MENOS4 trial: a multicentre randomised controlled trial (RCT) of a breast care nurse delivered cognitive behavioural therapy (CBT) intervention to reduce the impact of hot flushes in women with breast cancer: Study Protocol

BACKGROUND: Women who have been treated for breast cancer may identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. HFNS are unpleasant to experience and can have a significant impact on daily life, potentially leading to reduced adherence to life saving adjuvant hormonal therapy. It is known that Cognitive Behavioural Therapy (CBT) is effective for the alleviation of hot flushes in both well women and women who have had breast cancer. Most women with breast cancer will see a breast care nurse and there is evidence that nurses can be trained to deliver psychological treatments to a satisfactory level, whilst also maintaining treatment fidelity. The research team will assess whether breast care nurses can effectively deliver a CBT intervention to alleviate hot flushes in women with breast cancer.METHODS: This study is a multi-centre phase III individually randomised controlled trial of group CBT versus usual care to reduce the impact of hot flushes in women with breast cancer. 120-160 women with primary breast cancer experiencing seven or more problematic HFNS a week will be randomised to receive either treatment as usual (TAU) or participation in the group CBT intervention plus TAU (CBT Group). A process evaluation using May's Normalisation Process Theory will be conducted, as well as practical and organisational issues relating to the implementation of the intervention. Fidelity of implementation of the intervention will be conducted by expert assessment. The cost effectiveness of the intervention will also be assessed.DISCUSSION: There is a need for studies that enable effective interventions to be implemented in practice. There is good evidence that CBT is helpful for women with breast cancer who experience HFNS, yet it is not widely available. It is not yet known whether the intervention can be effectively delivered by breast care nurses or implemented in practice. This study will provide information on both whether the intervention can effectively help women with hot flushes and whether and how it can be translated into routine clinical practice.TRIAL REGISTRATION: ISRCTN 12824632 . Registered 25-01-2017.</p

Satisfaction with social care services among South Asian and White British groups

In national surveys, people from Black and Minority Ethnic (BME) groups have generally reported lower levels of satisfaction with social care services when compared with White people (NHS Information Centre, 2012). It is vital to investigate why this is the case so that services can be improved, particularly as there may be a greater need to use services due to higher levels of ill health and disability among certain minority ethnic groups. Utilising qualitative in-depth interviews with people from South Asian and White British groups in Hampshire, Portsmouth, and Southampton, this study compared experiences with social care services across the two groups. The project aimed to suggest improvements for the benefit of both groups

Evaluation of the ESRC Festival of Social Science 2009

The seventh ESRC Festival of Social Science was held from the 6 to the 15 of March 2009. There were over 110 events held across seven different regions and in 40 different cities (an increase of ten per cent from 2008). Feedback indicates approximately 6,000 people attended the Festival.This report analyses questionnaire responses by both attendees and organisers, media coverage achieved and the use of the Festival website

British South asian women in English universities: a study of 1st year and choice at university

This thesis is made up of three papers and aims to explore the higher education routes taken by British Asian women covering analyses of degree subject and institution choices. The first paper explores the subject choices of UK home applicants to undergraduate degree courses with the use of multinomial logistic regression and Universities and Colleges Admissions Services applicant data. The study finds that there are clear differences both across and within ethnic groups in terms of preferred subject choice. Overall, ethnic minority groups other than the Black Caribbean group are more likely to apply to study subjects leading to careers in the professions when compared to the White ethnic group. Differences were found within ethnic groups and these were related to socio-economic background. The second paper uses binary logistic regression analysis and HESA enrolment data for academic years 1998 and 2005 to explore (i) the decision to move out of the parental/guardian home whilst attending university and (ii) the decision to move out of one's home region conditional on the fact a student is not living in the parental home. Findings suggest that Indian, Pakistani and Bangladeshi female students are all more likely to live in the parental/guardian home than White students. Students from all three Asian groups that do move out are less likely to attend a university outside their home region. These patterns are persistent in both 1998 and 2005. The third paper examines with the use of qualitative semi-structured interviews Indian mothers' perceptions of their roles in their daughters' university subject choices. The sample included nine women from varying educational backgrounds with different migration stories. It was important to all the interviewees that their daughters attend university, and this was something they had always envisaged. This aspiration was prevalent across the sample. The women rarely offered specific subjects and careers that they preferred for their daughters. Instead they had an inclination for a wide number of careers that shared specific favourable features such as high pay rewards.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Asian women in higher education: support networks, success and aspects of ‘localism’

