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Sodium all-solid-state batteries may become a novel storage technology overcoming the safety and energy density issues of (liquid-based) sodium ion batteries at low cost and good resource availability. However, compared to liquid electrolyte cells, contact issues and capacity losses due to interface reactions leading to high cell resistance are still a problem in solid-state batteries. In particular, sulfide-based electrolytes, which show very high ionic conductivity and good malleability, exhibit degradation reactions at the interface with electrode materials and carbon additives. A new group of solid electrolytes, i.e., sodium halides, shows wider potential windows and better stability at typical cathode potentials. A detailed investigation of the interface reactions of Na3SbS4and Na2.4Er0.4Zr0.6Cl6as catholytes in cathodes and their cycling performance in full cells is performed. X-ray spectroscopy, time-of-flight spectrometry, and impedance spectroscopy are used to study the interface of each catholyte with a transition metal oxide cathode active material. In addition, impedance measurements were used to study the separator electrolyte Na3SbS4with the catholyte Na2.4Er0.4Zr0.6Cl6. In conclusion, cathodes with Na2.4Er0.4Zr0.6Cl6show a higher stability at low C-rates, resulting in lower interfacial resistance and improved cycling performance.

Aim: Maternal drinking (alcohol use during pregnancy/motherhood) is a hidden public health concern which can have significant negative effects on the woman and child. This pilot survey explored several domains that might influence maternal drinking. Subject and methods: Two cross-sectional, online surveys recruited (1) women who were pregnant and (2) mothers who were not pregnant. Surveys captured data on alcohol use and harmful drinking, attitudes on and motives for drinking/not drinking, and perceived barriers to drinking less. Content analysis of free text responses complemented quantitative data. Results: In this convenience sample of 836 pregnant women and 589 mothers, 91% of pregnant women and 28% of mothers reported abstinence. Of those reporting alcohol use, median consumption was 2.3 units/week in pregnant women, and 6.9 units/week in non-pregnant mothers. Of mothers currently drinking, 25.1% reported hazardous or harmful levels. Heavier drinking was associated with numerous motives, including using alcohol as a coping strategy. Child welfare was a key motivating factor for not drinking, as were practical issues of motherhood. The stresses of motherhood were a perceived barrier to reducing drinking, and mothers reported more barriers than pregnant women. Conclusion: Stress reduction motives may be a risk factor for heavier maternal drinking, while motives for not drinking seem to be focused on child welfare and maternal well-being. Stress and a lack of knowledge about how to reduce drinking appear to be barriers for mothers to change their drinking behaviour. These findings can inform the development of effective public health interventions to reduce maternal drinking.

AbstractThe development of mobile health applications (apps) is growing exponentially. Alcohol reduction apps can break down perceived barriers of seeking help for alcohol misuse, potentially making them more appealing than face-to-face methods. App usability is therefore essential in supporting individuals misusing alcohol. Alcohol misuse is common in the UK Armed Forces, therefore smartphone-based alcohol interventions could be valuable for this population. The aim of this pilot study was to assess the usability of Drinks:Ration, an alcohol reduction app for military veterans. Participants downloaded and used Drinks:Ration for 14-days (n = 16), completed a usability questionnaire (n = 14; 88%) and a semi-structured interview (n = 12; 75%). The mean usability score across all measures was 6.09 (SD 1.37), out of 7, indicating good usability. Three core themes were identified: simplicity; appropriateness for veterans; and engagement. Drinks:Ration was a usable app for veterans to monitor their alcohol consumption. Veteran users were more critical than expert users about the usefulness of the app. Feedback was incorporated into the app, where possible, to improve usability. Improvements included adding extra drink options, removing device notification sounds and adding a pop-up to each page which provides information about the features of the app on first use.

