Nonshared Environmental Influences on Academic Achievement at Age 16 : A Qualitative Hypothesis-Generating Monozygotic-Twin Differences Study

Twin studies find ~20% of the variance in achievement in public examinations taken at age 16 in the United Kingdom can be explained by experiences not shared within families. Nonshared environmental (NSE) influences, including measurement error, explain why monozygotic (MZ) twins differ from each other. Such influences work independently of genetic effects and may represent strong candidates for intervention. This study aimed to generate hypotheses about what these NSE factors might be. Perceptions of within-pair differences were gathered from n  = 497 pairs of MZ twins and their parents, and telephone interviews were conducted with n  = 56 families reporting different General Certificate of Secondary Education grades. “Environmental” explanations related to teacher quality, teacher–pupil relationships, and ability grouping. Families also explained discordance in terms of effort, interest, ability, and personality

Social Work with No Recourse to Public Fund Migrants : Obstacles and Strategies

Migrants with no recourse to public funds (NRPFs) are vulnerable to destitution due to the NRPF condition attached to their immigration status. In this quantitative study, fifty-five social workers in England completed an anonymous online survey identifying the obstacles faced in their practice with NRPF migrants and any strategies they developed to overcome these impediments. Informed by the Theoretical Domains Framework, the study identified four main obstacles when working with NRPF migrants: lack of resources to support NRPF migrants; lack of knowledge/skills; negative attitudes from colleagues and insufficient institutional support. Compared to their local authority counterparts, NHS social workers expressed lower levels of confidence in their knowledge and skill level, and received less specific training, organisational guidance and support in their work with NRPF migrants. A 4-fold typology of strategies used by social workers to overcome obstacles was devised from responses to an open-ended question. In addition to the need for more resourcing, the findings suggest a need for social work education and training on how to effectively support NRPF migrants using extant legislation and agencies, and suggest knowledge exchange to promote inter-agency collaboration

The Invisible Frontier: Practitioner Perspectives on the Privacy Implications of Utilising Social-Media in Mental Health Social Work Practice

In the digital age, traditional approaches to accessing information are disrupted by the ‘public’ nature of social media. The notion of accessing service users’ social media in social work practice is fraught with ethical issues around privacy and boundaries, yet lacks clear guidance from existing law and policy. This qualitative study sought to identify how mental health social workers were navigating these issues and how they thought practice could be developed. Ten mental health social workers, from one NHS Trust in England, were interviewed about their views and experiences around accessing service users’ social media without express permission. Semi-structured interviews were analysed using thematic analysis. Practitioners shared a variety of justifications for utilising social media, based upon statutory responsibility and professional values, but felt direct guidance/legislation and training would be helpful. A process of ‘digital reflexivity’ was outlined, which balanced reasons to access social media against considerations of privacy and the potential effects on the therapeutic relationship. Implications include the need for definitive guidance and training around if, when and how to access service users’ social media; inclusion of digital reflexivity in supervision and multidisciplinary meetings; educating service users about privacy controls; and a potential reconfiguration of theoretical boundaries to include the ‘public’ domain

The recovery process and access to social capital of people with severe mental health problems: secondary analysis of a six-month follow-up study in England.

Background: Many developed nations have made recovery-oriented practice a central part of their mental health policy, though less is known about whether mental health outpatients, access to social capital can improve their recovery process. Aims: This study investigates the relationship between the recovery process and access to social capital for people with severe mental health conditions. Methods: This is a secondary analysis of a six-month follow-up study. Service users were recruited from five Community Mental Health Teams in England and interviewed at baseline (n=151) and six-month follow-up (n=127). The recovery process was assessed using the Questionnaire about the Process of Recovery (QPR). All statistical analyses (Pearson's correlations and multiple regression) were conducted at two different points in time (p< 0.05). Results: The participants' experience of recovery increased slightly from baseline (M=45.2, SD=12.18) to six-month follow-up (M=49.72, SD=12.52), which is indicative of recovery. At follow-up, their access to social capital was positively associated with service users' experience of recovery (B=0.40 p Conclusions: This study supports the idea that the experience of recovery can be measured and should be defined by service users. People with higher mental well-being scores and more social connections had a better experience of recovery. This study is a contribution to the international endorsement of recovery-oriented practice which focuses on developing a person-centred rather than a clinician-centred model of recovery for people with severe mental health conditions

Interventions that support unpaid carers of adult mental health inpatients : a scoping review

Background Unpaid carers of adult mental health inpatients often lack support for their well-being and feel excluded from decisions about patient care. Aims This scoping review aimed to: synthesise the peer-reviewed literature evaluating the outcomes of brief interventions for unpaid carers of adult mental health inpatients, identify transferable lessons for evidenced-informed practice, and establish future research priorities. Methods PRISMA scoping review guidelines were followed to search 12 databases using predefined search terms. Two reviewers independently screened papers and applied exclusion/inclusion criteria. Studies were included if they evaluated the impact or outcomes of interventions. Two reviewers extracted data and assessed study quality. Data were synthesised to categorise types of interventions and evidence for their outcomes. Results 16 papers met the inclusion criteria, and five types of interventions were identified: those that aimed to (1) increase carer involvement in inpatient care; (2) facilitate organisational change to increase carer support and involvement; (3) provide carers with support; (4) deliver psychoeducation and offer support; and (5) reduce carer stress and improve coping skills. Conclusions Whilst evidence of intervention effectiveness was promising, the quality of studies was generally weak. More research is needed to develop an evidence-informed approach to supporting carers during inpatient stays

