BACKGROUND:Health care-associated infections (HAIs) are a major threat to patient safety and quality care. However, they are avoidable by implementing evidence-based infection prevention and control (IPC) measures. This review evaluated the evidence of the effectiveness of IPC interventions in reducing rates of HAIs in health care settings in Africa. METHODS:We searched several databases: CENTRAL, EMBASE, PUBMED, CINAHL, WHO IRIS, and AJOL for primary studies reporting rates of the 4 most frequent HAIs: surgical site infections, central line--associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumoniae, and increase in hand hygiene compliance. Two reviewers appraised the studies and PRISMA guidelines were followed. RESULTS:Out of 4,624 studies identified from databases and additional sources, 15 studies were finally included in the review. The majority of studies were of pre- and post-test study design. All the studies implemented a combination of interventions and not as stand-alone components. Across all included studies, an improvement was reported in at least 1 primary outcome. CONCLUSIONS:Our review highlights the potential of IPC interventions in reducing HAIs and improving compliance with hand hygiene in health care facilities in Africa. For future research, we recommend more pragmatic study designs with improved methodological rigor.

There has been little agreement on the role that socioeconomic factors play in the aetiology of cardiovascular diseases (CVDs), obesity, and diabetes among migrants in the United Kingdom (UK). We systematically reviewed the existing evidence on this association to contribute to filling this gap in the literature. Two reviewers were involved at each stage of the review process to ensure validity. We comprehensively searched through several electronic databases and grey literature sources to identify potentially eligible papers for our review. We extracted data from our finally included studies and appraised the methodological rigour of our studies. A narrative synthesis approach was used to synthesise and interpret the extracted data. We sieved through 2485 records identified from our search and finally obtained 10 studies that met our inclusion criteria. The findings of this review show that there is a trend towards an association between socioeconomic factors and CVDs, diabetes, and obesity among migrants in the UK. However, the picture was more complex when specific socioeconomic variables and migrant subgroups were analysed. The evidence for this association is inconclusive and its causal relationship remains speculative. There is, therefore, the need for further research to understand the exact association between socioeconomic factors and CVD, diabetes, and obesity among migrants in the UK.

Objectives Nostalgic memories are more social than other forms of autobiographical recall, often refer to atypical events, express more positive affect and reflect life as meaningful. Recalling a nostalgic (compared to ordinary) memory increases self-esteem, self-growth, meaning in life and social connectedness for people living with dementia. We set two objectives: to work with people living with dementia to develop an intervention based on nostalgia, and to assess whether couples could engage in nostalgic conversations. Method Our research fell into three phases. Initially, we consulted with people living with dementia and with carers to identify the parameters for a nostalgic intervention. From this, we drafted a workbook that contained triggers for nostalgic conversations, which we then took back to the public contributors for refinement. Finally, we trialled the workbook over 5 weeks with six couples, each of which included a person living with dementia. We assessed pre- and post-intervention self-esteem, self-growth, meaning in life and social connectedness for participants with dementia and social connectedness for carers. We then calculated Reliable Change Index scores and established levels of clinically significant change. We also interviewed couples at the end of the intervention to explore its implementation and acceptability. Results All six couples could identify nostalgic memories, with five couples successfully integrating the nostalgic conversations into their day-to-day lives. A sixth couple found it difficult to engage fully with the intervention, but still considered it useful. All six couples manifested a reliable change in at least one outcome, with one couple showing reliable change across three outcomes. Conclusion The psychological benefits of nostalgia have been robustly demonstrated in laboratory-based studies. This co-production of an intervention that sets nostalgic recall into the context of a conversation has clinical potential but requires further investigation through a larger study.

Purpose This paper aims to explore how food-focused social activities are a route for promoting intergenerational relationships, well-being and dietary benefits among residents in care homes and children in preschool/schools. Design/methodology/approach Using a case study methodology, this study undertook staff-focused research on a 26-month UK programme in 12 partnership clusters, involving a range of growing, cooking, eating and community activities. Findings Staff reported benefits for older people, including improved mood, surfacing positive memories, new personal connections and relief from feelings of boredom and loneliness. Children were reported to develop in-depth relationships, greater empathy and overcame negative preconceptions. Food-based activities enabled all parties to express caring and nurturing in tangible and often non-verbal ways. Originality/value Food-based activities appear to have specific material and emotive characteristics that resonate with the intergenerational interests of older people and children. Using mainly in-house resources, this study showed that it is feasible to generate novel food-based practices between children’s education and care home sectors. A “test-and-learn” programme model is recommended, given sensitivities and complexity associated with food-based activities and the limited organizational capacity of care home and early education service providers.

