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It is deemed good practice to involve patients routinely in research but no study has investigated the practical benefits, particularly to successful recruitment. To identify whether patient involvement is associated with study success. All studies listed on the Mental Health Research Network (MHRN) portfolio database (n = 374) were interrogated using logistic regression, ANOVA and Pearson's correlation to identify associations with study characteristics, funding bodies and recruitment success. Patient involvement increased over time although in some areas of research it was limited. Some funders, especially the National Institute for Health Research (NIHR), had more associated patient involvement than others. Studies that involved patients to a greater extent were more likely to have achieved recruitment targets (χ(2) = 4.58, P<0.05), defined as reaching at least 90% of the target. This is the first time associations with study success have been identified for patient involvement. Researchers might now consider ways to involve patients more comprehensively as this is associated with study success. Further research is needed to explore this finding.

Informed consent in research is partly achieved through the use of information sheets. There is a perception however that these information sheets are long and complex. The recommended reading level for patient information is grade 6, or 11-12 years old. To investigate whether the readability of participant information sheets has changed over time, whether particular study characteristics are related to poorer readability and whether readability and other study characteristics are related to successful study recruitment. Method: We obtained 522 information sheets from the UK National Institute for Health Research Clinical Research Network: Mental Health portfolio database and study principal investigators. Readability was assessed with the Flesch reading index and the Grade level test. Information sheets increased in length over the study period. The mean grade level across all information sheets was 9.8, or 15-16 years old. A high level of patient involvement was associated with more recruitment success and studies involving pharmaceutical or device interventions were the least successful. The complexity of information sheets had little bearing on successful recruitment. Information sheets are far more complex than the recommended reading level of grade 6 for patient information. The disparity may be exacerbated by an increasing focus on legal content. Researchers would benefit from clear guidance from ethics committees on writing succinctly and accessibly and how to balance the competing legal issues with the ability of participants to understand what a study entails.

A major objective of many healthcare providers is to increase patients' participation in their own care. The introduction of electronic personal health records (ePHRs) may help to achieve this. An ePHR is an electronic database of an individual's health information, accessible to and maintained by the patient. ePHRs are very much in vogue, with an increasing number of studies reporting their potential utility as well as cost. However, the vast majority of these studies focus on general healthcare. Little attempt has been made to document the specific problems which might occur throughout the implementation of ePHRs in mental health. This review identifies such concerns through an electronic search of the literature. Several potential difficulties are highlighted and addressed, including access to information technology, identifying relevant populations and the handling of sensitive information. Special attention is paid to the concept of 'empowerment' and what this means in relation to ePHRs.

BackgroundInformed consent in research is partly achieved through the use ofinformation sheets. There is a perception however that these informationsheets are long and complex. The recommended reading level for patientinformation is grade 6, or 11–12 years old.AimsTo investigate whether the readability of participant information sheetshas changed over time, whether particular study characteristics arerelated to poorer readability and whether readability and other studycharacteristics are related to successful study recruitment.MethodWe obtained 522 information sheets from the UK National Institute forHealth Research Clinical Research Network: Mental Health portfoliodatabase and study principal investigators. Readability was assessed withthe Flesch reading index and the Grade level test.ResultsInformation sheets increased in length over the study period. The meangrade level across all information sheets was 9.8, or 15–16 years old. Ahigh level of patient involvement was associated with more recruitmentsuccess and studies involving pharmaceutical or device interventions werethe least successful. The complexity of information sheets had littlebearing on successful recruitment.ConclusionsInformation sheets are far more complex than the recommended readinglevel of grade 6 for patient information. The disparity may beexacerbated by an increasing focus on legal content. Researchers wouldbenefit from clear guidance from ethics committees on writing succinctlyand accessibly and how to balance the competing legal issues with theability of participants to understand what a study entails.

Background Previous attempts to implement electronic Personal Health Records (ePHRs) underline the importance of stakeholder involvement. We describe the development of an ePHR for people with severe and enduring mental health problems, and provide a model of involving stakeholders throughout. Methods There were three stages to the development of the ePHR. These were 1) identifying and responding to user and clinical needs; 2) preliminary testing; and 3) preliminary implementation. Stakeholder involvement was pervasive in all stages. We collaborated with 133 stakeholders in the first stage, 13 in the second, and 26 in the third. On the micro-level, a service user researcher conducted much of the data collection and analysis. On the macro-level, a service user advisory group guided decisions throughout the project, and a service user was an active member of the project executive board and the implementation team. Results Service users and clinicians preferred an interactive ePHR with features such as access to care plans and care notes, a mood tracker, patient reported outcomes feeding into the clinical record, and social networking features. Many of the above were constructed following consultation with the relevant professionals, however further consultation is required before building a social networking function or providing access to full care notes. Service users positively rated the usability of the ePHR. Drop-in sessions helped service users access technology and learn how to use the ePHR. Conclusions We outline four considerations for future developers of ePHRs: appeal, construction, ease of use, and implementation. Success rests on implementation in routine practice, so ePHRs must be intuitive and useful for both service users and staff. Continued involvement of end users throughout the design and testing process can help to achieve this goal.

The focus of this thesis is on communication between a person diagnosed with dementia and a person who has not been diagnosed with dementia. It considers both theoretical and family perspectives on the topic.Chapter one is a scoping review and synthesis of theoretical accounts of communication in the context of dementia. Eighteen theories were identified. The theories were derived from diverse perspectives, yet many of them seemed to describe similar components. Many of the components described were also similar to those included in definitions of person-centred dementia care. The meaning of these findings is considered, alongside a discussion of theories situated outside of this discourse and the implications for dementia research and intervention development. Chapter two investigated family member experiences of communicating with a loved one diagnosed with dementia, using a novel video-based method. The study identified that the symptoms of dementia were often experienced as threats to knowledge, personhood and closeness. Communication was often the means by which participants attempted to counteract these threats, with varying success. A model is proposed to structure the findings, along with implications for communication interventions. Chapter three describes and reflects on the important decisions made in completing the research described in chapters one and two. There is also some reflection on the process of completing this research, alongside some considerations of how things might have been done differently.

Risk assessment is closely tied to the process of managing offender risk; that is, identifying and intervening with key risk factors in an effort to reduce the likelihood of future intimate partner violence (IPV). IPV risk assessment and management can be viewed within the framework of the Risk, Needs, and Responsivity (RNR) principles of effective correctional services. This chapter describes the RNR model and then examines research on IPV offender risk assessment and treatment needs, showing how the IPV literature can be understood within RNR. It uses exemplars to illustrate areas in which existing work appears consistent with RNR, highlight the gaps where the RNR framework may be able to help the field advance, and comment on its applicability to threat assessment. Antisocial cognition includes attitudes and beliefs that favour or support criminal behaviour. Antisocial attitudes are typically treated in offender intervention through cognitive behavioural methods.

A covert observation of posts on a pro‐pedophile Internet message board investigated evidence of distorted cognitions that were supportive of sexually abusive behavior. Implications for the treatment and supervision of members of online communities that support pedophilic interests and behaviors are discussed.