This book challenges the prevailing discourse centred on the problems of demographic change and long-term care provision for older people by focusing on solutions emerging from progression and improvement in policy and practice. Building on ample research in 13 European countries, evidence is provided for how the construction of long-term care systems can be taken forward by practitioners, policy-makers and stakeholder organizations. By focusing on prevention and rehabilitation, the support of informal care, the enhancement of quality development as well as by decent governance and financing mechanisms for long-term care, stakeholders may learn from European experiences and solutions on the local, regional and national levels.

The central aim of the healthPROelderly project was to contribute fundamentally to the development of health promotion for older people through producing guidelines and recommendations for potential actors in this field at EU, national and local level. The specific objectives of the healthPROelderly project were: ? to carry out a literature review concerning health promotion of older people in each of the participating countries. ? to identify models for health promotion for older people in each of the participating countries, evaluate three of them in each country and make them available in the form of a database on the website (www.healthproelderly.com). ? to inform and raise the awareness among experts and authorities throughout the EU about the issue of ageing and the impact of demographic change on our society.

Over recent years there have been several political imperatives in the UK directed toward children's palliative care and ensuring that services are high-quality, coordinated, family-centred, and able to meet the needs of children with complex disabilities. In addition, in 2010 the health and social care regulation authority in England-the Care Quality Commission (CQC)-aligned hospices with regulation and inspection requirements. This context has acted as a driver for the creation of effective education and training to ensure a skilled and expert workforce. Against this backdrop, this paper describes a project to develop a learning and development strategy for Children's Hospices across London (CHaL). CHaL educators worked with a research team to develop a unified strategy that was based on evidence of good practice, embedded in required CQC outcomes, and validated with a wider audience. The resultant strategy contains a set of four key leaming and development principles that are applicable and transferable across different hospices.

Background: Standards, benchmarking, and audits are integral to quality monitoring in health and social service provision. Recent policy in the UK National Health Service dictating the need for increased consumer involvement necessitates that service users have significant input into the composition of standards for quality of care. Objective: To report the authors' recent involvement in research towards developing a set of agreed, measureable statements regarding quality in the provision of continence services using the views of older service users. Methods: This article focuses on the third of a three-stage project to involve, identify, and incorporate the views of older continence service users in the development of standards of care in continence services. Whereas stage 1 developed a questionnaire with the assistance of service users, and stage 2 piloted this as a postal survey in two contrasting areas, stage 3 applied the tool in the context of face-to-face interviews with more vulnerable older people. The approach also included open-ended questions to elicit qualitative data around experiences of continence service provision. Results: Earlier stages of the project involved the relatively unproblematic construction of standards based on views given by experts and focus groups of older people. However, more in-depth, semi-structured interviews with service users brought to light the holistic, complex, and subjective way in which the sample viewed their experiences. Conclusions: This study raises a number of questions over the efficacy of simple statements in capturing what is important to service users. If such standards are to empower patients usefully and assist professionals informatively in their provision of high-quality care, greater effort and sophistication is needed to truly reflect the needs and interests of service users. Alongside these concerns, however, there are potential ways of bridging the gap between standard setting and the lived patient experience.

This article describes health promotion for older people in the Czech Republic from the European perspective. It is based on findings from the European project healthPROelderly. Implemention of health promotion in the Czech Republic as a new public health concept is outlined from the historical point of view. Structures and processes of health promotion in the Czech Republic are described in the context of social policy, demography and health. The European project healthPROelderly is presenting and the outcomes of an international literature search statisicallyanalysed. Participating coutries were devided into three macro-regions according to their geographical location and political and historical tradition - Mediterranean, West-European and formerly East-European macro-regions. The outcome orf correspondence analysis partially confirms the hypothesis on the cultural background of the health promotion activities and strategies. Concerning themes addressed by health promotion projects most countries belonging to the Mediterranean or 'Western European' macro-regions have concentrated on similar themes whereas this is not valid for the countries of the 'Former Eastern European' macro-region. The hypothesis on macro-regional similarities in relation to settings of health promotion projects was not confirmed. In the conclusions the location of the Czech Republic in an international perspective is discussed and three Czech selected best practice projects are evaluated in relation to the statistical findings.

People with incontinence problems are particularly vulnerable to feeling a loss of dignity. A recent study on dignity in care settings explored the factors important to residents in maintaining dignity during continence care.