AbstractBackground:Smartphone-based interventions are increasingly being used to facilitate positive behavior change, including reducing alcohol consumption. However, less is known about the effects of notifications to support this change, including intervention engagement and adherence. The aim of this review was to assess the role of notifications in smartphone-based interventions designed to support, manage, or reduce alcohol consumption. Methods:Five electronic databases were searched to identify studies meeting inclusion criteria: (1) studies using a smartphone-based alcohol intervention, (2) the intervention used notifications, and (3) published between 1st January 2007 and 30th April 2021 in English. PROSPERO was searched to identify any completed, ongoing, or planned systematic reviews and meta-analyses of relevance. The reference lists of all included studies were searched. Results:Overall, 14 papers were identified, reporting on 10 different interventions. The strength of the evidence regarding the role and utility of notifications in changing behavior toward alcohol of the reviewed interventions was inconclusive. Only one study drew distinct conclusions about the relationships between notifications and app engagement, and notifications and behavior change. Conclusions:Although there are many smartphone-based interventions to support alcohol reduction, this review highlights a lack of evidence to support the use of notifications (such as push notifications, alerts, prompts, and nudges) used within smartphone interventions for alcohol management aiming to promote positive behavior change. Included studies were limited due to small sample sizes and insufficient follow-up. Evidence for the benefits of smartphone-based alcohol interventions remains promising, but the efficacy of using notifications, especially personalized notifications, within these interventions remain unproven.

Background: Smartphone-based interventions are increasingly being used to facilitate positive behavior change, including reducing alcohol consumption. However, less is known about the effects of notifications to support this change, including intervention engagement and adherence. The aim of this review was to assess the role of notifications in smartphone-based interventions designed to support, manage, or reduce alcohol consumption. Methods:Five electronic databases were searched to identify studies meeting inclusion criteria: (1) studies using a smartphone-based alcohol intervention, (2) the intervention used notifications, and (3) published between 1st January 2007 and 30th April 2021 in English. PROSPERO was searched to identify any completed, ongoing, or planned systematic reviews and meta-analyses of relevance. The reference lists of all included studies were searched. Results:Overall, 14 papers were identified, reporting on 10 different interventions. The strength of the evidence regarding the role and utility of notifications in changing behavior toward alcohol of the reviewed interventions was inconclusive. Only one study drew distinct conclusions about the relationships between notifications and app engagement, and notifications and behavior change. Conclusions:Although there are many smartphone-based interventions to support alcohol reduction, this review highlights a lack of evidence to support the use of notifications (such as push notifications, alerts, prompts, and nudges) used within smartphone interventions for alcohol management aiming to promote positive behavior change. Included studies were limited due to small sample sizes and insufficient follow-up. Evidence for the benefits of smartphone-based alcohol interventions remains promising, but the efficacy of using notifications, especially personalized notifications, within these interventions remain unproven.

AbstractPrior research has shown that those with Post-Traumatic Stress Disorder (PTSD) have persistent reductions in quality of life (QoL), and higher rates of alcohol misuse. As such, it is important that we explore QoL and alcohol misuse on PTSD diagnosis. Therefore, the aim of this study was to assess the association between PTSD, QoL and alcohol misuse among United Kingdom (UK) veterans. 163 UK veterans who sought help for a mental health disorder were recruited to take part. Linear regressions were used to assess the association between probable PTSD, QoL and alcohol misuse. Pearson’s correlation analyses were used to assess the relationship between PTSD symptom clusters and QoL domains. We found unadjusted regressions showed evidence that, compared to those without PTSD, those with PTSD had lower QoL scores on physical health, psychosocial, social relationships and environment domains. Adjusting for age, sex, and outcome variables, only associations with the physical health domain and psychosocial domain remained statistically significant. Correlation analyses between PTSD and QoL domains showed the strongest negative correlations between the functional impairment and physical health domain, and between the functional impairment and psychosocial domain. We found that those with probable PTSD had lower QoL and higher alcohol misuse scores.

Significant social and political changes occurred in the UK between 2015 and 2020. Few studies have examined population level trends in experiencing discrimination and mental health problems during this period.

