recent survey of UK public health professionals, specifically in relation to the Public Health Knowledge and Skills Framework (PHSKF) and the ethical requirements that underpin public health practice. Only 38.4% of respondents reported accessing the PHKSF and a mere 13.7% reported accessing the accompanying background paper on ethical public health practice. Given that ethical practice underpins the PHSKF, it is concerning that so few respondents are familiar with the PHSKF and one of the source documents. While issuing frameworks and guidance is one way to support public health practice, there is a further need for greater integration of skills and knowledge around ethical public health practice within education and training initiatives. [ABSTRACT FROM AUTHOR]

Background: There are increasing numbers of total hip replacements (THR) and total knee replacements (TKR) being performed in patients of working age. Providing patients undergoing TKR and THR with return to work advice might facilitate return to work. The aim of this paper is to report on the process used to systematically develop an occupational advice intervention to be delivered in hospital for those undergoing arthroplasty., Methods: The six-step Intervention Mapping (IM) approach to development, implementation and evaluation of a theory and evidence-based interventions was followed. This paper reports on the development of the intervention covered by steps 1 to 4 of the IM process. Steps 1-3 gathered data on current practice and barriers to change using a mixed methods approach (cohort study of patients undergoing THR or TKR, stakeholder interviews, survey of practice, evidence synthesis) and provided a theoretical framework for intervention development. Step 4 used information from steps 1-3 in combination with a Delphi consensus process to develop the intervention and the associated tools and materials to facilitate its delivery., Results: The final intervention identified included a number of core principles including: early patient identification; delivery of key information to patients and their employers; assessment and support by a member of the orthopaedic team; procedures for escalation based on patient need; mechanisms to support communication; and training and support for the clinical teams delivering care. A total of 13 patient and 20 staff performance objectives as delivery requirements, were supported by a range of tools, roles and training resources. The intervention addressed outcomes based at the individual and interpersonal levels of the ecological model., Conclusions: Following the IM approach resulted in a structured and justified occupational intervention for delivery in secondary care for patients undergoing total hip and knee replacement. The feasibility of the intervention will subsequently be tested alongside further investigation to establish its effectiveness and cost-effectiveness.

Introduction: One in eight women suffer from depression during pregnancy. Currently, low-intensity brief treatment based on cognitive behavioural therapy (CBT) is the only talking treatment widely available in the National Health Service (NHS) for mild and moderate depression. CBT involves identifying and changing unhelpful negative thoughts and behaviours to improve mood. Mothers in our patient advisory groups requested greater treatment choice. Interpersonal counselling (IPC) is a low-intensity version of interpersonal therapy. It may have important advantages during pregnancy over CBT because it targets relationship problems, changes in role and previous losses (eg, miscarriage). We aim to compare CBT and IPC for pregnant women with depression in a feasibility study., Methods and Analysis: A two-arm non-blinded randomised feasibility study of 60 women will be conducted in two UK localities. Women with depression will be identified through midwife clinics and ultrasound scanning appointments and randomised to receive six sessions of IPC or CBT. In every other way, these women will receive usual care. Women thought to have severe depression will be referred for more intensive treatment. After 12 weeks, we will measure women's mood, well-being, relationship satisfaction and use of healthcare. Women, their partners and staff providing treatments will be interviewed to understand whether IPC is an acceptable approach and whether changes should be introduced before applying to run a larger trial.Several groups of patients with depression during pregnancy have contributed to our study design. A patient advisory group will meet and advise us during the study., Ethics and Dissemination: Study results will inform the design of a larger multicentre randomised controlled trial (RCT). Our findings will be shared through public engagement events, papers and reports to organisations within the NHS. National Research Ethics Service Committee approved the study protocol., Trial Registration Number: ISRCTN11513120., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.)

