Mood instability, mental illness and suicidal ideas : results from a household survey

Purpose: There is weak and inconsistent evidence that mood instability (MI) is associated with depression, post traumatic stress disorder (PTSD) and suicidality although the basis of this is unclear. Our objectives were first to test whether there is an association between depression and PTSD, and MI and secondly whether MI exerts an independent effect on suicidal thinking over and above that explained by common mental disorders. Methods: We used data from the Adult Psychiatric Morbidity Survey 2007 (N = 7,131). Chi-square tests were used to examine associations between depression and PTSD, and MI, followed by regression modelling to examine associations between MI and depression, and with PTSD. Multiple logistic regression analyses were used to assess the independent effect of MI on suicidal thinking, after adjustment for demographic factors and the effects of common mental disorder diagnoses. Results: There are high rates of MI in depression and PTSD and the presence of MI increases the odds of depression by 10.66 [95 % confidence interval (CI) 7.51–15.13] and PTSD by 8.69 (95 % CI 5.90–12.79), respectively, after adjusting for other factors. Mood instability independently explained suicidal thinking, multiplying the odds by nearly five (odds ratio 4.82; 95 % CI 3.39–6.85), and was individually by some way the most important single factor in explaining suicidal thoughts. Conclusions: MI is strongly associated with depression and PTSD. In people with common mental disorders MI is clinically significant as it acts as an additional factor exacerbating the risk of suicidal thinking. It is important to enquire about MI as part of clinical assessment and treatment studies are required

The utilisation of health research in policy-making: Concepts, examples and methods of assessment

The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies

Intergovernmental Relations in Scotland: what was the SNP effect?

In Scotland, the formation of a minority government in 2007 by the Scottish National Party (SNP) provided the potential for profound changes in intergovernmental relations. This followed eight years of a Scottish Labour-led coalition government characterised by a low-key and informal relationship with the UK Labour government. From 1999 to 2007, discussions were conducted informally and almost entirely through political parties and executives (ministers and civil servants). Although formal mechanisms for negotiation and dispute resolution existed-including the courts, concordats and Joint Ministerial Committees-they were used rarely. The Scottish Executive also played a minimal role in EU policy-making. Yet, an ‘explosive' new era of relations between the Scottish and UK governments did not arrive in tandem with the new era of party incongruence. The aim of this article is to explore these issues by asking two main questions: why were formal mechanisms used so rarely from 1999 to 2007, and what factors produced muted rather than problematic IGR in the third parliamentary session, between 2007 and 2011

Constitutional Reform in the UK: A Note on the Legacy of the Kilbrandon Commission

The past two decades have seen large shifts in the constitutional landscape of the United Kingdom. This began with the devolution of powers from Westminster to Scotland, Wales and Northern Ireland under the first Blair government. More recently, the localism agenda advanced by the Coalition and subsequent Conservative governments has sought to further devolve powers to areas within England, and the constitutional integrity of the UK itself was threatened by 2014s Scottish independence referendum and the 2016 referendum vote for the UK to leave the European Union. It is convenient to regard constitutional reform concerned with the dispersal of power through the creation of new executive and legislative bodies as a modern phenomenon. However, the roots of devolution go back much further. Largely forgotten is the work of the Kilbrandon Commission, established to consider the allocation of executive and legislative power within the UK, which reported in 1973 and effectively produced the first substantial proposals for the devolution of power from Westminster. Almost two decades on from the creation of the devolved institutions for Scotland, Wales and Northern Ireland, the present moment is as opportune as any to consider the longer-term legacy of the Kilbrandon Commission. This note revisits the major findings and recommendations of Kilbrandon and attempts to consider the extent to which these have been realised in subsequent constitutional reform initiatives. While difficult to quantify its significance, it is nonetheless important to recognise the relevance of the commission’s work for subsequent and unfinished developments within the area of constitutional reform. © 2017, The Author(s)

Religion, Resources and Representation: three narratives of engagement in British urban governance

Faith groups are increasingly regarded as important civil society participants in British urban governance. Faith engagement is linked to policies of social inclusion and “community cohesion,” particularly in the context of government concerns about radicalization along religious lines. Primary research is drawn upon in developing a critical and explicitly multifaith analysis of faith involvement. A narrative approach is used to contrast the different perspectives of national pol- icy makers, local stakeholders, and faith actors themselves. The narratives serve to illuminate not only this specific case but also the more general character of British urban governance as it takes on a more “decentered” form with greater blurring of boundaries between the public, private, and personal

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Constructing impairment and disability in school reading schemes.

This paper examines the cultural construction of disability detailed within school reading schemes. The study by the employment of proto text analysis followed the ‘reading journeys’ that a four and five year old child experienced during the course of one academic year. The study examined 61 reading books that contained 2199 illustrations, 100 photographs and 1006 pages of text. The major finding of the research is that the reading schemes contained a limited construction of disability and one which was contextualised within medical deficit and narrative prosthesis. The research concludes that school reading schemes are potentially acting as a Trojan horse to introduce a page thin hegemonic that inculcates young children into the systems of dominance and ‘ableist’ agendas which are seemingly replete in our society