How can we develop an increased awareness of equality & diversity issues amongst our staff

This paper charts a service development initiative, which consisted of a valuing diversity pathway including awareness training days for NHS staff in one Mental Health and Learning Disability Trust. The purpose of the training days was to give staff and service users the opportunity to explore each other’s perspectives, beliefs, values, knowledge and behaviours to better prepare them to tackle inequalities and improve access to services. The main aim of a valuing diversity awareness pathway as stated in this paper is to give staff and service users the opportunity to ensure that staff working in all care services are better prepared to tackle inequalities and to improve access to services for vulnerable groups of people such as those with a learning disability and others with mental health issues requiring treatment. It is recognised that to meet diverse needs both staff and service users need to recognise the value of their differences. The South West Yorkshire Partnership NHS Foundation Trust (SWYPFT) and the University of Huddersfield worked together to produce the pathway. Both of these organisations are committed to valuing diversity and they have a strong history of partnership working. The following paper provides background information, an overview of the innovative approach taken to develop the pathway and a more detailed account of the design, delivery and evaluation of the training days

Effectiveness and economic evaluation of self-help educational materials for the prevention of smoking relapse: randomised controlled trial.

BACKGROUND: Most people who quit smoking successfully for a short period will return to smoking again in 12 months. A previous exploratory meta-analysis indicated that self-help booklets may be effective for smoking relapse prevention in unaided quitters. OBJECTIVES: This study aimed to evaluate the effectiveness of a set of self-help educational booklets to prevent smoking relapse in people who had stopped smoking with the aid of behavioural support. DESIGN: This is an open, randomised controlled trial and qualitative process evaluation. Trial participants were randomly allocated to one of two groups, using a simple randomisation process without attempts to stratify by participant characteristics. The participant allocation was 'concealed' because the recruitment of quitters occurred before the random allocation. SETTING: Short-term quitters were recruited from NHS Stop Smoking Clinics, and self-help educational materials were posted to study participants at home. PARTICIPANTS: A total of 1407 carbon monoxide (CO)-validated quitters at 4 weeks after quit date in NHS Stop Smoking Clinics. The trial excluded pregnant women and quitters who were not able to read the educational materials in English. INTERVENTIONS: Participants in the experimental group (n = 703) received a set of eight revised Forever Free booklets, and participants in the control group (n = 704) received a single leaflet that is currently given to NHS patients. MAIN OUTCOME MEASURES: Follow-up telephone interviews were conducted 3 and 12 months after quit date. The primary outcome was prolonged, CO-verified abstinence from months 4 to 12 during which time no more than five cigarettes were smoked. The secondary outcomes included self-reported abstinence during the previous 7 days at 3 and 12 months, CO-verified abstinence at 12 months, costs (NHS and NHS and participant medication costs perspectives) and quality-adjusted life-years. Logistic regression analyses were conducted to investigate effect-modifying variables. A simultaneous qualitative process evaluation was conducted to help interpret the trial results. RESULTS: Data from 1404 participants were used for the final analysis, after excluding three participants who died before the 12-month follow-up. The proportion with prolonged abstinence from months 4 to 12 after quit date was 36.9% in the intervention group and 38.6% in the control group. There was no statistically significant difference between the groups (odds ratio 0.93, 95% confidence interval 0.75 to 1.15; p = 0.509). There were no statistically significant differences between the groups in secondary smoking outcomes. People who reported knowing risky situations for relapse and using strategies to handle urges to smoke were less likely to relapse. However, there were no differences between the groups in the proportion of participants who reported that they knew any more about coping skills, and no differences in reported use of strategies to cope with urges to smoke between the trial groups. The qualitative study found that some quitters considered self-help booklets unhelpful for smoking relapse prevention, although positive feedback by participants was common. CONCLUSIONS: Among quitters who had stopped smoking with the aid of intensive behavioural support, there was no significant difference in the likelihood of smoking relapse between those who subsequently received a set of eight revised Forever Free booklets and those who received a single leaflet. Although many people had suboptimal strategies to prevent relapse and most relapsed, the Forever Free booklets proved an ineffective medium for teaching them the skills to prevent relapse. Further research should focus on interventions that may increase the use of coping skills when required. TRIAL REGISTRATION: Current Controlled Trials ISRCTN36980856

Lynch syndrome screening in colorectal cancer: results of a prospective 2-year regional programme validating the NICE diagnostics guidance pathway throughout a 5.2-million population

Aims Screening all patients newly diagnosed with colorectal cancer (CRC) for possible Lynch syndrome (LS) has been recommended in the United Kingdom since the National Institute for Health and Care Excellence (NICE) released new diagnostics guidance in February 2017. We sought to validate the NICE screening pathway through a prospective regional programme throughout a 5.2-million population during a 2-year period. Methods and results Pathology departments at 14 hospital trusts in the Yorkshire and Humber region of the United Kingdom were invited to refer material from patients with newly diagnosed CRC aged 50 years or over between 1 April 2017 and 31 March 2019 for LS screening. Testing consisted of immunohistochemistry for MLH1, PMS2, MSH2 and MSH6 followed by BRAF mutation analysis ± MLH1 promoter methylation testing in cases showing MLH1 loss. A total of 3141 individual specimens were submitted for testing from 12 departments consisting of 3061 unique tumours and 2791 prospectively acquired patients with CRC. Defective mismatch repair (dMMR) was observed in 15% of cases. In cases showing MLH1 loss, 76% contained a detectable BRAF mutation and, of the remainder, 77% showed MLH1 promoter hypermethylation. Of the patients included in the final analysis, 81 (2.9%) had an indication for germline testing. Conclusion LS screening using the NICE diagnostics guidance pathway is deliverable at scale identifying significant numbers of patients with dMMR. This information is used to refer patients to regional clinical genetics services in addition to informing treatment pathways including the use of adjuvant/neoadjuvant chemotherapy and immunotherapy

Chief Constable's annual report 2002-2003

SIGLEAvailable from British Library Document Supply Centre- DSC:3172. 74402(2002/2003) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Violence and vandalism at football matches and public gatherings in West Yorkshire Involvement of police manpower; a report by a Special Sub-Committee of the West Yorkshire Metropolitan Police Authority

SIGLEAvailable from British Library Lending Division - LD:OP-LG/1986 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Bradford city ring road stage II An assessment of the built environment affected by the road scheme within the area of the Little Horton Lane Conservation Area

Environmental statement for public inquiryAvailable from British Library Document Supply Centre- DSC:OP/LG-5896 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo