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The views of children diagnosed with ADHD have, until recently, largely been neglected in research, policy and practice. This article focuses on qualitative research which explored children's lived experience, drawing attention to the ways that they actively 'take' responsibility for managing their physical, psychological and emotional well-being within the constraints of a medical diagnosis. The neglect of a tradition which asks children about their own experiences of ADHD is crucially bound up with children's low social and political status in UK society and notions of competency and responsibility in relation to ADHD. [ABSTRACT FROM AUTHOR]

Background The repeated pattern of heavy intoxication followed by withdrawal from alcohol (i.e., 'binge drinking') has been found to have substantial adverse effects on prefrontal neural systems associated with decision-making and impulse control. Repeated binge drinking has been linked to risky and unplanned sexual behavior; however few studies have examined the role of impulsivity and related cognitive processes in understanding this association. The aim of this study was to examine the relationship between binge drinking, 'reflection impulsivity' (deficits in gathering and evaluating information during decision-making), alcohol-related expectancies, and unplanned sexual behavior in a sample of young social drinkers. Methods Ninety-two university students completed the alcohol use questionnaire ( AUQ) to measure alcohol intake and binge drinking. Two groups (low-binge and high-binge) were generated from the AUQ data. The Information Sampling Task ( IST) was used to measure reflection impulsivity; the Alcohol Expectancy Questionnaire ( AEQ) for alcohol outcome expectancies; and an unplanned sexual behavior questionnaire, which asked about the number of unplanned sexual events. Results When compared to the low-binge drinking group, the high-binge drinkers had significantly more unplanned sexual encounters and were impaired on the IST, reflection-impulsivity task. They scored higher on the alcohol expectancy factors of sociability, risk and aggression, negative self-perception, and in particular liquid courage. In a regression analysis, number of unplanned sexual encounters, binge drinking score, and liquid courage were all significantly related. Conclusions These results support the role of binge drinking in reduced impulse control and decision-making deficits. The findings indicate that high-binge drinkers demonstrate impairments on an impulse control task similar to that observed in dependent samples and this may be a factor in understanding the negative behavioral consequences associated with excessive alcohol use. [ABSTRACT FROM AUTHOR]

Background and context Most people with urinary incontinence are given limited choice when provided with absorbent products through the British National Health Service (NHS), even though the available range is large. Objective To investigate users' preferences for four disposable designs (inserts, all-in-ones, belted/T-shaped and pull-ups) and towelling washable/reusable products, day and night. Design Shopping experiment. Setting and participants Community-dwelling women and men in England with moderate-to-heavy urinary incontinence recruited to a larger trial. Intervention Participants tested each design and selected products they would prefer with a range of different budgets. Main outcome measures Design preferences (rankings); 'purchasing' decisions from designated budgets. Results Eighty-five participants (49 men) tested products, 75 completed the shopping experiment. Inserts, most frequently supplied by the NHS, were ranked second to pull-ups by women and lowest by men. When faced with budget constraints, up to 40% of participants opted to 'mix-and-match' designs. Over 15 different combinations of products were selected by participants in the shopping experiment. Most (91%) stated a willingness to 'top-up' assigned budgets from income to secure preferred designs. Discussion Participants displayed diverse preferences. Enabling user choice of absorbent product design through individual budgets could improve satisfaction of consumers and efficiency of allocation of limited NHS resources. Conclusion Recent policy for the NHS seeks to provide consumers with more control in their care. Extension of the concept of individual budgets to continence supplies could be feasible and beneficial for patients and provide better value-for-money within the NHS. Further research is warranted. [ABSTRACT FROM AUTHOR]

Background Plantar heel pain is a common reason for referral to podiatric practice, and one of the key interventions is the use of orthoses. The aim of the present study was to compare the clinical efficacy of bespoke, casted foot orthoses and prefabricated foot orthoses for plantar heel pain. Methods People with plantar heel pain were included if, following initial assessment, foot orthoses were indicated and participants received either bespoke, casted foot orthoses or prefabricated semi-rigid orthoses (Powerstep™). Clinical efficacy was assessed at eight weeks using the Manchester Foot Pain and Disability Questionnaire (MFPDQ). Results A total of 67 patients completed the trial and at baseline there were no appreciable differences in the two groups of patients in terms of the MFPDQ score; however, at eight weeks post-treatment both had significantly reduced foot pain and disability (both p < 0.0001). There was no significant difference in effectiveness between the bespoke or prefabricated orthoses. However, prefabricated devices were 38% cheaper per patient compared with the average costs of casted devices. Conclusion For most patients with plantar heel pain, prefabricated semi-rigid insoles such as the Powerstep™ devices used in the present trial provide short-term benefit equivalent to that of bespoke, casted foot orthoses, but at considerably reduced costs. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to test whether maladaptive cognitions or difficulties in emotion regulation mediate the association between change in number of adverse life events (i.e. change in life stress) and emotional and behavioural problems in adolescence. Method Our sample consisted of 557 young people, aged 10-19 years from a state secondary school in London. We fitted a multiple mediator model to contrast five mediators: three maladaptive cognitions (negative cognitive errors, negative automatic thoughts, and dysfunctional attitudes) and the two emotion regulatory processes of cognitive reappraisal and expressive suppression. We adjusted for gender, age, ethnicity, special educational needs and family poverty. Results Taken as a set, our mediators explained the effect of change in life stress on adolescent emotional and behavioural problems. However, cognitive reappraisal, expressive suppression, dysfunctional attitudes and negative cognitive errors did not contribute to the indirect effect above and beyond negative automatic thoughts. Conclusions Only negative automatic thoughts mediated the association between change in life stress and emotional and behavioural problems. This suggests the possibility that negative automatic thoughts is the pathway through which an increase in life stress may lead to emotional and behavioural problems in adolescents. [ABSTRACT FROM AUTHOR]

Background Patients can make valuable contributions towards promoting the safety of their health care. Health care professionals ( HCPs) could play an important role in encouraging patient involvement in safety-relevant behaviours. However, to date factors that determine HCPs' attitudes towards patient participation in this area remain largely unexplored. Objective To investigate predictors of HCPs' attitudes towards patient involvement in safety-relevant behaviours. Design A 22-item cross-sectional fractional factorial survey that assessed HCPs' attitudes towards patient involvement in relation to two error scenarios relating to hand hygiene and medication safety. Setting Four hospitals in London Participants Two hundred sixteen HCPs (116 doctors; 100 nurses) aged between 21 and 60 years (mean: 32): 129 female. Outcome measures Approval of patient's behaviour, HCP response to the patient, anticipated effects on the patient- HCP relationship, support for being asked as a HCP, affective rating response to the vignettes. Results HCPs elicited more favourable attitudes towards patients intervening about a medication error than about hand sanitation. Across vignettes and error scenarios, the strongest predictors of attitudes were how the patient intervened and how the HCP responded to the patient's behaviour. With regard to HCP characteristics, doctors viewed patients intervening less favourably than nurses. Conclusions HCPs perceive patients intervening about a potential error less favourably if the patient's behaviour is confrontational in nature or if the HCP responds to the patient intervening in a discouraging manner. In particular, if a HCP responds negatively to the patient (irrespective of whether an error actually occurred), this is perceived as having negative effects on the HCP-patient relationship. [ABSTRACT FROM AUTHOR]

