The aim of this study was to investigate the leisure and recreational activities of a cohort of 34 students attending a full-time special school as reported by the students and their parents. Leisure activities which were mostly solitary and passive in nature were identified as those being most commonly engaged in. Barriers to leisure were also identified, with 'access to' and 'location of' the leisure facilities being barriers perceived by both students and parents. Data on aspects of leisure use, e.g. enjoyment, participation, assistance required, socialization and choice, were also collected.

The results support earlier findings that suggest people with ID have only a partial understanding of the concept of death leaving them vulnerable to factually incorrect thoughts. The study highlights the considerable scope for making sense of death using religious and spiritual themes and emphasises the need for teaching individuals biological explanations of the life cycle. The results also provide some insight into the views of individuals with ID for carers involved in providing post-bereavement support.

The Official Journal of the British Institute of Learning Disabilities for a change in the laws concerning sexuality and learning disability in the Republic of Ireland.

BackgroundThe involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care.MethodsThis Participatory Learning and Action (PLA) research study involved 21 members of various marginalised groups who contributed their views about access to primary care. Using a series of PLA techniques for data generation and co-analysis, we explored barriers and facilitators to primary healthcare access from the perspective of migrants, Irish Travellers, homeless people, drug users, sex workers and people living in deprivation, and identified their priorities for action with regard to primary care provision.ResultsFour overarching themes were identified: the home environment, the effects of the ‘two-tier’ healthcare system on engagement, healthcare encounters, and the complex health needs of many in those groups. The study demonstrates that there are many complicated personal and structural barriers to accessing primary healthcare for marginalised groups. There were shared and differential experiences across the groups. Participants also expressed shared priorities for action in the planning and running of primary care services.ConclusionsMembers of marginalised groups have shared priorities for action to improve their access to primary care. If steps are taken to address these, there is scope to impact on more than one marginalised group and to address the existing health inequities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0487-5) contains supplementary material, which is available to authorized users.

BackgroundThere have been recent important advances in conceptualizing and operationalizing involvement in health research and health‐care service development. However, problems persist in the field that impact on the scope for meaningful involvement to become a routine – normalized – way of working in primary care. In this review, we focus on current practice to critically interrogate factors known to be relevant for normalization – definition, enrolment, enactment and appraisal.MethodOurs was a multidisciplinary, interagency team, with community representation. We searched EBSCO host for papers from 2007 to 2011 and engaged in an iterative, reflexive approach to sampling, appraising and analysing the literature following the principles of a critical interpretive synthesis approach and using Normalization Process Theory.FindingsTwenty‐six papers were chosen from 289 papers, as a purposeful sample of work that is reported as service user involvement in the field. Few papers provided a clear working definition of service user involvement. The dominant identified rationale for enrolling service users in primary care projects was linked with policy imperatives for co‐governance and emancipatory ideals. The majority of methodologies employed were standard health services research methods that do not qualify as research with service users. This indicates a lack of congruence between the stated aims and methods. Most studies only reported positive outcomes, raising questions about the balance or completeness of the published appraisals.ConclusionTo improve normalization of meaningful involvement in primary care, it is necessary to encourage explicit reporting of definitions, methodological innovation to enhance co‐governance and dissemination of research processes and findings.

Background Care staff are an important source of information and support for people with intellectual disabilities following bereavement. The purpose of this study was to explore staff perceptions of service users' conceptualizations of death, reactions to bereavement, required levels of support and staff confidence in providing postbereavement support. Method Forty-two staff rated individuals with intellectual disabilities with whom they worked on a regular basis. Results In general, staff believed that service users had a good concept of death, though staff tended to overestimate levels of understanding and possibly underestimate the potential for dysfunctional behaviour post-bereavement. Although staff expressed confidence in their ability to recognize grief symptoms, they were less confident in their ability to provide post-bereavement support. Conclusions The overall picture was positive with good agreement between staff, though ensuring that staff consider the potential for psychopathology following bereavement is important in providing support. The implications for staff training and post-bereavement support are considered.

Background A range of factors have been suggested as determinants of staff behaviour in the context of working with people with challenging behaviour. The purpose of this study was to evaluate whether a typical challenging behaviour staff training course had an effect on staff feelings of efficacy, their negative emotional reactions to challenging behaviour, and their causal beliefs. Methods Forty-eight staff attending a 3-day training course on understanding challenging behaviour and managing stress were assessed pre-training and at a 3-month follow-up. Questionnaires assessing self-efficacy, emotional reactions and causal beliefs were used. Results Perceived self-efficacy in dealing with challenging behaviours increased significantly from pre-to post-training. There were no significant changes in either emotional reactions to challenging behaviours or causal beliefs. Conclusion In common with previous research, there was a sizeable impact on staff confidence and efficacy after a 3-day training course. Given the potential significance of emotional reactions both in terms of staff behaviour and their psychological well-being at work, more research is needed to explore how these reactions might best be dealt with in staff training interventions.

The letter to the editor plays a dual role in the literature. It serves a corrective critical function but also has the capacity to spread and share knowledge. We sought to identify the role and theme of letters to the editor published in four leading otorhinolaryngology journals, to elicit how well this form of communication is being utilised. All letters to the editor published in; Clinical Otolaryngology, The Laryngoscope, The European Archives of Otorhinolarygnology and The Journal of Laryngology and Otology, for the year 2012, were examined and the individual journal guidelines for submission of letters were noted. Seventeen different countries produced a total of 92 letters for the year 2012. The majority of letters originated from Otolaryngology/Head and Neck departments (78 %). Clinical Otolaryngology contributed to 58 % of total letters, of which 55 % were unrelated to original journal material (n = 29). The Laryngoscope published letters solely in response to original journal material. The Journal of Laryngology and Otology was the only journal to index letters with their corresponding article. More letters agreeing (49 %) than disagreeing (32 %) were published, with the remaining letters either clarifying or ignoring issues raised. Letters to the editor serve two main purposes; post-publication peer review and sharing experiences with fellow readers. Both are equally important in maintaining journals' high standards. Indexing needs to be improved otherwise valuable comment does not endure while the original manuscript's message lives on.