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Objectives: Procrastination is a common form of self-regulation failure that a growing evidence base suggests can confer risk for poor health outcomes, especially when it becomes habitual. However, the proposed linkages of chronic procrastination to health outcomes have not been tested over time or accounted for the contributions of higher-order personality factors linked to both chronic procrastination and health-related outcomes. We addressed these issues by examining the role of chronic procrastination in health outcomes over time in which the hypothesized links of procrastination to health problems operate via stress and health behaviours., Design: Three-wave longitudinal study with 1-month intervals., Methods: Participants (N = 379) completed measures of trait procrastination at Time 1, and measures of health behaviours, stress and health problems at each time point, in a lab setting., Results: Procrastination and the health variables were inter-related in the expected directions across the three assessments. Chronic procrastination was positively associated with stress and negatively with health behaviours at each time point. Path analysis testing a cross-lagged longitudinal mediation model found an indirect relationship operating between procrastination and health problems via stress, after accounting for the contributions of conscientiousness and neuroticism., Conclusions: This research extends previous work by demonstrating that the links between chronic procrastination and poor health are accounted for mainly by higher stress, after accounting for other key traits, and that these associations are robust over time. The findings are discussed in terms of the importance of addressing habitual self-regulation failure for improving health., (© 2023 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Background: Children from low-socioeconomic backgrounds exhibit more behavioural difficulties than those from more affluent families. Influential theoretical models specify family stress and child characteristics as mediating this effect. These accounts, however, have often been based on cross-sectional data or longitudinal analyses that do not capture all potential pathways, and therefore may not provide good policy guidance., Methods: In a UK representative sample of 2399 children aged 5-15, we tested mediation of the effect of household income on parent and teacher reports of conduct problems (CP) via unhealthy family functioning, poor parental mental health, stressful life events, child physical health and reading ability. We applied cross-lagged longitudinal mediation models which allowed for testing of reciprocal effects whereby the hypothesised mediators were modelled as outcomes as well as predictors of CP., Results: We found the predicted significant longitudinal effect of income on CP, but no evidence that it was mediated by the child and family factors included in the study. Instead, we found significant indirect paths from income to parental mental health, child physical health and stressful life events that were transmitted via child CP., Conclusion: The results confirm that income is associated with change in CP but do not support models that suggest this effect is transmitted via unhealthy family functioning, parental mental health, child physical health, stressful life events or reading difficulties. Instead, the results highlight that child CP may be a mediator of social inequalities in family psychosocial functioning.

Objective: Novice driver crash risk diminishes steeply over the first few months of driving. We explore the characteristics of driving over this period to identify behaviours that might underlie this change in risk., Methods: We conducted a cross-sectional study of 1456 UK drivers aged 17-21 within six months of gaining their licence. We examined how various forms of driving exposure, such as weekly mileage and driving at night, were related to duration of licencing. We explored the factor structure of the Early Driving Development Questionnaire (EDD-Q); a new instrument designed to measure safety relevant attitudes and behaviours in recently qualified drivers. We examined the relationship of the derived factors to licence duration., Results: There was little evidence that greater exposure to risky driving situations was more common in those with shorter licence durations. Exploratory and Confirmatory Factor Analyses identified EDD-Q factors measuring risky style (12 items), skill deficiencies (8 items) and driving confidence (4 items). Licence duration was positively correlated with both risky style and confidence, with these relationships stronger for older novices. Licence duration was also negatively related to skill deficiencies (i.e., positively correlated with perceived driving skill development): this relationship was stronger in younger novices., Conclusions: The negative correlation between license duration and skill deficiencies is consistent with the observation of decreasing novice crash involvement as experience is gained. The EDD-Q offers a new brief measure of aberrant driving that is specifically tailored for newly qualified drivers., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Richard Rowe, Christopher B. Stride, Andrew R. Thompson & Damian R. Poulter reports financial support was provided by Medical Research Council., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Workplace mistreatment regularly occurs in the presence of others (i.e., observers). The reactions of observers toward those involved in the mistreatment episode have wide-reaching implications. In the current set of studies, we draw on theories of perspective-taking to consider how this form of interpersonal sensemaking influences observer reactions toward those involved in a witnessed incident of workplace mistreatment. We find that observers' blame attributions and empathic concern for the individual whose perspective is taken explain the positive effects of perspective-taking on observer attitudes toward and performance evaluations of both the target and instigator of a witnessed incident of mistreatment. We also find that the effect of perspective-taking on observer reactions is stronger when the witnessed mistreatment is more severe. Finally, we find that although observer perspective-taking in the context of mistreatment can be encouraged, the effect seems to benefit instigators' performance evaluations rather than targets'. Implications for targets, instigators, and organizations are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Introduction: This study investigated the extent to which five human resource management (HRM) practices-systematic selection, extensive training, performance appraisal, high relative compensation, and empowerment-simultaneously predicted later organizational-level injury rates., Methods: Specifically, the association between these HRM practices (assessed via on-site audits by independent observers) with organizational injury rates collected by a national regulatory agency one and two years later were modeled., Results: Results from 49 single-site UK organizations indicated that, after controlling for industry-level risk, organization size, and the other four HRM practices, only empowerment predicted lower subsequent organizational-level injury rates. Practical Applications: Findings from the current study have important implications for the design of HRM systems and for organizational-level policies and practices associated with better employee safety., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)

