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Background: The sudden introduction of social distancing measures in response to the COVID-19 pandemic resulted in significant lifestyle changes for the UK population. People living with physical disabilities were deemed to be at greater risk of complications following COVID-19 infection and were subjected to stricter social distancing guidelines. But gaps remain in our understanding of how the COVID-19 pandemic and associated restrictions affected the ability to access support, health and wellbeing of people with physical disabilities. Such understanding is vital to ensure equitable future pandemic preparedness for people living with physical disabilities. Methods: We conducted qualitative semi-structured interviews with 31 people living in the UK between May 2020 and January 2022. All participants self-identified as having a physical disability that affected their mobility, sight, or hearing. We analysed the data using reflexive thematic analysis. Results: Six themes were identified that described the impact of the pandemic on ability to access support, health and wellbeing: (i) adaptations to healthcare provision led to difficulties in managing health and wellbeing; (ii) exacerbations of inequalities in access to public space due to social distancing guidelines; (iii) experiences of hostility from able-bodied people; (iv) loss of social lives and encounters; (v) difficulties maintaining distance from others and subsequent fear of infection and (vi) strategies to support wellbeing and coping when confined to the home. Conclusion: The COVID-19 pandemic exacerbated existing health and social inequalities experienced by disabled people. The disproportionate impact of the pandemic on service provision and social connections resulted in challenging circumstances for disabled people who faced unmet medical needs, deteriorating health, and at times, hostile public spaces. Disabled people's experiences need to be incorporated into future pandemic or health-related emergency planning to ensure equality of access to services and public spaces to ensure their health and wellbeing is supported and maintained. [ABSTRACT FROM AUTHOR]

We describe our experience of multidisciplinary teamworking in the oral and maxillofacial surgery (OMFS) department at the Queen Elizabeth University Hospital in Glasgow, which has a unique setup including both foundation doctors and dental core trainees (DCTs). Very few other units in the UK utilise DCTs and foundation doctors working together at a junior level in OMFS. This article explores the advantages and disadvantages of this interdisciplinary approach, and why we believe that other departments should also adopt this strategy [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide a critical, reflective examination of the organisation, delivery and evaluation of a training event conducted by postgraduate students undertaking a module on human resource development. Design/methodology/approach: The paper seeks to offer a triangulation of semi-structured interviews, archival student written reflective accounts of the training event together with oral narrative from past participants on the module. Findings: This paper examines the form and nature of a training event used as part of an assessment strategy on the human resource development (HRD) module of the MBA programme at the University of Abertay. The findings document the meanings and multiple realities that the participants ascribe to the training event. The interactional variable inherent in the informal and formal dichotomy of learning are also illustrated. Finally, the process of empowerment and reflection for all learners leads to a range of outcomes beyond the fulfilment of the assessment task. Research limitations/implications: The study is exploratory and the authors do not attempt to assess the generalisability of the findings. Practical implications: The significance of the assessment of the training event lies in the manner of its execution and the involvement of the postgraduate student learners. It is anticipated that the wider dissemination of the practice is deemed to be in the interests of the HRD community. Originality/value: The paper highlights an innovative approach to the teaching and learning of human resource development at postgraduate level.

People with mental health conditions have been identified as particularly vulnerable to poor mental health during the coronavirus disease 2019 (COVID-19) pandemic. However, why this population have faced these adverse effects, how they have experienced them and how they have coped remains under-explored. To explore how the COVID-19 pandemic affected the mental health of people with existing mental health conditions, and to identify coping strategies for positive mental health. Semi-structured qualitative interviews with 22 people with mental health conditions. Participants were purposively recruited via social media, study newsletters and third sector mental health organisations. Data were analysed using reflexive thematic analysis. Participants were aged 23–70 (mean age 43), predominantly female (59.1%) and of white ethnicity (68.2%). Fifty percent were unable to work due to illness and the most frequently reported mental health condition was depression. Five pandemic-related factors contributed to deteriorating mental health: (i) feeling safe but isolated at home; (ii) disruption to mental health services; (iii) cancelled plans and changed routines; (iv) uncertainty and lack of control; (v) rolling media coverage. Five coping strategies were identified for maintaining mental health: (i) previous experience of adversity; (ii) social comparison and accountability; (iii) engaging in hobbies and activities; (iv) staying connected with others; (v) perceived social support. Challenges were identified as a direct result of the pandemic and people with severe mental illnesses were particularly negatively affected. However, some found this period a time of respite, drew upon reserves of resilience and adapted their coping strategies to maintain positive well-being. [ABSTRACT FROM AUTHOR]

