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Carers of people with mental health problems present with high levels of burden, poor mental well-being and feelings of disempowerment by mental health services. The purpose of this paper is to establish whether providing a psychoeducation skill programme for carers would lead to an improvement of mental well-being, reduce the levels of burden that carers sometimes feel while caring for someone with mental illness and also to increase empowerment. This paper provides a service evaluation study of an innovative carer-led psychoeducational intervention that was undertaken.

This programme was initiated and led by a carer who had experienced a lack of service provision to support carers and families in understanding and caring for a relative with severe and enduring mental health diagnoses. A model of co-production was adopted with the carer who led this initiative working closely with an occupational therapist and consultant psychologist in its development and delivery. Data were collected to measure the impact of the training at five different time points. The measures employed to measure outcomes were the Warwick-Edinburgh Mental Well-being Scale, the Burden Assessment Scale and Family Empowerment Scale.

Results indicated improved well-being, reduced burden and increased family empowerment in carers who completed this peer-led carer initiative psychoeducational programme.

This service evaluation study was conducted in a single site and in the site in which it was developed. The carer consultant who led this evaluation and development of the intervention was also the peer worker who delivered the interventions. Hence, the authors are unable to ascertain if the results reported are unique to the individual peer worker. The transferability of this programme and generalisability of the result should therefore be treated with caution and further replication of this model and research is required. This would be beneficial to be conducted in an alternative site from where it was developed, delivered by different facilitators and include a control group.

The evidence from this study indicates that carers are able and willing to attend a group psychoeducational programme. A high number of referrals to the programme in a relatively short timeframe indicates that there is significant demand for such a service. The implementation of the programme is relatively straightforward. The key challenges for practical implementation are to have the right carer to lead and deliver the programme and the right support system in place for them (financial and supervision). Co-production also is not without challenges, the peer worker and occupational staff need to ensure that mutually valued and respected working relationship should develop.

This is the first evaluation of the impact of a carer-led psychoeducation intervention for carers of people with mental health difficulties in secondary mental health services.

Personality disorder is reported to elicit strong emotional responses and negative attitudes in mental health staff (Bodner et al., 2015). The purpose of this paper is to provide an overview of the design and development of a co-produced e-learning training package for personality disorder awareness and an evaluation of its effectiveness. This study was carried out to explore if e-learning is an effective mode of training delivery for raising personality disorder awareness.

The e-learning was uniquely developed by subject matter experts working in co-production with people with lived experience. Self-reported measures were completed at three separate intervals to evaluate the effectiveness of the training: at pre-, post- and three-month follow up. Quantitative data were collected via these questionnaires.

The results from this evaluation show that e-learning is an effective mode of delivery for raising the awareness of personality disorder among mental health professionals, achieving similar outcomes to those reported following face-to-ace training.

Attrition at follow-up phase was high which was consistent with other similar studies. The evaluation was led by the lead contributors and in the geographical area of its development. The study was relatively small and the participants were self-selected, therefore findings should be treated with caution.

E-learning can provide flexible training to compliment and act as an alternative to face-to-face personality disorder training. E-learning may provide an alternative refresher course to knowledge and understanding framework or other face-to-face methods. Co-produced training can be mirrored within an e-learning programme, careful planning to ensure the service user voice is heard and that their lived experience is embraced is required.

This is the first evaluation of a co-produced e-learning only personality disorder awareness training. It is also the first paper to carry out a review of the published evaluations of personality awareness training in the UK with comparisons explored across the studies.

Confidentiality in adoption has been the norm in this country since the 1930s. Traditionally, it has been perceived as beneficial to all sides of the adoption triangle: the adoptive parents, the adoptee, and the birth parents. Adoption agencies have supported the policy of confidentiality, and as a result the practice of concealment is almost universal in the United States. Alaska, Hawaii, and Kansas are the only states that allow adult adoptees access to their birth and adoption information.

An innovative training initiative to raise the awareness of personality disorder and enable more effective working with people with personality disorder who come into contact with the wider multi-agency system has been developed. For the purpose of the training initiative the nationally recognised Knowledge and Understanding Framework (KUF, awareness-level programme) has been employed. An overview of the comprehensive multi-agency training initiative will be outlined with reporting and discussion of the outcome data provided within this paper. The paper aims to discuss these issues.

This paper outlines the development and outcomes of a service evaluation study. The utilised outcome measures were carried out at pre-, post- and three-month follow-up measures. The Personality Disorder-Knowledge Attitude and Skills Questionnaire was utilised on the recommendation of the central team. Additionally a Visual Analogue Scale was developed for the purpose of this study was also employed.

Data findings are positive particularly when comparing pre- and post-results and the pre- and follow-up results. There appears to be an apparent peak in results post-training which could be attributed to the fact that knowledge and understanding is recent and fresh in the delegates mind, however positive results are still reported at follow-up there does appear to be decline in results and durability of the effect when three-month follow-up is compared against the post-training results.

