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Objectives: This paper considers home from the perspective of people living with dementia supporting ongoing discourse around ageing in place and the significance of creating more inclusive communities. Methods: Forty‐six home tour interviews led by people living with dementia were conducted in England and Scotland to better understand the connectivity between home and neighbourhood for people living with dementia. These interviews used a range of participatory and creative approaches including video, photographic images and in situ interviews. Data were analysed via reflexive thematic analysis. Results: Three themes were identified in data analysis. 1. Connected home and neighbourhood, where participants revealed the dynamic relationship between home and neighbourhood; 2. Practices of home, where participants discussed the everyday nature of their homes and routines; and 3. Displaying home and family, which reflected participant's biographical homes in the context of living with dementia. Discussion: The findings show that home holds multiple meanings for people living with dementia. For example, home is understood as a part of the neighbourhood and an extension of the home space into gardens and backyards, thus extending existing discourses that solely focus on the inside of people's homes. For people living with dementia, homes are also sites of negotiation and renegotiation where new meanings are created to reflect the changing nature and context of the home. There is not one fixed solution to these issues. Support and understanding for people living with dementia will need to evolve to adapt to the shifting dynamics and multiple meanings of home. Key points: Neighbourhoods begin within homes and are interconnected. This relationship has important implications for the discourse of ageing in place.'Home' for people living with dementia holds the same meanings for those without dementia, but with some notable differences. It is important to recognise the shifting dynamics of home and to recognise the complexity of home in the context of dementia. There is not a fixed solution to the challenges of ageing at home with dementia, but support and understanding need to evolve alongside people with lived experience.Homes are a site of renegotiation where new meanings are created to reflect the changing nature of home and the lived experience of home for those with dementia.The study has provided findings through innovation in the research design. The employment of creative methods enabled people living with dementia to participate in sharing their own narratives of home.The work provides evidence where there is a current gap in understanding 'what matters' about home for people living with dementia. [ABSTRACT FROM AUTHOR]

Background: A new diagnosis of complex post‐traumatic stress disorder, CPTSD, has been agreed by the World Health Organization, WHO, and evidence is needed for what psychological treatment might be effective, particularly from those with experience of the disorder. We used a novel participatory approach to explore patient views and simultaneously studied the impact on the patient researchers of the research process itself. In this paper, we report on the latter section of the study how the involvement in research of patients with CPTSD affected their mental health. Symptoms of CPTSD may include emotional dysregulation, feelings of self‐worthlessness and difficulties in relationships. Objective: The aim of this study section was to explore whether patients' mental health could be promoted through empowering them to participate in research on CPTSD. Design: The study had a qualitative, participatory design. The clinician who led the research (first author) held group meetings with patient researchers to explore the impact of the research process. The clinician also kept notes on the process in a reflective log. Setting and participants: Six patient researchers participated in research with other patients with lived experience of CPTSD in an NHS outpatient unit in a London hospital. Intervention studied: The research process itself was analysed in group meetings with researchers which the clinician recorded and transcribed. Findings: Participation in research may promote increased self‐confidence and social inclusion for those with CPTSD. Conclusion: Involvement in research may be seen as an empowering intervention because patients felt it contributed to recovery. [ABSTRACT FROM AUTHOR]

This paper reports on data from a qualitative case study of child protection social work in one local authority. Ethnographic methods were used and constructionist grounded theory employed to collect and analyse 329 pages of historical documents about the local authority child protection service, 246.5 hours of observations of social work practice and 19 interviews of social workers and their team managers. By interpreting the experiences of the social workers through the conceptual debates about the changes in the field of social administration, the social workers could be seen to want to perform a traditional form of social work but were required to perform a contemporary form of social administration. The aims and purposes of this form of practice could be considered to be distinct from those of social work as understood by the social workers, and as such, the social workers experienced the practice environment as constraining and often felt disillusioned. This paper conceptualizes these forms of practice, contributing to the debates about what practice is and how we are to analyse and categorize it for the purposes of influencing the institutions that create and maintain contemporary practice. [ABSTRACT FROM AUTHOR]

This paper describes the design and evaluation of a computer-assisted learning program called Link, which was designed to be used by psychology students to review their understanding of correlation. Unlike existing computer-assisted learning programs that were reviewed, Link makes use of data from authentic research studies in psychology and provides learner activities that are specifically designed to address students' misconceptions about correlation. A summative evaluation study of Link involving fifty psychology students was carried out to assess the effect on students' understanding of correlation. It was found that the use of Link significantly contributed to students' general understanding of correlation. However, it was found that students use of paper-based instructional materials could also achieve this. The implication of this research outcome is considered in relation to the design and use of computer-assisted learning applications for statistics in higher education. [ABSTRACT FROM AUTHOR]

