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Background: Healthy lifestyle changes for patients with stage 1 hypertension are recommended before antihypertensive medication. Exercise has antihypertensive benefits; however, low adoption and high attrition are common. Patients need easily adoptable, effective and manageable exercise interventions that can be sustained for life. We present participant and stakeholder perceptions of an isometric exercise intervention for stage 1 hypertension delivered in the National Health Service (NHS, UK). Methods: An embedded qualitative study within a randomised-controlled feasibility study included intervention arm participants (n = 10), healthcare professionals from participating NHS sites (n = 3) and non-participating NHS sites (n = 5) taking part in semi-structured interviews to explore feasibility of delivering an isometric exercise intervention within the study design and an NHS context. Data was analysed using reflective thematic analysis. Results: Three themes were identified: study deliverability; motivators and barriers; support for study participation. Findings indicated that the study was well designed. Health benefits, unwillingness to take medication, altruism and interest in the study helped motivation and adherence. Study support received was good, but healthcare professionals were insecure in intervention delivery with regular training/supervision needed. Perception of health improvement was mixed, but, in some, uptake of wider lifestyle changes resulted from participation. Stakeholders felt that current service challenges/demand would make implementation challenging. Conclusions: Despite participant positivity, delivery of an isometric intervention in an NHS setting was considered challenging given the current service demand, although possible with robust effectiveness evidence. Findings support further effectiveness data and implementation development of the isometric exercise intervention. Trial registration: ISRCTN, ISRCTN13472393. Registered 18 September 2020. [ABSTRACT FROM AUTHOR]

Background: Over 30,000 people experience out-of-hospital cardiac arrest in the United Kingdom annually, with only 7–8% of patients surviving. One of the most effective methods of improving survival outcomes is bystander intervention in the form of calling the emergency services and initiating chest compressions. Additionally, the public must feel empowered to act and use this knowledge in an emergency. This study aimed to evaluate an ultra-brief CPR familiarisation video that uses empowering social priming language to frame CPR as a norm in Scotland. Methods: In a randomised control trial, participants (n = 86) were assigned to view an ultra-brief CPR video intervention or a traditional long-form CPR video intervention. Following completion of a pre-intervention questionnaire examining demographic variables and prior CPR knowledge, participants completed an emergency services-led resuscitation simulation in a portable simulation suite using a CPR manikin that measures resuscitation quality. Participants then completed questionnaires examining social identity and attitudes towards performing CPR. Results: During the simulated resuscitation, the ultra-brief intervention group's cumulative time spent performing chest compressions was significantly higher than that observed in the long-form intervention group. The long-form intervention group's average compressions per minute rate was significantly higher than the ultra-brief intervention group, however both scores fell within a clinically acceptable range. No other differences were observed in CPR quality. Regarding the social identity measures, participants in the ultra-brief condition had greater feelings of expected emergency support from other Scottish people when compared to long-form intervention participants. There were no significant group differences in attitudes towards performing CPR. Conclusions: Socially primed, ultra-brief CPR interventions hold promise as a method of equipping the public with basic resuscitation skills and empowering the viewer to intervene in an emergency. These interventions may be an effective avenue for equipping at-risk groups with resuscitation skills and for supplementing traditional resuscitation training. [ABSTRACT FROM AUTHOR]

One of the most commonly identified obstacles in the learning-teaching of quantitative material is statistics anxiety. Of the factors analysed in relation to statistics anxiety, age and gender have received a substantial proportion of the research focus. Yet there is limited work that systematically examines the possibility of an interrelationship, or interaction, between age and gender and reported statistics anxiety. This article aims to directly address this gap in the research by examining this interaction. A secondary analysis of data gathered from across 34 institutions in the UK is undertaken. The research presented is the first to examine this issue using a multivariate-modelling framework in a UK context. Although the international literature tends to indicate that women disproportionately experience statistics anxiety, the findings here show women have a moderate likelihood of reporting anxiety. There is a group of unworried young men who are likely to require pedagogical attention. Indeed, it may be that the existence a group of complacent young men have women seem anxious by comparison. [ABSTRACT FROM AUTHOR]

