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Post-diagnostic dementia care is often fragmented in the United Kingdom, with great variation in provision. Recent policies suggest moving towards better community-based care for dementia; however, little is known on how this care is delivered. This study aimed to map the post-diagnostic dementia support provided in England a decade after the introduction of a National Dementia Strategy.

A mixed-methods e-survey (open Nov 2018–Mar 2019) of dementia commissioners in England recruited through mailing lists of relevant organisations was conducted. The authors descriptively summarised quantitative data and carried out thematic analysis of open-ended survey responses.

52 completed responses were received, which covered 82 commissioning bodies, with representation from each region in England. Respondents reported great variation in the types of services provided. Information, caregiver assessments and dementia navigation were commonly reported and usually delivered by the voluntary sector or local authorities. Integrated pathways of care were seen as important to avoid overlap or gaps in service coverage. Despite an increasingly diverse population, few areas reported providing dementia health services specifically for BME populations. Over half of providers planned to change services further within five years.

There is a need for greater availability of and consistency in services in post-diagnostic dementia care across England.

Post-diagnostic dementia care remains fragmented and provided by a wide range of providers in England.

This study aims to investigate whether factors previously shown to influence attendance rates for appointments in general practice and general mental health services also influence attendance rates in services for people with intellectual disabilities (ID).

Post hoc data from 452 psychology appointments, ID diagnostic and initial screening (triage) appointments were collected from the health-care files of a community adult ID psychology service. Demographic factors (age, sex) and clinical factors (waiting time, time between appointment invitation being sent and appointment being held, presence of prior telephone call or letter, type of appointment, weekday, month) were recorded along with the attendance outcome (attended/did not attend [DNA]). The impact of the COVID-19 pandemic was also explored by documenting whether the appointment predated March 2020.

No significant associations were found between any variable investigated and attendance outcome when analysing appointment data as a whole and when splitting the data between appointment type. Weekday was found to significantly be associated with attendance outcome for appointments held during COVID-19, in which more DNA appointments occurred on a Wednesday compared to the other days of the week. No other associations were found for appointments held during the COVID-19 pandemic or for appointments held prior to the COVID-19 pandemic. These results suggest that factors which influence attendance rates in general health-care settings do not necessarily generalise to ID services.

To the best of the authors’ knowledge, this study is the first to examine whether certain demographic and clinical factors influenced attendance rates in an adult intellectual disability service.

The recent food scares combined with the wide body of literature suggesting improved health status of vegetarians has apparently fuelled the growth in the number of vegetarians and semi/demi vegetarians. This expansion has been met by a considerable growth in the vegetarian convenience food market. A database of vegetarian convenience foods has been created which shows that there is a large and increasing number of vegetarian convenience foods available which show great within‐product ranges in terms of nutritional composition. The database indicates that vegetarian convenience foods are often high in fat and saturates and their consumption would not assist in meeting current dietary targets.

To consider how knowledge about social class is produced in research and how it can become obscured from view through certain empathic practices of representation.

A number of data extracts, generated through participant observation and focus group interviews, are reflexively (re)considered in the chapter. These are drawn from an ethnographic study, previously undertaken by the author with a class of 25 young women in one private, selective girls’ school in the United Kingdom.

Social class was found to be silenced in the accounts which resulted from the research. This relative neglect is considered to have resulted from the primacy given to gender in a feminist project; to an over-emphasised sense of empathy and due to the desire to build and maintain respect and rapport. Strategies of empathic identification and representation should not be evaded altogether, but they need to be carefully considered (how and why are they used and to what effect?) and not taken up too readily, so that researchers don’t inadvertently re-inscribe the inequalities they are seeking to eliminate.

The chapter argues that greater attention needs to be paid to the class-making practices which researchers and participants engage in during and after fieldwork. Social class is brought to the foreground in the analyses presented.

Adolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance-use disorders (SUDs). This study aims to compare the clinical profiles of adolescents (aged 12–17 years) and emerging adults (aged 18–25 years) presenting for treatment of posttraumatic stress disorder (PTSD) and SUD.

Data was collected from the baseline assessment of individuals (n = 55) taking part in a randomized controlled trial examining the efficacy of an integrated psychological therapy for co-occurring PTSD and SUDs (PTSD+SUD) in young people.

Both age groups demonstrated complex and severe clinical profiles, including high-frequency trauma exposure, and very poor mental health reflected on measures of PTSD, SUD, suicidality and domains of social, emotional, behavioral and family functioning. There were few differences in clinical characteristics between the two groups.

Similarity between the two groups suggests that the complex problems seen in emerging adults with PTSD + SUD are likely to have had their onset in adolescence or earlier and to have been present for several years by the time individuals present for treatment.

To the best of the authors’ knowledge, this is the first study to compare the demographic and clinical profiles of adolescents and emerging adults with PTSD + SUD. These findings yield important implications for practice and policy for this vulnerable group. Evidence-based prevention and early intervention approaches and access to care are critical. Alongside trauma-focused treatment, there is a critical need for integrated, trauma-informed approaches specifically tailored to young people with PTSD + SUD.