Follow-up was at three months, which is a relatively short-time span post-training it would be of great interest to see in the future if the decline in the three areas continues. If this was followed up and if this pattern continued this could provide us with evidence to support the development of refresher courses. In the future, due to the multi-agency design of this service evaluation, comparisons of the different sectors, agencies and occupations involved, could also be explored further to establish what multi-agency areas the training has had the most effect and impact.

High levels of demand from multi-agencies to receive training in personality disorder is reported. Our findings and experience provide evidence that multi-agencies partners from a variety of professional backgrounds can effectively work in partnership with people with lived experience to effectively deliver the KUF training.

This innovative roll-out of KUF training provides evidence that with a little investment, a comprehensive multi-agency roll-out of KUF is achievable and can provide statistically significant positive results displaying the effectiveness and change brought about via the KUF training.

The originality of this sustainable and low-cost approach to educating the wider system is reported in this paper. This has lead to the strategy receiving national recognition winning a nursing times award in 2011 and a model of innovative practice nationally.

Academic healthcare systems face great challenges in coordinating services across a continuum of care that spans hospital, community providers, home and chronic care facilities. The Johns Hopkins Community Health Partnership (J-CHiP) was created to improve coordination of acute, sub-acute and ambulatory care for patients, and improve the health of high-risk patients in surrounding neighborhoods. The paper aims to discuss this issue.

J-CHiP targeted adults admitted to the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, patients discharged to participating skilled nursing facilities (SNFs), and high-risk Medicare and Medicaid patients receiving primary care in eight nearby outpatient sites. The primary drivers of the program were redesigned acute care delivery, seamless transitions of care and deployment of community care teams.

Acute care interventions included risk screening, multidisciplinary care planning, pharmacist-driven medication management, patient/family education, communication with next provider and care coordination protocols for common conditions. Transition interventions included post-discharge health plans, hand-offs and follow-up with primary care providers, Transition Guides, a patient access line and collaboration with SNFs. Community interventions involved forming multidisciplinary care coordination teams, integrated behavioral care and new partnerships with community-based organizations.

This paper offers a detailed description of the design and implementation of a complex program to improve care coordination for high-risk patients in an urban setting. The case studies feature findings from each intervention that promoted patient engagement, strengthened collaboration with community-based organizations and improved coordination of care.

Public sector management has never been overwhelmingly applauded for efficiency in operations; but in the last few decades accusations of mismanagement in the American federal government have been common, particularly in the wake of the Grace Commission report and the Gramm‐Rudman Deficit Reduction Plan. The pressure is on government to streamline operations and become more “efficient”.

In today's highly competitive and customer oriented business environment, business firms in all sectors are looking for ways to improve customer satisfaction. In this context, textile firms are no exception. This research simulates the actual operations of a textile firm in order to show the impact of sequencing operational rules on the ability of the firm to improve its responsiveness to customers.

With a record of human occupancy for over 10,000 years, the Indian Wells Valley where Ridgecrest is located has long had much to offer casual and experienced desert visitors alike. Ghost‐towns from earlier active gold mining days, fossilised waterfalls, sculptured rock formations, desert tortoises, hiking trails against a High Sierra backdrop feature among the attractions of the area.

This paper aims to describe a robust empirical approach to generating plausible historically based interest rate shocks, which can be applied to any market environment. These interest rate shocks can be readily linked to movements in other key risk factors, and used to measure market risk on institutions with large fixed-income portfolios.

Using yield curve factorization, we parameterize a time series of historical yield curves and measure interest rate shocks as the historical change in each of the model’s factors. We then demonstrate how to add these parameterized shocks to any market environment, while retaining positive rates and plausible credit spreads. Given a set of shocked interest rate curves, joint risk factor movements are calculated based upon historical, reduced form dependencies.

Our approach is based upon yield curve parameterization and requires a parsimonious yet flexible factorization model. In the process of selecting a model, we evaluate three variants of the Nelson–Siegel approach to yield curve approximation and find that, in the current low interest rate environment, a 5-factor parameterization developed by Björk and Christensen (1999) is best suited for accurately translating historical interest rate movements into plausible, current period shocks.

An accurate measure of market risk can help to inform institutions about the amount of capital needed to withstand a series of adverse market events. A plausible set of shocks is required to ensure market value, and cash flow projections are indicative of meaningful market sensitivities.

Describes how specialist provider of five-star front-of-house services MITIE Client Services is ensuring it is one of the best places to work.

Details the company culture and the various innovative training methods to support staff development.

Reveals how team members attend a four-day experiential-training course at the Revolution Academy, and explains how staff members are helped to embrace the company vision of creating exceptional, memorable experiences – one guest at a time.

Demonstrates how, as the business does not deliver a tangible product, success is gauged through the quality of interaction among the team and that training is therefore not designed to instruct but to ignite certain behaviors in people, inspiring a change in mind-set that leads to long-lasting transformations in attitude and performance.

Discusses the approach to mind-set change that develops a strong culture at the company.