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An editorial is presented on the possible implications of personalization for adult care social workers. It outlines the considerable relevance for social work for the foreseeable future. An overview of the how similar personalization policy agendas in England and the Italian region of Lombardy are translated into practice is presented.

'Complexity' is theorised as a characteristic of modern food systems that poses a challenge to improving population diets. This paper seeks to explore the discursive deployment of 'complexity' in the context of public health. Doing so helps inform a more critical assessment of commercial and political determinants of health, and of 'complexity' as a prevailing frame for public health issues. Qualitative methods were used to explore 'responsibility' for healthy eating in the food system in the United Kingdom. Discourse analysis was conducted on corporate and government documents, and interviews with industry and government stakeholders. The aim was to examine the implications of 'complexity' within discourses of dietary public health. 'Complexity' was used not only to characterise dietary public health problems but also as a rhetorical device in public health narratives. It performed two main discursive functions: firstly, to represent diet-health problems as so multi-layered and difficult that they are intractable. Secondly, and despite this acknowledged complexity, to deflect from food system actions for improving diet to 'simpler' and non-food interventions, by industry and government. These uses of 'complexity' serve to attribute primary responsibility to individuals for dietary choice and to obscure inaction by government and industry, who have most control over the determinants of those choices. In short, 'complexity' can be used discursively to generate a smokescreen masking policy inaction in addressing public health problems. [ABSTRACT FROM AUTHOR]

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

This paper presents an overview of the importance of mental health services for unaccompanied asylum-seeking children in the United Kingdom. It reviews what mental health support appears to be available in the United Kingdom following an on-line search which took place in Spring 2021 and using information gathered through 22 interviews and focus groups with stakeholders. The latter group are defined as people working with asylum-seeking children. The primary stakeholders were local authority staff, although interviews were also conducted with local government associations (London Councils, the Local Government Association), NHS bodies and the voluntary sector. Often, further relevant stakeholders were identified during interviews. The report details the aims, methodology and context, before the findings are presented which is followed by recommendations for improving mental and social care provision for unaccompanied asylum-seeking children in the United Kingdom. [ABSTRACT FROM AUTHOR]

This paper examines the impact of major social security reform on mental health claimants by analysing the transition to Personal Independence Payment in the UK. Personal Independence Payment was introduced in April 2013, replacing Disability Living Allowance as the main non-means tested disability benefit intended to assist with the additional costs associated with disability or long-term health conditions. It is important to gain a better understanding of how people with mental health problems have experienced this reform. Twelve service users were interviewed for this qualitative research. Analysis identified three main themes: problems with the Personal Independence Payment claims process; problems conveying mental health problems during the assessment process; and positive experiences associated with the transition to Personal Independence Payment. This research demonstrates that major changes in benefit policy are challenging for people with mental health problems, particularly when delivered in a climate of austerity. The UK Government has changed the main disability benefit for disabled adults. From April 2013, Disability Living Allowance (DLA) has been phased out and replaced by Personal Independence Payment (PIP). This research found that this significant change caused difficulties for people with mental health problems. Everyone who took part reported increased anxiety, problems with claiming PIP, communicating with benefit officials and the medical assessment. It is important to learn from these problems so that future benefit changes, both in the UK and in other countries, can be developed and rolled-out in ways which are more appropriate for people with mental health problems. [ABSTRACT FROM AUTHOR]

While the COVID-19 pandemic now affects the entire world, countries have had diverse responses. Some responded faster than others, with considerable variations in strategy. After securing border control, primary health care approaches (public health and primary care) attempt to mitigate spread through public education to reduce person-to-person contact (hygiene and physical distancing measures, lockdown procedures), triaging of cases by severity, COVID-19 testing, and contact-tracing. An international survey of primary care experts' perspectives about their country's national responseswas conducted April to early May 2020. This mixed method paper reports on whether they perceived that their country's decision-making and pandemic response was primarily driven by medical facts, economic models, or political ideals; initially intended to develop herd immunity or flatten the curve, and the level of decision-making authority (federal, state, regional). Correlations with country-level death rates and implications of political forces and processes in shaping a country's pandemic response are presented and discussed, informed by our data and by the literature. The intersection of political decision-making, public health/primary care policies and economic strategies is analysed to explore implications of COVID-19's impact on countries with different levels of social and economic development. [ABSTRACT FROM AUTHOR]