Interviews with 15 participants in New Deal, a British training program for unemployed 18-24 year-olds, revealed overall skepticism about government training programs, distrust and disillusionment, little support for what the government identified as different about New Deal, and low expectations of long-term employment outcomes of the program. (SK)

The dominant view of careers is that they have been transformed by the emergence of 'post-bureaucratic' organizations. 'Neo-bureaucratic' structures have emerged, retaining centralized control over strategy and finance while outsourcing production, creating employment precarity. British television epitomizes a sector that has experienced long-run deregulation. Producing television content is risky and highly competitive. How do broadcasters minimize the risks of television production? Broadcasting neo-bureaucracies avoid relying on fragmented labour markets to hire technically self-disciplining crews. Control regimes are enacted through activating social networks by broadcast commissioners, green-lit to trusted creative teams who recruit key crew, through social networks that complement diffuse forms of normative control. Social networks and the self-discipline of crews are mutually constitutive, (re)producing patterns of labour market advantage/disadvantage. Younger freelancers prove vulnerable, exposed to precariousness inherent in freelance employment; to build a career they must access and sustain their social network membership. We locate individual decisions around career narratives in the context of specific social networks and industry structures. Careers are not boundaryless, individual constructs. We introduce the concept of 'mosaic-career', capturing the complexity of individual work histories, composed of fragmented employment in organizations/projects. How do neo-bureaucracies, then, intervene in labour markets? What are the consequences of those interventions? [ABSTRACT FROM AUTHOR]

While much research has focused on challenges that younger and older people have faced during the COVID-19 pandemic, little attention has been given to the capacity for resilience among these groups. We therefore explored positive psychological experiences and coping behaviours that protected mental health and well-being. Participants were 40 young people (aged 13–24) and 28 older adults (aged 70+) living in the UK during the COVID-19 pandemic. Interviews were held between May 2020 and January 2021. We generated six themes using qualitative thematic analysis, including: engagement in self-fulfilling activities, increased sense of social cohesion, personal growth, use of problem-focused strategies to manage pandemic-related stressors, giving and receiving social and community support, and utilising strategies to regulate thoughts and emotions. While all six themes were relevant both to younger and older adults, there were nuances in how each was experienced and enacted. For example, many older adults adjusted their routines given worries about virus vulnerability, while some young people experienced greater personal growth amidst increased awareness of mental health as they navigated the various lockdown restrictions. [ABSTRACT FROM AUTHOR]

Background: Increased numbers of domestic abuse cases were reported at the start of the COVID-19 pandemic. Many people experiencing abuse faced barriers to seeking support with service closures affecting the sector. Available evidence suggests women are overrepresented in the reported cases of intimate partner violence (IPV) and we aimed to learn more about how their lives were impacted by social distancing restrictions. Methods: We conducted an online qualitative interview study, using reflexive thematic analysis. Interviews were conducted between April 2021 and March 2022. 18 women in the UK with past experiences of IPV provided informed consent and participated in this study. Results: During the analysis, we identified five themes relating to the impact of lockdown restrictions on participants' lives, including: (1) Lockdown meant being confined to a place where abuse was escalating, (2) Barriers to accessing support, including "cancelled" services and missed opportunities to intervene during interactions in lockdown with frontline workers. (3) Increased feelings of fear, isolation, and loss of control, particularly during the early stages of the pandemic from the combination of abuse and pandemic-related changes to daily life. (4) Some forms of support were more accessible during the pandemic, such as provision of online psychological support and social groups. Participants also accessed new forms of support for the first time during the pandemic, in some cases sparked by posts and content on social media about abuse awareness. (5) For some, psychosocial wellbeing transformed during the pandemic, with several participants using the word "freedom" when reflecting on their experience of simultaneously escaping abuse and living through the COVID-19 pandemic. Conclusions: In this study, we explored the views of female survivors of IPV in the UK during the COVID-19 pandemic. Our results highlight the importance of combined public awareness campaigns and community intervention points for victims to safely seek help during social distancing restrictions. Having the time and space to reflect on healing after escaping abuse was described by women in our study as a benefit from their lives in lockdown, which is a factor that could be incorporated into future initiatives developed to support people subjected to violence and abuse. [ABSTRACT FROM AUTHOR]

