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Purpose -- This paper aims to outline the extent and cost of work-related mental ill health and the challenges it causes in the workplace. It focuses on what employers can do to facilitate an early return to work for those absent from work. It argues for a proactive approach to the management of mental ill health in the workplace and highlights the important role of the line manager. Good practice from Europe is reported. Design/methodology/approach -- This paper reviews evidence from the HSE, EU_OSHA and IOSH. Findings -- Rather than only dealing reactively with cases of mental ill health in the workplace, it is more effective for an employer to adopt a proactive approach, recognising that employees are a valuable asset, assessing psychosocial risks and promoting health and wellbeing. This involves not only protecting their employees from work-related health and safety risks, but also helping employees with minor conditions to stay at work, for example, by negotiating flexible hours. Employees also need opportunities to look after their own health and wellbeing at work. Finally, it is important to create a culture where working with a mental health condition is accepted by other employees as normal. Originality/value -- The paper highlights the importance of a proactive management approach to managing mental ill health. [ABSTRACT FROM AUTHOR]

Purpose – The aims of this paper are to determine the state of visiting for women in the English prison system and to explore the relationship between women's mental health and visits in prison. Design/methodology/approach – For the purpose of this paper the authors conducted a review of the literature. All literature published from 1983 onwards was included to coincide with the introduction of Pat Carlen's (1983) campaigning group Women in Prison (WIP). The review focused on all literature from England and Wales to reflect the National Criminal Justice System and used an inclusion criteria to achieve this. Findings – The review revealed key themes including visit rejection, the importance of visits for maintaining identity and the contradicting emotions that women in prison experience when visited. Originality/value – Social relationships and family ties are protective factors for prisoners' mental wellbeing, yet the number and frequency of visits to offenders in custody has declined. The potential role for prison visiting schemes to improve the mental wellbeing of women in custody is explored, including the implications for the education and training of staff and visitors involved in the visiting process. [ABSTRACT FROM AUTHOR]

Purpose |!|#8211; The purpose of this paper is to consider the statistical evidence on the effects that ill health has on labour market participation and opportunities for younger and older workers in the East Midlands (UK). Design/methodology/approach |!|#8211; A statistical analysis of Labour Force Survey data was undertaken to demonstrate that health issues affect older and younger workers alike. This has an equalling effect on labour market opportunities, which should reduce any potential for intergenerational conflict within the workforce. Findings |!|#8211; Although health problems that limit activities and affect the amount and kind of work an individual can undertake increase with age, there are high levels of ill health of these kinds within all age groups, including the youngest workers. Research limitations/implications |!|#8211; The regional statistical analysis can only provide indications, and further research is required to differentiate which groups of younger and older workers suffer from which types of illnesses, as this has direct implications for their employment. Practical implications |!|#8211; A more direct consideration of health in employment, education and training policy is required to enable the development of healthy and long-term working lives that benefit individuals and the economy. Social implications |!|#8211; The consideration of the effects of health issues on the labour market should lead to a reconsideration of the rhetoric, and the reality of intergenerational conflict. There might be less reason for such competition than is generally perceived. Originality/value |!|#8211; The paper considers intergenerational conflict in a labour market context and suggests that health issues have an equalising effect for the relative positions of older and younger workers. [ABSTRACT FROM AUTHOR]

Purpose – Travellers are consistently found to have poorer health outcomes and health status than other minority ethnic groups. Very few studies have examined alcohol use among Travellers, but some indicate that their drinking patterns are changing. This study aims to explore alcohol use, health needs and health service access within an Irish Traveller population in England with a view to identifying themes for further study. Design/methodology/approach – A qualitative exploratory pilot study was carried out using an oral life history approach. Ten individuals were interviewed along with two professionals working closely with the Traveller group. Findings – While improvements in general health and access to healthcare were widely reported, many Travellers were concerned about the effects of leaving behind their nomadic lifestyle to living more "settled" lives. This change was felt to bring young male Travellers, in particular, into contact with the risky drinking behaviours of non-Travellers and away from the monitoring and informal controls traditionally accompanying their former nomadic lifestyle. Research limitations/implications – These findings may not generalise to other Traveller groups; they draw on a small sample of Travellers living in "settled" accommodation. The sample was limited to discussions with older Travellers and further research is needed among younger generations to explore how health related behaviours and alcohol use may be changing. Originality/value – This study highlights potential pathways for young male Travellers to become "youth at risk" importantly through involvement in alcohol and drug use. It should be of value to health policy makers and health/support workers in contact with Traveller communities. [ABSTRACT FROM AUTHOR]

