Mental health literacy of negative body image: symptom recognition and beliefs about body image in a British community sample

The present study examined mental health literacy of negative body image in a sample of 485 British adults. Participants were presented with vignettes of a fictional woman (‘Kate’) and man (‘Jack’) suffering from negative body image and were asked questions addressing symptom recognition, distress, sympathy and sources of help-seeking. Participants also completed measures of body appreciation and psychiatric skepticism. Results showed that less than a fifth of participants correctly identified the vignettes as depicting cases of negative body image. The vignette describing Kate was rated as significantly more distressing, deserving of sympathy and requiring help than that of Jack. Women rated the conditions described by both vignettes as significantly more distressing and requiring help than did men. Psychiatric skepticism and body appreciation were significantly associated with beliefs about the vignettes. Implications of the results for the promotion of mental health literacy in relation to body image are discussed

Enhancing the experience of carers in the chemotherapy outpatient setting: an exploratory randomised controlled trial to test impact, acceptability and feasibility of a complex intervention co-designed by carers and staff

PurposeSupporting someone through chemotherapy can be emotionally and physically demanding. However, research has yet to establish the type of support carers require or the best way to provide this. This study tested the feasibility and acceptability of a complex intervention for carers that was co-designed by staff and carers of patients starting chemotherapy.MethodsForty-seven carers were recruited, randomised between the intervention (n?=?24) and control (n?=?23) groups. A questionnaire was completed pre- and post-intervention measuring knowledge of chemotherapy and its side effects, experience of care, satisfaction with outpatient services, coping and emotional wellbeing. The intervention process was evaluated by carers and healthcare professionals (HCPs) in focus groups.ResultsRecruitment to the study was unproblematic and attrition from it was low, suggesting the intervention and study processes were acceptable to patients and carers. Carers in receipt of the ‘Take Care’ intervention reported statistically significantly better understanding of symptoms and side effects and their information needs being more frequently met than carers in the control. Confidence in coping improved between baseline and follow-up for the intervention group and declined for the control although differences were insufficient to achieve statistical significance. There was no significant difference between the two groups’ emotional wellbeing. HCP and carer focus groups confirmed the feasibility and acceptability of the intervention.ConclusionsThe ‘Take Care’ intervention proved acceptable to carers and HCPs and demonstrates considerable promise and utility in practice. Study findings support the conduct of a fully powered RCT to determine the intervention’s effectiveness and cost-effectiveness

Quality of relationships as predictors of outcomes in people with dementia: a systematic review protocol

INTRODUCTION: Serious adverse outcomes for people with dementia include institutionalisation, hospitalisation, death, development of behavioural and psychiatric symptoms, and reduced quality of life. The quality of the relationship between the person with dementia and their informal/family carer is thought to affect the risk of these outcomes. However, little is known about which aspects of relationship quality are important, or how they affect outcomes for people with dementia. METHODS AND ANALYSIS: This will be a systematic review of the literature. Electronic databases MEDLINE, EMBASE, Web of Science, PsycInfo, the Cochrane Database, ALOIS and OpenGrey will be searched from inception. 2 independent reviewers will screen results for eligibility with standardised criteria. Data will be extracted for relevant studies, and information on the associations between relationship quality and dementia outcomes will be synthesised. Meta-analysis will be performed if possible to calculate pooled effect sizes. Narrative synthesis will be performed if study heterogeneity rules out meta-analysis. ETHICS AND DISSEMINATION: Ethical review is not necessary as this review summarises data from previous studies. Results will be disseminated via peer-reviewed publication. Results will also be disseminated to a patient and public involvement group and an expert panel for their views on the findings and implications for future work. TRIAL REGISTRATION NUMBER: CRD42015020518

Ethical issues in implementation research: a discussion of the problems in achieving informed consent

