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Chronic hepatitis B and C virus (HBV and HCV) infections are among the leading causes of preventable death worldwide. Chronic viral hepatitis is the cause of most primary liver cancer, which is the third leading cause of cancer deaths globally and the ninth leading cause of cancer deaths in the U.S. The extent to which Comprehensive Cancer Control (CCC) programs in states, tribal governments and organizations, territories, and Pacific Island jurisdictions address chronic hepatitis B and/or hepatitis C infections as risk factors for liver cancer or recommend interventions for liver cancer prevention in their CCC plans remains unknown. We searched CCC plans for this information using the search tool at http://www.cdc.gov/cancer/ncccp/ to access the content of plans for this information. A combination of key search terms including "liver cancer," "hepatitis," "chronic alcohol," and "alcohol abuse" were used to identify potential content regarding liver cancer risk factors and prevention. Relevant content was abstracted for further review and classification. Of 66* CCC plans, 27% (n=18) addressed liver cancer using the above-mentioned search terms. In the 23 plans that addressed HBV and/or HCV, there were 25 goals, objectives, strategies, and outcomes aimed at reducing the incidence or prevalence of HBV and/or HCV infection. While nearly a third of CCC programs identify at least one goal, objective, strategy, outcome, or prevention program to reduce cancer burden in their CCC plans, few plans discuss specific actions needed to reduce the burden of liver cancer.

The objectives of this study were to provide estimates of indoor tanning device use among US high school students and provide baseline data before implementation of a 10% excise tax on indoor tanning device use mandated by recent federal health care reform legislation. We examined the frequency of indoor tanning device use by using data from the 2009 national Youth Risk Behavior Survey. Overall, 15.6% of students used an indoor tanning device during the 12 months before the survey; almost half of those students used an indoor tanning device 10 or more times. Reported use and frequency of use varied by age, sex, and race/ethnicity. Given the high prevalence of indoor tanning device use among US high school students and the associated risk of melanoma, strategies to reduce exposure must be examined.

Abstract
Choice and control are pivotal in UK Government policy for achieving personalisation of social care for people with learning disabilities; however, little is known about the role care management plays in supporting people with learning disabilities finding social care services. This article explores that the support care managers provide people with learning disabilities, how care managers source and use information to offer choice in relation to accommodation and support, with a focus on people receiving managed budgets. Qualitative interviews with eight care managers from two local authorities in the South East of England were analysed using thematic network analysis, producing three global themes. The first 'shaping choice' describes the role of the care management process and assessments have in determining opportunities for choice. The gathering and interpretation of quality information is explored in the second global theme, highlighting the role of visiting settings to understand their quality. 'Choice in principle' is the third global theme, whereby the factors shaping choice come to be seen as choice akin to that anyone else has. These findings have implications for future policy and practice in relation to care management for people with learning disabilities.

AbstractBackgroundA 2005 review by Beart, Hardy and Buchan, asking how people with intellectual disabilities view their social identities, has been widely cited, indicating this important topic needs an updated review. This review covers research on how people with intellectual disabilities view their ascribed label; to what extent they ascribe it to themselves; and whether they recognize it as devalued in society.MethodRapid review methodology using PsycINFO, citation‐ and hand‐searching identified relevant studies.ResultsThe 16 studies identified indicate that the majority are aware of their ascribed label, or acknowledge they are "different". Others reject it, focusing on alternative attributes or roles. Most recognize others view the label negatively and express feelings of shame, anger and powerlessness.ConclusionsThe review advances our understanding of social identity formation in people with intellectual disabilities, with implications for future research and practice to support construction of positive social identities and stigma resistance.

Background: With increasing reductions in funding for social care across many countries, the need to ensure that resources are used to best effect is becoming increasingly important, in particular for those with severe and complex needs. Methods: In order to explore the outcomes and costs of skilled support for this group of people, quality of life was assessed for 110 people in 35 services in England. Information on costs was also collected. Results: People who received consistently good active support experienced better outcomes in terms of several quality of life domains. Good support did not require significantly more staff time, and there was no evidence of higher total costs for those receiving good support. Conclusions: The inclusion of active support in government guidance and local commissioning practices related to people with severe intellectual disabilities is likely to improve user outcomes. Observation should be an important element in measuring service quality.

