84 research outputs found

    Five Ways to Wellbeing: holistic narratives of public health programme participants

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    This paper reports on a study which formed part of a qualitative process evaluation of a wellbeing programme in North West England. The study used the biographic narrative interpretive method (BNIM) to undertake and analyse data from interviews with six participants from diverse projects within the programme. This generated rich case studies and spotlighted cross-case commonalities, building understanding of how the programme achieved its effects. We present findings using the Five Ways to Wellbeing framework, presenting one abridged ‘case’ and summarising cross-cutting themes. We explore how BNIM gives insight into the psychosocial complexity of wellbeing, building understanding of its holistic and dynamic nature, and then highlight the flexibility, resonance and widespread appeal of Five Ways to Wellbeing. In concluding, we argue that by enabling participants to tell their own stories of participation in the different projects, we gain a more authentic understanding of the ‘whole’ story of how involvement has affected wellbeing. Such approaches are crucial as wellbeing becomes a central concept in global health policy and promotion

    Wellbeing: The Challenge of ‘Operationalising’ an Holistic Concept within a Reductionist Public Health Programme

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    Background Wellbeing is a concept that, whilst contested, recognises individual and wider social, economic, political and environmental contextual influences – and is of growing interest and relevance locally and globally. In this paper, we report on one aspect of an evaluative research study conducted on a public health programme in North West England. Aims Within the context of a process evaluation that explored the delivery of a public health programme and sought to increase understanding of how and why different approaches worked well or not so well, this paper focuses specifically on the concept of wellbeing, examining perceptions of multiple stakeholders. Methods Interviews and focus groups were undertaken with 52 stakeholders involved in managing and facilitating the programme and its composite projects and with 90 community members involved as project participants. Data were subjected to thematic analysis, cross‐check and refining. Findings Findings highlight stakeholders’ diverse understandings of wellbeing, the complex relationship between health and wellbeing, and the perceived dissonance between the holistic concept of wellbeing and the reductionist design of the programme. Conclusions Wellbeing was understood to be ‘more than health’ and ‘more than happiness’, concerned with effective functioning, sense of purpose and flourishing. Essentially holistic, wellbeing offers opportunities to transcend clinical/pathogenic conceptions of ‘health’ and resonate with individuals, communities and local authorities. This raises concerns about how wellbeing can be meaningfully realised without compromising the concept, particularly when programmes are structured in reductionist ways requiring monitoring against discrete outcomes. Implications for practice include: utilising wellbeing as a driver for cross‐cutting public health in challenging economic and organisational contexts; acknowledging that wellbeing is essentially social as well as individual; appreciating that wellbeing is experienced in relation to contexts and surroundings; and recognising that wellbeing defined in terms of individual happiness risks compromising the future wellbeing of societies and the planet

    Relationships between adverse childhood experiences and adult mental well-being: results from an English national household survey.

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    BACKGROUND: Individuals' childhood experiences can strongly influence their future health and well-being. Adverse childhood experiences (ACEs) such as abuse and dysfunctional home environments show strong cumulative relationships with physical and mental illness yet less is known about their effects on mental well-being in the general population. METHODS: A nationally representative household survey of English adults (n = 3,885) measuring current mental well-being (Short Edinburgh-Warwick Mental Well-being Scale SWEMWBS) and life satisfaction and retrospective exposure to nine ACEs. RESULTS: Almost half of participants (46.4 %) had suffered at least one ACE and 8.3 % had suffered four or more. Adjusted odds ratios (AORs) for low life satisfaction and low mental well-being increased with the number of ACEs. AORs for low ratings of all individual SWEMWBS components also increased with ACE count, particularly never or rarely feeling close to others. Of individual ACEs, growing up in a household affected by mental illness and suffering sexual abuse had the most relationships with markers of mental well-being. CONCLUSIONS: Childhood adversity has a strong cumulative relationship with adult mental well-being. Comprehensive mental health strategies should incorporate interventions to prevent ACEs and moderate their impacts from the very earliest stages of life

    Happy to help? A systematic review and meta-analysis of the effects of performing acts of kindness on the well-being of the actor

