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This paper examines determinants of ethnic disparities in workplace risks of COVID-19 among health and social care workers (HCWs) in the UK. This was undertaken to inform public health policy in the management of COVID-19 relating to health and social care provision. A cross-sectional survey was administered in July–August 2020 (n = 456) to elicit HCWs' experiences of COVID-19 management in the workplace and their perceptions of exposure, personal protection against infection, involvement in local clinical management, and other workplace hazards. Findings suggest minority ethnic HCWs were twice as likely as White HCWs to be in a patient-facing role (OR = 2.14, 95% CI:1.21; 3.78, P < 0.01) and twice as likely (63% vs 39%) to be caring for COVID-19 positive patients (OR = 2.68, 95% CI: 1.77; 4.06, P < 0.01). Those in nursing, were three times as likely to be redeployed to a COVID-19 care setting (OR = 3.33, 95%CI: 1.23; 9.02, P= 0.02). Minority ethnic HCWs within lower- and mid-level roles carried a higher burden of frontline clinical management of COVID-19 positive patients than their White counterparts. This study found evidence of ethnic disparities across several workplace hazards, with increased exposure to and less protection against infection, more responsibility for the clinical management of infection, and evidence of systemic racial bias in the disproportionate redeployment of minority ethnic nursing staff to COVID-19 areas. An NHS-wide review is required to assess procedural fairness, ensure safe practices now, and to avert future crises. [ABSTRACT FROM AUTHOR]

The notion that you don't have to go to church to be a good Christian is accepted as an indicator of the form of implicit religiosity espoused by those who (in Bailey's analysis) say that they “believe in Christianity.” The present paper builds on the findings of a recently published survey of rural Anglican churchgoers celebrating harvest which suggested that de-institutionalised implicit religion may be superseding commitment to conventional explicit religious attendance. The responses of 1081 people who attended Christmas carol services in two English cathedrals in 2009 and 2010 are analysed. The findings of the previous paper that implicit religiosity is more prevalent among younger people and among those who attend church less frequently are replicated. Evidence is also found that women are more inclined to this view than men and that those who have a loose historical connection through baptism are more likely to endorse it than those with either no historical connections or stronger ones. Suggestions are made for further research. [ABSTRACT FROM AUTHOR]

Purpose: Drawing on survey data (N = 7,826) collected in the United Kingdom, Australia, and the United States, this paper examines whether sexual orientation is a differentiating factor in explaining relationship quality and maintenance. Previous research suggests that sexual orientation is not significant in determining relationship satisfaction; however, these analyses have used traditional variable driven approaches, which do not provide an holistic view of the relationship by considering the unique combination of characteristics. Method: In this study, latent profile analyses were used, which is a person-centered approach that allows for identification of different types of long-term relationships. Results: Data suggested that LGB individuals had marginally higher levels of relationship quality compared to their heterosexual counterparts, and sexual orientation was also associated with differing types of long-term relationships. Discussion: These findings are interrogated in more detail, in particular, how sexual orientation is associated with types of long-term relationships and how everyday practices are associated with relationship quality. [ABSTRACT FROM AUTHOR]

Positive outcomes of social networking use in both informal and non-educational settings have attracted significant research attention. These benefits include social capital formation, higher job performance and satisfaction, an increased sense of belonging, improved knowledge management skills, and enabling of life-long learning opportunities. Compulsive use of social networking, however, remains a major issue among the younger users, potentially leaving a long-lasting impact on the younger population. Concerns have been raised regarding links between the compulsive use of social media and individual academic, social and physical performance. This study explores the motivations for social networking use, their relations to compulsive use, and implications for academic, physical and social performance, in an effort to inform strategies for the appropriate adoption and utilisation of social networking technologies. The study employs a finite mixture approach to segmenting the sample, and results show that two distinct groups motivated by utilitarian and social objectives respectively drive compulsive use by British students. Unlike previous studies, the UK sample does not display differences in terms of age or gender. This finding highlights the trend of gender agnostic views of social platforms by developers. The paper concludes with a discussion of the implications for practice and future research. [ABSTRACT FROM AUTHOR]

Research applying rational-emotive behavior therapy (REBT) with athletes is sparse and findings are equivocal. REBT can be applied using education workshops, but previous studies in sport have not assessed changes in irrational beliefs following REBT. This paper reports the effects of a single REBT education workshop on irrational beliefs in elite soccer academy athletes from pretest to posttest. Statistical analyses indicate temporary reductions in irrational beliefs following the workshop. Results are discussed with reference to mechanisms of change, study limitations, workshop reflections, and recommendations for developing REBT workshops. [ABSTRACT FROM AUTHOR]

Objectives:This paper reports two related analyses of verbal material from sevenLiving Well with Dementiagroups: the first examines changes in the verbal behaviours of participants across the course of the sessions in all seven groups; while the second contrasts therapist behaviour in two groups. Methods:In the first analysis, recordings of three sessions from each group were transcribed and participant descriptions of dementia were analysed using the Markers of Assimilation of Problematic Experiences of Dementia (MAPED) rating procedure. In the second analysis, therapist behaviour in weeks 2 and 8 from two groups (F and G) was analysed using the Hill Counsellor Verbal response rating scale. Inter-rater reliabilities for the two sets of ratings were ‘good’ and ‘very good’, respectively. Results:For the MAPED ratings, a five by four contingency table was analysed using chi-squared, which indicated a highly significant change in assimilation. There were significant higher levels of level 1 and 2 markers in the first two sessions and level 4 for sessions 5 and 6. Facilitators used significantly more direct guidance and information giving behaviour in the second session at Location F compared to Location G. Conclusions:The results suggest that important changes occurred in the way that dementia was described across the seven LivDem groups: this includes both reductions in the avoidance of direct references to dementia after the first two sessions, as well as an increase in ‘insight’ statements. Directive facilitator behaviour may be associated with poorer outcomes. [ABSTRACT FROM PUBLISHER]

Assessed reflective writing is increasingly common in UK higher education. Students writing in this mode are typically required to narrate their experiences, evaluate their performance, investigate associated emotions, and comment on what has been learned. In this paper I focus on assessed reflective writing by students on an MA TESOL course who are required to write individual reflections on a process of working in a group to produce teaching materials. This task places particular demands on the writer. Like other students writing reflectively, they need to manage complex self presentation: to appear honest about relative successes and failures, to show evidence of appropriate reflection, and to indicate desirable learning. Because they are reflecting on a group experience, they also need to differentiate themselves from their work group in their account, and to reflect critically on others as well as on themselves. My focus in this paper is on the ways they manage these additional demands. I first examine the relative frequency with which writers refer to themselves and their work group, and then examine the content of self-referential and group-referential statements. Finally, I examine semantic patterns in the data and draw conclusions regarding possible reasons behind student writers’ choices about how to represent themselves and others. [ABSTRACT FROM PUBLISHER]

A task carried out in error creates a latent condition that can result in a future undesirable outcome if the error is not detected later. The paper presents a study of the relatively under-researched phenomenon of post-task latent error detection. Focusing on UK naval aircraft maintenance, it was hypothesised that time, location and systems cues influence individual latent error detection amongst naval air engineers who experience the phenomenon. The systems view of human error is combined with a multi-process approach to post-task latent error research, for which findings suggest that distributed cognition across the entire socio-technical system may be influential in post-task latent error detection. Directions for future research will be of benefit to those interested in furthering safety resilience using a systems approach to minimise the consequences arising from latent error. Relevance to human factors/ergonomics theoryThe nature and extent of post-task latent error detection is explored using a systems approach, for which distributed cognition across the entire socio-technical system appears influential. The aim of current research is to develop interventions to further mitigate for latent errors and thus advance the systems application of ergonomics theory. [ABSTRACT FROM PUBLISHER]

BackgroundAlthough many with intellectual disability come to the attention of services for fire setting, research in this area is scarce, which poses challenges for management. MethodIn this paper we examined those with a fire-setting history (n = 30), identified from a sample of 138 patients treated in a UK forensic intellectual disability service. Those with a fire-setting history were compared to those without this history on various clinical, forensic, and treatment outcome variables. ResultsFire-setting was associated with significant psychopathology, including psychosis and personality disorders. Only half of the fire setters had a formal arson conviction. Fire setters were more likely to have a violence conviction and criminal sections/restriction orders. ConclusionsHalf of those with fire-setting histories did not have formal arson convictions, highlighting the need for thorough history taking. Prevalent comorbidity suggests interventions should focus on treating psychopathology before commencing offence-specific arson therapies. [ABSTRACT FROM AUTHOR]

This paper investigates the influence of presenting volunteered and professionally created geographic information to 101 wheelchair users through an interactive website that included information collected by wheelchair-using volunteers. The aim of this experiment was to understand the influence that (1)knowinga map-based website contains volunteered information and (2)actually includingvolunteered information within an online interactive map (a mashup) have on the perceived trust of the user, described in terms of quality and authority. Analysis using Kruskal–Wallis showed that judgements ofcurrencywere influenced byincludinggeo-information from untrained volunteers (volunteered geographic information) within the mashup, but not influenced by the participantbeing toldthat the online map contained volunteered information. The participants appeared to make judgements based on what information they saw, rather than what they were told about the source of the information. Practitioner Summary:Since 2004, information services have combined crowdsourced (volunteered) alongside professional information within online interactive maps. An online experiment presented both of these information types to wheelchair users within a travel context. Including volunteered information was shown to increase the perceptions of how up-to-date the maps were. [ABSTRACT FROM PUBLISHER]

Introduction: With research playing a vital role in improving clinical practice, it is important that medical students understand the role of research and submitting articles for publication. Therefore, the aim of this study was to ascertain the experience, motivation and attitude of publishing of medical students. Methods: A cross-sectional survey of British medical students from seven medical schools in the United Kingdom. Results: Seventy-two of 515 had submitted an article for publication with a total of 124 articles being submitted. The main motivation to publish was for career progression. For the students that had not published, not having an opportunity to perform research was felt to be the main barrier. Only 49% of students had taken part in a research or audit project. Sixty-two percent of students stated they were not encouraged by the seniors to participate in research projects. From 515 medical students, only 88 students had submitted an article for a scientific meeting. Conclusions: Students have a positive attitude towards publishing and they feel it is important. However, it is clear that students require and would welcome education in writing papers and abstracts, skills that they will need in their postgraduate careers. [ABSTRACT FROM AUTHOR]

This paper investigates the relationship between an individual's experience of depression and her conceptualisation of its role in her life and sense of identity. Based on a mixed methods study involving interviews with 37 women diagnosed with unipolar or bipolar depression, the findings indicate that women who considered most of their episodes to have been triggered by events or circumstances in their lives were more likely to believe that their depression could in future be overcome, whereas those who did not consider the majority of their episodes to have been triggered were more likely to believe their depression to be chronic. Thus, women who participated in the study perceived the risk that they might never be able to overcome depression differently according to whether they believed most of their depressive episodes could be categorised as having been triggered or not. The reasons behind their beliefs are explored. Implications for the traditional medical exogenous–endogenous (reactive–endogenous) distinction are discussed. [ABSTRACT FROM PUBLISHER]

This paper reports on an investigation into the skills and competencies of forensic learning disability nurses in the United Kingdom. The two sample populations were forensic learning disability nurses from the high, medium, and low secure psychiatric services and non-forensic learning disability nurses from generic services. An information gathering schedule was used to collect the data; of 1200 schedules, 643 were returned for a response rate of 53.5%. The data identified the 'top ten' problems that forensic learning disability nurses may encounter, the skills and competencies necessary to overcome them, and the areas that need to be developed in the future. The results indicated that the forensic learning disability nurses tended to focus on the physical aspects to the role whilst the non-forensic learning disability nurses tended to perceive the forensic role in relational terms. This has implications for practice, policy, and procedures. [ABSTRACT FROM AUTHOR]

As sporting challenge at the elite level becomes ever harder, maximizing effectiveness of the talent development pathway is crucial. Reflecting this need, this paper describes the development of the Talent Development Environment Questionnaire, which has been designed to facilitate the development of sporting potential to world-class standard. The questionnaire measures the experiences of developing athletes in relation to empirically identified 'key features' of effective talent development environments. The first phase involved the generation of questionnaire items with clear content and face validity. The second phase explored the factor structure and reliability. This was carried out with 590 developing athletes through application of exploratory factor analysis with oblique rotation, principal axis factoring extraction and cronbach alpha tests. This yielded a 59-item, seven-factor structure with good internal consistency (0.616-0.978). The Talent Development Environment Questionnaire appears to be a promising psychometric instrument that can potentially be useful for education and formative review in applied settings, and as a measurement tool in talent development research. [ABSTRACT FROM AUTHOR]

In this paper, I examine the properties of the handicapping system in the UK. Using a generalized ordered logistic regression model of hole by hole scores of individuals, simulation was employed to calculate the probability of winning for an individual in stroke play and match play head to heads and also in tournament competitions with multiple entrants. The results suggest that the current handicapping system does not produce equal probabilities of players with different handicaps winning. Specifically, lower handicappers have a higher probability of winning in both stroke play and match play games. Having investigated the possibility of employing scaling factors in order to level these probabilities, I pose the question of the extent to which equal probabilities is in fact a desirable property of a handicapping system. [ABSTRACT FROM AUTHOR]

Predicting emergence from prolonged disorders of consciousness (PDOC) is important for planning care and treatment. We used machine learning to examine which variables from routine clinical data on admission to specialist rehabilitation units best predict emergence by discharge. A multicentre national cohort analysis of prospectively collected clinical data from the UK Rehabilitation Outcomes (UKROC) database 2010–2018. Patients (n = 1170) were operationally defined as "still in PDOC" or "emerged" by their total UK Functional Assessment Measure (FIM + FAM) discharge score. Variables included: Age, aetiology, length of stay, time since onset, and all items of the Neurological Impairment Scale, Rehabilitation Complexity Scale, Northwick Park Dependency Scale, and the Patient Categorisation Tool. After filtering, prediction of emergence was explored using four techniques: binary logistic regression, linear discriminant analysis, artificial neural networks, and rule induction. Triangulation through these techniques consistently identified characteristics associated with emergence from PDOC. More severe motor impairment, complex disability, medical and behavioural instability, and anoxic aetiology were predictive of non-emergence, whereas those with less severe motor impairment, agitated behaviour and complex disability were predictive of emergence. This initial exploration demonstrates the potential opportunities to enhance prediction of outcome using machine learning techniques to explore routinely collected clinical data. Predicting emergence from prolonged disorders of consciousness is important for planning care and treatment. Few evidence-based criteria exist for aiding clinical decision-making and existing criteria are mostly based upon acute admission data. Whilst acknowledging the limitations of using proxy data for diagnosis of emergence, this study suggests that key items from the UKROC dataset, routinely collected on admission to specialist rehabilitation some months post injury, may help to predict those patients who are more (or less) likely to regain consciousness. Machine learning can help to enhance our understanding of the best predictors of outcome and thus assist with clinical decision-making in PDOC. [ABSTRACT FROM AUTHOR]