The present paper adopts a social identity perspective to examine the relationship between community-based identification and well-being, resilience and willingness to pay back in the context of urban regeneration. A sample of 104 residents across five deprived urban areas in the southwest of England that have recently undergone or are about to undergo regeneration projects completed a survey. The results demonstrate that areas where a more community-centred, bottom-up, approach to regeneration was taken (i.e., 'culture-led') showed higher levels of community cohesion than areas where the community dynamics were ignored (i.e., a 'top-down' approach to regeneration). Increased community identification was linked to greater perceived social support, community-esteem, personal self-esteem and self-efficacy. These psychological processes were, in turn, linked to increased resilience and well-being, as well as a stronger willingness to pay back to the community. The results are consistent with the social identity approach. Implications for urban regeneration strategies are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Family Therapy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims This paper estimates how far monthly changes in prevalence of cigarette smoking, motivation to quit and attempts to stop smoking have been associated with changes in prevalence of high-risk drinking, and motivation and attempts to reduce alcohol consumption in England. Design Data were used from the Alcohol and Smoking Toolkit Studies between April 2014 and June 2016. These involve monthly household face-to-face surveys of representative samples of ~1700 adults in England. Measurements Autoregressive Integrated Moving Average with Exogeneous Input (ARIMAX) modelling was used to assess the association over time between monthly prevalence of (a) smoking and high-risk drinking; (b) high motivation to quit smoking and high motivation to reduce alcohol consumption; and (c) attempts to quit smoking and attempts to reduce alcohol consumption. Findings Mean smoking prevalence over the study period was 18.6% and high-risk drinking prevalence was 13.0%. A decrease of 1% of the series mean smoking prevalence was associated with a reduction of 0.185% of the mean prevalence of high-risk drinking 2 months later [95% confidence interval (CI) = 0.033 to 0.337, P = 0.017]. A statistically significant association was not found between prevalence of high motivation to quit smoking and high motivation to reduce alcohol consumption (β = 0.324, 95% CI = -0.371 to 1.019, P = 0.360) or prevalence of attempts to quit smoking and attempts to reduce alcohol consumption (β = −0.026, 95% CI = -1.348 to 1.296, P = 0.969). Conclusion Between 2014 and 2016, monthly changes in prevalence of smoking in England were associated positively with prevalence of high-risk drinking. There was no significant association between motivation to stop and motivation to reduce alcohol consumption, or attempts to quit smoking and attempts to reduce alcohol consumption. [ABSTRACT FROM AUTHOR]

Research which involves disabled children and young people now constitutes a fairly well-established body of work in the social sciences. However, discussion on the role of the (normally adult) researcher has arguably been marginalised in the much-needed exploration of disabled children's 'voices'. Drawing on a qualitative study of the transition to adulthood for young men with Duchenne muscular dystrophy, this paper reflects on the interview 'encounter' between the interviewer, young men and their families. It suggests that we may learn more about the experiences of disabled children and young people if we can find ways of describing the co-production of responses, non-responses and meaning within research interviews. [ABSTRACT FROM AUTHOR]

Background This paper analyses the costs and benefits of commissioning memory services for early diagnosis and intervention for dementia. Method A model was developed to examine potential public and private savings associated with delayed admissions to care homes in England as a result of the commissioning of memory services. Findings The new services would cost around £220 million extra per year nationally in England. The estimated savings if 10% of care home admissions were prevented would by year 10 be around £120 million in public expenditure (social care) and £125 million in private expenditure (service users and their families), a total of £245 million. Under a 20% reduction, the annual cost would within around 6 years be offset by the savings to public funds alone. In 10 years all people with dementia will have had the chance to be seen by the new services. A gain of between 0.01 and 0.02 QALYs per person year would be sufficient to render the service cost-effective (in terms of positive net present value). These relatively small improvements seem very likely to be achievable. Interpretation These analyses suggest that the service need only achieve a modest increase in average quality of life of people with dementia, plus a 10% diversion of people with dementia from residential care, to be cost-effective. The net increase in public expenditure would then, on the assumptions discussed and from a societal perspective, be justified by the expected benefits. This modelling presents for debate support for the development of nationwide services for the early identification and treatment of dementia in terms of quality of life and overall cost-effectiveness. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Highlights the Fifth International Congress of Analytical Psychology in London, England on September 1-8, 1971. Theme of the congress; List of the proceedings; Structure and organization of the congress.

Children taken into care and custody are arguably the most vulnerable and problematic groups within the wider debate and responses developing to the ‘troubled families’ agenda in England. They represent what the state most wants to avoid when it intervenes in the life of a family. This paper is based on an analysis of the service involvement and needs of the 196 children taken into care or custody over a 3‐year period (2008–2011) in one city local authority in England. The research was undertaken to inform the response to prevention of entry into care and custody which was the original focus of the most intensive part of the troubled families programme in the city. Interviews with 10 senior professionals from a range of agencies involved in setting up this local programme, explored the way the emerging troubled families agenda was shaping ideas about the understanding of and response to the needs of these children and their families. Key findings of the study illustrate the range and complexity of need as well as the sequence and amount of agency involvement. Professionals were often critical of the thinking behind the troubled families agenda, but were positive and creative about new ways of working with these families. [ABSTRACT FROM AUTHOR]

This article highlights three dimensions to understanding children's well-being during and after parental imprisonment which have not been fully explored in current research. A consideration of 'time' reveals the importance of children's past experiences and their anticipated futures. A focus on 'space' highlights the impact of new or altered environmental dynamics. A study of 'agency' illuminates how children cope within structural, material and social confines which intensify vulnerability and dependency. This integrated perspective reveals important differences in individual children's experiences and commonalities in broader systemic and social constraints on prisoners' children. The paper analyses data from a prospective longitudinal study of 35 prisoners' children during and after their (step) father's imprisonment to illustrate the arguments. [ABSTRACT FROM AUTHOR]

Editorial. Focuses on the papers produced by the Analytical Group of the Society of Analytical Psychology in London, England. Theme on borderline patients and their treatment in relation to the concept of self.

