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This qualitative case study aims to investigate how current services meet the emotional needs of young women growing up with perinatally acquired human immunodeficiency virus (HIV). Young women (15–19 years old), caregivers and service providers were recruited through three multidisciplinary HIV management centres in Malawi.

In-depth interviews were used to collect data for 14 “cases” (each “case” involved a young woman, a caregiver and a service provider, for a total of 42 participants). The interviews with adolescents were conducted using an innovative visual method known as the “my story” book.

Thematic analysis revealed that young women experienced traumatic experiences and emotional neglect after being diagnosed as HIV positive. Lack of adult support networks and social isolation were identified as intersecting factors contributing to their mental distress. According to the findings of this study, HIV care should more explicitly include comprehensive mental health-care services. This provision should include ongoing individualised counselling sessions, supplemented by communication skills training to help break the prevalent cultural silence on HIV issues. Young people living with HIV, in general, and young women, are more likely to experience mental health issues than their non-infected peers. Integrating comprehensive mental health evaluation and treatment into HIV care for young people can be beneficial.

Mental health issues are critical and underserved challenges among young people living with perinatally acquired HIV. Women experience a higher prevalence of mental challenges than men. Integrating comprehensive mental health evaluation and treatment into HIV care for young people can be beneficial. Therefore, interventions to assist young people with mental health issues are needed within the context of HIV management in Malawi.

Many studies on mental health and HIV/AIDS have been conducted. However, there is very little information as regards the emotional needs of young women growing up with perinatally acquired HIV. This study fills the void.

There is a need to increase access to HIV testing in the UK in male migrant communities. The purpose of this paper is to assess the uptake and acceptability of a workplace HIV testing intervention aimed at increasing access to testing in non-clinical settings.

A total of 20 health check events were delivered at 11 UK organisations employing male migrant workers. Intervention included HIV testing, cholesterol, BMI, blood glucose, blood pressure; tailored health advice; take-away resources; optional post-event text reminders about HIV and general health. Mixed-methods evaluation included exit questionnaires (n=771), follow-up text messages (n=465) and qualitative interviews (n=35) to assess event acceptability. Qualitative data were analysed thematically.

Attendees were 776 employees from 50 countries (51 per cent male; 30 per cent migrant workers). A total of 52 per cent of attendees undertook an HIV test (75 per cent were first-time testers). In total, 96 per cent considered HIV testing to be an acceptable element of workplace health checks; 79 per cent reported new health-related knowledge; 60 per cent of attendees opted for follow-up text messaging; 26 per cent of text respondents reported independently taking HIV test post-event. High acceptability and uptake of HIV testing was associated with convenience, opportunity taking (through removal of deliberation and intentional test-seeking), and normalisation of HIV testing within a general health check.

This study is the first to demonstrate that opt-in HIV testing can be successfully delivered in the workplace within a multi-component health check. The workplace is an effective means of increasing access to HIV testing in groups at risk for HIV, including male migrant workers.

The purpose of this paper is to reflect on the journey so far for the North Wales Regional Single Point of Access (SPOA) through the lens of programme manager with views from the programme team. SPOA is the integration of access points to community health and social care services with strengthened links to the third sector, one SPOA in each of six local authorities in the Betsi Cadwallader University Health Board footprint.

Kotter’s 8 step theory of change model (1996) supplemented by the organisational, cultural and professional and contextual factors from research that impact on integrated working between health and social care (Cameron et al., 2012); the focus is programme level.

Kotter’s 8 step model is a useful tool for reflection on the factors identified in research that promote and hinder integrated working. Key messages and innovative ideas of interest for practitioners embarking on a similar “Quest”, including: “keep using your ‘levers for change’”, “Adopt and Adapt”, “right people in the right place”, “it’s ok to tweak your vision, ‘Make it mean something to everyone’, ‘accept and Adapt’, ‘Don’t sweat what you can’t affect’, ‘Find your allies – it’s better together’, ‘Celebrate ‘small wins’’, ‘The people’s voice drives change’ and ‘a sense of humour brings you through’”.

This is a personal reflection from the North Wales Regional SPOA Programme.

It makes use of collaborative work focused on delivering a SPOA, helping others to learn from the struggle.

Diben y papur hwn yw adlewyrchu ar y daith hyd yn hyn ar gyfer Un Pwynt Mynediad Ranbarthol Gogledd Cymru (SPOA) yn bennaf trwy olwg rheolwr y rhaglen ond mae hefyd yn cynnwys safbwyntiau tîm ehangach y rhaglen. Yn greiddiol i’r SPOA ceir integreiddio pwyntiau mynediad i wasanaethau iechyd cymunedol a gofal Cymdeithasol gyda chysylltiadau wedi eu cryfhau i’r Trydydd Sector, un SPOA ym mhob un o’r 6 Awdurdod Lleol sydd o fewn ôl troed bwrdd Iechyd Prifysgol BC.

Canfu model damcaniaeth newid (1996) 8 cam Kotter, a ategir gan y ffactorau sefydliadol, diwylliannol a phroffesiynol a’r ffactorau cyd-destunol yn sgil ymchwil mai effaith ar waith integredig rhwng iechyd a gofal cymdeithasol (Cameron et al., 2012) sy’n rhoi’r strwythur i’r papur adlewyrchol hwn; sydd, ar y pwnt hwn o’r daith, yn canolbwyntio ar lefel y rhaglen.