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    © 2018 The Authors. Do acts of kindness improve the well-being of the actor? Recent advances in the behavioural sciences have provided a number of explanations of human social, cooperative and altruistic behaviour. These theories predict that people will be ‘happy to help’ family, friends, community members, spouses, and even strangers under some conditions. Here we conduct a systematic review and meta-analysis of the experimental evidence that kindness interventions (for example, performing ‘random acts of kindness’) boost subjective well-being. Our initial search of the literature identified 489 articles; of which 24 (27 studies) met the inclusion criteria (total N = 4045). These 27 studies, some of which included multiple control conditions and dependent measures, yielded 52 effect sizes. Multi-level modeling revealed that the overall effect of kindness on the well-being of the actor is small-to-medium (δ = 0.28). The effect was not moderated by sex, age, type of participant, intervention, control condition or outcome measure. There was no indication of publication bias. We discuss the limitations of the current literature, and recommend that future research test more specific theories of kindness: taking kindness-specific individual differences into account; distinguishing between the effects of kindness to specific categories of people; and considering a wider range of proximal and distal outcomes. Such research will advance our understanding of the causes and consequences of kindness, and help practitioners to maximise the effectiveness of kindness interventions to improve well-being

    The self-management of longer-term depression: learning from the patient, a qualitative study

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    Background Depression is a common mental health condition now viewed as chronic or long-term. More than 50 % of people will have at least one further episode of depression after their first, and therefore it requires long-term management. However, little is known about the effectiveness of self-management in depression, in particular from the patients’ perspective. This study aimed to understand how people with longer-term depression manage the condition, how services can best support self-management and whether the principles and concepts of the recovery approach would be advantageous. Methods Semi-structured in depth interviews were carried out with 21 participants, recruited from a range of sources using maximum variation sampling. Interpretative Phenomenological Analysis was used by a diverse team comprised of service users, practitioners and academics. Results Four super-ordinate themes were found: experience of depression, the self, the wider environment, self-management strategies. Within these, several prominent sub-themes emerged of importance to the participants. These included how aspects of themselves such as hope, confidence and motivation could be powerful agents; and how engaging in a wide range of chosen activities could contribute to their emotional, mental, physical, social, spiritual and creative wellbeing. Conclusions Services in general were not perceived to be useful in specifically facilitating self-management. Increased choice and control were needed and a greater emphasis on an individualised holistic model. Improved information was needed about how to develop strategies and locate resources, especially during the first episode of depression. These concepts echoed those of the recovery approach, which could therefore be seen as valuable in aiding the self-management of depression. Keywords: Depression; Patients’ perspective; Qualitative research; Recovery; Self-help; Self-managemen

    A Phase 1 Trial of MSP2-C1, a Blood-Stage Malaria Vaccine Containing 2 Isoforms of MSP2 Formulated with Montanide® ISA 720

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    Background: In a previous Phase 1/2b malaria vaccine trial testing the 3D7 isoform of the malaria vaccine candidate Merozoite surface protein 2 (MSP2), parasite densities in children were reduced by 62%. However, breakthrough parasitemias were disproportionately of the alternate dimorphic form of MSP2, the FC27 genotype. We therefore undertook a dose-escalating, double-blinded, placebo-controlled Phase 1 trial in healthy, malaria-naïve adults of MSP2-C1, a vaccine containing recombinant forms of the two families of msp2 alleles, 3D7 and FC27 (EcMSP2-3D7 and EcMSP2-FC27), formulated in equal amounts with Montanide® ISA 720 as a water-in-oil emulsion. Methodology/Principal Findings: The trial was designed to include three dose cohorts (10, 40, and 80 μg), each with twelve subjects receiving the vaccine and three control subjects receiving Montanide® ISA 720 adjuvant emulsion alone, in a schedule of three doses at 12-week intervals. Due to unexpected local reactogenicity and concern regarding vaccine stability, the trial was terminated after the second immunisation of the cohort receiving the 40 μg dose; no subjects received the 80 μg dose. Immunization induced significant IgG responses to both isoforms of MSP2 in the 10 μg and 40 μg dose cohorts, with antibody levels by ELISA higher in the 40 μg cohort. Vaccine-induced antibodies recognised native protein by Western blots of parasite protein extracts and by immunofluorescence microscopy. Although the induced anti-MSP2 antibodies did not directly inhibit parasite growth in vitro, IgG from the majority of individuals tested caused significant antibody-dependent cellular inhibition (ADCI) of parasite growth. Conclusions/Significance: As the majority of subjects vaccinated with MSP2-C1 developed an antibody responses to both forms of MSP2, and that these antibodies mediated ADCI provide further support for MSP2 as a malaria vaccine candidate. However, in view of the reactogenicity of this formulation, further clinical development of MSP2-C1 will require formulation of MSP2 in an alternative adjuvant. Trial Registration: Australian New Zealand Clinical Trials Registry 12607000552482

    The transport of sugars between pea and pea powdery mildew

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