Objective: To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions. Design: Systematic review. Data Sources: Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases. Review Methods: We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria. Results: Of 3,190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post-exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re-infection of treated patients. Conclusion: One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area. [ABSTRACT FROM AUTHOR]

Background: Recent evidence and recommendations suggest that physical activity health promotion should be aimed at persuading the whole population to adopt an active lifestyle. Intensive medical programmes aimed at promoting physical activity amongst those at risk are not effective at achieving this aim. Brief advice from primary care professionals to quit smoking has a small but, at a population level, important effect. Brief advice in primary care to adopt a more active lifestyle may be similarly effective. The aim of this review is to determine the effect of advice given in routine primary care consultations on levels of physical activity., Methods: A systematic review was carried out of trials assessing the effectiveness of advice given in routine primary care consultations. Data sources were four electronic databases (MEDLINE, EMBASE, Sport discus, Cochrane Library), and bibliographies of retrieved papers were searched. Experts were contacted., Results: Eight trials, with a total of 4747 participants, were identified; the majority were from the United States. Outcome measures varied considerably between trials, including continuous measures (e.g. duration of exercise) and dichotomous measures (e.g. being active), therefore statistical pooling was inappropriate. Two of the trials were cluster randomized controlled trials, the remainder were quasi-experimental. None of the trials fulfilled all of the predetermined quality criteria and selection bias in the nonrandomized studies may have exaggerated results. Four of the six trials that presented short-term (up to 8 weeks) results found advice to be effective; only one of the four trials with long-term follow-up (4-12 months) found a sustained effect. The two randomized controlled trials had negative short- and long-term results., Conclusions: From the available evidence it appears that advice in routine primary care consultations is not an effective means of producing sustained increases in physical activity. However, these results may not be applicable to the United Kingdom, where the structure of primary care is unique. Quality research in UK primary care would be valuable.

This paper examines key themes and theoretical assumptions which underpin current UK youth mentoring practice. We argue that youth mentoring should be examined in relation to the wider issues of transition for young people. The current emphasis on individual mentoring relationships should be reviewed and refined. We draw on findings from recent research in the UK to explore the potential of different forms of youth mentoring. The paper concludes that there is a need to move away from static models of mentoring which, we argue, can obscure the potential to link mentoring approaches with the diverse needs of different groups of young people. We suggest that a focus on promoting 'mentor rich' environments maybe a more fruitful direction for mentoring and contribute to the development of strategies for working with and not on young people. [ABSTRACT FROM AUTHOR]

Women's efforts to influence policies have complex effects, which are often difficult to evaluate. This paper identifies four themes in feminist politics through which to analyse whether a particular intervention involving substantial numbers of women — that of counselling in the UK — can be understood as a feminist practice. These themes are concerned with gender equality, women's autonomy, recognition of diversity among women and the deconstruction of gender norms. In its early post-war origins prior to the emergence of second wave feminism, and in the stories recounted by women practitioners at the turn of millennium, counselling emerges as contradictory and ambivalent in relation to these themes in feminist politics. [ABSTRACT FROM AUTHOR]

Serious criticisms have been raised about divorce mediators' claim that they act as purely neutral facilitators of party-driven agreements. This paper reports on a study, based on tape recordings of mediation in the United Kingdom, intended to describe the strategies used by mediators and clients in the attempt to resolve disputes. It identifies a technique, labeled "selective facilitation," through which clients may be steered in particular directions chosen by the mediator. This poses important questions for future evaluation studies and for the regulation of mediation practice. [ABSTRACT FROM AUTHOR]

This article looks at the implementation of so-called "assisted voluntary return" policies in Austria and Britain, where state agencies have recently replaced nongovernmental organizations as providers of return counseling. To better understand how such a shift affects the in/voluntariness of return, I identify three dimensions along which the "quality" of voluntariness can be assessed and relate them to concrete aspects of return counseling practice: absence of coercion; availability of acceptable alternatives; and access to adequate and trusted information. Based on original qualitative data, I show that even within an overall restrictive and oppressive regime, return counselors can make room for voluntariness by upholding ethical and procedural standards—if they retain substantial independence from the government. [ABSTRACT FROM AUTHOR]