Professional sports clubs (PSCs) are potentially effective settings for health promotion; however, their role within policy is unclear. Potential reasons include lack of awareness about existing provision of health and wellbeing (H&W) programmes and adequacy of monitoring and evaluation (M&E) practices. This review aimed to: (i) map the provision of H&W programmes delivered by PSCs in the United Kingdom (UK), and (ii) explore current M&E practices of PSCs and consider the policy implications of this. Websites from eight professional sport leagues were hand-searched for programmes and impact reports. Suitable programmes were quantified, whilst impact reports were analysed via inductive documentary content analysis. Results identified 176 H&W programmes and 36 impact reports, as well as 43 H&W impact statements, but only 14 of these were aligned to specific H&W outcomes. The H&W aims of programmes were typically vague, measurement tools were rarely used, and evaluations were usually anecdotal case studies and based on engagement figures, which may not only limit the potential uptake of these programmes but also the relevance of PSCs to public policy. Further research is thus needed to build a stronger evidence base for the use of PSCs as vehicles of public health promotion and policy, and to better address the challenges faced when seeking to monitor and evaluate PSC programmes effectively. [ABSTRACT FROM AUTHOR]

The Scottish Government's policy of minimum unit price (MUP) for alcohol has received significant scholarly attention. Much of the focus of this literature has been on the efforts by sections of the alcohol industry to oppose the policy, including attempts to 'frame' key terms of the debate and an understanding of its legitimacy and effects within the wider field of interpretative policy analysis. The present article builds on these studies by re-conceptualizing the MUP debate through the lens of post-structuralist discourse theory and the logics of critical explanation that emerge from this. It argues that the success and failure of MUP (as a projected social logic) can be understood through the shifting coalitions of actors that emerged (political logics) and the affective hold that industry narratives were able to exert (fantasmatic logics) in this context. While focused on UK alcohol policy, the article speaks to a wider research agenda on the 'commercial determinants of health' and, through the application of the critical logics approach, offers new analytical insights beyond those provided by existing models of industry influence. Similarly, it contributes to the field of post-structural policy analysis through its novel focus on the role of commercial entities as health policy actors. [ABSTRACT FROM AUTHOR]

It is estimated that one in seven couples in the UK experience infertility, though just over half of those affected by it seek professional help. Previous studies pointed to potential socioeconomic barriers in accessing assisted reproduction; however, less is known about geographic accessibility to fertility treatment and the way it is associated with measures of deprivation. In this study, we used publicly available data on fertility clinics, combined with official statistics for 315 local authorities in England, to create a standardized measure of geographic accessibility to fertility services. In addition, using a negative binomial regression model, we estimated the link between socioeconomic measures at the local authority level and availability of fertility services. We found that geographic accessibility to assisted reproduction is significantly higher in the most advantaged local authorities in terms of average household income and level of deprivation. This may lead to reduced opportunities for realizing fertility aspirations among those suffering from infertility in more deprived areas. Taking into account both socioeconomic and geographic barriers to accessing fertility treatment can contribute to a better understanding of help-seeking patterns for infertility, likelihood of achieving a live birth and inform policy to equalise opportunities in access to infertility treatment. [ABSTRACT FROM AUTHOR]

A critical discussion of the Brook Traffic Light Tool (TLT) is provided. The TLT supports professionals assessing sexual behaviour in children and young people (CYP). This critical commentary formed part of a wider evaluation of the TLT. The approach taken uses evidence-based, policy transfer and policy success frameworks. Conceptually, questions were raised about empirical research that underpins the TLT. The transfer of the TLT to the UK gave varied results with questions raised in relation to the suitability of the TLT for the UK context. Both successes and failures were evident within the UK. The findings suggest that more work needs to be done on TLT. Rigorous planning needs to be conducted when transferring to differing contexts. A more robust evidence base is required for the UK context and continuous evaluation is required. Yet the TLT exists where no other tool related to CYP and sexual behaviours is available for professionals. This article raises awareness around evidenced based policy, and how tools are introduced, to assess sexual behaviours in children and young people with very little consideration given to the context into which they are being introduced and how their success will be measured. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is often characterised as a 'crisis', requiring action by public, private, and third-sector stakeholders to achieve strategic change. Crisis narratives are powerful and may be co-opted to privilege solutions promoted by influential groups. In relation to AMR, this applies particularly to the pharmaceutical and medical diagnostics industries. Given the associated risk of inefficient use of public funds, critical attention must be paid to how the promoted 'solutions' to the AMR crisis are constructed, and their symbolic and material effects on health policy. We conducted a critical discourse analysis (CDA) of the seventy-one written submissions to the UK House of Commons Health and Social Care Committee's 2018 inquiry into AMR. Two researchers collaboratively coded the findings and categorised the submissions. We applied the Policy Dystopia Model to further analyse the proposed solutions and ascertain the discursive and instrumental arguments in the industry submissions to the Committee. We found that industry submissions deployed economic and governance discursive strategies, articulating three main 'market paradoxical' arguments: (i) interference but non-interference; (ii) power but powerlessness; and (iii) for-profit but not-for-profit. The industry submissions also drew upon instrumental strategies including: coalition management, information management, and direct involvement and influence in policymaking. Our analysis suggests that commercial interests deploy crisis narratives to advocate for solutions involving market deregulation and industry subsidies. Thus, the solutions presented to the Committee were heavily shaped by a technocratic-industrial complex. This contributes to influencing what is seen as possible and acceptable in the global AMR policy landscape. [ABSTRACT FROM AUTHOR]