Background: People using maternity services in the United Kingdom (UK) have faced significant changes brought on by the COVID-19 pandemic and social distancing regulations. We focused on the experiences of pregnant women using UK maternity services during the pandemic and the impact of social distancing rules on their mental health and wellbeing. Methods: We conducted 23 qualitative semi-structured interviews from June 2020 to August 2021, with women from across the UK who experienced a pregnancy during the pandemic. Nineteen participants in the study carried their pregnancy to term and four had experienced a miscarriage during the pandemic. Interviews took place remotely over video or telephone call, discussing topics such as mental health during pregnancy and use of UK maternity services. We used reflexive thematic analysis to analyse interview transcripts. Results: We generated six higher order themes: [1] Some pregnancy discomforts alleviated by social distancing measures, [2] The importance of relationships that support coping and adjustment, [3] Missed pregnancy and parenthood experiences, [4] The mental health consequences of birth partner and visitor restrictions, [5] Maternity services under pressure, and [6] Lack of connection with staff. Many participants felt a sense of loss over a pregnancy experience that differed so remarkably to what they had expected because of the pandemic. Supportive relationships were important to help cope with pregnancy and pandemic-related changes; but feelings of isolation were compounded for some participants because opportunities to build social connections through face-to-face parent groups were unavailable. Participants also described feeling alone due to restrictions on their partners being present when accessing UK maternity services. Conclusions: Our findings highlight some of the changes that may have affected pregnant women's mental health during the COVID-19 pandemic. Reduced social support and being unable to have a partner or support person present during maternity service use were the greatest concerns reported by participants in this study. Absence of birth partners removed a protective buffer in times of uncertainty and distress. This suggests that the availability of a birth partner or support person must be prioritised wherever possible in times of pandemics to protect the mental health of people experiencing pregnancy and miscarriage. [ABSTRACT FROM AUTHOR]

Background: Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public opinion is important, as research suggests that low confidence in government increases the extent of non-compliance with infection-dampening rules (for instance, social distancing); however, the detailed reasons for this association are still unclear. Methods: To understand public opinion on the central UK government during the first phase of the COVID-19 pandemic, we used structural topic modeling, a text mining technique, to extract themes from over 4000 free-text survey responses, collected between 14 October and 26 November 2020. Results: We identified eleven topics, among which were topics related to perceived government corruption and cronyism, complaints about inconsistency in rules and messaging, lack of clear planning, and lack of openness and transparency. Participants reported that elements of the government's approach had made it difficult to comply with guidelines (e.g., changing rules) or were having impacts on mental wellbeing (e.g., inability to plan for the future). Conclusions: Results suggested that consistent, transparent communication and messaging from the government is critical to improving compliance with measures to contain the virus, as well as protecting mental health during health emergencies. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to examine factors that threatened and protected the wellbeing of older adults living in the UK during social distancing restrictions due to the COVID-19 pandemic.Methods: Semi-structured telephone or video interviews with 20 adults aged over 70. Purposive sampling methods were used to increase diversity within the group. Transcripts were analysed using reflexive thematic analysis.Results: Participants described potential threats to their wellbeing during the pandemic, including fears for mortality, grieving normal life, and concerns for the future. Participants also described activities and behaviours that helped to protect their mental health, including adopting a slower pace of life, maintaining routine, socialising, and using past coping skills. Many participants drew on their resilience and life experience to self-manage fear and uncertainty associated with the pandemic, using their time during lockdown to reflect or organise end-of-life affairs.Discussion: This study provides UK-based evidence that while some older adults experienced challenges during the first wave of COVID-19, many were resilient throughout social distancing restrictions despite early reported concerns of mental health consequences among the older adult population. Our findings highlight the importance of maintaining access to essentials to promote feelings of normality and use of social support to help reduce uncertainty in times of pandemics. [ABSTRACT FROM AUTHOR]

This article examines path dependency and technological lock-in in the evolution of the Dundee jute industry, from its beginnings in the 1860s to its demise in the 1970s. The evolution of the industry is explored using the resource-based view of the firm (RBV). The results suggest that the nature and construct of jute fibre was the root cause of a lack of sustainable strategic responses in the sector. Path dependent decisions and technological lock-in meant that many firms were not able to make successful strategic switches, although the capabilities of their engineering skills allowed some firms to endure for longer. Thus, the article extends the RBV to a deeper firm capability level and complements cognate literature on the UK textile sector with a finer specification of the phases in jute's evolution. [ABSTRACT FROM AUTHOR]