ABSTRACT 5 Boroughs Partnership NHS Foundation Trust, in the Northwest of England, has trained over 500 staff in the Knowledge and Understanding Framework, level 1 personality disorder awareness training. This is a 3-day nationally devised training programme delivered via an innovative co-production model (i.e. co-delivery and partnership working with service users who have lived experience). This paper provides quantitative and qualitative information on the effectiveness of training delivery and also serves to provide some insight into the impact of service-user involvement via such a co-production model. Information on 162 participants using the Knowledge and Understanding Framework bespoke questionnaire (Personality Disorder Knowledge, Attitudes and Skills Questionnaire) suggests that the training can be effectively delivered by and within a local NHS Mental Health Trust. Results immediately post-training suggest an improvement in levels of understanding and capability efficacy and a reduction in negative emotional reactions. Indications from a 3-month follow-up suggest that while understanding and emotional reaction remain improved, capability efficacy regresses back to pre-training levels, suggesting the need for ongoing supervision and/or support to consolidate skills. Discussion includes guidelines for the implementation of a truly integrated co-production model of training provision, as well as advice relating to the maximization of long-term benefits. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose. Supporting Offenders through Restoration Inside (SORI) is a programme that aims to: increase victim empathy in offenders; motivate offenders to change their offending behaviour; and to take personal responsibility for the harm that he has caused. A 5-day course based on the SORI principles has been piloted across seven prison sites in the UK. The aim of the study reported here was to evaluate the effectiveness of the programme across these sites. Methods. Three psychometric questionnaires [Victim Concerns, Locus of Control, and Stages of Change (SoC) scales] were administered to the participants immediately before and after the programme had taken place (data were available for 131 participants for the Victim Concern Scale, 82 participants for the Locus of Control measure, and 96 participants for the SoC questionnaire). These psychometric measures were the primary research outcome. Statistical analyses were employed to assess whether any changes had been effected by the programme. Results. The results of this study found that: participants had an enhanced victim concern for all types of victims, were more motivated to change their offending behaviours, and were more willing to take responsibility for their actions, after completion of the course. No change was found in terms of participants seeing themselves as being more in control of their actions/environment. Conclusions. The results lend support for the notion that the 5-day SORI course is effective in increasing participants' levels of victim concern and motivation to change, while not really impacting upon levels of ownership for one's ownership for one's actions. Suggestions for future research and limitations of the study are discussed in the paper. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether less invasive methods of autopsy would be acceptable to bereaved parents and likely to increase uptake.Design: Mixed methods study.Setting: Bereaved parents recruited prospectively across seven hospitals in England and retrospectively through four parent support organisations.Sample: Eight hundred and fifty-nine surveys and 20 interviews with bereaved parents.Methods: Cross-sectional survey and qualitative semi-structured telephone interviews.Main Outcome Measures: Likely uptake, preferences, factors impacting decision-making, views on different autopsy methods.Results: Overall, 90.5% of participants indicated that they would consent to some form of less invasive autopsy [either minimally invasive autopsy (MIA), non-invasive autopsy (NIA) or both]; 53.8% would consent to standard autopsy, 74.3% to MIA and 77.3% to NIA. Regarding parental preferences, 45.5% preferred MIA, 30.8% preferred NIA and 14.3% preferred standard autopsy. Participants who indicated they would decline standard autopsy but would consent to a less invasive option were significantly more likely to have a lower educational level (odds ratio 0.49; 95% CI 0.35-0.70; P = 0.000062). Qualitative findings suggest that parents value NIA because of the lack of any incision and MIA is considered a good compromise as it enables tissue sampling while easing the parental burden associated with consenting to standard autopsy.Conclusion: Less invasive methods of autopsy are acceptable alternatives for bereaved parents, and if offered, are likely to increase uptake and improve parental experience. Further health economic, validation and implementation studies are now required to assess the viability of offering these in routine widespread clinical care.Tweetable Abstract: Mixed methods UK study finds less invasive methods of autopsy are acceptable alternatives for bereaved parents, and if offered, are likely to increase uptake and improve parental experience. [ABSTRACT FROM AUTHOR]

In April 1999, academics from the Systems Department at the Open University in UK devised a matrix for assessing third-level systems students-the matrix was based upon systemic practitioner behaviours taught in the course. It was based upon earlier methods that sought to understand and assess student progress based upon evidence of changing behavioural traits rather than the expression of learned responses or 'right' answers. This was the beginning of the being, engaging, contextualizing and managing (BECM) matrix. The European Union-funded research project called Policy Influence of Indicators (POINT) made use of BECM as part of a process for exploring ways in which groups make use of indicators in several domains. This paper tells the story of how BECM was used in the POINT project to gain an understanding of group behaviour by observation of four segregated but linked qualities. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Presents an introduction to the January 1993 issue of the periodical "Journal of Analytical Psychology." Activities of the Analytic Group of the Society of Analytical Psychology in London, England.

Presents a testimony of the author on the psychoanalyst Louis Zinkin at the funeral in London. Experience of Zinkin in teaching with undergraduates and postgraduates; Goal of Zinkin in life; Conception of an idea for a workshop on termination.

Six years ago a small research unit was established at the Management Centre of the University of Bradford, with the purpose of investigating the effects of changes in job design and job content on worker productivity. Since that time a number of studies have been completed, and the philosophy and strategy of the programme of research have changed. This paper describes the evolution of the project and summarizes the major results obtained up to the present date. [ABSTRACT FROM AUTHOR]

The Francis Report, which was based on the investigation of complaints regarding standards of care in the Staffordshire NHS Trust in the UK, was published in 2013. The Report revealed that while the Trust appeared to be compliant with the standards set by official regulating bodies, the quality of care provided to patients was often appalling. While the Report constituted a 'critical moment' in health care, its findings resonated with widespread concern in the UK and elsewhere that health care is sometimes characterised by a lack of compassion. The Francis Report partially attributed this lack of compassion to a task-based culture which tended to prioritise the meeting of targets over the quality of care provided to patients. Older patients, in particular, were identified as being vulnerable to neglect. This qualitative study of hospice volunteers responds to concerns regarding the quality of organisational forms of care by considering how motivations to care may be sustained and enhanced within organisational contexts. Charitable and third sector organisations, such as the hospice in this study, have been identified as potentially relevant to other health and social care contexts precisely because they emphasise values such as altruism and goodwill. Our sociological approach suggests that altruism or compassion can be encouraged within contexts that emphasise a sociability of care. We argue that a sociability of care may be encouraged in organisational contexts if dominant understandings of rationality are extended through the incorporation of aesthetic rationality, a feminist perspective taken from Roslyn Bologh. This, however, would require a degree of authentic emotional engagement on the part of formal caregivers, which is more typically associated with relationships in the private sphere. [ABSTRACT FROM AUTHOR]