Although dementia may affect the reliability of autobiographical memories, the psychological properties of nostalgic memories may be preserved. We compared the content of nostalgic (n = 36) and ordinary (n = 31) narratives of 67 participants living with dementia. Narratives were rated according to their self-oriented, social, and existential properties, as well as their affective content. Social properties and affective content were assessed using a linguistic word count procedure. Compared to the ordinary narratives described in the control condition, nostalgic narratives described a typical events, expressed more positive affect, and had more expressions of self-esteem and self-continuity. They were also rated higher on companionship, connectedness and the closeness of relationships, and reflected life as being meaningful. Despite their cognitive impairment, people living with dementia experience nostalgia in similar ways to cognitively healthy adults, with their nostalgic narratives containing self-oriented, social, and existential properties.

Purpose This paper aims to provide critical insight into the impact of locally embedded, community business-related approaches internationally to health and social care on users’ outcomes, in particular exploring their effectiveness in delivering outcomes for users. Design/methodology/approach The study used a robust systematic review methodology. It carefully identifies relevant studies that have been conducted on the impact of community business-related approaches, rigorously evaluates how well these studies have been carried out and combines the results from these studies to address that particular topic. Findings Health and social care-related community businesses deliver on a range of health and well-being outcomes and impacts positively on local residents’ satisfaction with their community/local area. Existing research into community businesses uses mostly qualitative methods, but a few studies have also used quantitative survey and mixed methods and demonstrate the challenges of conducting methodologically rigorous real-world research within local community settings. Research limitations/implications The review was limited to papers published in English language and may have missed relevant studies published in other languages which could have influenced the overall findings. Only one reviewer screened the titles and abstracts of the identified papers. Having multiple reviewers would have strengthened the validity of the screening process. Originality/value Community businesses offer a positive contribution to health and well-being, and highlight the significance of engaging local communities in promoting health, reducing health inequalities and addressing the wider determinants of health. This paper provides a baseline of evidence about community business’ broad impacts on health and well-being to help inform new and emerging evidence

Background: Evidence from a range of major public health incidents shows that neighbour-based action can have a critical role in emergency response, assistance and recovery. However, there is little research to date on neighbour-based action during the 2020 coronavirus pandemic. This article reports on a survey of people engaged in supporting their neighbours in weeks three and four of the UK COVID-19 lockdown. Methods: Members of area-based and community of interest COVID-19 support groups in the Bristol conurbation were invited to complete an online survey. Of 1,255 people who clicked on the survey link, 862 responded; of these, 539 responses were eligible for analysis. Results: Respondents reported providing a wide range of support that went beyond health information, food and medical prescription assistance, to include raising morale through humour, creativity and acts of kindness and solidarity. A substantial proportion felt that they had become more involved in neighbourhood life following the lockdown and had an interest in becoming more involved in future. Neighbour support spanned all adult age groups, including older people categorised as being at-risk to the virus. With respect to most measures, there were no differences in the characteristics of support between respondents in areas of higher and lower deprivation. However, respondents from more deprived areas were more likely to state that they were involved in supporting certain vulnerable groups. Conclusions: As with previous research on major social upheavals, our findings suggest that responses to the viral pandemic and associated social restrictions may increase existing social and health inequalities, and further research should explore this issue in more depth.

Background: Evidence from a range of major public health incidents shows that neighbour-based action can have a critical role in emergency response, assistance and recovery. However, there is little research to date on neighbour-based action during the 2020 coronavirus pandemic. This article reports on a survey of people engaged in supporting their neighbours in weeks three and four of the UK COVID-19 lockdown. Methods: Members of area-based and community of interest COVID-19 support groups in the Bristol conurbation were invited to complete an online survey. Of 1,255 people who clicked on the survey link, 862 responded; of these, 539 responses were eligible for analysis. Results: Respondents reported providing a wide range of support that went beyond health information, food and medical prescription assistance, to include raising morale through humour, creativity and acts of kindness and solidarity. A substantial proportion felt that they had become more involved in neighbourhood life following the lockdown and had an interest in becoming more involved in future. Neighbour support spanned all adult age groups, including older people categorised as being at-risk to the virus. With respect to most measures, there were no differences in the characteristics of support between respondents in areas of higher and lower deprivation. However, respondents from more deprived areas were more likely to state that they were involved in supporting certain vulnerable groups. Conclusions: As with previous research on major social upheavals, our findings suggest that responses to the viral pandemic and associated social restrictions may increase existing social and health inequalities, and further research should explore this issue in more depth.

Objective This review systematically examines evidence relating to the effect of nostalgia on psychological well-being through a meta-analysis of measures of social connectedness, self-esteem, meaning in life, self-continuity, optimism and positive and negative affect. Rationale: If nostalgia is to be used as a clinical intervention to boost well-being in dementia by reducing threat, then it is important to assess its therapeutic potential. Results Searches carried out in July 2014 and updated in February 2018 identified 47 eligible experimental studies comparing nostalgic reminiscence and non-nostalgic reminiscence to be included in the meta-analysis. Nostalgic reminiscence had moderate effects on positive affect (0.51 (0.37, 0.65), p= 0.001), social connectedness (0.72 (0.57, 0.87), p= 0.001), self-esteem (0.50 (0.30, 0.70), p= 0.001), meaning in life (0.77 (0.47, 1.08), p= 0.001) and optimism (0.38 (0.28, 0.47), p= 0.001) and a large effect on self-continuity (0.81 (0.55, 1.07), p= 0.001). There was, however, no difference between the effect of nostalgic reminiscence and non-nostalgic reminiscence for negative affect (−0.06 (−0.20, 0.09), p= 0.443). Conclusion This systematic review and meta-analysis provides an overview of the evidence base for nostalgia. This is an important stage in developing nostalgia as a clinical intervention for people with dementia which might be achieved, for instance, by adapting current reminiscence and life review techniques. This meta-analysis will therefore also serve as a valuable reference point for the continued exploration of nostalgia as an intervention.

