Contribution of the voluntary sector to mental health crisis care in England: protocol for a multimethod study.

Introduction - Timely access to the right kind of support for people experiencing a mental health crisis can be problematic. The voluntary sector (VS) plays a key role in providing support and enabling access, but there is a knowledge gap concerning its contribution and interface with public services in mental health crisis care. Methods and analysis - This study aims to address this. The study has three empirical elements: (1) a national survey of voluntary sector organisations (VSOs) in England and national stakeholder interviews to develop a typology of organisations and interventions provided by VSOs; (2) detailed mapping of VS services in two regions through interviews and extending the national survey; (3) four case studies, identified from the regional mapping, of VS mental health crisis services and their interface with National Health Service (NHS) and local authority services, at both a system and individual level. Data collection will involve interviews with commissioners; VSO and NHS or local authority providers; and focus groups with people who have experience of VSO crisis support, both service users and carers; and mapping the crisis trajectory of 10 service users in each study site through narrative interviews with service users and informal carers to understand the experience of VSO crisis care and its impact. Ethics and dissemination - The University of Birmingham Humanities and Social Sciences Ethical Review Committee granted ethical approval (reference ERN_16-1183) for the national and regional elements of the study. Ethical review by the Health Research Authority will be required for the case study research once the sites have been identified from the first two elements of the study. A range of methods including a policy seminar, publication in academic journals and a tool kit for commissioners and practitioners will be produced to maximise the impact of the findings on policy and practice

Retrieval cues fail to influence contextualized evaluations.

Initial evaluations generalise to new contexts, whereas counter-attitudinal evaluations are context-specific. Counter-attitudinal information may not change evaluations in new contexts because perceivers fail to retrieve counter-attitudinal cue-evaluation associations from memory outside the counter-attitudinal learning context. The current work examines whether an additional, counter-attitudinal retrieval cue can enhance the generalizability of counter-attitudinal evaluations. In four experiments, participants learned positive information about a target person, Bob, in one context, and then learned negative information about Bob in a different context. While learning the negative information, participants wore a wristband as a retrieval cue for counter-attitudinal Bob-negative associations. Participants then made speeded as well as deliberate evaluations of Bob while wearing or not wearing the wristband. Internal meta-analysis failed to find a reliable effect of the counter-attitudinal retrieval cue on speeded or deliberate evaluations, whereas the context cues influenced speeded and deliberate evaluations. Counter to predictions, counter-attitudinal retrieval cues did not disrupt the generalisation of first-learned evaluations or the context-specificity of second-learned evaluations (Experiments 2-4), but the counter-attitudinal retrieval cue did influence evaluations in the absence of context cues (Experiment 1). The current work provides initial evidence that additional counter-attitudinal retrieval cues fail to disrupt the renewal and generalizability of first-learned evaluations

Proceedings of the 24th annual Central Plains irrigation conference

Presented at Proceedings of the 24th annual Central Plains irrigation conference held on February 21-22 in Colby, Kansas.Includes bibliographical references

Work-integrated learning gone full circle: How prior work placement experiences influenced workplace supervisors

This article reports of a study of workplace supervision and student experiences and outcomes through insights from semi-structured interviews with 21 graduates who had previously supervised work placement students. The study focused on questions framed from the perspective of the interviewees’ work placement experiences as a student and then as a supervisor (e.g., impact, motivation, insights for future students/supervisors, and graduate attributes). The findings from this study indicate importance of workplace supervisors setting expectations and engaging in initial planning and organizing for effective management of the work placement. Findings also suggest that the supervising can usefully take the form of mentoring, and that this provides the supervisor with professional development in self-management, effective communication and leadership. Implications for future WIL practice include utilizing workplace supervisors, particularly those who are themselves WIL graduates, to help further enhance student WIL experiences, learning outcomes, and legacie

Service Evaluation of the Encompass Community Hub Operating Centres (CHOCS), Report: June 2018

