The nature and strength of the relationship between expenditure on alcohol and food: an analysis of adult-only households in the UK

Introduction and Aims. Unhealthy lifestyle behaviours can cluster to produce more detrimental overall health consequences than expected with a simple additive effect. This study aims to expand current knowledge of the nature and strength of the relationship between two such health behaviours, alcohol and diet, through analysis of household expenditure on food and drink from a nationally representative UK sample. Design and Methods. Data from the Expenditure and Food Survey for 2005–2006 was used to analyse expenditure on alcohol and diet for 3146 UK households. The classification of a food as healthy or unhealthy was determined using dietary advice provided by the Food Standards Agency. Alcohol expenditure was disaggregated into spending in pubs, bars, clubs and restaurants (on-trade expenditure) and spending in off-licenses and supermarkets (off-trade expenditure). Analyses were stratified according to household disposable income quintile and household beverage preference. Results. As household expenditure on alcohol increases, spending on both healthy and unhealthy food decreases. Higher income households spend proportionately more on on-trade alcohol and healthy food than lower income households, and less on unhealthy food. Off-trade alcohol expenditure does not differ significantly according to household income. Households that prefer to purchase wine have healthier expenditure patterns than those that prefer to buy beer or spirits, even after controlling for income. Discussion and Conclusions. Low-income households and those that purchase more beer or spirits than wine could be targeted for health promotion interventions to reduce their risk of negative health outcomes from the clustering of alcohol consumption and unhealthy diet

Learning from refugees and asylum seekers: experiences of distressing suspicious thoughts and accessing mental health support

This portfolio has three parts: a systematic literature review, an empirical paper and appendices. This thesis aims to explore the experiences of psychological distress and accessing support for refugees and asylum seekers, from the perspectives of service users and staff who work with them.Part one: Systematic Literature ReviewPart one contains a systematic literature review, exploring the experiences of refugees and asylum seekers who access therapy, from the perspectives of service users and staff. A systematic review of five databases was conducted and ten papers were selected that met the inclusion criteria. Thematic analysis identified fifteen analytical themes, divided into supportive, hindering and neutral factors. Conclusions and clinical implications are discussed.Part two: Empirical PaperPart two contains a qualitative empirical study, exploring the experiences of staff working with refugees experiencing distressing suspicious thoughts. Seven staff members working with refugees experiencing distressing suspicious thoughts were interviewed using semi-structured interviews. These were analysed using interpretative phenomenological analysis, and three superordinate themes were developed: working in broken systems; the social self, and self-identity and its transformation. These each contained three-four subthemes. Overall, this research highlights the critical role staff play in the systems of refugees experiencing distressing suspicious thoughts. The role of cultural, societal and community influences on this therapeutic relationship are considered

What role does communication technology have in redefining loneliness in ageing?

This thesis is a step forward in understanding how older people experience loneliness and whether they consider communication technology as means to alleviate it. By using a mixed methods approach to triangulate the three concepts of loneliness, communication technology and successful ageing, the study casts critical doubt on the current thinking that communication technology can alleviate loneliness in an older population. The findings have important considerations for those involved in projects and policies in this area and creates a valuable insight into the experiences of loneliness and how it affects successful ageing through individual experiences that avoid normative measures