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School systems across the country are transitioning from paper-based testing (PBT) to computer-based testing (CBT). As this technological shift occurs, more research is necessary to understand the practical and performance implications of administering CBTs. Currently, there is a paucity of research using CBTs to examine working memory (WM) performance, even though CBTs may negatively influence performance. The present study compared a WM CBT and PBT and found enhanced WM performance on the PBT across several verbal and visuospatial WM tests. This pattern was evident even after age was controlled, indicating that test mode effects were persistent across ages (4-11 years). CBTs on WM performance may yield lower scores due to developmental WM differences, increased cognitive workload, test mode effects stemming from individual access to technology, and participant characteristics, such as developmental, biological, or gender differences. The presence of divergent WM in CBT and PBT indicates the need for additional options for children at risk of academic failure because of testing modality. [ABSTRACT FROM AUTHOR]

Background: Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. Aims: To compare the impact of standard parent‐based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. Methods and Procedures: A multicentre clustered blind randomised controlled trial was used to compare the effect of parent‐based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20‐week period. Participants received one of two interventions: (1) Standard Care – indirect group PBI – (PBI) (2) Enhanced Care: indirect group enhanced PBI – (EPBI). Both standardised and non‐standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure – Speech & Language Therapy (PAM‐SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well‐being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development. Outcomes and Results: One hundred fifty‐five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur‐Bates Communicative Development Inventories Sentence Length, from pre‐intervention to post‐intervention and 6 months post‐intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval –0.02 to 0.76), although wide variation was found. Conclusions and Implications: This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents. WHAT THIS PAPER ADDS: What is already known on the subject: Speech, language and communication needs (SLCN) have a knock‐on effect on emotional well‐being, school readiness, literacy and school attainment, putting children at increased risk of long‐term consequences such as poor literacy, mental health problems and unemployment. In disadvantaged areas, the prevalence of language difficulties is higher than elsewhere. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. What this paper adds to existing knowledge: Children with SLCN from more socially disadvantaged areas can make improvements in their language development through parent intervention, although wide individual variation was found. There was some evidence that children achieve better outcomes with EPBI, which employed an interagency collaborative approach. Parent's engagement (activation levels) increased significantly over time with intervention, with the increase twice as big for EPBI. What are the potential or actual clinical implications of this work?: This trial provides some evidence that it is possible to facilitate the language development of children from more socially disadvantaged areas through supporting their caregivers. Further research would be useful to determine whether increases in parent engagement are related to adherence to intervention and change in child outcomes. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

The prevalence of dyslexia identification has increased significantly over the last two decades. Yet there is debate over whether there are distinct biological and cognitive differences between those with literacy difficulties and the subgroup of people identified as dyslexic. This is the first paper that provides evidence for this ongoing debate by investigating the socio-demographic factors, outside biology and cognition, that predict whether a child is identified as dyslexic in the UK. Using secondary data from the UK's Millennium Cohort Study, this paper examines the socio-demographic factors that predict whether a child's teacher identifies them as dyslexic at age 11. Gender, season of birth, socio-economic class and parental income are found to be significant predictors of the dyslexia label. Therefore, factors seemingly unrelated to the clinical aspects of dyslexia influence whether a child is identified as dyslexic in England and Wales. This suggests that label may not be evenly distributed across a population; furthermore, it may also indicate that resources for support may not be fairly allocated. The findings further support the argument that a 'dyslexic sub-group' within poor readers is created due to the impact of environmental factors. The results from this national-scale study thus questions the reliability, validity and moral integrity of the allocation of the dyslexia label across current education systems in the UK. [ABSTRACT FROM AUTHOR]

In seventeenth-century England, many religiously devout people believed they had an obligation to immediately stifle any sinful thought that entered their minds. As some prominent clerics during the time period recognised, however, the effort to subdue unwelcome thoughts often can increase the thoughts. Indeed, recent cognitive science research bears out the counterintuitive phenomenon that trying to suppress an undesired thought can boomerang. With this in mind, just how effective was the endeavour in seventeenth-century England to purify thoughts? The paper argues that it was frequently counterproductive. The paper also explores a disagreement among mental health professionals, historians, and literary scholars regarding how to interpret the numerous seventeenth-century English autobiographical descriptions of tormenting, uncontrollable sinful thoughts. For instance, were the ungovernable blasphemous thoughts that Pilgrim's Progress author John Bunyan (1628-1688) recounted experiencing the product of a bodily illness equivalent to obsessive-compulsive disorder? The question presents methodological challenges. [ABSTRACT FROM AUTHOR]

Transport can pose substantial challenges for people with dementia. Dementia-friendly approaches seek to encourage public transport use by enhancing people and places through educational initiatives and architectural augmentation respectively. The Greater Manchester Combined Authority is implementing dementia-friendliness within a major re-municipalisation of public transport. Reporting findings from a journeying ethnography of bus travel with passengers with dementia, this paper critiques contemporary friendly transport. It argues that buses are vital sociospatial infrastructures, the friendliness of which is constituted by entangled socio-material and political economic forces. The re-municipalisation of friendly transport requires a radical civic offer of social de-segregation and equitable development. • Dementia-friendly public transport centres education & architectural augmentation • This paper critiques conventional DF approaches • Reports on creative go-along ethnography with passengers with dementia • Repositions buses as vital sociospatial infrastructures • Friendliness is constituted by entangled socio-material & political economic forces [ABSTRACT FROM AUTHOR]

Background: Obesity rates are higher among people of lower socioeconomic status. While numerous health behaviour interventions targeting obesity exist, they are more successful at engaging higher socioeconomic status populations, leaving those in less affluent circumstances with poorer outcomes. This highlights a need for more tailored interventions. The aim of this study was to enhance an existing weight loss course for adults living in low socioeconomic communities. Methods: The Behaviour Change Wheel approach was followed to design an add‐on intervention to an existing local authority‐run weight loss group, informed by mixed‐methods research and stakeholder engagement. Results: The COM‐B analysis of qualitative data revealed that changes were required to psychological capability, physical and social opportunity and reflective motivation to enable dietary goal‐setting behaviours. The resulting SMART‐C booklet included 6 weeks of dietary goal setting, with weekly behavioural contract and review. Conclusion: This paper details the development of the theory‐ and evidence‐informed SMART‐C intervention. This is the first report of the Behaviour Change Wheel being used to design an add‐on tool to enhance existing weight loss services. The process benefitted from a further checking stage with stakeholders. [ABSTRACT FROM AUTHOR]