This study examined week-level changes in affective well-being among school teachers as they transitioned into and out of a 1-week vacation. In addition, we investigated the interactive influence of personality characteristics (specifically perfectionism ) and spillover work activities during the vacation on changes in teachers' well-being. A sample of 224 teachers completed study measures across 7 consecutive weeks, spanning the period before, during, and after a midterm vacation (providing a total of 1,525 responses across the study period). Results obtained from discontinuous multilevel growth models revealed evidence of a vacation effect, indicated by significant reductions in emotional exhaustion, anxiety, and depressed mood from before to during the vacation. Across 4 working weeks following the vacation, exhaustion and negative mood exhibited a nonlinear pattern of gradual convergence back to prevacation levels. Teachers with a higher level of perfectionistic concerns experienced elevated working week levels of exhaustion, anxious mood, and depressed mood, followed by pronounced reductions in anxious and depressed mood as they transitioned into the vacation. However, a strongly beneficial effect of the vacation was only obtained by perfectionistic teachers who refrained from spillover work tasks during the vacation. This pattern of findings is consistent with a diathesis-stress model, in that the perfectionists' vulnerability was relatively dormant (or deactivated) during a respite from job demands. Our results may provide an explanation for why engaging in work-related activities during vacations has previously exhibited weak relationships with employees' recovery and well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The dual burden of enteric infection and childhood malnutrition continues to be a global health concern and a leading cause of morbidity and death among children. Campylobacter infection, in particular, is highly prevalent in low- and middle-income countries, including Bangladesh. We examined longitudinal data to evaluate the trajectories of change in child growth, and to identify associations with Campylobacter infection and household factors. The study analyzed data from 265 children participating in the MAL-ED Study in Mirpur, Bangladesh. We applied latent growth curve modelling to evaluate the trajectories of change in children's height, as measured by length-for-age z-score (LAZ), from age 0-24 months. Asymptomatic and symptomatic Campylobacter infections were included as 3- and 6-month lagged time-varying covariates, while household risk factors were included as time-invariant covariates. Maternal height and birth order were positively associated with LAZ at birth. An inverse association was found between increasing age and LAZ. Campylobacter infection prevalence increased with age, with over 70% of children 18-24 months of age testing positive for infection. In the final model, Campylobacter infection in the preceding 3-month interval was negatively associated with LAZ at 12, 15, and 18 months of age; similarly, infection in the preceding 6-month interval was negatively associated with LAZ at 15, 18, and 21 months of age. Duration of antibiotic use and access to treated drinking water were negatively associated with Campylobacter infection, with the strength of the latter effect increasing with children's age. Campylobacter infection had a significant negative effect on child's growth and this effect was most powerful between 12 and 21 months. The treatment of drinking water and increased antibiotic use have a positive indirect effect on linear child growth trajectory, acting via their association with Campylobacter infection., Competing Interests: The authors have declared that no competing interests exist.