Initial findings from the survey in Bristol and the West Country, 6th - 12th April 2020 (days 14-20 of the UK Government Coronavirus Restrictions)

This report provides insight into the impact of community business-related approaches to health and social care on users’ outcomes, in particular exploring how effective they are in delivering outcomes for users. Community businesses are rooted within a particular area, trade for the benefit of the local community, are accountable to and led by the local community and demonstrate broad community impact. In recent years community businesses have emerged in the wider health and social care market to address factors in local communities that may benefit or harm health and wellbeing. Moreover, publications focused on the evaluation of health and wellbeing benefits of community businesses have also increased within the last four years.

BACKGROUNDStudies with non-clinical populations show that nostalgia increases psychological resources, such as self-esteem and social connectedness.OBJECTIVESOur objectives were to find out if the benefits of nostalgia in non-clinical populations generalize to people with dementia and if nostalgia facilitates recall of dementia-related information.METHODSAll three experiments recruited participants with mild or moderate levels of dementia. Experiment 1 tested whether nostalgia (compared to control) enhances psychological resources among 27 participants. Experiment 2 used music to induce nostalgia (compared to control) in 29 participants. Experiment 3 compared recall for self-referent dementia statements among 50 participants randomized to either a nostalgia or control condition. Findings across experiments were synthesized with integrative data analysis.RESULTSNostalgia (compared to control) significantly increased self-reported social connectedness, meaning in life, self-continuity, optimism, self-esteem, and positive (but not negative) affect (Experiments 1-3). Compared to controls, nostalgic participants also recalled significantly more self-referent dementia-related information (Experiment 3).CONCLUSIONThis series of experiments extends social psychological research with non-clinical populations into dementia care, providing evidence that nostalgia significantly enhances psychological resources. The finding that nostalgia increased recall of self-referent statements about dementia suggests that this emotion lends participants the fortitude to face the threat posed by their illness. The finding has potentially important clinical implications both for the development of reminiscence therapy and for facilitating adjustment to a diagnosis of dementia.

Background Primary care-led dementia services are an increasingly common form of service delivery; however, little is known about how these services are understood by their main stakeholders: the patients, family members and health care professionals. A primary care-led dementia service was piloted in the South Gloucestershire area during 2012, in which general practitioners (GPs) led the process of assessment and establishing a diagnosis. Of the 26 surgeries in the area, 11 initially agreed to participate in the pilot, with 12 more joining the project by the end of December 2012. Aim The aim of this study was to provide a qualitative analysis of the experiences of health care professionals, patients and their families, of the new process of assessment, diagnosis and treatment of dementia within a primary care service. Methods Four patients, three care-givers and eight health care professionals were interviewed by peer researchers – all of whom were current care-givers. Interviews were transcribed and analysed using thematic analysis following Braun and Clarke’s model. Data were also gathered about the number of referrals and what happened to these referrals. Results Themes gathered into four main areas: ‘the journey’, ‘what next?’, ‘the benefits and limits of primary care’ and ‘are GPs getting it right’? Conclusions The analysis provided a perspective on the experiences of patients, family members and health care professionals involved in the relocation of part of the memory service, from secondary care (memory clinics) to primary care, being piloted in South Gloucestershire. This identified both practical issues to be improved upon as well as possible barriers.

© 2015, Science Reviews 2000 Ltd, All right reserved. Dementia is an umbrella term for a large number of illnesses, all of which involve neurodegenerative changes in the brain. The most common forms of dementia are Alzheimer’s disease and vascular dementia, but there are over 100 other, rarer conditions. All of these different illnesses involve a progressive decline of cognitive functions in which symptoms gradually spread, so that eventually almost all areas of cognitive functioning are affected. Over time, these cognitive changes compromise the person’s practical ability to manage everyday activities, leading to increasing levels of dependency on those around them. At present there is no cure for any form of dementia. If we are to achieve an understanding of the psychological impact of dementia, then we also need to understand the way in which dementia acts as an existential threat. Dementia can compromise identity, challenge independence, prompt social isolation and threaten our ability to find meaning and purpose in life. Thus, a 2014 YouGov poll commissioned by Channel Five news in the UK found that fear of dementia was greater than fear of cancer, particularly amongst older people1