Purpose – The authors examined the cardiac care pathway with the aim of identifying factors that impact on diagnosis and treatment of coronary heart disease in British Pakistani women. Design/methodology/approach – This is an exploratory qualitative study. In depth interviews and focus groups with an opportunistic sample of Pakistani women and a purposive sample of clinicians working at different points along the care pathway were conducted. The authors used a pathways to care approach to illustrate how their individual and cumulative effect may contribute to differential receipt of treatment, including revascularisation, and health inequalities. Findings – Four major issues were identified: complex life circumstances; "atypical" presentation and symptomatology; problems related to investigative testing; and poor communication. Mapping these barriers onto the Pathways to Care Model provided valuable insight into their impact on patients' progression through the different stages of the care pathway. Research limitations/implications – Adopting a care pathway approach demonstrated how individual factors have an impact at several points along the care pathway. It indicated where further, more detailed enquiry is merited and where intervention studies might usefully be directed to improve care. Practical implications – Examining the whole care pathway identified areas of service improvement that merit a co-ordinated response. Originality/value – The framework provided by the Pathways to Care Model offered insight into the causes of the previously observed attenuation in women's progress along the cardiac diagnosis and treatment pathway and is an important first step to addressing this health inequality in a holistic way. [ABSTRACT FROM AUTHOR]

Purpose – This paper seeks to discuss the attitudes and beliefs of the Pakistani/Kashmiri community in Birmingham towards the cultural practice of consanguineous (cousin) marriage and health, and how an understanding of Pakistani/Kashmiri community views may help institute good practice for health care professionals. Design/methodology/approach – A qualitative research study using eight gender- and age-specific focus group discussions and eight in-depth one-to-one interviews with participants who were in consanguineous relationships. All participants were from the Pakistani/Kashmiri community and residents of Springfield ward in Birmingham. Findings – The findings illustrate Pakistani/Kashmiri attitudes towards consanguinity and health. There was awareness of still births and genetic conditions but a poor understanding of genetics; respondents were reluctant to accept the link between cousin marriages and birth issues and explanations for still births and impairments were largely attributed to the "will of God". Female respondents were in favour of screening for genetic conditions but would not terminate pregnancies as this was contrary to Islamic ideas about pre-destiny and all respondents wanted more medical and Islamic scholarly information on cousin marriage and how it is linked to disabilities. Clearly there is a need to improve healthcare outcomes and reduce infant mortality in the Pakistani/Kashmiri community. Research limitations/implications – Research findings correspond with previous studies that have explored ethnic minority knowledge and attitudes to health and healthcare services and the need for culturally competent services. Originality/value – This paper presents some suggestions on effecting behaviour change in this important area. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to provide a conceptual framework for understanding how, even in the absence of identifiable racist behaviours by white people and predominantly white institutions, African Caribbean people can suffer detriment to their mental health due to toxicity in interactions. Design/methodology/approach – This paper was developed through a desktop review of literature that analyses the factors that cause the sustained variation in experience and outcome in mental health for people from African Caribbean backgrounds. Findings – Prior experiences of personalised racism (interpersonal and institutional) and an awareness of non-personalised racism in society creates conditions which mean that African Caribbean people experience toxicity in their dealings with white people and white institutions, including mental health services. This is detrimental to service user outcomes. Originality/value – The paper provides a language for the process that leads to negative outcomes for African Caribbean people in mental health services resulting from interactions with white people or white institutions even in the absence of racism or racist events directed at them. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe the first 15 months of operation of an innovative specialist national public health observatory for intellectual disability. Design/methodology/approach – The paper provides a narrative account of aims and achievements of the service. Findings – In the first 15 months of operation the observatory has: made available to those involved in commissioning health and social care services, a wealth of information on the health needs of people with intellectual disabilities; identified specific improvements that could viably be made to increase the quality of future information; and begun working with local agencies to support them in making the best use of the available information. Originality/value – People with intellectual disabilities experience significant health inequalities. This paper describes an innovative approach to helping local agencies make the best use of available information in order to commission services that may reduce these inequalities. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore the impact of domestic abuse on the health and lives of older women.Design/methodology/approach - A qualitative research design was used and data were collected using in-depth interviews with 16 older women who had experienced domestic abuse. The interviews varied between one and two hours in length and, with the participant's permission, all of the interviews were audio recorded and transcribed verbatim. Analysis was undertaken utilising an iterative approach. In the present study all data were manually indexed and coded.Findings - The findings of this study illustrate that the consequences of domestic abuse for older women are far reaching, impacting significantly on the long-term health and emotional wellbeing of those affected. This paper also highlights that there is currently little available data regarding older women and domestic abuse within the particular context of health. This is increasingly being recognised as a significant deficit in awareness and understanding within society as a whole and, more particularly, for those responsible for support and care provision. Existing policy in this field and the implications for service development are also considered.Research limitations/implications - This is a small scale study and therefore there are limitations in terms of generalisability.Originality/value - This paper discusses the specific issues that arise for older women who have experienced domestic abuse within the particular context of health. [ABSTRACT FROM AUTHOR]