This paper will examine the support networks available to Asian women whilst studying at a ‘new’ (post-1992) university. It will explore the strategies of success associated with community membership that Asian women use whilst at university. The paper is based on 45 in-depth interviews carried out with Indian, Sikh and Muslim women who were studying for a Social Sciences or Education Studies degree. All of the interviews were tape-recorded and subsequently transcribed. The findings examine how women form particular communities whilst at university (Bhopal, 2010) – these in effect are translated into ‘communities of practice’ (Wenger, 1998). It is through these ‘communities of practice’ that women are able to support each other by regular interaction, shared language and support for assignments and exams. Part of this ‘community of practice’ is based on the issue of ‘localism’ and ‘critical mass’ and is associated with particular boundaries of membership. Many of the Asian women chose to attend their local university as they felt their experience in higher education would include women who were ‘like them’ and with whom they could identify. Such attendance enabled women to draw support from the communities of practice they were engaged in within the university. The idea of identifying with like minded students encouraged women to draw support from each other in an environment in which many of the women identified as ‘outsiders’. The paper will also explore quantitative data which supports the notion of ‘localism’. Differences in the accommodation choices made by female students from the White and Asian communities are highlighted. HESA enrolment data for academic years 1998 and 2005 are used in the analysis presented here in order to explore (i) the decision to move out of the parental/guardian home whilst attending university and (ii) the decision to move out of one’s home region conditional on the fact a student is not living in the parental home. Findings suggest that Indian, Pakistani and Bangladeshi female students are all more likely to live in the parental/guardian home than White students. Students from all three Asian groups that do move out are less likely to attend a university outside their home region. These patterns are persistent in both 1998 and 2005. The key changes between this period included an increase in students recorded as living in their parental/guardian home. More students that did move out decided to stay in their region in 2005 than they had done in the earlier year. Finally, in 1998 the Indian group was quite distinct from the other two Asian groups in that it was very similar to the White group in terms of the decision to live in the parental home. In 2005, this gap reduces and the Pakistani and Bangladeshi groups behave more similarly to the Indian and White groups <br/

Satisfaction with social care services among South Asian and White British older people: the need to understand the system

National surveys show that people from minority ethnic groups tend to be less satisfied with social care services compared with the white population, but do not show why. Research indicates that barriers to accessing services include lack of information, perceptions of cultural inappropriateness, and normative expectations of care. Less research has examined the experience of minority ethnic service users after they access services. This study conducted in-depth interviews with 82 South Asian and White British service users and family carers, the majority of whom were older people. Thematic analysis was used. The key theme was understanding the social care system. Participants with a good understanding of the system were more able to adapt and achieve control over their care. Participants with a poor understanding were uncertain about how to access further care, or why a service had been refused. More White British than South Asian participants had a good understanding of the system. There was more in common between the South Asian and White British participants’ experiences than might have been expected. Language was an important facilitator of care for South Asian participants, but ethnic matching with staff was less important. Recommendations include better communication throughout the care process, to ensure service users and carers have a clear understanding of social care services and hence a better experienc

Home or away? The significance of ethnicity, class and attainment in the housing choices of female university students

Given the financial implications for studying at a higher education institution, students are faced with many decisions both in terms of the topics they wish to study but also the decision of whether to remain at home or move away. The aim of this paper is to compare the experiences of South Asian (Indian, Bangladeshi and Pakistani) female students to White females, to identify similarities and differences between women from the three Asian groups and also compare changes over time. This paper is focused on the term-time accommodation status of these students i.e. the decision to move away or stay residing in the parental/guardian home during their first year of university. Understanding students’ accommodation choices is important as it can limit the other choices they have to make such as which course to choose and students who are limited to their local institutions can only study what is offered by those particular institutions. We examine this issue by using binary logistic regression to analyse administrative enrolment data on HE students in England for academic years 1998/99 and 2005/06 from the Higher Education Statistics Agency (HESA)

British-born second generation return migrants to India: caring responsibilities in a transnational context

The Indian migrant population in Britain has aged-in-place, such that second and third generation British Indians now make up a large proportion of this group. For instance, East African-born Asians in England and Wales (including their British-born children) make up around one-third of the Indian ethnic population in the United Kingdom. Research on the topic of second generation ‘counter-diasporic migration’ is limited when compared to first generation migration. The research presented in this paper provides academic evidence on this particular flow of migrants. There is some anecdotal evidence to suggest that British Indian counter-diasporic return migration is occurring. It is the relationship between these British born migrants and their ancestral homeland that is the subject of our research interest. This paper is a presentation of results from a pilot study exploring caring responsibilities. That is, the approaches return migrants, particularly those in the ‘sandwich’ generation that are expected to provide care for their children as well as parents, are adopting to balance their responsibilities. With relatives living in India and the UK, we explored how they envisage these responsibilities to change over coming years and potential strategies for dealing with this. Results showed an emphasis on extended families, the advantages of living in multi-generational households and evidence of chain migration. This is in line with Jeremy Hunt’s advice to British families to follow the example of people in Asia, by taking in elderly relatives once they can no longer live alone.<br/