Aims To investigate the prevalence of cannabis use and problem use in boys and girls at age 16 years, and to investigate the role of adversity in early life and of conduct disorder between the ages of 4 and 13 years as risk factors for these outcomes. Design Birth cohort study. Setting England. Participants A total of 4159 (2393 girls) participants in the Avon Longitudinal Study of Parents and Children ( ALSPAC) birth cohort providing information on cannabis use at age 16. Measurements Cannabis use and problem cannabis use at age 16 were assessed by postal questionnaire. Material adversity, maternal substance use, maternal mental health and child conduct disorder were all assessed by maternal report. Findings Cannabis use was more common among girls than boys (21.4% versus 18.3%, P = 0.005). Problem cannabis use was more common in boys than girls (3.6% versus 2.8%, P = 0.007). Early-onset persistent conduct problems were associated strongly with problem cannabis use [odds ratio ( OR) = 6.46, 95% confidence interval ( CI) = 4.06-10.28]. Residence in subsidized housing ( OR = 3.10, 95% CI = 1.95, 4.92); maternal cannabis use ( OR 8.84, 95% CI 5.64-13.9) and any maternal smoking in the postnatal period ( OR = 2.69, 95% CI = 1.90-3.81) all predicted problem cannabis use. Attributable risks for adolescent problem cannabis use associated with the above factors were 25, 13, 17 and 24%, respectively. Conclusions Maternal smoking and cannabis use, early material disadvantage and early-onset persistent conduct problems are important risk factors for adolescent problem cannabis use. This may have implications for prevention. [ABSTRACT FROM AUTHOR]

Background Alcohol consumption ( AC) and alcohol problems ( AP) are complex traits. How many factors reflecting parental AC and AP are present in the large prospectively followed Avon Longitudinal Study of Parents and Children cohort? Would these factors be uniquely associated with various temperamental and alcohol-related outcomes in the children? Methods We factor-analyzed multiple items reflecting maternal and paternal AC and AP measured over a 12-year period from before the birth of the child ( n = 14,093 families). We examined, by linear regression controlling for socioeconomic status, the relationship between scales derived from these factors and offspring early childhood temperament, externalizing traits, and adolescent AC and AP ( ns ranging from 9,732 to 3,454). Results We identified 5 coherent factors: typical maternal AC, maternal AC during pregnancy, maternal AP, paternal AC, and paternal AP. In univariate analyses, maternal and paternal AC and AP were modestly and significantly associated with low shyness, sociability, hyperactivity, and conduct problems in childhood and early adolescence; delinquent behavior at age 15; and AC and AP at ages 15 and 18. AC and AP at age 18 were more strongly predicted by parental factors than at age 15. Maternal AC during pregnancy uniquely predicted externalizing traits at ages 4, 13, and 15. Conclusions Parental AC and AP are complex multidimensional traits that differ in their association with a range of relevant measures in their children. Controlling for background AC and AP, self-reported levels of maternal AC during pregnancy uniquely predicted externalizing behaviors in childhood and adolescence. [ABSTRACT FROM AUTHOR]

Background In recent years, patient-focused interventions have been introduced aimed at increasing patient involvement in safety-related behaviours. However, patients' attitudes towards these interventions and comfort in participating in the recommended behaviours remain largely unexplored. Objective To evaluate patients' attitudes towards a video and leaflet aimed at encouraging patient involvement in safety-related behaviours. Design Two exploratory studies employing a within-subjects mixed-methods design. Setting Six hospital wards on an inner-city London teaching hospital. Participants Medical and surgical inpatients: 80 patients in study 1 (mean age 55; 69% men) and 80 patients in study 2 (mean age 52; 60% men). Intervention Patients watched the PINK patient safety video (study 1) or read the National Patient Safety Agency's 'Please Ask' about staying in hospital leaflet (study 2). Main outcome measures Perceived comfort in participating in safety-related behaviours; attitudes towards the video or leaflet. Results Both video and leaflet increased patients' perceived comfort in engaging in some (but not all) safety-related behaviours ( P < 0.05). In both studies, the majority of patients questioned whether the intervention could help to reduce medical errors in health care. Suggestions on how the video/leaflet could be improved mainly related to content and layout. Conclusion Video and leaflet could be effective at encouraging patient involvement in some safety-related behaviours. Further in-depth research on patients' attitudes towards different educational materials is required to help inform future policies and interventions in this very important but under-researched area. [ABSTRACT FROM AUTHOR]

In the run-up to the 2012 London Olympics, the sense of national identity was salient. We tested children ( N = 401) aged 5-15 years living near the Olympic site on national ( British) and ethnic identification, national ingroup and outgroup attitudes, and sport participation. It was found that the strength of British identification peaked at age 9 years, but the strength of ethnic identification remained stable with age. Both liking for, and stereotyping of, different national groups diverged from age 9 years, but whilst stereotyping remained diverged liking converged by 15 years. The ingroup was one of the most liked, but one of the least positively stereotyped groups. Sport participation declined with age and was higher among boys, whilst the lowest socio-economic group showed the greatest discrepancy between normal and recent reported participation. The strength of British identification was associated with liking for, and stereotyping of, the British as well as sport participation, but the degree of associations varied between different groups of children. [ABSTRACT FROM AUTHOR]

Objective To investigate hospital patients' reports of undesirable events in their health care. Design Cross-sectional mixed methods design. Participants A total of 80 medical and surgical patients (mean age 58, 56 male). Intervention Patients were interviewed post-discharge using a survey to assess patient reports of errors or problems in their care. Patients' medical records and notes were also reviewed. Main outcome measures Frequency of health care process problems, medical complications and interpersonal problems, and patient willingness to report an undesirable event in their care. Results In total, 258 undesirable events were reported (rate of 3.2 per person), including 136 interpersonal problems, 90 medical complications and 32 health care process problems. Patients identified a number of events that were reported in the medical records (30 out of 36). In addition, patients reported events that were not recorded in the medical records. Patients were more willing ( P < 0.05) to report undesirable events to a researcher (as in the present case) than to a local or national reporting system. Conclusion Patients appear able to report undesirable events that occur in their health care management over and above those that are recorded in their medical records. However, patients appear more willing to report these incidents for the purpose of a study rather than to an established incident reporting system. Interventions aimed at educating and encouraging patients about incident reporting systems need to be developed in order to enhance this important contribution patients could make to improving patient safety. [ABSTRACT FROM AUTHOR]

Background In recent years, factors that affect patients' willingness and ability to participate in safety-relevant behaviours have been investigated. However, how trained healthcare professionals or medical students would feel participating in safety-relevant behaviours as a patient in hospital remains largely unexplored. Objectives To investigate medical students' willingness to participate in behaviours related to the quality and safety of their health care. Design A cross-sectional exploratory study using a survey that addressed willingness to participate in different behaviours recommended by current patient safety initiatives. Three types of interactional behaviours (asking factual or challenging questions, notifying doctors or nurses of errors/problems) and three non-interactional behaviours (choosing a hospital based on the safety record, bringing medicines and a list of allergies into hospital, and reporting an error to a national reporting system) were assessed. Participants One hundred and seventy-nine medical students from an inner city London teaching hospital participated in the study. Findings Students' willingness to participate was affected ( P < 0.05) by the action required by the patient and (for interactional behaviours) whether the patient was engaging in the specific action with a doctor or nurse. Students were least willing to ask 'challenging' questions to doctors and nurses and to report errors to a national reporting system. Doctors' and nurses' encouragement appeared to increase self-reported willingness to participate in behaviours where baseline willingness was low. Conclusion Similar to research on lay patient populations; medical students do not view involvement in safety-related behaviours equally. Interventions should be tailored at encouraging students to participate in behaviours they are less inclined to take on an active role in. Future research is required to examine students' motivations for participation in this important but heavily under-researched area. [ABSTRACT FROM AUTHOR]

Little is known about the dietary patterns of toddlers. This period of life is important for forming good dietary habits later in life. Using dietary data collected via food frequency questionnaire (FFQ) at 2 years of age, we examined the dietary patterns of children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Principal component analysis was performed for 9599 children and three patterns were extracted: 'family foods' associated with traditional British family foods such as meat, fish, puddings, potatoes and vegetables; 'sweet and easy' associated with foods high in sugar (sweets, chocolate, fizzy drinks, flavoured milks) and foods requiring little preparation (crisps, potatoes, baked beans, peas, soup); 'health conscious' associated with fruit, vegetables, eggs, nuts and juices. We found clear associations between dietary pattern scores and socio-demographic variables, with maternal education being the most important. Higher levels of education were associated with higher scores on both the 'family foods' and the 'health conscious' patterns, and decreased scores on the 'sweet and easy' pattern. Relationships were evident between dietary pattern scores and various feeding difficulties and behaviours. Notably, children who were introduced late to lumpy (chewy) solids (after 9 months) scored lower on both the 'family foods' and the 'health conscious' patterns. Further analyses are required to determine the temporal relationship between perceived feeding difficulties and behaviours, and it will be important to assess the contribution of the age of introduction to lumpy solids to these relationships. [ABSTRACT FROM AUTHOR]

Background Low socio-economic status ( SES), post-natal mental distress and parenting impact child mental health and future well-being. There are unexplained differences in child mental health between South Asian ethnic minority groups living in the UK that may be due to variation in, and differential mediation of, these factors. Methods We used multivariate multiple regression analysis of the effect of symptoms of mental distress, socio-demographic variables and warmth of parenting on child internalizing and externalizing scores at age seven (measured in 2010) in a population cohort of English children whose mothers were of Indian ( n = 211) and Pakistani ( n = 260) origin. Results In the fully adjusted models the legacy of mental distress was visible for both internalizing (β coefficient 1.52, P = 0.04) and externalizing (1.68, P = 0.01) behaviour in the Pakistani children, and on the Indian children's internalizing (2.08, P = 0.008) but not externalizing (0.84, P = 0.204) behaviour. Lower SES was associated with worse behavioural scores for the Pakistani children, and warmth of parenting on Indian children's externalizing scores. Conclusions Symptoms of post-natal mental distress are associated with Indian and Pakistani child outcomes at age seven. The finding that warmth of parenting had a stronger association on Indian children's externalizing scores than mental distress might be explained by differences in the expression of SES on family characteristics and functioning between the two ethnic groups. [ABSTRACT FROM AUTHOR]

Objectives To examine how the severity of postoperative pain affects patient's health-related quality of life ( HRQoL) at 1 week following surgery and to compare two generic validated HRQo L instruments. Methods Patients undergoing general or orthopaedic surgery at the Royal London Hospital were randomly sampled. The following patient outcome data were collected EQ-5D ( Euro Qo L) pre-operatively and the Revised American Pain Society Patient Outcome Questionnaire ( APS- POQ-R) at 24 hours postoperation; and EQ-5D, Short- Form-12 ( SF-12) and APS- POQ- R at 7 days postoperation. The degree of association between pain and HRQoL was assessed using Pearson's correlation coefficient and multivariate generalized linear regression models. Results Of the 228 patients included, 166 patients provided data at 7 days. Sixteen percent reported severe pain ≥ 50% of the day at 7 days. The severity of pain on both the APS- POQ- R pain severity and interference and affective impairment domains at 7 days was highly correlated with a decrease in HRQo L as assessed by the SF-12 Physical Component Score ( PCS), SF-12 Mental Component Score ( MCS), and EQ-5 D scores ( r = −0.34 to −0.61, P < 0.0001). Multivariate regression analyses showed that irrespective of confounding factors (eg, age, gender, and pre-operative HRQo L) patients with severe postoperative pain experience important reductions in both physical and mental well-being domains of their HRQo L. Conclusions A proportion of patients continue to experience severe pain at 7 days postoperatively, even after minor surgery. HRQoL is strongly associated with the level of pain and provides additional data on the impact of postsurgery pain on patient's function and well-being. Additional studies are needed to elucidate the interaction between pain severity and HRQoL during the peri-operative period. [ABSTRACT FROM AUTHOR]

Introduction The concept of participation was introduced by the World Health Organisation in the International Classification of Functioning, Disability and Health, 2001. Instruments to measure participation have been developed for children and adults, but none specifically for adolescents. Adolescence is a life stage with distinct patterns of participation, and previous research has shown that young people with disabilities have poorer participation than the general population. The aim of this study was to develop a measure of participation frequency, covering all major domains, for young people with cerebral palsy ( CP). CP was chosen as an exemplar because it is a significant cause of disability in young people, with affected individuals experiencing a range of different impairments of varying severity. Methods A pool of 88 items was developed using the published literature, existing measures and qualitative data from young people. The item pool was revised following expert review by 17 experts. Cognitive interviews on the items were carried out with 12 young people and 12 carers; field-testing was then undertaken with 107 young people with CP aged 13-21 years, and 540 young people from the general population to enable item reduction and to examine reliability and construct validity. Results The content review resulted in a 92-item draft questionnaire, content validity index of 93%. Cognitive interviews led to further wording changes. Following field-testing, the questionnaire was shortened to 45 items. Known-groups validity was demonstrated by correlation with impairment severity. Test-retest reliability was satisfactory for all domains. Internal consistency varied between domains. Conclusion This is the first instrument developed specifically to measure frequency of participation across multiple domains for young people with disability. Use of the questionnaire in research and clinical work will enable its properties to be better understood and its generalizability to wider groups to be clearer. [ABSTRACT FROM AUTHOR]

Objective The present study sought to investigate emotion regulation strategies in people with anorexia nervosa (AN) and whether the theoretical concept of 'emotion coupling' between anger and disgust could help to explain some of the specific eating disorder symptomatology in people with AN. Method This 'emotion coupling' hypothesis was tested using a mood induction procedure within laboratory conditions, where individuals with AN ( n = 22) were matched with control participants ( n = 19). Participants completed a bank of different measures prior to the study, and these included measures of eating pathology, core beliefs about the self and others, and emotion regulation strategies. Within the experimental part of this study, anger, disgust and body size estimation were measured prior to and after an anger induction procedure (i.e., a repeated measures design). Results People with AN demonstrated a significantly more internal-dysfunctional way to regulate their emotional states, when compared with matched controls. Within the 'emotional coupling' part of the study, participants showed a significant increase in levels of disgust and body size estimation following an anger induction when compared with matched controls. Discussion The significance of these results was considered in the light of the new Schematic, Propositional, Analogical and Associative Representation Systems in eating disorders model. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message Emotions and emotion processing are problematic for people with anorexia nervosa., Overestimation in body size for people with anorexia nervosa may be due to the coupling of anger and disgust., Clinicians need to consider the importance of automatic cognitive routes of emotion elicitation that may maintain certain eating disorder symptoms, such as poor body image. [ABSTRACT FROM AUTHOR]

Aims To characterize e-cigarette use, users and effects in a sample of Electronic Cigarette Company (TECC) and Totally Wicked E-Liquid (TWEL) users. Design and setting Online survey hosted at the University of East London with links from TECC/TWEL websites from September 2011 to May 2012. Measurements Online questionnaire. Participants One thousand three hundred and forty-seven respondents from 33 countries (72% European), mean age 43 years, 70% male, 96% Causacian, 44% educated to degree level or above. Findings Seventy-four percent of participants reported not smoking for at least a few weeks since using the e-cigarette and 70% reported reduced urge to smoke. Seventy-two percent of participants used a 'tank' system, most commonly, the eGo-C (23%). Mean duration of use was 10 months. Only 1% reported exclusive use of non-nicotine (0 mg) containing liquid. E-cigarettes were generally considered to be satisfying to use; elicit few side effects; be healthier than smoking; improve cough/breathing; and be associated with low levels of craving. Among ex-smokers, 'time to first vape' was significantly longer than 'time to first cigarette' ( t1104 = 11.16, P < 0.001) suggesting a lower level of dependence to e-cigarettes. Ex-smokers reported significantly greater reduction in craving than current smokers (χ21 = 133.66, P < 0.0007) although few other differences emerged between these groups. Compared with males, females opted more for chocolate/sweet flavours (χ21 = 16.16, P < 0.001) and liked the e-cigarette because it resembles a cigarette (χ23 = 42.65, P < 0.001). Conclusions E-cigarettes are used primarily for smoking cessation, but for a longer duration than nicotine replacement therapy, and users believe them to be safer than smoking. [ABSTRACT FROM AUTHOR]

Objectives To investigate the association between serum 25-hydroxy vitamin D (25( OH) D) concentrations and respiratory diseases in older people. Design Cross-sectional, nationally representative sample. Setting Community. Participants Two thousand seventy noninstitutionalized adults aged 65 and older taking part in the Health Survey for England 2005. Measurements Serum 25( OH)D levels, self-reported long-term respiratory tract diseases, and covariates (age, sex, social class, season of examination, use of vitamin supplements, and physical health status). Results Participants with severe deficiency (25( OH)D < 35 nmol/L) had more than twice the risk of respiratory disease than those in the highest quartile of 25( OH) D status (>64 nmol/L), and those with moderate deficiency (second quartile: 25( OH) D 35-48.9 nmol/L) had 1.75 times greater odds of respiratory diseases, even after adjustment with covariates. Adjusted analysis showed that those in the third quartile (25( OH) D 49.0 to 63.9 nmol/L) also had a greater risk of respiratory disease (odds ratio = 1.63, 95% confidence interval = 1.04-2.57). Conclusion Low serum 25( OH)D concentrations are associated with respiratory disease. Ensuring adequate 25( OH)D levels is of public health importance for older populations living in northern latitudes and may be an effective way to prevent concurrent respiratory infections and related complications in older people. Further studies are required to investigate whether vitamin D supplementation may reduce the incidence and exacerbations of respiratory disease. [ABSTRACT FROM AUTHOR]

Aims Nurse home-visiting programmes are employed to enhance the functioning of disadvantaged mothers and young children. Despite the key role played by nurses, there is little empirical evidence describing the views and experiences of nurses who deliver home-visiting programmes. This study compared the views and experiences of nurses delivering home-visiting programmes in England and South Australia. Methods Participants were 108 nurses delivering the South Australian Family Home Visiting programme (2008-2011), and 44 nurses delivering the Family Nurse Partnership programme in England (2007-2009). Data were collected using a standard questionnaire that was completed by nurses in each country. The questionnaire asked nurses about their level of influence on programme outcomes, approaches they used to retain maternal engagement with the home-visiting programmes, barriers to effective programme delivery and the effectiveness of supervision. Results Both groups of nurses considered that their greatest influence was improving mothers' confidence with parenting skills and increasing mothers' knowledge about children's development. Each group identified quality of nurse-mother relationships as the factor most relevant to retaining maternal engagement. Other influential factors were flexibility of timing for visits and the capacity of the programmes to meet specific needs of mothers. Conclusion There was consistency in the nurses' views about the home-visiting programmes delivered in England and Australia. Future studies should utilise prospective designs to identify the mechanisms by which factors influence the quality of nurse-mother relationships, approaches used by nurses to solve family problems and elements of mother-nurse relationships that have the strongest influence on programme outcomes. [ABSTRACT FROM AUTHOR]

Aims To investigate associations between socio-economic position in early life and later alcohol use and problem use among male and female adolescents. Design Birth cohort study. Setting South West England. Participants A total of 2711 girls and 2379 boys with one or more measures of alcohol use or problem use at age 15 years. Measurements Exposure measures were highest parental social class, maternal education and household disposable income (all maternal self-report before school-age); outcome measures were heavy typical drinking, frequent drinking, regular binge drinking, alcohol-related psychosocial problems and alcohol-related behavioural problems. Findings Alcohol use and related problems were relatively common amongst adolescent girls and boys. Boys were slightly more likely to report frequent drinking and girls were slightly more likely to drink heavily and to experience alcohol-related psychosocial problems. Higher maternal education appeared protective in relation to alcohol-related problems, particularly among boys. Higher household income was associated with greater risk of alcohol use and problem use, most apparently among girls. Conclusions Children from higher-income households in England appear to be at greater risk of some types of adolescent alcohol problems, and these risks appear different in girls compared to boys. Childhood social advantage may not generally be associated with healthier behaviour in adolescence. [ABSTRACT FROM AUTHOR]

Background The Equipping Youth to Help One Another Programme ( EQUIP) was designed for young offenders to address a developmental delay in moral reasoning, distorted cognitions and social skills. Methods The present authors undertook a single case series study and piloted an adapted version of the EQUIP programme with three men with intellectual disabilities and four men with a diagnosis of Asperger Syndrome, all of whom were detained in a medium-secure forensic unit for people with intellectual disabilities. Treatment was delivered over a 12-week period, and participants took part in four-one-hour sessions per week. Results The results suggested that treatment was successful at increasing moral reasoning ability, reducing distorted cognitions and improving ability to choose effective solutions to problems. However, treatment did not have a significant effect upon anger. Conclusions The EQUIP programme is a promising treatment, but further research is needed to investigate its effectiveness with men with intellectual or other developmental disabilities. [ABSTRACT FROM AUTHOR]

Background Duchenne muscular dystrophy (DMD) leads to progressive muscular weakness and death, most typically from respiratory complications. Dysphagia is common in DMD; however, the most appropriate swallowing assessments have not been universally agreed and the symptoms of dysphagia remain under-reported. Aims To investigate symptoms of dysphagia in DMD and to determine the potential of the validated Sydney Swallow Questionnaire (SSQ) to diagnose dysphagia in this patient group. Methods & Procedures Three participant groups completed the SSQ and the results were compared: nine DMD participants with dysphagia, six DMD participants without dysphagia and 12 healthy controls. Outcomes & Results The questionnaire scores for dysphagic DMD participants were significantly higher than for non-dysphagic DMD participants ( p = 0.039) and for healthy controls ( p ≤ 0.001). The diagnostic ability of the questionnaire was good for detecting dysphagia in participants with DMD (receiver operating characteristic (ROC) area under the curve = 0.89, p = 0.013), with a cut-off score of 224.5 (13.2%) giving a sensitivity of 0.78 and a specificity of 0.83 for determining dysphagia. Dysphagic participants rated time to eat a meal, swallowing hard food, swallowing thick liquids and needing to cough up or spit during meals with the highest severity of all questionnaire items. Results of the questionnaire by item are presented to inform the clinician of the symptoms of dysphagia in DMD. Conclusions & Implications DMD leads to pervasive symptoms of dysphagia. The simple SSQ is a clinically informative assessment tool for patients with DMD. [ABSTRACT FROM AUTHOR]

Our re-analysis of census data shows that 95% of kinship arrangements are 'informal', i.e. made outside the formal child welfare system. Interviews with 80 children aged 8-18 years in informal kinship care and their carers showed that most children were well attached to their kin carers, but one-third had been taunted or bullied because they did not live with their parents. Many children tightly controlled who knew about this potentially stigmatizing information. Most children had good numbers of adults and children in their social networks, and for three-fifths, their parents were still key figures in their lives. The children who regarded few people as very important to them significantly more often lived with older kin carers (many of whom were in poor health), were more often anxious and depressed, and did not talk about their living situation to others. A considerable number of children worried about their carers' poor health and about their own future if they died. The significance of these findings for statutory and voluntary services is discussed. [ABSTRACT FROM AUTHOR]

Background Treatment trials that enquire into parents' and teachers' views on speech-language interventions and outcomes for primary school-age children are relatively rare. The current study sought perceptions of the process of intervention and value placed on outcomes resulting from a trial of intervention, the Social Communication Intervention Project (SCIP), for children with communication disorders characterized by persistent needs in pragmatics and social use of language. Aims Aims: To describe parent and teacher views around the process and experience of participating in SCIP intervention, including aspects of collaborative practice; and to gain understanding of parents' and teachers' perceptions of communication outcomes for children who had received intervention. Methods & Procedures Parents and teachers of eight children in the intervention arm of the SCIP study participated in semi-structured interviews with a researcher within 2 months of completion of SCIP intervention. The framework method of analysis was used to explore predetermined themes based around a list of topics informed by previous thinking and experience of the research. Outcomes & Results Parents and teachers perceived liaison with the SCIP speech and language therapist as being an important element of the intervention. Indirect approaches to liaison with parents were perceived as effective in transferring information as were brief meetings with teachers. Teachers and parents were able to make explicit links between therapy actions and perceived changes in the child. Work on comprehension monitoring and emotional vocabulary was perceived to be particularly effective with respect to communication outcomes. Parents also reflected that they had adopted different strategies towards communication and behaviour in the home as a result of intervention. The limits of potential change in terms of child communication in areas such as non-verbal communication and pragmatic skills were discussed by parents. Conclusions & Implications This analysis has contributed essential information to the evaluation of SCIP by describing the experience of the intervention as delivered, exploring processes of effective implementation and change in the school setting and by describing the value placed on different outcomes by parents and teachers. These findings can inform planning for collaborations between speech and language therapists and teachers and provide useful information about mechanisms of change in different components of the SCIP intervention which have not been individually evaluated before. Information on changes in children's communication skills which were perceived as meaningful to those living and working with the children daily is crucial to the acceptance and translation of the SCIP intervention into practice. [ABSTRACT FROM AUTHOR]

Aims The NHS Stop Smoking Service ( NHS-SSS) helps approximately half its clients to quit for 4 weeks. However, most initially successful quitters relapse within 6 months. Short message service ( SMS) texting has been shown to facilitate stopping smoking. We describe the development, implementation and subsequent evaluation, in terms of practicability and client response, of an SMS text-based relapse prevention intervention ( RPI) delivered within routine community and specialist National Health Service ( NHS) Stop Smoking Service (SSS) provision in four Primary Care Trusts. Design Text messages aimed at motivation to remain abstinent, preventing careless lapses and continuing the full course of medicine for smoking cessation were developed and sent weekly to clients' mobile phones for 12 weeks and fortnightly for 6 months. They were asked to respond to some of the texts and contact the NHS SSS if they lapsed. They were also offered free nicotine mini lozenges to be sent via the mail on three occasions. Setting NHS SSS. Participants 202 clients who had been abstinent for 4 weeks. Measurements Feasibility of introducing RPI into routine care; response to interactive messages and requests for the medication; rating of the helpfulness of RPI; self-reported and carbon monoxide ( CO)-validated smoking status for up to 26 weeks. Findings A text-based RPI was easy to implement within the NHS SSS provided by specialist advisers, but enrolment of clients from services provided by a network of pharmacists was difficult because client contact details were often lacking. Where records of the number of people invited to RPI were available, 94% of eligible participants enrolled. The RPI was well received by both SSS clients and staff, with 70% ( n = 63) of clients who completed follow-up considering the intervention helpful. Eighty-five per cent ( n = 172) of clients responded to at least one of the nine interactive text messages. Sixty-four clients (32% of the total, 47% of those we managed to contact) reported continuous abstinence at 6 months. Eighteen (9%) clients who relapsed to smoking used the RPI to re-engage with the NHS SSS and 10 (5%) successfully re-established abstinence. Conclusions In smokers attending National Health Service Stop Smoking Services who are abstinent 4 weeks after their quit date, a relapse prevention intervention based on SMS text messaging was well received, and can be implemented economically and rapidly. A controlled trial is needed to establish whether it has a significant impact on relapse. [ABSTRACT FROM AUTHOR]

Based on 65 interviews with professionals and parents conducted during 2007-2008, this 16-month, mainly qualitative evaluation of Parentline Plus' Time to Talk Community Programme (a preventative initiative within England's teenage pregnancy strategy) found that a community development approach and an ethos of partnership with parents and professionals facilitated engagement. Respectful and realistic implementation involved skilled workers building relationships of trust. By consulting with other professionals and parents it was possible to establish local need and to build on existing provision. Initially, insufficient prior local consultation and negotiation created perceptions of an imposed initiative, led by outsiders, resulting in wary local parents and professionals. The engagement and evaluation processes are considered in relation to the short-term nature of the initiative and potential conflicts between responding flexibly to the needs of parents and delivering targeted programmes. [ABSTRACT FROM AUTHOR]

Background: Irritability is a subdimension of ODD, which predicts mainly to internalizing disorders, and to a lesser extent, conduct problems and callous-unemotional traits. Given that youth with similar dispositions as the irritable types - as well as youth high in callous-unemotional (CU) traits - have both been reported to experience high levels of victimization by peers, the authors examined an extension of the failure model (Patterson & Capaldi, 1990): that irritability increases peer victimization, which, in turn, predicts both CU and internalizing symptoms. Sample: Using data from 5,923 mother-child pairs participating in The Avon Longitudinal Study of Parents and Children, the authors tested the outcomes of internalizing difficulties and callous-unemotional traits (based on mother report at age 13) via the predictors (at ages 8 and 10) of irritability (mother report) and the experience of peer victimization (youth report). Results: Irritability and peer victimization (age 10) directly predicted both CU and internalizing difficulties (age 13). Contrary to strict interpretation of the failure model, the significant indirect pathway described peer victimization (age 8) as increasing irritability (age 10), which, in turn, increased both CU and internalizing difficulties (age 13). Conclusion: Results suggest that - for youth with irritable dispositions - co-occurring CU and internalizing difficulties can be acquired via adverse experiences in the social environment. [ABSTRACT FROM AUTHOR]

Swami, V. (2012). Written on the body? Individual differences between British adults who do and do not obtain a first tattoo. Scandinavian Journal of Psychology 53, 407-412. This study compared individual psychological differences of individuals who do and not obtain their first tattoo. A total of 136 British residents visiting a tattoo parlour completed measures of the Big Five personality factors, Sensation Seeking, Need for Uniqueness, distinctive appearance investment, attitudes to authority, and sociosexual orientation. As compared to individuals who did not subsequently obtain a tattoo, individuals that did were significantly less conscientious, more extraverted, more willing to engage in sexual relations in the absence of commitment, and had higher scores on sensation seeking, Need for Uniqueness, and distinctive appearance investment. The effect sizes of uncovered differences were small-to-moderate (ηp2 = .07-.14). These results are discussed in relation to the mainstreaming of tattoos in contemporary, post-industrialised societies. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims This study investigated associations between self-reported illness, social factors and health behaviours and non-drinking among young people aged 18-34 years. Design Logistic regression analysis of cross-sectional national survey data, collected from the Health Survey for England 2006 and 2008. Data were collected through face-to-face interviews and are self-reported. Participants and settings A total of 2826 male and 3618 females aged 18-34 years drawn from a nationally representative multi-stage stratified probability sampling design across England. Measurements Non-drinkers were based on those who reported 'no' to drinking alcohol currently. Exposure measures included self-reports of having a limiting long-standing illness, long-standing illness or self-reported poor health. We adjusted for ethnicity, income, education, general physical activity and other factors. Findings Having a limiting long-standing illness during early adulthood increased the odds of being a non-drinker 1.74 times for men ( P < 0.01) and 1.45 times for women ( P < 0.01). In both men and women belonging to the lowest income quintile or having no qualifications was associated with increased odds of being a non-drinker ( P < 0.001), indicating that the social gradient in non-drinking begins at an early age. Men and women aged 18-34 years with the lowest activity levels were also more likely to be non-drinkers ( P < 0.01). Conclusion Young adults who have a limiting long-standing illness are more likely not to drink alcohol even after adjusting for a range of social and demographic measures. Studies on the putative health benefits of moderate alcohol consumption later in life need to take account of early life history. [ABSTRACT FROM AUTHOR]

Background Behavioural change interventions for persons with chronic illness draw on a variety of theoretical approaches including motivational interviewing and shared decision making. Health literacy provides an additional, potentially powerful explanatory framework to guide research and practice. Objective To examine the changes in the depth and detail of diabetes-related knowledge and confidence for persons with type 2 diabetes. Design Two-year, prospective, observational study, using questionnaire data at two time points (baseline and 2 years later) and in-depth interviews with a theoretically selected subsample. Setting and participants A total of 319 patients initially recruited from a deprived urban area in north-west England Intervention Dedicated tele-carer education and support, tailored to the individual circumstances of the patient. Main outcome measures Perceptions of confidence, levels of empowerment, learning for self-care and most helpful aspects of the intervention. Results Over 90% expressed confidence in keeping their blood sugar controlled, and high levels of perceived empowerment (mean = 4.25; 95% CI, 4.17-4.33) were found. Changes in the depth and detail of diabetes-related knowledge and confidence, from the specific to the more general, were observed and enhanced competence in translating knowledge into practice. Discussion and conclusions The intervention, built within a developed working partnership between tele-carer and patient, operated at two levels: health literacy, enhancing knowledge, developing personal skills and enabling self-control; and socio-psychological behavioural change, tailored to individuals within their socio-economic environments, enabling increased motivation and supportive problem-solving. Both approaches find reflection in the findings and provide powerful explanatory lenses to interrogate the data. [ABSTRACT FROM AUTHOR]

Objective Studies have established a link between shame and eating disorder symptoms but have generally been cross-sectional or failed to differentiate between general shame and bodily shame. The present study addressed both these issues. Design This study used a longitudinal panel design. Method Fifty-five women with a past or current eating disorder participated. They completed measures of eating pathology, depression, general shame (internal and external) and bodily shame (current feelings of bodily shame as well as bodily shame that is anticipated were the individual to gain weight) and were followed up over 2.5 years. Results Bodily shame uniquely predicted an increase in anorexic (but not bulimic) symptoms. Current bodily shame predicted an increase in the degree of underweight and the misperception of body size. Anticipated bodily shame predicted an increase in fear of weight gain. Discussion Current versus anticipated bodily shame predicts different anorexic symptoms. Both therefore should be considered in developing interventions and aetiological models of anorexia nervosa. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Context: The long-term sustainability of whole-system change programs is rarely studied, and when it is, it is inevitably undertaken in a shifting context, thereby raising epistemological and methodological questions. This article describes a transferable methodology that was developed to guide the evaluation of a three-year follow-up of a large health care change program in London, which took place during a period of economic turbulence and rapid policy change. Method: Using a mixed-method organizational case study design, we studied three services (stroke, kidney, and sexual health) across primary and secondary care. Each had received £5 million (US$7.8 million) in modernization funding in 2004. In 2010/2011, we gathered data on the services and compared them with data from 2004 to 2008. The new data set contained quantitative statistics (access, process, and outcome metrics), qualitative interviews with staff and patients, documents, and field notes. Our data analysis was informed by two complementary models of sustainability: intervention-focused (guided by the question, What, if anything, of the original program has been sustained?) and system-dynamic (guided by the question, How and why did change unfold as it did in this complex system?). Findings: Some but not all services introduced in the original transformation effort of 2004-2008 were still running; others had ceased or been altered substantially to accommodate contextual changes (e.g., in case mix, commissioning priorities, or national policies). Key cultural changes (e.g., quality improvement, patient centeredness) largely persisted, and innovative ideas and practices had spread elsewhere. To draw causal links between the original program and current activities and outcomes, it was necessary to weave a narrative thread with multiple intervening influences. In particular, against a background of continuous change in the local health system, the sustainability of the original vision and capacity for quality improvement was strongly influenced by (1) stakeholders' conflicting and changing interpretations of the targeted health need; (2) changes in how the quality cycle was implemented and monitored; and (3) conflicts in stakeholders' values and what each stood to gain or lose. Conclusions: The sustainability of whole-system change embodies a tension between the persistence of past practice and the adaptation to a changing context. Although the intervention-focused question, What has persisted from the original program? (addressed via a conventional logic model), may be appropriate, evaluators should qualify their findings by also considering the system-dynamic question, What has changed, and why? (addressed by producing a meaningful narrative). [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Patients can play an important role in reducing health care harm. Finding strategies to encourage patients to take on an active role in issues related to the quality and safety of their care is therefore essential. The aim of this study was to examine patients' and health care professionals' attitudes towards a video aimed at promoting patient involvement in safety-related behaviours. Method A within-subjects design was used where participants were required to complete a questionnaire pre and post screening of a patient safety video. Participants are 201 patients aged 19-103 years (mean 52) and 95 health care professionals aged 23-48 years (mean 32). Main outcome measures include (i) patients' willingness to participate and perceived importance in participating in safety-related behaviours; and (ii) health care professionals' willingness to support patient involvement. Results After watching the video patients elicited more positive attitudes towards asking doctors and nurses if they had washed their hands and notifying them about issues to do with personal hygiene. No significant effects were observed in relation to patients notifying staff if they have not received their medication or if they were in pain or feeling unwell. In relation to health care professionals, doctors and nurses were more willing to support patient involvement in asking about hand hygiene after they had watched the video. Conclusion Video may be effective at changing patients' and health care professionals' attitudes towards patient involvement in some, but not all safety-related behaviours. Our findings suggest video may be most effective at encouraging involvement in behaviours patients are less inclined to participate in and health care professionals are less willing to support. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Cardiovascular disease (CVD) often arises from modifiable lifestyle factors. Health care professionals may lack the skills and resources to sustain behaviour change, lay 'health trainers' (LHT) offer a potential alternative. We sought to assess the cost-effectiveness of using a LHT to improve heart-health lifestyles in deprived communities. Methods Participants in this randomized trial were aged ≥18 years with at least one risk factor for CVD (hypertension, raised cholesterol, diabetes, BMI>30 or current smoker). Both groups received health promotion literature. LHT were also able to provide intervention participants with information, advice and support aimed at changing beliefs and behaviour. Costs and quality-adjusted life year (QALY) changes were estimated over 6 months. The cost-utility [incremental cost-effectiveness ratio (ICER)] of LHT was calculated and assessed in relation to the cost-effectiveness threshold of £20 000-30 000 per QALY. The probability of LHT being cost-effective was also calculated. Results Seventy-two participants were randomized to a LHT, with 38 controls. The mean cost of the LHT intervention was £151. On average, other health and social service costs fell by £21 for controls and £75 for intervention participants giving a LHT mean overall incremental cost of £98. The mean QALY gains were 0.022 and 0.028, respectively. The ICER for LHT was £14 480, yet there was a 61% chance of making the wrong decision at a £20 000/QALY threshold. Conclusion LHT provision was estimated to be cost-effective for people at risk of CVD. However, a large level of uncertainty was associated with that decision. [ABSTRACT FROM AUTHOR]

Objectives The objective of the study was to investigate factors that influence pain intensities associated with routine dental procedures. Method Four hundred and fifty-one dental patients self-reported pain experienced during the procedure immediately after undergoing a variety of common dental interventions and 1 day after the completion of the procedure. Pain character was measured using the Mc Gill short-form pain questionnaire and intensity using a numerical rating ( NRS) scale. Information was collected on a number of factors that could influence pain: dental anxiety was measured using the Corah Dental Anxiety Scale to categorize patients into four domains (fearless, some unease, nervous and very anxious). Dentists provided information regarding the type(s) of procedure and use of local anaesthetic ( LA). Results Seventy-five percent of patients (339/451) reported no pain during their procedure when the data were collected immediately postoperatively ( NRS score = 0). Univariate analyses showed that dental anxiety, LA use and type of procedure (extractions) were significant ( P < 0.05) predictors of reported intra-operative pain. However, when these factors were combined in a multivariate model, the strongest predictor of pain was dental anxiety [odds ratio ( OR) = 4.98 (95% CI 1.42-17.44)] and LA use [ OR = 2.79 (95% CI 1.39-5.61)]. Although the strongest predictor of postoperative pain on the next day was pain reported during the procedure [ OR = 5.85 (95% CI 2.71-12.64)], LA remained a significant predictor of pain the day after the procedure [ OR = 3.16 (95% CI 1.02-9.81)]. Conclusions Dentists need to assess their patients both preoperatively for dental anxiety and intra-operatively for signs of suboptimal local anaesthesia so as to effectively align patient management and clinical techniques to control dental anxiety and produce adequate anaesthesia. [ABSTRACT FROM AUTHOR]

Objective Cognitive remediation therapy (CRT) has been used with adults with anorexia nervosa (AN) in individual and group formats; however, evaluation of CRT with adolescents in this population is very limited. Method Seven CRT groups were carried out with a total of 30 adolescents with AN. Adolescents' cognitive flexibility and motivation was assessed before and after the group, and they completed qualitative questionnaires after the group to determine their perceptions. Results There was a small effect size in self-reported cognitive flexibility post group. Adolescents found the group interesting and useful; however, some wanted more support with application to real life. Discussion Cognitive remediation therapy has the potential to be used with adolescents with AN. More research is needed to determine if CRT is beneficial for young people with AN. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Emotions influence information processing because they are assumed to carry valuable information. We predict that induced anger will increase ethnic but not gender intergroup bias because anger is related to conflicts for resources, and ethnic groups typically compete for resources, whereas gender groups typically engage in relations of positive interdependence. Furthermore, we also predict that this increased ethnic intergroup bias should only be observed among men because men show more group-based reactions to intergroup conflict than women do. Two studies, with 65 and 120 participants, respectively, indeed show that anger induction increases ethnic but not gender intergroup bias and only for men. Intergroup bias was measured with an implicit measure. In Study 2, we additionally predict (and find) that fear induction does not change ethnic or gender intergroup bias because intergroup bias is a psychological preparation for collective action and fear is not associated with taking action against out-groups. We conclude that the effect of anger depends on its specific informational potential in a particular intergroup context. These results highlight that gender groups differ on a crucial point from ethnic groups and call for more attention to the effect of people's gender in intergroup relations research. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We propose that the perceived continuity between a group's past and present can be a psychological resource that provides confidence in the group's future vitality, thereby reducing the need to preserve identity. In two studies, English participants were told that there was continuity or discontinuity between England's past and present. Both studies showed that higher identifiers (but not lower identifiers) experienced more collective angst (i.e., concern for the group's future) and were more opposed to immigration when English history was presented as discontinuous compared with continuous. Importantly, collective angst mediated the effect of the historical continuity manipulation on opposition to immigration. We conclude that, particularly among those higher in group identification, perceived discontinuity of the group's past can undermine the perceived vitality of the future, thereby increasing the need to preserve current collective identity. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This research examined whether peer relationships amongst ethnic minority status children reflect the social groups to which children belong and the degree to which they identify with these groups. A longitudinal study was conducted to investigate the influence of group identities (i.e., ethnic and national) on children's perceived peer acceptance and preference for same-ethnic friendships. Measures of ethnic and English identification, perceived peer acceptance, and friendship choice were administered to 207 south-Asian English children, aged between 5 and 11, at two time points 6 months apart. In line with predictions, longitudinal analysis showed that bicultural identification (i.e., higher ethnic and English identity) was related to higher perceived peer acceptance and less preference for same-ethnic friendships. Importantly, as hypothesized, this finding was limited to the older children with more advanced social-cognitive abilities. The results suggest that older children who adopted a bicultural identity were able to strategically 'flag' their multiple group identities, within their multicultural peer groups, to obtain acceptance amongst the maximum number of peers and show less preference for same-ethnic friendships. This study extends previous peer relations research, which has typically focused on individual social deficits or classroom norms, by showing that group identities influence peer relationships amongst ethnic minority status children. [ABSTRACT FROM AUTHOR]

ABSTRACT Background A model of psychologically informed offender management for high risk of harm offenders with personality disorder (PD) was piloted, in which NHS psychologists worked alongside London probation staff. Aim The aim of the study was to evaluate the initiatives taken to develop probation staff's capability to work effectively with the group of offenders. Method Self-report measures assessing competency for working with PD and team climate were administered to the probation staff ( N = 150) at baseline and at 1 year follow-up. At follow-up, qualitative data was also collected from a subset of Public Protection Unit staff ( N = 17), evaluating their experience of the project. Results The probation staff significantly improved across a range of generic and forensic PD-related competencies. The largest improvements were found in the Public Protection Unit, which received the highest level of support. There was also a significant improvement in one facet of team climate (team vision). The qualitative findings suggested that the primary areas of skills development were in the participants' understanding of PD and their capacity to identify PD and to develop treatment and management pathways. Conclusions The results provide evidence for the effectiveness of the project model that supports its implementation on a broader scale. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background When support staff use questions to instruct, advise or guide adults with intellectual disabilities (ID), or to solicit information from them, the interaction does not always proceed smoothly, particularly when replies are ambiguous, absent or not obviously relevant. That can lead to interactional trouble and dissatisfaction, or worse. Methods We report on the ways in which staff members transform their questions over a series of conversational turns in order to solicit an adequate reply, and thereby to fulfil the interactional goal of the question. Our data come from approximately 30 h of recordings of natural conversation between staff members and adults with ID in two residential and one outdoor activities settings. Results We identify seven practices by which staff attempt to resolve the dilemma between undue direction and premature closure. These include: expansion of the original question, simplifying its format, changing its content in various ways and realising its alternatives in physical form. Conclusions We highlight strategies which produce answers satisfactory to both parties, and improve the quality of interaction between staff and people with ID. [ABSTRACT FROM AUTHOR]