BackgroundTranexamic acid (TXA) is an antifibrinolytic drug used to prevent bleeding. It was introduced as an intervention for post-traumatic haemorrhage across emergency medical services (EMS) in the UK during 2012. However, despite strong evidence of effectiveness, prehospital TXA administration rates are low. This study used the theoretical domains framework (TDF) to identify barriers and facilitators to the administration of TXA to trauma patients by EMS providers (paramedics) in the UK.MethodsInterviews were completed with 18 UK paramedics from a single EMS provider organisation. A convenience sampling approach was used, and interviews continued until thematic saturation was reached. Semistructured telephone interviews explored paramedics’ experiences of administering TXA to trauma patients, including identifying whether or not patients were at risk of bleeding. Data were analysed inductively using thematic analysis (stage 1). Themes were mapped to the theoretical domains of the TDF to identify behavioural theory-derived barriers and facilitators to the administration of TXA to trauma patients (stage 2). Belief statements were identified and assessed for importance according to prevalence, discordance and evidence base (stage 3).ResultsBarriers and facilitators to paramedics’ administration of TXA to trauma patients were represented by 11 of the 14 domains of the TDF. Important barriers included a lack of knowledge and experience with TXA (Domain: Knowledge and Skills), confusion and restrictions relating to the guidelines for TXA administration (Domain: Social/professional role and identity), a lack of resources (Domain: Environmental context and resources) and difficulty in identifying patients at risk of bleeding (Domain: Memory, attention and decision processes).ConclusionsThis study presents a behavioural theory-based approach to identifying barriers and facilitators to the prehospital administration of TXA to trauma patients in the UK. It identifies multiple influencing factors that may serve as a basis for developing an intervention to increase prehospital administration of TXA.

BackgroundBirth before arrival at hospital (BBA) is associated with unfavourable perinatal outcomes and increased mortality. An important risk factor for mortality following BBA is hypothermia, and emergency medical services (EMS) providers are well placed to provide warming strategies. However, research from the UK suggests that EMS providers (paramedics) do not routinely record neonatal temperature following BBA. This study aimed to determine the proportion of cases in which neonatal temperature is documented by paramedics attending BBAs in the South West of England and to explore the barriers to temperature measurement by paramedics.MethodsA two-phase multi-method study. Phase I involved an analysis of anonymised data from electronic patient care records between 1 February 2017 and 31 January 2020 in a single UK ambulance service, to determine 1) the frequency of BBAs attended and 2) the percentage of these births where a neonatal temperature was recorded, and what proportion of these were hypothermic. Phase II involved interviews with 20 operational paramedics from the same ambulance service, to explore their experiences of, and barriers and facilitators to, neonatal temperature measurement and management following BBA.ResultsThere were 1582 ‘normal deliveries’ attended by paramedics within the date range. Neonatal temperatures were recorded in 43/1582 (2.7%) instances, of which 72% were below 36.5°C. Data from interviews suggested several barriers and potential facilitators to paramedic measurement of neonatal temperature. Barriers included unavailable or unsuitable equipment, prioritisation of other care activities, lack of exposure to births, and uncertainty regarding responsibilities and roles. Possible facilitators included better equipment, physical prompts, and training and awareness-raising around the importance of temperature measurement.ConclusionsThis study demonstrates a lack of neonatal temperature measurement by paramedics in the South West following BBA, and highlights barriers and facilitators that could serve as a basis for developing an intervention to improve neonatal temperature measurement.

Background The optimal airway management strategy for in-hospital cardiac arrest is unknown.Methods An online survey and telephone interviews with anaesthetic and intensive care trainee doctors identified by the United Kingdom Research and Audit Federation of Trainees. Questions explored in-hospital cardiac arrest frequency, grade and specialty of those attending, proportion of patients receiving advanced airway management, airway strategies immediately available, and views on a randomised trial of airway management strategies during in-hospital cardiac arrest.Results Completed surveys were received from 128 hospital sites (76% response rate). Adult in-hospital cardiac arrests were attended by anaesthesia staff at 40 sites (31%), intensive care staff at 37 sites (29%) and a combination of specialties at 51 sites (40%). The majority (123/128, 96%) of respondents reported immediate access to both tracheal intubation and supraglottic airways. A bag-mask technique was used ‘very frequently’ or ‘frequently’ during in-hospital cardiac arrest by 111/128 (87%) of respondents, followed by supraglottic airways (101/128, 79%) and tracheal intubation (69/128, 54%). The majority (60/100, 60%) of respondents estimated that ≤30% of in-hospital cardiac arrest patients undergo tracheal intubation, while 34 (34%) estimated this to be between 31% and 70%. Most respondents (102/128, 80%) would be ‘likely’ or ‘very likely’ to recruit future patients to a trial of alternative airway management strategies during in-hospital cardiac arrest. Interview data identified several barriers and facilitators to conducting research on airway management in in-hospital cardiac arrest.Conclusions There is variation in airway management strategies for adult in-hospital cardiac arrest across the UK. Most respondents would be willing to take part in a randomised trial of airway management during in-hospital cardiac arrest.

