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  • Living with dementia during the COVID-19 pandemic: coping and support needs of community-dwelling people with dementia and their family carers. Research findings from the IDEAL COVID-19 Dementia Initiative (IDEAL-CDI)

    O'Rourke, G.; Pentecost, C.; van den Heuvel, E.; Victor, C.; Quinn, Catherine; Hillman, A.; Litherland, R.; Clare, L. (Older People and Frailty Policy Research Group, 2021-02)
    We interviewed people with dementia and carers from the IDEAL cohort to find out how the COVID-19 lockdown and continuing restrictions affected those living with dementia. Some people with dementia coped well, while others coped with difficulty or were only just coping. The additional stress of COVID-19 exacerbated pre-existing coping difficulties. For many, social isolation increased anxiety. Some felt that lack of activity or lack of social contact caused a decline in their abilities to manage everyday tasks. Confusion about COVID-19 rules or difficulty remembering what to do led to anxiety when leaving the house. People felt that members of the public might not understand their particular needs. While some carers felt they were coping well, others experienced stress when having to leave the home because the person with dementia might not be safe if left alone. Some experienced increased strain in the caring relationship compounded by an uncertainty about future availability of respite. Some were concerned about the complex health needs of the person with dementia alongside COVID-19 risk and lack of personalised information. Both people with dementia and carers talked about the importance of access to safe outdoor space. People were anxious about how others would react or behave towards them regarding keeping a distance if they went out. Being connected to friends, family and wider community or support groups was important to help combat the effects of isolation. People from BAME communities worried about their increased vulnerability to the virus. A lack of trust in Government guidance and in health care services added to their anxiety. However, some benefitted from strong community and faith group involvement. What might be helpful for people with dementia? • Reablement to help regain or maintain skills • Personalised health advice regarding managing COVID-19 risk and the opportunity to ask questions. • Identification of people with dementia who live alone and an assessment of their needs. What might be helpful for carers? • Needs assessment in regard to respite. • Novel forms of respite care that incorporate social distancing. What might be helpful for both carers and people with dementia? • Access to COVID-safe outdoor spaces. • Continuation and expansion of ‘just checking’ services. • Support to get online and use the internet. • Communication and information through non-digital means. • Community COVID-19 ‘dementia awareness’ initiatives. What might be helpful for people from Black and minority ethnic groups? • Addressing concerns about their increased risk of COVID-19. • Directing information and support through existing community and faith groups.
  • A systematic review to identify key elements of effective public health interventions that address barriers to health services for refugees

    Jallow, M.; Haith-Cooper, Melanie; Hargan, Jae; Balaam, M-C. (Springer, 2021)
    Aim: Refugees often face barriers to accessing health services, especially after resettlement. The aim of this study is to identify key elements of effective public health interventions that address barriers to health services for refugees. Methods: Key online databases were searched to identify studies published between 2010 and 2019. Six studies met the inclusion criteria: two qualitative, one quantitative and three mixed-methods studies. An adapted narrative synthesis framework was used which included thematic analysis for systematic reviews. Results: Five themes were identified: peer support, translation services, accessible intervention, health education and a multidisciplinary approach. Conclusion: These key elements identified from this review could be incorporated into public health interventions to support refugees’ access to health services. They could be useful for services targeting refugees generally, but also supporting services targeting refugee resettlement programmes such as the Syrian resettled refugees in the UK. Future research is needed to evaluate the impact of public health interventions where these elements have been integrated into the intervention.
  • HARP (Health for Asylum Seekers and Refugees) project interim evaluation

    Haith-Cooper, Melanie; Balaam, M.C.; Mathew, D.; Big Lottery (Refugee Council, 2020-09)
  • Developing supportive local communities: Perspectives from people with dementia participating in the IDEAL programme

    Quinn, Catherine; Hart, N.; Henderson, C.; Litherland, R.; Pickett, J.; Clare, L. (2021)
    Communities play an important role in supporting people living with affected by dementia. The aim of this study was to explore what could be changed in the local community to enable those with dementia to live well. People with dementia and carers taking part in the IDEAL programme responded to open-ended questions. Responses from 1,172 people with dementia and 702 caregivers were analysed using thematic analysis. Four themes were identified: raising awareness, improving access to support services, providing social events and activities, and supporting people to engage in the community. These highlight the role of individuals, resources and the environment in supporting those with dementia. Longer-term investment in services is needed to underpin dementia-inclusive communities.
  • Sharing a living room: Empathy, reverie and connection