Purpose A one-hour intergenerational event held at an infant school in Norfolk, England, aimed to increase the citizenship experience of young children and their awareness of what it means to live with stroke, and to address social isolation or self-confidence in communicating among stroke survivors with aphasia. It was also intended to gauge whether this activity might provide a basis for future research. The paper aims to discuss these issues.Design/methodology/approach Four community-dwelling stroke survivors with aphasia were recruited. In total, 12 pupils aged six and seven were selected by their Year 2 teacher and head-teacher. At the event, participants sat in groups of one adult and three pupils and engaged in writing, hand-tracing and talking about pictures. The author circulated among the groups to facilitate engagement.Findings All participants enjoyed interacting together in the activities. The pupils gained insights into the stroke survivors’ lived experience and wanted them to return to “see us again soon”; the adults valued being in the “real world” and practising their conversation in activities different from their usual routines. Feedback indicated the value of the engagement and that participants welcomed similar intergenerational opportunities. The author will develop a research application exploring enablers, barriers and benefits of this type of engagement.Originality/value The event gave a rare opportunity for stroke survivors with aphasia to participate in intergenerational activities and for children to engage with vulnerable older adults. It demonstrated the value of interactions in which learning and insights are obtained on both sides. It also provided evidence that pursuing research in this field is feasible. [ABSTRACT FROM AUTHOR]

As a response to the ageing population, the United Kingdom (UK) government, like many others, has increased the State Pension Age. This has involved equalising women's State Pension Age with men's, raising it from 60 to 65, with further increases already underway. It has been argued that a key issue with how this change has been implemented is the lack of notice the government gave to the women affected, impacting on their ability to plan for retirement. So far, there has been very little research exploring inequalities in awareness of these developments and, in particular, considering whether women of particular socio-economic backgrounds are less likely to know about the changes. This has implications for potentially further widening inequalities in old age. In this paper we analyse data from the English Longitudinal Study of Ageing. We consider the role of cognitive ability in mediating the relationship between socio-economic background and awareness, given recent debates on deficiencies in financial literacy. We find that socio-economic inequalities exist, especially with respect to labour force status, occupation and education. We also find that cognitive ability, especially numeracy, mediates a sizeable proportion of the relationship. These findings have important implications in terms of implementing future policy changes and awareness campaigns to help mitigate the possibility that they will further entrench inequalities in older age. [ABSTRACT FROM AUTHOR]

Academics, social care practitioners, and policymakers speak different languages. If academic research is to have an impact on society, it must be understandable and convincing to the end users. We argue that the conceptualisation of social care "need" is different among these stakeholders, leading to poor communication between them. Academics should use concepts that have more meaning to practitioners. We propose resurrecting a little‐used concept from the 1970s, "interval of need", to help to bridge this gap. The interval of need concept identifies how often people require help, supplementing the usual data about types of tasks where assistance is needed. The history of the concept is described, followed by a test of its usefulness for today's researchers by applying it to data from the English Longitudinal Study of Ageing. An updated version of interval of need is proposed. Validation checks were conducted against mortality data, and through conceptual validation from a social work practitioner. The nature of the dataset limited comparability with previous studies. However, we conclude that the interval of need concept has promising scope to enhance communication of research findings, potentially leading to improved outcomes for service users. This paper strives to mark a turning point in the language and analysis of social care, ensuring that academic investigation in this field is convincing and clear to practitioners and policymakers. [ABSTRACT FROM AUTHOR]

Background: Sleep problems are common amongst people who use alcohol and other drugs, but treatment options are limited. This paper explores how people in residential treatment for alcohol and other drug problems perceived and described 'non-problematic' sleep to provide insights that might inform sleep interventions for this population. Methods: Qualitative interviews were conducted with 28 residents (19 women, 9 men; ages 24–83 years) in two residential drug and alcohol treatment centres in England during 2014/15. Interviews were audio-recorded, transcribed, and coded. Accounts of non-problematic sleep were then analysed inductively. Results: Non-problematic sleep comprised three linked components: i. personal sleep patterns and routines; ii. sleep perceptions; and iii. sleep metacognitions. Some participants reported they slept well; others described their sleep as problematic but improving. Participants believed that sleep improved naturally with residential treatment and abstinence, but perceptions of 'good' sleep varied greatly. Participants used a range of metacognitive strategies (e.g. downgrading the importance of sleep; adapting their sleeping patterns; and focusing on sleep quality alongside sleep quantity) to manage sleep problems and render them non-problematic. Conclusions: Metacognitive strategies that focus on changing perceptions of sleep can potentially inform sleep interventions for people with a history of alcohol and other drug use. [ABSTRACT FROM AUTHOR]

Carers play an ambiguous role within the personalisation paradigm currently shaping adult social care practice in England. Although carers have rights to assessments and support in their own right, these rights sit uneasily alongside the practices of assessment, support planning and personal budget ( PB) allocation for older and disabled people. This paper reports how 14 dyads of older and learning disabled people with cognitive and/or communication impairments and their carers viewed the roles - desired and actual - played by carers in PBs. Interviews with carers and with older and disabled people were conducted during 2012 as part of a wider study into carers' roles in assessment, support planning and managing PBs. The interviews complemented a survey of reported practice in two English regions - interviews with adult social care services senior managers and focus groups with front-line care managers. Talking Mats© were used to support interviews with some service users. Interviews were transcribed and data analysed using the Framework approach. The interviews indicated that carers played important roles in service users' assessments and support planning, but were less likely to report receiving assessments or support of their own. While carers had the potential to benefit from PBs and support arrangements for service users, this did not reflect practice that aimed to enhance choice and control for carers. The paper draws on Twigg's typology of service conceptualisations of family carers and concludes that, despite the important social rights won by carers in England, current practice continues to regard carers primarily as a resource or a co-worker, rather than a co-client. [ABSTRACT FROM AUTHOR]

Abstract: Background: Multiple interventions have been developed to address speech sound disorder (SSD) in children. Many of these have been evaluated but the evidence for these has not been considered within a model which categorizes types of intervention. The opportunity to carry out a systematic review of interventions for SSD arose as part of a larger scale study of interventions for primary speech and language impairment in preschool children. Aims: To review systematically the evidence for interventions for SSD in preschool children and to categorize them within a classification of interventions for SSD. Methods & Procedures: Relevant search terms were used to identify intervention studies published up to 2012, with the following inclusion criteria: participants were aged between 2 years and 5 years, 11 months; they exhibited speech, language and communication needs; and a primary outcome measure of speech was used. Studies that met inclusion criteria were quality appraised using the single case experimental design (SCED) or PEDro‐P, depending on their methodology. Those judged to be high quality were classified according to the primary focus of intervention. Outcomes & Results: The final review included 26 studies. Case series was the most common research design. Categorization to the classification system for interventions showed that cognitive–linguistic and production approaches to intervention were the most frequently reported. The highest graded evidence was for three studies within the auditory–perceptual and integrated categories. Conclusions & Implications: The evidence for intervention for preschool children with SSD is focused on seven out of 11 subcategories of interventions. Although all the studies included in the review were good quality as defined by quality appraisal checklists, they mostly represented lower‐graded evidence. Higher‐graded studies are needed to understand clearly the strength of evidence for different interventions. [ABSTRACT FROM AUTHOR]

