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The purpose of this paper is to explore current practice, barriers and facilitators to identifying and responding to alcohol problems in memory clinics.

A questionnaire sent to professionals in 55 memory clinics in England, Wales and the Isle of Wight and two focus groups with professionals from three memory clinics in England.

Only 1/35 clinics that responded to the questionnaire was using a standardised alcohol screening tool but all attempted to gain some information about alcohol use. Without screening tools, practitioners found it difficult to determine whether alcohol use was problematic. Barriers to identification/intervention included cognitive impairment, service-user being “on guard” during assessment, presence of family members/carers, time constraints and a perception that brief interventions were not within the remit of memory clinics. Facilitators were obtaining visual clues of problem drinking during home visits and collateral information from family members/carers.

Focus group participants were recruited through convenience sampling and a small number of professionals took part. This means that the findings may be subject to selection bias and limits the generalisability of the findings.

Memory clinics should provide guidance and training for practitioners on how to intervene and respond to alcohol misuse. Further research is required to determine the most effective way to identify alcohol problems in people with cognitive impairment and how to deliver brief alcohol interventions that take account of cognitive deficits.

This is the first study to examine alcohol screening and interventions in memory clinics and identifies a need for guidance, training and further research.

Although women have advanced in the economic sphere, the gender pay gap (GPG) remains a persisting problem for gender equality. Using Acker's theory of gendered organisations, this study strives to gain a better understanding from a macro and micro approach, how family and work-related policies, especially family-friendly measures (FFMs), and their uptake, contribute and maintain the GPG in Malta and specifically within the Financial and Insurance sector.

Two research instruments were used. National policy documents were analysed through the gender lens, followed by structured interviews with HR managerial participants within this sector.

Findings suggest that at a macro level, family and work-related policies could be divided into two broad categories: A set of family-friendly policies that contribute to the GPG because of their gendered nature, or because the uptake is mostly taken by women. These include make-work pay policies, which initially appear to be gender neutral, but which attracted lower educated inactive women to the Maltese labour market at low pay, contributing to an increase in the GPG. Second, a set of policies that take on a gender-neutral approach and help reduce the GPG. These include policies like the free childcare and after school care scheme that allow mothers to have a better adherence to the labour market. At the micro level within organisations, pay discrepancies between women and men were largely negated and awareness about the issue was low. Here, “ideal worker” values based on masculine norms seemed to lead to covert biases towards mothers who shoulder heavier care responsibilities in the families and make a bigger use of FFMs. Because men are better able to conform to these gendered values and norms, the GPG persists through vertical segregation and glass ceilings, among others.

Since not all the companies in the Eurostat NACE code list participated in this research, results could not be generalised but were indicative to future large-scale studies..

At the macro and policy level, some FFMs take on a clear gendered approach. For example, the disparity in length between maternity (18 weeks) and paternity leave (1 day) reinforces gender roles and stereotypes, which contribute to the GPG in the long run. While some FFMs like parental leave, career breaks, urgent family leave, telework, flexible and reduced hours seem to take on a more gender-neutral approach, the uptake of FFMs (except childcare) seems to generate discriminatory behaviour that may affect the GPG. When considering the make-work pay policies such as the “in-work benefit” and the “tapering of benefits”, this study showed that these policies attracted lower educated and low-skilled women into the labour market, which in turn may have further contributed to the increasing GPGs. On the other hand, the childcare and after school policies relieve working mothers from caregiving duties, minimising career interruptions, discriminatory behaviour and overall GPGs.

This study confirmed that organisations within the Financial and Insurance sector are gendered and give value to full-time commitment and long working hours, especially in managerial roles. Managerial positions remain associated with men because mothers tend to make more use of FFMs such as parental leave, reduced, flexible hours and teleworking. Mothers are indirectly penalised for doing so, because in gendered organisations, the uptake of FFMs conflict with the demands of work and ideal worker values (Acker, 1990). This maintains the vertical segregation and widens the GPG within the Financial and Insurance sector.

By using the gender lens and taking a wider and more holistic approach from the macro and micro level, this study highlights how interlinking factors lead to and sustain the GPG in the Financial and Insurance sector in Malta.