Objective: To understand the experiences of patients who had undergone neurologic rehabilitation. Design: An interpretative phenomenological analysis of semistructured interviews. Setting: Neurologic rehabilitation unit. Participants: A purposive convenience sample of 8 past patients. Interventions: Not applicable. Main Outcome Measure: Participants’ reports of neurologic rehabilitation obtained via in-depth semistructured interviews. Results: Participants predominantly described positive experiences of rehabilitation. The superordinate theme personcenteredness was developed, which included 4 key themes: ownership, personal value, holistic approach, and therapeutic atmosphere. These reflected patients’ perceptions of choice and control and feelings of personal respect and self-worth. These appeared to be promoted through the multidimensional benefits of the unit (eg, the understanding and friendly nature of staff and other patients, physical improvements, psychologic gains) as well as the unit’s informal, relaxed environment. When present, these factors created a positive rehabilitation experience; when absent, a negative experience. Conclusions: These findings support those from other literature, which has identified person-centered care as a core element of successful rehabilitation and linked its absence to dissatisfaction with health care. This research has increased our understanding of patients’ experience of neurologic rehabilitation, and could inform the development of a patient-centered assessment instrument for neurologic rehabilitation.

This project lays the foundation for the development of a sustainable and unified approach to learning and development by bringing together policy, practice and evidence, and interfacing with regulatory requirements that have recently been strengthened for hospices and that are inspected by the Care Quality Commission (CQC). It commences with CHaL’s vision for learning and development, follows with project description and methods, and summarises the initial scoping conducted to underpin the strategy. The subsequent analytical and conceptual development of the strategy is described, alongside a rational for aligning thinking with the CQC essential standards that are inspected. The project had a unique opportunity to link in to a set of three national workshops for hospices arranged by Children’s Hospices UK (CHUK) and working with CQC that served to act as a consultation forum; this process is described.

The "Am I Bovvered?" project is a two-year study aiming to develop, implement and evaluate sustainable exercise-based interventions with girls aged 11-15 years in order to improve their engagement in regular physical activity. The study took place in three phases that corresponded with the project?s main aims: The aims of the first phase of the study were to: Explore factors that motivate and create barriers to 11-12 and 14-15 year old girls engaging in regular physical activity (Phase One). The aims of the second and third phases were to: Develop and implement activities chosen by inactive 11-12 and 14-15 year old girls with the support of a multi-agency team (Phase Two). Evaluate the impact of the project, examining factors associated with young girls? engagement in physical exercise (Phase Three). Make recommendations for policy and practice.

The present report summarizes the work of the cross-frontier group which was established, within the framework of Interreg IV, to consider the concept of self-efficacy. A first full-scale study entitled "Let's Talk/Parlez-moi d'amour" had already been undertaken, under the aegis of the Interreg III programme, by several of the partners involved, to examine perceptions in Kent and the Somme of teenage pregnancy as a social phenomenon. This initial project was concluded in 2007 by a conference in Amiens, Somme, during which the French and English research groups were able to present and discuss their findings.

The main purpose of this one-year project was to locate, monitor and evaluate health promotion interventions that are characterised and embedded in the use of social marketing techniques. This project was comprised of two phases – The aims of Phase One were to: Identify and prioritise those projects that have used social marketing techniques Agree an evaluation plan in collaboration with local and national experts The completion of the scoping exercise for Phase One highlighted that the research team needed to move away from any explicit evaluation activities and towards assisting projects with conducting their own evaluation. The revised aims of Phase Two were to: Facilitate with the integration of robust evaluation methods into project planning and to advise on the collection and analysis of evaluation data Support the organisation in enhancing their strategic understanding of social marketing and its potential in health promotion activity Anticipate that projects using social marketing techniques successfully could be at the forefront of dissemination, providing illustrations of the practical application of techniques

This document reports upon two afternoon workshops on ‘Evaluating Social Marketing’, which were conducted on the 9th and 10th September 2009 for Eastern and Coastal Kent (ECK) PCT. The workshops were held at the Centre for Health Services Studies, University of Kent. The aims were to increase participants’ understanding of social marketing and evaluation, and to develop an action plan that will meet any training needs and identify how research support can be provided until the end of the project. Following a scoping exercise conducted by the CHSS Social Marketing Team between April and June 2009, a need was identified to inform social marketing project leads of the concept and application of social marketing, and help with the evaluation of social marketing initiatives.