According to the 2011 UK Census, Muslims form the second largest religious community in Britain. The relationship of this community to British society more generally has come under much scrutiny. The current study focused on British Muslim's constructions of belonging and conflict towards Britain. Data were collected through semi-structured interviews and analysed using discourse analysis. Findings suggested that for these participants second generation Muslims were more likely to construct themselves as belonging to Britain than first-generation Muslims, who show more attachments to their own culture and religion. Both generations produced rationalizations in order to negotiate their sense of belonging to British society and/or other culture. Moreover, their discourse was constructed in such a way that it fulfilled the function of protecting both generations from issues of accountability in social interactions. [ABSTRACT FROM AUTHOR]

Abstract: Recent events demonstrate the need for greater understanding of intercultural relations between Muslim minorities and majority of cultures in host societies. We examine British Muslims' descriptions of their experiences of acculturation. Data from interviews with first‐generation Muslims were analysed by using discourse analysis. Participants' descriptions reflect the acculturation possibilities made available in local interactional contexts. Where invited to choose between assimilation and separation, participants provide ‘trouble‐telling’ accounts that detail the difficulties involved. In contexts involving integration, participants account for their own efforts. By contrast, contexts that allow participants to introduce acculturation in their own terms lead to descriptions of acculturation success. Thus, participants' accounts of relations with British culture reflect not simply orientations towards acculturation but rather how acculturation is framed and negotiated in local contexts: The success or failure of intercultural relations reflects as much how the issues are presented as they do immigrants' acceptance or non‐acceptance of British culture. [ABSTRACT FROM AUTHOR]

In line with discursive work on the role of constructions of minority groups in social exclusion, we offer an examination of talk on immigrants and its links with employment of British residents, in the U.K. Parliament and interview talk with British residents looking for work, in the context of a financial crisis (2007-2009). Discursive analysis of data shows that parliamentarians treat immigration as problematic for British residents’ employment, whereas interviewees’ responses reject or minimally accept this, while displaying sensitivity to the status of this as a prevalent complaint about immigration. Parliamentarians do so to warrant and challenge or manage challenges to Government’s policies, whereas interviewees do so to manage being seen as discriminatory and work-shy. These findings show that constructions of immigration and its links with employment in the context of the financial crisis, and their use in warrants for exclusion are offered in ways to attend to the situated institutional and interactional relevancies in play for interlocutors. [ABSTRACT FROM AUTHOR]

This article explores the changes that took place in the BBC during the late 1980s and 1990s. The paper traces the antecedents to the changes, particularly a report prepared by McKinsey, the management consulting firm, in the early 1970s. Many of the problems identified by McKinsey were tackled a generation later, although using strikingly different methods from those advocated by the consulting firm. The second section of the paper focuses on the policy interventions made by the Peacock Committee, an application of public choice economics to broadcasting. A key insight of this paper is to explore the way in which the economic rationalities of the Peacock Committee were translated into the BBC through Producer Choice. Producer Choice constituted a new form of governmentality that largely rejected the BBC's Reithian legacy. It was a radical initiative that delegitimised the status quo. The paper explores how new languages and accounting numbers constructed new spaces for managerialism across the BBC. The article highlights how calculation is a central dimension to managerialism and a prime means of bringing the market into organizations. A key insight of the paper is to highlight how markets are created within organizations. [ABSTRACT FROM AUTHOR]

A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians’ explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the USA, are discussed. [ABSTRACT FROM PUBLISHER]

Endocrine disrupting (ED) chemicals are compounds that alter the normal functioning of the endocrine system, potentially causing disease or deformity in organisms and their offspring. Pesticides are used widely to kill unwanted organisms in crops, public areas, homes and gardens and medicinally to kill parasites. Many are proven or suspected to be EDs. Ancient physiological similarities between different vertebrate groups suggest that disorders observed in wildlife may indicate risks to humans. This makes accurate risk assessment and effective legislation difficult. In this paper, the hazardous properties of pesticides which are known to have ED properties are reviewed in order to assess the implications for risk assessment. As well as data on sources of exposure in the United Kingdom (UK) an assessment of the evidence on the health effects of ED pesticides is also included. In total, 127 have been identified from the literature and their effects and modes of action are listed in this paper. Using the UK as a case study, the types and quantities of pesticides used, and their methods of application are assessed, along with their potential pathways to humans. In the UK reliable data are available only for agricultural use, so non-agricultural routes of pesticide exposure have been poorly quantified. The exposure of people resident in or visiting rural areas could also have been grossly under-estimated. Material links between ED pesticide use and specific illnesses or deformities are complicated by the multifactorial nature of disease, which can be affected by factors such as diet. Despite these difficulties, a large body of evidence has accumulated linking specific conditions to ED pesticides in wildlife and humans. A more precautionary approach to the use of ED pesticides, especially for non-essential purposes is proposed. [Copyright &y& Elsevier]