Objective To estimate the carbon footprint of behavioural support services for smoking cessation: text message support, telephone counselling, group counselling and individual counselling. Design Carbon footprint analysis. Data source Publicly available data on National Health Service Stop Smoking Services and per unit carbon emissions; published effectiveness data from the txt2stop trial and systematic reviews of smoking cessation services. Main outcome measures Carbon dioxide equivalents (CO2e) per 1000 smokers, per lifetime quitter, and per quality-adjusted life year gained, and cost-effectiveness, including social cost of carbon, of smoking cessation services. Results Emissions per 1000 participants were 8143 kg CO2e for text message support, 8619 kg CO2e for telephone counselling, 16 114 kg CO2e for group counselling and 16 372 kg CO2e for individual counselling. Emissions per intervention lifetime quitter were 636 (95% CI 455 to 958) kg CO2e for text message support, 1051 (95% CI 560 to 2873) kg CO2e for telephone counselling, 1143 (95% CI 695 to 2270) kg CO2e for group counselling and 2823 (95% CI 1688 to 6549) kg CO2e for individual counselling. Text message, telephone and group counselling remained cost-effective when costeffectiveness analysis was revised to include the environmental and economic cost of damage from carbon emissions. Conclusions All smoking cessation services had low emissions compared to the health gains produced. Text message support had the lowest emissions of the services evaluated. Smoking cessation services have small carbon footprints and were cost-effective after accounting for the societal costs of greenhouse gas emissions. [ABSTRACT FROM AUTHOR]

Comments on youth services that the 2005 Green Paper, titled "Youth Matters," has failed to address in Great Britain. Legislative framework for young people; Schools; Counseling; Impact on the voluntary sector.

Background: Quality of life (QOL) is important to patients with end stage renal disease and their partners. Despite the first 12 weeks being a critical time in the treatment pathway, limited research exists which examines how the transition onto dialysis impacts QOL. In this study we measured QOL in patients and their partners at pre-dialysis and over the first 12 weeks on dialysis to investigate QOL during this crucial period.Methods: Patients and their partners, recruited from 10 renal units in England, completed questionnaires at pre-dialysis (n = 166 participants, 83 couples), 6 weeks (n = 90 participants, 45 couples) and 12 weeks (n = 78, 39 couples) after starting dialysis. On each occasion participants completed a QOL questionnaire (WHOQOL-BREF). Multilevel modelling accommodated the nested structure of couples with repeated measures within participants. Three-level random intercept models estimated changes in WHOQOL general QOL and its four domains (Physical, Psychological, Social and Environment). Two-level random intercept models assessed the relationship between baseline clinical and socio-demographic variables with changes in general QOL.Results: Patients reported positive changes in general QOL from pre-dialysis to 6 weeks (β = 0.42, p < 0.001, 95% CI 0.19, 0.65) and from pre-dialysis to 12 weeks (β = 0.47, p < 0.001, 95% CI 0.24, 0.71). Partners' general QOL decreased significantly from pre-dialysis to 6 weeks (β = - 0.24, p = 0.04, 95% CI -0.47, - 0.01) but returned to its original level at 12 weeks. Patients reported improvements in the physical domain between pre-dialysis and 12 weeks (β = 6.56, p < 0.004, 95% CI 2.10, 11.03). No other domains changed significantly in patients or partners. Only in patients were there significant associations between moderator variables and general QOL. High comorbidity risk level and diabetes were associated with poorer QOL at pre-dialysis whereas being female and having an arteriovenous fistula were linked with improvements in general QOL.Conclusions: Patients reported significant improvements in their general and physical QOL after starting dialysis. Partners' general QOL worsened after patients started dialysis but improved by 12 weeks. Both patients and partners may benefit from additional educational and counselling services in the lead up to, and immediately after starting dialysis, which could facilitate the transition onto dialysis and improve QOL in both.Study Registration: This study was adopted on the NIHR Clinical Research Network (UK). The details of this study are registered on the Research Registry website (www.researchregistry.com). The identifier for this study is researchregistry2574. [ABSTRACT FROM AUTHOR]