AbstractBackgroundWith increasing reductions in funding for social care across many countries, the need to ensure that resources are used to best effect is becoming increasingly important, in particular for those with severe and complex needs.MethodsIn order to explore the outcomes and costs of skilled support for this group of people, quality of life was assessed for 110 people in 35 services in England. Information on costs was also collected.ResultsPeople who received consistently good active support experienced better outcomes in terms of several quality of life domains. Good support did not require significantly more staff time, and there was no evidence of higher total costs for those receiving good support.ConclusionsThe inclusion of active support in government guidance and local commissioning practices related to people with severe intellectual disabilities is likely to improve user outcomes. Observation should be an important element in measuring service quality.

BackgroundQuality of life of people with intellectual and developmental disabilities has been found to primarily depend on whether staff are providing facilitative and enabling support that helps to compensate for severity of disability. Managers have a key role in facilitating staff to provide such support.MethodQualitative interviews were conducted with 35 managers of supported accommodation services to explore service aims and the nature of, and challenges in providing, skilled support. Key themes were identified using a Thematic Networks Analysis.ResultsService aims were rarely formalised, were related to the individuals supported and not to the organisation. Managers found it difficult to define skilled support, other than by reference to individuals. Practice leadership roles were challenged as a result of austerity measures.ConclusionsFront‐line managers need more information and training in skilled support, with stronger leadership from senior management to provide the motivation and resources needed.

Background: With increasing reductions in funding for social care across many countries, the need to ensure that resources are used to best effect is becoming increasingly important, in particular for those with severe and complex needs. Methods: In order to explore the outcomes and costs of skilled support for this group of people, quality of life was assessed for 110 people in 35 services in England. Information on costs was also collected. Results: People who received consistently good active support experienced better outcomes in terms of several quality of life domains. Good support did not require significantly more staff time and there was no evidence of higher total costs for those receiving good support. Conclusions: The inclusion of active support in government guidance and local commissioning practices related to people with severe intellectual disabilities is likely to improve user outcomes. Observation should be an important element in measuring service quality.

BackgroundThis study reports the experiences of developing and pre‐testing an Easy Read version of the Adult Social Care Outcomes Toolkit (ASCOT) for self‐report by people with intellectual disabilities.MethodsThe study has combined survey development and pre‐testing methods with approaches to create accessible information for people with intellectual disabilities. A working group assisted researchers in identifying appropriate question formats, pictures and wording. Focus groups and cognitive interviews were conducted to test various iterations of the instrument.ResultsSubstantial changes were made to the questionnaire, which included changes to illustrations, the wording of question stems and response options.ConclusionsThe process demonstrated the benefits of involving people with intellectual disabilities in the design and testing of data collection instruments. Adequately adapted questionnaires can be useful tools to collect information from people with intellectual disabilities in survey research; however, its limitations must be recognized.

AbstractBackgroundPeople with intellectual disabilities are at risk of experiencing stigma and require the skills and confidence to deal with stigma in their daily lives.MethodDevelopment and piloting of a 5‐session manualised psychosocial group intervention designed to increase the capacity of people with intellectual disabilities aged 16+ to manage and resist stigma. Ten pre‐existing groups (N = 67) in third sector and education settings participated. Interviews with participants (n = 26), facilitators (n = 9) and significant others (n = 7) 2–4 months after the intervention assessed perceived impact.ResultsPerceived benefits of the intervention for participants included increased understanding, improved connections with others, drive for advocacy, increased activity and self‐efficacy, and opportunity to process difficult events and emotions. Differential impact depending on individuals' pre‐existing self‐advocacy skills was noted.ConclusionsThis early‐stage study indicates that further evaluation is merited to examine feasibility and outcomes of the STORM intervention.

Background: Community-based estimates of psychopathology prevalence in developing countries such as Vietnam, are needed to reduce presumed significant burden of poor mental health. Aims: This study derived population-based prevalence estimates of mental distress, as measured by the SRQ-20, in a community sample of 4,981 adults living in Vietnam. This study also examined correlates of mental distress based on SRQ-20 caseness indications. Risk and protective factors were identified in terms of their unique contribution to caseness. Results: Using a cut-off of 7/8, 19.2% of the sample was considered to be a probable case ( n = 954), with females endorsing more items than males. Marital status and employment status were not associated with mental health distress. Higher wealth, endorsing religious affi liation, and self-reports of good health were associated with lower SRQ-20 scores. Age and being female were associated with higher SRQ-20 scores. Conclusions: A single item was as adequate a measure of wealth as multi-item rating scales. Our estimate of mental distress using the SRQ-20 is much greater than that of other studies, and in contrast to western prevalence studies, age was not a protective factor in this study. The SRQ-20 is a brief, cost-effective and reasonably valid measure of both community and individual mental distress.