Background: The way patients with coronary heart disease (CHD) are treated is partly determined by non-medical factors. There is a solid body of evidence that patient and physician characteristics influence doctors' management decisions. Relatively little is known about the role of structural issues in the decision making process. This study focuses on the question whether doctors' diagnostic and therapeutic decisions are influenced by the health care system in which they take place. This non-medical determinant of medical decision-making was investigated in an international research project in the US, the UK and Germany. Methods: Videotaped patients within an experimental study design were used. Experienced actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patients of different sex, age and social status. The videotapes were shown to 384 randomly selected primary care physicians in the three countries under study. The sample was stratified on gender and duration of professional experience. Physicians were asked how they would diagnose and manage the patient after watching the video vignette using a questionnaire with standardised and open-ended questions. Results: Results show only small differences in decision making between British and American physicians in essential aspects of care. About 90% of the UK and US doctors identified CHD as one of the possible diagnoses. Further similarities were found in test ordering and lifestyle advice. Some differences between the US and UK were found in the certainty of the diagnoses, prescribed medications and referral behaviour. There are numerous significant differences between Germany and the other two countries. German physicians would ask fewer questions, they would order fewer tests, prescribe fewer medications and give less lifestyle advice. Conclusion: Although all physicians in the three countries under study were presented exactly the same patient, some disparities in the diagnostic and patient management decisions were evident. Since other possible influences on doctors treatment decisions are controlled within the experimental design, characteristics of the health care system seem to be a crucial factor within the decision making process. [ABSTRACT FROM AUTHOR]

In this article, the authors demonstrate how qualitative methods can form a foundation for quantitative research by improving instrument validity, informing the data collection process, and improving cost-effectiveness in a study of physician decision making. To test terminology, applicability, and comprehension of a quantitative questionnaire for doctors in the United States and United Kingdom, each country's researchers conducted physician focus groups with questions organized around the experiment, including (a) validity of video vignettes of actor "patients," (b) population accessibility, ( level of remuneration, (d) appropriate endorsement figure, and (e) question comprehension. Focus group data collected during instrument development and fieldwork planning streamlined processes and achieved cost efficiencies and effectiveness for the overall study. Beyond simply adding a post hoc qualitative component to an already free-standing quantitative methodology, focus groups were used in the study formulation, where the qualitative methodology was integrated into the process of developing a valid survey instrument. [ABSTRACT FROM AUTHOR]

Objective. To determine the relative contributions of: (1) patient attributes; (2) provider characteristics; and (3) health care systems to health care disparities in the management of coronary heart disease (CHD) and depression. Data Sources/Study Setting. Primary experimental data were collected in 2001–2 from 256 randomly sampled primary care providers in the U.S. (Massachusetts) and the U.K. (Surrey, Southeast London, and the West Midlands). Study Design. Two factorial experiments were conducted in which physicians were shown, in random order, two clinically authentic videotapes of “patients” presenting with symptoms strongly suggestive of CHD and depression. “Patient” characteristics (age, gender, race, and socioeconomic status [SES]) were systematically varied, permitting estimation of unconfounded main effects and the interaction of patient, provider, and system-level influences. Data Collection/Data Extraction Methods. Analysis of variance was used to measure provider decision-making outcomes, including diagnosis, information seeking, test ordering, prescribing behavior, lifestyle recommendations, and referrals/follow-ups. Principal Findings. There is a high level of consistency in decision making for CHD and depression between the U.S. and the U.K. Most physicians in both countries correctly identified conditions depicted in the vignettes, although U.S. doctors engage in more information seeking, are more likely to prescribe medications, and are more certain of their diagnoses than their U.K. counterparts. The absence of any national differences in test ordering is consistent for both of the medical conditions depicted. U.K. physicians, however, were more likely than U.S. physicians to make lifestyle recommendations for CHD and to refer those patients to other providers. Conclusions. Substantively, these findings point to the importance of patient and provider characteristics in understanding between-country differences in clinical decision making. Methodologically, our use of a factorial experiment highlights the potential of these methods for health services research—especially the estimation of the influence of patient attributes, provider characteristics, and between-country differences in the quality of medical care. [ABSTRACT FROM AUTHOR]