In February 2009, the Health and Europe Centre commissioned an international literature review to identify effective interventions in relation to the issue of young people and alcohol. This piece of research has been funded through the NHS Eastern and Coastal Kent Social Marketing Committee and its primary purpose has been to inform the content of ‘WASTED: An International Conference on Alcohol and Young People’ which is taking place on 20th November 2009 in Ashford, Kent. The conference aims to highlight effective interventions which can be used to redesign services and target existing resources more effectively, leading to a longer-term reduction in underage drinking. Another specific aim of the literature review has been to identify successful or promising interventions which have used social marketing techniques to prevent, reduce or delay the onset of drinking amongst adolescents and to disseminate the results of these findings to local policy makers and practitioners.

In February 2009, the Health and Europe Centre commissioned an international literature review to identify effective interventions in relation to the issue of young people and alcohol. This piece of research has been funded through the NHS Eastern and Coastal Kent Social Marketing Committee and its primary purpose has been to inform the content of ‘WASTED: An International Conference on Alcohol and Young People’ which is taking place on 20th November 2009 in Ashford, Kent. The conference aims to highlight effective interventions which can be used to redesign services and target existing resources more effectively, leading to a longer-term reduction in underage drinking. Another specific aim of the literature review has been to identify successful or promising interventions which have used social marketing techniques to prevent, reduce or delay the onset of drinking amongst adolescents and to disseminate the results of these findings to local policy makers and practitioners.

This report forms part of an evaluation of activities undertaken by the Relativity Project at Aylesham. The overall aim of the Relativity Project is to engage families from the Aylesham community in a variety of fun and creative activities which will broaden family learning skills and provide opportunities for all family members to get actively involved. It also aims to develop community involvement in a variety of settings and target excluded and vulnerable families.

The ‘Am I Bovvered?’ project was a two-year study aiming to develop, implement and evaluate sustainable exercise-based interventions with girls aged 11-15 years in order to improve their engagement in regular physical activity. The study took place in three phases that corresponded with the project’s main aims. This summary provides an account of Phases Two and Three. The aims of the first phase of the study were to: Explore factors that motivate and create barriers to 11-12 and 14-15 year old girls engaging in regular physical activity (Phase One has been completed -http://www.kent.ac.uk/CHSS/docs/Am_I_Bovvered_Phase_One.pdf). The aims of the second and third phases were to: Develop and implement activities chosen by inactive 11-12 and 14-15 year old girls with the support of a multi-agency team (Phase Two). Evaluate the impact of the project, examining factors associated with young girls’ engagement in physical exercise (Phase Three). Make recommendations for policy and practice.

In recent years dignity in care has become a priority and the focus of a number of government reports and policy initiatives (DH 2003, 2007; SCIE 2006; Healthcare Commission, 2007). The National Service Framework for Older People (DH 2001) and its follow up document, (DH 2006a) emphasised the pivotal position of maintaining and improving care for older people. However, despite considerable political support, there continues to be a problem in health and social care related to preserving the dignity of older people (Levenson, 2007). Generalised policy statements appear to have little effect on actual practice and care unless they are operational, supported by guidelines for practice and actively monitored. There has been an increase in studies of dignity in health care over the past few years (Chochinov et al., 2002a, Woolhead et al., 2006) particularly focusing on the ways in which dignity is defined and what it means to people. There have, however, been far fewer studies on the relationship between dignity and personal care particularly when that care involves sensitive issues, of which continence care is a prime example. This report provides the initial analysis of emerging themes and findings from the first phase of a qualitative study of privacy and dignity in continence care for older people.

This report provides an account of the methods and findings of Phase 2 of the Privacy and Dignity in Continence Care for Older People study funded by the Royal College of Physicians and the British Geriatrics Society. The overall objectives of this two year project were to: • Identify and validate person-centred attributes of dignity in relation to continence; • Develop reflective guidelines for dignified care; • Produce recommendations for best practice.

This report features in-depth analyses of three health promotion interventions amongst older adults that have taken place in the UK during the last ten years (and much longer in one case). All three projects have been assessed as demonstrating high levels of effectiveness in achieving specific results with regard to the public health of their targeted local older people. The three interventions vary quite dramatically in both the nature and goals of the intervention as well as the means of evaluation, yet all possess a number of discernable characteristics which are crucial to their success in promoting the health of older people. Such facets may be taken to represent key components of what comprises ‘best practice’ in health promotion amongst older people. These features will be elucidated implicitly throughout this report before being clarified more explicitly in its concluding discussions.