Lancashire County Council

Issue/ProblemThere are inequalities in children's oral health outcomes with a widening gap between the least and most deprived and the highest rates of dentinal decay in marginalised groups. Traditional public health messaging fails to resonate with community groups due to cultural and linguistic barriers. Community-based co-creative interventions used in practice deserve greater research attention to evidence effectiveness of complex interventions and translation into policy.Description of the problemThe project was conducted over a 1-year period by public health community officers addressing children's oral health inequalities in the most vulnerable communities. The methods used were co-creative storytelling to develop oral health messaging with cultural sensitivity. Academic evaluation focused on the impact on community of women involved and the subsequent role development into community health champions.ResultsA creative, collaborative storytelling intervention co-produced with the Southeast Asian and Pakistani community provided culturally sensitive oral health messaging that was positively received by children and families. It empowered the women involved to become community health champions.LessonsCommunity engagement using co-creation can have multiple outcomes as effective public health interventions as well as role formalisation through empowerment of marginalised women.Key messages• Creative, culturally sensitive methods like storytelling can bridge cultural gaps and improve health education.• Recognition of community champions through role formalisation is required to sustain public health benefits of community engagement.

This research developed from a co-produced project called Moving Social Work. The purpose of this ongoing project is to train social workers in how to promote physical activity for and to disabled people. The first stage of the project consisted of building evidence to design a training programme prototype. As part of this stage, a Delphi study was conducted to ask leading experts about what should be included in the prototype. Questionnaires were sent to participants until consensus was reached. In reflecting on the results, people involved in the study commented that there was more about the experts’ opinions than percentages of agreement. Our co-production partners resolved that the Delphi was insufficient and called for detailed conversations with the experts. In response to this call, follow-up interviews with 10 experts who participated in the final questionnaire round of the Delphi were carried out. The interviews were co-produced, dyadic and data prompted. Dialogical inquiry was used to frame and co-analyse data. The results illuminate the capacity of qualitative research to justify, rectify, complicate, clarify, concretize, expand and question consensus-based evidence. The implications of the results for Moving Social Work are discussed. Beyond the empirical border of the project, wider contributions to literature are presented. As part of these, two key statements are highlighted and warranted: dialogical inquiry supports the practice of co-produced research, and Delphi studies should be followed by a Big Q qualitative study.

The pathways to vulnerability to debt and what works to reduce such vulnerability are poorly understood. To address this knowledge gap, we conducted an evidence review. Many low-income borrowers have little alternative but to resort to high interest lending. Developing ‘affordable’ lending alternatives has been a challenge. Policy-makers have advocated person-centred approaches (for example, financial education) despite little evidence supporting the efficacy of such behavioural measures. Arguably this has shifted the burden of social responsibility and risk for managing problem debt primarily onto borrowers. While better regulation of the credit industry is needed, ultimately policymakers need to look beyond market-based solutions.

This exploratory study adopted a mixed methods methodology, a critical realist ontological stance and a constructionist epistemological position to consider how special educational needs coordinators and pastoral managers in mainstream high schools understand the relationship between problem behaviours and language development. Semi-structured interviews were conducted with eight participants, and 20 participants completed a Q sort. The interview data were analysed using thematic analysis and in Q methodology an inverted factor analysis with a qualitative interpretation of the resultant factors was used. Triangulation was adopted as the method for the final integration of the data. Three meta-themes were identified indicating that, despite a range of recent initiatives, school staff continue to have a limited understanding of the relationship between problem behaviours and language difficulties. Previous experience and existing practice were drawn upon in considering causal relationships and interventions. Implications for educational psychology practice at casework, systems and commissioning levels are addressed.

People with intellectual disability have significantly worse health than those without, and have a higher level of complex health needs. The life expectancy for men and women is 13 and 20 years shorter, respectively, than the general population. The increasing role of general practice in delivering and coordinating care across health and social care settings requires expert generalist skills to implement an integrated approach to care. This article explores how general practice can improve the health of people with intellectual disability, by making reasonable adjustments within health promotion, disease prevention, screening and detection.

Stone mastic asphalt (SMA) and thin surfacing have been used in the UK for over 15 years. The primary location of failure and deterioration on the majority of thin surfacing is along the longitudinal joints. Traditionally, contractors used hot bitumen as the joint edge sealant material. More recently, many contractors used cold-applied bituminous edge sealants. This paper presents the findings of field and laboratory investigations aimed to explore which method provides the optimum performance of longitudinal joints. Dynamic shear rheology (DSR), indirect tensile strength (ITS), pull-off, permeability and air void content tests were performed. The results of the DSR tests showed that cold-applied sealant could outperform the field performance of the hot-applied 40/60 pen bitumen sealants. However, the adhesion and ITS tests showed that hot-applied sealant was more effective than the cold-applied sealant in creating a good bond between two asphalt mats. There was no significant difference in the permeability of joints constructed using either sealant. The survey of roads constructed using hot- and cold-applied sealants showed that both methods are capable of constructing durable longitudinal joints on roads with low-to-medium traffic volume.

This chapter sets the scene for asset management and asks a series of simple questions to answer the challenge of this new way of looking at highway maintenance. The chapter introduces the four key themes – highway condition, safety, availability and environmental considerations – that will inevitably arise in most authorities’ asset management plans.