Background: The developed world's population is aging but care of older patients is unpopular in nursing. Objectives: To determine student nurses' attitudes towards working with older patients and analyze underlying factors. Method: 172 UK student nurses were surveyed using the theory of planned behavior. Results: Positive intentions were related to attitudes ( p<0.01) and subjective norms ( p<0.05). Three underlying factors, intolerance ( p<0.01), humanism ( p<0.05), and concern about aging ( p<0.01) differentiated more and less positive participants. Discussion: Results are only partly consistent with previous findings. Future attitudinal research in this area must be more tightly specified to be relevant to health care and should measure actual behavior and employed nurses' views. Nursing curricula should refer to the three relevant factors. [ABSTRACT FROM AUTHOR]

WHAT IS ALREADY KNOWN IN THIS AREA• A high rate of GP retirement is likely in the next few years.•GPs with the necessary skills are needed to provide care.• Provision of MSc courses designed for GPs is limited.WHAT THIS WORK ADDS• After attending MSc accredited development courses, GPs clearly expressed their intention to retire later.• Many participants have extended their role to become educators, appraisers, GPwSI and also become involved in PCO work.• Participants demonstrated a high rate of progression to further academic modules.SUGGESTIONS FOR FUTURE RESEARCH• Follow-up of participants' intention of working longer, to measure if that translates into reduced early retirement.• Measurement of the impact of such courses directly against provision of patient care. [ABSTRACT FROM AUTHOR]

Background. The ageing of the United Kingdom (UK) population means that the care of older people will become an increasingly important part of nurses’ remit. However, employment statistics suggest that this is an unpopular nursing specialism. This may be due to a number of factors, one of which may be nurses’ negative attitudes towards working with older people. This constitutes a potential problem, especially if such attitudes have an impact on the quality of care provided. Aim. To examine the attitudes held by student nurses towards working with older patients. Methods. Questionnaires incorporating Likert-type scales, two vignettes and demographic questions were designed using the theory of planned behaviour. These were distributed to 172 student nurses undertaking preregistration nursing courses in the UK during the academic session 2000–2001. Results. Student nurses displayed positive intentions towards working with older patients. These were based on their own attitudes and beliefs about what others would wish them to do. Participants believed that their behaviour towards older patients was to a large extent under volitional control. Analysis of the beliefs underlying student nurses’ views showed that they differentiated between those participants who had a relatively positive approach to their work with older patients and those with a less positive approach. In addition, the results offered mixed support for the view that more knowledgeable or experienced nurses hold more positive views towards older people. Conclusions. The findings offer some support for previous studies that have looked at the more general issue of attitudes towards older people. However, the results also indicate that a more rigorous and more highly focused approach to the study of such attitudes is required if the research is to be relevant to the issue of working with older patients. The theoretical, methodological and practical implications of the... [ABSTRACT FROM AUTHOR]

SummaryHealth professionals' knowledge of ethnic minority cultures and lifestyles was assessed to determine whether the respondents' cultural background and experience of working with ethnic minorities affected the health care delivered by them and to assess the need for training. Improving access to health services for ethnic minorities requires continuing education and training of all health professionals. [ABSTRACT FROM AUTHOR]

BACKGROUND: The incidence of self-poisoning is on the increase. Most patients who self-poison are dealt with initially in the general hospital. Therefore, the type and quality of care self-poisoning patients receive will depend, in part, on how they are viewed by nursing staff within the general hospital setting. A knowledge and understanding of the attitudes held by nurses towards self-poisoning patients is therefore important to those involved in the planning and delivery of care towards this client group. Previous studies have examined health care professionals' attitudes towards people who self-poison. Usually, however, these have not focused specifically on nurses' attitudes, and they have ignored the relationship between the attitudes expressed by staff and their intentions to engage in subsequent caring behaviour of one sort or another. It is hence unclear how the findings of such studies are relevant or applicable to nursing policy and practice. AIMS: The present study aims to address these limitations using a methodology informed by the theory of reasoned action. The study aims to separate out the distinctive roles played by nurses' own attitudes, and the social pressures represented by other people's attitudes, in determining the types of caring behaviour in which nurses intend to engage when dealing with self-poisoning patients. DESIGN/METHODS: The study adopts a questionnaire-based approach incorporating two specially designed vignettes. RESULTS: The results show that nurses' own attitudes, and what they believe about the attitudes of others, predict their behavioural intentions towards self-poisoning patients. The study also shows that nurses with a more positive orientation towards self-poisoning patients differ in behavioural and normative beliefs from nurses who have a less positive orientation. CONCLUSIONS: The implications for future attempts to explore the relationship between nurses' attitudes and subsequent caring behaviour are considered, along with implications for nursing policy and practice. [ABSTRACT FROM AUTHOR]

