Written information about individual medicines for consumers.

Medicines are the most common intervention in most health services. As with all treatments, those taking medicines need sufficient information: to enable them to take and use the medicines effectively, to understand the potential harms and benefits, and to allow them to make an informed decision about taking them. Written medicines information, such as a leaflet or provided via the Internet, is an intervention that may meet these purposes

Why “intergenerational feminist media studies”?

Feminism and generation are live and ideologically freighted issues that are subject to a substantial amount of media engagement. The figure of the millennial and the baby boomer, for example, regularly circulate in mainstream media, often accompanied by hyperbolic and vitriolic discourses and affects of intergenerational feminist conflict. In addition, theories of feminist generation and waves have been and continue to be extensively critiqued within feminist theory. Given the compelling criticisms directed at these categories, we ask: why bother examining and foregrounding issues of generation, intergeneration, and transgeneration in feminist media studies? Whilst remaining sceptical of linearity and familial metaphors and of repeating reductive, heteronormative, and racist versions of feminist movements, we believe that the concept of generation does have critical purchase for feminist media scholars. Indeed, precisely because of the problematic ways that is it used, and the prevalence of it as a volatile, yet only too palpable, organizing category, generation is both in need of continual critical analysis, and is an important tool to be used—with care and nuance—when examining the multiple routes through which power functions in order to marginalize, reward, and oppress. Exploring both diachronic and synchronic understandings of generation, this article emphasizes the use of conjunctural analysis to excavate the specific historical conditions that impact upon and create generation. This special issue of Feminist Media Studies covers a range of media forms—film, games, digital media, television, print media, as well as practices of media production, intervention, and representation. The articles also explore how figures at particular lifestages—particularly the girl and the aging woman—are constructed relationally, and circulate, within media, with particular attention to sexuality. Throughout the issue there is an emphasis on exploring the ways in which the category of generation is mobilized in order to gloss sexism, racism, ageism, class oppression, and the effects of neoliberalism

Crisis resolution teams for people experiencing mental health crises: the CORE mixed-methods research programme including two RCTs

Background Crisis resolution teams (CRTs) seek to avert hospital admissions by providing intensive home treatment for people experiencing a mental health crisis. The CRT model has not been highly specified. CRT care is often experienced as ending abruptly and relapse rates following CRT discharge are high. Aims The aims of CORE (Crisis resolution team Optimisation and RElapse prevention) workstream 1 were to specify a model of best practice for CRTs, develop a measure to assess adherence to this model and evaluate service improvement resources to help CRTs implement the model with high fidelity. The aim of CORE workstream 2 was to evaluate a peer-provided self-management programme aimed at reducing relapse following CRT support. Methods Workstream 1 was based on a systematic review, national CRT manager survey and stakeholder qualitative interviews to develop a CRT fidelity scale through a concept mapping process with stakeholders (n = 68). This was piloted in CRTs nationwide (n = 75). A CRT service improvement programme (SIP) was then developed and evaluated in a cluster randomised trial: 15 CRTs received the SIP over 1 year; 10 teams acted as controls. The primary outcome was service user satisfaction. Secondary outcomes included CRT model fidelity, catchment area inpatient admission rates and staff well-being. Workstream 2 was a peer-provided self-management programme that was developed through an iterative process of systematic literature reviewing, stakeholder consultation and preliminary testing. This intervention was evaluated in a randomised controlled trial: 221 participants recruited from CRTs received the intervention and 220 did not. The primary outcome was re-admission to acute care at 1 year of follow-up. Secondary outcomes included time to re-admission and number of days in acute care over 1 year of follow-up and symptoms and personal recovery measured at 4 and 18 months’ follow-up. Results Workstream 1 – a 39-item CRT fidelity scale demonstrated acceptability, face validity and promising inter-rater reliability. CRT implementation in England was highly variable. The SIP trial did not produce a positive result for patient satisfaction [median Client Satisfaction Questionnaire score of 28 in both groups at follow-up; coefficient 0.97, 95% confidence interval (CI) –1.02 to 2.97]. The programme achieved modest increases in model fidelity. Intervention teams achieved lower inpatient admission rates and less inpatient bed use. Qualitative evaluation suggested that the programme was generally well received. Workstream 2 – the trial yielded a statistically significant result for the primary outcome, in which rates of re-admission to acute care over 1 year of follow-up were lower in the intervention group than in the control group (odds ratio 0.66, 95% CI 0.43 to 0.99; p = 0.044). Time to re-admission was lower and satisfaction with care was greater in the intervention group at 4 months’ follow-up. There were no other significant differences between groups in the secondary outcomes. Limitations Limitations in workstream 1 included uncertainty regarding the representativeness of the sample for the primary outcome and lack of blinding for assessment. In workstream 2, the limitations included the complexity of the intervention, preventing clarity about which were effective elements. Conclusions The CRT SIP did not achieve all its aims but showed potential promise as a means to increase CRT model fidelity and reduce inpatient service use. The peer-provided self-management intervention is an effective means to reduce relapse rates for people leaving CRT care. Study registration The randomised controlled trials were registered as Current Controlled Trials ISRCTN47185233 and ISRCTN01027104. The systematic reviews were registered as PROSPERO CRD42013006415 and CRD42017043048. Funding The National Institute for Health Research Programme Grants for Applied Research programme