Background: Improved quality of care is a policy objective of health care systems around the world. Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice, and hence to reduce inappropriate care. It includes the study of influences on healthcare professionals' behaviour and methods to enable them to use research findings more effectively. Cluster randomized trials represent the optimal design for evaluating the effectiveness of implementation strategies. Various codes of medical ethics, such as the Nuremberg Code and the Declaration of Helsinki inform medical research, but their relevance to cluster randomised trials in implementation research is unclear. This paper discusses the applicability of various ethical codes to obtaining consent in cluster trials in implementation research. Discussion: The appropriate application of biomedical codes to implementation research is not obvious. Discussion of the nature and practice of informed consent in implementation research cluster trials must consider the levels at which consent can be sought, and for what purpose it can be sought. The level at which an intervention is delivered can render the idea of patient level consent meaningless. Careful consideration of the ownership of information, and rights of access to and exploitation of data is required. For health care professionals and organizations, there is a balance between clinical freedom and responsibility to participate in research. Summary: While ethical justification for clinical trials relies heavily on individual consent, for implementation research aspects of distributive justice, economics, and political philosophy underlie the debate. Societies may need to trade off decisions on the choice between individualized consent and valid implementation research. We suggest that social sciences codes could usefully inform the consideration of implementation research by members of Research Ethics Committees

Improving the Welfare of Laboratory-Housed Primates Through the Use of Positive Reinforcement Training: Practicalities of Implementation

Whilst there has been a recent increase in interest in using positive reinforcement training for laboratory-housed primates, there remains a reluctance to put into practice training programmes. Much of this reticence seems to stem from lack of expertise in the running of training programmes, and a perception that training requires a large time investment, with concurrent staff costs. The aim of this thesis was to provide practical recommendations for the use of training programmes in laboratories, providing primate users and carestaff with background information needed to successfully implement training programmes whilst improving the welfare of the animals in their care. Training was carried out with two species, cynomolgus macaques (Macaca fascicularis) and common marmosets (Callithrix jacchus) in three different research laboratories to ensure practicability was as wide ranging as possible. Training success and the time investment required were closely related to the primate's temperament, most notably an individual's willingness to interact with humans, in both common marmosets and cynomolgus macaques. Age and sex however had no effect on an individual's trainability. The training of common marmosets was more successful than that with cynomolgus macaques, possibly due to differences in early experience and socialisation. Positive reinforcement training helped both species to cope with the stress of cage change or cleaning, with the monkeys showing less anxiety-related behaviour following the training programme than before. Involving two trainers in the training process did not affect the speed at which common marmosets learned to cooperate with transport box training, but behavioural observations showed that initial training sessions with a new trainer led to animals experiencing some anxiety. This however was relatively transient. Whilst the training of common marmosets to cooperate with hand capture was possible, there seemed little benefit in doing so as the monkeys did not show a reduced behavioural or physiological stress response to trained capture as compared to hand capture prior to training. However strong evidence was found that following both training and positive human interactions the marmosets coped better with capture and stress was reduced. It is recommended that an increased use of early socialisation would benefit laboratory-housed primates, and would also help improve the success of training. Further, the time investment required shows that training is practicable in the laboratory for both species, and that positive reinforcement training is an important way of improving their welfare likely through reducing boredom and fear

Home and neighbourhood correlates of BMI among children living in socioeconomically disadvantaged neighbourhoods

A detailed understanding of the underlying drivers of obesity-risk behaviours is needed to inform prevention initiatives, particularly for individuals of low socioeconomic position who are at increased risk of unhealthy weight gain. However, few studies have concurrently considered factors in the home and local neighbourhood environments, and little research has examined determinants among children from low socioeconomic backgrounds. The present study examined home, social and neighbourhood correlates of BMI (kg/m2) in children living in disadvantaged neighbourhoods. Cross-sectional data were collected from 491 women with children aged 5–12 years living in forty urban and forty rural socioeconomically disadvantaged areas (suburbs) of Victoria, Australia in 2007 and 2008. Mothers completed questionnaires about the home environment (maternal efficacy, perceived importance/beliefs, rewards, rules and access to equipment), social norms and perceived neighbourhood environment in relation to physical activity, healthy eating and sedentary behaviour. Children\u27s height and weight were measured at school or home. Linear regression analyses controlled for child sex and age. In multivariable analyses, children whose mothers had higher efficacy for them doing physical activity tended to have lower BMI z scores (B = − 0·04, 95 % CI − 0·06, − 0·02), and children who had a television (TV) in their bedroom (B = 0·24, 95 % CI 0·04, 0·44) and whose mothers made greater use of food as a reward for good behaviour (B = 0·05, 95 % CI 0·01, 0·09) tended to have higher BMI z scores. Increasing efficacy among mothers to promote physical activity, limiting use of food as a reward and not placing TV in children\u27s bedrooms may be important targets for future obesity prevention initiatives in disadvantaged communities