Using a whole person approach to support people with cancer: a longitudinal, mixed methods service evaluation

Introduction: Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this paper is to (1) evaluate short and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC); (2) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods: Longitudinal mixed-methods service evaluation (n=135). Data collected included health related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity - MYCaW); lifestyle behaviour (bespoke questionnaire) and participants’ experiences over 12 months post course. Results: Statistically and clinically significant improvements from baseline - 12 months in severity of MYCaW Concerns (n=64; p<0.000) and mean total HRQoL (n=66; p<0.000). The majority of MYCaW concerns were ‘psychological and emotional’ and about participants’ wellbeing. Spiritual, emotional and functional wellbeing contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. 3-6 months post-course was identified as the time when more support was most likely to be needed. Conclusions: Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behaviour change were also identified. These data then informed wider and more person-centred clinical provision to increase the maintenance of positive long-term behaviour changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.

Policy Solutions and International Perspectives on the Funding of Public Service Media Content for Children: A Report for Stakeholders

This project on Policy Solutions and International Perspectives on the Funding of Public Service Media Content for Children began on 8 February 2016 and concludes on 31 May 2016. Its outcomes contribute to the policy-making process around BBC Charter Review, which has raised concerns about the financial sustainability of UK-produced children’s screen content. The aim of this project is to evaluate different funding possibilities for public service children’s content in a more challenging and competitive multiplatform media environment, drawing on experiences outside the UK. The project addresses the following questions: • What forms of alternative funding exist to support public service content for children in a transforming multiplatform media environment? • What can we learn from the types of funding and support for children’s screen content that are available elsewhere in the world – in terms of regulatory foundations, administration, accountability, levels of funding, amounts and types of content supported? • How effective are these funding systems and funding sources for supporting domestically produced content (range and numbers of projects supported; audience reach)? This stakeholder report constitutes the main outcome of the project and provides an overview and analysis of alternatives for supporting and funding home-grown children’s screen content across both traditional broadcasting outlets and emerging digital platforms. The report has been made publicly available, so that it can inform policy work and responses to the UK Government White Paper, A BBC for the Future, published by the Department of Culture, Media and Sport in May 2016.

Children's television: the soft underbelly of public service broadcasting

The provision of children's content should be a key constituent of the public service brand, but has often been viewed as a programme category at risk. Certainly in many countries children's television has moved from the 'scarcity' associated with terrestrial provision, to the 'plenty' of digital (see Ellis 2000). However in spite of a range of dedicated public service children's channels in Europe (CBeebies, Kika, Z@ppelin), domestically produced children's television in Europe is notoriously under-resourced if not marginalised. There is a pronounced reliance on imports (particularly on commercial television) notwithstanding the launch by US-owned multinationals (Disney, Nickelodeon, Cartoon Network) of localised versions of their children's television channels in many European countries. Within the broader context of global developments in children's media, this paper starts by outlining the recent and rapid crisis in British children's television and the factors that caused it. This was a crisis, which caught broadcasters and producers by surprise in the middle of 2006, but reflects many of the challenges faced by the children's television sector in other countries. It clearly demonstrated how a combination of the lack of regulatory protection, a change in commercial priorities among broadcasters, advertising restrictions, budgetary pressures and the competitive environment at home and abroad all combined to reinforce the trend towards a contraction of domestic production. The crisis also served to underline the dominance of the BBC - both as a representative of public service principles, and as the dominant producer and commissioner in the market. With the reasons underpinning the crisis explained, the paper will then analyse how the children's television community responded to the crisis and with what effect. Based on interviews, contemporary accounts and documentary evidence the paper will chart the converging and diverging views of broadcasters, producers, regulatory authority Ofcom, and a range of advocacy groups which represent children's interests and the industry. What arguments were elaborated in favour of protecting children's television as an integral part of the public service media brand? Can lessons be learned about how best to ensure the origination of children's media within a public service environment? Can developments in the UK be used to provide insight into how children's media might develop further?

Handling the transfer of power: a note on the 1964 origins of the Douglas‐Home rules

Opposition is rarely a good preparation for government. The only post‐war government to enter office confident, well‐acquainted with the Civil Service and with a fund of administrative experience to draw on was the Attlee administration formed in 1945. The longer a party spends in opposition the more these assets disappear. Labour, by the end of the long period of Conservative rule in 1951–64, was largely unfamiliar with the burdens of office. This formed the background to the formulation of the Douglas‐Home rules, whereby informal contact is permitted between the Civil Service and the Opposition in advance of a general election. Since 1964 this arrangement has gradually become more extensive (especially after Neil Kinnock complained that the period for contact was too brief during the run‐up to the 1992 election) and more formalised. In late 1993 John Major agreed that contacts could be made from early 1996 in advance of the next election, rather than only during the last six months of a parliament, as had by then become the convention.’ The object of this short paper is, however, to explain how these rules originated.

Probation staff experiences of managing suicidal and self-harming service users.

The current study sought to explore the impact of suicidal behaviours on probation staff, in relation to their experiences of working with probation service users who have carried out suicide, attempted suicide or self-harm. Thirteen in-depth interviews were carried out with probation staff who had direct contact with probation service users in one probation area, and had varying degrees of experience of managing suicidal or self-injurious service users. These were analysed using thematic analysis and five themes were identified. Findings indicate that staff felt that suicide and self-harm by service users are serious issues which need to be recognized and dealt with in an effective yet compassionate manner. Not attending the suicide prevention training, or lack of experience, were perceived as restricting their ability to know how to deal with these individuals, and offer support. Furthermore, staff were emotionally affected by these incidents and it is recommended that they should continue to be provided with access to appropriate support services after an incident.

Good Practice in EU Public Service Media and Contemporary Practice in Jordan: A Comparative Analysis

UNESCO Amman Office Foreword: UNESCO Amman office is pleased to publish a comparative analysis between good Public Service Media (PSM) practices in Europe and the contemporary practice in Jordan. The study is part of the Support to Media in Jordan project, funded by the European Union, aiming to increase media freedom, media independence and journalistic professionalism in Jordan. The state owned broadcaster, Jordan Radio and Television (JRTV), has informed, entertained and educated Jordanians for decades. JRTV reaches almost every corner of the Kingdom and has the potential to serve all Jordanians with balanced, impartial and accurate news and programmes relevant to their day-to-day lives.Based on this potential there has been a long standing ambition to transform the JRTV from a state broadcaster to a public service broadcaster; from a TV and radio that predominately serves the state, to a broadcaster that serves the public and is independent from the Government of the day. This ambition is expressed also in the Support to Media in Jordan project, agreed between the Government an the EU, under which UNESCO has been asked to produce two studies: The comparative PSM analysis and a broader media landscape assessment based on UNESCO’s Media Development Indicators (MDI’s). The Jordanian MDI assessment was carried out by a team of national and international researchers during the first six months of 2015, and builds on the rich flora of recent studies on the Jordanian media landscape, as well as on original research. The study is available in Arabic and English. Professor Naomi Sakr carried out the comparative PSM analysis parallel to the MDI study, and in close cooperation with the MDI research team and UNESCO Amman office.