A web-based self-management programme for people with type 2 diabetes : the HeLP-Diabetes research programme including RCT

Background: In the UK, 6% of the UK population have diabetes mellitus, 90% of whom have type 2 diabetes mellitus (T2DM). Diabetes mellitus accounts for 10% of NHS expenditure (£14B annually). Good self-management may improve health outcomes. NHS policy is to refer all people with T2DM to structured education, on diagnosis, to improve their self-management skills, with annual reinforcement thereafter. However, uptake remains low (5.6% in 2014–15). Almost all structured education is group based, which may not suit people who work, who have family or other caring commitments or who simply do not like group-based formats. Moreover, patient needs vary with time and a single education session at diagnosis is unlikely to meet these evolving needs. A web-based programme may increase uptake. / Objectives: Our aim was to develop, evaluate and implement a web-based self-management programme for people with T2DM at any stage of their illness journey, with the goal of improving access to, and uptake of, self-management support, thereby improving health outcomes in a cost-effective manner. Specific objectives were to (1) develop an evidence-based theoretically informed programme that was acceptable to patients and health-care professionals (HCPs) and that could be readily implemented within routine NHS care, (2) determine the clinical effectiveness and cost-effectiveness of the programme compared with usual care and (3) determine how best to integrate the programme into routine care. / Design: There were five linked work packages (WPs). WP A determined patient requirements and WP B determined HCP requirements for the self-management programme. WP C developed and user-tested the Healthy Living for People with type 2 Diabetes (HeLP-Diabetes) programme. WP D was an individually randomised controlled trial in primary care with a health economic analysis. WP E used a mixed-methods and case-study design to study the potential for implementing the HeLP-Diabetes programme within routine NHS practice. / Setting: English primary care. / Participants: People with T2DM (WPs A, D and E) or HCPs caring for people with T2DM (WPs B, C and E). / Intervention: The HeLP-Diabetes programme; an evidence-based theoretically informed web-based self-management programme for people with T2DM at all stages of their illness journey, developed using participatory design principles. / Main outcome measures: WPs A and B provided data on user ‘wants and needs’, including factors that would improve the uptake and accessibility of the HeLP-Diabetes programme. The outcome for WP C was the HeLP-Diabetes programme itself. The trial (WP D) had two outcomes measures: glycated haemoglobin (HbA1c) level and diabetes mellitus-related distress, as measured with the Problem Areas in Diabetes (PAID) scale. The implementation outcomes (WP E) were the adoption and uptake at clinical commissioning group, general practice and patient levels and the identification of key barriers and facilitators. / Results: Data from WPs A and B supported our holistic approach and addressed all areas of self-management (medical, emotional and role management). HCPs voiced concerns about linkage with the electronic medical records (EMRs) and supporting patients to use the programme. The HeLP-Diabetes programme was developed and user-tested in WP C. The trial (WP D) recruited to target (n = 374), achieved follow-up rates of over 80% and the intention-to-treat analysis showed that there was an additional improvement in HbA1c levels at 12 months in the intervention group [mean difference –0.24%, 95% confidence interval (CI) –0.44% to –0.049%]. There was no difference in overall PAID score levels (mean difference –1.5 points, 95% CI –3.9 to 0.9 points). The within-trial health economic analysis found that incremental costs were lower in the intervention group than in the control group (mean difference –£111, 95% CI –£384 to £136) and the quality-adjusted life-years (QALYs) were higher (mean difference 0.02 QALYs, 95% CI 0.000 to 0.044 QALYs), meaning that the HeLP-Diabetes programme group dominated the control group. In WP E, we found that the HeLP-Diabetes programme could be successfully implemented in primary care. General practices that supported people in registering for the HeLP-Diabetes programme had better uptake and registered patients from a wider demographic than those relying on patient self-registration. Some HCPs were reluctant to do this, as they did not see it as part of their professional role. / Limitations: We were unable to link the HeLP-Diabetes programme with the EMRs or to determine the effects of the HeLP-Diabetes programme on users in the implementation study. / Conclusions: The HeLP-Diabetes programme is an effective self-management support programme that is implementable in primary care. / Future work: The HeLP-Diabetes research team will explore the following in future work: research to determine how to improve patient uptake of self-management support; develop and evaluate a structured digital educational pathway for newly diagnosed people; develop and evaluate a digital T2DM prevention programme; and the national implementation of the HeLP-Diabetes programme. / Trial registration: Research Ethics Committee reference number 10/H0722/86 for WPs A–C; Research Ethics Committee reference number 12/LO/1571 and UK Clinical Research Network/National Institute for Health Research (NIHR) Portfolio 13563 for WP D; and Research Ethics Committee 13/EM/0033 for WP E. In addition, for WP D, the study was registered with the International Standard Randomised Controlled Trial Register as reference number ISRCTN02123133. / Funding details: This project was funded by the NIHR Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 6, No. 5. See the NIHR Journals Library website for further project information

