Prostitution policy, morality and the precautionary principle

Purpose: This paper explores the contemporary regulation of sex work in England and Wales, placing this in the context of debates concerning morality, evidence and the efficacy of policy. Design/methodology/approach: This brief paper is based on reflections on the authors’ research and contribution to policy debates over the last two decades. Findings: This paper presents prostitution policy as morality policy and suggests that this discounts evidence in favour of a precautionary approach based on the idea that prostitution is sinful and hence must be inherently harmful. Practical implications: The paper makes a strong case for evidence-based policy in an area where morality tends to promote a more partial and selective reading of evidence. Social implications: It is argued that the dominance of a particular policy approach to sex work perpetuates stigma for those in the sex industries and exacerbates risks of harm. Originality/value: The drift towards the criminalization of sex work in England and Wales mirrors that in many other nations, but this is not informed by academic evidence. This paper argues for a more balanced assessment of evidence and the consideration of data rather than a privileging of particular moral standpoints

The development and use of the Assessment of Dementia Awareness and Person-centred Care Training (ADAPT) tool in long-term care

Policy and practice guidelines recommend person-centred care (PCC) to support people to live well with dementia in long-term care (LTC). Therefore, staff working in LTC settings need to be trained in dementia awareness and PCC. However, the access to, content of and reach of training across LTC settings can be varied. Data on current and ongoing access to PCC training can form and important component of data gathered on usual care (UC) in research studies, in particular clinical trials within LTC. However, no suitable assessment tools are available to measure dementia awareness and PCC training availability, content and reach. This paper describes the development of a training audit tool to meet this need for a UC measure of dementia awareness and PCC training. The ‘Assessment of Dementia Awareness and Person-centred care Training’ (ADAPT) tool was based on a review of published PCC literature and consultation with dementia and aged care experts. The ADAPT tool was piloted in 13 LTC facilities the UK and Australia, before being used to assess the content of dementia and PCC awareness training in 50 UK settings in a randomized controlled trial (RCT) as part of a UC recording. Following pilot testing, modifications to the ADAPT tool’s wording were made to enhance item clarity. When implemented in the RCT, pre-baseline training assessment data showed that the ADAPT tool was able to differentiate between LTC and identify settings where further dementia awareness training was required. ADAPT was then used as a method of recording data on dementia awareness and PCC training as part of UC data collection. The ADAPT tool is suitable for use by researchers to establish the availability, content and reach of dementia and PCC awareness training to staff within research studies

Introducing the Care Certificate evaluation (innovative practice)

Although investment in staff development is a prerequisite for high quality and innovative care, the training needs of unregistered care staff have often been neglected, particularly within dementia care provision. The Care Certificate, which was fully launched in in England in April 2015, has aimed to redress this neglect by providing a consistent and transferable approach to the training of the front line health and social care workforce. In order to optimise its impact, the implementation of the Care Certificate is now being evaluated through an 18 month study funded by the Department of Health Policy Research Programme. It is the purpose of this article to outline this evaluation

Minority women, activism and austerity

Based on their study of minority women’s activism in the context of the economic crisis in Scotland, England and France, the authors question how well third sector organisations, policy-makers and social movements have responded to minority women’s perspectives and needs arising from austerity and racism. Apart from being disproportionately affected by the cuts, minority women are also undermined by dominant discourses which can (mis)represent them as either ‘victims’ or ‘enterprising actors’. There appears, from the excerpted interviews, to be a disconnect between minority women’s experiences and analyses of their precarity, their desire to take radical action and the compliant and domesticating projects and programmes that are currently being offered by some of their third sector ‘allies’

Socially engaged photography and wellbeing: reflections on a case study in the northwest of England

This paper describes a 9-month project commissioned by Halton Clinical Commissioning Group (CCG) and Liverpool photography organisation, Open Eye Gallery. Socially engaged photographers worked with local residents from the Windmill Hill estate in Runcorn to describe healthy and unhealthy aspects of the area. Six women were trained to use cameras to document everyday things that mattered to them. Through focus groups they discussed what these photographs revealed about the health and ill-health of the area. The resulting exhibition, As and When, told their story. Despite being a deprived area with more than average incidence of illness, they identified many positive things that enhanced their sense of wellbeing and resilience. The benefits of the project included increased social engagement and participation, an improved sense of vitality and rejuvenation, emotional benefits, a feeling of greater political agency and increased visual literacy. This paper outlines the model of practice developed with the support of CCG and in collaboration with local stakeholders. It makes a case for the value and the ways in which clusters of general practices could develop links and work with health assets in their local communities

'Unlocking the door to being there'. The contribution of creative facilitators in supporting people living with dementia to engage with heritage settings

This article reports findings from the evaluation of ‘Sensory Palaces’, an innovative project developed by the charity Historic Royal Palaces (HRP), which looks after six of the United Kingdom’s unoccupied royal palaces. The Sensory Palaces (SP) project employs creative facilitators to support people living with dementia and their care partners in engaging with two of these sites; Hampton Court Palace, and Kew Palace. This paper focusses on the role and contribution of the creative facilitators in supporting people living with dementia to connect with these heritage spaces. It reports on data collected from facilitator interviews relating to the benefits of engaging together through sensory and creative methods to explore and share experiences of the palaces, drawing out important factors from the design, content and delivery of the sessions

Depression in people with skin conditions: The effects of disgust and self‐compassion

Objectives Skin conditions can be accompanied by significant levels of depression; there is therefore a need to identify the associated psychological factors to assist with the development of appropriate interventions. This study sought to examine the effects of disgust propensity, disgust sensitivity, self‐focused/ruminative disgust, and self‐compassion on depression in people with skin conditions. Design A cross‐sectional survey with follow‐up survey. Methods Dermatology outpatients (N = 147) completed self‐report measures of disgust traits, self‐compassion, and depression. At three‐month follow‐up, participants (N = 80) completed the depression measure again. Results Multiple regression analyses revealed that disgust propensity, disgust sensitivity, self‐focused/ruminative disgust, and self‐compassion each explained significant amounts of variance in baseline depression. Self‐compassion also explained a significant amount of variance in depression at follow‐up, after accounting for baseline depression. In addition, self‐compassion moderated the effect of disgust propensity on depression at baseline, such that at high levels of self‐compassion, disgust propensity no longer had a positive relationship with depression. Conclusions Disgust traits contribute to depression in people with skin conditions, while being self‐compassionate may be protective against depression. High self‐compassion also buffers the effects of disgust propensity on depression in people with skin conditions. The findings indicate the potential of compassion‐focused interventions for depression in people with skin conditions

Promoting Early Presentation intervention sustains increased breast cancer awareness in older women for three years: A randomized controlled trial

Objective In a randomized controlled trial, the Promoting Early Presentation intervention increased older women’s breast cancer awareness after two years. We investigated whether this increase was sustained at three years, and the effect on breast screening self-referral. Methods We randomly allocated 867 women attending their final invited breast screening appointment to the Promoting Early Presentation intervention or usual care. We examined breast cancer awareness after three years and breast screening self-referrals after four years. Results Women in the Promoting Early Presentation intervention arm had higher breast cancer awareness at three years than the usual care arm (odds ratio: 10.4; 95% confidence interval: 3.1 to 34.8). There were no differences in proportions self-referring for breast screening between arms, but statistical power was limited. Conclusion The Promoting Early Presentation intervention has a sustained effect on breast cancer awareness in older women. The effect on self-referral for breast screening is unclear