Household level health and socio-economic vulnerabilities and the COVID-19 crisis : an analysis from the UK

Objectives. To investigate how COVID-19-related health and socio-economic vulnerabilities occur at the household level, and how they are distributed across household types and geographical areas in the United Kingdom. Design. Cross-sectional, nationally representative study. Setting. The United Kingdom. Participants. ~19,500 households. Main outcome measures. Using multiple household-level indicators and principal components analysis, we derive summary measures representing different dimensions of household vulnerabilities critical during the COVID-19 epidemic: health, employment, housing, financial and digital. Results. Our analysis highlights three key findings. First, although COVID-19 health risks are concentrated in retirement-age households, a substantial proportion of working age households also face these risks. Second, different types of households exhibit different vulnerabilities, with working-age households more likely to face financial, housing and employment precarities, and retirement-age households health and digital vulnerabilities. Third, there are area-level differences in the distribution of vulnerabilities across England and the constituent countries of the United Kingdom. Conclusions. The findings imply that the short- and long-term consequences of the COVID-19 crisis are likely to vary by household type. Policy measures that aim to mitigate the health and socio-economic consequences of the COVID-19 pandemic should consider how vulnerabilities cluster together across different household types, and how these may exacerbate already existing inequalities.Publisher PD

Diverse early-life family trajectories and young children's mental health in the UK

Authors gratefully acknowledge funding from the Economic and Social Research Council (ESRC); grant number 2460061.Past research suggests that children from two-parent married families fare better than children from other families on many outcomes. Only fragmented evidence on diverse family trajectories in association with child mental health is available. Using multi-channel sequence analysis and data from the UK Household Longitudinal Study, we jointly capture maternal partnership trajectories and type of father co-residence between birth and age 5. We then assess the association between these family trajectories and child mental health at age 5 and 8 using random effects regression. Children whose trajectories include the entrance of a non-biological father or parental separation have the lowest levels of mental health. However, children of never partnered mothers and those who repartner with the biological father have comparable mental health to children of stably married biological parents. Thus, not all types of family complexity or instability appear to be equally detrimental to children’s mental health.Peer reviewe

Evaluating Home Health Care Nursing Outcomes With OASIS and NOC

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73163/1/j.1547-5069.2007.00209.x.pd

Discussion Paper for Regional Consultations on the Implementation of the United Nations Environment Assembly Resolution on Mineral Resource Governance (UNEP/EA.4/Res. 19)

This discussion paper is prepared to support regional consultations held on the implementation of the United Nations Environment Assembly\ua0resolution on Mineral Resource Governance.\ua0The discussion paper summarises global trends in minerals\ua0and sustainable development and presents key findings from recent studies of mineral governance\ua0developed by UNEP and others. Options for the governance of minerals and lessons from best practices are also discussed. Questions are posed for consideration during consultations and future action on the topic. Findings from the regional consultations will feed into the report on the implementation of the resolution, which will be presented to the UNEA at its fifth session in February 2021

Implementing e-learning and e-tools for care home staff supporting residents with dementia and challenging behaviour: A process evaluation of the ResCare study using normalisation process theory

© The Author(s) 2018. Dementia-related symptoms, sometimes termed challenging or distressing behaviour, can give rise to significant distress in care homes. Individualised formulation-led interventions show promise in reducing these behaviours. ResCare, a cluster randomised controlled trial in England, tested an online individualised intervention, comprising e-learning and decision support e-tools, designed to enable staff to better support residents with such symptoms. Normalisation process theory was used to understand the implementation processes. We analysed contextual process data for all 27 ‘intervention’ care homes and identified three implementation mechanisms. These were examined for four illustrative case study homes. Seven qualitative interviews with care home staff and one interview with two research therapists informed this understanding. The main barrier to implementation was difficulty in conveying a sustained understanding of the value of individually tailored interventions. Emphasis was placed on training rather than practice change. Implementation seemed easier in smaller homes and in those with flexible managerial styles where transfer of knowledge and skill might have been easier to achieve. Take up of e-learning and e-tools proved hard. There may be a need to continually promote ‘buy-in’ of the potential benefits of individualised formulation-led interventions, and this would have to be congruent with other priorities. Interventions within care homes need to consider organisational readiness, capacity for innovation and ongoing appraisal and adjustment to maintain changes in practice

App-based mindfulness training supported eudaimonic wellbeing during the COVID19 pandemic

A randomized-controlled-trial study (N = 219) tested two pre-registered hypotheses that mobile-phone app-based mindfulness training improves wellbeing and increases self-transcendent emotions: gratitude, self-compassion, and awe. Latent change score modeling with a robust maximum likelihood estimator was used to test how those changes are associated in the training versus the waiting-list group. The training increased wellbeing and all self-transcendent emotions regardless of interindividual variance in the changes across time. Changes in all self-transcendent emotions were positively associated with changes in wellbeing. The strength of those associations was comparable in the waiting-list group and the training group. More studies are needed to test whether the effects of mindfulness practice on wellbeing are driven by increases in self-transcendent emotions. The study was conducted over 6 weeks during the COVID19 pandemic. The results indicate that the mindfulness training can be an easily accessible effective intervention supporting eudaimonic wellbeing in face of adversity

‘We’re passengers sailing in the same ship, but we have our own berths to sleep in’: Evaluating patient and public involvement within a regional research programme: An action research project informed by Normalisation Process Theory

© 2019 Keenan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background: Patient and public involvement (PPI) is a requirement for UK health and social care research funding. Evidence for how best to implement PPI in research programmes, such as National Institute for Health Research (NIHR) Collaborations for Applied Health Research and Care (CLAHRCs), remains limited. This paper reports findings from an action research (AR) project called IMPRESS, which aims to strengthen PPI within CLAHRC East of England (EoE). IMPRESS combines AR with Normalisation Process Theory (NPT) to explore PPI within diverse case study projects, identifying actions to implement, test and refine to further embed PPI.Methods:We purposively selected CLAHRC EoE case study projects for in-depth analysis of PPI using NPT. Data were generated from project PPI documentation, semi-structured qualitative interviews with researchers and PPI contributors and focus groups. Transcripts and documents were subjected to abductive thematic analysis and triangulation within case. Systematic across case comparison of themes was undertaken with findings and implications refined through stakeholder consultation.Results:We interviewed 24 researchers and 13 PPI contributors and analysed 28 documents from 10 case studies. Three focus groups were held: two with researchers (n = 4 and n = 6) and one with PPI contributors (n = 5). Findings detail to what extent projects made sense of PPI, bought in to PPI, operationalised PPI and appraised it, thus identifying barriers and enablers to fully embedded PPI.Conclusion:Combining NPT with AR allows us to assess the embeddedness of PPI within projects and programme, to inform specific local action and report broader conceptual lessons for PPI knowledge and practice informing the development of an action framework for embedding PPI in research programmes. To embed PPI within similar programmes teams, professionals, disciplines and institutions should be recognised as variably networked into existing PPI support. Further focus and research is needed on sharing PPI learning and supporting innovation in PPI.Peer reviewedFinal Published versio