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Mental health problems in old age have attracted policy attention in the UK over the past decade. An important issue is how to improve services for people who have both mental health and other problems. This article sets out some of the challenges facing planners and commissioners in developing integrated services for older adults, by using the case study of people with dementia and incontinence problems. It uses integrated service models and observations from the EVIDEM‐C study to suggest some incremental actions that would help develop the long‐term strategy for integrated services.

The purpose of this paper is to investigate the presence of bladder and bowel symptoms in women recently imprisoned in Western Australian prisons, specifically; stress, urge and mixed urinary incontinence, faecal incontinence, nocturia, nocturnal enuresis and constipation and the impact on the quality of life (QOL).

Over a 12-month period 29 women, recently released from Western Australia’s female prisons, were surveyed using a questionnaire previously validated for the prison population. The Short Form King’s Health Questionnaire and a modified version of the Manchester Health Questionnaire were used to assess the effects of these symptoms on QOL.

Of those surveyed only one respondent reported having no bladder or bowel symptoms following release from prison. Trends assessed by Chi-square analysis suggest women imprisoned for any period of time are more likely to develop both bladder and bowel symptoms which persist after release back into the community. A history of substance or alcohol abuse is often concurrent with the presence of symptoms. QOL scores are also lower for those reporting either bladder or bowel symptoms affecting total scores and the domains of both activities of daily living and mental health.

Women imprisoned for any length of time developed bladder and bowel symptoms which had a negative impact on their QOL. Larger studies need to be conducted to investigate these trends and whether small changes in conservative measures can influence outcomes.

This article describes actual UI prevalence and quality of care at Israeli LTC institutions for the elderly. The analysis is based on current regulatory data on 14,406 residents at 196 residential homes, and 8,278 patients at 159 hospitals for the chronically ill. It includes a calculation of summary indices of quality, the percentage of institutions with deficient items and of those showing change, and a description of functional status profiles. Multiple regression explains the deficiency rate variance through independent institutional variables. There is a higher prevalence of severe functional impairment and full incontinence at hospitals for the chronically ill than at residential homes. There were higher rates of deficiencies and lower rates of corrections for structural items than for process items at both. A major improvement occurred for process items (50‐100 per cent). Regarding outcomes, 34 percent of the residents with UI during the first assessment were continent two years later.

Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective.

This research employs randomized, prospective studies to obtain robust cost and utility data used in the Markov chain decision model for examining which of these surgical interventions is more effective in treating women with stress UI based on two measures: number of quality adjusted life years (QALY) and cost per QALY. Treeage Pro Healthcare software was employed in Markov decision analysis.

Results showed the Sling procedure is a more effective surgical intervention than the Burch. However, if a utility greater than certain utility value, for which both procedures are equally effective, is assigned to persistent incontinence, the Burch procedure is more effective than the Sling procedure.

This paper demonstrates the efficacy of a Markov chain decision modeling approach to study the comparative effectiveness analysis of available treatments for patients with UI, an important public health issue, widely prevalent among elderly women in developed and developing countries. This research also improves upon other analyses using a Markov chain decision modeling process to analyze various strategies for treating UI.

Urinary incontinence is one of the most important health problems for people over 65 years of age. It is defined as involuntary and uncontrolled loss of urine. This paper aims to present a contemporary view on the effects of physiotherapeutic procedures in combating urinary incontinence. Physiotherapeutic procedures were compared: pelvic floor muscle exercises, physical therapy and biofeedback (BF) to demonstrate their effectiveness in managing urinary incontinence in the elderly.

The databases Pubmed and GoogleScholar have been searched for articles on the impact of interventions – physiotherapeutic procedures on the effectiveness of the treatment of urinary incontinence in the elderly.

Pelvic floor muscle exercises are effective in the treatment of urinary incontinence, strengthen muscle strength and improve patients' quality of life. A long-lasting, systematic and individual training program with a physiotherapist is the most effective. BF helps to intensify the therapeutic effect of exercise but also allows you to achieve good results as an independent treatment method. Positive effects are also noticeable in physical therapy, electrostimulation and magnetotherapy are very effective. Physiotherapeutic procedures have a positive effect in the treatment of urinary incontinence in the elderly. However, further research is needed to clarify the most effective methods.

This paper offers many ways to deal with urinary incontinence in the elderly using physiotherapeutic procedures, thus helping to improve the quality of life of those affected by urinary incontinence.

The purpose of this paper is to provide a narrative review of what is currently known about the high rates of falls, and fall injuries, which are experienced by people with learning disabilities (LDs) throughout their lives.

Narrative review. Current evidence is summarised as key points and recommendations for practitioners and researchers.

People with LDs experience similar rates of falls as older adults in the wider population, but throughout their lives, or at an earlier age.

Key points and recommendations are summarised for practitioners and researchers to promote fall prevention strategies and interventions for people with LDs.

NHS Direct Digital was available to almost exactly the same number of users in both Hull and London via two different transmission DiTV companies: Kingston Interactive Television (KIT) and HomeChoice. This paper employs metrics based on server generated logs to compare use and user differences between the two services. Server logs that record user activity on a real‐time and continuous basis were made available and used to make comparisons between the two services. The data were collected for both services over a similar period, February 2002 to May 2002. During this period the NHS Direct Digital service was visited by approximately 3,000 people and more than 5,000 NHS Direct videos were viewed. Making the study probably the largest analysis of health videos ever conducted.

The purpose of this paper is to determine the impact of self reported gastrointestinal (GI) disturbances in middle aged and older women and the role of food in alleviating these disturbances, so that the effect of food on overall psychological state when experiencing the disturbances and their alleviation can be explored.

One‐on‐one interviews with general questions and laddering/means‐end chain (MEC) elicitation were used to reveal both physical and psychological impacts of GI disturbances and alleviation of the disturbances in women aged between 45 and 70 years old.

In terms of the laddering procedure and cognitive mapping, the number of linkages apparent between concrete and abstract levels demonstrated a complex map of cognitions regarding GI disturbances that involved both physical and psychological impacts. Positive or negative framing of context altered the cognitions revealed in the laddering, with the role of food highlighting these differences.

To the best of the authors' knowledge, MEC theory has not been applied to explore the impact of acute GI disturbances in healthy participants on their quality of life. The exploratory research demonstrates that mild and/or acute experiences of GI dysfunction have negative impacts on psychological well‐being, similar in type to those suffering from chronic conditions and deepens our understanding of the complexity of inter‐relationships between components of well‐being in the context of gut health.