The aims of this study were to describe how and why adults with CP living in the UK and Ireland accessed and used physiotherapy services; to describe the type of physiotherapy accessed and satisfaction with physiotherapy services and to examine the associations between relevant factors. A cross-sectional semi-structured online survey was employed. Participants were adults with CP aged 18 and above living in the UK and Ireland; able to complete an online questionnaire in English independently or with technical or physical assistance. Data were collected from April 2019 to February 2020. Participants (n = 162) were aged 18–74 years. The majority were female (75%) and lived in the UK (83%). Ninety percent of participants reported a need for physiotherapy but only 35% received physiotherapy services. The most common reason for visiting physiotherapy was mobility decline (62%). Satisfaction with the availability and quality of physiotherapy services were 21% and 27%, respectively. Adults with scoliosis and mobility decline were less likely to report that they received the physiotherapy they needed. Adults with CP did not receive the physiotherapy services that they perceived they needed. There is a need to develop physiotherapy services in collaboration with people living with CP. Adults with cerebral palsy (CP) needed physiotherapy services, but were not receiving the physiotherapy services that they perceive they needed. Adults were not satisfied with the availability or quality of physiotherapy services received. Adults with scoliosis and mobility decline were less likely to report that they received the physiotherapy they needed. There is a need to develop physiotherapy services from a life-span perspective for adults living with CP. [ABSTRACT FROM AUTHOR]

This study investigates the impact of the perceptions of antisocial behaviour on the use of the social media platform Twitter. We extend the Unified Theory of Acceptance and Use of Technology (UTAUT) with the Perception of Antisocial Behaviour as a risk factor, and two supporting constructs: Strategic Self-Presentation and Protective Self-Presentation. We call this extended model Technology Acceptance and Use under Risk (TAUR). We investigate two groups via an online questionnaire, contrasting Anglophone countries (the UK, USA, and Canada, 200 responses), with Saudi Arabia (540 responses). In both cases the data shows that the Perception of Antisocial Behaviour impacts Twitter use, but not directly, rather it negatively impacts the influence of other factors such as Behavioural Intention – it also shows that this affects Anglophones more than Saudis. This indicates that future work should differentiate between different cultural groups, and different solutions may be needed to assuage users' fears in different parts of the world. [ABSTRACT FROM AUTHOR]

13% of deaf children in the UK use more than one spoken language. Parents of deaf children from bilingual backgrounds must decide whether to communicate with their child using more than one spoken language, with or without a signed language(s) as well. As most deaf children are born to hearing parents with little or no knowledge of deafness, professional guidance received during this decision-making process is critical. This study examined the beliefs of professionals on the ability of a deaf child to acquire two spoken languages and the advice professionals give to parents considering spoken language bilingualism for their deaf child. 108 professionals who work with deaf children in the UK (50 Teachers of the Deaf [ToDs], 47 speech and language therapists [SLTs] and 11 audiologists) completed an online questionnaire between the 24th May 2019 and the 1st July 2019. Most participants believed deaf children can achieve spoken language bilingualism and would advise parents to speak in their home language, regardless of the parents' English proficiency. However, audiologists were 11 times more likely than SLTs to report linguistic confusion, and ToDs at least 11 times more likely than SLTs to report reduced proficiency in English and the home language because of bilingualism. ToDs and SLTs were found to play a key role in bilingual parents' decision-making process. Consequently, there is a need for specific training and interprofessional learning to ensure parents receive consistent evidence-based advice. [ABSTRACT FROM AUTHOR]

To explore the prevalence of health anxiety in stroke survivors and its relative impact on quality of life. A cross-sectional design was used including between group comparisons of high and low health anxious stroke survivors. Stroke survivors (n = 105) were recruited via online stroke community forums. Participants completed measures of health anxiety (Short Health Anxiety Inventory), general anxiety and depression (Hospital and Anxiety and Depression Scale), disability (WHO Disability Assessment Schedule), and quality of life (Quality of Life Index). Demographics and medical histories were also assessed. Thirty percent of the sample scored above the clinical cut off for health anxiety. Stroke survivors with high health anxiety (HiHA) were found to have significantly lower quality of life (p < 0.001) and higher rates of depression (p < 0.001). Regression analysis found health anxiety to be a significant predictor of quality of life (β = –0.12; p < 0.05) in addition to levels of depression (β = –0.33; p < 0.001) and disability (β = –0.53; p < 0.001). Almost a third of stroke survivors were experiencing clinical levels of health anxiety, with HiHA significantly associated with lower quality of life. Future research should explore the use of existing evidence based psychological interventions for health anxiety in this population. Our findings suggest almost one in three stroke survivors residing in the community have clinical levels of health anxiety. High health anxiety in stroke survivors was significantly related to lower levels of quality of life. Given this finding, evidence-based treatments for health anxiety may improve quality of life and reduce distress for a significant proportion of stroke survivors. Rehabilitation approaches aimed at improving overall quality of life for stroke survivors should consider both physical and psychological interventions, with levels of physical disability, depression and anxiety all significantly associated with quality of life. [ABSTRACT FROM AUTHOR]

Working remotely from home within lockdown conditions can have implications on wellbeing and how people perceive and interact with technology to coordinate, communicate and collaborate with others. Previous research has shown relationships amongst life satisfaction, loneliness and problematic internet use and, also, between the latter and cyber security behaviours. We re-examine these relationships during the UK COVID-19 lockdown through an online survey completed by 299 participants working from home. The survey included demographics and work conditions questions and also the Satisfaction With Life Scale (SWLS), UCLA-3 Loneliness Scale, Problematic Internet Use Questionnaire-Short Form-6 (PIUQ-SF-6), and Security Behavior Intentions Scale (SeBIS). Structural equation modelling revealed that most notably, loneliness positively predicted problematic internet use, life satisfaction negatively predicted problematic internet use and that problematic internet use negatively predicted cyber security behaviours Implications includes educational and therapeutic interventions which could be applied by employers/governing bodies to target those at risk of loneliness and problematic internet use with the hope of mitigating these experiences and improving cyber security behaviours. The current findings may be especially relevant should waves of COVID-19 or similar crisis are experienced, and when working from home becomes a norm for some organisations and jobs. [ABSTRACT FROM AUTHOR]

Visual perceptual deficits are frequently underdiagnosed in stroke survivors compared to sensory vision deficits or visual neglect. To better understand this imparity, we evaluated current practice for screening post-stroke visual perceptual deficits. We conducted a survey targeted at professionals working with stroke survivors involved in screening visual perceptual deficits across the United Kingdom and the Republic of Ireland. Forty orthoptists and 174 occupational therapists responded to the survey. Visual perceptual deficit screening was primarily conducted by occupational therapists (94%), with 75∼100% of stroke survivors screened per month. Respondents lacked consensus on whether several common post-stroke visual deficits were perceptual or not. During the screening, respondents primarily relied on self-reports and observation (94%), while assessment batteries (58%) and screening tools were underutilised (56%) and selected inappropriately (66%). Respondents reported lack of training in visual perception screening (20%) and physical/cognitive condition of stroke survivors (19%) as extremely challenging during screening. Visual perceptual deficits are screened post-stroke at a similar rate to sensory vision or visual neglect. Underdiagnosis of visual perceptual deficits may stem from both reliance on subjective and non-standardised screening approaches, and conflicting definitions of visual perception held among clinicians. We recommend increased training provision and use of brief performance-based screening tools. Lack of agreement among clinicians on what constitutes as visual perceptual or sensory vision deficits may prove problematic, as precise and exact language is often required for clinical decision-making (e.g., referrals). Biases for more familiar visual (perceptual) deficits held among clinicians during the screening process may lead to other visual deficits being missed. To avoid problems being missed, clinicians should aim to use standardised assessments rather than stroke survivor self-report and observations of function when screening for visual perceptual difficulties. [ABSTRACT FROM AUTHOR]

In the UK, core surgical training (CST) is the first specialty experience that early-career surgeons receive but training differs significantly across CST deaneries. To identify the impact these differences have on trainee performance, we assessed whether success at the Membership of the Royal College of Surgeons (MRCS) examinations is associated with CST deanery. A retrospective cohort study of UK trainees in CST who attempted MRCS between 2014 and 2020 (n = 1104). Chi-squared tests examined associations between locality and first-attempt MRCS performance. Multivariate logistic regression models identified the likelihood of MRCS success depending on CST deanery. MRCS Part A and Part B pass rates were associated with CST deanery (p < 0.001 and p = 0.013, respectively). Candidates that trained in Thames Valley (Odds Ratio [OR] 2.52 (95% Confidence Interval [CI] 1.00–6.42), North Central and East London (OR 2.37 [95% CI 1.04–5.40]) or South London (OR 2.36 [95% CI 1.09–5.10]) were each more than twice as likely to pass MRCS Part A at first attempt. Trainees from North Central and East London were more than ten times more likely to pass MRCS Part B at first attempt (OR 10.59 [95% CI 1.23–51.00]). However, 68% of candidates attempted Part A prior to CST and 48% attempted Part B before or during the first year of CST. MRCS performance is associated with CST deanery; however, many candidates passed the exam with little or any CST experience suggesting that some deaneries attract high academic performers. MRCS performance is therefore not a suitable marker of CST training quality. [ABSTRACT FROM AUTHOR]

This paper reports on an evaluation of a domestic violence intervention in the maternity and sexual health services of a UK hospital. The intervention encompassed guidelines, staff training, inclusion of routine enquiry for domestic violence with all patients, and referral of women disclosing violence to an on-site advocacy service. An "assumption querying" approach was applied to evaluate the intervention. Programmatic assumptions were identified and tested using interviews with service providers and patients, review of patient records, and pre- and post-training questionnaires. Domestic violence training resulted in changes in health professionals' knowledge and practice in the short-term, but universal routine enquiry was not achieved even in a context of organisational support, guidelines, training and advocacy. Potential and actual harm occurred, including breaches of confidentiality and failure to document evidence, limiting women's ability to access civil and legal remedies. Advocacy support led to positive outcomes for many women, as long as support to maintain positive changes, whether women stayed with or left the violent partner, continued to be given. Maternity and sexual health services were found to be opportune points of intervention for domestic violence services that combine routine enquiry by clinicians, support after disclosure and attention to harm reduction. Cet article décrit l'évaluation d'une intervention en matière de violence domestique dans les services de santé génésique et de maternité d'un hôpital britannique. L'intervention comportait des directives, la formation du personnel, une enquête systématique auprès de toutes les patientes sur la violence domestique et l'aiguillage des femmes révélant des violences vers un service de sensibilisation sur place. L'intervention a été évaluée avec une approche de « questionnement des postulats ». On a identifié et testé les postulats des programmes par des entretiens avec les prestataires de services et les patientes, l'examen des dossiers des patientes et des questionnaires avant et après la formation. La formation sur la violence domestique a changé à court terme les connaissances et la pratique des professionnels de santé, mais n'a pas réussi à les inciter à questionner systématiquement toutes les patientes, même dans un contexte de soutien organisationnel, de directives, de formation et de sensibilisation. On a constaté des préjudices potentiels et réels, notamment des violations de la confidentialité et l'incapacité à réunir des preuves, limitant ainsi la possibilité des femmes d'avoir accès à des réparations civiles et juridiques. Le soutien à la sensibilisation a eu des résultats positifs pour beaucoup de femmes, tant que le soutien s'est poursuivi pour maintenir des changements positifs, que les femmes restent ou non avec le partenaire violent. Les services de santé génésique et de maternité se sont révélés des points précieux d'intervention pour les services de violence domestique car ils associent l'enquête systématique des cliniciens, le soutien après la révélation et l'attention à la réduction des risques. Este artículo resume la evaluación de una intervención relacionada con la violencia doméstica en los servicios de salud materna y sexual de un hospital del Reino Unido. La intervención comprendió guías, capacitación del personal, indagación rutinaria de todas las pacientes respecto a la violencia doméstica y referencia de las que denunciaron violencia a un servicio de promoción y defensa in situ. Se aplicó un enfoque de "investigación de suposiciones" para evaluar la intervención. Las suposiciones programáticas fueron identificadas y probadas utilizando entrevistas con profesionales de la salud y pacientes, revisión de los expedientes médicos y cuestionarios pre- y post-capacitación. La capacitación en violencia doméstica produjo cambios en los conocimientos y las prácticas de los profesionales de la salud a corto plazo, pero no se logró establecer una rutina de indagación universal, ni tan siquiera en un contexto con apoyo organizacional, guías, capacitación y promoción y defensa. Ocurrieron daños posibles y reales, como violación de confidencialidad e incumplimiento de documentar la evidencia; éste último limitó la capacidad de las mujeres para acceder remedios civiles y jurídicos. El apoyo de promoción y defensa llevó a resultados positivos para muchas mujeres, siempre y cuando se les continuara brindando apoyo para mantener cambios positivos, independientemente de que la mujer permaneciera con su pareja violenta o la dejara. Se concluyó que los servicios de salud materna y sexual son puntos oportunos de intervención para los servicios contra la violencia doméstica, que combinan la indagación rutinaria por parte del personal de salud, apoyo después de confirmada la violencia y atención a la reducción de daños. [ABSTRACT FROM AUTHOR]

The aim of the current study was to examine the social representation (SR) of hearing aids in people with hearing loss (PHL) in India, the Republic of Korea (ROK), the United Kingdom (UK), and the United States of America (US). The study used a cross-sectional survey design. The data collected by using a free association task were analysed qualitatively (i.e. content analysis) and quantitatively (i.e. chi-square analysis, similarities analysis, prototypical analysis). 424 participants with hearing loss The most commonly reported categories across all countries were "beneficial," "cost and time," and "appearance and design." Approximately 50% of the associations reported were negative. There were variations in terms of the categories that were predominant in the SR of each country. "Others actions and attitude" category was predominantly reported by PHL in India. "Disturbance" and "dissatisfaction" of hearing aids and the "repairs and maintenance of hearing aids" categories were mainly reported from the ROK and the US, respectively. The current results highlight the main aspects that PHL report spontaneously when they think about hearing aids. The findings will help to further inform public health campaigns and will contribute to develop culturally appropriate media materials regarding hearing aids. [ABSTRACT FROM AUTHOR]

Objective This study sought to estimate the prevalence of depression and anxiety in UK college students and examine associations between mental health symptoms and quality of life (QoL). Associations between psychiatric comorbidity and degree of QoL impairment were also investigated. Participants: Participants (N = 286) were recruited from a UK university (76.1% ≤20 years-old; 86.8% female; 71.1% White). Methods: Self-report measures of depression, anxiety, and QoL were completed online. Group differences and within-group associations were examined with Chi-square analyses, linear regressions, and ANOVAs. Results: Prevalence rates were in line with global estimates and suggest female students are at elevated risk of mental health problems. Symptom severity and comorbidity were associated with greater QoL impairment. Conclusions: Presence of depression, anxiety, or both was associated with QoL impairment. Findings develop understanding of the impact of mental health problems on QoL and could inform appropriate screening and effective interventions for student mental health. [ABSTRACT FROM AUTHOR]

Type II odontoid fractures are known to have low fusion rates following conservative management with a hard collar. However, most patients are elderly with comorbidities and are not fit for surgery. The present study identified the rates of bony fusion, complications, and clinical outcomes following conservative management of type II odontoid fractures. We included consecutive patients referred with a suspected odontoid fracture to a Major Trauma Centre in the UK between March 2015 and December 2017. Data including patient demographics, fracture management, complications and outcomes. Bony fusion was assessed by two neurosurgeons and one neuroradiologists. Results were analysed with simple statistics and chi-squared test. 102 patients were included in the study (mean age = 80.4 ± 15.3). 10 (9.8%) were managed surgically and 92 (90.2%) were managed conservatively with a hard collar, for a mean of 87 days. Patients were followed up for a mean of 28.1 months (range 1–855 days) until discharge. 37% developed collar complications, namely pain, stiffness and non-tolerance. Bony union was achieved in 37.3% of patients treated with a hard collar (versus 80% in the surgical group, p = 0.0096). Increasing age was an independent risk factor for non-union (p < 0.001). Of the patients without bony union, none reported symptoms, and 90% were discharged without a collar. The management of type II odontoid fractures are difficult in an elderly, co-morbid population. With conservative management fusion rates are low, and collar complications are not insignificant. However, outcomes are good regardless of union. [ABSTRACT FROM AUTHOR]

The press' representation of mental illness often includes images of people as dangerous, and there is evidence that this contributes to stigmatising understandings about mental illness. Little is known about how newspapers portray mental health on their Twitter feeds. To explore the representation of mental health in the UK national press' Twitter feeds. Content analysis was used to code the Tweets produced by UK national press in two time periods, 2014 and 2017. Chi-square analysis was used to identify trends. The analysis identified a significant reduction in the proportion of tweets that were characterised as Bad News between 2014 and 2017 (χ2 = 14.476, d.f.=1, p < 0.001) and a significant increase in the tweets characterised as Understanding (χ2 = 9.398, d.f.=1, p = 0.002). However, in 2017, 24% of the tweets were still characterised as Bad News. Readers did not retweet Bad News stories significantly more frequently than they were produced. There is a positive direction of travel in the representations of mental health in the Twitter feeds of the UK press, but the level of Bad News stories remains a concern. [ABSTRACT FROM AUTHOR]

Victims of bullying are often reluctant to seek formal support, and instead, internalise their emotions, hindering recovery. Some will subsequently encounter discussions of bullying online, giving them an unexpected opportunity to share their feelings or experience vicarious support. In this article, we investigate reactions to discussions of offline and online bullying in the comments posted to the YouTube channels of 34 popular UK female lifestyle influencers. We used a thematic analysis of keywords associated with comments mentioning bullying to identify bullying-related themes. The almost universally supportive comments position female YouTube influencer channels as sources of unexpected indirect support for victims that professionals may also recommend. The comments also reveal a previously undiscussed strategy for helping victims: abstraction. [ABSTRACT FROM AUTHOR]

Objective: Describe and compare levels of happiness, psychological well-being, perceived stress, and health behaviors of university students. Participants: Thai university students were selected (N = 478) during November 2016 using random cluster sampling. Methods: A health and well-being questionnaire was constructed, translated from English to Thai, back-translated, and pilot tested. Descriptive and chi-square statistics were calculated for study variables. Results: Thai male students had lower happiness and psychological well-being than Thai female students. Overall, Thai students had lower happiness and higher perceived stress than US/UK samples. Thai male students reported greater alcohol and tobacco use than Thai female students. Overall, Thai students reported inadequate diet (57%), poor sleep quantity/quality (67%) and depressive symptoms (40%). Conclusions: These preliminary results identify specific areas of concern in the health and well-being of Thai university students. Further analyses are needed to shed light on the factors contributing to these increased health risks. [ABSTRACT FROM AUTHOR]

Black, Asian and Minority Ethnic nurses and midwives are under-represented in higher and managerial roles. This study explored the presence and nature of career progression delays for Black, Asian and Minority Ethnic nurses and midwives and investigated where the barriers to progression were. A secondary analysis of data from a wider cross-sectional survey investigating workplace experiences, burnout and patient safety in nurses and midwives. 538 nurses and midwives were recruited from four UK hospitals between February and March 2017. A career progression delay was viewed as being present if Black, Asian and Minority Ethnic nurses and midwives had spent longer on the entry level nursing grade and less time on higher grades in the previous 10 years. The analysis included items pertaining to: receipt of professional training, perceived managerial support for progression, likelihood of submitting applications and application success rates. Data were analysed using linear regression, odds ratios and t-tests. Results were reported using the STROBE Checklist. Black, Asian and Minority Ethnic nurses and midwives (n = 104; 19.4%) had spent more months working at the entry-level grade (M = 75.75, SD = 44.90) than White nurses and midwives (n = 428; 79.7%; M = 41.85, SD = 44.02, p < 0.001) and fewer months at higher grades (M = 15.29, SD = 30.94 v 29.33, SD = 39.78, p = 0.006 at Band 6; M = 6.54, SD = 22.59 v M = 19.68, SD = 37.83, p = 0.001 at Band 7) over the previous 10 years. Black, Asian and Minority Ethnic nurses and midwives were less likely to have received professional training in the previous year (N = 53; 53.0% v N = 274; 66.0%, p = 0.015) and had to apply for significantly more posts than White nurses and midwives before gaining their first post on their current band (M = 1.22, SD = 1.51 v M = 0.81, SD = 1.55, p = 0.026). Interventions are needed to improve racial equality regarding career progression in nurses and midwives. Increasing access to professional training and reducing discriminatory practice in job recruitment procedures may be beneficial. Black, Asian and Minority Ethnic nurses and midwives experience career progression inequalities. Interventions should improve transparency in recruitment procedures and enhance training opportunities. [ABSTRACT FROM AUTHOR]

A number of Healthcare Practitioners (HCPs), mostly from Black, Asian and minority ethnic (BAME) origin have died with COVID-19. This survey aimed to explore the views of an ethnically diverse sample of HCPs in the UK about COVID-19-related deaths among HCPs in general and BAME HCPs in particular. It is a cross-sectional prospective survey of HCPs in UK and was conducted online using Google Forms between 28th April and 4th May 2020. A total of 1119 UK HCPs (aged 45.0 ± 9.5 years, 56% males, 71% BAME) participated. Seventy-two per cent of respondents reported being worried about COVID-19 and 84% had concerns about personal protective equipment (PPE). Almost all (93%) respondents felt that inadequate PPE may be a contributory factor to HCP deaths. Half of the respondents, especially younger and BAME, reported feeling unable to say 'no', if asked to work without adequate PPE. BAME HCPs were considered at a higher-risk of acquiring coronavirus and dying with COVID-19. Reasons for excess BAME HCP deaths were believed to be comorbidities, inadequate PPE and working in high-risk areas. Majority (81%) of respondents felt that the government has been slow to respond to COVID-19 related deaths in HCPs and 67% HCPs were of the opinion that BAME workers with risk factors should be removed from direct clinical care. HCPs have significant COVID-19-related concerns. BAME HCPs are considered at increased risk due to comorbidities, working in high-risk areas, and inadequate PPE. BAME HCP should have a thorough risk assessment and high-risk HCPs may need work adjustment or redeployment. All HCPs must have appropriate training and provision of PPE. [ABSTRACT FROM AUTHOR]

There is no doubt that organisational security threats are currently surging, internally and externally. In an effort to prevent internal threats – employee violations of information security policy (ISP) – security training programmes and sanction policies are implemented to a large extent in organisations. However, few studies have verified their practical effectiveness and the impact of individual characteristics within organisations. This study conducted a field experiment to examine the actual deterrent effect of those measures against phishing attacks. By fabricating fake phishing schemes through a simulation programme, the specific deterrent effect of punishment, the general deterrent effect of education, and employees' organisational position were tested on their ISP compliance behaviour. Findings confirmed that punishment effectively prevented the punished from falling for phishing again and that the trained group fell for phishing much less often than the untrained group. In addition, the higher one's organisational position, the more likely the person fell for phishing. Regardless of the treatment (i.e. training or punishment), this position effect stood out. The results of this study offer researchers and practitioners insightful information about effective deterrence measures and policies for organisational information security. [ABSTRACT FROM AUTHOR]

Objective: Two studies explored hearing-aid user and audiologist experiences of hearing-aid use and fitting for music in the UK. Design and sample: One-hundred-seventy-six hearing-aid users (age range: 21–93 years; mean: 60.56 years) answered a 4-item questionnaire on music listening difficulties and discussions about music in clinic. 99 audiologists (age range: 22–71 years; mean: 39.18 years) answered a 36-item questionnaire on the frequency and type of discussions, training received, and strategies for optimizing hearing aids for music. Closed and open-ended questions were included. Results: Sixty seven percent of hearing-aid users reported some degree of difficulty listening to music with hearing aids, and 58% had never discussed music in clinic. 50% of audiologists surveyed asked 1 in 5 (or fewer) patients about music and 67% had never received music-specific training. Audiologist training on music was significantly associated with confidence in providing advice, confidence in programming hearing aids for music, and programming hearing aids for music for a greater number of patients. Conclusions: Hearing-aid users' and audiologists' experiences of music remain mixed. In the absence of formalised training in optimizing hearing aids for music, there is a need for systematic research relating fitting strategies to clinical outcomes and the development of guidelines for audiologist training. [ABSTRACT FROM AUTHOR]

The Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A), is widely used as a measure of suggestibility to screen participants for research purposes. To date, there have been a number of normative studies of the HGSHS:A, the majority of which originate from Western countries. The outcomes of these Western studies are summarized, and variations in methodologies are described and discussed. Also reported are the psychometric properties of the HGSHS:A in a large contemporary United Kingdom (UK) sample. Overall, these UK results are consistent with the earlier Western norms studies in terms of response distribution and item difficulty, with only minor differences. The continued use of HGSHS:A as a screening procedure is supported, particularly if corrected for response subjectivity/involuntariness and with revised amnesia scoring. The HGSHS:A is also important as a potential measure of the broader trait of direct verbal suggestibility. [ABSTRACT FROM AUTHOR]

Aim: To determine current UK pediatric physiotherapist (PT) and occupational therapist (OT) management of perinatal stroke. Design: Web-based cross-sectional survey. Methods: Participants were members of the Association of Paediatric Chartered Physiotherapists and Occupational Therapists specialist section: children young people and families working with infants. Items covered prioritization of referrals, assessments, therapy approaches aimed at the upper limb, and parental support. Results: 179 therapists responded. 87.2% of PTs and 63.0% of OTs managed infants with perinatal stroke. Infants with clinical signs of motor dysfunction at referral were prioritized for early initial assessment. The most frequently used assessments were the Alberta Infant Motor Scale (AIMS) and Bayley Scales of Infant Development (BSID). Of PTs and OTs, 41.9 and 40.0% used no standardized assessments. Frequently used therapy interventions were Bobath/Neurodevelopmental Therapy (NDT), positioning aids and passive movements. 88.1% of therapists would choose a bilateral rather than unilateral (affected side) therapy approach for infants with perinatal stroke aged up to 6 months. Of PTs and OTs, 56.9 and 57.1% provided psychological support to families. Conclusions: Assessment and provision of therapy services following perinatal stroke is variable. Increased use of standardized assessments and centralized data collection regarding service provision for high-risk infants is recommended. [ABSTRACT FROM AUTHOR]

Purpose: This first psychometric evaluation of the Patient Categorisation Tool examined its properties as an instrument to measure complexity of needs in a mixed population of patients presenting for specialist neurorehabilitation. Materials/methods: Analysis of a large multicentre cohort of patients (n = 5396) from the national clinical dataset representing 63 specialist rehabilitation services across England. Structural validity was examined using exploratory and confirmatory factor analysis. Concurrent and criterion-validity were tested through a priori hypothesized relationships with other validated measures of resource requirements and dependency. Results: All but two items loaded strongly onto a single principal component with Cronbach's alpha 0.88. A total score of ≥30 identified patients with complex (category A) needs with sensitivity 76% and specificity 75%. However, confirmatory factor analysis provided a better fit when the scale was split into two subscales – a 'Cognitive/psychosocial' and a 'Physical' sub-scale (alpha 0.83 and 0.84, respectively). Moderate convergent and discriminant correlations were consistent with hypothesized relationships. Conclusions: The findings provide some overall support for the Patient Categorisation Tool as a unidimensional tool for measuring complexity of needs for neurorehabilitation, but the subscales may be more suitable for certain groups of patients. Further analysis is now required to evaluate its performance in different conditions. A psychometrically robust tool for measuring the complexity of rehabilitation needs has potential value, both at an individual level for treatment planning, and at a population level for planning and commissioning rehabilitation services. The Patient Categorisation Tool now forms part of the United Kingdom national clinical dataset mandated by the National Health Service in England This psychometric analysis from a large national multicentre cohort representing a diverse range of conditions, provides evidence for its validity as a means to identity patients with complex rehabilitation needs requiring specialist rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: To explore the psychometric properties of the full 22-item English (UK and US) version of the Zarit Caregiver Burden Interview administered to caregivers to patients with Duchenne muscular dystrophy. Materials and methods: Caregivers to patients with Duchenne muscular dystrophy from the United Kingdom and the United States, recruited through the TREAT-NMD network, completed the Zarit Caregiver Burden Interview online. The psychometric properties of the Zarit Caregiver Burden Interview were examined using Rasch analysis. Results: A total of 475 caregivers completed the Zarit Caregiver Burden Interview. Model misfit was identified for 9 of 22 items (mean item fit residual 0.061, SD: 2.736) and 13 of 22 items displayed disordered thresholds. The overall item-trait interaction chi-square value was 499 (198 degrees of freedom, p < 0.001). The mean person fit residual was estimated at −0.213 (SD: 1.235). The Person Separation Index and Cronbach's α were estimated at 0.902 and 0.914, respectively. Item dependency was low and we found no significant differential item functioning by country or sex. Conclusion: Our Rasch analysis shows that the Zarit Caregiver Burden Interview fails to fully operationalize a quantitative conceptualization of caregiver burden among caregivers to patients with Duchenne muscular dystrophy from the United Kingdom and the United States. Further research is needed to understand the psychometric properties of the Zarit Caregiver Burden Interview in other populations and settings. Duchenne muscular dystrophy is a terminal disease characterized by progressive muscle degeneration resulting in substantial disability and a significant burden on family caregivers. The Zarit Caregiver Burden Interview is one of the most widely applied measures of caregiver burden. Our Rasch analysis suggests that the Zarit Caregiver Burden Interview is not fit for purpose to measure burden in UK and US caregivers to patients with Duchenne muscular dystrophy. Clinicians and decision-makers should interpret Zarit Caregiver Burden Interview data from these populations with caution. [ABSTRACT FROM AUTHOR]

Purpose: To explore exercise beliefs and behaviours of individuals with Joint Hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type and to explore patient experiences of physiotherapy. Methods: A cross sectional questionnaire survey design was used to collect quantitative and qualitative data from adult members of the Hypermobility Syndromes Association and Ehlers-Danlos Syndrome Support UK. Descriptive and inferential statistics were used to analyse the data. Qualitative data was analysed thematically. Results: 946 questionnaires were returned and analysed. Participants who received exercise advice from a physiotherapist were 1.75 more likely to report high volumes of weekly exercise (odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.30-2.36, p < 0.001) than those with no advice. Participants who believed that exercise is important for long-term management were 2.76 times more likely to report a high volume of weekly exercise compared to the participants who did not hold this belief (OR = 2.76, 95% CI = 1.38-5.50, p = 0.004). Three themes emerged regarding experience of physiotherapy; physiotherapist as a partner, communication - knowledge, experience and safety. Conclusion: Pain, fatigue and fear are common barriers to exercise. Advice from a physiotherapist and beliefs about the benefits of exercise influenced the reported exercise behaviours of individuals with Ehlers-Danlos syndrome - hypermobility type in this survey. Implications for rehabilitation: Exercise is a cornerstone of treatment for Ehlers-Danlos syndrome/Ehlers-Danlos syndrome - hypermobility type. Pain, fatigue and fear of injury are frequently reported barriers to exercise. Advice from physiotherapists may significantly influence exercise behaviour. Physiotherapists with condition specific knowledge and good verbal and non-verbal communication facilitate a positive therapeutic experience. [ABSTRACT FROM AUTHOR]

Significant progress has been made since the 1980s in supporting adults with learning disability to live independent lives in the community. In 2012, the Department of Health in England announced the latest policy initiative to further invest in community support for people with learning disabilities,Transforming Care.Building the right community supported living setting for people does not in isolation provide for a comprehensive strategy towards achieving a paradigm shift in how people with learning disabilities experience their full right to inclusion in their communities. We undertook a practice inquiry into the quality of life experienced by people with learning disabilities. Social workers chose the focus of the inquiry to be on people’s evening routines to answer the question — were people living in the community experiencing independence or did institutional routines define their lives. The findings were that 69% of people with a learning disability were either in bed or were ready for bed. There was evidence that institutionalised routines existed in the settings with an association between an early evening meal time and the person being ready for or in bed (p = 0.0001 at Time 1 andp = 0.051 at Time 2). Implications for social work practice are discussed. [ABSTRACT FROM PUBLISHER]

Young people who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ) experience higher levels of suicidality compared to heterosexual or cisgender peers, and face significant barriers accessing mental health services including prejudice from staff. In a cross-sectional survey, mental health staff who reported receiving LGBT awareness training were significantly more likely to report in relation to working with LGBT youth that they routinely discussed issues of sexuality and gender (χ2=8.782, df=2,p< 0.05); to feel that their organisation supported them to work with this group (χ2=14.401, df=2,p< 0.001); and report that they had access to adequate skills training that supported their work with suicidality and self-harm with this group (χ2=21.911, df=2,p<0.001). There is a need to enhance the mental health workforce in LGBTQ awareness, and these findings indicate that awareness training could impact positively on practice. [ABSTRACT FROM AUTHOR]

Objective: To review the current criteria for the interpretation of positional nystagmus (PN).Design: Videonystagmography data on PN was collected for 90 patients presenting for balance testing with a history of vertigo or imbalance (excluding those diagnosed with benign paroxysmal positional vertigo). These were compared to normative data from 90 asymptomatic subjects. A literature review was carried out regarding threshold criteria for clinically significant PN. These were evaluated using the data collected.Study sample: Clinic group: 90 patients; 37 male, 53 female. Age range 15–82 years.Normative group: Ninety subjects; 31 male, 59 female. Age range 21–79 years. Results: PN was seen in 75.6% of the clinic group and in 50% of the normative group. The prevalence of nystagmus of slow phase velocity (SPV) > 3°/s was significantly higher in the clinic group than the normative group. The maximum SPV recorded in each position was greater from the clinic group than the normative group.Conclusions: This study supports the use of normative thresholds for SPV for both horizontal and vertical PN. A normative threshold of >3°/s for horizontal and >7°/s for vertical nystagmus is proposed. [ABSTRACT FROM PUBLISHER]

Background:Alcohol is one of the least intervened risk factors in the management of hypertension at the primary care level. In order to improve alcohol interventions, a better understanding of knowledge, attitudes and clinical practice of lifestyle interventions in the management of hypertension is needed. Method:As a part of a European study (France, Germany, Italy, Spain, UK), 211 German general practitioners (GPs) were recruited in Bavaria and Hamburg and surveyed via an Internet-based questionnaire. Results were compared with the European sample (n = 2870). Results:One-third of the patients seen by German GPs had hypertension (36.2%, standard deviation (SD): 14.6) and among cases with hypertension, less than half were ever screened for alcohol (4.5 out of 10 patients). The foremost reasons for not screening for alcohol were that alcohol was not considered a major risk factor for hypertension plus the lack of knowledge of appropriate alcohol screening instruments. The majority of German GPs managed patients with hazardous drinking levels themselves or in their practice (71.3%, 95% confidence interval (CI): 64.6–77.2%), but only 42.0% (95% CI: 35.2–49.0%) managed alcohol dependent patients. German screening rates were slightly lower but interventions of screened positive patients higher than the European average. Conclusions:Rates of alcohol screening in patients with hypertension in primary health care may be increased by improving GPs knowledge of alcohol as a major risk factor for hypertension, increasing GPs education on alcohol and screening instruments, and providing reimbursement. This may increase treatment of alcohol problems in patients with hypertension and reduce hypertension. [ABSTRACT FROM PUBLISHER]

Objective: To determine the short-term cognitive and symptomatic outcome following mild traumatic brain injury. Methods: Setting: Emergency Departments of two UK tertiary referral hospitals. Participants: Adult patients presenting to the Emergency Departments of the Royal London Hospital and Salford Royal Hospital with suspected traumatic brain injury within 24 hours and Glasgow Coma Score > 8. A non-TBI comparison group included adult patients with no head or neck injury. Design: Prospective multi-centre cohort study. Main measures: The Standardized Assessment of Concussion (SAC), the Concussion Symptom Inventory (CSI) and total number of symptoms, measured at baseline and 72 hours. Results: This study enrolled 189 patients with and 51 patients without TBI. Patients with TBI had marked cognitive impairment which persisted at 72 hours (SAC score at baseline = 25 [23-27] vs 72 hours = 25 [22-27]; p = 0.1). Patients with TBI had persistent high symptom severity, although this had decreased at 72 hours (CSI score at baseline = 9 [4-22] vs 72 hours = 5 [1-19], p = 0.002). A similar pattern was observed with the total number of symptoms (baseline = 4 [2-8] vs 72 hours = 0 [0-4]; p < 0.001). Patients with TBI had worse neurocognitive function, higher overall symptom severity and higher total number of symptoms compared with patients without TBI. Patients without TBI' neurocognitive function and symptom severity remained constant, but the number of symptoms reduced between baseline and 72 hours. Conclusion: There is a cognitive deficit and symptom burden in patients with mild TBI presenting to the Emergency Department which persists at 72 hours. [ABSTRACT FROM AUTHOR]

