Exploring the efficacy of a low intensity psychological intervention for family members and carers of individuals with a first episode of psychosis in early intervention services.

AIM: The study aimed to evaluate the efficacy, and explore carers' experience, of a brief carer focussed intervention in an Early Intervention in Psychosis (EIP) service using a mixed methods approach. METHODS: Carers within EIP services were invited to have the intervention, comprising a psychoeducation and wellbeing component, and 153 carers completed routine outcome measures including the Brief Experience of Caregiving Inventory (BECI), The Warwick-Edinburgh Mental Well-being Scale (WEMWEBS) and the Hospital Anxiety and Depression Scale (HADS) at baseline and after the completion of the intervention. Separately, nine carers took part in semi-structured interviews about their experience of the intervention. RESULTS: The intervention resulted in improvement of overall well-being, a reduction in self-reported anxiety and caregiving experience relating to difficult behaviours and stigma/effects on the family. Overall, the carers' subjective experiences of the intervention were positive. Thematic analysis indicated epistemic trust indexed by the connection carers achieved with the service, an experience of being valued and of experiencing change through the intervention. CONCLUSION: A short, 8 weeks intervention delivered by assistant psychologists, may offer an effective method for facilitating understanding of the illness and acclimatizing to new challenges. Exploring the effectiveness of psychoeducation and capturing this with specific measures may allow the service to make meaningful adaptations to their intervention.

School meals for better nutrition and bone health.

Mandatory new standards for food served in schools in England are being phased in from September 2008. These comprise three sets of standards: food-based, nutrient-based and standards covering food other than lunch. They reflect the Governments concern about poor nutrition and rising trends of obesity among the school-age population and the effect of these on ong- as well as short-term health, including increased risks of diabetes, coronary heart disease and cancers. The standards set minimum requirements for healthier foods and restrict less healthy items served at lunchtimes and other meals and snacks at school, including from vending machines or tuck shops. The standards set specific requirements for nutrients and the frequency, and in some cases the quantity, on which they should be provided. They cover fruit and vegetables (not less than two portions per pupil per day), drinks, deep-fried foods and micronutrients. There are requirements for calcium, as evidence shows that many school-age children and adolescents do not consume adequate amounts for bone health. The standards recommend that a variety of dairy foods, low-fat where possible, should be provided, including milk, cheese, yoghurt, fromage frais and custard. A minimum of 193 mg of calcium must be provided at lunch for all primary school children from September 2008. The standards apply to all Local Authority maintained primary and secondary schools, sixth forms on the premises of secondary schools, schools for children with special educational needs, and pupil referral units. They are not mandatory for independent schools although these will be expected to comply. The standards are derived from the UK nutrient recommendations (Dietary Reference Values). Responsibility for the provision of school meals and for ensuring the standards are met lies with the Local Authorities, or the schools under delegated powers. Monitoring will be by Ofsted, the body responsible for inspecting schools. Implementing the standards will be a major task in which schools, caterers, Local Authorities and health professionals need to work together. School nurses have a part to play, e.g. in starting a School Nutrition Action Group in their schools. The local Healthy Schools Coordinator and dietitians and registered nutritionists are useful sources of information and support, as is the School Food Trust's website www.schoolfoodtrust.org.uk.