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Physiotherapists throughout the UK have a professional obligation to keep up to date and practice effectively. The Scottish Physiotherapists Clinical Effectiveness Network (SPCEN) was established in 1999 with the aim of providing a mechanism through which physiotherapists could share and learn from experiences, avoid duplication of effort and undertake proactive activities. The purpose of this paper is to report on the experience of the SPCEN and provide an evaluation of the impact the network has made on the clinical effectiveness activities of physiotherapists throughout Scotland.

A questionnaire survey was distributed to 2,118 physiotherapists across Scotland (response rate of 54.5 per cent). It aimed to determine the level of clinical effectiveness activity, the confidence of physiotherapists in engaging in these activities and the extent of involvement with clinical guideline implementation.

Results were analysed in two groups. Group 1 consisted of those that reported that they did participate in network activities (40 per cent n=330) and Group 2, those who did not (60 per cent n=686). Participants were significantly more engaged in undertaking a range of clinical effectiveness activities than non‐participants (p<0.0001), had greater confidence in their own ability to engage and were involved in the implementation of clinical guidelines to a greater extent (p<0.0001).

Establishing the SPCEN has resulted in more confident physiotherapists who are engaging in greater levels of clinical effectiveness activity throughout Scotland.

This paper provides the reader with an indication of the value networks can achieve.

John D. Blair examines, in systematic detail, the challenges and opportunities that arise from the significantly different perspectives of context-specific versus context-free researchers and the literatures to which they contribute. He argues that reviews of one type or the other or both types of literatures may provide different understandings of the state of the art in a particular area of health care management. He also provides some detailed suggestions for writing quality reviews along with suggested topics for future reviews.

The purpose of this paper is to evaluate Feel WonderFull Fitness (FWF), a program adhering to the Health At Every SizeTM (HAES) paradigm, on larger women's physical activity and psychosocial health. FWF was tailored to overcome barriers based on weight bias.

The study compared “overweight” and “obese” women in FWF to those not currently enrolled in formal exercise programs. Controls were divided into low physical activity (LPA) and moderate physical activity (MPA) conditions based on pretest exercise level. Outcome measures were collected at pretest and three months later at posttest.

FWF participants had the greatest gains in physical activity and demonstrated significantly greater improvements in depression than the LPA group. FWF and the MPA group showed more improved scores on perceived body attractiveness than the LPA group. Scores on an eating disorders measure improved for all groups, but somewhat more so for the FWF group. Improvements occurred in the absence of weight loss or decreases in body mass index and body fat percentage.

The study was based on a small, homogenous sample using a quasi-experimental design.

The study illustrates HAES strategies that practitioners might incorporate into various health and fitness settings.

The study highlights weight bias as a social justice issue and as a barrier to physical activity participation for larger women.

The study adds to a growing body of literature evaluating HAES approaches, with HAES representing a novel alternative to weight-loss interventions for improving psychosocial health among larger women. It also contributes to the literature on weight bias that has been understudied relative to bias based on other areas of difference.

This paper aims to maintain the high service quality of the long-term care service providers by establishing a knowledge-based system so as to enhance the service quality of nursing homes and the performance of its nursing staff continually.

An intelligent case-based knowledge management system (ICKMS) is developed with the integration of two artificial intelligence techniques, i.e. fuzzy logic and case-based reasoning (CBR). In the system, fuzzy logic is adopted to assess the performance through the analysis of the long-term care services provided, nurse performance and elderly satisfaction, whereas CBR is used to formulate a customized re-training program for quality improvement. A case study is conducted to validate the feasibility of the proposed system.

The empirical findings indicate that the ICKMS helps in identification of those nursing staff who cannot meet the essential service standard. Through the customized re-training program, the performance of the nursing staff can be greatly enhanced, whereas the medical errors and complaints can be considerably reduced. Furthermore, the proposed methodology provides a cost-saving approach in the administrative work.

The findings and results of the study facilitate decision-making using the ICKMS for the long-term service providers to improve their performance and service quality by providing a customized re-training program to the nursing staff.

This study contributes to establishing a knowledge-based system for the long-term service providers for maintaining the high service quality in the health-care industry.

In 2002 there were 19.8 million people in the United Kingdom over the age of 50 and it is estimated that by 2031 there will be close to 27 million (UK National Statistics Office, 2005). Predictions about the older population changes in the next twenty years indicate that although overall growth will be low, the numbers of ‘young old’ (65‐74) and ‘middle old’ (75‐84) remaining stable until 2011, the ‘old old’ (85+) will show a substantial increase (Grundy, 2004).Bowling et al (2002) stressed the importance of maintaining independence and control over one's life with ageing. This, together with having social roles and participating in social and voluntary activities/hobbies to include those performed alone, contributes to the foundation of good quality of life in old age. New European policies for older adults focus on the provision of equal opportunities, health promotion and stress their involvement in decision‐making (Fletcher, 2000). The increase in the ageing population is evident in the corresponding rise in the growth of nursing and residential homes, sheltered accommodation and home care support and it is anticipated that greater provision will be needed (Wittenberg et al, 1998), particularly if the aspirations of European policy are to be realised. However, some studies (eg, Sheppard, 2003) have documented the paucity of rehabilitation in residential and nursing homes and highlighted the disempowerment experienced by residents. The process of transition in the later stages of the life span from full independence in a familiar home environment to one of total care while providing security may engender feelings of helplessness with a decrease in psychological well‐being.This article outlines and discusses the findings of a study using narratives with older adults, undertaken to explore such effects of life changes, including transition, on their self‐concept.