Employees often self-initiate changes to their jobs, a process referred to as job crafting, yet we know little about why and how they initiate such changes. In this paper, we introduce and test an extended framework for job crafting, incorporating individuals' needs and regulatory focus. Our theoretical model posits that individual needs provide employees with the motivation to engage in distinct job-crafting strategies-task, relationship, skill, and cognitive crafting-and that work-related regulatory focus will be associated with promotion- or prevention-oriented forms of these strategies. Across three independent studies and using distinct research designs (Study 1: N = 421 employees; Study 2: N = 144, using experience sampling data; Study 3: N = 388, using a lagged study design), our findings suggest that distinct job-crafting strategies, and their promotion- and prevention-oriented forms, can be meaningfully distinguished and that individual needs (for autonomy, competence, and relatedness) at work differentially shape job-crafting strategies. We also find that promotion- and prevention-oriented forms of job-crafting vary in their relationship with innovative work performance, and we find partial support for work-related regulatory focus strengthening the indirect effect of individual needs on innovative work performance via corresponding forms of job crafting. Our findings suggest that both individual needs and work-related regulatory focus are related to why and how employees will choose to craft their jobs, as well as to the consequences job crafting will have in organizations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Objective: A number of studies demonstrate a social gradient in behavioural problems, with children from low-socioeconomic backgrounds experiencing more behavioural difficulties than those from high-socioeconomic families. Antisocial behaviour is a heterogeneous concept which includes diverse behaviours such as physical fighting, vandalism, lying, disobedience and irritability. It remains unclear whether the mechanisms underlying social inequalities are similar across these different subtypes of antisocial behaviour. This study aimed to simultaneously test a range of individual, family and neighbourhood factors as mediators of the relationship between income and subtypes of antisocial behaviour., Method: Data on a UK representative sample of 7977 children and adolescents, aged 5-16, was analysed in a series of nested structural equation models. A range of antisocial outcomes, including irritability, aggression, and callous-unemotional traits, were measured. Income quintiles were used to indicate family socioeconomic status. A range of potentially mediating or confounding variables, such as family functioning and parental mental health, were also measured., Results: Analyses revealed that unhealthy family functioning, neighbourhood disadvantage, stressful life events and children's literacy difficulties were mediating variables contributing to the indirect effect of income on a range of antisocial behaviours., Conclusion: As expected family functioning accounted for a substantial proportion of the association between SES and antisocial behaviour, we also found evidence that child cognitive functioning might perform an important role. Our findings emphasise the importance of addressing the mechanisms underlying the association between SES and behavioural problems.

Drivers are at high crash risk when they begin independent driving, with liability decreasing steeply over the first three months. Their behavioural development, and other changes underlying improved safety are not well understood. We adopted an innovative longitudinal qualitative design, with thirteen newly qualified drivers completing a total of 36 semi-structured interviews, one, two and three months after acquiring a full UK driving license. The interviews probed high-risk factors for new drivers, as well as allowing space for generating novel road safety issues. Analysis adopted a dual deductive and inductive interpretative thematic approach, identifying three super-ordinate themes: (1) Improvements in car control skills and situation awareness; (2) A reduction in the thrill of taking risks when driving against a background of generally increasing driving speed; (3) Early concerns about their social status in the eyes of other road users during the early stages of driving, which may put pressure on them to drive faster than they felt comfortable with. The study provides important new leads towards understanding how novice driving becomes safer over the first few months of driving, including how well-studied concepts of driving skill and style may change during development of independent driving, and bringing the less rigorously studied concept of social status into focus., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Health-related quality of life (HRQoL) from diagnosis until end of treatment for children with acute lymphoblastic leukaemia was investigated, examining effects of age, gender, risk-stratified treatment regimen, and therapy intensity (one vs. two 'delayed intensifications' [DIs])., Method: In a multi-centre prospective study, parents reported their child's generic and disease-specific HRQoL and their own care-giving burden at five time points. From 1,428 eligible patients, 874 parents completed questionnaires at least once during treatment., Results: At each time point, generic HRQoL was significantly lower than equivalent norm scores for healthy children. HRQoL decreased significantly at the start of treatment, before recovering gradually (but remained below pre-treatment levels). Parents reported that older children worried more about side effects and their appearance, but showed less procedural anxiety than younger children. Concern for appearance was greater among girls than boys. Compared to Regimen B (i.e. additional doxorubicin during induction and additional cyclophosphamide and cytarabine during consolidation chemotherapy), patients receiving Regimen A had fewer problems with pain and nausea. There were no statistically significant differences in HRQoL by number of DI blocks received., Interpretation: HRQoL is compromised at all stages of treatment, and is partly dependent on age. The findings increase understanding of the impact of therapy on children's HRQoL and parental care-giving burden, and will contribute to the design of future trials., (© 2017 The Authors. Pediatric Blood & Cancer Published by Wiley Periodicals, Inc.)

