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Factors that will ensure success of the Transition Care Program initiated by the Australian Government that aids the smooth transition of seniors in need of care from the home to care systems are presented.

ObjectiveVolunteers are often needed to be employed in community- based health projects to ensure the viability of such schemes. This paper describes their important role in an exercise promotion scheme 'Health Walks', where they lead community walks. The aim of the study is to determine why people volunteer as walk leaders, what challenges they face, why they are committed to the scheme and whether they fit a particular demographic profile. This information will be useful in order for future schemes to understand and support their work.DesignThe research design consisted of a simple questionnaire, sent to all the volunteers who were part of the walking programme.SettingCommunity based.MethodThe survey was mailed to all 29 walk leaders. A prepaid response envelope was included along with a covering letter informing them of the project aims and a request to take part in the study. A total of 22 people (76 per cent) completed the survey.ResultsSimilarities were found between the traditional volunteer demographic profile and those of the walk leaders, who were middle- aged and previously worked in managerial or professional occupations. However, the motivations of the leaders were more related to self-interest or enjoyment than altruism.ConclusionIn order to maintain volunteers' commitment to the scheme, future walking programmes must support their efforts, by showing appreciation and by giving them opportunities for ownership.Key words:walking, volunteers, leaders, health walks

This study describes results from a double blind randomised controlled trial which examined the efficacy of a primary care-based exercise promotion programme (the Health Walks Scheme). Quality of life data from the SF-36 questionnaire are presented from 260 previously sedentary participants randomly selected from a large GP practice (data are available for 72% at the 12-month follow-up). After 12 months, only 61% of participants in the health walks group were still classified as sedentary, compared with 73% in the control group who were simply given advice regarding exercise (p=0.05). There were no significant changes in the dimensions of the SF-36 questionnaire at 12 months. Those people who actually completed a health walk showed larger improvements in dimensions of the SF-36 (although these were also not significant). The appropriateness of quality of life outcome measures in health promotion trials is discussed in the light of the findings.

Exercise promotion schemes often fail to keep people exercising after the first few months. However, schemes that promote walking have been associated with longer-term adherence to exercise. Health Walks is a community-based exercise programme that emphasizes brisk walking activity. In the first year of an important new scheme in the Thames Valley, over 700 people took part. A survey was designed to determine the motivation of the participants and the benefits of the scheme. It was mailed to all of the participants in the scheme, of whom 48% replied. The evaluation found that 90% of participants said that they would continue walking on the scheme. In addition to physical fitness, the countryside and the social aspects of the walks were important motivating factors. The majority of the participants were women, in higher social classes and over 50 years of age, indicating the efficacy of this type of activity for older participants. The average number of walks taken each month was only three, yet participants perceived that there were health benefits. This may be due to the additional exercise which participants engaged in outside the organized scheme. Over half of the participants said that they were doing more walking, in addition to the Health Walks, and relied on their car less for short journeys. Primary care groups and trusts only need to provide minimal support to develop and co-ordinate walking schemes, in contrast to traditional exercise prescription schemes. Further research is needed to examine whether ‘walking for health’ schemes encourage people to adopt healthy lifestyles.

A combination of qualitative and quantitative methods has been employed in this study in order to assess the impact of a variety of factors on young peoples drug-using behaviour. The focus is on the responses to an enquiry with respondents who had never used heroin, methadone, other opiates, cocaine powder, crack cocaine, benzodiazepines, amphetamines, ecstasy, LSD, cannabis, and solvents who were asked for their reasons for this non-use. The data were also analysed to ascertain whether reasons for non-use varied according to age, what respondents thought the effects of the drugs they had never used would be, and how likely they thought it was that they would use them in the year following the interview. No single reason was given by the majority of respondents for the non-use of drugs, but the motive most frequently reported - particularly by older respondents - was a lack of interest in the effects. Younger respondents'reasons for non-use were, overall, related to a fear of drugs and their effects. Most non-users of each substance were convinced they would continue to abstain, even though they perceived the effects of some drugs (particularly ecstasy) to be pleasurable.

This paper focuses on a study to identify and evaluate nursing research activity between 1990 and 1996 within a large acute hospital trust. One of the first steps in this process involved establishing a database of nursing research. On the surface, the task appeared to be relatively straightforward. In reality, it proved to be far more complex and time-consuming than originally anticipated. The data collection process is reviewed and the key features of the database described. Issues concerning the coordination and dissemination of nursing research activity within the trust are highlighted. Finally, recommendations for coordinating nursing research within the trust are made, including the role of the university and suggestions for further research.

The long-term care of older people is increasingly characterised by a mixed economy model and independent nursing homes have become an important contributor to this form of provision. Concerns about the quality of care in this sector have, however, focused attention on a number of policy issues. There are proposals to revise existing legislation, modify inspection processes, introduce national standards and consider alternative models of funding. Within this changing policy context, little is known about the challenges facing homes in providing quality care. This paper draws on the findings of a Delphi survey of 196 clinical nurse managers in the Anglia and Oxford region of the NHS Executive. The aim of the study was to identify and prioritise the challenges facing nurse managers in the delivery of quality care. A wide range of clinical nursing issues and 'indirect' nursing issues was identified. The findings highlight the demands of increasingly dependent residents of advanced age, including their needs for physical and psychosocial care. Funding constraints, recruitment and retention of staff, and education and training were priority issues believed by nurse managers to influence the quality of care they could deliver. The implications of these findings for policy and practice are considered.

Fertility difficulties, along with their investigation and treatment, are widely believed to cause significant psychological problems. This study was designed to investigate the efficacy of a non-directive counselling intervention with couples undertaking their first cycle of in-vitro fertilization treatment. Couples were randomly assigned to either a control group, given information about the treatment programme, or to an experimental group, given the same information plus three sessions of counselling before, during and on conclusion of the first treatment cycle. Psychological assessments were made at three points in the treatment process. Ratings were also obtained from the couples on the stress engendered by different parts of the treatment, the effects on their relationship and satisfaction with counselling. The results showed the patients to be generally well adjusted and anxiety levels dropped over the course of treatment. Counselling compared to information alone did not lead to any enhanced reduction in levels of anxiety or depression. The implications of the findings for service provision are discussed.

An obituary is presented for the neurosurgeon John Richard Bartlett who had an Associateship of the Royal Photographic Society (ARPS).