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The limited evidence of effectiveness of existing teenage pregnancy strategies which focus on sex education, together with growing evidence that factors such as poor school ethos, disaffection, truancy, poor employment prospects and low expectations are associated with teenage pregnancy, has increased interest in interventions which target these “wider” social determinants. This paper aims to identify promising interventions and priorities for future research and to make recommendations for policy and practice in the UK.

This paper discusses the evidence regarding the potential of interventions which target determinants of teenage pregnancy relating to school disaffection and low expectations, drawing on recent systematic reviews and trials to consider future directions for research, policy and practice.

High‐quality research evidence illustrates the potential of two approaches to address determinants of teenage pregnancy relating to disaffection and low expectations. These are school‐ethos interventions, which aim to facilitate a positive and inclusive school‐ethos, strengthen school relationships and reduce disaffection; and targeted, intensive youth work interventions, which aim to promote positive expectations, vocational readiness and self‐esteem through vocational and life‐skills education, volunteering and work experience.

Two forms of intervention which address key social determinants of teenage pregnancy – school‐ethos interventions and targeted youth work interventions – require more attention from researchers and policy‐makers.

This paper calls for a shift in the research and policy agenda. In addition to interventions that aim to address proximal, individual factors, such as sexual health‐related knowledge, there should be a more complementary focus on socio‐environmental as well as targeted individual‐focused interventions aiming to address the wider social determinants of teenage pregnancy.

The purpose of this paper is to examine the impact of mindfulness awareness practice (MAP) on mid-level health-care managers’ leadership.

In total, 11 mid-level health-care managers in eastern Canada took part in an intensive weekend retreat and a follow-up webinar on mindfulness awareness. Perceived stress and leadership effectiveness were assessed pre- and post-intervention (i.e. four and eight weeks). A control group (n=10) also completed the same measures twice. Additionally, informants (n=28) provided assessments of participants’ leadership pre- and post-intervention. Follow-up interviews were carried out with eight participants 12-16 weeks post-intervention.

In comparison to controls, retreat participants showed significant increases in mindfulness and corresponding decreases in stress that were sustained across eight weeks post-retreat; retreat participants reported significant positive changes in their leadership effectiveness that were corroborated by informants. Qualitative data, however, suggest that sustaining a mindfulness practice presents significant challenges to middle managers in a health care setting.

The findings are useful to management working in health services that are plagued by increasing demands and changes. Despite the small sample and lack of random assignment, the pilot data support the efficacy of MAP in improving leadership.

Little empirical research supports the claim that MAP enhances leadership. The present study employed a mixed methods approach to address this gap and demonstrates the potential benefits of MAP among mid-level managers.

The purpose of this paper is to report on findings from an evaluative research study which looked at a timed intervention model of practice comprising of up to 24 weeks of intensive meetings with adult service users set up by one local authority in England, to prevent and delay the need for care and support. A particular focus of this paper is on adults who hoard.

The study employed a mixed-methods design, consisting of interviews with service users (n=13), social workers (n=3), social work managers (n=2) and stakeholders from external services and agencies (n=6). It included a costing analysis of staff time and an analysis of goals of service users and “satisfaction with life” self-report questionnaires (n=20), completed at pre- and post-intervention stages.

There was evidence that social workers used strengths, relationship-based and outcome-based focused approaches in their work. The techniques used by social workers to engage, achieve change and assess effectiveness with service users varied. These techniques included the use of photographs to enable the service user to map and assess their own progress over time, encouraging hoarders to declutter and reclaim their living space. The service users valued the time the social workers spent with them and the way that they were treated with sensitivity and respect.

The study focused on one local authority in England; there was no comparison group. This, and the small sample size, means that statistical generalisations cannot be made and only limited conclusions can be drawn from the quantitative data.

The paper provides insights into the work undertaken by social workers with adults who hoard. It contributes to the body of knowledge on effective social work interventions with adults who hoard.

There is mixed evidence regarding the efficacy of low-intensity integrated care interventions in reducing the use of emergency services and costs of care. The purpose of this paper is to examine the effects of a low-intensity intervention formulated for older adults and delivered in an urban medical center serving low-income individuals.

The intervention included an initial evaluation of stress, psychiatric symptomatology and health habits; potential referrals for lifestyle management and psychiatric treatment; and training for physicians about the impact of lifestyle change in older adults. Participants included older adults (at or above 50 years of age) seen as outpatients in an urban medical center serving a low-income community (n=945). Participants were entered into the intervention at any point during this two-year period. Mixed models analyses examined all visits for all enrolled individuals over a two-year period, comparing visits before the individual received the initial intervention evaluation to those received after this evaluation. Outcomes included total health care costs incurred, average cost per visit, and emergency department (ED) usage within the facility.

The intervention was associated with reduced likelihood of emergency department use and reduced costs per visit following the intervention. These effects were seen across all participants.

Limitations of the study include the lack of control group.

This program is easy to disseminate and could improve the quality of care and costs.