Aims There is a clear association between alcohol use and offending behaviour and significant police time is spent on alcohol-related incidents. This study aimed to test the feasibility of a trial of screening and brief intervention in police custody suites to reduce heavy drinking and re-offending behaviour. Short summary We achieved target recruitment and high brief intervention delivery if this occurred immediately after screening. Low rates of return for counselling and retention at follow-up were challenges for a definitive trial. Conversely, high consent rates for access to police data suggested at least some outcomes could be measured remotely. Methods A three-armed pilot Cluster Randomised Controlled Trial with an embedded qualitative interview-based process evaluation to explore acceptability issues in six police custody suites (north east and south west of the UK). Interventions included: 1. Screening only (Controls), 2. 10 min Brief Advice 3. Brief Advice plus 20 min of brief Counselling. Results Of 3330 arrestees approached: 2228 were eligible for screening (67%) and 720 consented (32%); 386 (54%) scored 8+ on AUDIT; and 205 (53%) were enroled (79 controls, 65 brief advice and 61 brief counselling). Follow-up rates at 6 and 12 months were 29% and 26%, respectively. However, routinely collected re-offending data were obtained for 193 (94%) participants. Indices of deprivation data were calculated for 184 (90%) participants; 37.6% of these resided in the 20% most deprived areas of UK. Qualitative data showed that all arrestees reported awareness that participation was voluntary, that the trial was separate from police work, and the majority said trial procedures were acceptable. Conclusion Despite hitting target recruitment and same-day brief intervention delivery, a future trial of alcohol screening and brief intervention in a police custody setting would only be feasible if routinely collected re-offending and health data were used for outcome measurement. Trial registration ISRCTN number: 89291046. [ABSTRACT FROM AUTHOR]

To compare the clinical effectiveness and cost-effectiveness of a stepped-care intervention versus a minimal intervention for the treatment of older hazardous alcohol users in primary care.~Aims~Unassigned~Multi-centre, pragmatic RCT, set in Primary Care in UK. Patients aged ¿ 55 years scoring ¿ 8 on the Alcohol Use Disorders Identification Test were allocated either to 5-min of brief advice or to 'Stepped Care': an initial 20-min of behavioural change counselling, with Step 2 being three sessions of Motivational Enhancement Therapy and Step 3 referral to local alcohol services (progression between each Step being determined by outcomes 1 month after each Step). Outcome measures included average drinks per day, AUDIT-C, alcohol-related problems using the Drinking Problems Index, health-related quality of life using the Short Form 12, costs measured from a NHS/Personal Social Care perspective and estimated health gains in quality adjusted life-years measured assessed EQ-5D.~Method~Unassigned~Both groups reduced alcohol consumption at 12 months but the difference between groups was small and not significant. No significant differences were observed between the groups on secondary outcomes. In economic terms stepped care was less costly and more effective than the minimal intervention.~Results~Unassigned~Stepped care does not confer an advantage over a minimal intervention in terms of reduction in alcohol use for older hazardous alcohol users in primary care. However, stepped care has a greater probability of being more cost-effective.~Conclusions~Unassigned~Current controlled trials ISRCTN52557360.~Trial Registration~Unassigned~A stepped care approach was compared with brief intervention for older at-risk drinkers attending primary care. While consumption reduced in both groups over 12 months there was no significant difference between the groups. An economic analysis indicated the stepped care which had a greater probability of being more cost-effective than brief intervention.~Short summary~Unassigned [ABSTRACT FROM AUTHOR]