This commentary about alcohol marketing regulation in the UK draws on a conference held by the Institute of Alcohol Studies, highlighting a need for policy interventions to prevent harm and improve public health. Hazardous and harmful alcohol use is associated with many health conditions, wider social consequences, and harms to others. Following no improvement in alcohol mortality rates in the past decade, 2020 saw alcohol-specific deaths rise to record levels in the UK. Bans or comprehensive restrictions on alcohol advertising across multiple types of media are listed by the World Health Organization (WHO) as one of the 'best buy' policies to reduce alcohol harm. The UK's current complaints-led self-regulatory approach fails to protect consumers and vulnerable groups from being exposed to influential alcohol marketing. There are few meaningful sanctions to deter brands and companies from violating existing codes, processes are retrospective, reactive and slow, and the codes fail in their stated aim of protecting young people. Other important impacts on heavier drinkers and those in recovery, as well as on gender and health equity, are also inadequately addressed. Innovation is also urgently needed to effectively regulate ever-evolving digital alcohol marketing. Addressing these issues through a combination of comprehensive restrictions, content controls, labelling, and replacing self-regulation with an independent body will benefit public health as well as protecting the vulnerable, including heavier drinkers, people in recovery, and children and young people. [ABSTRACT FROM AUTHOR]

The 'inclusion health' agenda aims to draw attention to health disadvantages accompanying experiences putatively characterised by social exclusion, such as homelessness, problem substance use, or imprisonment. However, its increasing prominence has surfaced conceptual uncertainties and potential tensions with other understandings of health inequalities. We undertook a discourse analysis of how recent health inequalities policy documents describe, explain, and make recommendations relating to inclusion health. Using the UK as a case study, and with reference to public health accounts of multi-level governance theory, we selected five recent health inequalities policy reviews covering Scotland, UK, European Union, and the World Health Organisation. All documents referred to some inclusion health concerns, though their relative emphasis differed between documents. Terms like inclusion, exclusion, and vulnerability were commonly used, but ill-defined and often ambiguous. Explanatory discourses were diverse, with a particular focus on intergenerational cycles and disproportionate exposure to risk, with a varying emphasis on individual versus structural factors. Few documents provided coherent explanatory accounts for the relationship between the issues of interest to inclusion health, their associations with poor health, and other axes of inequality. Our results suggest that health inequalities policymaking in a multi-level context may benefit from comprehensive conceptual frameworks which encompass diverse forms of social stratification, advantage, and disadvantage, and acknowledge potential tensions and trade-offs between different understandings. This may necessitate further theoretical and empirical work for inclusion health on its definitions, bounds, and how its scope of interest interacts with other forms of social and health inequality. [ABSTRACT FROM AUTHOR]

Issues of domestic space standards and occupancy levels rarely receive much attention in debates about UK housing and planning policies. This is exemplified by examining the history of space and occupancy standards as applied in England, demonstrating that standards have been under-specified, partial in coverage, and applied inconsistently. The outcomes are seen in the production of relatively small homes, overcrowding and (perversely) extensive under-occupation, residential dissatisfaction and mobility. Evidence for the health and wellbeing impacts of space shortages highlights the consequences for infectious diseases, particularly respiratory illness, mental health and stress, and educational attainment. Moreover, the mediating and moderating roles of domestic space upon the impacts of the Covid-19 pandemic show the crucial importance of space and occupancy standards for health, wellbeing and learning in a future where more time is spent at home. Areas of future research are identified which together could help address a probable underestimate of the current health sector costs of inadequate domestic space, this being an important lever for policy action. Such evidence, including crucially more from the UK itself, has an important role to play if stronger, more effective policies are to be developed and implemented in this area in future. [ABSTRACT FROM AUTHOR]