BackgroundThe role of the Emergency Medical Service (EMS) in End of Life (EOL) is often overlooked. The Gold Standards Framework Proactive Identification Guidance (GSFPIG) is an evidence-based screening tool to identify patients nearing EOL. We conducted a quantitative investigation using the GSFPIG to determine how often paramedics attend EOL patients with and without Advance Care Planning (ACP) in place followed by a qualitative interview study of paramedic perspectives on the usability and acceptability of the GSFPIG.MethodsA mixed methods explanatory sequential design was used. Thirty-five paramedics were recruited from one EMS in England. Paramedics were trained in study procedures and asked to apply the GSFPIG to every patient they attended, aged 65 and over, and to record EOL status and ACP presence. Data was analysed using descriptive statistics.Ten paramedics were purposively selected for an individual interview to explore their experiences of using the GSFPIG and the concept of paramedics referring EOL patients to the GP to implement ACP. Framework analysis was used to analyse interview data.ResultsAlmost half (108/244;44.2%) of patients identified as EOL had no ACP in place. Where ACP was in place 37% of patients had a Do Not Attempt Resuscitation Order only, 50% a Recommended Summary Plan for Emergency Care or Treatment Escalation Plan and 13% unknown ACP type.Analysis of ten paramedic interviews identified three key themes: Participant experiences of using the GSFPIG; Putting a screening and referral tool into practice; Paramedic views on ACPs.ConclusionParamedics are well placed to identify patients who would benefit from an ACP. The GSFPIG has utility in EMS and paramedics found it easy to use. Paramedics report that good quality ACP allows them to provide treatment and care in line with patient preferences.

A synthesis toward sequence-controlled multiblock glycopolymers, presenting a mannopyranoside (Man) glyco(oligoamide) block followed by a poly(ethylene glycol) (PEG) (M̅nof 6 kDa) block, is shown. Therefore, monodisperse and sequence-defined glyco(oligoamide) macromonomers derived from solid phase synthesis (SPS) are polymerized with dithiol-functionalized PEG via thiol–ene coupling (TEC) in a step-growth fashion. For the polymerization, a novel building block introducing a norbornene moiety is developed which is used for end-functionalization of the glyco(oligoamide) macromonomers. As a highly reactive alkene moiety in photoinduced TEC, this gives access to X̅nof up to 45. A total of 12 glyco(oligoamide)–PEG multiblock copolymers with maximum M̅nof 200 kDa are obtained and subjected to a series of purification steps decreasing overall dispersity. In different binding studies toward model lectin Concanavalin A, despite their high number of Man ligands, we see rather weak binding of glycopolymers that we attribute to the introduction of higher molecular weight PEG blocks.

This paper presents a suitable combination of different sodium solid electrolytes to surpass the challenge of highly reactive cell components in sodium batteries. The focus is laid on the introduction of ceramic Na3.4Zr2Si2.4P0.6O12serving as a protective layer for sulfide-based separator electrolytes to avoid the high reactivity with the sodium metal anode. The chemical instability of the anode|sulfide solid electrolyte interface is demonstrated by impedance spectroscopy, X-ray photoelectron spectroscopy, and scanning electron microscopy. The Na3.4Zr2Si2.4P0.6O12disk shows chemical stability with the sodium metal anode as well as the sulfide solid electrolyte. Impedance analysis suggests an electrochemically stable interface. Electron microscopy points to a reaction at the Na3.4Zr2Si2.4P0.6O12surface toward the sulfide solid electrolyte, which does not seem to affect the performance negatively. The results presented prove the chemical stabilization of the anode-separator interface using a Na3.4Zr2Si2.4P0.6O12interlayer, which is an important step toward a sodium all-solid-state battery. Due to the applied pressure that is mandatory for battery cells with sulfide-based cathode composite, the use of a brittle ceramic in such cells remains challenging.

