Collaborative working in health and social care: Lessons learned from post‐hoc preliminary findings of a young families’ pregnancy to age 2 project in South Wales, United Kingdom

Children of young and socially disadvantaged parents are more likely to experience adverse outcomes. In response to this, a unique young families’ project in Swansea, UK, was created, which drew together a team of multi-agency professionals, to support people aged 16–24 from 17 weeks of pregnancy throughout 1,001 days of the child's life. The aim of the JIGSO (the Welsh word for Jigsaw) project is for young people to reach their potential as parents and to break the cycle of health and social inequality. This evaluation analysed routinely collected data held by the project from January 2017 to December 2018 exploring health and social outcomes, including smoking and alcohol use in pregnancy, breastfeeding, maternal diet and social services outcomes. Outcomes were compared to local and national averages, where available. Data relating to parenting knowledge and skills were available via records of 10-point Likert scales, one collected at the start of the JIGSO involvement and one around 4–6 months later. Findings showed higher than average levels of breastfeeding initiation and lower smoking and alcohol use in pregnancy. Parents also reported enhanced knowledge and confidence in their child care skills, as well as improved family relationships. Parents with high levels of engagement with JIGSO also appeared to have positive outcomes with Social Services (their child's name was removed from child protection register or their case was closed to social services). This was a post-hoc evaluation, not an intervention study or trial, and thus findings must be interpreted with caution. Despite this, the findings are promising and more prospective research exploring similar services is required

Rethinking City-regionalism as the Production of New Non-State Spatial Strategies: The Case of Peel Holdings Atlantic Gateway Strategy

This article was published in the journal, Urban Studies [© Sage]. The publisher's website is at: http://usj.sagepub.com/content/early/2013/08/19/0042098013493481City-regions are widely recognised as key to economic and social revitalization. Hardly surprising then is how policy elites have sought to position their own city-regions strategically within international circuits of capital accumulation. Typically this geopolitics of city-regionalism has been seen to represent a new governmentalised remapping of state space conforming to the prevailing orthodoxy of neoliberal state spatial restructuring. Through a case study of the Atlantic Gateway Strategy, this paper provides a lens on to an alternative vision for city-region development. The brainchild of a private investment group, Peel Holdings, the Atlantic Gateway is important because it points toward the production of new non-state spatial strategies. Examining Peel’s motives for invoking the city-region concept, the paper goes on to explore the tensions which currently surround the strategy to further identify the potential and scope for non-state spatial strategies. Connecting this to emerging debates around the key role of asset ownership and the privatisation of local democracy and the democratic state, the paper concludes by suggesting the key question arising is can and will the state maintain its degree of governmental control over capital investment in major urban regions in an era where persistent under-provision of investment in urban economic infrastructure behoves institutions of the state to become ever more reliant on private investment groups to deliver the deliver the jobs, growth and regeneration of the future

Trends in, and factors associated with, HIV infection amongst tuberculosis patients in the era of anti-retroviral therapy: a retrospective study in England, Wales and Northern Ireland

Background: HIV increases the progression of latent tuberculosis (TB) infection to active disease and contributed to increased TB in the UK until 2004. We describe temporal trends in HIV infection amongst patients with TB and identify factors associated with HIV infection. / Methods: We used national surveillance data of all TB cases reported in England, Wales and Northern Ireland from 2000 to 2014 and determined HIV status through record linkage to national HIV surveillance. We used logistic regression to identify associations between HIV and demographic, clinical and social factors. / Results: There were 106,829 cases of TB in adults (≥ 15 years) reported from 2000 to 2014. The number and proportion of TB patients infected with HIV decreased from 543/6782 (8.0%) in 2004 to 205/6461 (3.2%) in 2014. The proportion of patients diagnosed with HIV > 91 days prior to their TB diagnosis increased from 33.5% in 2000 to 60.2% in 2013. HIV infection was highest in people of black African ethnicity from countries with high HIV prevalence (32.3%), patients who misused drugs (8.1%) and patients with miliary or meningeal TB (17.2%). / Conclusions: There has been an overall decrease in TB-HIV co-infection and a decline in the proportion of patients diagnosed simultaneously with both infections. However, high rates of HIV remain in some sub-populations of patients with TB, particularly black Africans born in countries with high HIV prevalence and people with a history of drug misuse. Whilst the current policy of testing all patients diagnosed with TB for HIV infection is important in ensuring appropriate management of TB patients, many of these TB cases would be preventable if HIV could be diagnosed before TB develops. Improving screening for both latent TB and HIV and ensuring early treatment of HIV in these populations could help prevent these TB cases. British HIV Association guidelines on latent TB testing for people with HIV from sub-Saharan Africa remain relevant, and latent TB screening for people with HIV with a history of drug misuse, homelessness or imprisonment should also be considered

The Polycentric State: New Spaces of Empowerment and Engagement?

New Labour claims to have radically reformed territorial governance structures in the UK by devolving political power to the Celtic nations and London, begetting the most enduring legacy of the first Blair government. More recently it has sought to extend its devolution agenda by embracing city-regionalism and the new localism, ostensibly to create new spaces of empowerment and engagement. But devolution is not the whole story of New Labour’s attitude to power. On the contrary, this article argues that New Labour is a modern Janus because its commitment to devolving power, so clear in principle, is more equivocal in practice. Drawing on these three devolution narratives, the article concludes by assessing the implications for the current debate about relational versus territorial readings of place politics

Towards a contemporary social care ‘prevention narrative’ of principled complexity: An integrative literature review

Prevention has become increasingly central in social care policy and commissioning strategies within the United Kingdom (UK). Commonly there is reliance on understandings borrowed from the sphere of public health, leaning on a prevention discourse characterised by the 'upstream and downstream' metaphor. Whilst framing both structural factors and responses to individual circumstances, the public health approach nonetheless suggests linearity in a cause and effect relationship. Social care and illness follow many trajectories and this conceptualisation of prevention may limit its effectiveness and scope in social care. Undertaken as part of a commissioned evaluation of the Social Services and Wellbeing Act (2014) Wales, a systematic integrative review was conducted to establish the key current debates within prevention work, and how prevention is conceptually framed, implemented and evaluated within the social care context. The databases Scopus, ASSIA, CINAHL and Social Care Online were initially searched in September 2019 resulting in 52 documents being incorporated for analysis. A further re-run of searches was run in March 2021, identifying a further 14 documents, thereby creating a total of 66. Predominantly, these were journal articles or research reports (n = 53), with the remainder guidance or strategy documents, briefings or process evaluations (n = 13). These were categorised by their primary theme and focus, as well as document format and research method before undergoing thematic analysis. This highlighted the continued prominence of three-tiered, linear public health narratives in the framing of prevention for social care, with prevention work often categorised and enacted with inconsistency. Common drivers for prevention activity continue to be cost reduction and reduced dependence on the care system in the future. Through exploring prevention for older people and caregivers, we argue for an approach to prevention aligning with the complexities of the social world surrounding it. Building on developments in complexity theory in social science and healthcare, we offer an alternative view of social care prevention guided by principles rooted in the everyday realities of communities, service users and caregivers

Local democracy in Wales The implications of a Welsh Assembly

English/Welsh text on inverted pagesAvailable from British Library Document Supply Centre-DSC:q97/12231 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Building prosperous communities A local government agenda for Wales; report of the Advisory Group on Agencies and Initiatives for Economic Development

English/Welsh text on inverted pagesAvailable from British Library Document Supply Centre-DSC:98/28520 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Working together for a healthy Wales The local government role

In English/Welsh text on inverted pagesAvailable from British Library Document Supply Centre-DSC:99/12320 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo