The assessment, meaning and amelioration of everyday memory difficulties in people with epilepsy

The project was inspired by a frequent, if rather paradoxical, clinical observation. While patients with epilepsy frequently reported disruptive memory difficulties, neuropsychological testing often failed to confirm the serious nature of the patients' complaints. It had previously been assumed that patients were overstating their difficulties. However, the same anomalous pattern has been noted elsewhere, notably in elderly and head-injured samples. This investigation was therefore undertaken to assess further the nature and degree of everyday memory difficulties in people with epilepsy. The first study assessed subjects' beliefs about the incidence of memory failures using self-report techniques. Seven hundred and sixty patients with epilepsy and one hundred and forty-six subjects without epilepsy participated in the study. The level of patients' complaints was explored with respect to epilepsy, treatment and psychological factors. Findings demonstrated significantly more perceived memory failures in the subjects with epilepsy. Factors which were related to this increased vulnerability to failures included later onset of the condition, elevated levels of negative moods and, to a lesser extent, perhaps a less efficient use of preventative memory strategies. In study two the relationship between subjects' beliefs and the prospective recording of memory failures was examined. Results indicated that subjects with epilepsy are underestimating the level of memory failures on the retrospective questionnaire. Study three examined the relationship between memory complaints and actual test performance in a subsample of patients with epilepsy, thirty of whom were classified as complainers and thirty non-complainers. Relationships between performance measures and beliefs were weak. Only 'two memory tests were predictive of self-report indices. Contrary to expectation, tests of planning and organisation were not found to be sensitive to prospective memory performance. Finally, two small scale interventions aimed at ameliorating memory difficulties in this population were conducted. Results were promising though variable with motivational factors contributing greatly

Victims’ Voices:Understanding the Emotional Impact of Cyberstalking and Individuals’ Coping Responses

Recent quantitative research has identified similar detrimental effects on victims of cyberstalking as those that arise from traditional stalking. The current study thematically analyzed one hundred victim narratives gathered by means of an online survey with a view to assessing the mental health and well-being implications of the experience of cyberstalking. Coping strategies employed by victims and the perceived effectiveness of each strategy were also explored. The findings suggest that the emotional impact of cyberstalking predominantly includes comorbid anxiety and depression. Common coping strategies adopted by victims in our sample include avoidant coping, ignoring the perpetrator, confrontational coping, support seeking, and cognitive reframing. Taken together, the findings demonstrate that the ramifications of cyberstalking are widespread, affecting psychological, social, interpersonal, and economic aspects of life. To adapt, some victims made major changes to both their work and social life, with some ceasing employment and others modifying their usual daily activities. The widespread negative effects of cyberstalking identified in this study highlight that this phenomenon should be a concern to both legal and mental health professionals, particularly as the comments made by our sample illustrate the current inadequacy of response and provision. Recommendations are discussed and provided for law enforcement and mental health professionals

Beyond the sentence: Shared reading within a high secure hospital.

Ashworth Hospital provides care for inpatients detained under the Mental Health Acts who present a danger to themselves or others. Rehabilitative interventions can help support the best outcomes for patients, their families, care providers, and society. The efficacy of weekly Shared Reading sessions for four patients with experience of psychosis and a history of self-harm was investigated using a 12-month longitudinal case series design. Session data were subjected to psychological discourse analysis to identify discursive strategies employed to accomplish social action and change over the duration of the intervention. Archetypes of interactional achievement across sessions emerged. Broadening of capacity to consider was demonstrated through increased hedging and less declarative language. Increased assertiveness was achieved through reduced generalisation marked by a transition from second-person plural pronouns to more first-person singular pronouns. Avoidance of expression and disagreement strategies diminished over time. In addition, heightened engagement was accomplished through the increased tendency to employ functionally related and preferred responses within adjacency pairs, which mirrored non-verbal communicative strategies. Shared Reading shows promise for promoting the interactional accomplishment for individuals within high secure settings, who are ready to undertake a recovery-related activity. Pathways of interaction should continue to be explored, with consideration to the current study's strengths and limitations. This study contributes to the understanding of efficacious reading study design and the interactional outcomes of therapeutic reading

"Traditionally you would be passing them from pillar to post": an evaluation exploring the Life Rooms model of partnership working

Abstract Background NHS systems are under increasing, unsustainable pressure. In the context of rising demand, limited resources and changing population needs, partnership working across sectors is crucial. The Liverpool City Region has a richness of voluntary organisations and community based assets that the Life Rooms innovation draws upon to widen the base of health and wellbeing support. The Life Rooms therefore aims to facilitate the collaboration of NHS systems with arts, voluntary and community organisations in the local health economy. This evaluation explores the Life Rooms model of partnership working spread over in excess of one hundred partnerships with voluntary, community, and corporate sector organisations. Methods The evaluation drew on thematic analysis of semi-structured interviews with Life Rooms staff members (n = 10), partner organisations (n = 16), and users of the Life Rooms (n = 7). Results Five overarching themes were identified: Quality of partnerships; Benefits of partnership working; Facilitators; Challenges within the Life Rooms model; and Making things even better. Conclusions One of the significant successes of the Life Rooms partnership working model is the way in which the service collaborates with a wide range of organisations with the aim of providing more effective and holistic support. The success of this approach illustrates how, led by NHS Trust innovation, multiple bodies can play a role in supporting health care by bringing unique skills, expertise and programmes together to ensure multiple options to support the multiple different aspects of people’s health. These insights may be useful to other NHS organisations that may be considering a similar integration agenda

Is toothbrushing behaviour habitual? Cues, context, motivators and patient narratives.

ObjectivesToothbrushing is generally considered as a key self-care behaviour necessary for maintaining good oral health. Although twice-daily brushing is widely recommended as beneficial since this provides both biofilm removal and a regular application of fluoride, some people such as those with low socio-economic (SES) backgrounds often brush less regularly. Habit theory identifies that behaviours become habitual when they are undertaken repeatedly in response to a particular cue within a stable context. Once behaviour becomes automatic, long-term maintenance is more likely even if motivation wanes. Establishing toothbrushing as a habitual behaviour is therefore an intervention strategy which may help reduce health inequalities. Therefore, the objective was to more fully understand the nature of toothbrushing behaviour in adults and what prompts its instigation and execution in the morning and evening, in order to inform the design of interventions in this area.MethodsTwenty-nine semi-structured interviews were undertaken in an urgent dental care centre in a deprived area of North West England. Thematic analysis using a framework method was used to code the data into theoretically derived categories.ResultsMorning toothbrushing was found to be strongly integrated into cleansing routines and was identified as a behaviour predominantly initiated in response to visual cues. Some toothbrushing behaviour was prompted by internal cues, expressed as strong feelings or urges. These were more related to night-time toothbrushing habits. Common morning motivators were aesthetics and social acceptability. Evening motivators were relatively idiosyncratic. Cleaning of the mouth following a hard, manual working day emerged as a strong driver for low SES males.ConclusionUnderstanding the nature of habitual morning and evening toothbrushing is important for the design of effective behavioural interventions, especially those aiming to achieve sustainable improvement in the frequency of night-time toothbrushing