BackgroundFollowing prehospital birth, babies can become hypothermic within minutes, sometimes before paramedics arrive. The risk of the baby dying increases by at least 28% for every degree that their temperature drops below <36.5°C. The earlier we can provide effective warming interventions, the lower the risk of poor outcomes. The aim of this project was to 1), examine the neonatal temperature management advice given to people calling 999 about a prehospital birth in the UK and 2), explore NHS staff and patient views about the content and accessibility of advice given.MethodsAll 999 calls between January 2021-January 2022 were searched by the Clinical Information and Records teams at two ambulance services using the two different triage systems (AMPDS and NHS Pathways). Thirty eligible calls were selected from postcodes with varying levels of deprivation and passed to the study team for content analysis. Nine focus groups were held with 18 NHS staff (paramedics, midwives, neonatal nurses/doctors, call-handlers), and 22 members of the public who had experienced prehospital birth, to discuss the content and accessibility of the advice given.ResultsFive themes were identified as potential barriers to good quality neonatal temperature management: confusing or conflicting advice on where the baby should be placed following birth, vague or unclear instructions on warming the baby, the timing of temperature management advice, the priority given to other instructions, and a lack of importance placed on neonatal temperature. Participants suggested a number of simple changes to advice, including increased focus on the importance of neonatal temperature, encouraging skin-to-skin contact, and providing specific advice on warming the baby.ConclusionsThere is an opportunity to improve the neonatal temperature management advice given by 999 call-handlers during calls related to prehospital birth. This could reduce the number of babies arriving at hospital hypothermic, therefore improving outcomes.

The United Kingdom has seen a substantial rise in immigration over the past 10 years. This new population has a high percentage of women of childbearing age (Office for National Statistics, 2012b), consequently placing an increased demand on U.K. maternity services. Previous research suggests lower satisfaction and worse maternity outcomes for migrant and minority ethnic women both in the United Kingdom and abroad. Most papers exploring ethnic health inequalities have centered on causal factors such as differences in socioeconomic status and host country language ability. Health care policies to tackle inequalities in the United Kingdom, based on these assumptions, have had limited success. Consequently, alternative causal factors need to be explored. This article discusses ethnic inequalities in maternity outcomes in the United Kingdom and proposes that research exploring the client–provider relationship in migrant women’s maternity care could provide important new insights.

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with unknown etiology. This is the first study to use a life course approach to examine premorbid risk markers for self-reported IBS in a UK birth cohort.

Several combat- and noncombat-related stressors have been reported in Afghanistan. There is now accumulating evidence that suggests that posttraumatic stress disorder (PTSD) is linked to combat experiences; however, little is known about how these exposures might affect elite combat troops. This research aims to evaluate the prevalence of combat and noncombat related stressors, as well as PTSD in Portuguese Special Forces deployed in Afghanistan. Overall, participants reported high levels of exposure to combat and adverse physical conditions but also high levels of within-unit comradeship. The analysis also exposed that 2.7% of the participants reported symptoms compatible with PTSD and 8.8% with compatible partial PTSD. When the authors conducted a binary logistic regression, only the higher levels of combat exposure explained the symptoms of PTSD.

Delayed-onset posttraumatic stress disorder (PTSD) is defined as onset at least 6 months after a traumatic event. This study investigates the prevalence of delayed-onset PTSD in 1397 participants from a two-phase prospective cohort study of UK military personnel. Delayed-onset PTSD was categorized as participants who did not meet the criteria for probable PTSD (assessed using the PTSD Checklist Civilian version) at phase 1 but met the criteria by phase 2. Of the participants, 3.5 met the criteria for delayed-onset PTSD. Subthreshold PTSD, common mental disorder (CMD), poorfair self-reported health, and multiple physical symptoms at phase 1 and the onset of alcohol misuse or CMD between phases 1 and 2 were associated with delayed-onset PTSD. Delayed-onset PTSD exists in this UK military sample. Military personnel who developed delayed-onset PTSD were more likely to have psychological ill-health at an earlier assessment, and clinicians should be aware of the potential comorbidity in these individuals, including alcohol misuse. Leaving the military or experiencing relationship breakdown was not associated.