Objectives: There have been calls for greater exchange between research and practice in health care policy and management, but little empirical research on what commissioners of research and researchers themselves consider appropriate, good quality research knowledge. This paper addresses this gap, considering the views of commissioners and producers of policy and management research in health care and other fields. Methods: Qualitative semi-structured interviews with 18 commissioners and producers of research, in central government, the NHS and other commissioning organizations, and in universities and independent sector providers. Results: Commissioners and producers agreed that research often fails to fulfil policy-makers' and managers' needs, and that greater interaction is required to improve this relationship. However, they offered differing accounts of the nature of research knowledge (as a 'product' or a 'mindset'), and of what constitutes value, validity and originality in research, reflecting the differing priorities and pressures faced by the two groups. Conclusions: Efforts to promote greater interaction between research, policy and practice, and more critical, reflexive engagement between policy-makers, managers and researchers, are likely to face significant obstacles given these competing constructions of research knowledge and their reinforcement by divergent priorities. [ABSTRACT FROM AUTHOR]

Background: People with acquired progressive dysarthria typically experience increased problems with intelligibility in everyday conversation as their disease progresses. Such problems are likely to impact on both the person with dysarthria and those with whom they interact. If this is the case then we may ask questions not just about the nature of these problems but how it is that such problems are dealt with by participants when they occur. Aims: To investigate ways through which problems resulting from dysarthria in everyday conversation are resolved by participants. Further, to examine some of the features of repair resolution, particularly where understanding of self-repair attempts themselves prove difficult. Methods & Procedures: Video data of natural conversation from two dyads were selected for this paper. One dyad features a 58 year-old man with multiple sclerosis and moderate intelligibility problems, the other a 79 year-old woman with motor neurone disease with mild to moderate intelligibility problems. Both elected to be recorded in conversation with their spouses. The dyads were video-recorded at home with no researcher present. Using the methods of Conversation Analysis (CA) a collection of sequences was identified and transcribed. The sequences were analysed with reference to how the participants resolve problems in the understanding of dysarthric speech. Outcomes & Results: It is shown how some problems resulting from dysarthria in conversation can be resolved relatively quickly, particularly where a specific element of a prior turn is highlighted by the recipient as problematic. In other instances, the recipient's understanding problem may be more global. These result in longer repair sequences in which problematic elements are addressed individually. Such a resolution method is ultimately successful but may also be characterised by additional understanding problems. These findings draw attention to an important distinction between intelligibility and understandability. Conclusions & Implications: It is concluded that problems resulting from dysarthria in conversation can require extensive repair work involving both parties. This has implications for the assessment of dysarthria in everyday conversation and also the promotion of intervention strategies that encompass the activities of both participants when dealing with dysarthria in interaction. These findings may be usefully employed in informing both direct clinical work and through training those who work with this client group and their significant others. [ABSTRACT FROM AUTHOR]

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Background: Increasing age is the biggest risk factor for dementia, of which Alzheimer's disease is the commonest cause. The pathological changes underpinning Alzheimer's disease are thought to develop at least a decade prior to the onset of symptoms. Molecular positron emission tomography and multi-modal magnetic resonance imaging allow key pathological processes underpinning cognitive impairment - including β-amyloid depostion, vascular disease, network breakdown and atrophy - to be assessed repeatedly and non-invasively. This enables potential determinants of dementia to be delineated earlier, and therefore opens a pre-symptomatic window where intervention may prevent the onset of cognitive symptoms.Methods/design: This paper outlines the clinical, cognitive and imaging protocol of "Insight 46", a neuroscience sub-study of the MRC National Survey of Health and Development. This is one of the oldest British birth cohort studies and has followed 5362 individuals since their birth in England, Scotland and Wales during one week in March 1946. These individuals have been tracked in 24 waves of data collection incorporating a wide range of health and functional measures, including repeat measures of cognitive function. Now aged 71 years, a small fraction have overt dementia, but estimates suggest that ~1/3 of individuals in this age group may be in the preclinical stages of Alzheimer's disease. Insight 46 is recruiting 500 study members selected at random from those who attended a clinical visit at 60-64 years and on whom relevant lifecourse data are available. We describe the sub-study design and protocol which involves a prospective two time-point (0, 24 month) data collection covering clinical, neuropsychological, β-amyloid positron emission tomography and magnetic resonance imaging, biomarker and genetic information. Data collection started in 2015 (age 69) and aims to be completed in 2019 (age 73).Discussion: Through the integration of data on the socioeconomic environment and on physical, psychological and cognitive function from 0 to 69 years, coupled with genetics, structural and molecular imaging, and intensive cognitive and neurological phenotyping, Insight 46 aims to identify lifetime factors which influence brain health and cognitive ageing, with particular focus on Alzheimer's disease and cerebrovascular disease. This will provide an evidence base for the rational design of disease-modifying trials. [ABSTRACT FROM AUTHOR]

Purpose -- The relationship between accessing indecent images online and the perpetration of contact child sex offences remains unclear. The purpose of this paper is to provide a better understanding of the offence process of offenders who have both such convictions. Design/methodology/approach -- A total of eight semi-structured interviews were conducted with older adult males who had downloaded indecent images and also had a history of contact sex offences against children. Data analysis involved thematic coding based on guidelines suggested by Braun and Clarke (2006). Findings -- Themes which emerged suggest some similarities (offence process behaviours), but also some differences (developmental factors) between the eight offenders. Data relevant to developmental factors formed two primary themes: childhood attachment difficulties and experiences of childhood abuse, both of which appeared to influence the offence process. Escalating factors generated a further three themes: adult relationships, personality problems and substance use. Five main categories also emerged with regard to offence behaviours: sexually deviant interests, lack of self-control, opportunity, the role of the internet (availability, easy access and anonymity), and cognitive distortions (justifications: interest in challenge and sexual frustration; denial: accidental access and denial of a victim, normalisation; blame: blame on the victim, new technologies and authorities and blame on other factors; and minimisation). Practical implications -- A better understanding of the offence process would inform clinical practice with such offenders and aid in the process of prevention. Originality/value -- This is the first research to date which explores the rationale provided for their behaviour by those convicted of both internet and contact child sex offences. [ABSTRACT FROM AUTHOR]

