Food insecurity amongst older people in the UK

Purpose The purpose of this paper is to present findings from research into food insecurity amongst older people aged 50 years and older in the UK. Design/methodology/approach This paper uses secondary analysis of national-level survey data and semi-structured interviews with older people receiving emergency food from foodbanks. Findings There is a forgotten care gap in the UK where a substantial number of older people are living in food insecurity. Many older people live alone and in poverty, and increasing numbers are constrained in their spending on food and are skipping meals. Food insecurity amongst older people can be hidden. Within families a number of older people were trying to ensure that their children and grandchildren had enough to eat, but were reluctant to ask for help themselves. Research limitations/implications The broad categorisation of older people aged 50 and above comprises people in very different circumstances. The qualitative component of the research was undertaken across various sites in a single city in England. Despite these limitations, the analysis provides important insights into the experiences of the many older people enduring food insecurity. Practical implications An increased public and professional awareness of food insecurity amongst older people is needed. Increased routine screening for under-nutrition risk is a priority. Policy initiatives are needed that are multifaceted and which support older people across a range of age groups, particularly those living alone. Social implications Food insecurity amongst older people in the UK raises questions about the present policy approach and the responsibilities of the government. Originality/value The research provides important new insights into the experiences of the many older people experiencing food insecurity in the UK by drawing on survey data and interviews with older people using foodbanks

The interactive role of income (material position) and income rank (psychosocial position) in psychological distress : a 9-year longitudinal study of 30,000 UK parents

Purpose Parents face an increased risk of psychological distress compared with adults without children, and families with children also have lower average household incomes. Past research suggests that absolute income (material position) and income status (psychosocial position) influence psychological distress, but their combined effects on changes in psychological distress have not been examined. Whether absolute income interacts with income status to influence psychological distress are also key questions. Methods We used fixed-effects panel models to examine longitudinal associations between psychological distress (measured on the Kessler scale) and absolute income, distance from the regional mean income, and regional income rank (a proxy for status) using data from 29,107 parents included in the UK Millennium Cohort Study (2003–2012). Results Psychological distress was determined by an interaction between absolute income and income rank: higher absolute income was associated with lower psychological distress across the income spectrum, while the benefits of higher income rank were evident only in the highest income parents. Parents’ psychological distress was, therefore, determined by a combination of income-related material and psychosocial factors. Conclusions Both material and psychosocial factors contribute to well-being. Higher absolute incomes were associated with lower psychological distress across the income spectrum, demonstrating the importance of material factors. Conversely, income status was associated with psychological distress only at higher absolute incomes, suggesting that psychosocial factors are more relevant to distress in more advantaged, higher income parents. Clinical interventions could, therefore, consider both the material and psychosocial impacts of income on psychological distress

Uninterested youth? Young people's attitudes towards party politics in Britain

Following the outcome of the 2001 and 2005 General Elections, when the numbers of abstainers outweighed the numbers of Labour voters on both occasions, much attention has focused upon the state of British democracy and how to enthuse the electorate, especially young people. While the government is exploring ways to make the whole process of voting easier, it may be failing to tackle the real problem - that youth appear to find the business of politics uninviting and irrelevant. This paper examines data derived from a nationwide survey of over 700 young people in order to shed light on what lies at the heart of young people's apparent disengagement from formal politics in Britain - political apathy or a sense of political alienation. The findings reveal that they support the democratic process, but are sceptical of the way the British political system is organised and led, and are turned off by politicians and the political parties. However, there is no uniform youth orientation to politics, and the data indicate that views differ according to social class, educational history, and also gender. However both ethnicity and region of the country in which young people live seem to have little influence in structuring political attitudes and behaviour

TENDINopathy Severity Assessment - Achilles (TENDINS-A):Development and Content Validity Assessment of a New Patient-Reported Outcome Measure for Achilles Tendinopathy

