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Background: First Contact Practitioners (FCP) have developed as a more advanced physiotherapy clinical role delivering specialist MSK services in GP practice settings. They aim to support GPs in effectively managing increasing patient workloads. As FCPs are now a more established NHS role, it is important to understand how these clinicians perceive their roles to guide and support future service development. Aims: To review the current evidence regarding the experience of FCPs in the UK. To understand how FCPs perceive their role. To gain an insight into FCP practice which can inform future primary research studies. Method: A systematic review of FCP primary qualitative research studies. Multiple database and grey literature search with screening following PRISMA guidelines. Qualitative critical appraisal and analysis used tools and frameworks from the Joanna Briggs Institute. Results: The review reports on 11 included studies which informed the creation of six key concepts impacting upon FCP role experience and perceptions. These were complexity, competency and role development, role understanding, job satisfaction, wellbeing and burnout and service delivery. Conclusion: FCP clinicians feel broadly positive about their roles, although they report a clear risk of burnout and associated negative impact on their wellbeing. Job satisfaction is linked to adequate training and developing the competencies required to manage patients in an environment of clinical uncertainty. Having access to regular clinical mentorship is a key requirement and FCPs must adapt to the specific demands of work in a GP practice environment. [ABSTRACT FROM AUTHOR]

Research question:This paper examined the impact of participation in YOG on Norwegian team members with a particular emphasis on differences between those who continued in elite sport and those that dropped out. Research methods:We used a retrospective survey design to collect quantitative and qualitative data from former Norwegian YOG participants (from 2010, 2012, and 2014), with 58 of the 64 athletes responding to the survey in December 2015. Results and findings:Ericsson, Krampe, and Tesch-Roemer’s [(1993). The role of deliberate practice in the acquisition of expert performance.Psychological Review,100(3), 363–406] typology of constraints and their concept of deliberative practice provided the framework for the data analysis. Key findings include: (a) the dropout rate was lower than that reported for similar groups; (b) the main reasons for dropout were school pressures and poor relations with the coach; (c) there was little difference in the perceived level of support from schools, parents and coaches between those who dropped out and those who did not; (d) participation in the YOG was a significant motivating factor for staying in elite-level sport for some athletes; (e) medal winners were as likely to dropout as non-medal winners; and (f) the national context for elite youth development may play a larger role in deeper engagement in sport than YOG participation. We derive hypotheses/propositions based on our results, which should be tested in future studies. Implications: Our findings suggest the entourage’s support is critical for continued engagement in sport, but is not sufficient for preventing dropout. The national context, in terms of the sport and education systems, must align to ensure young athletes do not need to choose between elite-level sport and school. The national context may play a larger role in deeper engagement in sport than YOG participation/success. [ABSTRACT FROM PUBLISHER]

Previous research on mistreatment of older people in black and minority ethnic communities has identified limited service responses and the need to consider mistreatment as an issue not only for individuals but also for families, communities, and institutions. The impact of cultural factors on understandings, experiences, and remedies for mistreatment has been debated. Drawing on empirical research in the United Kingdom involving service providers and ethnically-diverse community members, the article explores implications of cultural variation for service provision. Clear gaps exist between service provision and people experiencing mistreatment due to structural and contextual factors; cultural factors have a relatively minor impact. [ABSTRACT FROM AUTHOR]

Abstract: This paper examines clinician–manager interactions within healthcare organizations in the UK and contrasts the notions of dialetics and dialogues within such interactions. We draw particularly on Bakhtin’s work on dialogue to frame our focal research question, which considers the extent to which clinician–manager interactions are dialogic. Using data drawn from a thirty-two month study of five UK healthcare organizations we suggest that clinician-manager interactions are more dialectic than dialogic in their orientation. Further, we suggest that, despite the appearance of dialogical possibility between clinicians and non-clinicians, the tendency to dialectic positioning reinforces opposition between these groups and we conclude that local, rather than system-wide interventions, offer the best means of disrupting these dialectics and fostering productive dialogues. [Copyright &y& Elsevier]

