A qualitative study of satisfaction and dissatisfaction with Jobcentre Plus; an exploration of issues identified in the 2007 Customer Satisfaction Survey with a particular focus on those most likely to be dissatisfied

This report presents the findings of qualitative research undertaken with Jobcentre Plus staff and customers to further understand the findings of the 2007 Customer Satisfaction Survey. The research took place in all 11 regions/countries between September and December 2008 and involved interviews with staff from jobcentres and Benefit Delivery Centres, and follow-up telephone interviews and focus groups with customers. The report identifies differences in the drivers of satisfaction and dissatisfaction between different benefit groups. It also explores customer satisfaction with different services and contact channels, identifies what is seen as good customer service and puts forward some suggestions for how this may be improved

Jobcentre Plus Jobseeker's Allowance off-flow rates: Key Management Indicator Post-Implementation Review

N/

Researching Bradford: A review of social research on Bradford District

A synthesis of findings from social research on the District of Bradford. This report synthesises the findings from a wide range of social research undertaken on the District of Bradford, primarily between 1995 and 2005. The researchers reviewed almost 200 pieces of work. The key results are summarised under thematic headings: - The social, economic and institutional context - Community cohesion - Housing, neighbourhoods and regeneration - Business and enterprise - Health, disability and social care - Children and young people - Education, skills and the labour market - Crime and community safety It also identifies a future research agenda. The main purpose of the review was to provide the Joseph Rowntree Foundation and local organisations in Bradford with a firm basis upon which to build future work in the District

National Evaluation of the Capacity Building Programme in English Local Government: Evaluation of the National Programmes: Annex 2: Evaluation of the National Programmes

The report is one of a series of outputs from the national evaluation of the CBP, being undertaken by a team of researchers at the Policy Research Institute (PRI) at Leeds Metropolitan University and the Cities Research Unit at the University of West of England. The Capacity Building Programme for local government was launched in 2003 as a joint Department for Communities and Local Government (DCLG) / Local Government Association (LGA) initiative to support capacity building and improvement activities within local authorities in England. The evaluation of the Capacity Building Programme has been underway since late 2004. A scoping phase was conducted until May 2005, including a short evaluation of the Pilot Programmes. The main phase of the evaluation commenced in September 2005 and encompassed four main phases (see Section 1.3: p10)

Genomic identification of a novel co-trimoxazole resistance genotype and its prevalence amongst Streptococcus pneumoniae in Malawi

Objectives This study aimed to define the molecular basis of co-trimoxazole resistance in Malawian pneumococci under the dual selective pressure of widespread co-trimoxazole and sulfadoxine/pyrimethamine use. Methods We measured the trimethoprim and sulfamethoxazole MICs and analysed folA and folP nucleotide and translated amino acid sequences for 143 pneumococci isolated from carriage and invasive disease in Malawi (2002–08). Results Pneumococci were highly resistant to both trimethoprim and sulfamethoxazole (96%, 137/143). Sulfamethoxazole-resistant isolates showed a 3 or 6 bp insertion in the sulphonamide-binding site of folP. The trimethoprim-resistant isolates fell into three genotypic groups based on dihydrofolate reductase (encoded by folA) mutations: Ile-100-Leu (10%), the Ile-100-Leu substitution together with a residue 92 substitution (56%) and those with a novel uncharacterized resistance genotype (34%). The nucleotide sequence divergence and dN/dS of folA and folP remained stable from 2004 onwards. Conclusions S. pneumoniae exhibit almost universal co-trimoxazole resistance in vitro and in silico that we believe is driven by extensive co-trimoxazole and sulfadoxine/pyrimethamine use. More than one-third of pneumococci employ a novel mechanism of co-trimoxazole resistance. Resistance has now reached a point of stabilizing evolution. The use of co-trimoxazole to prevent pneumococcal infection in HIV/AIDS patients in sub-Saharan Africa should be re-evaluated

Practitioner Review: Assessment and treatment of body dysmorphic disorder in young people

Body dysmorphic disorder (BDD) is a relatively common and highly impairing mental disorder that is strikingly underdiagnosed and undertreated in Child and Adolescent Mental Health Services (CAMHS). The only clinical guidelines for the management of BDD in youth were published nearly 20 years ago, when empirical knowledge was sparse. Fortunately, there has been a surge in research into BDD over the last 10 years, shedding important insights into the phenomenology, epidemiology, assessment and treatment of the disorder in young people. This review aimed to provide an overview of recent research developments of relevance to clinicians and healthcare policymakers. We summarise key findings regarding the epidemiology of BDD in youth, which indicate that the disorder usually develops during teenage years and affects approximately 2% of adolescents at any one point in time. We provide an overview of aetiological research, highlighting that BDD arises from an interplay between genetic and environmental influences. We then focus on screening and assessment strategies, arguing that these are crucial to promote detection and diagnosis of this under-recognised condition. Additionally, we summarise the recommended treatment approaches for BDD in youth, namely cognitive behaviour therapy with or without selective serotonin reuptake inhibitors. The review concludes by highlighting key knowledge gaps and priorities for future research including, but not limited to, better understanding aetiological factors, long-term consequences and treatment