OBJECTIVE: To develop a new patient-reported outcome measure (PROM) assessing TENDINopathy Severity of the Achilles (TENDINS-Achilles) and evaluate its content validity. DESIGN: Mixed-methods, modified Delphi. METHODS: We performed 1 round of semistructured one-on-one interview responses with professionals and patients, for initial item generation. This was followed by 1 round of survey responses for professionals and a final round of semistructured one-on-one interviews with patients. The work culminated in a PROM to quantify Achilles tendinopathy severity under the core health domain of disability. Participants identified 3 subdomains contributing to the severity of disability of Achilles tendinopathy: pain, symptoms, and functional capacity. RESULTS: All 8 patient participants invited to participate were enrolled. Forty professional participants (50% women, six different continents) were invited to participate and 30 were enrolled (75% response rate). Therefore, a total of 30 professionals and 8 patients were included within this study. Following 3 rounds of qualitative or quantitative feedback, this study has established the content validity of TENDINS-A (good relevance, comprehensibility, and comprehensiveness) as a new PROM to assess the severity of Achilles tendinopathy, which assesses aspects of pain, symptoms, and functional capacity. CONCLUSION: TENDINS-A has established content validity and is appropriate for use with clinical and research populations. We recommend users interpret TENDINS-A results cautiously, until further testing evaluates the most appropriate scoring scale, reliability, construct validity, criterion validity, and responsiveness of TENDINS-A. Until these psychometric properties are established, we suggest using TENDINS-A alongside existing tools. J Orthop Sports Phys Ther 2023;53(11):1-16. Epub: 24 August 2023. doi:10.2519/jospt.2023.11964.</p

ICON 2019: International Scientific Tendinopathy Symposium Consensus: Clinical Terminology

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.Background Persistent tendon pain that impairs function has inconsistent medical terms that can influence choice of treatment.1 When a person is told they have tendinopathy by clinician A or tendinitis by clinician B, they might feel confused or be alarmed at receiving what they might perceive as two different diagnoses. This may lead to loss of confidence in their health professional and likely adds to uncertainty if they were to search for information about their condition. Clear and uniform terminology also assists inter-professional communication. Inconsistency in terminology for painful tendon disorders is a problem at numerous anatomical sites. Historically, the term ‘tendinitis’ was first used to describe tendon pain, thickening and impaired function (online supplementary figure S1). The term ‘tendinosis’ has also been used in a small number of publications, some of which were very influential.2 3 Subsequently, ‘tendinopathy’ emerged as the most common term for persistent tendon pain.4 5 To our knowledge, experts (clinicians and researchers) or patients have never engaged in a formal process to discuss the terminology we use. We believe that health professionals have not yet agreed on the appropriate terminology for painful tendon conditions.Peer reviewedFinal Accepted Versio

The normalisation of Food Aid: What happened to feeding people well?

In the UK, food poverty has increased in the last 15 years and the food aid supply chain that has emerged to tackle it is now roughly 10 years old. In this time, we have seen the food aid supply chain grow at a rate that has astounded many.  Recently that growth has been aided by a grant of £20m from a large supermarket chain. It appears institutionalisation is just around the corner, if not already here. It also appears that there is far greater emphasis on dealing with  the symptoms as opposed to solving the root causes of the problem. As an opinion piece, this paper reflects on some of the prevalent issues, and suggests some ways forward

Differential training loads and individual fitness responses to pre-season in professional rugby union players

We aimed to compare differentiated training loads (TL) between fitness responders and non-responders to an eight-week pre-season training period in a squad of thirty-five professional rugby union players. Differential TL were calculated by multiplying player’s perceptions of breathlessness (sRPE-B) and leg muscle exertion (sRPE-L) with training duration for each completed session. Performance-based fitness measures included the Yo-Yo Intermittent Recovery Test Level 1 (YYIRTL1), 10-, 20-, and 30-m linear sprint times, countermovement jump height (CMJ) and predicted one-repetition maximum back squat (P1RM Squat). The proportion of responders (≥ 75% chance that the observed change in fitness was > typical error and smallest worthwhile change) were 37%, 50%, 52%, 82% and 70% for YYIRTL1, 20/30-m, 10-m, CMJ and P1RM Squat, respectively. Weekly sRPE-B-TL was very likely higher in YYIRTL1 responders (mean difference = 18%; ±90% confidence limits 11%), likely lower in 20/30-m (19%; ±20%) and 10-m (18%; ±17%) responders, and likely higher in CMJ responders (15%; ±16%). All other comparisons were unclear. Weekly sRPE-B discriminate between rugby union players who respond to pre-season training when compared with players who do not. Our findings support the collection of differential ratings of perceived exertion and the use of individual response analysis in team-sport athletes