Objectives: To prospectively investigate the impact of transitions in informal caregiving on emotional well-being over two years in a large population study of older people. Methods: Information on provision of unpaid care in 2004/2005 and 2006/2007 was available for 6571 participants in the English Longitudinal Study of Ageing. Three well-being domains were also assessed on each occasion: life satisfaction (measured with the Satisfaction with Life Scale); quality of life (assessed with the CASP-19 scale); and depression symptoms (measured using the Centers for Epidemiologic Studies Depression Scale). Multivariable analyses of the impact on well-being of two-year caregiving transitions (caregiving entry and caregiving exit, or continued caring) were conducted separately for spousal/child carers and carers of other family/non-relatives. Results: Compared to non-caregiving, entry into spousal/child caregiving was associated with decline in quality of life (B = −1.60, p <.01) whereas entry into caregiving involving other kin relations increased life satisfaction (B = 1.02, p <.01) and lowered depression symptoms (B = −0.26, p <.05). Contrary to expectations, caregiving exit was related to increased depression in both spousal/child (B = 0.44, p <.01) and non-spousal/child (B = 0.25, p <.05) carers. Continued spousal/child caregiving was also related to decline in quality of life (B = −1.24, p <.05). Other associations were suggestive but non-significant. Conclusion: The emotional impact of different caregiving transitions in later life differs across kin relationships; notably, spousal and child carers' well-being was consistently compromised at every stage of their caregiving career over the two-year study period. [ABSTRACT FROM AUTHOR]

Background:Evidence suggests that college students are often unclear about how much alcohol is present in different drinks.Objectives:To evaluate the abilities of students to estimate the alcohol contents of drinks, both in relative and absolute terms, and to examine how alcohol strength informs behavior.Methods:For 10 popular drinks that varied by alcohol content, beverage and volume, 209 UK university students rank-ordered the drinks according to total alcohol content and then estimated, for each drink, the number of UK “units” of alcohol contained and its percentage alcohol-by-volume (% ABV). Participants also reported the importance of drink strength as a factor in drink choice, and its influence in different scenarios.Results:There was low but significant concordance between participants’ rank-orderings of drinks by strength, and the correlation of mean ranks with correct ranks was also significant. However, their explicit estimates of the numbers of “units” in the drinks, and their % ABV values, often diverged dramatically from actual values. Participants tended to overestimate the unit contents of spirit-based drinks but underestimated the unit contents of beers and wine; women were consistently less accurate than men, typically making greater underestimates for commonly-consumed drinks. Over one-third of the sample reported that strength influenced drink choice, but its importance ranked below flavor and cost; drink strength might contribute to drink choice depending on the drinking situation.Conclusion/Importance:Young drinkers (women especially) have a poor awareness of the alcohol contents of different drinks, particularly wines and beers, but they make better judgments of relative strength. [ABSTRACT FROM PUBLISHER]

There are limited comparisons between the experience of disabled students in higher education and their non-disabled peers, particularly on practice placements. This article presents the results of such a comparison, across six professional disciplines in one UK university. The results revealed that both disabled and non-disabled students reported positive placement experiences and also similar difficulties. Such difficulties were exacerbated for some disabled students, however, including as a consequence of the attitudes of others to disability. Recommendations for practice are identified that aim to enhance the placement experience of all students and to remove barriers to access. [ABSTRACT FROM PUBLISHER]

Background:Engaging and inspiring the next generation of physician-scientists at an early stage is recognised as key to ensure the future of medical research. However, little is known about medical student perceptions of research. Objectives:We attempted to ascertain perceptions of research and research-orientated careers from medical students studying in different countries. Methods:An online questionnaire was developed, piloted, and promoted to medical students in various countries. Results:1625 responses were collected from 38 countries. Analysis was restricted to data collected from countries with >100 responses (n = 890). Less than half the respondents felt their medical school provided adequate research training. Key perceived barriers to research participation as a student included lack of time and difficulty finding mentors or projects. A significant gender disparity existed in research ambitions of students with females desiring less research involvement. The importance of barriers and satisfaction with research training differed significantly between countries. Conclusions:Students perceive a number of key barriers to research involvement and pursuit of research-orientated careers. Programmes designed to engage students with research should focus on overcoming identified barriers. Greater effort is needed to engage female students who report more significant barriers and less desire to follow research-orientated careers. [ABSTRACT FROM PUBLISHER]

Objective: To investigate the relationship between deficits associated with traumatic brain injury (TBI) and case management (CM) and care/support (CS) in two UK community samples. Research design: Prospective descriptive study. Method: Case managers across the UK and from a single UK CM service contributed client profiles to two data sets (Groups 1 and 2, respectively). Data were entered on demographics, injury severity, functional skills, functional-cognition (including executive functions), behaviour and CM and CS hours. Relationships were explored between areas of disability and service provision. Results: Clients in Group 2 were more severely injured, longer post-injury and had less family support than clients in Group 1. There were few significant differences between Groups 1 and 2 on measures of Functionalskill, Functional-cognition and Behaviour disorder. Deficits in Functionalskills were associated with CS, but not CM. Deficits in measures of executive functions (impulsivity, predictability, response to direction) were related to CM, but not to CS. Insight was related to both CM and CS. Variables related to behaviour disorder were related to CM, but were less often correlated to CS. Conclusions: The need for community support is related not only to Functionalskills (CS), but also to behaviour disorder, self-regulatory skills and impaired insight (CM). [ABSTRACT FROM PUBLISHER]

Objectives.In this study we aimed to test the associations between area-level ethnic density and health for Pakistani and White British residents of Bradford, England. Design.The sample consisted of 8610 mothers and infant taking part in the Born in Bradford cohort. Ethnic density was measured as the percentage of Pakistani, White British or South Asian residents living in a Lower Super Output Area. Health outcomes included birth weight, preterm birth and smoking during pregnancy. Associations between ethnic density and health were tested in multilevel regression models, adjusted for individual covariates and area deprivation. Results.In the Pakistani sample, higher own ethnic density was associated with lower birth weight (β= −0.82, 95% CI: −1.63, −0.02), and higher South Asian density was associated with a lower probability of smoking during pregnancy (OR = 0.99, 95% CI: 0.98, 1.00). Pakistani women in areas with 50−70% South Asian residents were less likely to smoke than those living in areas with less than 10% South Asian residents (OR = 0.39, 95% CI: 0.16, 0.97). In the White British sample, neither birth weight nor preterm birth was associated with own ethnic density. The probability of smoking during pregnancy was lower in areas with 10−29.99% compared to <10% South Asian density (OR = 0.79, 95% CI: 0.64, 0.98). Conclusion.In this sample, ethnic density was associated with lower odds of smoking during pregnancy but not with higher birth weight or lower odds of preterm birth. Possibly, high levels of social disadvantage inhibit positive effects of ethnic density on health. [ABSTRACT FROM PUBLISHER]