Despite the rapid growth of interest in social enterprises (SEs) and the intense controversies over their merits in addressing pressing social and economic issues, there has been surprisingly little attention given to explicit theorization of how the markets for their goods and services are constructed and maintained. Towards this end this paper examines the conceptualization of market fields formulated by Jens Beckert. His approach conceptualizes firms as engaged in a constant struggle to defend or improve their position in relation to other firms by either protecting existing structures or changing them to realize new opportunities. This framework is used to analyze the reciprocal interactions between forces of institutions, networks, and cognitive frameworks as they serve to construct opportunities for SE. These relationships are exemplified with evidence from respondents in SEs in four cities in England--Liverpool, Birmingham, Southampton, and the London Borough of Ne wham. The analysis suggests that Beckert's approach helps to move beyond a singular notion of a single 'market logic' and allows us to unpack some of the hybrid character of SE markets. However, because of the way in the field perspective has been designed to explain agency in orthodox capitalist markets, it struggles to incorporate the motivations that drive agency in these markets. [ABSTRACT FROM AUTHOR]

Background: Whilst many studies have analysed predictors of longitudinal cognitive decline, few have described their impact on population distributions of cognition by age cohort. The aim of this paper was to examine whether gender, education, social class and birth cohort affect how mean population cognition changes with age. Methods: The Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) is a multi-centre population based longitudinal study of 13,004 individuals in England and Wales. Using ten years of follow-up data, mean Mini-mental State Examination (MMSE) scores were modelled by age and birth cohort adjusting for nonrandom drop-out. The model included terms to estimate cohort effects. Results are presented for five year age bands between 65-95 years. Results: At a population level, women show greater change in MMSE scores with age than men. Populations with lower education level and manual work also show similar effects. More recent birth cohorts have slightly higher scores. Conclusion: Longitudinal data can allow examination of population patterns by gender, educational level, social class and cohort. Each of these major socio-demographic factors shows some effect on whole population change in MMSE with age. [ABSTRACT FROM AUTHOR]

The Mental Capacity Act 2005 was fully implemented in England and Wales in 2007. The Deprivation of Liberty Safeguards were introduced into the MCA and fully implemented in England and Wales in April 2009. A range of anomalies and paradoxes in the use of DOLS are described in detail in this paper. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at a one-day conference held November 11, 2010 at the Institute of Child Health in central London, England on the topics of health and hydration is presented. Topics include hydration and water intake in children and infants, hydration maintenance in older people, and the hydration status in relation to physical activities of athlete. The conference featured academic researchers including dr. Susan Shirreffs, dr. Sue Reeves, and dr. Ricardo Costa.

Deficits in time perception (the ability to judge the duration of time intervals) have been found in children with both attention-deficit/hyperactivity disorder (ADHD) and dyslexia. This paper investigates time perception, phonological skills and executive functions in children with dyslexia and/or ADHD symptoms (AS). Children with dyslexia-only ( n = 17), AS-only ( n = 17), comorbid dyslexia+AS ( n = 25), and typically developing controls ( n = 42), matched for age and non-verbal ability, were assessed on measures of phonological skills, executive function and time perception (duration discrimination and time reproduction). Children with dyslexia were impaired on measures of phonological skill and duration discrimination compared to children without dyslexia (though problems on duration discrimination appeared to be attributable to mild symptoms of inattention in this group). In contrast, children with AS exhibited impairments on measures of both time perception and executive function compared to children without AS. Children with dyslexia+AS showed an additive combination of the deficits associated with dyslexia-only and AS-only. Dyslexia and AS appear to be associated with distinct patterns of cognitive deficit, which are present in combination in children with dyslexia+AS. [ABSTRACT FROM AUTHOR]

This paper takes a new look at the role of narrative construction in sojourner adjustment through a case study of two female Korean entrepreneurs (selected from interviews with 10 Korean sojourners) to best differentiate their cultural adjustment from 'culture shock' in the UK. We review the literature on culture shock, beginning with Oberg's classic modernist/foundational 'transformational' model. The limitations of this model are shown in terms of the restricted focus upon individualistic, universal cognitive stages of change experienced by the sojourner. Then the benefits afforded by applying Goffman's dramaturgy and Weick's sensemaking approach are discussed. These approaches, informed by relationalist metatheory and metamethods, focus upon persons and interaction. They provide more collective, particularistic, social constructivist lenses that incorporate emotional, symbolic, communicative and linguistic viewpoints to complement cognitive explanations. The narrative methodology employed is that of Barbara Czarniawska whose work is heavily influenced by Goffman and Weick. [ABSTRACT FROM AUTHOR]

Primary objective: Neurobehavioural disability (NBD) has a major impact on long-term psychosocial outcome following acquired brain injury (ABI). A recent review highlighted that a reliable and valid measure that can adequately capture the subtle and varied characteristics of NBD has yet to be developed. In this paper, the work underpinning the 'St Andrews-Swansea Neurobehavioural Outcome Scale' (SASNOS) is described using a conceptual framework underpinned by the WHO ICF. The intention is that SASNOS will provide a reliable and valid means of measuring NBD. Methods and procedures: Three hundred and thirty-six sets of ratings were made regarding ABI and neurologically healthy samples. The initial pool of 117 items was subjected to exploratory factor analysis and Rasch analysis. Reliability and validity of the new measure were determined using a range of appropriate statistical methods. Main outcomes: Forty-nine items were retained, falling into five principal factors. Content and construct validity are calculated. SASNOS has excellent discriminant/diagnostic validity. Inter-rater and test-re-test reliability are good. Conclusions: SASNOS has a range of clinical and research applications and can be employed when measuring outcome. This new measure will enable neurorehabilitation services to directly compare the clinical populations they serve using the same frame of reference for NBD. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to conduct an exploratory analysis of low-income women consumers' consumption of low-involvement grocery products, and to explore the relevance of cognitive dissonance in this consumption. Design/methodology/approach -- One focus group discussion and 30 in-depth interviews are conducted with low-income women consumer at Salford area of the north-west of England to explore their salient beliefs, motivations, attitudes and behaviours in respect of their consumption of low-involvement grocery products. Findings -- Findings suggest that low-income women consumers engage in habitual purchasing and are not loyal to brands of grocery products. However, they often buy stores' own value-range brands as they believe that these products are similar to manufacturers' brands. They do not perceive price to be an indication of quality, rather they attribute basic differences between the stores' own value-range and manufacturers' brands as "expensive packaging" and the popularity of the brand name. Value for money is revealed as a key motivation underlying their purchasing of grocery products. Consequently, they are very sensitive to sales promotions and actively engage in making comparisons between the promotions in different stores within their locality. These confirm the incidence of cognitive dissonance in their consumption of these products. Originality/value -- This paper shows that generalisation in consumer behaviour without due reference to the contextual factors identified among low-income women consumers provides a limited understanding of their decision making and purchase behaviour. It also supplements the limited empirical information on low-income consumers, and consequently will be of interest to marketing practitioners, as it will reveal potential directions for low-involvement product strategies in respect of the low-income consumer. [ABSTRACT FROM AUTHOR]