This report details the findings of a service evaluation of the Vanguard Encompass MCP (MultiSpecialty Community Provider) in East Kent. Encompass was awarded Vanguard status in 2015, through the first wave of Vanguards prompted by NHS England’s ‘Five Year Forward View’ strategy. The evaluation was conducted from March 2017 to April 2018 by the Centre for Health Service Studies in partnership with Encompass, who provided and analysed the metric data. The operational model developed and implemented by Encompass is Community Hub Operating Centres (CHOCs). CHOCs are holistic community based models of integrated service delivery aiming to improve user experience of co-ordinated care and self-management at home; contribute to a reduction in A&E demand and onward admission in the short term; and reduce pressure on acute services and long term care home placements in the longer term. Five CHOCs were initiated after an initial pilot period in 2016, which consist of clusters of GP practices serving a total practice population of 180,784 patients. The evaluation focused on the CHOCs, and the evaluation questions were informed by the NHSE local evaluation document (NHS 2015): ? What impact are the CHOCs having on user outcomes and experience? ? What are the components of the care model delivery (or ‘active/successful ingredients’) that are really making a difference? ? What are the influencing contextual factors and how have they affected implementation and outcomes? ? What changes to the use of resources and activity in the local health system have taken place and to what costs? ? What could be improved, replicated and sustained

Enhancing motivation within a rapid opioid substitution treatment feasibility RCT: a nested qualitative study

BACKGROUND: Opioid substitution treatment (OST) has multiple benefits for heroin injectors and is an evidence-based major component of international treatment. The current qualitative study sought to explore participants’ attitudes to and reasons for participating in a feasibility randomised trial in primary care offering ‘same day’ OST (methadone) for injecting heroin users compared to usual care. METHODS: Twenty injecting heroin users (8 intervention and 12 controls; 16 males and 4 females) were interviewed; purposive sampling was used to select a maximum variation sample from those who agreed; and analysis used thematic methods. RESULTS: Motivation to join the trial included the need to secure treatment set against some ambivalence due to previous negative experiences of trying to obtain OST. Positive effects of securing methadone via the trial, included self-reported improvements in health and self-care; reduction in crime, stress and drug use. Completing the baseline questionnaires at recruitment appeared to enhance motivation for treatment for all participants. For some control participants, this motivation seemed to increase a sense of self-efficacy and cognitive dissonance generated was resolved by seeking treatment from their GP. Self-determination theory suggests that behaviour change may have been initiated during the recruitment appointment, resulting in an increased determination to seek treatment amongst control participants. CONCLUSIONS: Taking part in the ‘script in a day’ trial enabled participants in the intervention arm to gain same-day access to methadone and reduce their drug use. For those in the control arm, completing the baseline questionnaires at recruitment appeared to create cognitive dissonance between their current health state and own aspirations, so increasing motivation for treatment. Over 50% obtained and were still in receipt of OST (methadone or buprenorphine) at the 3 month follow-up. We suggest that a regular ‘health evaluation’ for injecting heroin users not in treatment, paired with low-barrier access to treatment, may be a way of exploring this and encouraging more into obtaining OST more quickly and at the best time for them. This intervention should be delivered without pressure for change. CLINICAL TRIAL REGISTRATION: This trial is registered with International Standard Randomised Controlled Trial Number Register: SCript In a Day for injecting drug users: feasibility trial: ISRCTN16846554

Cold chains in Hanoi and Bangkok:changing systems of provision and practice

We know that patterns of domestic consumption are situated within broader systems of provision and that home appliances like the fridge freezer bridge between practices of cooking, shopping and eating, on the one hand, and increasingly global systems of food production, distribution and diet on the other. In analysing uses of fridge freezers in Hanoi and Bangkok as expressions, in microcosm, of complex and evolving processes of urbanisation and food provisioning this paper provides new insight into how specific configurations, dependencies and patterns of consumption take hold and how they vary and change. Our analysis of systems and practices in flux has the dual function of showing how household strategies reflect and contribute to more extensive transformations, and of demonstrating how these are shaped by ongoing tensions and relations between new and established forms of urban food supply and associated concepts of freshness and safety. The result is a subtle account of the multiple routes through which consumer ‘needs’ evolve