Many sociologists have observed the close connection between coordination and rhythm. In order to accomplish a communal task, participants need to develop a common rhythm if they are to coordinate their actions. Indeed, the harder the collective task, the more critical - but difficult - it is for participants to develop a common rhythm in order to synchronize their actions. Rhythm is thus an important and recurrent feature of social performance. This article explores the ways in which participants try to generate common rhythm in order to execute collective performances. To this end, the paper takes a single sporting example. It examines a decisive period in the 153rd Oxford and Cambridge Boat Race in 2007 to examine how a small social group, the Cambridge crew, struggled to create and maintain a rhythm in order to maximize their rowing performance. [ABSTRACT FROM AUTHOR]

Many sociologists have observed the close connection between coordination and rhythm. In order to accomplish a communal task, participants need to develop a common rhythm if they are to coordinate their actions. Indeed, the harder the collective task, the more critical - but difficult - it is for participants to develop a common rhythm in order to synchronize their actions. Rhythm is thus an important and recurrent feature of social performance. This article explores the ways in which participants try to generate common rhythm in order to execute collective performances. To this end, the paper takes a single sporting example. It examines a decisive period in the 153rd Oxford and Cambridge Boat Race in 2007 to examine how a small social group, the Cambridge crew, struggled to create and maintain a rhythm in order to maximize their rowing performance. [ABSTRACT FROM AUTHOR]

While the growth in usage and practice of varying forms of complementary and alternative medicine (CAM) continues apace, social science has increasingly turned to CAM's often individualistic approach to health and illness. CAM has been perceived as both partly a cause of and a response to the well-documented ideology in modern healthcare of ‘individual responsibility for health’. This occasionally manifests in a ‘victim-blaming’ ideology amongst both orthodox and CAM practitioners alike. These issues emerged as key themes in an ethnographic study of a Centre for spiritual healing in the North of England. By drawing upon a range of qualitative data gained through the researcher's participation at this healing centre, I argue that the healers’ focus on individual responsibility for health is not so much a part of the current socio-political health ideology of ‘victim-blaming’, rather, it is illustrative of an important contemporary social phenomenon: the movement towards the subjectification and personalisation of public life. [ABSTRACT FROM AUTHOR]

This article provides information about various meetings related to psychophysiology as of November 1981. The Ninth Annual Scientific Meeting of the Psychophysiology Society will be held at St. George's Hospital Medical School, London, England from December 16-18, 1981. The Conference will consist of formal paper sessions, workshops, symposia and science fairs. The Third Annual Meeting of the Society of Behavioral Medicine will be held in Chicago from March 3-5, 1982. This year's meeting will include courses in the fundamentals of behavioral medicine, numerous workshops, practica, symposia, and short courses and a debate on the "Dangers and Benefits of Exercise."

Presents the life and works of psychoanalyst Louis Zinkin in London. Educational attainment; Career profile; Importance of the Russian Jewish lineage for Zinkin.

The dominant model in cross‐cultural psychology largely disregards culture (Boski, 2018). An alternative theory of sociocultural models (SCMs) has been proposed in this volume. SCMs mould cognitive, affective, and behavioural processes of individual persons, as well as their corrective measures should such processes be sidetracked. Because SCMs are culture‐bound, intercultural contacts are likely to be fraught in misconceptions and conflicts, but they may also give rise to attraction and to culture change. This article compares Polish script of gender roles and its transformations between the ingroup and English (outgroup) contexts. Framed in a {Request → Compliance} format, a cultural experiment was conducted with university students in England and Poland. It was based on four video‐recorded enactments of that script, controlling for gender expressions on the request and on actor‐compliance sides. It was hypothesised that compared to foreign observers from England, Polish participants should provide confirmatory evidence to video installations, reflecting the script and should resist its transformation attempts. Results largely confirmed these expectations. The {Male addressed request → Male compliance} was of the Polish normative and behavioural prototype, but not appealing for English participants, for whom gender neutrality was the preferred cultural arrangement. [ABSTRACT FROM AUTHOR]

Accessible summary: ·There is significant concern about medication being given to people with intellectual disability (ID) inappropriately particularly to manage their behaviours which needs to stop.·This needs people who work and support people with ID with their distress to be aware of the national concerns and guidance.·We checked whether NHS staff who work with people with ID , that is the ID service, are aware of the latest guidance and whether training them will help improve their knowledge.·We found that there were differences in knowledge in some groups such as nurses and psychologists compared to others and training can make a positive change. This is important as training can possibly deliver better care to people with ID . Background: Intellectual disability (ID) is associated with polypharmacy particularly off‐label psychotropics for "challenging behaviour." NHS England introduced the "stopping over medication of people with a learning disability (LD), autism or both" (STOMP) initiative. As ID services are a professionally diverse group, it is important to know whether teams have suitable knowledge to deliver STOMP. The impact of delivering bespoke STOMP training was evaluated. Methods: A 21‐item multiple‐choice questionnaire was distributed to three specialist ID teams in the south‐west of England. Current best practice and national guidance knowledge on psychotropic medication use in ID were assessed. One team received bespoke training covering the content of the questionnaire prior to completion. Results: Survey participation was 44% (21/48) by the trained team, 34% (15/44) and 70% (7/10) in the untrained teams. The trained team participants scored over 80% on 19/21 questions compared to 15/21 and 16/21 in the untrained teams. Subspeciality analysis of pooled data (n = 43) showed nursing scored more than 80% on 16/21 questions, psychology 15/21 and allied health professionals (AHPs) 19/21. Nursing and psychology both reported STOMP to be a priority. Majority responded "yes" to potentially being involved in STOMP. Conclusions: Better STOMP knowledge and understanding of best practice and guidelines are associated with training. Nursing and psychology are essential to STOMP delivery but scored lower than AHPs. We recommend semi‐structured STOMP training developed locally with national underpinnings for all specialist ID teams, particularly focussed on front‐line staff directly involved in the management of challenging behaviour. [ABSTRACT FROM AUTHOR]