Background: Smoking remains a public health problem and although unsolicited GPs' advice against smoking causes between one and three percent of smokers to stop, a significant proportion of smokers are particularly resistant to the notion of stopping smoking. These resistant smokers have been called "hardcore smokers" and although 16% of smokers in the community are hardcore, little is known about hardcore smokers presenting to primary care physicians. Consequently, this study reports the characteristics and prevalence of hardcore smokers attending UK GPs. Methods: A cross-sectional survey using data from two different research projects was conducted. Data for this analysis had been collected from surgery consultation sessions with 73 GPs in Leicestershire, England, (42 GPs from one project). Research assistants distributed preconsultation questionnaires to 4147 adults attending GPs' surgery sessions. Questionnaires identified regular smokers, the proportion of hardcore smokers and their characteristics. Nonhardcore and hardcore smokers' ages, gender and nicotine addiction levels were compared. Results: 1170 regular smokers attended surgery sessions and, 16.1% (95% CI, 14.1 to 18.4) were hardcore smokers. Hardcore smokers had higher levels of nicotine addiction than others (p = 0.000), measured by the Heaviness of Smoking Index and were more likely to be male [50.5% hardcore versus 35.3% non-hardcore, (OR = 1.88, 95% CI = 1.4 to 2.6)] but no age differences were observed between groups. Conclusion: A significant minority of the smokers who present in general practice are resistant to the notion of smoking cessation and these smokers are more heavily nicotine addicted than others. Although clinical guidelines suggest that GPs should regularly advise all smokers against smoking, it is probable that hardcore smokers do not respond positively to this and help to make up the 97%-99% of smokers who do not quit after being advised to stop smoking by GPs. General practitioners need to find approaches for raising the issue of smoking during consultations in ways that do not reinforce the negative opinions of hardcore smokers concerning smoking cessation. [ABSTRACT FROM AUTHOR]

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This paper documents the major issues arising from the UK local authority e-voting pilots. The formal evaluation reports on all the UK e-voting pilots conducted in 2002, which provided actual case data. Identified issues are categorised into four high-level areas: legal, social, political, and voter education. Each category is presented and the major issues discussed. Verification of the initial findings is achieved through a web site review of the Local Authority web sites involved in the 2003 e-voting pilots. [ABSTRACT FROM PUBLISHER]

Examines the market, technological and industrial context of Business Process Re-engineering (BPR) in Great Britain businesses, reviewing the history of BPR and its relationship to existing management approaches. Attention drawn by BPR in both the management literature and management practices; Information on growing popularity of BPR in Great Britain businesses; Discussion on BPR in relation to other management techniques.

Presents correspondence related to medicine in Great Britain. Management of mild hypertension; Recommendation for target systolic blood pressure in elderly patients; Screening for trisomy 18.

The article focuses on the English National Chlamydia Screening programme in Great Britain. The programme, which was launched in 1998, is offered to people less than 25 years old of both sexes who are sexually active. The tests are available in a wide range of settings including general practices, family planning clinics, pharmacies and a variety of community initiatives.

Examines the risk of neoplasia and malignancy in 'dominant' thyroid swellings in Great Britain. Information on thyroid swellings; Classification of swellings; Terminology and indications for operation.

The article reports that Great Britain's Conservative Party has formed a coalition government as it could not achieve majority votes in recent general elections of the county's House of Commons. As stated, the coalition government can be good for Great Britain as it brought various changes in the working procedure of ministers. It further states that the coalition government is intended to work effectively in order to solve various problems of the nation such as budget deficits and unemployment.

The article reports on the National Chlamydia Screening Programme (NCSP) in Great Britain which is regarded as the cornerstone of the drive for better sexual health. NCSP aims to control and prevent Chlamydia, the most common bacterial sexually transmitted infection in England. Early detection and treatment of asymptomatic infection are the focus of NCSP.

Comments on the importance of key skills in the educational system in Great Britain. Reference to the 1997 Dearing Report on Higher Education in the learning society; Relevance of the implementation of key skills on students and lecturers; Role of the Higher Education in the implementation of key skills.

Associations between body mass index (BMI) and psychological distress (PD) have been reported; however, few longitudinal studies have accounted for likely life-course differences in BMI and PD stability, consistency, and their interplay across time. Via random intercepts cross-lagged panel models, we assessed the predictive effects (from BMI to PD or vice-versa) across the last two centuries in the Coronary Artery Risk Development in Young Adults [CARDIA, beginning in 1985-6] study using the Center for Epidemiological Studies-Depression Scale [CES-D], and in the National Child Development Study [NCDS, beginning in 1958] and British Cohort Study [BCS, beginning in 1970] using the Malaise Inventory [MI]), assessed at least 4 times in adult life. In CARDIA (n = 4724), NCDS58 (n = 7149) and BCS70 (n = 5967), autoregressive effects were stronger for BMI than for PD, meaning that carry-over effects from one occasion to the next were larger for BMI than for PD. Small interindividual correlations between traits of higher BMI and higher PD were identified among females (r female <|0·2|) but not males (r male <|0·03|) in CARDIA and NCDS. Cross-lagged effects were very weak or close to zero (standardized effects η<|0·1|). In the United States, depressive symptoms and BMI were positively correlated at the trait level among females. In the United Kingdom, relationships between PD and BMI were inconsistent between generations, with effect sizes of unlikely clinical importance, indicating negligible dominance of an intraindividual effect of BMI on PD or vice versa. • BMI and psychological symptoms were heavily dependent on enduring traits across adulthood. • The trait of BMI was weakly correlated with the trait of psychological distress among women. • Individuals who gained BMI were more likely to continue to gain BMI at later stages. • Gaining or losing BMI did not reliably predict changes in psychological symptoms, or vice versa. [ABSTRACT FROM AUTHOR]