Background – Studies suggest text messaging is beneficial to health care; however, no one has synthesized the overall evidence on texting interventions. In response to this need, we conducted a systematic review of the impacts of text messaging in health care.

Methods – PubMed database searches and subsequent reference list reviews sought English-language, peer-reviewed studies involving text messaging in health care. Commentaries, conference proceedings, and feasibilities studies were excluded. Data was extracted using an article coding sheet and input into a database for analysis.

Results – Of the 61 papers reviewed, 50 articles (82%) found text messaging had a positive effect on the primary outcome. Average sample sizes in articles reporting positive findings (n=813) were significantly larger than those that did not find a positive impact (n=178) on outcomes (p=0.032). Articles were categorized into focal groups as follows: 27 articles (44.3%) investigated the impact of texting on disease management, 24 articles (39.3%) focused texting's impact to public health related outcomes, and 10 articles (16.4%) examined texting and its influence on administrative processes. Articles in focal groups differed by the purpose of the study, direction of the communication, and where they were published, but not in likelihood of reporting a positive impact from texting.

Conclusions – Current evidence indicates that text messaging health care interventions are largely beneficial clinically, in public health related uses, and in terms of administrative processes. However, despite the promise of these findings, literature gaps exist, especially in primary care settings, across geographic regions and with vulnerable populations.

Individual psychodynamic psychotherapy for people with learning disabilities has been more available since the 1980s, with numerous case studies and reports of effectiveness, yet little is know about the history of psychodynamic psychotherapy. This paper is a historical account of the international development of psychodynamic psychotherapy for people with learning disabilities. It discusses some of the clinicians' case reports, views and conclusions. It is important that, as therapists, we continue to learn and develop. This is a story of ‘opportunities lost’. Although a number of therapists were well‐placed to develop psychotherapy as a valuable treatment option, it did not happen. The paper discusses the reasons, ranging from widespread therapeutic pessimism to inability in the therapist to process the ‘disability transference’. It outlines the various British contributions before and since the ground‐breaking and well‐known work of Valerie Sinason, whose 1992 book is still the most influential contribution. Psychodynamic psychotherapy has developed more of a tradition than other therapy approaches in this field, but there is still only sparse literature on and recognition of this work.

Consumers have an important role to play in preventing food‐borne disease. The purpose of this study was to demonstrate that consumers could be segmented successfully based on their food safety knowledge and practice.

Principal component analysis (PCA) and hierarchical cluster analysis (HCA) were applied to data on food safety knowledge and practice, collected by individual face‐to‐face questionnaires with domestic food preparers (n=1,020) and refrigerator swabs (n=726).

From the food safety questionnaires four factors were identified as important for inclusion in the HCA. This analysis identified three groups of consumers based on the knowledge factors; they were “Conscientious” (21 per cent), “Cavalier” (25.4 per cent) and “Careful” (53.3 per cent) food handlers. In terms of food safety knowledge, the higher risk consumers were found to be in the Cavalier food handler group. This group of food handlers also engaged in less hygienic food handling practices. This group were more likely than the other groups to be less than 45 years of age, male, living in urban environments and those with higher levels of formal education.

The identification of consumer groups with respect to food safety is important as it can inform more effective tailoring and targeting of food consumer safety education programmes to reach higher risk groups and individuals. This is the first study to not only identify the demographic characteristics of higher risk groups, but also to relate the levels of food safety knowledge/practice to levels of contamination in the fridges of such at risk groups using HCA and PCA.

Using a general model of corruption that explains and accounts for corruption across professions and institutions, this chapter will examine how certain practices in the media, especially in areas where journalism, advertising and public relations regularly intersect and converge, can be construed as instances of corruption. It will be argued that such corruption, as in the case of cash-for-comment scandals, advertorials, infomercials, and infotainment, as well as public relations media releases disseminated misleadingly as journalistic opinion, is regular, ubiquitous, and systematic.

The purpose of this paper is to explore employees' perceptions of work‐life balance (WLB) in an Australian infrastructure construction project, using semi‐structured focus groups.

In total, 43 employees participated in the focus groups, representing 50 per cent of the project workforce at the time. Focus groups explored employees' experiences of WLB during the planning and design stage of the project, as well as their expectations for the management of WLB during the construction phase.

Project culture, project resourcing and the schedule demands of the construction stage of the project were identified as barriers for WLB, while participants believed that the “project alliance” delivery model, flexibility of working hours and the project management team's support for WLB would facilitate WLB in the project.

Data were collected from one case study project which utilised an alliance delivery model. Therefore, the results cannot be generalised to the construction industry as a whole or to construction projects utilising an alliance delivery model. Data were collected from professional and white collar workers therefore the results cannot be generalised to blue collar workers. The research findings suggest new directions for future research in WLB related to project settings.

The study will provide project managers with a better understanding of work‐life experiences of project teams and highlight the barriers and facilitating factors for WLB.

WLB has been widely investigated in static work settings, however it is not well understood how research findings translate to project settings as little research has been conducted in this area.