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Prescribing nature-based health interventions (green prescribing)-such as therapeutic horticulture or conservation activities-is an emerging transdisciplinary strategy focussed on reducing noncommunicable diseases. However, little is known about the practice of, and socioecological constraints/opportunities associated with, green prescribing in the UK. Furthermore, the distribution of green prescribing has yet to be comprehensively mapped. In this study, we conducted a socioecological exploration of green prescribing. We deployed online questionnaires to collect data from general practitioners (GPs) and nature-based organisations (NBOs) around the UK and conducted spatial analyses. Our results indicate that GPs and NBOs perceive and express some common and distinct constraints to green prescribing. This highlights the need to promote cross-disciplinary communication pathways. Greenspace presence and abundance within close proximity (100 and 250 m) to GP surgeries (but not greenness-as a proxy for vegetation cover) and NBO presence within 5 km were associated with higher levels of green prescribing provision. Lower levels of deprivation were associated with higher frequency of NBOs. This suggests that the availability of greenspaces and NBOs could be important for green prescribing provision, but there could be greater opportunities in less deprived areas. Important foci for future research should be to establish transdisciplinary collaborative pathways, efficient infrastructure management and a common vocabulary in green prescribing-with the overall aim of reducing inequalities and enhancing planetary health., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Despite elevated rates of suicide and evidence of poor mental health among medical professionals, there is a paucity of research in the UK into the mental health of students destined for these careers. This study estimated and compared the prevalence of mental ill-health in students studying veterinary medicine, medicine, dentistry and pharmacy in the United Kingdom. A group of law students was also included, who, although subject to similar stressors as undergraduates, do not go on to share a heightened risk of suicide as professionals. A total of 1744 respondents completed a questionnaire with validated measures to assess wellbeing, psychological distress, depression and suicidal ideation and attempts. Results indicated that law students experienced the poorest mental health of the student groups studied. Wellbeing was highest among veterinary and medical students. However, the medical students were the most likely to have previously attempted suicide. These findings highlight the importance of directly comparing student groups and of appropriately supporting students as they progress through training and into the professions.

Recently there has been renewed interest in basing teachers’ professional learning on medically derived models. This interest has included clinical practice models and evidence-based teaching as well as the use of various forms of ‘Rounds’ which claim to derive from medical rounds. However, many arguing for these approaches may well not have a detailed knowledge of the actuality of professional learning in medicine but may be basing their ideas on idealised models drawn from popular conceptions. In addition, the model used by some calling for medically derived teacher learning is biomedicine, an area in which parallels with Education are difficult. This paper argues that mental health and public health provide a better analogue for Education than biomedicine. It considers some of the lessons that can be drawn from research on evidence-based practice in these areas. The paper concludes that a way forward is neither uncritically to assume the superiority of medical models of professional learning nor to rely only on empirical evidence from Education, but rather to enter into dialogue with colleagues in mental and public health about shared concerns and experiences in professional learning. [ABSTRACT FROM PUBLISHER]

The article discusses how by taking up more functions undertaken by general practitioners pharmacists can expand roles in primary care. Topics include how value to the primary healthcare outcomes for consumers can be added through innovative and expanded roles for pharmacists and how quality use of medicines can be driven through digital health through electronic medication management systems and electronic health records.

Background: It is assumed that the oxytocin receptor gene (OXTR) is associated with factors that are related to features of reproduction as well as the currently emerging fields of mood and emotional response. Methods: We analysed data from over 8000 mothers who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). We determined reproductive, emotional and personality differences related to the two SNPs rs53576 and rs2254298 of the oxytocin receptor gene to determine whether there was evidence in this population for: (i) associations with emotional and personality differences, and (ii) behavioural or environmental links with these SNPs using a hypothesis free approach with over 1000 types of exposure. Results: Our analyses of 7723 women showed that there were no differences in 11 mood, social or relationship characteristics associated with the rs2254298, and just one with rs53576 (with emotional loneliness) – one statistically significant out of 22 tests is no more than would be expected by chance. There were no interactions with childhood abuse. Using a hypothesis-free approach we found few indicators of environmental or behavioural differences associated with rs2254298, but there was an excess of associations with eating habits with rs53576. The findings included an association with dieting to lose weight, and habits typical of bulimia for the women with GG. The nutrition of the women also showed negative associations of the GG genotype with 13 nutrients, including vitamins D, B12 and retinol, and intake of calcium, potassium and iodine. Conclusions: We conclude that this large database of pregnant women was unable to provide confirmation of the types of personality associated with these two OXTR SNPs, but we have shown some evidence of eating differences in those with GG on rs53576. Confirmation of our hypothesis free associations using other data sets is important. [ABSTRACT FROM AUTHOR]

