Knowledge of the patient journey can inform both selection and care of patients awaiting gastric band surgery and is required by all health professionals working with this patient group.

Background: Many factors are associated with medication non-adherence in Parkinson's disease (PD), including complex treatment regimens, mood disorders and impaired cognition. However, interventions to improve adherence which acknowledge such factors are lacking. A phase II randomised controlled trial was conducted investigating whether Adherence Therapy (AT) improves medication adherence and quality of life (QoL) compared with routine care (RC) in PD. Methods: Eligible PD patients and their spouse/carers were randomised to intervention (RC plus AT) or control (RC alone). Primary outcomes were change in adherence (Morisky Medication Adherence Scale) and QoL (Parkinson's Disease Questionnaire-39) from baseline to week-12 follow up. Secondary outcomes were MDS-UPDRS (part I, II, IV), Beliefs about Medication Questionnaire (BMQ), EuroQol (EQ-5D) and the Caregiving Distress Scale. Blinded data were analysed using logistic and linear regression models based on the intention-to-treat principle. Results: Seventy-six patients and 46 spouse/carers completed the study (intervention: n = 38 patients, n = 24 spouse/carers). At week-12 AT significantly improved adherence compared with RC (OR 8.2; 95% CI: 2.8, 24.3). Numbers needed to treat (NNT) were 2.2 (CI: 1.6, 3.9). Compared with RC, AT significantly improved PDQ-39 (À9.0 CI: À12.2, À5.8), BMQ general harm (À1.0 CI: À1.9, À0.2) and MDS-UPDRS part II (À4.8 CI: À8.1, À1.4). No significant interaction was observed between the presence of a spouse/carer and the effect of AT. Conclusion: Adherence Therapy improved self-reported adherence and QoL in a PD sample. The small NNT suggests AT may be cost-effective. A larger pragmatic trial to test the efficacy and cost-effectiveness of AT by multiple therapists is required. What's known• Non-adherence to medication is prevalent in Parkinson's disease (PD).• Various interventions have been widely investigated in chronic conditions for improving adherence.• Very few studies of interventions to improve medication adherence have focused on PD.• Adherence Therapy (AT) is a novel approach to maximising adherence that has shown benefit in other chronic conditions. What's new• This randomised controlled trial is the first to investigate AT in PD.• Adherence therapy significantly improved both medication adherence and quality of life in people with PD. Specifically, patients who received AT reported improvements in mobility, activities of daily living, emotional wellbeing, cognition, communication and body discomfort.• General beliefs about medication also significantly improved in those who received AT compared with controls.

Nurses working within a chronic care framework of ongoing advice and support can improve experiences for those living with hepatitis C. Practice aimed at reducing both the disruptive effect of the diagnosis and the uncertainties it creates can help facilitate a transition to life with the disease.

This qualitative article explores the attitudes of Thai adolescents and parents concerning the barriers that prevent parents providing sex education to their adolescent children. Focus groups were conducted with 30 parents and 36 adolescents in rural north-eastern Thailand and were analyzed by using thematic analysis. The results showed that most Thai parents have not taught their children about sex education issues. Five themes emerged in relation to the limitations in providing sex education in Thai families. These were: restrictions imposed by traditional Thai culture; sex education is not a parental duty; parental limitations; the generation gap; and better not bring it up. We conclude that the core values in Thai society restrict the discussion of sex, resulting in youth missing the opportunity to acquire the knowledge that is needed about sexual issues from their family. This article provides evidence of how parents' knowledge and perceptions are linked to their ability and willingness to discuss sexual matters with their teenagers. Therefore, future sex education policies could be greatly enhanced by empowering parents to take part in the sex education of their teenage children.

Even when exercise is seen to benefit a child's well-being, families experience challenges in adhering to a physiotherapy programme for hypermobility. Therapists can utilize findings on what enhances adherence to help CYP effectively exercise in the home setting.

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Gastric banding is an established and effective form of weight-loss surgery. However, the nursing contribution to it remains largely unexplored. Using semi-structured interviews, this study explored the experiences and opinions of 20 purposively recruited patients about their nurses' contribution to weight-loss surgery. The data were analysed using thematic analysis. Three themes emerged. First, the provision of knowledge and fostering of understanding, both before and after surgery, focusing on information that addresses patients'needs. Second, staying in touch throughout the treatment period,being available whenever problems arise and advice or interventions are needed. The third theme concerned qualities demonstrated by the nurses. Open-minded patient engagement combined with person centered care fostered confidence in patients and promoted a close therapeutic relationship. Nurses make a substantial contribution to weight-loss surgery, caring for their patients' physical, surgical and,most importantly, psychosocial needs. Their role descriptions should emphasise the psychological, supportive aspects of this role.

Fifty-six children in two groups were discharged within 24 hours of an uncomplicated appendicectomy. While the children in the first group (N = 21) were visited by a nurse at home within 24 hours of discharge, the second group (N = 35) just received telephone calls. The cohort was evaluated by telephone interviews two weeks after discharge. All children fulfilling the discharge standards were discharged safely within 24 hours of surgery. Any physical complaints post-discharge were considered minor. The nurses were able to provide reassurance to the families, give advice and deal with minor problems. As a result the families felt safe and reassured, and in only one case did the fragility of parental confidence become obvious. This study has demonstrated the safety of discharging these children within 24 hours of surgery and the value to nursing contacts in enabling the families to care for their children at home.