This study is among the few available to document a decrease in medical costs, as well as decreased ED utilization following a low-intensity integrated care intervention.

Applied Behavior Analysis (ABA) is a scientific method for modelling human behavior, successfully applied in the context of Autism. Recording and sharing measurable data (on subjects’ performance) between caregivers guarantees consistency of learning programs and allows monitoring the learning enhancements. Data are usually recorded on paper, which requires considerable effort and is subject to error. The purpose of this paper is to describe a portable application developed to support ABA tutors in their work with autistic subjects. It allows gathering data from ABA sessions, giving tutors rapid access to information, also in graphical formats.

The tool was designed via participatory design. Various ABA team members were involved, in order to make the application respond perfectly to their needs. The approach aims to ensure maximum usability, while minimizing errors and ambient interference.

The use of mobile devices (i.e. tablets or smartphones) allows mobility and ease of interaction, enabling efficient data collection and processing. Data plotting allows one to easily interpret gathered data.

The proposed application, free open source software, can be a valuable aid for supporting the ABA intervention and favor the inclusion of children with autism.

Available software to assist tutors during therapy sessions is often proprietary, and research prototypes are not freely available, so paper forms are still widespread. Besides, without attention to usability requirements, assisting tools would be comparable in efficiency with data insertion on paper. Our software was specifically designed following ABA principles and favors efficient data entry allowing natural interaction with touch screen interfaces: drag and drop, taps and gestures. Furthermore, it is shared in the public domain.

The purpose of this paper is to explore and review the range and quality of international epidemiological and observational studies reporting impacts of psychiatric disorders on labour force activity. This information is needed to explore the relative priority of different diagnostic groups for more intensive forms of vocational rehabilitation.

The authors provide an overview of the current literature. A systematic review of papers measuring labour force variables and psychiatric disorders across a range of countries is conducted. These results are compared to OECD background unemployment rates during the same period. The results for each diagnostic category included are aggregated and compared to the other diagnostic categories.

The proportions of people employed decreased with the more severe disorder categories, indicating that severe psychiatric illnesses are contributing to employment struggles for people with these illnesses, across countries.

This review is exploratory and shows that there is little consistency in reporting of labour force variables. Future research should endeavour to utilise internationally agreed definitions of labour force activity.

This conclusion is relevant to matching community residents with psychiatric disorders to the more intensive and costly forms of vocational rehabilitation.

To our knowledge, no previous review has examined diagnostic categories of psychiatric disorders by labour force activity internationally while taking into account background unemployment. This review found an employment gradient related to severity of diagnostic category that will be of interest to clinicians and policy makers.

This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.

This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.

From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01).

A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.

This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.

The UK public has been fairly resistant to health promotion messages encouraging reduced fat intake as a component of the strategy to help achieve the targets for cardiovascular disease risk reduction identified in The Health of the Nation and extended in Saving Lives: Our Healthier Nation. This project is designed to test the hypothesis that a more positive message to eat more (low fat) starchy foods would be better received and achieve the desired dietary goals. Newcastle families, in enumeration districts in the middle three quintiles of the Townsend Deprivation Index who do not meet current dietary targets for fat and starch, are being recruited to one of three interventions designed to encourage and enable them to choose diets richer in starchy foods. Dietary outcomes are being measured at three and six months after the interventions. We are investigating the process of change through use of questionnaires and in‐depth interviews with both “achievers” and “non‐achievers”.

This article sets out to provide information regarding the evidence base for psychological treatments and to demonstrate that the number of mental health professionals who are available and competent to deliver these treatments is very small compared with the numbers of people who might benefit. The article also considers the prevalence of conditions that are amenable to psychological treatment and then explores how ‘stepped care’ may be one solution for providing available treatment resources in a way that is fairest and most effective for the population at large.

One limitation of research that assesses the effectiveness of physical activity interventions for people with dementia is that most do not describe the intervention in sufficient detail to ascertain a theoretical basis or mechanism of action that determines the effective components. This paper aims to identify studies which evaluate the mechanisms of action of physical activity interventions for people with dementia, to further inform effective intervention development.

Papers were screened for evidence of evaluation of specific forms of physical activity, using pre-defined inclusion criteria. Analysis was conducted to ascertain if mechanisms of action were corroborated by data within and between studies.

The authors identified 26 studies with a measured mechanism of action; these related to the effects of physical activity on either neurological structure or endocrinal markers, including hormones. Physical activity had potential to reduce hippocampal atrophy, increase neural recruitment, activate the noradrenergic system and improve anti-inflammatory responses. While individual studies were hampered by small sample sizes, the body of evidence indicated that physical activity may have potential to delay cognitive decline.

Mechanisms of action in relation to dementia and physical activity are likely to be multifaceted, and physical activity may be protective against progression in the early stages of cognitive decline. Physical activity may be of greatest benefit if incorporated into on-going lifestyle, rather than engaged in for short periods, and combined with social interaction.

This paper is unique in its focus on the mechanisms of action of physical activity interventions for people with dementia.