In postgraduate medical education there will always be a tension between delivering the service and ensuring time for reflection and learning. The balance requires monitoring to ensure national implementation of standards and to provide an external review for hospitals. However, the current system in the United Kingdom of visiting by many different agencies is disruptive to hospitals and wasteful of resources. The North Western Deanery has worked with medical royal colleges to develop a co-ordinated system of visiting and reporting which is designed to share information and expertise while reducing the pressure on hospitals. Setting and maintaining standards Clear standards are published and hospitals are encouraged to measure their own performance against these so that they are able to address identified problems. The effectiveness of the visits depends on collection and collation of data, especially face-to-face interviews with trainees and consultants. At the end of the visit a structured verbal feedback is given to senior managers and clinicians in the hospital and is followed by a written report. Improving the quality of training Systematic review of training placements by the postgraduate dean’s team has resulted in a steady increase in the quality of training placements and a structured approach has given trusts a framework to review the quality of training between visits. The future must lie in greater investment of responsibility in postgraduate deans for routine monitoring of training placements to consistent standards, which would allow the newly emerging Medical Education Standards Board (MESB) to review deaneries rather than individual placements. [ABSTRACT FROM AUTHOR]

This article examines several issues concerning the Federation of British Industries (FBI) and the European integration from 1945 to 1963. Since 1945, the relationship of Great Britain with the rest of Europe has been problematic. Britain is often regarded as the reluctant European. The British industry is often portrayed as one of the main forces in favor of closer integration with western Europe. Despite this, most accounts of Britain's relations with Europe have focused on the diplomatic and political dimensions while the views of British industry have received cursory consideration at most on the ground that British industry had little impact on the policy process. From a wider perspective, business-government relations are commonly placed into a pluralist or a corporatist framework. At the end of World War II, Britain confronted an enormous external problem. It had accrued the largest enormous debt in history. The only solution was further borrowing and enormous increase in exports. Government policy was driven by external considerations. Import controls were maintained on most goods and an export drive was started. The government deliberately used the FBI to disseminate information and adjust the pace and shape of public debate.

Objectives: To project the likely worldwide increase in the prevalence of erectile dysfunction (ED) over the next 25 years, and to identify and discuss some possible health-policy consequences using the recent developments in the UK as a case study. Methods: Using the United Nations projected male population distributions by quinquennial age groups for 2025, the prevalence rates for ED were applied from the Massachusetts Male Aging Study (MMAS) to calculate the likely incidence of ED. The MMAS has the advantage of being the first study to provide population-based rates rather than rates based on clinical samples. All the projections were age-adjusted. Results: It is estimated that in 1995 there were over 152 million men worldwide who experienced ED; the projections for 2025 show a prevalence of approx. 322 million with ED, an increase of nearly 170 million men. The largest projected increases were in the developing world, i.e. Africa, Asia and South America. Discussion: The likely worldwide increase in the prevalence of ED (associated with rapidly ageing populations) combined with newly available and highly publicized medical treatments, will raise challenging policy issues in nearly all countries. Already under-funded national health systems will be confronted with unanticipated resource requests and challenges to existing government funding priorities. The projected trends represent a serious challenge for healthcare policy makers to develop and implement policies to prevent or alleviate ED. [ABSTRACT FROM AUTHOR]

Explores the relationship between management strategy, technological change and collective bargaining in the commercial television industry in Great Britain during 1979 to 1998. Termination of the national collective bargaining that had regulated minimum crewing levels; Achievements of British broadcasting; Benefits of digital production technologies.

Examines the causes of the 1993 strike by workers at Yarrow Shipbuilders in Great Britain. Impact of privatization on management strategy and shop steward organization; Restructuring of the defense market in the 1980s; Shipyard industrial relations from 1945 to 1979; Dilemma faced by shop stewards' leadership; Changes in the neighboring Govan Kvaerner shipyard.

Examines the dynamics of the British engineering unions' campaign for a 35 hour week in the 1989-1990 strike. Strike strategy and its impact on collective bargaining institutions; Tensions between the national and local leaderships of the union campaign; Comparison of the campaign with the one staged by the German metalworkers' union, IG Metall.

Examines organizational responses to economic crisis in Great Britain. Impact of change processes on different business organizations; Dependence of companies on existing managerial expertise; Factors necessary for coping with business turnarounds.