The purpose of this paper is to provide an overview of the context for strategies to overcome antimicrobial resistance in Australia, which may provide valuable learnings for other jurisdictions.

Non-systematic review of literature from websites of national, state and territory health departments and interviews with key stakeholders for Australian strategies to reduce antimicrobial resistance.

In July 2015 all states and territories in Australia adopted the National Antimicrobial Resistance Strategy 2015-2019, which is built on the World Health Organization policy package to combat antimicrobial resistance. This strategy represents “the collective, expert views of stakeholders on how best to combat antimicrobial resistance in Australia. It will also support global and regional efforts, recognising that no single country can manage the threat of antimicrobial resistance alone”. It combines quantitative and qualitative monitoring strategies with frameworks and guidelines to improve management of the use of antimicrobial resistant drugs. Prior to this, health services and states developed and implemented initiatives aimed at monitoring and improving prescribing practices. Development of the national strategy has encouraged and fostered debate within the Australian health system and a raft of new policy initiatives.

Surveillance strategies are in place to monitor impact and trends at jurisdictional and sector levels. However, actual impact on antimicrobial resistance and prescribing practices remains to be seen as existing initiatives are expanded and new initiatives implemented.

This overview of key Australian initiatives balancing quantitative and qualitative surveillance, accreditation, research, education, community awareness and price signals on antibiotic prescribing practices may be valuable to health systems in developing local strategies.

The authors provide an up to date overview of the context, strategies and aims of antimicrobial stewardship in Australia.

This paper charts the technological developments that have taken place within primary health care during the last 20 years, drawing upon previous research and presenting new survey findings on the current state of computerisation. The survey reveals that 96 per cent of UK practices use a clinical computer system, with repeat and acute prescribing, the collation of annual data and audits/searches being the most well used applications. The move towards the so‐called “paperless” practice is strongly related to GPs’ computing expertise, with larger practices more likely to have gone in this direction. Over half of GP practices now have access to the Internet. Improvement of computing skills appears a major determinant of successful integration of technology within a practice. There is a need to develop a social architecture and learning environment that allows GPs to provide good quality health care with clinical computer systems at its heart.

This paper describes a grounded theory that emerged from a study of Hong Kong Protestant secondary school principals’ values and their impact on principals’ perceptions and management of problems. This substantive theory is labelled the “value‐based congruence theory”. It implies first, that values influence how Hong Kong principals perceive and manage problems in their schools. Second, that particular principal's value orientations correspond with their behaviour in terms of their perceptions, problem‐solving strategies and the outcomes experienced. Principals’ value orientations fall along the following five value dimensions: the relationship, reform, empowerment, client‐focus and rationality dimensions. These correlations result in five principal types – the pacifists, the progressive mentors, the philosopher mentors, the pragmatists and the eclectics. However, other factors, namely, personal and organizational characteristics as well as the value properties of clarity, commitment, consistency, versatility, breadth and focus, are found to moderate the linkages between principals’ values and their concomitant responses.

The purpose of this paper is to examine the discourses that shape nurses’ understanding of self-harm and explore strategies for working with people who self-harm in a relational and a recovery-oriented manner.

Self-harm is a relatively common experience for a cohort of people who present to the mental health services and is, therefore, a phenomenon that mental health nurses will be familiar with. Traditionally, however, mental health nurses’ responses to people who self-harm have been largely framed by a risk adverse and biomedical discourse which positions self-harm as a “symptom” of a diagnosed mental illness, most often borderline personality disorder.

This has led to the development of largely unhelpful strategies to eliminate self-harm, often in the absence of real therapeutic engagement, which can have negative outcomes for the person. Attitudes towards those who self-harm amongst mental health nurses can also be problematic, particularly when those who hurt themselves are perceived to be attention seeking and beyond help. This, in turn, has a negative impact on treatment outcomes and future help-seeking intentions.

Despite some deficiencies in how mental health nurses respond to people who self-harm, it is widely recognised that they have an important role to play in self-harm prevention reduction and harm minimisation.

By moving the focus of practice away from the traditional concept of “risk” towards co-constructed collaborative safety planning, mental health nurses can respond in a more embodied individualised and sensitive manner to those who self-harm.

This paper adds further knowledge and understanding to assist nurses’ understanding and working with people who self-harm in a relational and a recovery-oriented manner.

The librarian and researcher have to be able to uncover specific articles in their areas of interest. This Bibliography is designed to help. Volume IV, like Volume III, contains features to help the reader to retrieve relevant literature from MCB University Press' considerable output. Each entry within has been indexed according to author(s) and the Fifth Edition of the SCIMP/SCAMP Thesaurus. The latter thus provides a full subject index to facilitate rapid retrieval. Each article or book is assigned its own unique number and this is used in both the subject and author index. This Volume indexes 29 journals indicating the depth, coverage and expansion of MCB's portfolio.