Background and aims: Harmful alcohol use places a significant burden on health services. Sophisticated nowcasting and forecasting methods could support service planning, but their use in public health has been limited. We aimed to use a novel analysis framework, combined with routine public health data, to improve now‐ and forecasting of alcohol‐related harms. Design We used Bayesian structural time–series models to forecast alcohol‐related hospital admissions for 2020/21 (from 2015 to 2016). Setting: England. Participants: We developed separate models for each English lower‐tier local authority. Measurements Our primary outcome was alcohol‐related hospital admissions. Model covariates were population size and age‐structure. Findings Nowcasting validation indicated adequate accuracy, with 5‐year nowcasts underestimating admissions by 2.2% nationally and 3.3% locally, on average. Forecasts indicated a 3.3% increase in national admissions in 2020/21, corresponding to a 0.2% reduction in the crude rate of new admissions, due to population size changes. Locally, the largest increases were forecast in urban, industrial and coastal areas and the largest decreases in university towns and ethnically diverse areas. Conclusions: In 2020/21, alcohol‐related hospital admissions are expected to increase in urban and coastal areas and decrease in areas associated with inward migration of younger people, including university towns and areas with greater ethnic diversity. Bayesian structural time–series models enable investigation of the future impacts of alcohol‐related harms in population subgroups and could improve service planning and the evaluation of natural experiments on the impact of interventions to reduce the societal impacts of alcohol. [ABSTRACT FROM AUTHOR]

Background: High profile failures of care in the NHS have raised concerns about regulatory systems for health‐care professionals and organizations. In response, the Care Quality Commission (CQC), the regulator of health and social care in England overhauled its regulatory regime. It moved to inspections which made much greater use of expert knowledge, data and views from a range of stakeholders, including service users. Objective: We explore the role of service users and citizens in health and social care regulation, including how CQC involved people in inspecting and rating health and social care providers. Design: We analyse CQC reports and documents, and 61 interviews with CQC staff and representatives of groups of service users and citizens and voluntary sector organizations to explore the place of service user voice in regulatory processes. Results: Care Quality Commission invited comments and facilitated the sharing of existing service user experiences and engaged with representatives of groups of service users and voluntary sector organizations. CQC involved service users in their inspections as "experts by experience." Information from service users informed both the inspection regime and individual inspections, but CQC was less focused on giving feedback to service users who contributed to these activities. Discussion and conclusions: Service users can make an important contribution to regulation by sharing their experiences and having their voices heard, but their involvement was somewhat transactional, and largely on terms set by CQC. There may be scope for CQC to build more enduring relationships with service user groups and to engage them more effectively in the regulatory regime. [ABSTRACT FROM AUTHOR]

Background: Little is known about the lives of parents with intellectual disabilities from minority ethnic communities. Previous research suggests that what it means to live with intellectual disabilities varies across cultural contexts. The current research aimed to explore how cultural values and practices impact upon the experiences of parents with intellectual disabilities within the Bangladeshi community in London, England. Method: Six members of the Bangladeshi community, four Bangladeshi parents with intellectual disabilities and four of their family members were interviewed. Thematic analysis was used to identify key themes. Results: Both parenting and intellectual disability are thought about in this community in ways that make parenting more accessible for people with learning disabilities, but also create tensions to be negotiated. Conclusions: Bangladeshi family carers face dilemmas balancing the benefits and risks of promoting parenting for sons and daughters with intellectual disabilities, particularly in the context of service principles of autonomy and informed consent. [ABSTRACT FROM AUTHOR]

Objectives: Prior research has examined various components involved in the impact of public and internalized stigma on people with mental health problems. However, studies have not previously investigated the subjective experiences of mental health stigma by those affected in a non‐statutory treatment‐seeking population. Design: An in‐depth qualitative study was conducted using thematic analysis to investigate the experiences of stigma in people with mental health problems. Methods: Eligible participants were recruited through a local mental health charity in the North West of England. The topic of stigma was examined using two focus groups of thirteen people with experience of mental health problems and stigma. Results: Two main themes and five subthemes were identified. Participants believed that (1) the ‘hierarchy of labels’ has a profound cyclical impact on several levels of society: people who experience mental health problems, their friends and family, and institutional stigma. Furthermore, participants suggested (2) ways in which they have developed psychological resilience towards mental health stigma. Conclusions: It is essential to utilize the views and experiences gained in this study to aid understanding and, therefore, develop ways to reduce the negative impact of public and internal stigma. Practitioner points: People referred to their mental health diagnosis as a label and associated that label with stigmatizing views. Promote awareness and develop improved strategies (e.g., training) to tackle the cyclical impact of the ‘hierarchy of labels’ on people with mental health problems, their friends and family, and institutional stigma. Ensure the implementation of clinical guidelines in providing peer support to help people to combat feeling stigmatized. Talking about mental health in psychological therapy or health care professional training helped people to take control and develop psychological resilience. [ABSTRACT FROM AUTHOR]

Abstract: Peer supporters are individuals with lived experience and are an integral part of health care systems, providing support to those affected by various phenomena such as homelessness and addictions. However, little is known about the critical elements that underpin peer support interventions. This qualitative study sought to understand the critical elements of intentional peer support with a homeless population, voiced by those who provide and/or receive this support. Twenty‐nine participants from 4 different homeless charities in England were interviewed about their experiences of providing/receiving peer support and what they felt were critical factors to its success. Participants defined peer support as an experience‐based relationship, built upon mutual understanding, empathy, and support. Thematic analysis was utilised to in developing 6 themes. Results identified peers' persistence in developing unique experience‐based relationships, providing social support, role modelling recovery, and peers' motivations were perceived as important factors involved in peer support. It was also found that peers described benefitting from helping, such as, undergoing transformative identity developments that helped them to escape homelessness. Through the retelling of their stories, they create meaning and restructure their autobiography, attributing experiences of homelessness as a catalyst for positive changes in their lives. Limitations and future research are discussed. [ABSTRACT FROM AUTHOR]