Exercising in natural, green environments creates greater improvements in adult's self-esteem than exercise undertaken in urban or indoor settings. No comparable data are available for children. The aim of this study was to determine whether so called ‘green exercise’ affected changes in self-esteem; enjoyment and perceived exertion in children differently to urban exercise. We assessed cardiorespiratory fitness (20 m shuttle-run) and self-reported physical activity (PAQ-A) in 11 and 12 year olds (n = 75). Each pupil completed two 1.5 mile timed runs, one in an urban and another in a rural environment. Trials were completed one week apart during scheduled physical education lessons allocated using a repeated measures design. Self-esteem was measured before and after each trial, ratings of perceived exertion (RPE) and enjoyment were assessed after completing each trial. We found a significant main effect (F (1,74), = 12.2, p<0.001), for the increase in self-esteem following exercise but there was no condition by exercise interaction (F (1,74), = 0.13, p = 0.72). There were no significant differences in perceived exertion or enjoyment between conditions. There was a negative correlation (r = −0.26, p = 0.04) between habitual physical activity and RPE during the control condition, which was not evident in the green exercise condition (r = −0.07, p = 0.55). Contrary to previous studies in adults, green exercise did not produce significantly greater increases in self-esteem than the urban exercise condition. Green exercise was enjoyed more equally by children with differing levels of habitual physical activity and has the potential to engage less active children in exercise. [ABSTRACT FROM AUTHOR]

Background: Omega-3 long-chain polyunsaturated fatty acids (LC-PUFA), especially DHA (docosahexaenonic acid) are essential for brain development and physical health. Low blood Omega-3 LC-PUFA have been reported in children with ADHD and related behavior/learning difficulties, as have benefits from dietary supplementation. Little is known, however, about blood fatty acid status in the general child population. We therefore investigated this in relation to age-standardized measures of behavior and cognition in a representative sample of children from mainstream schools. Participants: 493 schoolchildren aged 7–9 years from mainstream Oxfordshire schools, selected for below average reading performance in national assessments at age seven. Method: Whole blood fatty acids were obtained via fingerstick samples. Reading and working memory were assessed using the British Ability Scales (II). Behaviour (ADHD-type symptoms) was rated using the revised Conners’ rating scales (long parent and teacher versions). Associations were examined and adjusted for relevant demographic variables. Results: DHA and eicosapentaenoic acid (EPA), accounted for only 1.9% and 0.55% respectively of total blood fatty acids, with DHA showing more individual variation. Controlling for sex and socio-economic status, lower DHA concentrations were associated with poorer reading ability (std. OLS coeff. = 0.09, p = <.042) and working memory performance (0.14, p = <.001). Lower DHA was also associated with higher levels of parent rated oppositional behavior and emotional lability (−0.175, p = <.0001 and −0.178, p = <.0001). Conclusions: In these healthy UK children with below average reading ability, concentrations of DHA and other Omega-3 LC-PUFA were low relative to adult cardiovascular health recommendations, and directly related to measures of cognition and behavior. These findings require confirmation, but suggest that the benefits from dietary supplementation with Omega-3 LC-PUFA found for ADHD, Dyspraxia, Dyslexia, and related conditions might extend to the general school population. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether multisystemic therapy (MST) is more cost-effective than statutory interventions that are currently available for young offenders in England. Method: A cost-offset evaluation of MST based on data from a randomised controlled trial conducted in North London, England, comparing MST with usual services provided by two youth offending teams (YOT). Service costs were compared to cost savings in terms of rates of criminal re-offending. Results: 108 adolescents, aged 11–17 years, were randomly allocated to MST+YOT (n = 56) or YOT alone (n = 52). Reductions in offending were evident in both groups, but were higher in the MST+YOT group. At 18-month follow-up, the MST+YOT group cost less in terms of criminal activity (£9,425 versus £11,715, p = 0.456). The MST+YOT group were significantly cheaper in terms of YOT services than the YOT group (£3,402 versus £4,619, p = 0.006), but more expensive including the cost of MST, although not significantly so (£5,687 versus £4,619, p = 0.195). The net benefit per young person for the 18-month follow-up was estimated to be £1,222 (95% CI −£5,838 to £8,283). Conclusions: The results reported in this study support the finding that MST+YOT has scope for cost-savings when compared to YOT alone. However, the limitations of the study in terms of method of economic evaluation, outcome measures used and data quality support the need for further research. [ABSTRACT FROM AUTHOR]