AbstractThe treatment of validity in the newest edition o/Standards for Educational and Psychological Testing (Standards; American Educational Research Association, American Psychological Association, & National Council on Measurement in Education, 1999) is quite different from coverage in earlier editions of the Standards and in most measurement textbooks. The view of validity in the 1999 Standards is discussed, and suggestions for instructors of measurement courses are offered.

Two distinct two-dimensional growth models, each with a single growth mechanism parameter, are explored. One model produces Eden growth at one limit of the parameter, and DLA growth at the other. A second, related, model is a modified cellular atomata. The fractal dimension of the structure boundary is studied as a function of the continuous parameter.

Using a set of hypothetical data, four approaches to the estimation of interrater reliability are illustrated and compared: correlation, comparison of means, percentage of agreement, and generalizability (G) theory techniques. For these data—composed of ratings for 10 subjects on 6 items by 2 raters—the reliability estimates varied widely. The highest estimate was .90 (the simple correlation between the two raters' total scores), and the lowest was a percentage of agreement between the two raters of 26.67% (when “agreement" meant exact match). The G theory techniques allow the researcher to estimate the amount of variance attributable to multiple sources of error within one study. Although more complex than the other methods illustrated here, the G theory procedures yield very beneficial information in many reliability-estimation situations in early childhood special education.

A follow-up study of the graduates of an infant stimulation program was conducted in order to determine (1) the subsequent educational placements of the children, (2) the subsequent medical histories of the children, and (3) the parents' perceptions concerning the efficacy of the early intervention program. Forty-two primary caregivers of graduates of an infant stimulation program were intervlewed by means of an orally administered questionnaire. Question categories included medical and educational diagnoses and history, parents' perceptions of the child's effect on the family, the degree to which family members were involved in the program, and an open-ended question designed to explore the parents' feelings about their life with their handicapped child. Results indicated that children's medical diagnoses tended to be serious, ranging from Down syndrome to brain damage, and approximately two-thirds of the children remained in some kind of special education program full-time. About 20% were mainstreamed, and another 15% were placed in regular classrooms full-time. Parents generally were very positive about their infant's participation in the stimulation program. Mothers were involved in the program to a significantly greater extent than fathers.

While research and policy trends have been moving toward serving a broader range of younger handicapped children in public schools and integrated settings, little information has been available regarding the perceptions of local special education administrators regarding these issues. This study surveyed the views of local special education directors in terms of which populations and ages should be served, in what settings, and for what purposes. The findings indicate that administrators see an emerging role for the public schools, are willing to serve a broader range of young handicapped children, and see the need for far more integrated settings for such children.

This research study investigated consumers' viewpoints of current early intervention services and how they should be changed Parents and professionals were surveyed regarding the family-centered provisions of Public Law 99–457. The survey focused on consumers' perceptions of (a) accessing infant services, (b) delivering infant sewices, (c) identifying family priorities and resources, (d) developing and implementing individual family service plans (IFSPs), and (e) coordinating services. The major concerns of parents and professionals related to accessing services, developing IFSPs, and coordinating sewices.

The interrater reliability of three different interaction scales—the Maternal Behavior Rating Scale, the Rating Scales of Mother-Child Interaction, and the Teaching Skills Inventory—were estimated with four different statistical techniques: Pearson correlations, percentages of agreement, comparisons of raters' means, and generalizability theory techniques. The estimates varied widely, both within and across the three interaction scales. The meanings of each statistical approach are discussed, and some suggestions are given to help a researcher decide which approach to use in particular circumstances.