Three studies examined how people assess their progress on personal goals (e.g., whether they compare their progress to the past and/or to a desired target state), along with factors that might influence the nature of progress monitoring (e.g., whether the goal involves attaining a positive outcome or avoiding a negative outcome). Study 1 involved semi-structured interviews with 40 participants, in which we examined how participants monitored their progress and whether this was related to: (a) their level of self-efficacy, (b) whether the goal was prevention focused, and (c) whether goal progress was represented in quantifiable terms. Studies 2 ( N = 492) and 3 ( N = 481) were conducted online and additionally examined whether how participants monitored their progress differed as a function of the domain of the goal (i.e., whether it was related to physical development/health, finances, work/study, or social relationships). The findings suggest that participants: (i) were less likely to monitor their progress toward goals that were related to avoiding negative outcomes, (ii) were less likely to monitor their progress toward goals related to finances, work, or study with reference to the past, than progress toward other goals (e.g., those relating to physical development and health), (iii) found it easier to monitor their progress toward goals that they felt confident of attaining, but harder to monitor their progress toward goals related to work or study. Finally, the more participants thought about their goal in quantifiable terms, the more likely they were to monitor their progress, and the easier they found monitoring their progress to be. Taken together, these studies begin to describe the nature of progress monitoring and the factors that influence this important self-regulatory process.

Background: Low income is a widely studied risk factor for child and adolescent behavioural difficulties. Previous research on this relationship has produced mixed findings., Aims: To investigate the level, shape and homogeneity of income gradients in different types of antisocial behaviour., Method: A representative sample of 7977 British children and adolescents, aged 5-16 years, was analysed. Hypotheses concerning the shapes and homogeneity of the relationships between family socioeconomic status and multiple antisocial behaviour outcomes, including clinical diagnoses of oppositional-defiant disorder, conduct disorder and symptom subscales, such as irritability and hurtfulness, were tested by structural equation models., Results: Consistent income gradients were demonstrated across all antisocial behaviours studied. Disorder prevalence and mean symptom counts decreased across income quintiles in a non-linear fashion., Conclusions: Our findings emphasise that income gradients are similar across different forms of antisocial behaviour and indicate that income may lead to greater behavioural differences in the mid-income range and less variation at low- and high-income extremes., (© The Royal College of Psychiatrists 2015.)

Previous research on the association between socioeconomic status (SES) and child and adolescent antisocial behaviour has produced mixed findings showing variation in the strength of association. This systematic review and meta-analysis aimed to summarise evidence on the relationship between socioeconomic status and broadly conceptualised antisocial behaviour, investigating variation across a range of antisocial subtypes and other potential moderators, including age, sex and informant. We identified 133 studies containing data suitable for effect size calculation, and 139 independent effect sizes were analysed (total N=339868). The global meta-analysis showed that lower family socioeconomic status was associated with higher levels of antisocial behaviour. Moderation analyses revealed this relationship was stronger where callous-unemotional traits were the outcome, and where antisocial behaviour was reported by parents or teachers rather than self-reported. The relationship between family SES and antisocial behaviour, however, was independent of higher-level constructs such as national income inequality. These results indicate that SES can be considered a robust correlate of broadly conceptualised antisocial behaviour but the strength of this relationship may depend on the antisocial subtype under investigation and the design of the study., (Copyright © 2014. Published by Elsevier Ltd.)