Empirically informed symptom severity cutoffs for body dysmorphic disorder

Background: Symptom severity cutoffs for body dysmorphic disorder (BDD) are lacking, hindering communication between professionals and with the patient community. / / Method: We pooled data from 11 clinical trials or high-quality cohort studies from specialist clinics, totaling 804 individuals with BDD (80% girls/women, 67% adults). All participants had baseline scores on the adult or adolescent versions of the Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS) and the Clinical Global Impressions–Severity scale (CGI-S). Receiver-operating characteristic analyses were used to identify BDD-YBOCS severity cutoffs, using the CGI-S as the benchmark measure. The classification performance of the cutoffs was evaluated in a holdout sample, consisting of 20% of randomly selected participants. / / Results: No participants had subclinical symptoms and the cutoff for clinical versus subclinical cases was not computed. A BDD-YBOCS score ≥24 distinguished moderate from mild cases (area under the curve [AUC] = 0.72 [0.64–0.81]; accuracy: 77%), a score ≥30 distinguished severe from moderate cases (AUC = 0.83 [0.90–0.87]; accuracy: 77%), and a score ≥37 distinguished extreme from severe cases (AUC = 0.82 [0.77–0.87]; accuracy: 80%). The classification performance of the cutoffs was modest in the holdout sample (62%), but consistent cutoffs were found across sexes/genders, age groups (children and adults), and participants from Europe and the United States. / / Conclusion: These BDD-YBOCS severity cutoffs can be used for clinical and research purposes across different populations but should not be used as the sole basis for important clinical decisions affecting individual patients. The boundary between subclinical and clinical BDD will require further study

AstraZeneca COVID-19 vaccine induces robust broadly cross-reactive antibody responses in Malawian adults previously infected with SARS-CoV-2

Background: Binding and neutralising anti-Spike antibodies play a key role in immune defence against SARS-CoV-2 infection. Since it is known that antibodies wane with time and new immune-evasive variants are emerging, we aimed to assess the dynamics of anti-Spike antibodies in an African adult population with prior SARS-CoV-2 infection and to determine the effect of subsequent COVID-19 vaccination. Methods: Using a prospective cohort design, we recruited adults with prior laboratory-confirmed mild/moderate COVID-19 in Blantyre, Malawi, and followed them up for 270 days (n = 52). A subset of whom subsequently received a single dose of the AstraZeneca COVID-19 vaccine (ChAdOx nCov-19) (n = 12). We measured the serum concentrations of anti-Spike and receptor-binding domain (RBD) IgG antibodies using a Luminex-based assay. Anti-RBD antibody cross-reactivity across SARS-CoV-2 variants of concern (VOC) was measured using a haemagglutination test. A pseudovirus neutralisation assay was used to measure neutralisation titres across VOCs. Ordinary or repeated measures one-way ANOVA was used to compare log10 transformed data, with p value adjusted for multiple comparison using Šídák's or Holm-Šídák's test. Results: We show that neutralising antibodies wane within 6 months post mild/moderate SARS-CoV-2 infection (30–60 days vs. 210–270 days; Log ID50 6.8 vs. 5.3, p = 0.0093). High levels of binding anti-Spike or anti-RBD antibodies in convalescent serum were associated with potent neutralisation activity against the homologous infecting strain (p < 0.0001). A single dose of the AstraZeneca COVID-19 vaccine following mild/moderate SARS-CoV-2 infection induced a 2 to 3-fold increase in anti-Spike and -RBD IgG levels 30 days post-vaccination (both, p < 0.0001). The anti-RBD IgG antibodies from these vaccinated individuals were broadly cross-reactive against multiple VOCs and had neutralisation potency against original D614G, beta, and delta variants. Conclusions: These findings show that the AstraZeneca COVID-19 vaccine is an effective booster for waning cross-variant antibody immunity after initial priming with SARS-CoV-2 infection. The potency of hybrid immunity and its potential to maximise the benefits of COVID-19 vaccines needs to be taken into consideration when formulating vaccination policies in sub-Saharan Africa, where there is still limited access to vaccine doses

Genomic identification of a novel co-trimoxazole resistance genotype and its prevalence amongst Streptococcus pneumoniae in Malawi.

OBJECTIVES: This study aimed to define the molecular basis of co-trimoxazole resistance in Malawian pneumococci under the dual selective pressure of widespread co-trimoxazole and sulfadoxine/pyrimethamine use. METHODS: We measured the trimethoprim and sulfamethoxazole MICs and analysed folA and folP nucleotide and translated amino acid sequences for 143 pneumococci isolated from carriage and invasive disease in Malawi (2002-08). RESULTS: Pneumococci were highly resistant to both trimethoprim and sulfamethoxazole (96%, 137/143). Sulfamethoxazole-resistant isolates showed a 3 or 6 bp insertion in the sulphonamide-binding site of folP. The trimethoprim-resistant isolates fell into three genotypic groups based on dihydrofolate reductase (encoded by folA) mutations: Ile-100-Leu (10%), the Ile-100-Leu substitution together with a residue 92 substitution (56%) and those with a novel uncharacterized resistance genotype (34%). The nucleotide sequence divergence and dN/dS of folA and folP remained stable from 2004 onwards. CONCLUSIONS: S. pneumoniae exhibit almost universal co-trimoxazole resistance in vitro and in silico that we believe is driven by extensive co-trimoxazole and sulfadoxine/pyrimethamine use. More than one-third of pneumococci employ a novel mechanism of co-trimoxazole resistance. Resistance has now reached a point of stabilizing evolution. The use of co-trimoxazole to prevent pneumococcal infection in HIV/AIDS patients in sub-Saharan Africa should be re-evaluated