Roedd model 8 cam Kotter yn offeryn defnyddiol ar gyfer yr adlewyrchiad hwn ar y daith hyd yn hyn. Mae ein profiad hyd yn hyn mewn cytgord â’r ffactorau a nodir mewn ymchwil sy’n hyrwyddo ac yn rhwystro gwaith integredig. Mae ymarfer adlewyrchu wedi galluogi negeseuon allweddol a syniadau arloesol a allai fod o ddiddordeb i ymarferwyr sy’n dechrau ar ‘Gais’ tebyg, i gael eu hatgyfnerthu. Mae ein negeseuon allweddol sydd mewn cytgord ag eraill ym maes gwaith integredig fel a ganlyn: ‘Nodi a pharhau i ddefnyddio eich ‘dylanwadau ar gyfer newid’, ‘Mabwysiadu ac Addasu’ , ‘Cael y bobl iawn yn y lle iawn’ , ‘Ni fydd eich rhaglen yn dod i ben os byddwch yn addasu eich gweledigaeth, ‘Gwneud iddo feddwl rhywbeth i rywun’, ‘Derbyn ac Addasu’, ‘Peidio poeni am y pethau na allwch wneud unrhyw beth yn eu cylch’, ‘Canfod eich cynghreiriaid – mae’n well gyda’ch gilydd’, ‘Dathlu eich ‘buddugoliaethau bach’, ‘Mae llais y bobl yn bwerus i lywio newid’ a ‘chofiwch mae synnwyr digrifwch yn dod â chi drwyddi’.

Mae hwn yn adlewyrchiad personol o Raglen Un Pwynt Mynediad Rhanbarthol Gogledd Cymru.

Mae’n defnyddio gwaith cydweithredol ag yn canolbwyntio ar gyflawni SPOA, gan gynorthwyo eraill i ddysgu trwy’r her.

This article reports on three pragmatic randomised controlled trials (RCTs) to help children at risk of conduct disorder (CD): two involved the Incredible Years (IY) BASIC parent programme and the other concerned the IY teacher programme. All three interventions took place in regular service settings in North‐ and Mid‐Wales. In all three studies, staff from the provider agency delivered the programme and participated in RCT evaluations in which participants were randomly allocated to intervention or waitinglist control conditions. After a brief introduction to research into the prevention or treatment of CD, and the issues to be considered by services in selecting and delivering interventions, this article summarises the structure, content and evidence base of the IY programmes. The three Welsh studies are briefly described before exploring what factors contributed to service participation in the trials and the benefits and lessons learned in undertaking them.

The purpose of this paper is to explain how adaptive capacity is accomplished through communication processes and can contribute to enhancing disaster resilience. The authors adopt a structurational “four flows” explanation of communication processes.

The authors observed and analyzed discourse in meetings of a crisis communication network consisting of representatives of municipalities and public authorities involved in crisis communication management during the Västmanland wildfire in Sweden.

Adaptive capacity during the wildfire was principally accomplished through the structurational communication processes or “flows” of self-structuring, activity coordination, and institutional positioning. These flows intersected demonstrating how communication accomplishes the development of a responsive affiliation, organizes stabilizing structuring practices, and enables adaptive structuring practices.

The main contribution of this study is a communicative explanation for adaptive capacity, which draws from a structurational model of constitutive communication, and lends further understanding to improvisation during disasters.

The authors discuss the findings in relation to improvisation, suggesting how the findings can inform future coordinated crisis communication for the public and news media. The recommendations address how practitioners might build a responsive affiliation, use minimal structures (e.g. communication practices), and maintain flexibility by introducing group reflexivity behaviors.

The authors provide new theoretical and empirical knowledge of the communicative constitution of adaptive capacity during a disaster.

Therapeutic Community (TC) approaches have not been applied to individuals with intellectual disability. This paper aims to present preliminary evaluation of a planned TC service intervention in a secure setting for men with mild intellectual disabilities and personality disorder over a period of 12 months.

The TC intervention group (n=11) was compared on repeated measures of violent incidents, seclusion hours, and informant and self‐report clinical outcome measures collected six months prior to, six and 12 months post the start of the intervention. The TC group was also compared with a pragmatic control group (n=10) receiving treatment as usual (TAU).

Clinical changes in the predicted direction were evident, with the TC group showing comparatively less pathology both over time and in relation to the comparison group. However, change was more likely for clinical scales measuring internalising problems, than for externalising problems. The mean number of violent incidents did not reduce over time. There was nevertheless a strong trend towards reduction in seclusion hours in the TC treatment group over time, with significant differences between groups also being observed at the six and 12 months stage.

The sample size is small. The literature suggests a minimum of 18 months in TC treatment, so this is an interim evaluation. The planned evaluation period is two years, although attrition may affect the numbers of participants in the study after this period.

TC treatment is consistent with the core principles of involvement and choice. The findings of this preliminary service evaluation are promising in terms of the TC approach being a potential mode of treatment suitable for a proportion of patients with learning disability in secure conditions.

TC approaches are innovative in forensic learning disability. No previous evaluations of TC based interventions have been published in this field, and this paper contributes to an evidence base.