Transitioning to adulthood with a mild intellectual disability: Young people's experiences, expectations, and aspirations

Aim: Very little attention has been paid to the views and experiences of young people with mild intellectual disabilities on the broad topics of adulthood and adult identity. The following study was undertaken to explore how young adults with mild intellectual disabilities conceptualize, relate to, and experience the process of transition. Method: Eight young adults with mild to borderline intellectual disabilities participated in semi‐structured interviews. Results were analysed using interpretive thematic analysis. Results: Two umbrella themes were identified: “On a developmental pathway” and “Negotiations in the environment”. Conclusions: The participants concerns were surprisingly similar to those commonly expressed by young adults without disabilities. Self‐perceived adult identity appeared to be affected by the participants' personal definitions of adulthood, as well as by social comparisons with both peers and adults. Finally, while concerns were expressed about their capacity to cope with responsibility, most felt optimistic about adopting full adult status in the future

Informing investment to reduce inequalities: a modelling approach

Background: Reducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions. Objectives: To provide estimates of the impact of a range of interventions on health and health inequalities. Materials and methods: Literature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a ‘living wage’; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII). Results: Introduction of a ‘living wage’ generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted. Conclusions: Interventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities

Give It Up for Baby: Outcomes and factors influencing uptake of a pilot smoking cessation incentive scheme for pregnant women

The use of incentives to promote smoking cessation is a promising technique for increasing the effectiveness of interventions. This study evaluated the smoking cessation outcomes and factors associated with success for pregnant smokers who registered with a pilot incentivised smoking cessation scheme in a Scottish health board area (NHS Tayside)

Is concern about young people's anti-social behaviour associated with poor health? cross-sectional evidence from residents of deprived urban neighbourhoods

<p><b>Background:</b> Young people in disadvantaged neighbourhoods are often the focus of concerns about anti-social behaviour (ASB). There is inconsistent evidence to support the hypothesis that perceptions of ASB (PASB) are associated with poor health. We ask whether perceptions of young people's ASB are associated with poor health; and whether health, demographic and (psycho)social characteristics can help explain why PASB varies within disadvantaged neighbourhoods (Glasgow, UK).</p> <p><b>Methods:</b> Regression analysis of survey data exploring associations between perceiving teenagers hanging around to be a serious neighbourhood problem and SF-12v2 mental and physical health scores (higher = better), including adjustment for demographic characteristics. Further analysis explored associations with self-reported measures of health service use, psychosocial characteristics of homes and neighbourhoods and social contacts.</p> <p><b>Results:</b> 6008 adults participated (50% response) and 22% (n = 1,332) said teenagers were a serious neighbourhood problem (the most frequently reported local problem). Demographic characteristics associated with perceiving serious teenager problems included regular health service use, age (inverse relationship), financial problems and living with children. Lower SF-12v2 physical health scores were associated with perceiving teenager problems after adjustment for demographic variables (OR 0.98; 95%CI 0.97,0.99; p = < 0.001), whilst adjusted findings for mental health scores were less conclusive (OR 0.99; 95%CI 0.98,1.00; p = 0.103). Further analysis suggested that perceiving teenager problems was more strongly associated with a number of self-reported psychosocial factors: e.g. lacking social support, < weekly family contacts, poor neighbourhood safety, low trust in neighbours, neighbourhood perceived to be a barrier to self-esteem, and neighbourhood decline.</p> <p><b>Conclusions:</b> Given the evidence we found of weak and small associations between PASB and health, we caution against assuming that tackling concern about teenagers' ASB will lead to substantial public health gains in disadvantaged areas. Although the findings do not present a compelling case for making PASB a public health priority, it is still important to address concerns about young people's ASB. Reasons for doing so may include improving social cohesion, reducing fear and isolation, and improving the general quality of people's lives - particularly in neighbourhoods burdened by multiple disadvantages. Future research should evaluate interventions that attempt to reduce PASB in disadvantaged areas. Findings from this study could help inform the targeting of such interventions.</p&gt

Garment Quality and Sustainability : A User-Based Approach

This paper explores the role played by female perceptions of garment quality in relation to how long clothing is kept and how it is used. It considers perceptions of quality in relation to implications for sustainability in fashion. The research involves two phases of empirical data collection conducted in the UK. The first phase draws on a subset of findings from a 12-month laundry study that surveyed the use and laundering of 32 different garments across a group of 16 women. The second phase comprises a semi-structured interview study with 13 women and focuses on exploring factors that influence garment lifetimes. The central contributions of this paper are the distinctions it makes between the immediate concepts of clothing quality that are understood as “pre-use” to those more gradually developed experiences of quality learnt “during use.” In use, garments are tied into user practices and as such become woven into the actions and experiences of everyday life. The length of time garments are worn and kept is more closely connected to how quality is experienced subjectively by the user than understood within objective industry-based definitions of quality. In relation to sustainability, this suggests new directions for understanding quality with emphasis on user behavior

Public services in a “post-democratic age” : an alternative framework to network governance

This paper questions the continued dominance of the network governance approach in public policy and administration and proposes an alternative framework. We find little evidence to support claims for a paradigmatic shift towards network governance in the English case. Neither does the evidence support claims for a weakening of vertical linkages or a strengthening of horizontal linkages within, or across, service delivery chains in England. Instead, bureaucratic and hierarchical structures remain pervasive and power remains highly centralised. The two case studies, of economic development and affordable housing provision, demonstrate how reforms are driven by elected politicians' political objectives and their support of various target groups in society. Nevertheless, policy making is constrained by conditions of ‘postdemocracy’—essentially, the exigencies of contemporary electoral politics and the pervasive influence of business. The study of public administration and management needs to refocus on the implications for the public services of postdemocracy and address critical questions of power, competing interests, mechanisms of exclusion and inclusion, and contested claims to knowledge and expertise within service delivery chains

No Place for Drones

Building design is a process often divorced from considerations about construction. Digital design methods are increasingly challenging the historic relationship between architecture and its means of production, but this extended reach is not necessarily accompanied by extended understanding or leverage of the production process. We present an urban sculptural project, The Travellers, in which digital techniques resolved critical issues of design, documentation and fabrication, but more importantly facilitated highly beneficial processes of negotiation. We suggest that this case based research has implications for future interactions between designers, makers and managers, shedding additional light onto issues of negotiation, responsibility, risk and trust that are often critical to the pragmatic undertaking of making