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Dependent alcohol use is a severe addictive disorder with significant enduring consequences for health and social functioning. This study aims to inductively explore the process of identity change for alcohol dependent people progressing through a “pre-habilitation” intervention, alcohol detoxification and post-detoxification recovery support.

Qualitative study as a part of a process evaluation situated within a UK feasibility trial of a group-based intervention in preparation for structured alcohol detoxification. Semi-structured qualitative interviews (face-to-face or telephone) collected self-reported data on experiences of treatment provision as part of the feasibility trial. Thematic analysis of transcripts and iterative categorisation of identity-related themes and concepts was conducted with verification of analysis undertaken by a second coder.

Identity change was revealed in participant narratives around the meta themes of external (social-identity) and internal (self-identity) concepts. External influences impacting social identity were key, having influenced initiation into alcohol use, influencing acceptance of the stigmatised “alcoholic” label and then being central to the treatment journey. Internal influences on self-identity also impacted on the process of identity change. In recovery, there was hope in discovering a new “normal” identity or rediscovering normality.

Analysis demonstrates that moving from regular alcohol use to problematic use is a journey of identity change that is influenced at the macro (cultural), meso (group) and micro (relational) social levels. Throughout the treatment journey, social influences in gaining a new non-drinker identity are key. Findings suggest a need for long-term support through treatment and community-based groups specifically to foster positive identity change that may not have been addressed previously.

Whilst there are pockets of excellence in the provision of Child and Adolescent Mental Health Services (CAMHS), many services fail to meet young people’s needs. Considering this, the purpose of this paper is to ascertain perceptions of CAMHS provision in a rural county of the UK to inform re-design of youth mental health services.

The study comprised of two phases: phase one involved analysis of questionnaire data of youth views of CAMHS. Phase two involved analysis of the “Have Your Say” event data which explored perceptions of CAMHS and future service re-design. Data were thematically analysed.

Knowledge of the existence and purpose of CAMHS was variable. Participants wanted accessible information about services, rights, confidentiality and for this to be provided in multiple media. Young people wanted staff who were easy to talk to, genuine, understanding and who valued their insights. Participants wanted to be offered choice about appointments, location and timing. An ideal mental health service was described as a “one-stop-shop” of co-locality and multi-agency collaboration. Young people clearly expressed a desire to influence the design and delivery of the radical service re-design and to be embedded in its development.

The results highlighted multiple problems with CAMHS provision and provided a clear justification for the re-design of services.

This was a novel approach demonstrating the importance, utility and power of effective participatory practices for informing the re-design of services.

Approximately 3.5% of the workforce is diagnosed with attention deficit hyperactivity disorder (ADHD). With a greater risk of work-related stress and absences, work-based social interactions and environments are significant factors. The purpose of this study was to identify the professional challenges and benefits of living with ADHD in healthcare settings.

Interpretative phenomenological analysis was used to explore how employees with ADHD both experience and make sense of their employment and professional relationships. Participants self-identified from two NHS trusts and participated in semi-structured interviews.

A total of seven interviews contributed to the final analysis. A total of four themes emerged: social environment (relationships), physical environment, behaviour and work tasks. Complex interactions were observed between individuals’ internal constructs and overall employment experience.

The findings can be used to inform local NHS management frameworks for supporting workforce with ADHD.

This is a novel study that explores the psychodynamic and physical presentations of ADHD providing a unique perspective on the challenges and strengths of employees with ADHD.

The purpose of this paper is to review the barriers in the dissemination of effective smoking cessation treatments and services globally. Offering tobacco users help to stop using tobacco is a key demand reduction measure outlined under Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC). Implementing Article 14 can reap great dividends for the billion plus tobacco users around the world and their families, friends and societies.

A review of the status of the global implementation of Article 14 using available literature on smoking cessation products, services and national guidelines. Discussing innovative approaches being currently explored in South Asia that can lead to faster adoption and implementation of Article 14 globally.

Major gaps remain in cessation products’ availability and resource allocation for cessation services globally. Current licensed products are falling short on delivering and sustaining smoking cessation. Innovation in cessation products and services needs to build on learnings in nicotine pharmacokinetics, behavioural insights from consumer research and tap into 21st century tools such as mobile based apps. National implementation of FCTC’s Article 14 needs to follow guidelines that encourage integration into existing health programmes and health-care practitioners’ (HCPs) upskilling.

Smoking cessation is a desirable health outcome and nicotine replacement products are a means of achieving cessation through tobacco harm reduction. E-cigarettes are sophisticated nicotine replacement products. Innovation is urgently needed to fill the gaps in smoking cessation products and services, and for converting global policy into local practice. In low- and middle-income countries (LMICs), HCPs’ knowledge, attitudes and practice regarding tobacco use and cessation may hold the key to rapidly scaling up cessation support and delivery to achieve FCTC objectives sooner. Additionally, HCPs can play an important role in offering smoking cessation support in existing national health programmes for TB, cancer screening and maternal and child health. Also, widely prevalent smartphone devices may deliver smoking cessation through telemedicine in LMICs sooner, leapfrogging the hurdles of the existing health-care infrastructure.

This paper aims to track the development of climate policy in the province of Alberta, Canada, particularly the province’s unique greenhouse gas emission offset mechanism. The analysis shows how the policy has influenced, and been influenced by, policy processes at the national and international levels.

The paper begins with an analytical framework that recognizes different types of influence between international, national and provincial climate policy processes. That framework is used to structure a review of four historical periods of climate policy change: prior to 1992, 1992 to 2002, 2002 to 2012 and between 2012 and mid-2015.

The analysis illustrates the interplay between the Alberta approach to climate policy and the international and national policy contexts. A period of intense policy conflict between Canada’s federal and provincial governments led to a situation in which the Alberta Government sought to lead rather than follow national policy. Subsequent periods have seen the Canadian national government oscillate between following the lead of Alberta or the USA.

Rather than national and international policies simply setting the context for Alberta’s policy, the paper identifies multiple flows of influence between the three levels of governance. The results illustrate the need to consider forward and backward flows of influence between the different levels of government that set climate change policies. Elements of several models of policy change are supported.

The Alberta climate mitigation policy has many elements that can be effective in reducing carbon emissions in a way that is both flexible and predictable. These elements are of interest to other jurisdictions. Other elements of the current policy, however, limit its effectiveness in reducing emissions. More concerted policy action is needed to mitigate carbon emissions in Alberta for Canada to meet its agreed targets.

No other paper has tracked the historical evolution of climate policy at the provincial/state level in a way that clarifies the forward and backward linkages with national and international policy.