Sarossa (Jersey)

Purpose The purpose of this article is to provide a definition of Positive Behaviour Support (PBS), developed by a group of practitioners of PBS, in the United Kingdom (UK). Design/methodology/approach The definition was developed through a series of online meetings with a group of practitioners, and through reference to the existing research. Findings A definition is presented in the form of 9 defining characteristics. These include a specific underpinning philosophy (functional contextualism), a focus on promoting quality of life, rights, relationships, the use of Applied Behaviour Analysis, functional assessment to inform function-based strategies, the provision of multielement support, collaborative working and implementation support. Originality/value There are numerous pre-existing definitions of PBS. However, this article seeks to present a definition specifically from the perspective of practitioners in the United Kingdom.

BackgroundThe healthcare professional must look beyond the facts of diagnosis and medical treatment to see the person within the experience. Only then can the patient benefit from spiritual and comprehensive holistic care. This need is amplified within the realms of palliative care. After honest conversations about the gaps in our service provision, we began a journey to develop spiritual care across the service.AimTo ensure the outcomes of spiritual care assessment continually inform all personalized care planning for every patient. That our clinical teams are equipped and empowered to provide excellent spiritual care for all patients and their loved ones.MethodThe hospice team reviewed relevant published literature. A Spiritual Care Lead post was created. A clinical staff survey was formulated to identify understanding, strengths, and weaknesses to inform education provision and staff support. We got to know our community’s faith and belief groups and asked what they needed from their hospice and planned to reclaim the Sanctuary space. A working group was formed to analyse the process and provision of spiritual care and implement key changes.ResultsOur first Spiritual Care Lead joined the MDT in 2022. 18 surveys were completed which resulted in classroom and in practice forms of education being developed. Routine staff support and reflective practice sessions are offered by the Spiritual Care Lead. Representation from across the community’s faith and belief groups now form a vital resource and together we celebrate Inter Faith Week. The hospice now has a welcoming Sanctuary with key resources for different faiths. ‘About Me’ – a spiritual care assessment was created and trialled in practice where it continues to inform the holistic care of patients.ConclusionSpiritual care is now a considered and continually developing aspect of the care the hospice provides for the community.

Adults with intellectual disability (ID) are prescribed high levels of medication, with polypharmacy and psychotropic polypharmacy common. However, reported rates vary between studies, and there has been an over-reliance on obtaining data from convenience samples. The objective of this study was to determine the prevalence of medication use and polypharmacy in a population-level sample of adults with IDs. Factors associated with polypharmacy and psychotropic polypharmacy are explored. We used a total population sample of 217 adults with IDs known to services in Jersey (sampling frame n=285). The Anatomical Therapeutic Chemical classification system was used to categorise medications that participants were currently taking on a regular basis. We examined associations of polypharmacy and psychotropic polypharmacy with socio-economic status, health and demographic variables using univariate and multivariate analyses. A total of 83.4% of participants were prescribed medication, with high doses common. Of the participants, 38.2% were exposed to polypharmacy while 23% of participants were exposed to psychotropic polypharmacy. After controlling for demographic, health and socio-economic characteristics, polypharmacy was significantly associated with older age, increased severity of ID, living in a residential setting and having increased comorbidities. Psychotropic polypharmacy was associated with being male, being aged 50+years and having had a psychiatric diagnosis over the life course. Being prescribed psychotropic drugs above the defined daily dose was not associated with having had a psychiatric diagnosis over the life course, suggesting the possibility of 'off label' prescribing. Our results indicate that medication use, in high doses, alongside polypharmacy and psychotropic polypharmacy are highly prevalent in adults with ID. The exposure to multiple medications increases the risk of developing adverse drug events, drug-drug interactions and medication-related problems. Future population-level, prospective cohort studies should examine the prevalence of polypharmacy and psychotropic polypharmacy using standardised definitions and consider the potential impact of adverse drug events, drug-drug interactions and medication-related problems in this population.

The Second World War brought large-scale significant changes to the demands on meteorologists and the types of service they needed to provide. Although the technological developments between the two World Wars set the scene for many of these new requirements, there were few weather forecasters until the last few months before the Second War, so demands for training were significant. Many developments led into the services that would be required when peace returned and a description of these is given in this article. Meteorological Research Flight Vickers-Supermarine Spitfire PR Mk. 19 (the last to be manufactured), now one of the Battle of Britain Memorial Flight aircraft. Courtesy Airpowerworld.com

> Experiencing and understanding the IPM training, transformed my working life. It helped me grow as a general practitioner, not just as a psychosexual . I had been a general practitioner (GP) in Jersey for nearly 20 years when the Internet and PDE5 inhibitors, among other things, changed patients’ knowledge, awareness and expectations of sexual problems. The ‘Swinging Sixties’ and the availability of the Pill probably started it all, but more and more patients started attending the practice with ‘door-handle' questions about sex. As an experienced GP, I’d previously found there weren’t many problems with which I felt unable to help. If I didn’t have the answer then I had an excellent network of specialist colleagues who could provide assistance, either via telephone advice or formal referral. Help with sexual problems, however, drew a blank, as there was no-one running a specialist clinic on Jersey, an island of 100 000 inhabitants. It was my late sister-in-law, Dr Mary Gabbott, a doctor trained in psychosexual medicine back in its early days and one of the first psychosexual specialists to work in a joint clinic with a urologist, who challenged me to train with the Institute of Psychosexual Medicine (IPM) and see these patients myself. For those readers who may not know much about the IPM, I shall provide a brief overview. More information is available on their website (www.ipm.org.uk). The IPM is a specialist training organisation recognised by the Royal College of Obstetricians and Gynaecologists (UK). It was initiated in the 1960s by a group of family planning doctors faced, like me, with increasing numbers of patients presenting with sexual difficulties, and with little help available. Originally an exclusive organisation for doctors, the IPM has recently changed its constitution and now welcomes allied health professionals (AHPs) whose work involves ‘body medicine’. In practice, these AHPs are mainly specialist nurses …

A reluctant researcher finds the process easier than she thought