Continuity of care is concerned with quality of care over a period of time. It describes a process by which service users and their families are co-operatively involved with health and social care professionals in managing their care needs. Continuity of care can be divided into informational, managerial and relational and has been associated with improved user- and service-related outcomes. To date, there have been few studies which examine how continuity of care is developed and maintained in integrated primary care systems. This paper explores continuity of care in an integrated Over 75 Service for people living at home with complex health and social care needs. Using a case study approach, qualitative data was collected from multiple sources including interviews with managers and professionals, users and carers, care plans, steering group minutes and field notes. Data was analysed thematically. A number of factors are identified which characterise continuity of care, namely: information sharing through direct communication between providers and the development of trusted relationships within the team; identified care co-ordinators who acted as a conduit for information and communication; the development of ongoing relationships with users and carers requiring dedicated time and accessible and flexible services delivered in the users' own home. [ABSTRACT FROM AUTHOR]

Mine is a rather UK-centric view. The ability to understand numbers is increasingly vital for citizenship in a world where almost every argument, no matter how bogus, comes with numbers attached. Maths and stats, however, are too important to leave to the mathematicians and statisticians alone. There are as many varieties of application as there are disciplines and interests. Maths faculty are not there to be polymaths. The best solution to this problem is as much interaction as possible between maths and stats and 'applied' disciplines. I don't know about the US, but in the UK such interdisciplinarity is lauded in principle but crushed in practice by the target culture sweeping across education. In addition, I found many items on which to agree. In sum, I can report that Shifting Contexts is full of useful experiences and experiments for us to consider. Moreover, both sides of the Atlantic would benefit from a closer relationship and fuller discussion of what both of us are trying, and sometimes succeeding, to do. [ABSTRACT FROM AUTHOR]

Background: Periprosthetic osteolysis resulting in aseptic loosening is a leading cause of THA revision. Individuals vary in their susceptibility to osteolysis and heritable factors may contribute to this variation. However, the overall contribution that such variation makes to osteolysis risk is unknown.Questions/purposes: We conducted two genome-wide association studies to (1) identify genetic risk loci associated with susceptibility to osteolysis; and (2) identify genetic risk loci associated with time to prosthesis revision for osteolysis.Methods: The Norway cohort comprised 2624 patients after THA recruited from the Norwegian Arthroplasty Registry, of whom 779 had undergone revision surgery for osteolysis. The UK cohort included 890 patients previously recruited from hospitals in the north of England, 317 who either had radiographic evidence of and/or had undergone revision surgery for osteolysis. All participants had received a fully cemented or hybrid THA using a small-diameter metal or ceramic-on-conventional polyethylene bearing. Osteolysis susceptibility case-control analyses and quantitative trait analyses for time to prosthesis revision (a proxy measure of the speed of osteolysis onset) in those patients with osteolysis were undertaken in each cohort separately after genome-wide genotyping. Finally, a meta-analysis of the two independent cohort association analysis results was undertaken.Results: Genome-wide association analysis identified four independent suggestive genetic signals for osteolysis case-control status in the Norwegian cohort and 11 in the UK cohort (p ≤ 5 x 10). After meta-analysis, five independent genetic signals showed a suggestive association with osteolysis case-control status at p ≤ 5 x 10 with the strongest comprising 18 correlated variants on chromosome 7 (lead signal rs850092, p = 1.13 x 10). Genome-wide quantitative trait analysis in cases only showed a total of five and nine independent genetic signals for time to revision at p ≤ 5 x 10, respectively. After meta-analysis, 11 independent genetic signals showed suggestive evidence of an association with time to revision at p ≤ 5 x 10 with the largest association block comprising 174 correlated variants in chromosome 15 (lead signal rs10507055, p = 1.40 x 10).Conclusions: We explored the heritable biology of osteolysis at the whole genome level and identify several genetic loci that associate with susceptibility to osteolysis or with premature revision surgery. However, further studies are required to determine a causal association between the identified signals and osteolysis and their functional role in the disease.Clinical Relevance: The identification of novel genetic risk loci for osteolysis enables new investigative avenues for clinical biomarker discovery and therapeutic intervention in this disease. [ABSTRACT FROM AUTHOR]

The author reflects on the failure of the majority of undergraduate social science degree programs in Great Britain to provide students a good foundation in social statistics. Topics covered include reasons behind the evaporation of statistics from the undergraduate curriculum such as the poor standard of methodological training of most faculty recruited, the early specialization of school students in subjects of study, and the way in which the social sciences came to understand theory.

