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Effective transitions from child and adolescent to adult services are important for continuity of care for patients with eating disorders. This study aims to examine the relative importance of a series of statements about the transition process, elicited from an earlier service evaluation, from the perspectives of patients, parents/carers and clinicians.

Twenty-eight participants completed a Q-sort task ranking 40 statements, developed from an earlier study, using a normal distribution pattern on a scale, which ranged from strongly agree to strongly disagree, to identify their priorities for transition. Analysis resulted in the extraction of four factors explaining 52% of the variance.

Four distinct factors were elicited: “parents and carers need including too”, “facilitating effective transfer between services”, “supporting the patient through transition” and providing “timely, patient-centred care”. The study enabled similarities and differences in priorities to be observed for the three respondent groups.

These rankings, noting the differences between the respondent groups, can be used to inform the development of effective transition protocols. This study suggests these protocols should ensure a person-centred approach; timely planning; include parents/carers; provide continuous care and have good transfer of information and sensible timing of transitions. Differences in priorities/opinions can be addressed through open communication channels.

To the best of the authors’ knowledge, this is the first UK-wide study examining priorities for transition from the perspectives of patients, parents/carers and clinicians.

Referrals to specialist eating disorder (ED) services from the South Asian (SA) community are under-represented, despite research suggesting that disordered eating attitudes and behaviours of SA people are similar to the population in general. The purpose of this paper is to identify the reasons for this and sought to inform ways to encourage help-seeking.

A qualitative methodology was used to investigate barriers to help-seeking for EDs among the SA community. A key informant focus group was conducted with clinicians working within the local specialist ED service (participants n=16, 12 female, 4 male). Six focus groups were conducted with members of the SA community in Leicester, UK (participants n=28, 23 female, 5 male), recruited from a local university, two charities and Children, Young People and Family Centres.

A number of themes emerged as possible factors for delaying early access to help: lack of knowledge about EDs and their potential seriousness, ideals regarding body shape, family living circumstances and the role of food in the community. Participants acknowledged stigma among their community associated with mental health issues, including EDs and concerns about confidentiality when approaching services, particularly primary care.

General practitioners and specialist services need to be aware of the potential barriers to help-seeking for EDs as early specialist help is recommended for effective treatment. An educational campaign around EDs specifically designed with the SA community in mind may improve awareness, reduce stigma and promote early help-seeking.

There is a dearth of research on what constitutes effective transfer of care from children’s and young people services to adult services for patients with eating disorders (EDs) in the UK. Transition has implications for continuity of care and particularly for early intervention which has the best prognosis. The purpose of this paper is to understand the experience of transition and identify facilitators and barriers to this.

Qualitative methodology was used. Focus groups (n = 4) were held with clinicians (n = 22) working in Child and Adolescent Mental Health Services or adult ED services. Individual interviews were conducted with patients (n = 5) who had commenced/completed transition to adult services and with parents/carers (n = 6) of patients invited for interview.

A number of factors may facilitate or impede transition and can be grouped into the broad themes of communication, managing the differences between services and timing of transition. Improvements in communication, clear explanation of service differences and flexibility around the timing of transitions may enhance the experience for patients and parents/carers.

The service evaluation was limited to transition between two specialist ED services in one geographical location. The findings provide the basis for a wider research study to examine which factors are most important when planning transition from the perspectives of patients, parents/carers and clinicians.

This is the first study examining ED transitions in the UK. It provides valuable insight of the experience of service users and carers and highlights potential improvements when planning transitions for this patient group.

There has been wide debate around early interventions following traumatic exposures. Many of the studies examining the effectiveness of debriefing have not been undertaken in a workplace setting for which they were designed. The study was undertaken with prison staff and evaluated the debriefing provided as part of a trauma support programme provided by the prison service. This study was designed to evaluate the effectiveness and a programme of support for prison service staff following a traumatic incident within a prison environment.

Prison staff exposed to a range of traumatic events were offered debriefing. Measurements were taken soon after the incident and again one month later. The scores of those receiving debriefing were compared with those who did not receive debriefing.

The results showed that the prison staff receiving debriefing showed a significant reduction in their traumatic stress, anxiety and depression scores. There was no significant difference in the symptoms of the non-debriefed group.

The findings suggest that group-based well structured debrief sessions can be useful in reducing symptoms of post-traumatic stress following exposure to critical incidents in the workplace. The findings were accepted with the limitation that the groups were self-selecting, a randomised control trial was not allowed for the purpose of this study due to ethical concerns.

The results suggest that there are benefits in undertaking group debriefing within an organisational setting.

Problem solving and continuous process improvement are key elements to achieve business excellence. Many problem solving and process improvement methodologies have been proposed and adopted by organisations, with DMAIC being the most widely used. The purpose of this paper is to present an empirical application of a modified version of DMAIC which enabled a world-class organisation to achieve an optimum reduction in the lead time of its aerospace engine assembly process.

The paper reviews the most commonly used problem solving and process improvement methodologies and specifically, DMAIC, its variations and limitations. Based on this, it presents define, measure, analyse, improve, review, control (DMAIRC). Finally, DMAIRC is empirically applied through a case study, in a world-class manufacturing organisation.

The results obtained from the case study indicate that DMAIRC is an effective alternative to achieve the maximum improvement potential of a process. In particular, DMAIRC helped the organisation studied to achieve a 30 percent reduction in the lead time of its engine assembly process.

The novel problem solving and process improvement methodology presented in this paper can be used by organisations to undertake a more effective improvement project by assuring that the maximum potential of their improvement initiatives and processes is achieved.

Several years after the regularization of microfinance activity in Côte d’Ivoire, smallholder farmers’ access to microfinance credits still remains marginal. The purpose of this paper is to identify and analyze key determinants of access to microfinance credit in Sassandra-Marahoué District.

A total of 150 smallholder farmers were randomly sampled using an interview guide and semi-structured questionnaires. Univariate statistics and Probit binary modeling were employed for data analyses.

Results revealed that socio-economic/demographic characteristics of smallholder farmers and credit requirements imposed by microfinance institutions (MFIs) are key determinants of smallholder farmers’ access to microfinance credits in the district.

Although, the authors shed light on the determinants of microfinance credit access for smallholder farmers in this district, the study focused on a single source of financial credit. Future research will need to explore the determinants of credit demand and the choice between different sources of rural credits in Côte d’Ivoire.

The findings suggest that MFIs seldom take into account smallholder farmers who are not engaged in off-farm income-generating activities and savings account; and those with low level of education. Sensitization programs on the importance of savings mobilization and credit policy by MFIs will potentially increase smallholder’s knowledge on credit access requirements and thereby increased access.

To the authors’ knowledge, this is the first study investigating determinants of smallholder farmers’ access to microfinance credits in Côte d’Ivoire specifically in the Sassandra-Marahoué District. The results of this study will serve as a guide for MFIs for improving smallholder farmers’ access to credit.