Background: Habit-interventions are designed to promote the automaticity of healthy behaviours and may also enhance self-regulatory skills during the habit-formation process. A recent trial of habit-based advice for weight loss (10 Top Tips; 10TT), found that patients allocated to 10TT lost significantly more weight over 3 months than those allocated to usual care, and reported greater increases in automaticity for the target behaviours. The current study aimed to test the hypothesis that i) 10TT increased self-regulatory skills more than usual care, and ii) that self-regulatory skills and automaticity changes mediated the effect of 10TT on weight loss. Methods: 537 obese patients from 14 primary care practices in the UK were randomized to receive 10TT or usual care. Patients in the 10TT group received a leaflet containing tips for weight loss and healthy habits formation, a self-monitoring log book and a wallet-sized shopping guide on how to read food labels. Patients were weighed and completed validated questionnaires for self-regulation and automaticity at baseline and 3-month follow-up. Within-group and Between-group effects were explored using Paired T-test and ANCOVA, respectively. Mediation was assessed using bootstrapping to estimate indirect effects and the sobel test. Results: Over 3 months patients who were given 10TT reported greater increases in self-regulatory skills (Mean difference: .08; 95% CI .01; .15) than those who received usual care. Changes in self-regulatory skills and automaticity over 3 months mediated the effect of the intervention on weight loss (β = .52, 95% Bias Corrected CI .17; .91). Conclusions: As hypothesised, 10TT enhanced self-regulatory skills and changes in self-regulatory skills and automaticity mediated the effect of the intervention on weight loss. This supports the proposition that self-regulatory training and habit formation are important features of weight loss interventions. Trial registration: This study was prospectively registered with the International Standard Randomised Controlled Trials () on 26 September 2011. [ABSTRACT FROM AUTHOR]

Background: It is important for policy planning to chart the methods smokers and high-risk drinkers use to help them change their behaviour. This study assessed prevalence of use, and characteristics of users, of support for smoking cessation and alcohol reduction in England. Methods: Data were used from the Smoking and Alcohol Toolkit Studies, which involve monthly face-to-face computer-assisted interviews of adults aged 16+ in England. We included data collected between June 2014 and July 2015 on 1600 smokers who had made at least one quit attempt and 911 high-risk drinkers (defined as scores >8+ on the full AUDIT or 5+ on questions 1-3 of the AUDIT-C) who had made an attempt to cut down in the past 12 months. Participants provided information on their socio-demographic characteristics and use of aids during their most recent quit attempt including pharmacotherapy, face-to-face counselling, telephone support, self-help materials (digital and printed), and complementary medicine. Results: A total of 60.3% of smokers used aids in the past year, compared with just 14.9% of high-risk drinkers. Use of pharmacotherapy was high among smokers and very low among drinkers (56.0%versus1.2%). Use of other aids was low for both behaviours: face-to-face counselling (2.6%versus4.8%), self-help materials (1.4%versus4.1%) and complementary medicine (1.0%versus0.5%). Use of aids was more common among smokers aged 25-54 compared with 16-24 year olds (25-34,ORadj1.49,p = 0.012; 35-44,ORadj1.93,p < 0.001; 35-44,ORadj1.93,p < 0.001; 45-54,ORadj1.66, p = 0.008), with cigarette consumption >10 relative to <1 (10-20,ORadj2.47,p = 0.011; >20,ORadj4.23,p = 0.001), and less common among ethnic minorities (ORadj0.69,p = 0.026). For alcohol reduction, use of aids was higher among ethnic minority groups (ORadj2.41;p = 0.015), and those of social-grade D/E relative to AB (ORadj2.29,p = 0.012&ORadj3.13,p < 0.001). Conclusion: In England, the use of pharmacotherapy is prevalent for smoking cessation but not alcohol reduction. Other aids are used at a low rate, with face-to-face counselling being more common for alcohol reduction than smoking cessation. [ABSTRACT FROM AUTHOR]

Key content Infertility is a complex state. In addition to the medical causes and implications of involuntary childlessness, there is interplay between several psychosocial and emotional factors., Along with advances in infertility treatment options, clinicians should also focus on patients' changing psychosocial needs., The counselling service plays a major complementary role in providing holistic patient-centred care by multidisciplinary staff in fertility clinics., This article provides a general introduction to the role of counselling in the UK, within the context of fertility treatment. Counselling aims to explore, understand, resolve and more effectively deal with the issues arising from infertility and related treatments., Learning objectives Role of the independent infertility counselling practitioner and the counselling service., Counselling in relation to specific aspects of infertility/assisted reproductive technology., Eligibility criteria for individuals carrying out infertility counselling., The role of guidelines in addressing and promoting the use of specialist fertility counselling skills., Ethical issues Ensuring all legal implications for the patient, the practitioner and the fertility clinic are addressed., Ensuring specialist, professional competence regarding the training and practice of the infertility counselling practitioner., Development of counselling guidelines by professional bodies. [ABSTRACT FROM AUTHOR]