Children in Scotland Requiring Palliative Care : identifying numbers and needs (The ChiSP Study)

This report sets out the findings from an investigation into the numbers of children and young people with life-limiting conditions in Scotland, and what current evidence tells us about their, and their families’, psychosocial support needs. The overall purpose of the study was to develop an evidence base to support and inform planning for children’s palliative care in Scotland. It is hoped that the evidence generated will be a resource to organisations with responsibility for, or delivering services to, children and young people with life-limiting conditions

Adapting to Climate Change: The urgency and some challenges to begin

Our response to the challenge of climate change will shape our future in many different and crucial ways. Adaptation is about realizing the impacts of climate change and acting in such a way to limit negative impacts and embrace positive outcomes in order to reduce our vulnerability from the effects of climate change

Public policies, law and bioethics: : a framework for producing public health policy across the European Union

Unlike the duties of clinicians to patients, professional standards for ethical practice are not well defined in public health. This is mainly due to public health practice having to reconcile tensions between public and private interest(s). This involves at times being paternalistic, while recognising the importance of privacy and autonomy, and at the same time balancing the interests of some against those of others. The Public Health specialist operates at the macro level, frequently having to infer the wishes and needs of individuals that make up a population and may have to make decisions where the interests of people conflict. This is problematic when devising policy for small populations; however, it becomes even more difficult when there is responsibility for many communities or nation states. Under the Treaty on European Union, the European Commission was given a competence in public health. Different cultures will give different moral weight to protecting individual interests versus action for collective benefit. However, even subtle differences in moral preferences may cause problems in deriving public health policy within the European Union. Understanding the extent to which different communities perceive issues such as social cohesion by facilitating cultural dialogues will be vital if European institutions are to work towards new forms of citizenship. The aim of EuroPHEN was to derive a framework for producing common approaches to public health policy across Europe. Little work has been done on integrating ethical analysis with empirical research, especially on trade-offs between private and public interests. The disciplines of philosophy and public policy have been weakly connected. Much of the thinking on public health ethics has hitherto been conducted in the United States of America, and an ethical framework for public health within Europe would need to reflect the greater respect for values such as solidarity and integrity which are more highly valued in Europe. Towards this aim EuroPHEN compared the organisation of public health structures and public policy responses to selected public health problems in Member States to examine how public policy in different countries weighs competing claims of private and public interest. Ethical analysis was performed of tensions between the private and public interest in the context of various ethical theories, principles and traditions. During autumn 2003, 96 focus groups were held across 16 European Union Member States exploring public attitudes and values to public versus private interests. The groups were constructed to allow examination of differences in attitudes between countries and demographic groups (age, gender, smoking status, educational level and parental and marital status). Focus group participants discussed issues such as attitudes to community; funding of public services; rights and responsibilities of citizens; rules and regulations; compulsory car seat belts; policies to reduce tobacco consumption; Not-In-My-Back-Yard arguments; banning of smacking of children; legalising cannabis and parental choice with regards to immunisation. This project proposes a preliminary framework and stresses that a European policy of Public Health will have to adopt a complex, pluralistic and dynamic goal structure, capable of accommodating variations in what specific goals should be prioritised in the specific socio-economic settings of individual countries

Biofortification of wheat with zinc for eliminating deficiency in Pakistan: Study protocol for a cluster-randomised, double-blind, controlled effectiveness study (BIZIFED2)

Introduction: Micronutrient deficiencies, commonly referred to as “hidden hunger”, affect more than two billion people worldwide, with zinc and iron deficiency frequently reported. The aim of this study is to examine the impact of consuming zinc biofortified flour (Zincol-2016) on biochemical and functional measures of status in adolescent girls and children living in a low resource setting in Pakistan. Methods and analysis: We are conducting a pragmatic, cluster-randomised, double-blind, controlled trial. A total of 483 households have been recruited from two catchment areas approximately 30-40 km distance from Peshawar. Household inclusion criteria are the presence of both an adolescent girl, aged 10-16 years, and a child aged 2-5 years. The study duration is 12 months, divided into two 6-month phases. During phase 1, all households will be provided with locally procured flour from standard varieties of wheat. During phase 2, clusters will be paired, and randomised to either the control or intervention arm of the study. The intervention arm will be provided with zinc biofortified wheat flour, with a target zinc concentration of 40 mg/kg. The control arm will be provided with locally procured wheat flour from standard varieties with an expected zinc concentration of 20 mg/kg. The primary outcome measure is plasma zinc concentration. Secondary outcomes include anthropometric measurements, biomarkers of iron and zinc status, and the presence and duration of respiratory tract infections and diarrhoea. Ethics and dissemination: Ethical approval was granted from the University of Central Lancashire STEMH Ethics Committee (reference number: STEMH 1014) and Khyber Medical University Ethics Committee (DIR/KMU-EB/BZ/000683). The final study methods will be published in peer reviewed journals, alongside the study outcomes. In addition, findings will be disseminated to the scientific community via conference presentations and abstracts and communicated to the study participants through the village elders at an appropriate community forum. Registration details: The trial has been registered with the ISRCTN registry, study ID ISRCTN17107812