Suchergebnisse

Kyle reviews The Cultic Milieu: Oppositional Subcultures in an Age of Globalization edited by Jeffrey Kaplan and Helene Loow.

IntroductionImprovements in health in the UK are beginning to stall. Differences between the health of people living in the most and least deprived areas continue to grow. An excess in mortality, not explained by deprivation, has been observed in Scotland. Some of this difference likely results from limitations in deprivation measures.
Objectives and ApproachWe seek to test whether Nurses experience health inequalities in Self-Rated Health comparable with the general population. We also aim to explore cross-national differences within the Nursing occupational group.
We utilise data from Census-derived Longitudinal Studies in Scotland and England & Wales which are linked to an adjusted UK-consistent Multiple Deprivation measure. The databases can only be accessed securely, so an innovative method (eDatashield) has been used to conduct analysis as if the two were combined.
Nurses are of interest as they are a large occupational group with potentially protective characteristics against inequalities including high health literacy and level of education. Socioeconomic homogeneity in this group may reduce the effect of confounding when exploring area-based deprivation measures.
ResultsComparing Nurses to Non-Nurses we found they have systematically different and more homogenous characteristics. Nurses are; older, have a higher level of education, are more likely to be female, own their home, are less likely to live in deprived areas and they report better Self-Rated Health. However, inequalities persist.
Comparing Self-Rated Health of Scottish with English & Welsh Nurses will determine whether an 'excess' in worse health outcomes exists and if so, whether the UK- consistent Deprivation Measure can account for this. Full results will be cleared for dissemination through disclosure control, prior to the conference.
Conclusion / ImplicationsEven in a privileged group with characteristics which protect against poor health, inequalities remain. The methods applied here present an opportunity for improved cross-national comparison and address limitations in confounding when exploring inequalities based on area deprivation.

Rising global demand for informal care makes it increasingly important to have a comprehensive understanding of carers' experiences. However, research is thought to be skewed towards women's experience, leading some to call men 'forgotten carers'. A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines was conducted to assess the gender balance of study samples of family carers of someone living with cancer. A total of 82 articles involving 14,352 participants were reviewed. Overall, 35.5 per cent of participants were men and 64.5 per cent were women. Researchers should seek to overcome barriers to men's participation in carer research in order to ensure the experiences of male and female carers are recognised through research.

IntroductionScottish health outcomes are worse than in England and Wales. This variation remains after controlling for deprivation, which explains less excess mortality now than previously. Alternative cross-national deprivation measures have limitations which may explain some of this trend. Recent policy interventions to reduce inequalities have not been effective.
Objectives and ApproachThis study aims to test a recently developed measure of area deprivation, the UK adjusted Index of Multiple Deprivation which has been linked to National Census derived Longitudinal Studies in England, Wales and Scotland. This adjusted measure is consistent across UK countries and addresses some limitations of previously utilised area measures of deprivation.
This study also aims to test whether characteristics of Nurses are protective against inequalities in health. This study will test whether Nurses are more socio-economically homogenous and whether higher health literacy is protective against the social gradient in health outcomes.
Results(1) Comparing Nurses to Non-Nurses in Scotland we found that they have systematically different demographic characteristics. Nurses are; older on average, more likely to be female, more likely to own their home, more likely to live in less deprived areas and they report better self-rated health. (1a) Correlation tests will examine the strength of relationship between health and Deprivation quintile for these groups.
(2) Comparing Self-Rated Health of Scottish Nurses with English and Welsh Nurses will determine whether any 'excess' in worse health outcomes exists and (2a) if an excess does exist, whether the UK consistent deprivation measure can account for this.
Analysis is currently ongoing and will be completed, with full results cleared for dissemination through disclosure control, prior to conference.
Conclusion/ImplicationsThis study implements methods which provide a basis for cross-national comparison of inequalities using individual-level data and a consistent measure of area deprivation.
Results from this study may also permit recommendations to improve the effectiveness of policy aimed at improving population health and reducing socio-economic inequalities in health.