    McVey, Lynn (2019-09)
    This paper examines what the originally psychoanalytic concept of reverie can add to non-psychoanalytic practitioners’ understandings of empathy. It uses case material from a study into UK therapists’ experiences of reverie, which centres on a single moment in a session, when an image of her own living room flashed suddenly through a therapist’s mind. Reverie – a capacity to contain the other’s unprocessed emotional experiencing - can offer a magnifying lens through which to view some forms of empathy, revealing the relational, embodied and imaginative materials from which they are constructed. The paper links shared experiencing like that found in reverie with simulative accounts of empathy, but does not claim this enables us to experience exactly what the other feels; rather, when approached sensitively, tentatively and with clients’ needs foremost, it can foster deep connection, enabling us, as it were, to enter others’ inner worlds – perhaps even their living rooms - and make ourselves at home there. Finally, practical ways to work empathically with reverie are suggested, which may interest therapists from a range of modalities, including humanistic approaches.
  • Moderate-to-vigorous physical activity in primary school children: inactive lessons are dominated by maths and English

    Daly-Smith, Andrew; Hobbs, M.; Morris, J.L.; Defeyter, M.A.; Resaland, G.K.; McKenna, J. (MDPI, 2021-01)
    Background: A large majority of primary school pupils fail to achieve 30-min of daily, in-school moderate-to-vigorous physical activity (MVPA). The aim of this study was to investigate MVPA accumulation and subject frequency during academic lesson segments and the broader segmented school day. Methods: 122 children (42.6% boys; 9.9 ± 0.3 years) from six primary schools in North East England, wore uniaxial accelerometers for eight consecutive days. Subject frequency was assessed by teacher diaries. Multilevel models (children nested within schools) examined significant predictors of MVPA across each school-day segment (lesson one, break, lesson two, lunch, lesson three). Results: Pupils averaged 18.33 ± 8.34 min of in-school MVPA, and 90.2% failed to achieve the in-school 30-min MVPA threshold. Across all school-day segments, MVPA accumulation was typically influenced at the individual level. Lessons one and two—dominated by maths and English—were less active than lesson three. Break and lunch were the most active segments. Conclusion: This study breaks new ground, revealing that MVPA accumulation and subject frequency varies greatly during different academic lessons. Morning lessons were dominated by the inactive delivery of maths and English, whereas afternoon lessons involved a greater array of subject delivery that resulted in marginally higher levels of MVPA.
  • The role of subjective social status in living well for carers of people with dementia: findings from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme

    Victor, C.R.; Rippon, I.; Quinn, Catherine; Martyr, A.; Clare, L. (2021)
    We investigated how carers of people with dementia evaluate their standing in their community and wider society, and if this is related to ‘living well’. We used baseline data from the Improving the experience of Dementia and Enhancing Active Life programme and found that carers rated their standing in society higher than in their local community. Higher evaluations of both were associated with enhanced life satisfaction, well-being and quality of life. Initiatives that increase support or engagement in the community or wider society may help to increase carers’ perceptions of their social status, enhancing their ability to ‘live well’.
  • The perceived and objective availability of green and blue spaces and quality of life in people with dementia: results from the IDEAL programme

    Wu, Y.T.; Clare, L.; Jones, I.R.; Nelis, S.M.; Quinn, Catherine; Martyr, A.; Victor, C.R.; Lamont, R.A.; Rippon, I.; Matthews, F.E. (2021)
    The aim of this study was to investigate the associations between quality of life and both perceived and objective availability of local green and blue spaces in people with dementia, including potential variation across rural/urban settings and those with/without opportunities to go outdoors. This study was based on 1540 community-dwelling people with dementia in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme. Quality of life was measured by the Quality of Life in Alzheimer’s Disease (QoL-AD) scale. A list of 12 types of green and blue spaces was used to measure perceived availability while objective availability was estimated using geographic information system data. Regression modelling was employed to investigate the associations of quality of life with perceived and objective availability of green and blue spaces, adjusting for individual factors and deprivation level. Interaction terms with rural/urban areas or opportunities to go outdoors were fitted to test whether the associations differed across these subgroups. Higher QoL-AD scores were associated with higher perceived availability of local green and blue spaces (0.82; 95%CI: 0.06, 1.58) but not objective availability. The positive association between perceived availability and quality of life was stronger for urban (1.50; 95%CI: 0.52, 2.48) than rural residents but did not differ between participants with and without opportunities to go outdoors Only perceived availability was related to quality of life in people with dementia. Future research may investigate how people with dementia utilise green and blue spaces and improve dementia-friendliness of these spaces.
  • COVID-19-related social support service closures and mental well-being in older adults and those affected by dementia: a UK longitudinal survey