Aims and objectives To explore the beliefs patients with heart failure hold about their illness and its treatment using the common-sense model of illness cognitions and behaviour as the theoretical framework. Background Heart failure is a disabling condition, which has a significant impact on individuals, their families and healthcare provision. The common-sense model provides a framework within which lay beliefs about illness and its treatment can be examined. Previous studies have reported a number of misconceptions in relation to the nature of and treatment for heart failure. Inaccurate beliefs are related to limited self-care and nonadherence to medication. Design A qualitative research design was used in which thematic analysis was used to interpret interview data. Methods Semi-structured interviews were carried out with twelve patients with chronic heart failure in a community setting in South East England. An interview schedule based on the dimensions of the common-sense model guided data collection. Data were analysed thematically using the framework method. Results A cluster of beliefs around a chronic illness with serious consequences was found. However, patients were unable to distinguish between symptoms of heart failure, effects of medication and emotional responses to the illness. The illness was attributed to external factors, especially stressful life events. There was a strong belief in the necessity of medication coupled with the belief that the illness and its symptoms could be controlled by medication. Concerns about drug interactions and side effects were prevalent. Conclusions This study highlights the need for nurses to explore illness representations and treatment beliefs in heart failure. Misconceptions should be corrected to influence behaviour change. Relevance to clinical practice An understanding of illness representations and treatment beliefs should enable structured interventions to be developed, which improve clinical outcomes in this population. [ABSTRACT FROM AUTHOR]

Accessible summary In this paper we review past research that suggests video conferencing (VC) can be successfully used in a number of ways in mental health services. These ways include holding staff meetings remotely, conducting assessment and treatment when it is not easy for the clinician and service user to be at the same location, and running staff training remotely., We also present some guidance regarding issues to be considered when introducing VC into mental health settings, such as the importance of staff and service user consultation, the necessity for training in VC and advice about how to conduct meetings by VC., Beginning to use VC can represent a significant cultural change for staff and service users. We hope that this paper will provide a useful summary of things that may help support this change., Abstract The aim of this paper is to provide an overview of the evidence base regarding the use of video conferencing (VC), implementation issues, policies, procedures, technical requirements and VC etiquette. The paper is based on a literature review of VC within the mental health sector and the authors' experience in implementing VC. Six themes emerged from the literature review: applications of VC, VC assessments, treatment, training and supervision, practitioner anxiety, and VC administrative processes. The results of the review support the use of VC in mental health services. Guidelines for the implementation of VC are discussed, including the importance of staff and service user consultations, training in the use of VC, clear guidance for staff with regards to usage, confidentiality and data protection policies, and VC etiquette. Challenges that can arise when implementing VC in a mental health context are also discussed. Arguably, it is not the technology, but the cultural change it represents to staff which seems to be the most important factor regarding successful implementation. [ABSTRACT FROM AUTHOR]

Although globalization has highlighted the danger of conflating state, society and nation, sociologists remain insufficiently alert to such banal nationalism. Newspapers offer a strong test case of the extent of diversity in the construction of state, national and social boundaries, since Billig and Anderson have argued they comprise a special case where their orientation to an audience simultaneously located in a state, society and nation allows them to reproduce a sense of national identity. However, despite the commonsense obviousness of the term, it proves remarkably difficult to define what the ‘British national press’ might comprise. Circulation density of titles varies substantially across different parts of the UK and editorial copy is altered to address diverse ‘national’ readerships. ‘British’ newspapers also circulate in other states, especially the Republic of Ireland. After reviewing how newspapers might be defined as ‘national’ and/or ‘British’, we conclude that both Anderson and Billig over-estimate the congruence, relevance and obviousness of state, society and national boundaries. If the conceptualization of such boundaries is problematic in the case of the press, it follows that it must be still more so for most other objects of sociological analysis, including that of ‘society’ itself. [ABSTRACT FROM AUTHOR]

This paper examines one particular aspect of the relationship between citizenship and media, namely the way in which newspapers establish, define or reinforce the boundaries of “national” communities (and thus determine who might be a member). The research is conducted against the background of devolution in the United Kingdom, which helped to focus upon and illuminate the diverse conceptions of national identities within multi-national states. We critique the routine application of theories of “banal nationalism” and “imagined community” in settings where different understandings of what may constitute “the national” co-exist. Analysis of newspaper editions distributed in England and Scotland highlight the complex, ambiguous and shifting use of national terminology and markers. Rather than focus on specific “newsworthy” events, the paper investigates everyday reporting of “ordinary” news and reveals the limitations of existing theories and accounts of the links between media and national (and wider social) identities. [ABSTRACT FROM AUTHOR]