Interest in and use of qualitative methodological strategies in evaluation research have increased considerably in the last few years. Many of the recent evaluationframe-works or models are entirely or partly oriented toward use of qualitative methods. A number of methodological issues and concerns have been raised, including the appropriateness of validity and reliability estimation for the measurement strategies employed in qualitative evaluations becoming more common in health and other fields. In this article, the views of prominent qualitative methodologists on this topic are briefly summarized; a case is madefor the relevance of validity and reliability estimation; definitions of validity and reliability for qualitative measurement are presented; and appropriate estimation techniques are suggested. It is hoped that discussions such as this will promote increased attention to validity and reliability concerns in qualitative evaluations and thus help improve the quality of those evaluations.

The purpose of this article is to illustrate the utility of nonreactive measures for those measuring preschool children in a variety of contexts. The topics presented are: 1) a rationale for using nonreactive, as well as observational, test, and interview measures; 2) a description of four types of nonreactive measures and their limitations; and 3) examples of how caregivers and teachers can use nonreactive measures for preschoolers in order to gather information.

The statistical techniques used in American Educational Research Journal(AERJ) research articles between 1979 and 1983 were coded by (a) type of technique, and (b) "major" or "minor" importance for comprehending the research findings. Twenty-seven types of technique were identified and further classified as "basic," "intermediate," or "advanced" level, in terms of typical statistics course progression. Of the "major" techniques, 33%, 37%, and 17% were basic, intermediate, and advanced level,, respectively. A review of statistics texts currently in use revert led that basic texts predominate and that the content coverage in both the basic-and intermediate-level texts generally matched well the techniques found in theAERJ articles. The findings suggest that students with both a basic-and intermediate-level knowledge of statistics would understand most of the techniques encountered inAERJ. Other topics addressed included an examination of trends in use of statistical techniques over time, and a comparison ofAERJ techniques with those used in a sample of Journal of Educational Psychology(JEP) articles for the same time period.

Although alcohol research often comments on observed sex differences (i.e. patterns of consumption), there is a lack of investigation into the reasons for these differences. For females, the regular hormonal fluctuations across the menstrual cycle are a potential influencing factor for alcohol consumption. In this pilot we aimed to investigate the relationship between menstrual cycle phase (follicular-phase [FP] and luteal-phase [LP]) and status (naturally-cycling [NC] and hormonal-contraception [HC]) on alcohol consumption and craving of casual drinkers, and identify potential influencing factors in this relationship.

ABSTRACTBackground: British Armed Forces’ and Police Forces’ personnel are trained to operate in potentially traumatic conditions. Consequently, they may experience post-traumatic stress disorder (PTSD), which is often comorbid with harmful alcohol use.Objective: We aimed to assess the proportions, and associations, of probable PTSD and harmful alcohol use among a covariate-balanced sample of male military personnel and police employees.Methods: Proportions of probable PTSD, harmful alcohol use, and daily binge drinking, were explored using data from the police Airwave Health Monitoring Study (2007–2015) (N = 23,826) and the military Health and Wellbeing Cohort Study (phase 2: 2007–2009, phase 3: 2014–2016) (N = 7,399). Entropy balancing weights were applied to the larger police sample to make them comparable to the military sample on a range of pre-specified variables (i.e. year of data collection, age and education attainment). Multinomial and logistic regression analyses determined sample differences in outcome variables, and associated factors (stratified by sample).Results: Proportions of probable PTSD were similar in military personnel and police employees (3.67% vs 3.95%), although the large sample size made these borderline significant (Adjusted Odds Ratio (AOR): 0.84; 95% Confidence Intervals (CI): 0.72 to 0.99). Clear differences were found in harmful alcohol use among military personnel, compared to police employees (9.59% vs 2.87%; AOR: 2.79; 95% CI: 2.42 to 3.21). Current smoking, which was more prevalent in military personnel, was associated with harmful drinking and binge drinking in both samples but was associated with PTSD in military personnel only. Conclusions: It is generally assumed that both groups have high rates of PTSD from traumatic exposures, however, low proportions of PTSD were observed in both samples, possibly reflecting protective effects of unit cohesion or resilience. The higher level of harmful drinking in military personnel may relate to more prominent drinking cultures or unique operational experiences.

