977 research outputs found
Monitoring and evaluation in global HIV/AIDS controlĀ -Ā weighing incentives and disincentives for coordination among global and local actors
This paper discusses coordination efforts of both donors and recipient countries in the monitoring and evaluation (M&E) of health outcomes in the field of HIV/AIDS. The coordination of M&E is a much underdeveloped area in HIV/AIDS programming in which, however, important first steps towards better synchronisation have already been taken. In this paper, we review the concepts and meanings commonly applied to M&E, and approaches and strategies for better coordination of M&E in the field of HIV/AIDS. Most importantly, drawing on this analysis, we examine why the present structure of global health governance in this area is not creating strong enough incentives for effective coordination among global and local actors. Copyright Ā© 2010 John Wiley & Sons, Ltd
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Mental Health and Wellbeing in England: the Adult Psychiatric Morbidity Survey 2014
This report presents findings of a survey of mental illness and wellbeing among people aged 16 and over living in private households in England. The survey was commissioned by NHS Digital and funded by the Department of Health, and is the fourth in a series of surveys of adult mental health
Peer assessment to improve medical studentās contributions to team-based projects: randomised controlled trial and qualitative follow-up
Background
Medical schools increasingly incorporate teamwork in their curricula but medical students often have a negative perception of team projects, in particular when there is unequal participation. The purpose of this study is to evaluate whether a novel peer evaluation system improves teamwork contributions and reduces the risk of students āfree loadingā.
Methods
A cluster randomised controlled trial (RCT) with qualitative follow up enrolled 37 teams (n =ā223 students). Participating teams were randomised to intervention group (19 teams) or control group (18 teams). The validated Comprehensive Assessment Team Member Effectiveness (CATME) tool was used as the outcome measure, and was completed at baseline (week 2) and at the end of the project (week 10). The team contribution subscale was the primary outcome, with other subscales as secondary outcomes. Six focus group discussions were held with students to capture the teamās experiences and perceptions of peer assessment and its effects on team work.
Results
The results of the RCT showed that there was no difference in team contribution, and other forms of team effectiveness, between intervention and control teams. The focus group discussions highlighted studentsā negative attitudes, and lack of implementation of this transparent, points-based peer assessment system, out of fear of future consequences for relationships with peers. The need to assess peers in a transparent way to stimulate open discussion was perceived as threatening by participants. Teams suggested that other peer assessment systems could work such as rewarding additional or floating marks to high performing team members.
Conclusions
Other models of peer assessment need to be developed and tested that are non-threatening and that facilitate early acceptance of this mode of assessment
The mental health of ex-prisoners: analysis of the 2014 English National Survey of Psychiatric Morbidity
Purpose: Prisoners experience extremely high rates of psychiatric disturbance. However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisonersā mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS). / Methods: APMS 2014 provides cross-sectional data from a random sample (Nā=ā7546) of Englandās household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample. / Results: One participant in seventy had been in prison (1.4%; 95% CI 1.1ā1.7; nā=ā103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02ā3.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity. / Conclusions: Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs
The contribution of work and non-work stressors to common mental disorders in the 2007 Adult Psychiatric Morbidity Survey
Evidence for an effect of work stressors on common mental disorders (CMD) has increased over the past decade. However, studies have not considered whether the effects of work stressors on CMD remain after taking co-occurring non-work stressors into account.
Method. Data were from the 2007 Adult Psychiatric Morbidity Survey, a national population survey of participants
>= 16 years living in private households in England. This paper analyses data from employed working age
participants (N=3383: 1804 males; 1579 females). ICD-10 diagnoses for depressive episode, generalized anxiety
disorder, obsessive compulsive disorder, agoraphobia, social phobia, panic or mixed anxiety and depression in the
past week were derived using a structured diagnostic interview. Questionnaires assessed self-reported work stressors
and non-work stressors.
Results. The effects of work stressors on CMD were not explained by co-existing non-work stressors. We found
independent effects of work and non-work stressors on CMD. Job stress, whether conceptualized as job strain or
effortāreward imbalance, together with lower levels of social support at work, recent stressful life events, domestic
violence, caring responsibilities, lower levels of non-work social support, debt and poor housing quality were all
independently associated with CMD. Social support at home and debt did not influence the effect of work stressors
on CMD.
Conclusions. Non-work stressors do not appear to make people more susceptible to work stressors ; both contribute
to CMD. Tackling workplace stress is likely to benefit employee psychological health even if the employeeās home life
is stressful but interventions incorporating non-work stressors may also be effective
Mental health: Future challenges [Mental Capital and Wellbeing: Making the most of ourselves in the 21st century]
The aim of the Foresight Project on Mental Capital
and Wellbeing (www.foresight.gov.uk)
is to advise the Government on how to achieve the best possible mental development
and mental wellbeing for everyone in the UK in the future.
The starting point of the Project was to generate an understanding of the science of
mental capital and wellbeing (MCW) and to develop a vision for how the size and
nature of the challenges exposed by the Project could evolve over the next 20 years.
To make this analysis tractable, the work was divided into five broad areas: Mental capital through life; Learning through life; Mental health; Wellbeing and work; and Learning difficulties.
This report presents the findings for Mental health and draws upon a comprehensive
assessment of the scientific state-of-the art: overall, around 80 reviews have been
commissioned across the five areas
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The mental health of ex-prisoners: analysis of the 2014 English National Survey of Psychiatric Morbidity
Purpose
Prisoners experience extremely high rates of psychiatric disturbance. However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisonersā mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS).
Methods
APMS 2014 provides cross-sectional data from a random sample (Nā=ā7546) of Englandās household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample.
Results
One participant in seventy had been in prison (1.4%; 95% CI 1.1ā1.7; nā=ā103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02ā3.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity.
Conclusions
Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs
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