Values-based practice is a new skills-based approach to working with complex and conflicting values in health care. In this paper we outline the point of values-based practice (to support balanced decision making), its premise (in respect for differences of values) and the ten elements of the process by which it supports balanced decision making in practice. We give examples of how values-based approaches have been applied in the development of policy and practice in mental health in the UK and outline its potential applications for contemporary psychotherapy. In a brief concluding section we show how the development of values-based practice in mental health is leading the way towards linking science more effectively with people across medicine as a whole. [ABSTRACT FROM AUTHOR]

The article reviews the websites Bexley Hospital (http://www.bexleyhospital.co.uk/) and Testimony (http://www.insidestories.org/), containing oral evidence related to mental health history in Great Britain.

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Presents letters and comments from contributors published on the British Medical Journal as of October 1987. Estimation of cost on acquired immunodeficiency syndrome; Treatment on impotence by autoinjection of vasoactvie drugs; Mental Health of unemployed men in different parts of England and Wales.

All consultants in general psychiatry appointed in Britain between 1 October 1975 and 30 September 1978 were sent a questionnaire asking about their training and adequacy of experience before making a final decision. Over a quarter of the respondents were women, of whom a third had trained part-time. Family circumstances and availability of part-time posts were important determinants. Overseas graduates formed another quarter. For many psychiatry was not their first love but availability of posts and status were important factors in choice of career. Many consultants felt they lacked experience in the subspecialties within psychiatry. [ABSTRACT FROM AUTHOR]

This section offers medical news briefs as of April 26, 2015. Topics discussed include medical advice issued to survivors of the earthquake in Japan about the possibility of developing deep vein thrombosis among those living in cramped conditions and the first session of a musical project called "Song of Contagion." The efforts of doctors in the Netherlands to initiate a debate on the use of nuclear weapons is also mentioned.

The article offers news briefs related to medicine in Great Britain. SANE, the mental health charity, celebrated its 25th anniversary with the launch the Black Dog depression campaign. The Royal College of Surgeons suggests that high risk emergency cases be given importance than elective cases for the prevention of high rate complications in abdominal surgery. The World Organization of National Colleges and Academies (WONCA) conference in Europe discusses issues related to family medicine.

Gives medical news briefs as of December 14, 2002. Elimination of onchoceriasis from West Africa; Investigation of the Rowan ward at Manchester Mental Health and Social Care NHS Trust by the Commission for Health Improvement in Great Britain; Performance ratings which will be received by primary care trusts and mental health trusts; Rise in the rate of breast cancer in Hong Kong.

Reports developments related to medicine in Great Britain as of December 1985. Membership of the British Medical Association; Discussions on mental health; Details on the seminar for private practice and finance for general practitioners.

Reports developments related to medicine as of June 1992 in Great Britain. Plan strike of doctors on the legislation to control rising of medical cost; Appointment of David King as the head of a mental health task force; Launch of an appeal to raise the profile of pathology.