Clare Thetford

RELIABILITY OF HEROIN USERS' REPORTS OF DRUG USE BEHAVIOUR USING A 24 MONTH TIMELINE FOLLOW-BACK TECHNIQUE TO ASSESS THE IMPACT OF THE AUSTRALIAN HEROIN SHORTAGE

Background: In early 2001 Australia experienced a dramatic disruption to heroin supply. In order to investigate the impact of this phenomenon, heroin users were interviewed retrospectively to determine drug use behaviour over a two year period. Aim: To examine the reliability of the timeline follow-back (TLFB) technique in determining heroin users’ patterns of drug use and related behaviours over a 24 month period. Method: 27 current heroin users were recruited through drug use services and interviewed about their drug use behaviour retrospectively using the calendar method of the TLFB. Test–retest reliability was measured over seven days. Results: Recall of regular drug use was generally reliable. Recall was poorest during January–April 2001, the peak period of the heroin shortage. Recall of criminal activity and weekly expenditure on drugs was variable, though generally poor. Recall of treatment entry and drug related health problems such as overdose was also variable. Conclusion: The 24 month TLFB did not obtain information reliable enough to examine sporadic drug use or overall changes in the patterns of drug use associated with the heroin shortage. To avoid this situation cohorts of injecting drug users need to be established as these phenomena cannot be accurately studied retrospectively.

Living with age-related macular degeneration treatment: Patient experiences of being treated with ranibizumab (Lucentis)(R) intravitreal injections

This study reports the results of a qualitative study of patient experiences of receiving treatment for wet age-related macular degeneration with ranibizumab (Lucentis)(R). Treatment involved monthly hospital visits for assessment and, where required, an intravitreal Lucentis injection. Qualitative narrative interviews were conducted with 22 patients, 18 of whom received treatment and were interviewed at two points during their treatment journey. Interviews allowed participants to reflect on their experiences of being assessed for and receiving this treatment. Overall, treated participants reported that while they had been apprehensive about treatment, the actual experience of it was far less unpleasant than they had expected. However, the data also revealed a number of issues surrounding the provision of information about treatment, as well as service delivery issues, which had considerable impact upon their experience.

Long-term access to support for people with sight loss

The impact of sight loss on everyday life changes over time, through further deterioration of vision, as well as a result of other physical changes and key events in people’s lives. As such, even the support needs of people with relatively stable visual impairment are likely to change throughout their life course. This article explores the long-term support needs of people with sight loss and the barriers they face when accessing services over time and at the time of need. Data from biographical interviews with 36 participants with sight loss is presented, with particular focus upon three illustrative case studies. The study reveals that many participants experienced problems gaining information about, and access to, services in the short and longer term. There is a need for systematic referral from clinical services to social and voluntary services and for regular follow-up to identify and respond to people’s changing needs.

Finding your own way around : experiences of health and social care provision for people with a visual impairment in the United Kingdom

The systems of support for people with a visual impairment in the United Kingdom are complex and can be difficult to access, involving input from a range of health and social care services. In this article, we report qualitative findings from research looking at people’s experiences of accessing health and social care services. These highlight the inconsistencies and variability in existing systems of support for people with a visual impairment, and show that access to services is largely dependent on the agency and initiative of individual service users in establishing networks of support for themselves. This means that those who are less able to do this may find themselves without the support necessary to maintain or improve their quality of life. We argue that health and social care agencies need to be more proactive in addressing the support needs of people with a visual impairment beyond the point of initial diagnosis or registration.

Habilitation provision for children and young people with vision impairment in the United Kingdom: A lack of clarity leading to inconsistencies

The key to empowering and supporting children and young people (CYP) with vision impairment (VI) to achieve their potential lies in the delivery of habilitation training. Evidence has revealed that provision of habilitation services across the United Kingdom was inconsistent, with CYP with VI not receiving services in some areas. This research explored the accessibility and quality of habilitation provision for CYP with VI via two studies: (1) 12 qualitative case studies of habilitation practice and (2) surveys of habilitation training experiences, with CYP with VI (n = 43) and with parents of CYP with VI (n = 68). Five themes were identified highlighting inconsistencies and variability in the delivery of habilitation training in recent years, a lack of focus on independent living skills training, on social inclusion and emotional well-being, a lack of support for parents and a lack of clarity with regard to the definition of habilitation, and who is responsible for providing training.