The National Health Service (NHS) is known to be a challenging place to work, with financial and performance targets placing increasing pressure on the organisation. This study aimed to investigate whether these pressures and threats might be detrimental to the quality of care and the compassion that the NHS strives to deliver. Quantitative data were collected via self‐report questionnaires from healthcare professionals across 3 NHS trusts in England in order to measure Self‐compassion; Compassion for Others; Perceived Organisational Threat; and Perceived Organisational Compassion. Qualitative data were also collected to explore the threats considered most pertinent to healthcare professionals at present. The key findings suggest that an increase in Perceived Organisational Threat may reduce an individual's ability to give compassion to others; however, Self‐compassion and Perceived Organisational Compassion were better predictors of Compassion for Others. This highlights the need to consider compassion at a systemic level, providing interventions and training not only to cultivate self‐compassion in healthcare professionals, but also to encourage compassion across the NHS more generally. In promoting self‐compassion and increasing the level of compassion that employees feel they receive at work, healthcare professionals may be better able to maintain or improve their level of compassion for service users and colleagues. [ABSTRACT FROM AUTHOR]

Accessible summary: When young people with learning disabilities leave the care system, they can experience many problems. Here we describe some of these problems and what they do (or would like us to do) to improve things. Young people do not always want the same things that professionals or family carers want. We do not spend enough time listening to what young people can tell us. Abstract: Background: Young people with learning disabilities are frequently underrepresented in research accounts. This study describes the experiences of young people moving from the care system. Methods: We scoped the English and Swedish literature for first‐hand accounts and interviewed four young people with learning disabilities leaving the English care system. We combined findings from both sources. Findings: “Grey” and campaigning literature are more likely than academic studies to include the voices of service users, but even then, the voices tend to be those of professional or family carers. Both the literature and interviews demonstrate young peoples’ awareness and understanding of the social as well as financial benefits of work. Good foster care could be precarious, and young people in unhappy placements lacked direction. Exploitation around a young person's housing and finances could be problems. There was evidence of “threshold” difficulties in accessing services. Conclusions: Despite an NHS commitment to listening to users in the UK, and similar aspirations in Sweden, our search of the literature identified few studies reporting care leavers' with learning disabilities own words. Our data add to the voices of a group frequently silent or silenced. We found evidence of resilience and hope as well as difficulties and frustrations. The accounts in the literature and our interviews provide data on what it can be like to try to operate “the system.” The people we spoke with and those whose accounts we found in the literature were thoughtful and engaging. They provide an important source of knowledge for policy and practice. [ABSTRACT FROM AUTHOR]

Abstract: The role that area deprivation, family poverty, and austerity policies play in the demand for and supply of children's services has been a contested issue in England in recent years. These relationships have begun to be explored through the concept of inequalities in child welfare, in parallel to the established fields of inequalities in education and health. This article focuses on the relationship between economic inequality and out‐of‐home care and child protection interventions. The work scales up a pilot study in the West Midlands to an all‐England sample, representative of English regions and different levels of deprivation at a local authority (LA) level. The analysis evidences a strong relationship between deprivation and intervention rates and large inequalities between ethnic categories. There is further evidence of the inverse intervention law (Bywaters et al., 2015): For any given level of neighbourhood deprivation, higher rates of child welfare interventions are found in LAs that are less deprived overall. These patterns are taking place in the context of cuts in spending on English children's services between 2010–2011 and 2014–2015 that have been greatest in more deprived LAs. Implications for policy and practice to reduce such inequalities are suggested. [ABSTRACT FROM AUTHOR]

Despite considerable quantifiable data about the circumstances of care leavers in the United Kingdom, there is less qualitative data about how these circumstances are experienced. This article is underpinned by positioning theory, with a particular focus on the unfolding personal narratives of young care leavers in relation to their mental health and wellbeing and the role of a life-skills programme in supporting them in this respect. The research illustrates that leaving care projects, such as the one in the current study, are more focused on employment and housing issues than on addressing the mental health and wellbeing needs of young people. Our analysis of interviews with young people illustrates the ambiguity of understandings of concepts such as 'mental health' and 'wellbeing,' and the complexity of responses to questioning around this area. This illustrates one of the major problems in evaluating the outputs and outcomes of such projects in terms of simplistic targets, where mental health and wellbeing are not clearly defined or understood by young people themselves. The current research provides a more complex picture. More research is needed that involves in-depth and longitudinal assessment of specific mental health needs of care leavers and how they can be addressed successfully. [ABSTRACT FROM AUTHOR]

Objectives There is consensus that empowerment is key to recovery from mental health problems, enabling a person to take charge of their life and make informed choices and decisions about their life. However, little is known about the mechanisms through which empowerment affects mental health in young people. The current study involved young people aged 16-29 years and examined empowerment as a potential mediator of the relationship between psychological factors (psychosocial, cognition, coping, and control) and mental health, well-being, and recovery from personal problems. Methods A cross-sectional, Internet-based questionnaire study recruited 423 young people aged between 16 and 29 attending universities in England ( n = 336) and Ireland ( n = 87). Psychological factors, mental well-being, empowerment, and recovery from personal problems were measured using self-report measures. Results Mediation analysis in both the single and one over-arching mediator models revealed that empowerment mediates the relationship between psychological factors (psychosocial, self-efficacy, thinking style, coping, and control) and mental health, well-being, and recovery from general life problems. Conclusions This study demonstrates the importance of empowerment, showing that it mediates the relationship between psychological processes and mental health, well-being, and recovery in young people. Clinical implications for working with young people within mental health services, and facilitating their empowerment are discussed. Practitioner points Empowerment is currently a poorly defined concept. This study demonstrates how empowerment mediates the relationship between psychological processes and mental health, well-being, and recovery in young people., Clinicians working with young people might benefit from a structured means of understanding and assessing the different ways in which individuals manage their thinking styles., Empowerment in young people is influenced by the manner in which clinicians facilitate them in establishing social networks in support of employment, education, family/social relations and to encourage young people to take an assertive role in their own care. [ABSTRACT FROM AUTHOR]