Sex work, or the exchange of sexual services for money or goods, is ubiquitous across eras and cultures. However, the practice of selling sex is often hidden due to stigma and the varying legal status of sex work. Online platforms that sex workers use to advertise services have become an increasingly important means of studying a market that is largely hidden. Although prior literature has primarily shed light on sex work from a public health or policy perspective (focusing largely on female sex workers), there are few studies that empirically research patterns of service provision in online sex work. This study investigated the determinants of pricing and popularity in the market for commercial sexual services online by using data from the largest UK network of online sexual services, a platform that is the industry-standard for sex workers. While the size of these influences varies across genders, nationality, age and the services provided are shown to be primary drivers of rates and popularity in sex work. [ABSTRACT FROM AUTHOR]

Universities' decisions during technology transfer may affect affordability, accessibility, and availability of COVID-19 health technologies downstream. We investigated measures taken by the top 35 publicly funded UK universities to ensure global equitable access to COVID-19 health technologies between January and end of October 2020. We sent Freedom Of Information (FOI) requests and analysed universities' websites, to (i) assess institutional strategies on the patenting and licensing of COVID-19-related health technologies, (ii) identify all COVID-19-related health technologies licensed or patented and (iii) record whether universities engaged with the Open COVID pledge, COVID-19 Technology Access Pool (C-TAP), or Association of University Technology Managers (AUTM) COVID-19 licensing guidelines during the time period assessed. Except for the Universities of Oxford and Edinburgh, UK universities did not update their institutional strategies during the first year of the pandemic. Nine universities licensed 22 COVID-19 health technologies. Imperial College London disclosed ten patents relevant to COVID-19. No UK universities participated in the Open COVID Pledge or C-TAP, but discussions were ongoing in autumn 2020. The University of Bristol endorsed the AUTM guidelines. Despite important COVID-19 health technologies being developed by UK universities, our findings suggest minimal engagement with measures that may promote equitable access downstream. We suggest universities review their technology transfer policies and implement global equitable access strategies for COVID-19 health technologies. We furthermore propose that public and charitable funders can play a larger role in encouraging universities to adopt such practices by making access and transparency clauses a mandatory condition for receiving public funds for research. [ABSTRACT FROM AUTHOR]

Young people's voices remain underrepresented in health policy processes. This scoping review focuses on the United Kingdom (UK) and investigates how and to what degree young people have participated in policy-making processes. We adapt an established framework categorizing how young people are involved in policy-related processes, ranging from advisory roles to communicating findings. We report a spectrum of practical examples, highlighting opportunities for successful policymaking with youth, in relation to key factors, such as type of involvement, role of facilitators, and the integration of young people in different stages of the process. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a global pandemic. Measures to reduce transmission of the virus have altered usual activities, routines, and livelihoods, and have had a significant impact on mental health. The current study aims to examine the potential alterations in psychological wellbeing, mental health, sleep and diurnal preference due to the COVID-19 pandemic. A cross sectional online questionnaire-based study with n = 200 participants (aged 18–62; 7.86.0% female, 93.0% white, 92.5% UK-based, 73.5% students). Data were collected between 15th April and 8 June 2020. Participants answered questions on lifestyle changes and their concerns and worries about COVID-19, and completed the SCI, PHQ9, GAD7, PWB18, UCLA3 and MEQ. Results showed self-isolation was linked to lower psychological well-being, and increased loneliness, anxiety and depression. Home-working was related to a shift in diurnal preference. Reduced work/income was related to decreased psychological well-being and sleep quality and increased anxiety, depression, loneliness and. Intensity of worried thoughts and concerns about COVID-19 were positively correlated with anxiety, depression and negatively with sleep quality. In conclusion, the social, occupational and economic disruption due to COVID19 has had a negative impact on psychological well-being. However, the transition to home-working may have been somewhat beneficial for some individuals in terms of sleep. These findings should be taken into account by policy makers during the transition to the 'new normal' post-pandemic. [ABSTRACT FROM AUTHOR]

The provision of high-quality end-of-life care for all is high on national (and international) agendas, but areas of unmet needs identified includes elderly people. This article draws on an autoethnographic account of the dying and death of my father to identify and interrogate disjunctions between end-of-life care policy and commonplace experiences of elderly people who die in a hospital setting. There are significant disjunctions between the "blunt" tools of end-of-life care policy and the everyday experiences of the dying and death of an elderly patient and an urgent need to improve end-of-life care for our oldest generations. [ABSTRACT FROM AUTHOR]