Self-report research suggests that much violence is triggered by perceived insults and disrespect. This may be particularly true in the context of a prison or another environment of acute deprivation, whereby individuals have little other recourse to means of reputation enhancement. This paper presents the findings of two studies conducted with prisoner volunteers inside a Category C (minimum security) prison in England. In the first study, the authors randomly assigned a sample of 89 prisoners to one of two conditions: the experimental group were asked to discuss times they have been disrespected by authority figures inside and outside the prison; the control group were asked more neutral questions. Both groups then completed several measures of cognitive beliefs, distortions, and hostile attribution biases. None of the measures differed across the two groups except the measure of excuse and justification acceptance. Controlling for other factors, the experimental group endorsed these rationalisations at a significantly higher rate than the control group. This finding suggests that raising the salience of disrespect - reminding prisoners of times they have been made to feel unworthy of consideration - may raise the risk that prisoners will engage in violence by providing prisoners with justifications or excuses for actions they might not otherwise endorse. These findings received some additional validation in the second study, a qualitative analysis of offender accounts of violence and aggression within the prison. Implications for reducing violence within prisons are discussed. [ABSTRACT FROM AUTHOR]

The theoretical understanding of firesetting behaviour has predominantly been developed with men in prisons or psychiatric hospitals without neurodevelopmental disabilities. Consequently, there is a lack of evidence regarding the validity of current theory when applied to adults with intellectual disabilities and/or autism. Thirteen adults in England with intellectual and other developmental disabilities were interviewed about the affective, cognitive, behavioural, and contextual factors leading up to and surrounding a recorded firesetting incident. Interviews were analysed using a Grounded Theory approach. The resulting model consists of four phases: (1) background, (2) early adulthood, (3) pre-offence period, and (4) offence, and post offence period. The model accounts for unique precursors to firesetting including mental health deterioration, poor problem solving, and new motivations for firesetting. Unlike other offence chain theories, the significance of post-offence behaviour and cognitions are highlighted. [ABSTRACT FROM AUTHOR]

Background: Dementia leads to multiple issues including difficulty in communication and increased need for care and support. Discussions about the future often happen late or never, partly due to reluctance or fear. In a sample of people living with dementia and carers, we explored their views and perceptions of living with the condition and their future. Methods: Semi-structured interviews were conducted in 2018-19 with 11 people living with dementia and six family members in England. Interviews were audio-recorded, transcribed and analysed using reflexive thematic analysis. Results: Findings were explored critically within the theory of social death and three themes were developed: (1) loss of physical and cognitive functions, (2) loss of social identity, and (3) social connectedness. Most participants living with dementia and carers wanted to discuss the present, rather than the future, believing a healthy lifestyle would prevent the condition from worsening. Those with dementia wanted to maintain control of their lives and demonstrated this by illustrating their independence. Care homes were often associated with death and loss of social identity. Participants used a range of metaphors to describe their dementia and the impact on their relationships and social networks. Conclusion: Focusing on maintaining social identity and connectedness as part of living well with dementia may assist professionals in undertaking advance care planning discussions. [ABSTRACT FROM AUTHOR]

To establish whether ethnic inequalities exist in levels of self-reported hearing difficulty and hearing aid use among middle-aged adults. Cross-sectional data from the UK Biobank resource. 164,460 participants aged 40–69 who answered hearing questions at an assessment centre in England or Wales. After taking into account objectively assessed hearing performance and a corresponding correction for bias in non-native English speakers, as well as a range of correlates including demographic, socioeconomic, and health factors, there were lower levels of hearing aid use for people from Black African (OR 0.36, 95% CI 0.17–0.77), Black Caribbean (OR 0.38, 95% CI 0.22–0.65) and Indian (OR 0.60, 95% CI 0.41–0.86) ethnic groups, compared to the White British or Irish group. Men from most ethnic minority groups and women from Black African, Black Caribbean and Indian groups were less likely to report hearing difficulty than their White British or Irish counterparts. For equivalent levels of hearing loss, the use of hearing aids is lower among ethnic minority groups. Inequalities are partly due to lower levels of self-reported hearing difficulty among minority groups. However, even when self-reported hearing difficulty is considered, hearing aid use remains lower among many ethnic minority groups. [ABSTRACT FROM AUTHOR]

Aims: To explore how older people's experiences of COVID‐19 restrictions influenced their decision to receive a vaccine and to support nurse–patient vaccination conversations. Design: A longitudinal hermeneutic phenomenological study. The application of the COREQ checklist informed the reporting of this study. Methods: Data were collected through semi‐structured telephone interviews with older people (age ≥70) during two national restrictions implemented in England due to COVID‐19. Phase one of interviews occurred between April and July 2020 (six interviews), and phase two of interviews between January and April 2021 (four interviews). Data analysis was performed through content analysis. Results: Thirteen older people (mean age 78) worked through six stages about their thoughts and beliefs about receiving a vaccine, which encompassed four of the five elements of the 5C model of vaccine hesitancy, confidence, convenience, calculation, collective, but not complacency. Stages included 'our only hope is a vaccine'; 'understanding and acceptance of an effective vaccine'; 'social responsibility to protect others'; 'organized but left with unanswered questions'; 'need to feel secure' and finally 'vaccination alone is not enough'. Conclusion: The experience of COVID‐19 restrictions by older people informed their approach of engaging with scientific information to inform their decisions to be vaccinated but also developed their sense of collective responsibility to younger generations and those at risk, which informed their adherence to restrictions and the vaccination programme. Impact Nurses are optimally placed to support older people to implement and adhere to national government restrictions as appropriate and prevent obsessive routines, and support discussions and the provision of scientific information on COVID‐19 vaccinations, whilst being inclusive of older peoples' sense of collective responsibility. [ABSTRACT FROM AUTHOR]