The agricultural labourer ... [Assistant commissioners' reports] Presented to both Houses of Parliament by command of Her Majesty

I. England. pt. 1. by William E. Bear.--pt. 2. by Cecil M. Chapman.--pt. 3. by Arthur Wilson Fox.--pt. 4. by Roger C. Richards.--pt. 5. by Aubrey J. Spencer.--pt. 6. by Edward Wilkinson.-pt.7. Indexes to the reports v. 1, pt. 1-6. 1893. (C. 6894--I-VI, XIII) Pts. 5-7 bound with v. II. --II. Wales. by D. L'leufer [and] C.M. Chapman. 1893. (C.6894--XIV) --III. Scotland. pt. 1. by H. Rutherfurd and G.R. Gillespie.--pt. 2. by R. Hunter Pringle. and Edward Wilkinson.--pt. 3. Indexes to reports, v. 3, pt. 1-2. 1893-94. (C. 6894--XV-XVII) --IV. Ireland. pt. 1. by R. McCrea.--pt. 2. by W.P. O'Brien.--pt. 3. by Roger C. Richards.--pt. 4. by Author Wilson Fox.-pt.5. Indexes to reports v. 4, pt.1-4. 1893-94. (C. 6894--XVIII-XXII). --V. pt. 1. General report, by William C. Little. Return by the Board of Agriculture, showing the cultivated area, the acreage under certain crops, and the number of cattle and sheep in the registered sub-districts of various selected unions in England and Wales for the year 1891; with summary by William C. Little.--pt. 2. Miscellaneous memoranda, abstracts, and statistical tables, by William C. Little. 1894. (C. 6894--XXIV-XXV)Mode of access: Internet

The role and contribution of women to rural economies A report prepared for the Countryside Agency

Includes bibliographical referencesAvailable from British Library Document Supply Centre- DSC:m03/11248 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Vocational higher education Does it meet employers' needs?

Includes bibliographical references. Title from coverSIGLEAvailable from British Library Document Supply Centre- DSC:m03/38130 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Study to identify future commercial trends affecting the aviation industry in the period 2005 to 2015 Final part 1 report

Title from coverAvailable from British Library Document Supply Centre- DSC:02/42991 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Report[s], [minutes of evidence, indexes, answers to questions].

Answers to the schedules of questions issued by the commission, groups A-C. 1892. 3 v. in 2. (C. 6795--VII-IX).Indexes: I-II. Indexes to the evidence, groups A-C.--III. Glossary of the technical terms used in the evidence -- IV. Index to the evidence given by representatives of co-operative societies and of various movements and by public officials. 1892-94. 4 [i.e. 6] v. in 1. (C. 7063--III-V C).Minutes of evidence, with appendices, taken before groups A, B and C [with digests and indexes]: Group A. Mining, iron, engineering, hardware, shipbuilding and cognate trades -- Group B. Transport and agriculture (the term "transport" including railways, shipping, canals, docks and tramways) -- Group C. Textile, clothing, chemical, building and miscellaneous trades. 1892-93. 18 v. in 9 (C. 6708--I-VI, C. 6795--I-VI, C. 6894--VII-XII).Minutes of evidence taken before the commission (sitting as a whole) Representatives of co-operative societies and of various movements, and of public officials. [With Digest, and appendix] 1893-94. 3 v. in 1. (C. 7063--I, II, IIIA).First [to Fifth and final] report[s] 1892-94. 5 v. in l (C. 6708, 6795, 6894, 7063, 7421)."The agricultural labourer. Review of the inquiry carried out in England and Wales, Scotland and Ireland, in 1892 and 1893, and of the reports of the assistant commissioners, by William C. Little, (senior assistant commissioner)": 5th report, p. 195-253.Report by Sir John E. Gorst: 5th report, p. 148-151.Minority report signed by William Abraham, Michael Austin, James Mawdsley, Tom Mann: 5th report, p. 127-147.The Duke of Devonshire, chairman. Geoffrey Drage, secretary.Mode of access: Internet.With First [to Fifth and final (Part I)] report[s] 1892-1894 is bound: Employment of women. Reports by Miss Eliza Orme, Miss Clara E. Collett, Miss May E. Abraham, and Miss Margaret H. Irwin (lady assistant commissioners) on the conditions of work in various industries in England, Wales, Scotland, and Ireland