Issues surrounding drug use and drug services among the South Asian

This is the first of a series of publications to inform drug service planning and provision by presenting results from the Department of Health’s Black and minority ethnic drug misuse needs assessment project that was conducted throughout England in thre

Public support for older disabled people: evidence from the English Longitudinal Study of Ageing on receipt of disability benefits and social care subsidy

In England, state support for older people with disabilities consists of a national system of non-means tested cash disability benefits, and a locally-administered means-tested system of social care. Evidence on how the combination of the two systems targets those in most need is lacking. We estimate a latent factor structural equation model of disability and receipt of one or both forms of support. The model integrates the measurement of disability and its influence on receipt of state support, allowing for the socio-economic gradient in disability, and adopts income and wealth constructs appropriate to each part of the model. We find that receipt of each form of support rises as disability increases, with a strong concentration on the most disabled, especially for LA-funded care. The overlap between the two programmes is confined to the most disabled. Less than half of recipients of local authority-funded care also receive a disability benefit; a third of those in the top 10% of the disability distribution receive neither form of support. Despite being non means-tested, disability benefits display a degree of income and wealth targeting, as a consequence of the socio-economic gradient in disability and likely disability benefit claims behaviour. The scope for improving income/wealth targeting of disability benefits by means testing them, as some have suggested, is thus less than might be expected

Ensuring the right to education for Roma children : an Anglo-Swedish perspective

Access to public education systems has tended to be below normative levels where Roma children are concerned. Various long-standing social, cultural, and institutional factors lie behind the lower levels of engagement and achievement of Roma children in education, relative to many others, which is reflective of the general lack of integration of their families in mainstream society. The risks to Roma children’s educational interests are well recognized internationally, particularly at the European level. They have prompted a range of policy initiatives and legal instruments to protect rights and promote equality and inclusion, on top of the framework of international human rights and minority protections. Nevertheless, states’ autonomy in tailoring educational arrangements to their budgets and national policy agendas has contributed to considerable international variation in specific provision for Roma children. As this article discusses, even between two socially liberal countries, the UK and Sweden, with their well-advanced welfare states and public systems of social support, there is a divergence in protection, one which underlines the need for a more consistent and positive approach to upholding the education rights and interests of children in this most marginalized and often discriminated against minority group

Cross-national mixed methods comparative case study of recovery-focused mental health care planning and coordination in acute inpatient mental health settings (COCAPP-A)

Background: Serious concerns have been identified in relation to care planning, patient involvement and consent to treatment in mental health wards, including for those patients detained under the Mental Health Act. Further evidence is needed to develop care planning interventions that embed dignity, recovery and participation for all people using inpatient mental health care. Design: We propose to undertake a cross-national comparative study of recovery-focused mental health care planning in inpatient settings. This two-phase exploratory mixed methods study will produce theory and empirical evidence to complement that developed in our current study of community mental health services to inform a future whole systems intervention study. The study is guided by a theoretical framework emphasising the connections between different 'levels' of organisation (macro/meso/micro). In phase 1 we study the macro-level through the comparative analysis of English and Welsh policy contexts. In phase 2 concurrent quantitative and qualitative data will be collected at 6 NHS Trust/Health Board case study sites (meso-level) and within each site, a single micro-level mental health ward will be selected to provide in-depth qualitative data related to care planning processes. Phase 1: We will extend our current meta-narrative mapping review (Wong et al 2013) of English and Welsh policies and the international literature on personalised recovery-oriented care planning and coordination in community settings to include inpatient settings. We will provide a review of evidence that is useful, rigorous and relevant for service providers and decision-makers and to inform Phase 2. Phase 2: We are employing a concurrent transformative mixed methods approach with embedded case studies (Creswell 2009: 215). We will conduct six in-depth meso-level case study investigations across contrasting NHS Trusts in England (n=4) and Local Health Boards in Wales (n=2), selected to reflect variety in geography and population and include a mix of rural, urban and inner city settings providing routine inpatient care. A large sample of service users (total n=300), inpatient staff (n=300) and informal carers (n=150) will be surveyed about perceptions of acute mental health care and care planning, recovery oriented practices, therapeutic relationships and empowerment using validated questionnaires. Documents and interviews with managers, consultant psychiatrists, ward staff and informal carers (n=60) will also be generated relating to local contexts, policies and practices. In each site we will also select a single inpatient ward and conduct a series of case studies embedded within each organisational case study, to explore care planning in detail. We will invite a sample of service users (total n=36) to participate in in-depth interviews about care planning and structured narrative reviews of their care plans; undertake a structured review of anonymised care plans for a further sample (n=60) of consecutively discharged patients; and conduct observation of care planning processes (n= 18). Framework method will be employed to integrate and compare textual and statistical summaries of qualitative and quantitative analyses within each case study site, informed by the theoretical framework focused on recovery and personalisation. Armed with our set of six within-case analyses we will then conduct a cross-case analysis to draw out key findings from across all sites