Background: Patients belonging to marginalised (medically under-served) groups experience problems with medicines (i.e. non-adherence, side effects) and poorer health outcomes largely due to inequitable access to healthcare (arising from poor governance, cultural exclusion etc.). In order to promote service equity and outcomes for patients, the focus of this paper is to explore the implementation and impact of a new co-produced digital educational intervention on one National Health Service (NHS) funded community pharmacy medicines management service. Methods: Semi-structured interviews with a total of 32 participants. This included a purposive sample of 22 community pharmacy professionals, (16 pharmacists and 6 pharmacy support staff) all who offered the medicine management service. In order to obtain a fuller picture of the barriers to learning, five professionals who were unable to complete the learning were also included. Ten patients (from a marginalised group) who had received the service (as a result of the digital educational intervention) were also interviewed. Drawing on an interpretative analysis, Normalisation Process Theory (NPT) was used as a theoretical framework. Results: Three themes are explored. The first is how the digital learning intervention was implemented and applied. Despite being well received, pharmacists found it challenging completing and cascading the learning due to organisational constraints (e.g. lack of time, workload). Using the four NPT constructs (coherence, cognitive participation, collective action and reflexive monitoring) the second theme exposes the impact of the learning and the organisational process of 'normalisation'. Professional reflective accounts revealed instances where inequitable access to health services were evident. Those completing the intervention felt more aware, capable and better equipped to engage with the needs of patients who were from a marginalised group. Operationally there was minimal structural change in service delivery constraining translation of learning to practice. The impact on patients, explored in our final theme, revealed that they experience significant disadvantage and problems with their medicines. The medication review was welcomed and the discussion with the pharmacist was helpful in addressing their medicine-related concerns. Conclusions: The co-produced digital educational intervention increases pharmacy professionals' awareness and motivation to engage with marginalised groups. However structural barriers often hindered translation into practice. Patients reported significant health and medicine challenges that were going unnoticed. They welcomed the additional support the medication review offered. Policy makers and employers should better enable and facilitate ways for pharmacy professionals to better engage with marginalised groups. The impact of the educational intervention on patients' health and medicines management could be substantial if supported and promoted effectively. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of the fourth Be Clear on Cancer (BCoC) 'Blood in Pee' (BiP) campaign (July to September 2018) on bladder and kidney cancer symptom awareness and outcomes in England. Methods: In this uncontrolled before and after study, symptom awareness and reported barriers to GP attendance were assessed using panel and one‐to‐one interviews. The Health Improvement Network (THIN), National Cancer Registration and Analysis Service (NCRAS) and NHS Cancer Waiting Times (CWT) data were analysed to assess the impact on GP attendances, urgent cancer referrals, cancer diagnoses and 1‐year survival. Analyses used Poisson, negative binomial and Cox regression. Results: Symptom awareness and intention to consult a GP after one episode of haematuria increased following the campaign. GP attendance with haematuria (rate ratio (RR) 1.17, 95% confidence interval (CI): 1.07–1.28) and urgent cancer referrals (RR 1.18 95% CI: 1.08–1.28) increased following the campaign. Early‐stage diagnoses increased for bladder cancer (difference in percentage 2.8%, 95% CI: −0.2%–5.8%), but not for kidney cancer (difference −0.6%, 95% CI: −3.2%–2.1%). Conclusions: The fourth BCoC BiP campaign appears to have been effective in increasing bladder cancer symptom awareness and GP attendances, although long‐term impacts are unclear. [ABSTRACT FROM AUTHOR]

Objectives: There is now a body of research into the attributions that carers make of the challenging behavior of people with intellectual disabilities; however the attributions that people with intellectual disabilities make have not been studied. This paper describes the attributions that people with intellectual disabilities make of challenging behavior and compares them to those of their carers. Methods: Twenty-three day-service staff and 34 adults with intellectual disabilities completed measures of attribution, optimism, emotion and need for help and gave open-ended responses to questions about the causes of and potential interventions for challenging behaviors. Results: The overall pattern of attribution, emotion, optimism and intention to help is similar for people with intellectual disabilities and staff. However, compared to staff, people with intellectual disabilities were less optimistic and less happy about challenging behavior. Conclusions: This area of research will help identify the impacts of challenging behavior on the well being of people with intellectual disabilities and may help structure support for people who live alongside those who challenge. [ABSTRACT FROM AUTHOR]

Human engagements with the world form the basis for their intelligent understanding of it. Such material engagements are not piecemeal but follow some broad set of regularities as activities in one area of life are picked up and developed in another. Sweeping changes in life processes, which we might see as bursts of creativity, occur across areas of life we might label as secular or pragmatic and the sacred, calling into question such distinctions. In this paper, I follow the case of the emergence of the early medieval village and parish in England from around AD 750 onwards to examine how new cognitive landscapes emerge and what their entailments are more generally. I conclude by looking at the links between material engagement, identity and novelty. [ABSTRACT FROM AUTHOR]

The DESCANT (Dementia Early Stage Cognitive Aids New Trial) intervention provided a personalised care package designed to improve the cognitive abilities, function and well-being of people with early-stage dementia and their carers, by providing a range of memory aids, together with appropriate training and support. This sub-study aimed to assess implementation and identify contextual factors potentially associated with participant outcomes. A mixed-methods approach was adopted alongside the pragmatic randomised trial. Data were obtained from intervention records and interviews with five dementia support practitioners across seven National Health Service Trusts in England and Wales. A reporting framework was constructed from available literature and data assessed by descriptive statistics and thematic analysis. Participation and engagement was high with 126 out of 128 participants completing the intervention with packages tailored to individual participants. Misplacing items and poor orientation to date and time were common areas of need. Memory aids frequently supplied included orientation clocks (91%), whiteboards (60%), calendars (43%) and notebooks (32%), plus bespoke items. Intervention duration and timing were broadly consistent with expectations. Variation reflected participants' needs, circumstances and preferences. Qualitative findings suggested a potentially positive impact on the well-being of people with dementia and their carers. Issues associated with successful roll-out of the intervention are explored in the discussion. Successful implementation increased confidence in future findings of the randomised trial. Depending on these, DESCANT may prove a scalable intervention with potential to improve the function and quality of life of people with dementia and their carers. [ABSTRACT FROM AUTHOR]

Infection control has long been the focus of the attention of anyone working in healthcare, due to the risks posed to patients and staff if appropriate infection control procedures are not followed properly. This article explores a recap of important infection control measures and also outlines the Government's policy for tackling antimicrobial resistance, and its link to infection control procedures. The article covers the key points of the recent publication from NHS England on the topic of infection control. [ABSTRACT FROM AUTHOR]