Aim To provide an understanding of the factors that discouraged staff members from using a new web-based platform ( CAMHSweb) with young people in a child and adolescent mental health service ( CAMHS). Although evidence-based service improvement technology like CAMHSweb is becoming more common in child mental health, the staff-level barriers to the use of web-based platforms have not been explored in depth in the literature. Method Semi-structured interviews with six employees were carried out in a London-based child mental health service that a preliminary audit had identified as having a poor utilisation of the platform. All participants had previously been invited to use the platform as part of their clinical work. Results were analysed using thematic analysis (Braun and Clarke, 2006). Findings Three overarching themes covered staff's practical, personal and philosophical barriers to implementation. Interviewees believed that CAMHSweb was too challenging to implement, that it was not an asset to therapists, and that it interfered with the therapeutic process. Discussion and Implications These findings provide a nuanced understanding of the multiple factors that may discourage clinicians from using web-based platforms. This may have implications for researchers or practitioners who aim to design or implement technology in child mental health services. [ABSTRACT FROM AUTHOR]

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Background Oesophageal abnormalities are common findings in a speech-language therapy videofluoroscopy clinic. Fluoroscopic screening involving oropharynx alone fails to identify these patients. Oesophageal screening as an adjunct to videofluoroscopy is gaining popularity. Yet currently, little is known about the reliability of speech and language therapists' judgement of the oesophageal phase. Aim To measure the inter-rater reliability of oesophageal abnormality judgement in speech and language therapists during upright videofluoroscopy. Methods & Procedures Seventy-four speech and language therapists were trained in oesophageal physiology and oesophageal visualization. Participants were asked to provide a rating of bolus transit (> or <15 s) for 10 segments of videofluoroscopy with oesophageal visualization showing ingestion of one 20 ml fluid barium bolus. Participants then provided a binary judgement of (1) the presence of stasis, (2) the presence of redirection and (3) the need for referral for further investigation. If stasis were present, they then rated the level of stasis as cervical, aortic or thoracic. Outcomes & Results Participants achieved substantial agreement for bolus transit time, presence of stasis, presence of redirection and need for referral ( K = 1.0.63.63 and .61 respectively). The level of stasis achieved only fair agreement ( K = .22) with disagreement primarily between aortic, thoracic or aortic/thoracic across clinicians. Conclusions & Implications Speech and language therapists demonstrated substantial agreement in judging oesophageal abnormality during videofluoroscopy. Oesophageal screening as an adjunct to videofluoroscopy can be used reliably in trained clinicians. [ABSTRACT FROM AUTHOR]

Supervision is fundamental to the social work profession. However, increasing concern has been expressed over the managerial capture of local authority social work and the use of supervision as a way of enabling management oversight (or surveillance) of practice. Despite the importance of supervision, we have little evidence about what happens when managers and child and family social workers meet to discuss casework and less about how supervision influences practice. In this study, 34 supervision case discussions were recorded. Detailed descriptions are given of what happens in supervision. Overall, case discussions operated primarily as a mechanism for management oversight and provided limited opportunity for reflection, emotional support or critical thinking. With reference to organizational context, it is suggested that these deficits result from a system that focuses too much on 'what and when' things happen and not enough on 'how and why'. [ABSTRACT FROM AUTHOR]

Background: Circles of support and accountability, or Circles, use community volunteers to help reintegrate sex offenders at risk of reoffending in the community.Aims: The aims of this study are to describe the first 275 male sex offenders ('core members') in England and Wales supported by a Circle and to compare those attending the five largest Circles.Methods: As part of their monitoring activity, 10 Circles extracted data from case files, anonymised it and submitted it to Circles UK, the national oversight body.Results: Circles have expanded rapidly with 165 (60%) of Circles commencing in the three years 2011-2013 compared with 110 in the nine years 2002-2010. Most core members were referred from the Probation Service (82%). Circles were provided to men with a range of predicted risks of reoffending - from low (26%) to very high (12%). There were some positive changes between the beginning and end of Circles, such as fewer men being unemployed and more living in their own chosen accommodation.Conclusions/implications For Practice: Circles have been used to support the reintegration of a wide range of sex offenders. Given their rapid growth and flexibility, consistent recording standards are required across. These standards should be reviewed periodically to ensure all important fields of change are captured, including frequency of attendance, length per session and quality of engagement in the work. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Overactive bladder (OAB) has been found to have a number of psychological consequences, including anxiety, depression and shame. However, there is little research on how drug treatment, which has been found to be effective at reducing physical symptoms, impacts on these psychological effects. This study aimed to examine patients' experiences of anticholinergic treatment for OAB, and the impact of both OAB and its treatment on psychological well‐being. A cross‐sectional, qualitative interview design with a secondary care outpatient sample was used. The approach was idiographic and sought to understand the detailed complexities and nuances of patient experiences. This small‐scale qualitative study found that, even where there had been symptom reduction, patients did not feel ‘better’, and found it difficult to let go of worries and fears around OAB. These findings suggest that a person with OAB may need support even after a ‘successful’ treatment, as OAB continues to be at the centre of patients' lives. [ABSTRACT FROM AUTHOR]