Screening for glucose intolerance and development of a lifestyle education programme for prevention of Type 2 diabetes in a population with intellectual disabilities

Background: The prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited. Objectives: The objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD). Setting: Leicestershire, UK. Participants: Adults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2 and/or IGR were invited to take part in the education programme. Main outcome measures: The primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed. Data sources: Participants were recruited from general practices, specialist ID services and clinics, and through direct contact. Results: A total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals, n = 14; people with ID, n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity. Limitations: We were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work. Conclusions: The results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population. Future work: Further work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation

Issues surrounding drug use and drug services among the Black African

This is the second of a series of publications to inform drug service planning and provision by presenting results from the Department of Health’s Black and minority ethnic drug misuse needs assessment project that was conducted throughout England in three phases during 2000-2001, 2004-2005, and 2006. This project employed the Centre for Ethnicity and Health’s Community Engagement Model to train and support 179 community organisations to conduct the needs assessments (Fountain, Patel and Buffin, 2007; Winters and Patel, 2003). Each community organisation was also supported by a steering group whose membership included local drug service planners, commissioners and providers. This publication collates the findings from 42 reports on issues surrounding drug use and drug services among England’s Black African communities. In total, 4,657 members of these communities, who originated from 30 different countries in Africa, provided the data for the reports (Black Caribbeans in England are the subject of the third publication in this series). Thirty-three of the reports were concerned solely with Black Africans, while the remaining nine included a substantial proportion of members o

Issues surrounding drug use and drug services among the Black Caribbean

This is the third of a series of publications to inform drug service planning and provision by presenting results from the Department of Health’s Black and minority ethnic drug misuse needs assessment project that was conducted throughout England in three phases during 2000-2001, 2004-2005, and 2006. This project employed the Centre for Ethnicity and Health’s Community Engagement Model to train and support 179 community organisations to conduct the needs assessments (Fountain, Patel and Buffin, 2007; Winters and Patel, 2003). Each community organisation was also supported by a steering group whose membership included local drug service planners, commissioners and providers. This publication collates the findings from 34 reports on issues surrounding drug use and drug services among England’s Black Caribbeans and those of mixed Black Caribbean and white heritage (Black Africans are the subject of the second publication in this series). For convenience, this publication refers to the whole sample as ‘Black Caribbean ’ unless those of mixed ethnicity are specifically discussed. In total, 1,863 members of these communities provided the data for the 34 reports

Village halls in England 1998 Report of the National Village Halls Survey

SIGLEAvailable from British Library Document Supply Centre-DSC:9236.42045(1998) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Homelessness Young people and housing in rural areas

SIGLEAvailable from British Library Document Supply Centre-DSC:98/23212 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Village halls in England 1988 The Ronseal village hall survey

SIGLEAvailable from British Library Document Supply Centre- DSC:q89/15342(Village) / BLDSC - British Library Document Supply CentreGBUnited Kingdo