Abstract: This paper investigates patterns of scraper retouch at the Lower Palaeolithic site of High Lodge, England. The unifacial scrapers from High Lodge are intensively retouched tools with regular and complex shapes that have been routinely interpreted as evidence of intentional design. The primary aim is to determine whether the different scraper types identified in the assemblage represent discrete and discontinuous implement categories made according to fixed designs, or rather, points or stages along one or more reduction continuums. To achieve this, we apply a range of quantitative measures of artifact reduction to all complete single, double, convergent, and transverse scrapers from the site (n =165). Our results indicate that morphological and typological diversity in the High Lodge scraper assemblage can be parsimoniously explained as a result of both the extent to which implements were resharpened during use and subtle variability in the nature of blank forms selected for retouch. Accordingly, we critique the notion that high levels of morphological complexity in retouched Lower Palaeolithic tool types necessarily reflect the imposition of preconceived forms on stones. [ABSTRACT FROM AUTHOR]

Abstract: Theoretical conceptualizations of generalized anxiety disorder (GAD) continue to undergo scrutiny and refinement. The current paper critiques five contemporary models of GAD: the Avoidance Model of Worry and GAD [Borkovec, T. D. (1994). The nature, functions, and origins of worry. In: G. Davey & F. Tallis (Eds.), Worrying: perspectives on theory assessment and treatment (pp. 5–33). Sussex, England: Wiley & Sons; Borkovec, T. D., Alcaine, O. M., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In: R. Heimberg, C. Turk, & D. Mennin (Eds.), Generalized anxiety disorder: advances in research and practice (pp. 77–108). New York, NY, US: Guilford Press]; the Intolerance of Uncertainty Model [Dugas, M. J., Letarte, H., Rheaume, J., Freeston, M. H., & Ladouceur, R. (1995). Worry and problem solving: evidence of a specific relationship. Cognitive Therapy and Research, 19, 109–120; Freeston, M. H., Rheaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17, 791–802]; the Metacognitive Model [Wells, A. (1995). Meta-cognition and worry: a cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301–320]; the Emotion Dysregulation Model [Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice, 9, 85–90]; and the Acceptance-based Model of GAD [Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive behavioral models. Clinical Psychology: Science and Practice, 9, 54–68]. Evidence in support of each model is critically reviewed, and each model''s corresponding evidence-based therapeutic interventions are discussed. Generally speaking, the models share an emphasis on avoidance of internal affective experiences (i.e., thoughts, beliefs, and emotions). The models cluster into three types: cognitive models (i.e., IUM, MCM), emotional/experiential (i.e., EDM, ABM), and an integrated model (AMW). This clustering offers directions for future research and new treatment strategies. [Copyright &y& Elsevier]

With growing social science interest in the potential for images to facilitate access to embodied experience, this study re-examines the relative value of visual and verbal methods in body-oriented research. Taking one lead from Kyrölä's (2016) idea of body image as the relationship between representation and corporeality, and another from Gendlin's (1993, 1995, 1997) methods for attending to and articulating from pre-reflective experience, we develop a method that juxtaposes words and images to explore the role of pre-reflective understanding on body image among teenage girls. The study highlights both an influencing role for pre-reflective understanding in body image and the availability of pre-reflective understanding to participants. While recognising persistent challenges in communicating embodied experience, we propose a method for engaging and working with embodied or pre-reflective experience in social science research by integrating the verbal and the visual in a specific way. [ABSTRACT FROM AUTHOR]

Self-monitoring may represent a mechanism to enhance physical activity among people with multiple sclerosis. To optimise activity monitoring as a behavioural tool to increase physical activity, user experience must be understood. This study evaluated user experience of the Yamax SW-200 Digi-walker pedometer in a group of people with MS. Semi-structured interviews were conducted with 15 adults who participated in a 12-week pedometer-supported behavioural change intervention, the iStep-MS trial. Interviews were audio-recorded and transcribed verbatim. Data were analysed using the Framework Method. An overarching theme Pedometers, the frustrating motivators captures the complex and often contradictory experience of the pedometer. Sub-themes include: Increasing activity awareness, which describes the pedometer's utility in raising activity consciousness; Numeric motivation provides insight into dual motivating and demotivating experiences of using an objective feedback device; (Un) usability focuses on practical concerns encountered in the day-to-day use of the monitor. The Yamax SW-200 Digi-walker raised awareness and enhanced participant motivation to engage in physical activity. Accuracy and usability concerns highlighted warrant consideration in the selection of this pedometer within a population with multiple sclerosis. Changing physical activity behaviour in people with MS: the iStep-MS trial; ISRCTN15343862; Use of self-monitoring tools such as pedometers can enhance physical activity awareness. Objective, numeric step count feedback is an effective motivational tool for physical activity. Accuracy and usability concerns may limit the value of the Yamax SW-200 Digiwalker for people with MS. Identification of individualised, reliable, usable and acceptable tools is important to ensure engagement with self-monitoring. [ABSTRACT FROM AUTHOR]

Despite the large number of behavioral and functional neuroimaging studies employing the Tower of London (ToL), the task''s structural parameters and particularly their impact on planning have not been addressed so far. In this paper, we highlight the structural properties of ToL problems and provide evidence for their systematic and substantial effects on the cognitive processes involved in planning. In a problem set with three-move problems, the following structural parameters were experimentally manipulated: the ambiguity of goal hierarchy, the demand for subgoal generation, and the existence of suboptimal alternatives. Analysis of preplanning time as an indicator for the planning process revealed highly significant effects for all three parameters which seems to reflect differences in cognitive processing due to structural task properties. Therefore, we suggest that the common consideration of ToL problem difficulty solely in terms of the minimum number of moves is not sufficient. Moreover, the applied problem sets should be more carefully selected and their structural parameters explicitly noted. [Copyright &y& Elsevier]