    Giebel, C.; Pulford, D.; Cooper, C.; Lord, Kathryn; Shenton, J.; Cannon, J.; Shaw, L.; Tetlow, H.; Limbert, S.; Callaghan, S.; et al. (2021-01-04)
    Background: The COVID-19 pandemic has had a major impact on delivery of social support services. This might be expected to particularly affect older adults and people living with dementia (PLWD), and to reduce their well- being. Aims: To explore how social support service use by older adults, carers and PLWD, and their mental well-being changed over the first 3 months since the pandemic outbreak. Methods: Unpaid dementia carers, PLWD and older adults took part in a longitudinal online or telephone survey collected between April and May 2020, and at two subsequent timepoints 6 and 12 weeks after baseline. Participants were asked about their social support service usage in a typical week prior to the pandemic (at baseline), and in the past week at each of the three timepoints. They also completed measures of levels of depression, anxiety and mental well-being. Results: 377 participants had complete data at all three timepoints. Social support service usage dropped shortly after lockdown measures were imposed at timepoint 1 (T1), to then increase again by T3. The access to paid care was least affected by COVID-19. Cases of anxiety dropped significantly across the study period, while cases of depression rose. Well-being increased significantly for older adults and PLWD from T1 to T3. Conclusions: Access to social support services has been significantly affected by the pandemic, which is starting to recover slowly. With mental well-being differently affected across groups, support needs to be put in place to maintain better well-being across those vulnerable groups during the ongoing pandemic.
  • Context matters: Problematizing the policy‐practice interface in the enactment of gender equality action plans in universities

    Ní Laoire, C.; Linehan, C.; Archibong, Uduak E.; Picardi, I.; Udén, M. (John Wiley & Sons Ltd, 2021-03)
    This study argues for recognition of the constitutive role of context in shaping the dynamics of the policy‐practice interface in the field of gender equality in universities. Using a comparative and reflective case‐study approach, we draw on our experiences, as action‐researchers, of developing and implementing Gender Equality Action Plans (GEAPs) in four universities in four different European countries and we explore the role of national and local context in the mediation and translation of the GEAP model. Drawing on the concepts of gendered organizations, dialogic organizational change, and policy mobilities, we argue for the need to be critical of approaches to gender equality in higher education (HE) that presume policy measures and good practice models transfer unproblematically to different HE organizations in different international contexts; instead, we draw attention to the contingent ways in which uneven gender relations articulate and manifest in different contexts, shaping possibilities for, and obstacles to, gender equality intervention. Thus, we argue that context plays a crucial constitutive role in the interpretation, enactment, and impact of gender equality policy in HE.
  • Teacher Perceptions of Fundamental Movement Skills and their Assessment in Primary Schools

    Eddy, L.H.; Hill, L.J.B.; Mon-Williams, M.; Preston, N.; Daly-Smith, Andrew; Medd, G.; Bingham, D.D. (2021)
    Evidence suggests that children struggle to acquire age-appropriate fundamental movement skills (FMS), despite their importance for facilitating physical activity. This has led to calls for routine school-based screening of children’s FMS. However, there is limited research exploring schools’ capacity to conduct such assessments. This study investigated what factors might affect the adoption and implementation of FMS assessments in primary schools. School staff (n=853) completed an online questionnaire developed using the Capability, Opportunity, Motivation and Behaviour (COM-B) model. A majority reported that knowledge of pupils’ FMS ability would be beneficial (65.3%), and 71.8% would assess FMS if support was provided. Barriers included: Capability – few possessed knowledge of FMS (15%); Opportunity – teachers reported 30-60 minutes as acceptable for assessing a class, a substantially shorter period than current assessments require; Motivation – 57.2% stated FMS assessments would increase workload stress. Solutions to these issues are discussed using the COM-B theoretical framework.
  • Point-of-care lactate measurement for suspected sepsis in the prehospital environment: are we missing the point at the sharp end?

    Lightowler, Bryan (Mark Allen Group, 2020-04-02)
    Expecting ambulance clinicians to dependably differentiate the life-threatening organ dysfunction caused by sepsis from an inflammatory response to a non-infectious aetiology, relying upon vital signs and a physical examination of the patient alone, must be considered unrealistic. Although lactate measurement has been integrated into numerous prehospital sepsis screening tools, it is not yet measured routinely within UK ambulance services. Research has generally focused on whether handheld point-of-care lactate measurement devices are as accurate as laboratory analysis of venous or arterial samples. The weight of literature has concluded negatively in relation to this. However, there is potential for handheld devices to be used independently to monitor trends in lactate elimination or accumulation to inform decisions on the efficacy of prehospital interventions, or simply to report categorical data in terms of whether lactate levels are elevated or not. This offers UK paramedics the opportunity to improve sepsis care through the enhanced assessment of risk and acuity, the identification of patients with cryptic shock, more aggressive fluid resuscitation and advanced notification to receiving units.
  • The “weanling’s dilemma” revisited: Evolving bodies of evidence and the problem of infant paleodietary interpretation