Work–life balance policies aimed at reducing working hours are often assumed to be of particular interest to workers with family responsibilities such as young children. Although workers in Britain report the kind of time-stress envisaged by the debate over a‘long-hours culture’, there is little relationship between workers’ family situation and preferences for working fewer hours. Women workers’ hours already reflect family commitments to some extent, while families with young children may need the income levels that only substantial working hours bring. Conversely workers without family commitments may have more capacity to swap income or career progression for increased leisure time. [ABSTRACT FROM AUTHOR]

There are two problems with the existing account of the relationship between newspapers and national identity in the UK. The first is that although it is widely assumed that the mass media are central to the reproduction and evolution of national identity this has never been empirically demonstrated. The second is that exactly what comprises the relevant‘national’ context in the UK is unclear. Content analysis of 2,500 sampled articles, together with qualitative comparison of different editions of the same newspaper titles and interviews with editors and journalists are used to show the extent and nature of‘national’ frames of reference in newspapers in England and Scotland. Paradoxically, devolution may have reduced the spatial diversity of news stories in the press in England and Scotland. [ABSTRACT FROM AUTHOR]

Describes some of the findings of an investigation into the factors affecting health care provision in a prison in Greater London, using qualitative approaches to access information, attitudes and perceptions not readily accessible though quantitative means. Illnesses and short-term behavioural responses implicated in the physical and mental reactions associated with stress; Adverse organisational effects attributable to stress, listed by the Great Britain Health and Safety Executive; Factors identified as contributing to stress; Conclusions.

The article presents information related to the status of labor in Great Britain with reference to the article "Voting for Ford." The article was published in 1980 which criticized radical analyses of industrial democracy that argued forms of workers control within capitalism could only lead to the 'incorporation' of the working class. During 1980s, the initiative of labor was vital in the production process and it created the space for class conflicts over the organization of work and the allocation of resources from it whose results were not determined in advance. Various legislations including legislations on health and safety, employment protection, union recognition and sex discrimination were passed by the British government in 1980s.

Presents several letters on medical care in Great Britain. Investigation of hyperparathyroidism; Performance of general practitioners; Relevance of bicarbonate in diabetic ketoacidosis.

This article examines the role of industrial psychological consultation in the field of private manufacturing in Great Britain during the post-war period. Academic evaluations of the apparent growth of consultation have been guarded and confined to remarks about its extent. But some practitioners have made more ambitious claims for consultation. According to them not only is it more extensive, it has also changed its character. The renaissance of consultation is said to prove that without legislation industrial democracy in Britain is already developing. In one area of industrial relations at least the British tradition of voluntarism is not dead. Information on joint consultation has been gathered in at least fifteen surveys. Different studies were based on individuals, establishments and companies. Many reported only management or worker representatives' views without cross checking. The coverage of industrial orders has been uneven. But with the qualification that we are dealing with broad trends rather than precise statistics we can discuss whether or not its incidence has changed.

The article offers insights on building preservation or listing in Great Britain. Listing involves someone who will choose the buildings or structures that are of historic interest. These buildings should be over a certain age before it is listed. But recently, there has been an international surge of interest to preserve post 1945 architecture since it reveals the public, historical and political arguments, which usually surround any decisions made concerning preservation.

The article proposes an alternative measure of population ageing for Great Britain and other developed countries. The authors note that the old age dependency ratio, which is the standard indicator of population ageing, is a poor measure of the burden of an ageing population. The need to consider life expectancy in gauging population ageing is explained. The implications of population ageing for public health policy are discussed.