The article discusses counselling evaluation in the National Health Service (NHS) in Great Britain. The author reflects on the effectiveness of counselling in NHS. He mentions the inadequate in-house training conducted by NHS and states that trainees lack communication skills. He suggests on improving the counselling and communication skills of all health care personnel to increase patient satisfaction.

Background Hospital admission provides a powerful opportunity to promote smoking cessation. We explored patients' and healthcare professionals' (HCP) views of a specialist smoking cessation service comprising systematic smoking ascertainment, default provision of pharmacotherapy and behavioural counselling at the bedside, and post-discharge follow-up, in a clinical trial in a United Kingdom teaching hospital. Methods Semi-structured interviews with 30 patients who were offered the intervention, and 27 HCPs working on intervention wards, were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results The shock of being admitted, and awareness that smoking may have contributed to the need for hospital admission, caused many patients to reassess their quit intentions. Most patients felt the service was too good an opportunity to pass up, because having long-term support and progress monitored was more likely to result in abstinence than trying alone. Had they not been approached, many patients reported that they would have attempted to quit alone, though some would have been discouraged from doing so by pharmacotherapy costs. Service delivery by a specialist advisor was favoured by patients and HCPs, largely because HCPs lacked time and expertise to intervene. HCPs reported that in usual practice, discussions about smoking were usually limited to ascertainment of smoking status. Timing of service delivery and improved co-ordination between service staff and inpatient ward staff were matters to address. Conclusions A hospital-based specialist smoking cessation service designed to identify smokers and initiate cessation support at the bedside was deemed appropriate by patients and HCPs. [ABSTRACT FROM AUTHOR]

The article discusses the findings of audits on management of epileptic pregnant women conducted at the Whittington Hospital from 2004-2006 and 2007-2010. It notes that 10-20 percent of women experience an increase in the frequency of epileptic seizures during pregnancy. The 2004-2006 audit compared the management of epileptic women in antenatal clinics from those in obstetric clinics while the 2007-2010 audit assessed how recommendations from the first audit were implemented.

The article presents a study which aims to establish a best practice model for the support of general practice teams (GPTs) such as family caregivers. The study used the Great Britain Medical Research Council (MRC) phases 0, I and II as a development framework, complex interventions model and design. The GPTs involved underwent questionnaires such as the Standardised self-reported questionnaires, Qualitative measurement of the teams' experience and quantitative assessment of the model. Results show that the GPs play a vital role in meeting the needs for support and counseling of the family caregivers.

The identification of healthy carriers by newborn screening programmes raises questions about how and when the carrier results will be conveyed to child. There is currently a lack of information concerning how best to convey carrier information to children. This is a serious gap in the literature and practice. This study examined genetic counsellors' experiences of counselling children to explore how to support and inform children about their carrier result. Practising members of the United Kingdom (UK) Association of Genetic Nurses and Counsellors took part in semi-structured telephone interviews. Respondents described the communication process and identified barriers and facilitators of communication. Age, illness experience and maturity were variously discussed as facilitators; all of which are integral to psychological theories of children's understanding of illness. Adaptive family communication, school tuition and educational materials were also seen as influencing counselling efficacy. Relevant materials that children could keep were also seen as important to enhance children's autonomy. Yet, such resources were rare, constituting a barrier to communication. Counsellors reported communication was further impeded by maladaptive family communication and resistance from children to engaging in counselling. By exploring the facilitators and barriers inherent in communicating genetic information to children, guidance can be offered to counsellors, researchers and parents. This study indicates that some factors (eg illness experiences) previously identified by psychological theories may act in complex ways within this setting. Importantly, the factors identified as being most influential when communicating with children about genetics are amenable to change through interventions, support and training. [ABSTRACT FROM AUTHOR]

