There is good evidence that multi-component exercise with sufficient intensity improves global physical and cognitive functions and activities of daily living skills. There is also good evidence that group-based cognitive stimulation improves cognitive functions, social interaction and quality of life. This synthesis also highlights the potential importance of group activities to improve social integration for people with dementia. Future research should investigate longer-term specific outcomes, consider the severity and types of dementia, and investigate mechanisms of change.

Computer-based cognitive interventions have moderate effects in cognition and [corrected] anxiety and small effects in depression in PWD. No significant effects were found on activities of daily living. They led to superior results compared to non-computer-based interventions in cognition. Further research is needed on cognitive recreation and cognitive stimulation. There is also a need for longer term [corrected] follow-up to examine the potential retention of treatment effects, and for the design of specific outcome measures.

Background-Despite major developments in community mental health services, inpatient care remains an important yet costly part of the service system and patients who are admitted frequently spend a long period of time in hospital. It is, therefore, crucial to have a good understanding of activities that take place on inpatient wards.

Within western cultures, portrayals of dementia as 'a living death' are being challenged by people living with the diagnosis. Yet dementia remains one of the most feared conditions. The sociological lens of citizenship provides a conceptual framework for reviewing the role of society and culture in repositioning dementia away from deficit to a discourse of agency and interdependence. Awareness of cognitive change, and engaging with the diagnostic process, moves people into a transitional, or 'liminal' state of uncertainty. They are no longer able to return to their previous status, but may resist the unwanted status of 'person with dementia'. Drawing on qualitative studies on social participation by people with dementia, we suggest that whether people are able to move beyond the liminal phase depends on acceptance of the diagnosis, social capital, personal and cultural beliefs, the responses of others and comorbidities. Some people publicly embrace a new identity whereas others withdraw, or are withdrawn, from society to live in the shadow of the fourth age. We suggest narratives of deficit fail to reflect the agency people with dementia can enact to shape their social worlds in ways which enable them to establish post-liminal citizen roles. (A Virtual Abstract of this paper can be viewed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA).

BackgroundService users express dissatisfaction with inpatient care and their concerns revolve around staff interactions, involvement in treatment decisions, the availability of activities and safety. Traditionally, satisfaction with acute care has been assessed using measures designed by clinicians or academics.AimsTo develop a patient-reported outcome measure of perceptions of acute care. An innovative participatory methodology was used to involve services users throughout the research process.MethodA total of 397 participants were recruited for the study. Focus groups of service users were convened to discuss their experiences and views of acute care. Service user researchers constructed a measure from the qualitative data, which was validated by expert panels of service users and tested for its psychometric properties.ResultsViews on Inpatient Care (VOICE) is easy to understand and complete and therefore is suitable for use by service users while in hospital. The 19-item measure has good validity and internal and test–retest reliability. Service users who have been compulsorily admitted have significantly worse perceptions of the inpatient environment.ConclusionsA participatory methodology has been used to generate a self-report questionnaire measuring service users’ perceptions of acute care. VOICE encompasses the issues that service users consider most important and has strong psychometric properties.

"Infant-demand" care and conventional Western care, as practiced by London parents, are associated with different benefits and costs. As used by proximal care and Copenhagen parents, infant demand parenting is associated with less overall crying per 24 hours. However, the proximal form of infant-demand parenting is associated with more frequent night waking and crying at 12 weeks of age. Copenhagen infants cry as little per 24 hours as proximal care infants but are settled at night like London infants at 12 weeks of age. Colicky crying bouts at 5 weeks of age are unaffected by care. The findings have implications for public health care policy. First, they add to evidence that bouts of unsoothable crying, which are common in early infancy, are not much affected by variations in parenting, providing reassurance that this aspect of infant crying is not parents' fault. Second, the findings provide information that professionals can give to parents to help them to make choices about infant care. Third, the findings support some experts' concerns that many English parents are adopting methods of care that lead to increased crying in their infants. There is a need for informed debate among professionals, policy makers, and parents about the social and cultural bases for the marked differences between London and Copenhagen parents' approach to care.

The phenomenon of 'pro-eating disorder' websites remains relatively unexplored by researchers in published formats. Supporters of the sites claim beneficial effects but health professionals worry that the sites propagate disordered behaviours. The present study addressed visitor characteristics and perceived impact of visits. A 24-item questionnaire supplemented with the Eating Attitudes Test-26 (EAT-26) was developed and posted on the website of the UK mental health charity SANE. Participants who interacted with others on the sites and sought emotional support reported improved mental state after visiting, and for them, evidence was found of reduced impact from potentially damaging content. 'Silent browsing' in order to sustain a disorder was found to be mainly harmful. 'Silent browsers' may be particularly vulnerable to a worsening of their symptoms in the absence of beneficial effects from emotional support, but those who interact and find support could face a danger of a different sort.

Data on the impact of design on treatment outcomes are inconclusive. Rigorous randomised controlled trials, qualitative studies and novel methods are called for. Different stakeholders' responses to the ward as a symbolic environment merit further investigation.