Background: Challenges to the sustainability of global healthcare systems are prompting a shift towards more population-focused models of care. Nurse educators need to develop courses that prepare students for population health practice. However, the educational approaches that can support this shift are poorly understood. Publication of new standards for nurse education by the United Kingdom's (UK) Nursing and Midwifery Council that place greater emphasis on population health presented an opportunity to seek nursing leaders' views on population health in nurse education.Objectives: To assess the views of nursing leaders within a Scottish context on the connection between nurse education and population health for all students, evaluate what student nurses need to know to support population health practice, and draw insights from the UK for pre-registration programmes internationally.Design: Qualitative interview studyParticipants: Twenty-four nursing leaders from academic (n=15), practice (n=4) and regulatory (n=5) sectorsMethods: Semi-structured interviews were conducted face-to-face (n=21), by telephone (n=2) or Skype (n=1). Interviews were transcribed and analysed, using interview questions as structural themes, followed by thematic and content analyses.Results: Nursing leaders encouraged rebalancing nurse education towards population health, suggesting that population health concepts should sit at the core of spiral curricula to enable students to (re)view learning through a population health lens. Seven outcomes were identified to equip student nurses for practice in any setting. These formed the mnemonic FULCRUM: Find and interpret evidence; Understand the psychology of behavior and change; Link epidemiology to population health; Consider others and themselves in context; Recognise social determinants of health; Understand the impact of policy and politics on health; Motivate to encourage behaviour change.Conclusions: FULCRUM can guide nurse educators globally to support preparation of graduate nurses for ...

BackgroundAverage health in the UK is improving, yet geographical inequalities in health persist. The relative difference between the least and most deprived is also growing. Recent policy interventions to reduce these inequalities have not been effective.
MethodsThis work compares Self-Rated Health using the ONS LS and SLS linked to an adjusted UK-consistent small-area Deprivation measure.
This study aims to compare Nurses to the general population to assess whether they also exhibit a social gradient in health. Using a single occupational group adjusts for potential confounders and tests whether characteristics of Nurses, such a good health literacy, degree education and above average income, are protective against inequalities.
ResultsIn Scotland, Nurses are more likely to be older, female, homeowners who live in less deprived areas with better Self-Rated Health than Non-Nurses. We will test whether the social gradient in health is observed for this occupational group.Forthcoming results from cross-national analysis will be presented at conference following disclosure checks.
ConclusionThe relationship between area deprivation and health may remain even in relatively privileged groups.
Results from this study may inform recommendations to improve the effectiveness of policy aimed at improving population health and reducing socio-economic inequalities in health

Developing strategies to support student nurses' health is a global priority for healthcare organisations and governments. This is because emerging international evidence indicates that improvements in student nurses' health are required to increase the longevity of careers and reduce the loss of time, skill and financial cost of sickness absence and workforce exit. However, we do not know what intervention strategies student nurses think would support their health. The study aim was to explore student nurses' views on factors that influence health-related behaviours and strategies that could improve health. Data were collected through participatory activities during focus groups with student nurses in Scotland. Analysis was theoretically informed and involved mapping to the Behaviour Change Wheel framework. Students identified several factors that influenced health-related behaviours. Four were ranked most important: knowledge, culture, time constraints, and stress. Strategies student nurses thought should be prioritised to improve nurses' health-related behaviours were: stimulating a health-promoting environment by reviewing shift work, improving workplace support, increasing staffing levels, subsidising and role-modelling of healthy food and exercise; and creating applied health-promoting curricula by integrating time and stress management training and lifestyle advice into nursing education. Educational and environmental interventions are needed to support student nurses' health.

Summary Unpaid carers were profoundly impacted by the coronavirus disease 2019 pandemic and public health responses. In the UK, in March 2020, people identified as clinically extremely vulnerable and their household members were advised to "shield" for an initial 12-week period, which meant minimizing all contacts from outside the household and not leaving the house at all, unless in an emergency. In a modified form, shielding guidance remained in place until August 2020 and was reinstituted from December 2020 until April 1, 2021. This article, reporting on qualitative interviews with 47 unpaid carers in Wales, thematically analyzed using a coding framework, explores the experiences of unpaid carers affected by this shielding guidance and their wider implications for social work with unpaid carers in the future. Findings Participants in our study described ways in which their caring role expanded, due to the need to provide additional practical and emotional support for loved ones who were shielding, and who lost access to other avenues of support. Some also described their caring role as becoming more involved and complex due to the declining health or self-care capacity of the person cared-for as a direct consequence of shielding restrictions. Alongside the increase in their caring responsibilities, carers reported losing access to important avenues of support for their own well-being. Applications We draw on ecological systems theory to highlight the importance during care planning and management of exploring the carer's mesosystem to identify and optimize sustaining forces, and of attending to the microsystem involving the carer and person cared-for.