Background This study investigates the breast and cervical screening status of women with moderate to severe learning disability and whether uptake could be improved by one to one counselling. [ABSTRACT FROM PUBLISHER]

Brain K, Sivell S, Bennert K, Howell L, France L, Jordan S, Rogers MT, Gray J, Sampson J. An exploratory comparison of genetic counselling protocols for HNPCC predictive testing. Most UK genetics centres offering predictive testing for hereditary non-polyposis colorectal cancer (HNPCC) use an extended counselling protocol originally developed for Huntington's disease. Shortened counselling may be more appropriate in the context of treatable genetic conditions such as HNPCC. Twenty-six high-risk individuals were randomized to extended genetic counselling (two sessions of education and reflection held 1 month apart) or shortened genetic counselling (a single educational session) prior to HNPCC testing. Prospective questionnaires, interviews and transcripts of counselling sessions were analysed. Participants were unsure what to expect prior to genetic counselling and had already decided to undergo genetic testing. There was no evidence of psychological harm caused by shortened genetic counselling, with a high level of satisfaction with the counselling received in both groups. Reflective counselling occurred in both groups but was framed in terms of practical action and information. Participants expressed differing preferences for the level of information received. This exploratory study indicates that shortened genetic counselling may be an appropriate means of supporting decisions already made by individuals about HNPCC testing. However, participants would benefit from preparatory information to help them reflect on issues not previously considered, which can then be explored more fully as part of a tailored counselling approach. [ABSTRACT FROM AUTHOR]

Counselling is of increasing importance in British society. Yet, very few detailed ethnographic descriptions exist of how it works in practice. This article focuses on training courses with the national bereavement care organization, Cruse. The discussion revolves around Cruse's conception of grief as a natural and ordinary process, yet individually variable and unique, and its client-centred approach, which attributes 'expert' status to clients. Consideration of the 'ordinary' and 'expert' in Cruse ideology suggests fundamental questions: how does Cruse justify its counselling activity? How does it train and motivate people to carry out counselling? I argue that this is achieved by grounding the sense of grief in the trainees themselves through a process of situated learning that allows the trainees to assume expertise of the ordinary. Addressing the work of counselling theoretically, I argue that, while Foucauldian analysis of the psy-sciences is to some extent applicable to counselling, detailed participant observation reveals complexities in the interplay of subjectivity and subjection that the Foucauldian approach is unable to grasp. [ABSTRACT FROM AUTHOR]

Belbin's Team-Role Theory is extensively used as a counselling and team development tool by organisations and management consultancies in the UK. However, there is little empirical support for his work, largely because there has been scant research. This study sought to redress this situation by testing Belbin's proposal that teams in which a wide range of team-roles are represented perform better than those where there is an imbalance of roles because certain roles are over-represented. The task performance of six teams of four individuals identified as shapers by the Team-Role Self-Perception Inventory (Belbin, 1981), was compared with that of six mixed teams of four individuals; one co-ordinator, one plant, one completer finisher, and one team worker. It was found that consistent with Belbin's proposal the "mixed'' teams performed better than teams consisting of shapers alone. Some possible explanations and implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on practical problems and issues associated with HIV counseling. Motivating people at risk of HIV infection to make a reliable change in their sexual behavior is believed to be the only available way to stop the HIV pandemic. A series of studies in Great Britain have shown that advertisements about AIDS failed to adjust public misconception and anxieties on the disease.

The article compares school counseling in the United States and Great Britain. During 1964-1965, around 40,975 guidance personnel were employed in public secondary schools in the United States. Around 260 institutions of higher education have programs for school counselor preparation. In Great Britain, a few schools offer more comprehensive guidance services. Four universities currently maintain counselor training facilities. Money is one differential factor that influences American and English school counseling. Another factor is the differing size of school enrolments. A third factor is the use of examinations as an early selective device by English educators.