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The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.

The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.

Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.

This paper uses data collected in a co-produced research study including peer researchers.

The purpose of this paper is to examine the evaluation of a universal, mental well-being and mindfulness programme in a UK graduate entry medical school.

Mixed methods used in the paper were the measurement of mental well-being and mindfulness in two cohorts at three time points over 15 months; descriptive, regression and repeated measures analysis with post hoc pairwise comparisons; qualitative interviews with purposive sample of 13 students after one year analysed thematically; and spontaneous anonymous feedback on the course.

The course was a surprise to students, and reactions were mixed. Respect for its contents grew over the first year. Most students had actively implemented a well-being strategy by the end of the course, and an estimated quarter was practicing some mindful activity. In the context of an overall decline in well-being and limited engagement with mindfulness practice, increases in mindfulness were protective against this decline in both cohorts (p<001). A small minority of students thought that the course was a waste of time. Their attitudes influenced engagement by their peers. The mindfulness and well-being practices of the facilitators were evident to students and influenced perceived effects.

The uncontrolled nature of this observational study and low response rates to the survey limit conclusions. Further research in other medical education settings is needed.

Results are encouraging, suggesting modest benefit in terms of changing attitudes and practices and a modest protective effect on the well-being of students who engaged.

This is the first study of a universal well-being and mindfulness programme in a UK medical school. Universal programmes are rare and evaluation studies are scarce.

We report the findings from a study exploring the experiences of individuals undergoing MRI scanning for research. Semi‐structured interviews took place before and after scanning with 17 participants; 12 were healthy volunteers and five were patients with a diagnosis of remitted depression. Themes of apprehension and curiosity prior to scanning were common in both groups. Patients were often confused about the procedure. Negative feelings were an issue at the outset, characterised by shock related to the physical surroundings, after which positive feelings, for example relaxation, were often experienced, and in the case of patients, learning more about their brain. Written information about imaging was deemed satisfactory; however the ability to ‘experience’ aspects of scanning beforehand was suggested. Scanning may be viewed as a process beginning prior to the procedure itself and involving positive and negative emotions. Increased information, reassurance and a more interactive intervention to reduce anxiety may be beneficial and may improve individuals' experience of this widely used procedure.

In this article attention will focus on the risks to high street solicitors in England and Wales who handle money on behalf of clients which may be the proceeds of criminal activity. There are many difficult issues involved and some of these will be discussed.

The purpose of this paper is to explore the gaps between experienced working conditions (WCs) and the perceived importance of these conditions in relation to subjective health in Swedish public sector workplaces.

In total, 379 employees answered questions concerning WCs and health. Nine WC areas were created to measure the gap between the experienced WCs and the perceived importance of each condition. These WC areas were: physical work environment, social relationships, communication, leadership, job control, recognition, self-development, workplace culture and work/life satisfaction. Subjective health was measured using mental ill health, well-being and general health.

The results indicated relatively large gaps in all nine WC areas. Leadership, physical work environment and work/life satisfaction in particular seemed to be problematic areas with relatively large gaps, meaning that employees have negative experiences of these areas while perceiving these areas as very important. Additionally, all WC areas were significantly related to subjective health, especially regarding mental ill health and well-being; the larger the gaps, the worse the subjective health. The WC areas of work/life satisfaction, self-development, social relationships, communication and recognition had the highest relationships and model fits. This indicates that it is most problematic from an employee’s point of view if there are large gaps within these WC areas.

This study improves the understanding of workplace health by exploring the gap between experienced WCs and the perceived importance of these conditions.

This review explores some of the key issues relevant to children and adults who have dysphagia, or eating, drinking and swallowing difficulties, and a learning disability. It explores the methods for attempting to identify this area of difficulty effectively, and reflects on some of the other issues that may affect management, such as carer support and training and use of appropriate communication strategies to support and enable participation from the client with learning disability.