    Kendall, E.; Beaumont, Julia; Millard, A.M. (2021)
    Breastfeeding is known to be a powerful mediator of maternal and childhood health, with impacts throughout the lifecourse. Paleodietary studies of the past thirty years have accordingly taken an enduring interest in the health and diet of young children as a potential indicator of population fertility, subsistence, and mortality patterns. While progress has been made in recent decades towards acknowledging the agency of children, many paleodietary reconstructions have failed to incorporate developments in cognate disciplines revealing synergistic dynamics between maternal and offspring biology. Central to this understanding has been heavy reliance on the “weanling’s dilemma”, in which infants are thought to face a bleak choice between loss of immunity or malnutrition. Using a review of immunological and epidemiological evidence for the dynamic and supportive role that breastfeeding plays throughout the complementary feeding period, this paper offers context and nuance for understanding past feeding transitions. We suggest that future interpretative frameworks for infant paleodietary and bioarchaeological research should include a broad knowledge base that keeps pace with relevant developments outside of those disciplines.
  • Competition and Collusion among Criminal Justice and Non-State Actors in Brazil’s Prison System

    Macaulay, Fiona (Palgrave Macmillan, 2021-02)
    This chapter examines competition and collusion among criminal justice institutions and non-state actors in imprisonment in prisons in Brazil to analyse how both formal and informal dispositions and practices have created and sustain the mass incarceration that is a pre-condition for extensive prisoner self-governance. The chapter thus looks from the outside-in, examining how relationships between extra-mural institutions have created and sustained such an enormous prison population in Brazil. It also analyses these institutions and organisations as intra-mural actors that, through their action or inaction, exercise a key role in shaping the carceral experience for inmates. It highlights the competition between the different actors involved in the penal arena for control of the carceral space and of prisoners, driven by a variety of motives – rent-seeking, moral/philosophical, and territorial.
  • Transforming State Responses to Feminicide: Women’s Movements, Law and Criminal Justice Institutions in Brazil

    Macaulay, Fiona (Emerald Press, 2021-01)
    Global concern about feminicide -- the killing of girls or women for reasons related to gender roles – started in Latin America with the epidemic of sexualised murders and disappearances in Central America and Mexico. There, the killers walked free due to state indifference and an incompetent criminal justice system. But this book tells a more positive story from the region. Brazil has high numbers of feminicides, mostly committed by intimate partners. Yet, the state’s responses to this crime have been transformed in recent years. This is the first country study to examine in detail how strategic action by the women’s movement has resulted in significant improvements in the investigation, prosecution and prevention of domestic violence and of feminicide. This study traces the interaction between the main contributory factors to that transformation. Innovation and capacity-building in the criminal justice system has been driven by the development of norms and protocols at the inter-American level, by changes in Brazilian law and jurisprudence, and by policy entrepreneurs within the police and justice sector. Executive branch investment since the early 2000s in tackling gender-based violence created a propitious political environment. Coalitions of interest involving feminist academics, NGOs, local campaigners, bureaucrats within the state machineries for women, politicians, journalists, and criminal justice professionals were able to identify, create and use institutional spaces for change and diffuse good practices.
  • Princípios e práticas de formação de policiais para o atendimento às mulheres em situação de violência

    Macaulay, Fiona; Martins, J. (Brazilian Forum on Public Safety, 2020-10)
    This training manual on gender-based violence is intended for use by all those who train the police and other actors in the local protection networks. It outlines the principles of effective training based on the integrated competencies of knowledge, attitudes and skills, and emphasises the use of appreciative inquiry, group learning and dynamic techniques such as dramatisation and case-based learning
  • Practitioner-based research and qualitative interviewing: Using therapeutic skills to enrich research in counselling and psychotherapy

    McVey, Lynn; Lees, J.; Nolan, G. (2015-06)
    The researcher’s reflexive use of self forms part of a well-established tradition in counselling and psychotherapy research. This paper reviews that tradition briefly, with particular reference to an approach known as ‘practitioner-based research’ that has developed from it. In this approach, researcher-practitioners use their therapeutic skills and judgement and thereby enrich their understanding of research participants, themselves and their relationship. Aim: The paper aims to contribute to the practitioner-based approach by showing how it can impact on data collection, using an example from a qualitative interview. Methodology: A moment of interaction between a participant and a therapy researcher in a qualitative interview is examined, framed within psychotherapeutic intersubjectivity theory. The researcher’s reflexive awareness of micro-aspects of the relationship with the participant is reviewed, captured in their language and the split-second daydreams or reveries that arose as they interacted. Findings: The authors argue that the approach enhanced this small-scale study by intensifying the researcher’s engagement with the participant and enriching her understanding of their relationship and the subject under investigation. Implications: The paper highlights the unique value and contribution that this approach offers to therapy research and practice.

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