This article focuses on the journal articles about the business history in Great Britain during 1990. The key to understanding the modern vertically integrated corporation is a contracting rationale rather than releasing the potential of improving technologies. If the convergence of economic theory and business history advocated by Clive Lee initially appears to offer the prospect of the entrepreneur returning to the center-stage then he quickly dismisses such a prospect. Lee damns entrepreneurial history as a blight on the theoretical development of the discipline. Entrepreneurial history lacks the analytical penetration needed to resolve the problems it has sought to explore. It has surely outlived its usefulness. Despite its ambition, Lee's review of the theory and history of corporate behavior offers little beyond a theorization of the current state of empirical knowledge built on Alfred Chandler's foundations. A more innovative departure would have been the actual use of Oliver Williamson's concepts to analyze an empirical case study, either of a particular firm or of an economic sector. The inherent weakness of defining the theoretical boundaries of business history through Williamson's work is that it mirrors the classic microeconomic focus on the individual enterprise.

This article examines the industrial relations and the organization of engineering work from 1880 to 1939 in Great Britain. According to the author, the last 15 years have witnessed an explosion of academic interest in the historical development of industrial work. The theoretical touchstone of this debate, Harry Braverman's Labour and Monopoly Capitalism, depicted the evolution of industrial work as the progressive separation of conception and execution, in which machinery and Taylorism combined to wrest knowledge and control over work from an increasingly deskilled and enfeeble proletariat. Braverman's argument has, however, come under increasingly severe criticism as historical and comparative studies have undermined the view that the evolution of specific labour processes can be deduced from an a priori model of capitalist development. The contingent nature of long run changes in work organization has shifted attention from the refinement of teleological theories of industrial development to the search for an adequate method of studying change and continuity in work organisation. Particularly important in this respect is the insistence that the division of labour is shaped by the complex interaction between employer strategies, labour and product markets.

The article presents information on working with health services to implement the Code of Practice of the Education Act 1993:. The Education Act (1993) required the British Secretary of State for Education to publish guidance on good practice for the identification and assessment of children with special educational needs in a 'Code of Practice' (DFE 1994) to which all involved must 'have regard'. For the Education Act (1993) to achieve its aims, all parties concerned must commit themselves to it while the Code of Practice is evolving. During prior consultation, exceptional in its scope and effectiveness, a large number of professionals became aware of the new legislation.

Presents several correspondence concerning the articles published in the 'British Medical Journal.' Prevalence of childhood malaria; Suggestion in the management of children with nephrotic syndrome; Prevention of vitamin D deficiency in the elderly.

The article presents a case study on the misinterpretation of severe bronchospasm as anaphylaxis of a young adult female. She received vecuronium and bag ventilation following the induction of anaesthesia. She was diagnosed with anaphylaxis with close administration with cefuroxime and prompt anaphylaxis management as governed by the Association of Anaesthetists of Great Britain. Moreover, the case highlights the deleterious effects of gas trapping during bronchospasm associated as anaphylaxis.

This report examines correspondence between perceived and objective (American Heart Association's RISKO) risk of heart attack and stroke in a randomly selected sample from two surveys (n = 4,171) conducted in each of two New England cities, in 1981-82 and 1983-84, respectively. Results confirmed prior reports that people ten to underestimate their CVD (cardiovascular disease) risk and showed that estimates of those at lowest risk were most accurate. [ABSTRACT FROM AUTHOR]

The article presents obituaries for several physicians including Elizabeth Jocelyn Clements, Michael John Thomson Dalton and Reginald Seymour Lawrie.

Abstract: Objective: To analyse effects of patient and physician characteristics on questions and advice about smoking in primary care practice and to examine country differences. Methods: We conducted a factorial experiment, employing filmed scenarios in which actors played the role of patients with symptoms of coronary heart disease (CHD) or type 2 diabetes. Versions were filmed with patient–actors of different gender, age, race, and socioeconomic status. The videotapes were presented to primary care physicians in the US, UK and Germany. Physicians were asked whether they would ask questions about smoking or give cessation advice. Results: Female and older CHD patients are less likely to be asked or get advice about smoking in all three countries. Effects of physician attributes are weak and inconsistent. Compared to physicians in the US and the UK, German doctors are least likely to ask questions or give advice. Conclusions: Although all physicians viewed the same cases their questioning and advice giving differed according to patient attributes and country. Due to the experimental design external validity of the study may be limited. Practice implications: Findings have implications for medical education and professional training of physicians as well as for the organization and financing of health care. [Copyright &y& Elsevier]

Abstract: Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort–reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005 to 2007. Results demonstrate country-specific differences in work stress with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions. [Copyright &y& Elsevier]