Purpose - Although the effort-reward imbalance (ERI) model of job stress has gained support in predicting employee health, it has rarely been examined in the context of the work-home interface. This study aims to test an expanded ERI model in predicting work-life conflict (WLC) in university employees. Three hypotheses relating to the EM are tested. It is also predicted that lower organisational support for work-life balance, less schedule flexibility and lower levels of separation between work and home life will lead to increased work-life conflict. Design/methodology/approach - In this cross-sectional study, 1,108 employees working in UK universities completed questionnaires assessing EM, WLC, schedule flexibility, employer support and work-life separation/integration. Findings - Strong main effects of job-related efforts, rewards and over-commitment on WLC are found. A significant two-way interaction (effort x reward) and some evidence for a three-way interaction effort x reward x over-commitment) are observed. Perceived schedule flexibility and work-life integration also make significant contributions to the variance in WLC. The final model explains 66 per cent of criterion variance. Research limitations/implications - As the study is cross-sectional, causal relationships cannot be established. Practical implications - This study extends knowledge of the EM model as a predictor of WLC. More research is required into ways in which effort-reward inequity and over-commitment might threaten work-life balance, together with the working practices and organisational factors which might modify this threat. Originality/value - The EM model has rarely been examined in the context of the work-home interface. The importance of effort-reward imbalance and over-commitment to WLC has been highlighted. [ABSTRACT FROM AUTHOR]

Purpose — To consolidate and review current literature that relates children's health to their housing and living environments. Design/methodology/approach — A range of published sources which review the relationship between children, housing and health. The sources consolidate research that applies specifically to children and their domestic situation. The paper also reviews literature around municipal tower block estates and the unique health/architecture relationship before turning to children living in temporary bed and breakfast accommodation. An overview of current public health policy that seeks to reintegrate housing and well-being is undertaken. Findings — Decent housing lies at the heart of health for all. Generally, the picture is more positive, but action remains slow. Children's needs must be given a higher priority in housing in future to promote physical and emotional well-being. Research limitations/implications — It is not an exhaustive list and the sources are mainly UK publications. Practical implications — The UK approach to children, housing and health may be of interest to a number of overseas countries in Eastern Europe, Africa and Asia. Originality/value — This paper fulfils an identified information/resources need and offers readers such as students, academics and practitioners an overview of the UK approach. [ABSTRACT FROM AUTHOR]

This study looks at the ability of retail food outlets to provide suitable meals for those with special dietary needs. Thus, some food allergies are described briefly and the personnel involved in food preparation and service are examined. Groups of owners of catering outlets were interviewed to discover from them their knowledge of food allergies and how readily they could feed such sufferers. The results of the surveys are reported. All establishments serving food in a small town and its surrounding area were considered, and many were then included in the sample. In addition, some restaurants and hotels in a seaside holiday resort were questioned. The results showed that the knowledge of allergies was varied, as was the ability to provide suitable meals. The food outlets in the holiday resort had staff so well-trained that special needs would be reported to management. The proprietors recognised a need for greater education, but many did not perceive it to be a training issue, and suggested other potential providers. [ABSTRACT FROM AUTHOR]