Conceptual frameworks for school-based, preventive interventions recognise that educators' capacity is, in part, dependent on school-level characteristics. This study aimed to (i) examine the factor structure and internal consistency of the Mental Health Literacy and Capacity Survey for Educators (MHLCSE); (ii) assess responses in relation to supporting students' mental health; (iii) describe schools' mental health provision in terms of designated roles, training offered, and perceived barriers; (iv) investigate variance in MHLCSE outcomes explained by schools; and, (v) explore school-level predictors of educators' perceived MHL and capacity after controlling for individual-level characteristics. A multi-level, cross-sectional design involving 710 educators across 248 schools in England was used, and secondary analyses of baseline data collected as part of the Education for Wellbeing Programme were conducted. Mental health provision data was available for 206 schools, of which 95% offered training to some staff, and 71% had a designated mental health lead. Secondary schools offered significantly more training than primary schools. Significant barriers included lack of capacity in Child and Adolescent Mental Health Services (CAMHS) and within school, and communication challenges between agencies. The amount of training offered by schools significantly predicted educators' awareness and knowledge of mental health issues, treatments and services, legislation and processes for supporting students' mental health and comfort providing active support, with increased training predicting higher scores. However, little variance was explained by schools (1.7–12.1%) and school-level variables (0.7–1.2%). Results are discussed in relation to current mental health and education policy in England. [ABSTRACT FROM AUTHOR]

Medium chain acyl-CoA dehydrogenase deficiency (MCADD) is a rare metabolic disorder, and commonly now part of newborn screening programs. Those diagnosed at birth are now progressing from childhood to adulthood. The study aim was to explore young people's experiences of living with MCADD and managing their condition. A descriptive qualitative study design involving semi-structured interviews with 12 participants aged 10 to 15 years, recruited from one regional pediatric metabolic disorder service in England. Data were analyzed using thematic analysis. The two major themes were "Eating for energy" and "Growing into a self-management role." Self-monitoring and self-management skills had been nurtured from early childhood by parents and healthcare providers. Young people's anxieties concerned having to maintain adequate energy input to stay safe and the associated burden of responsibility. Growing up with MCADD presents specific challenges. Self-management and ongoing support are important for dealing with those challenges. [ABSTRACT FROM AUTHOR]

A new form of narrative counselling for adolescents at risk of exclusion was piloted in 3 schools with 11 students between the ages of 13–14 years over a 6–7-week period. The intervention took into consideration that compared to adults, adolescents are more susceptible to being influenced by their immediate surroundings of home and school. A measure of progress on a student engagement scale showed an improvement in educational engagement, particularly in students' behavioural engagement in class. The process of narrative counselling adolescents at school is described and the issues addressed in the narrative counselling sessions are discussed. Finally, the inclusive ethos of the secondary schools that the counsellors worked in are considered, as they facilitated or hindered the counselling intervention. [ABSTRACT FROM AUTHOR]

Dementia-friendly communities (DFCs) are one way in which people living with dementia can be supported to be active, engaged and valued citizens. Quantitative evaluations of the experiences of those with dementia living within these communities are scarce. This article reports findings from a survey of people living with dementia on their experience of living in a DFC. Two-hundred and forty people living with dementia completed a cross-sectional survey in six DFCs across England. Around half of respondents reported they were aware they were living in a DFC. Being aware of living in a DFC was associated with taking part in leisure activities (p = 0.042), community centre attendance (p = 0.009), being involved in organised activities or groups (p < 0.001), feeling understood (p = 0.008), and feeling valued for their own contributions to the community (p = 0.002). This study illustrates the contribution that surveys can make in facilitating the expression of views and experiences of people living with dementia. Awareness of living within a DFC is associated with greater involvement in, and belonging to, the wider community. [ABSTRACT FROM AUTHOR]

Objectives This study aims to examine the relationship between childhood socioeconomic position (SEP) and cognitive function in later life within nationally representative samples of older adults in the United States and England, investigate whether these effects are mediated by later-life SEP, and determine whether social mobility from childhood to adulthood affects cognitive function and decline. Method Using data from the Health and Retirement Study (HRS) and the English Longitudinal Survey of Ageing (ELSA), we examined the relationships between measures of SEP, cognitive performance and decline using individual growth curve models. Results High childhood SEP was associated with higher cognitive performance at baseline in both cohorts and did not affect the rate of decline. This benefit dissipated after adjusting for education and adult wealth in the United States. Respondents with low childhood SEP, above median education, and high adult SEP had better cognitive performance at baseline than respondents with a similar childhood background and less upward mobility in both countries. Discussion These findings emphasize the impact of childhood SEP on cognitive trajectories among older adults. Upward mobility may partially compensate for disadvantage early in life but does not protect against cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) may positively stimulate the brain, cognition and mental health during adolescence, a period of dynamic neurobiological development. High-intensity interval training (HIIT) or vigorous PA interventions are time-efficient, scalable and can be easily implemented in existing school curricula, yet their effects on cognitive, academic and mental health outcomes are unclear. The primary aim of the Fit to Study trial was to investigate whether a pragmatic and scalable HIIT-style VPA intervention delivered during school physical education (PE) could improve attainment in maths. The primary outcome has previously been reported and was null. Here, we report the effect of the intervention on prespecified secondary outcomes, including cardiorespiratory fitness, cognitive performance, and mental health in young adolescents. Methods: The Fit to Study cluster randomised controlled trial included Year 8 pupils (n = 18,261, aged 12–13) from 104 secondary state schools in South/Mid-England. Schools were randomised into an intervention condition (n = 52), in which PE teachers delivered an additional 10 min of VPA per PE lesson for one academic year (2017–2018), or into a "PE as usual" control condition. Secondary outcomes included assessments of cardiorespiratory fitness (20-m shuttle run), cognitive performance (executive functions, relational memory and processing speed) and mental health (Strength and Difficulties Questionnaire and self-esteem measures). The primary intention-to-treat (ITT) analysis used linear models and structural equation models with cluster-robust standard errors to test for intervention effects. A complier-average causal effect (CACE) was estimated using a two-stage least squares procedure. Results: The HIIT-style VPA intervention did not significantly improve cardiorespiratory fitness, cognitive performance (executive functions, relational memory or processed speed), or mental health (all p > 0.05). Subgroup analyses showed no significant moderation of intervention effects by sex, socioeconomic status or baseline fitness levels. Changes in cardiorespiratory fitness were not significantly related to changes in cognitive or mental health outcomes. The trial was marked by high drop-out and low intervention compliance. Findings from the CACE analysis were in line with those from the ITT analysis. Conclusion: The one-academic year HIIT-style VPA intervention delivered during regular school PE did not significantly improve fitness, cognitive performance or mental health, but these findings should be interpreted with caution given low implementation fidelity and high drop-out. Well-controlled, large-scale, school-based trials that examine the effectiveness of HIIT-style interventions to enhance cognitive and mental health outcomes are warranted. Trial registration: ISRCTN registry, 15,730,512. Trial protocol and analysis plan for primary outcome prospectively registered on 30th March 2017. ClinicalTrials.gov, NCT03286725. Secondary measures (focus of current manuscript) retrospectively registered on 18 September 2017. [ABSTRACT FROM AUTHOR]