Caring is a positive social act, but can it result in negative attitudes towards those cared for, and towards others from their wider social group? Based on intergroup contact theory, we tested whether care workers' (CWs) positive and negative contact with old-age care home residents (CHRs) predicts prejudiced attitudes towards that group, and whether this generalises to other older people. Fifty-six CWs were surveyed about their positive and negative contact with CHRs and their blatant and subtle attitudes (humanness attributions) towards CHRs and older adults. We tested indirect paths from contact with CHRs to attitudes towards older adults via attitudes towards CHRs. Results showed that neither positive nor negative contact generalised blatant ageism. However, the effect of negative, but not positive, contact on the denial of humanness to CHRs generalised to subtle ageism towards older adults. This evidence has practical implications for management of CWs' work experiences and theoretical implications, suggesting that negative contact with a subgroup generalises the attribution of humanness to superordinate groups. Because it is difficult to identify and challenge subtle prejudices such as dehumanisation, it may be especially important to reduce negative contact. © 2016 The Authors. Journal of Community & Applied Social Psychology Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Accessible summary This study looks at the experience of women with learning disabilities who go for breast screening (X-ray of the breast), Women with learning disabilities reported that there were many things that encouraged and discouraged them from going for breast screening., Carers were very important in supporting women with learning disabilities through breast screening, Abstract Background: Despite breast screening in Britain being free to all women within the allotted age range, uptake of this service is often poor in women with intellectual disabilities. Reasons put forward are numerous, including poor knowledge, pain and difficulty travelling to the centre. However, what influences the decision to attend is rarely discussed. Methods: Twelve semi-structured interviews and three focused observation were undertaken with women with intellectual disabilities to explore what influenced them to participate in breast screening and their experience of having mammography. Data were analysed thematically using a blended framework. Results: Despite the experience of mammography being negative, high uptake of breast screening services was reported in this study. Pain and previous poor treatment in hospital were reasons for nonparticipation in breast screening. Although awareness about breast screening varied, those who had previous breast problems were more knowledgeable; however, there was poor awareness of the risks of hereditary breast cancer. Overall, paid-carers were found to play a key role, as means of support, information and a potential influence in determining participation in breast screening. Conclusions: There was general equality of access but an inequality in the preparation and delivery of the service which was dependent on a complex range of issues and relationships. Key to participation was preparation with the paid-carer facilitating discussions about breast screening were key to participating in mammography. This has implications on the future direction of funding and policy making. Risks associated with hereditary breast cancer and earlier presentation of breast tumours also needs highlighting. [ABSTRACT FROM AUTHOR]

Objective: Inequalities exist in colorectal cancer (CRC) screening uptake, with people from lower socioeconomic status backgrounds less likely to participate. Identifying the facilitators and barriers to screening uptake is important to addressing screening disparities. We pooled data from 2 trials to examine educational differences in psychological constructs related to guaiac fecal occult blood testing.Methods: Patients (n = 8576) registered at 7 general practices in England, within 15 years of the eligible age range for screening (45-59.5 years), were invited to complete a questionnaire. Measures included perceived barriers (emotional and practical) and benefits of screening, screening intentions, and participant characteristics including education.Results: After data pooling, 2181 responses were included. People with high school education or no formal education reported higher emotional and practical barriers and were less likely to definitely intend to participate in screening, compared with university graduates in analyses controlling for study arm and participant characteristics. The belief that one would worry more about CRC after screening and concerns about tempting fate were strongly negatively associated with education. In a model including education and participant characteristics, respondents with low emotional barriers, low practical barriers, and high perceived benefits were more likely to definitely intend to take part in screening.Conclusions: In this analysis of adults approaching the CRC screening age, there was a consistent effect of education on perceived barriers toward guaiac fecal occult blood testing, which could affect screening decision making. Interventions should target specific barriers to reduce educational disparities in screening uptake and avoid exacerbating inequalities in CRC mortality. [ABSTRACT FROM AUTHOR]

Multiple drug intolerance to antihypertensive medications (MDI-HTN) is an overlooked cause of nonadherence. In this study, 55 patients with MDI-HTN were managed with a novel treatment algorithm utilizing sequentially initiated monotherapies or combinations of maximally tolerated doses of fractional tablet doses, liquid formulations, transdermal preparations, and off-label tablet medications. A total of 10% of referred patients had MDI-HTN, resulting in insufficient pharmacotherapy and baseline office blood pressure (OBP) of 178±24/94±15 mm Hg. At baseline, patients were intolerant to 7.6±3.6 antihypertensives; they were receiving 1.4±1.1 medications. After 6 months on the novel MDI-HTN treatment algorithm, both OBP and home blood pressure (HBP) were significantly reduced, with patients receiving 2.0±1.2 medications. At 12 months, OBP was reduced from baseline by 17±5/9±3 mm Hg (P<.01, P<.05) and HBP was reduced by 11±5/12±3 mm Hg (P<.01 for both) while patients were receiving 1.9±1.1 medications. Application of a stratified medicine approach allowed patients to tolerate increased numbers of medications and achieved significant long-term lowering of blood pressure. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify the factors determining carer burden in a group of carers supporting people with dementia (PwD) deemed to be at high risk of moving to long-term residential or nursing home care.Design: National data collected as part of the European RightTimePlaceCare project were analysed. This included 81 dyads of community-dwelling people with dementia and their informal carers.Methods: Structured face-to-face interviews were conducted in North West England between June 2011 and April 2012. Interviews collected data relating to the person with dementia (cognitive functioning, activities of daily living, neuropsychiatric symptoms and formal and informal dementia care resource use) and carers' level of burden (22-item Zarit Burden Index), hours spent caring and availability of additional informal support.Results: Logistic regression analysis identified five factors associated with high carer burden: neuropsychiatric symptomatology in the PwD, intensive supervision of the PwD by the carer, being a female carer, being an adult-child carer and absence of informal carer support. Use of home care or day care services was unrelated to burden.Conclusion: Support programmes focusing on challenging behaviours and risk management may be of benefit to carers. More individually tailored interventions for specific carer groups including female or younger carers may be warranted. The implementation of peer support networks could be beneficial to carers who lack additional family support. [ABSTRACT FROM AUTHOR]