Objectives: This study sought to apply behavioural reasoning theory (BRT) to the prediction of undergraduate students' binge drinking intentions and behaviour. The reasons students use to justify and defend binge drinking may provide important information on motivations underlying such behaviour., Methods: Undergraduate students (N= 265) completed questionnaires assessing their reasons for and against binge drinking, attitude, subjective norm, perceived behavioural control, intention, and past behaviour. Frequency of binge drinking was assessed at 1-week follow-up (N= 172)., Results: A series of path analyses were conducted to assess the direct and indirect effects of the BRT variables on binge drinking intentions and behaviour. The variables under consideration accounted for 80% of the variance in binge drinking intentions (with past behaviour, reasons for binge drinking, and attitude having significant direct effects on intention), and 34% of the variance in binge drinking at 1-week follow-up (with past behaviour, perceived behavioural control, and intention having significant direct effects on future behaviour). Additional regression analyses revealed that respondents who strongly endorsed being sociable and having fun as reasons for binge drinking were more likely to intend to engage in binge drinking over the subsequent week., Conclusions: The results provide support for BRT as a framework for understanding undergraduate students' binge drinking intentions and behaviour, and suggest that interventions need to focus on the social reasons for engaging in binge drinking in undergraduate students., (©2012 The British Psychological Society.)

Background: The relationship between social position and physical health is well-established across a range of studies. The evidence base regarding social position and mental health is less well developed, particularly regarding the development of antisocial behavior. Some evidence demonstrates a social gradient in behavioral problems, with children from low-socioeconomic backgrounds experiencing more behavioral difficulties than children from high-socioeconomic families. Antisocial behavior is a heterogeneous concept that encompasses behaviors as diverse as physical fighting, vandalism, stealing, status violation and disobedience to adults. Whether all forms of antisocial behavior show identical social gradients is unclear from previous published research. The mechanisms underlying social gradients in antisocial behavior, such as neighborhood characteristics and family processes, have not been fully elucidated. This review will synthesize findings on the social gradient in antisocial behavior, considering variation across the range of antisocial behaviors and evidence regarding the mechanisms that might underlie the identified gradients., Methods: In this review, an extensive manual and electronic literature search will be conducted for papers published from 1960 to 2011. The review will include empirical and quantitative studies of children and adolescents (<=18 years old) recruited from the general population, which include measures of both social position and antisocial behavior. A standardized data extraction form and quality appraisal checklist will be used to retrieve essential information and critically appraise each study and the inter-rater reliability of the quality scores will be assessed. If practical, meta-analysis will be used to synthesize the data. However, it is expected that the selected studies will be heterogeneous, in which case narrative synthesis will be applied. Separate conclusions may be drawn for logically grouped studies on the basis of their quality score, scope or methodology., Discussion: This systematic review has been proposed in order to synthesize cross-disciplinary evidence of the social gradient in antisocial behavior and mechanisms underlying this effect. The results of the review will inform social policies aiming to reduce social inequalities and levels of antisocial behavior, and identify gaps in the present literature to guide further research.

The aim of this study was to explore whether work characteristics (job demands, job control, social support) comprising Karasek and Theorell's (1990) Job Demands-Control-Support framework predict employee safety performance (safety compliance and safety participation; Neal and Griffin, 2006). We used cross-sectional data of self-reported work characteristics and employee safety performance from 280 healthcare staff (doctors, nurses, and administrative staff) from Emergency Departments of seven hospitals in the United Kingdom. We analyzed these data using a structural equation model that simultaneously regressed safety compliance and safety participation on the main effects of each of the aforementioned work characteristics, their two-way interactions, and the three-way interaction among them, while controlling for demographic, occupational, and organizational characteristics. Social support was positively related to safety compliance, and both job control and the two-way interaction between job control and social support were positively related to safety participation. How work design is related to employee safety performance remains an important area for research and provides insight into how organizations can improve workplace safety. The current findings emphasize the importance of the co-worker in promoting both safety compliance and safety participation., (Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.)

