This study aims to (1) investigate current practice regarding ‘weaning workshops’ to support complementary infant feeding delivered within Irish primary care, (2) explore the experiences and opinions of community dietitians regarding optimal content and modes of delivery of weaning workshops and (3) identify the key factors to be considered in the development and implementation of weaning workshops delivered within primary care.

Cross-sectional survey.

Irish primary care.

Forty-seven community-based dietitians.

Sixteen dietitians reported that workshops were run in their area with variable frequency, with ten reporting that workshops were never run in their area. Participants reported that mostly mothers of medium socio-economic status (SES) attended weaning workshops when infants were aged between 4 and 7 months, and that feedback from workshop attendees was predominantly positive. Dietitians identified that key factors to be considered in future development and delivery of weaning workshops are (1) workshop characteristics such as content, timing and venue, (2) organisational characteristics such as availability of resources and multidisciplinary involvement and (3) attendee characteristics such as SES.

This study highlights substantial variability regarding provision of weaning workshops in Ireland, and a lack of standardisation regarding the provider, content and frequency of workshops where workshops are being delivered. The study also provides unique insights into the experiences and opinions of primary care community dietitians regarding the development and delivery of weaning workshops in terms of optimal content and delivery options. These perspectives will make a valuable contribution given the dearth of evidence in this area internationally.

Breastfeeding provides optimal nutrition for infants yet breastfeeding rates worldwide do not meet WHO targets for 50% exclusive breastfeeding at 6 months. Ireland's breastfeeding rate is one of the lowest in the world (only 58% initiation) and maternal obesity and overweight is prevalent (> 50% pregnancies). Women with obesity and overweight are particularly at risk of having lower breastfeeding rates but little is known about the factors that supported this sub-group to successfully breastfeed. Our aim was to explore barriers and enablers present in: women with high body mass index (BMI) who successfully breastfed for > 6 months, partners of women with > 6 months breastfeeding, and healthcare professionals (HPs) who support women to breastfeed.

Women with high BMIs (n = 20) were recruited via an extended breastfeeding Facebook group and snowballing. Partners (n = 20) were recruited via social media and word of mouth. HPs (n = 19) were recruited via posters and direct invitation. Semi-structured interviews were conducted either in-person or on telephone and digitally recorded. Interviews were verbatim transcribed and thematically analysed. Two research students independently coded each interview and consensus decided any discrepancies.

Barriers to breastfeeding identified aligned with previous research but the challenges appear to be increased for either the frequency or intensity of occurrence in women with high BMIs. Common barriers are: a lack of breastfeeding culture; limited access within health services to high quality and consistent breastfeeding advice; large breast size; and issues with breastfeeding in public. Enablers for successful extended breastfeeding are: strong self-efficacy; supportive partner and family; social networks for creating breastfeeding-friendly settings; seeking support from a lactation consultant; and breastfeeding aides (clothing, pillows, lanolin, etc.).

Women with high BMIs are able to successfully breastfeed for extended periods of time when they are provided with the right support at the right time and in a way that is acceptable to them and their families. Reorientation of maternity health services to ensure greater and more consistent support for women with high BMIs to initiate breastfeeding is needed. HPs engaging with women with high BMIs should seek to support them through the use of the enablers identified and make a conscious decision to include appropriate advice for women with high BMIs in their antenatal education and any postpartum services provided.

Comorbid substance misuse in people with schizophrenia is associated with poor clinical and social outcomes. There are few studies of psychological treatments for this population and little long-term follow-up of their benefits.

To investigate symptom, substance use, functioning and health economy outcomes for patients with schizophrenia and their carers 18 months after a cognitive–behavioural treatment (CBT) programme.

Patients with dual diagnosis from a randomised controlled trial of motivational intervention, individual CBT and family intervention were assessed on multiple outcomes at 18-month follow-up. Carers were assessed on symptom, functioning and needs over 12 months. Health economy data were collected over 18 months.

There were significant improvements in patient functioning compared with routine care over 18 months. No significant differences between treatment groups were found in carer or cost outcomes.

The treatment programme was superior to routine care on outcomes relating to illness and service use, and the cost was comparable to the control treatment.