BackgroundPatients are approaching End of Life when they are likely to die within the next 12 months. Quality in End of Life Care is variable and identifying patients in the End of Life phase is challenging, particularly in those people with diagnoses other than cancer. Many patients accessing the ambulance service are in the last year of their lives and the role of ambulance services in recognising patients approaching the end of their lives is often overlooked. Patients who are End of Life should be offered advanced care planning.Research QuestionWhat are stakeholders’ views on a paramedic screening and referral intervention aimed at improving care planning in patients in the last year of life?MethodsA qualitative study using semi-structured telephone interviews conducted with 17 stakeholders to investigate stakeholders’ views on:the utility of a paramedic screening and referral toolthe likely impact of a paramedic screening and referral toolPreliminary ResultsAll staff groups:Increasing advanced care planning would be advantageous for patientsPatients with non-malignant conditions are not readily recognised as End of Life.Paramedics should use the Gold Standards Framework Proactive Identification Guidance to identify patients in the last year of life.The proposed intervention has the potential to reduce unnecessary hospital admissions and unnecessary resuscitation.Specific staff groups:GPs: Concerns about additional workload.GPs: The intervention is useful for patients who may ‘fall under the radar’.GPs and ED doctors: Concerns about the need for paramedics to have sensitive communication skills.Paramedics and GPs: A dedicated End of Life lead or team would be advantageous.ConclusionsThe introduction of an end of life screening and referral tool into paramedic practice is a welcome intervention and will have a positive impact on patients at the end of life. GPs expressed concern about capacity to manage referrals.

ABSTRACTBackground: UK armed forces personnel are at risk of occupational psychological injury; they are often reluctant to seek help for such problems.Objective: We aimed to examine and describe sources of support, prevalence and associates of help-seeking among UK serving and ex-serving personnel.Method: A total of 1450 participants who self-reported a stress, emotional or mental health problem in the past 3 years were sampled from a health and wellbeing study and subsequently completed a telephone interview comprising measures of mental disorder symptoms, alcohol misuse and help-seeking behaviour.Results: Seven per cent of participants had not sought any help, 55% had accessed medical sources of support (general practitioner or mental health specialist), 46% had received formal non-medical (welfare) support and 86% had used informal support. Gender, age, perceived health, functional impairment, social support, deployment, alcohol and comorbidity impacted upon the choice of help source.Conclusions: This study found that the majority of those with perceived mental health problems sought some form of help, with over half using formal medical sources of support.

ABSTRACTBackground: Military families can experience unique stressors that may contribute towards poorer well-being among the spouses/partners of Service personnel. However, there is little UK research regarding mental health or alcohol consumption among this population.Objective: This study examined mental health outcomes (probable depression and post-traumatic stress disorder (PTSD)) and alcohol consumption among UK military spouses/partners compared to women in the general population. Associations with military and socio-demographic characteristics were examined.Method: Survey data from 405 female spouses/partners of current and former UK Service personnel participating in a study of military-connected children (2010–2012) was analysed. Comparisons to women in the general population were made using the 2007 Adult Psychiatric Morbidity Survey (n = 1594).Results: Compared to women from the general population, military spouses/partners were significantly more likely to meet criteria for probable depression (adj. OR 2.50 (95% CI 1.52–4.11)). There was no significant difference regarding probable PTSD. Spouses/partners were significantly more likely to meet criteria for hazardous alcohol consumption (adj. OR 2.55 (95% CI 1.87–3.47)) and more likely to report episodes of weekly, daily or almost daily binge-drinking (adj. OR 2.15 (95% CI 1.28–3.61)) than women in the general population. Binge-drinking was significantly higher among spouses/partners of Service personnel reporting family separations of more than 2 months in the last 2 years compared to those reporting no, or shorter, separations (adj. OR 1.88 (95% CI 1.08–3.27)).Conclusion: This is the first study to examine mental health and alcohol consumption among UK military spouses/partners. The significantly higher prevalence of probable depression, hazardous alcohol consumption, and binge-drinking compared to women in the general population suggests further research is needed into the drivers of poor mental health and alcohol consumption among this population and in identifying or developing prevention campaigns to reduce alcohol use and support their well-being.