Abstract: Objective: To assess preliminary effects of a program of transcutaneous posterior tibial nerve stimulation (TPTNS) on lower urinary tract symptoms and number of episodes of urinary and fecal incontinence in older adults in residential care homes and the feasibility of a full-scale randomized trial. Design: Pilot randomized single-blind, placebo-controlled trial. Setting: Seven residential care homes and 3 sheltered accommodation complexes in the United Kingdom. Participants: Thirty care home residents aged 65 and older with urinary or bowel symptoms and/or incontinence. Interventions: Twelve 30-minute sessions of TPTNS or sham stimulation (placebo). Measurements: Lower urinary tract symptoms using American Urological Society Symptom Index, urinary incontinence using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), postvoid residual urine volumes using portable bladder scanning, bowel symptoms and fecal incontinence using selected ICIQ questions. Results: Total American Urological Society Symptom Index scores improved, showing a median reduction of 7 (interquartile range [IQR] –8 to –3) in the TPTNS group and a median increase in the sham stimulation (placebo) group of 1 (IQR –1 to 4) (Mann-Whitney U 16.5000, Z –3.742, P < .001). Total ICIQ-SF scores improved by a median of 2 (IQR –6 to 0) in the TPTNS group and 0 points (IQR –3 to 3) in the sham stimulation group (Mann-Whitney U 65.000, Z –1.508, P = .132). Significant reduction was found in postvoid residual urine of 55 mL in the TPTNS group (t = –2.215, df 11.338, P = .048). Bowel urgency improved in 27% of the TPTNS group compared with 8% of the sham group (χ2 2.395, df 2, P > .302), fecal leakage improved in 47% of the TPTNS group compared with 23% of the sham group (χ2 4.480, df 2, P > .106); however, these differences were not significant. No adverse effects were reported by older adults or care staff. Conclusion: TPTNS is safe and acceptable with evidence of potential benefit for bladder and bowel dysfunction in older male and female residents of care homes. Data support the feasibility of a substantive trial of TPTNS in this population. [Copyright &y& Elsevier]

Abstract: Background: The interests of users should lead service developments. However, it has been claimed that forensic mental health services have largely ignored examining users’ views on the nature and quality of the service offered to them. Perceived social climate and perceived therapeutic relationship are viewed as important indicators of treatment outcome; however previous findings about how these variables may be associated with satisfaction with forensic services are equivocal. Objectives: This study aims to assess the levels of service user satisfaction in forensic in-patient settings in one mental health trust and explore how the perceived therapeutic relationship of the service users with their key-workers and the perceived social climate of the wards are associated with service user satisfaction. Design: A cross-sectional survey design was chosen and an independent researcher facilitated the completion of three standardised assessments measuring service user satisfaction, therapeutic relationships and the social climate of the ward. Method: Forty-four service users detained in secure settings completed the standardised assessments. The study was conducted in four medium secure and three low secure units in one NHS mental health trust. The data was analysed to examine the level of satisfaction with services and how both the therapeutic relationship and the ward environment were related to levels of satisfaction. Results: The majority of service users who responded were generally satisfied with services; “rehabilitation” and “perceived safety” were viewed most positively. Service users’ perceptions about the social climate of the ward were found to have a significant relationship with service users’ satisfaction with forensic services. However, the variables with the strongest association with satisfaction with forensic services are service users’ perceptions about the nature of therapeutic relations with staff. Conclusions: This study indicates that service users’ satisfaction with forensic services is strongly associated with their experiences of the therapeutic relationship with their key-workers and the social climate of the ward. The findings emphasize the importance of forming and maintaining effective therapeutic relations and reinforce the need to maintain a therapeutic environment free of aggressive tension and threats of violence. The results also highlight the potential for service users to be dissatisfied with their financial situation following admission. [Copyright &y& Elsevier]

Historically, oral and dental issues for head and neck cancer patients were often not considered until after cancer treatment was complete. As a result, outcomes for oral rehabilitation were sometimes suboptimal. Inconsistencies in service delivery models and qualification, training and experience of staff delivering dental care often compounded this problem, making research and audit almost impossible. Collaborative working by consultants in restorative dentistry from all over the UK as part of a Restorative Dentistry-UK (RD UK) subgroup, renamed more recently as the RD-UK Head and Neck Cancer Clinical Excellence Network (CEN), has re-emphasised the importance of specialist restorative dentistry intervention at the outset of the head and neck cancer pathway to optimise outcomes of patient care. The CEN has driven several initiatives, reflecting Getting It Right First Time (GIRFT) principles aimed at reducing unwarranted variation. This improved consistency in approach and optimised collaborative working of the team now presents a better environment for multicentre audit and research. Ultimately, this should result in a continued improvement in patient and carer experience., (© 2022. The Author(s).)