Rationale, aim and objective In 2009, the UK Department of Health formalized recommended National Health Service practices for the management of tinnitus from primary care onwards. It is timely therefore to evaluate the perceived practicality, utility and impact of those guidelines in the context of current practice. Methods We surveyed current practice by posting a 36-item questionnaire to all audiology and hearing therapy staff that we were able to identify as being involved in tinnitus patient care in England. Results In total, 138 out of 351 clinicians responded (39% response rate). The findings indicate a consensus opinion that management should be tailored to individual symptom profiles but that there is little standardization of assessment procedures or tools in use. Conclusions While the lack of standardized practice might provide flexibility to meet local demand, it has drawbacks. It makes it difficult to ascertain key standards of best practice, it complicates the process of clinical audit, it implies unequal patient access to care, and it limits the implementation of translational research outcomes. We recommend that core elements of practice should be standardized, including use of a validated tinnitus questionnaires and an agreed pathway for decision making to better understand the rationale for management strategies offered. [ABSTRACT FROM AUTHOR]

This study investigates discriminatory peer aggression among primary school aged children as a function of minority status (based on nationality, ethnicity, religion) of the target and the relative proportions of minority and majority children in the school. Participants were 925 8- to 12-year-olds attending schools in Britain. Children of minority status were no more likely than children of majority background to experience peer aggression in general. However, minority children were more likely to experience being the victims of discriminatory aggression. Two contrasting predictions were tested: that discriminatory aggression would be more likely when the minority group was relatively small in number or, alternatively, that as the proportions of children of minority backgrounds increased across schools, discriminatory aggression would be greater. The latter hypothesis was supported. Findings also revealed that in schools with a lower minority presence, discriminatory aggression experienced by majority children was significantly lower than that reported by minority children. When the school minority rate exceeded 81%, discriminatory aggression was more commonly experienced among majority children than among minority children. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives. To determine (1) inter-relationships between social network size and quality and therapeutic relationship ratings and (2) inter-relationships between attachment style, team attachment, therapeutic relationships, social networks, and clinical and social functioning. Design. A cross-sectional survey. Method. A sample of 93 people using community mental health teams were assessed on their attachment status, social networks, relationship to the keyworker, attachment to the team, characteristics, and clinical and social functioning. Network size and the number friends and confidants were tested for associations with user- and professional-rated therapeutic relationship. Regression analysis was used to determine variables associated with team attachment. Results. There was no evidence that network size or number of confidants was associated with therapeutic relationship ratings. Therapeutic relationship was strongly associated with team attachment, but of the four attachment dimensions, only preoccupied attachment was associated with team attachment. Conclusion. There is no evidence that therapeutic relationships are associated with the service user's 'affability' or predisposition to form relationships, suggesting that measures of therapeutic relationship and service attachment do measure something distinct about service users' experience of their care. Team attachment and therapeutic relationship measures seem likely to be measuring very similar constructs. It is possible that service users with more preoccupied attachment styles may find it particularly difficult to form positive attachments to services undergoing frequent change. [ABSTRACT FROM AUTHOR]

Background: Efficacious parenting interventions are under-utilised in mainstream services. Empowering Parents, Empowering Communities (EPEC) aims to increase community access to effective parenting support through a peer-led manualised intervention. Method: Training outcomes, clinical effectiveness and acceptability of EPEC were evaluated using a pre-post cohort design. Data were collected from trained peer facilitators ( n=31) and parenting group participants ( n=73). Results: Peer facilitators demonstrated significantly increased knowledge of and confidence in delivering parenting groups. Parents attending groups reported improvements in child behaviour and parenting stress, and high satisfaction. Conclusions: Early evidence suggests that EPEC may be an effective and acceptable service model in socially disadvantaged communities. [ABSTRACT FROM AUTHOR]

Swami, V. & Allum, L. (2011). Perceptions of the physical attractiveness of the self, current romantic partners, and former partners. Scandinavian Journal of Psychology 53, 89-95. This study examined ratings of physical attractiveness of the self and former and current partners. A total of 304 participants completed measures of attractiveness, relationship satisfaction, love dimensions, self-esteem and sociosexual orientation. Consistent with previous work, results showed that participants rated their current partners as more attractive than themselves and their former partners. However, results also showed that former partners were rated as more attractive than the self on a number of bodily characteristics. Finally, results showed that ratings of former partner physical attractiveness were associated with passion for the former partner, self-esteem, sociosexual orientation, and attributions of relationship termination. These results are discussed in relation to the available literature on positive illusions in intimate relationships. [ABSTRACT FROM AUTHOR]

Summary. Around 80% of hepatitis C virus (HCV) infections in England are among injecting drug users (IDUs). The HCV Action Plan launched in 2004 includes targets to reduce HCV prevalence in recent initiates (those starting injecting in the preceding 3 years), and to increase HCV voluntary confidential testing (VCT). The Action Plan's impact is examined using surveillance data from recent initiates participating in an annual survey of IDUs in contact with specialist services across England, 2000-2008. Participants provided an oral fluid sample (tested for anti-HCV) and completed a short questionnaire (including HCV VCT and result of last test). Overall, anti-HCV prevalence among the recent initiates was 18% (619/3463); in 2004, it was 20% (59/291), other than being lower in 2000 [11%, 73/672, adjusted odds ratio (AOR) = 0.63 95%CI 0.42-0.93] there was no change over time. Prevalence increased with age; was higher among those ever imprisoned, using a needle exchange, and having a HCV VCT; and varied by region. Overall, 42% (1460) had ever had a HCV VCT; in 2004 uptake was 45% (130/291) having increased from 26% (175/672, AOR = 0.57 95%CI 0.42-0.77) in 2000, and it rose to 62% (197/320, AOR = 2.12 95%CI 1.50-2.99) in 2008. The proportion of anti-HCV-positive IDUs aware of their infection was higher in 2006-2008 than in earlier years. The HCV Action Plan has probably helped increase recent initiates' uptake of HCV VCT and the proportion of those diagnosed with HCV infection. However, its impact on HCV transmission is unclear. There is a need to reinvigorate, and improve coverage of, interventions to prevent HCV transmission. [ABSTRACT FROM AUTHOR]

Aims: Counsellors are becoming commonplace within the support structures of secondary schools. To date, research findings from practice‐based outcome studies suggest this is a positive move. There are, however, numerous limitations to this work, and this project aims to develop this existing body of literature. Method: Nine 13–15 year olds attending counselling in six school‐based services participated in the project – one individual withdrew. A standardised self‐report questionnaire (YP‐CORE) was collected at four intervals: (1) the point of referral; (2) the onset of counselling; (3) the completion of counselling; and, (4) a two‐month follow‐up. The change indicated in each of these phases is examined and reported here. Additionally, YP‐CORE was completed during each session. Findings: The YP‐CORE indicates an improvement in the well‐being of this small sample, while waiting for and attending therapy. Further examination of session‐by‐session data also highlights how pre‐ and post‐outcome data should not necessarily be viewed as linear in nature. Discussion: This is a small‐scale investigation and further work is needed in this area. It does, however, raise a number of issues regarding the complexity inherent in conducting outcome research that warrant further investigation. [ABSTRACT FROM AUTHOR]

Cross-sectional research has shown that frequency of self-disclosure to outgroup members mediates the positive relationship between intergroup friendship and outgroup attitudes. The current research investigated the relationship between self-disclosure and attitudes in more depth. New undergraduate students were asked to nominate an ingroup or outgroup friend and then report the intimacy of their disclosures to them, their anxiety and attitudes towards a series of social groups, in the first week of the semester and 6 weeks later. Intimacy of disclosure predicted more positive attitudes towards outgroups over time, but this association was only found among participants who nominated an outgroup friend. In the ingroup friend condition, a negative association was found. These associations were mediated by general intergroup anxiety. These relationships highlight the importance of integrating theories of interpersonal and intergroup relations when investigating intergroup contact. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]