Background: There is renewed interest in the role of the built environment in public health. Relatively little research to date investigates its impact on healthy ageing. Ageing in place has been adopted as a key strategy for coping with the challenges of longevity. What is needed is a better understanding of how individual characteristics of older people's residential environments (from front door to wider neighbourhood) contribute to their wellbeing, in order to provide the basis for evidence-based housing/urban design and development of interventions. This research aimed to develop a tool to objectively measure a large range of built environment characteristics, as the basis for a preliminary study of potential relationships with a number of 'place-related' functional, emotional and social wellbeing constructs., Methods: Through a review of urban design literature, design documents, and existing measures, a new tool, the NeDeCC (Neighbourhood Design Characteristics Checklist) was developed. It was piloted, refined, and its reliability validated through inter-rater tests. A range of place-related wellbeing constructs were identified and measured through interviews with 200 older people living in a wide variety of rural-urban environments and different types of housing in England. The NeDeCC was used to measure the residential environment of each participant, and significant bivariate relationships with wellbeing variables were identified., Results: The NeDeCC was found to have convincing face and construct validity and good inter-rater and test/retest reliability, though it would benefit from use of digital data sources such as Google Earth to eliminate the need for on-site survey. The significant relationships found in the study suggest that there may be characteristics of residential environments of potential relevance for older people's lives that have been overlooked in research to date, and that it may be worthwhile to question some of the assumptions about where and how older people want to live (e.g. villages seem to be positive). They also point to the importance of considering non-linear relationships., Conclusions: The NeDeCC provides the basis for generation of evidence-based design guidance if it is used in prospective controlled studies or 'natural experiments' in the future. Ultimately, this will facilitate the creation of better places for ageing in place.

To examine the predictive effects of perceived injustice in two different interpersonal relationships (i.e., working relationship with a supervisor, romantic relationship with a partner) on aggression enacted in those relationships, we computed a series of multilevel regressions on 62 heterosexual couples with all 124 partners employed part-time and working for different supervisors. Higher levels of perceived supervisor injustice predicted higher supervisor-directed aggression, whereas higher levels of perceived partner injustice predicted lower supervisor-directed aggression. An interaction between perceived partner injustice and anger predicted higher levels of partner-directed aggression. Implications and recommendations for future research on the relationship specificity of perceived injustice are discussed., (© 2010 APA, all rights reserved.)

We investigated the extent to which the safety performance (i.e., self-reported safety compliance and safety participation) of employees with 2 jobs was predicted by their respective supervisors' transformational leadership behaviors. We compared 2 within-person models: a context-specific model (i.e., transformational leadership experienced by employees in 1 context related to those same employees' safety performance only in that context) and a context-spillover model (i.e., transformational leadership experienced by employees in 1 context related to those same employees' safety performance in the same and other contexts). Our sample comprised 159 "moonlighters" (73 men, 86 women): employees who simultaneously hold 2 different jobs, each with a different supervisor, providing within-person data on the influence of different supervisors on employee safety performance across 2 job contexts. Having controlled for individual differences (negative affectivity and conscientiousness) and work characteristics (e.g., hours worked and length of relationship with supervisor), the context-specific model provided the best fit to the data among alternative nested models. Implications for the role of transformational leadership in promoting workplace safety are discussed.

In the present study, we modeled 2 sources of safety support (perceived organizational support for safety and perceived coworker support for safety) as predictors of employee safety voice, that is, speaking out in an attempt to change unsafe working conditions. Drawing on social exchange and social impact theories, we hypothesized and tested a mediated model predicting employee safety voice using a cross-sectional survey of urban bus drivers (n = 213) in the United Kingdom. Hierarchical regression analysis showed that perceived coworker support for safety fully mediated the relationship between perceived organizational support for safety and employee safety voice. This study adds to the employee voice literature by evaluating the important role that coworkers can play in encouraging others to speak out about safety issues. Implications for research and practice related to change-oriented safety communication are discussed.

The demands of the modern office are thought to contribute to the development of musculoskeletal disorders. For upper body and lower back disorders, these effects are hypothesized to be mediated by psychological strain. A study of 936 employees from 22 call centers supports this hypothesis. Using logistic regression and structural equation modeling, the authors found that the relationship of workload to upper body and lower back musculoskeletal disorders was largely accounted for by job-related strain. This mediating effect was less evident for arm disorders. Contrary to expectation, job autonomy had neither a direct nor a moderating effect on any musculoskeletal disorder., ((c) 2007 APA.)

Aim: To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care., Setting: Four acute hospital trusts and nine primary care trusts in England., Methods: The questionnaire used was the 27 item Teamwork and Safety Climate Survey. Thirty three healthcare staff commented on the wording and relevance. The questionnaire was then sent to 3650 staff within the 13 NHS trusts, seeking to achieve at least 600 responses as the basis for the factor analysis. 1307 questionnaires were returned (36% response). Factor analyses and reliability analyses were carried out on 897 responses from staff involved in direct patient care, to explore how consistently the questions measured the underlying constructs of safety climate and teamwork., Results: Some questionnaire items related to multiple factors or did not relate strongly to any factor. Five items were discarded. Two teamwork factors were derived from the remaining 11 teamwork items and three safety climate factors were derived from the remaining 11 safety items. Internal consistency reliabilities were satisfactory to good (Cronbach's alpha > or =0.69 for all five factors)., Conclusions: This is one of the few studies to undertake a detailed evaluation of a patient safety climate questionnaire in UK health care and possibly the first to do so in primary as well as secondary care. The results indicate that a 22 item version of this safety climate questionnaire is useable as a research instrument in both settings, but also demonstrates a more general need for thorough validation of safety climate questionnaires before widespread usage.

Background: With current treatments, approximately 75% of children diagnosed with cancer can expect to achieve disease-free survival. However, treatments are complex and aggressive, potentially compromising QOL for children and their parents. Although previous work has shown increased anxiety and depression among parents after diagnosis, the recent development of standardised measures of QOL enables us to look more directly at the impact of diagnosis on mothers' and children's QOL. The aims of this study are to i) describe QOL for children and their mothers after diagnosis by comparing their scores with population norms, ii) explore the relationship between mothers' worries about the illness and their QOL, and iii) determine the relationship between mothers ratings of their own QOL and their child., Method: A total of 87 families took part, constituting 60% of those eligible. The children included 58 males and 29 females aged between 2 years 6 months to 16 years 3 months (mean = 7 years, median = 5 years 8 months). Diagnoses were acute lymphoblastic leukaemia (ALL, n = 57), brain tumours (n = 11), bone tumours (n = 17) and 2 rare cancers. Mothers completed questionnaires about their own and the child's QOL., Results: Mothers' reported their own and the child's QOL to be significantly lower than population norms. There were significant correlations between mothers' worries and their own and their ratings of the child's QOL and mothers' ratings of their own QOL correlated with their ratings of the child's QOL., Conclusion: Both children and their mothers experience significantly compromised QOL in the months following diagnosis. Mothers who rated their own QOL to be poor also rate their child's QOL to be low. These results suggest caution is required where mothers rate their child's QOL. Efforts must continue to be made to improve QOL of children especially in the period immediately following diagnosis.

Purpose. We investigated self-reported quality of life (QoL), body image and daily competence of patients as a consequence of limb salvage surgery (LSS), primary or secondary amputation, and the views of patients following secondary amputation.Patients. Patients (n=37) had all been treated for osteosarcoma or Ewing's sarcoma in the lower limb.Methods. QoL was measured by questionnaire. A separate interview to determine satisfaction with decision-making was conducted with those treated for secondary amputation.Results. For the total group, QoL was below that expected from population norms. There were no differences in QoL between those undergoing LSS surgery compared with amputation. However, LSS reported better daily competence and were less likely to use a walking aid. For the total group, body image and daily competence were associated with better QoL.Discussion. All these patients are at risk of compromised QoL following surgery. Our data are in line with previous work suggesting outcomes may be better for LSS compared with amputation. Following secondary amputation, most patients (80%) did not regret initial LSS treatment, but felt that the time gained allowed them to come to terms with subsequent surgery.