A randomised control trial and cost-consequence analysis to examine the effects of a print-based intervention supported by internet tools on the physical activity of UK cancer survivors

Objective: The objective of this study was to evaluate the effectiveness of a print-based intervention supported by Internet tools at improving physical activity in cancer survivors compared with a standard letter recommendation. Prediagnosis physical activity and self-efficacy were hypothesised to predict physical activity improvement. Study design: Waiting list randomised control trial and cost-consequence analysis. Methods: Adult cancer survivors who could become physically active without prior medical approval were randomised to receive either a print-based intervention supported by Internet tools (intervention, n - 104) or a standard letter recommendation (control, n - 103). Physical activity was assessed at 12 weeks with maintenance assessed at 24 weeks in the intervention arm. The number needed to treat was calculated, and a cost-consequence analysis completed. Results: Participants in receipt of a print-based intervention supported by Internet tools improved their physical activity by 36.9% over 12 weeks compared with 9.1% in the control arm. Physical activity was maintained at 24 weeks in the intervention arm. A total of 6.29 cancer survivors needed to receive the intervention for one cancer survivor to improve their physical activity over a standard letter recommendation. Intervention delivery cost £8.19 per person. Prediagnosis physical activity and self-efficacy did not predict physical activity improvement. Conclusion: A print-based intervention supported by Internet tools offers a promising low-cost means to intervene to improve physical activity in cancer survivors

Sexual harassment experienced by police staff serving in England, Wales and Scotland : a descriptive exploration of incidence, antecedents and harm

An online survey (N = 1,776) was conducted with support staff to explore the type and incidence of sexual harassment within the police working environment and the explanatory value of known antecedent factors. Univariate results indicated that the highest levels of sexual harassment were associated with sexual banter, reported by three quarters of those surveyed, and diminishing levels of exposure to more serious types of harassment. Multivariate analyses showed statistically significant associations between levels of exposure and organisational variables but few demographic factors. Having established a better understanding of salient risk factors, the discussion identifies implications for organisational preventative intervention

Is homonationalism influencing public opinion? Experimental and survey evidence from the UK and Romania

Homonationalism is a proposed value configuration that promotes both accepting gay people and prejudice towards immigrants and ethnic minorities. This value configuration contrasts with the widely supported theory that all prejudices are positively related, and are explained by underlying causes such as authoritarianism. Although homonationalism has received attention in qualitative research on mass-media and political discourse, this is the first quantitative exploration of the concept. We used data from a society likely to be high on homonationalism (UK), and one likely to be low (Romania). None of our results were consistent with homonationalism, either in an experiment conducted with students (Study 1, N = 110), or in a secondary analysis of data from the same two countries (Study 2, N = 2638). Ethnic prejudice and homophobia were positively related, while homonationalism was negatively related to homophobia and authoritarianism. Homonationalism has little utility as a construct for understanding public opinion at this point in time, and research investigating it at other levels of analysis may be more fruitful

Diagnostic uncertainty, guilt, mood, and disability in back pain

Objective: In the majority of patients a definitive cause for low back pain (LBP) cannot be established, and many patients report feeling uncertain about their diagnosis, accompanied by guilt. The relationship between diagnostic uncertainty, guilt, mood, and disability is currently unknown. This study tested 3 theoretical models to explore possible pathways between these factors. In Model 1, diagnostic uncertainty was hypothesized to correlate with pain-related guilt, which in turn would positively correlate with depression, anxiety and disability. Two alternative models were tested: (a) a path from depression and anxiety to guilt, from guilt to diagnostic uncertainty, and finally to disability; (b) a model in which depression and anxiety, and independently, diagnostic uncertainty, were associated with guilt, which in turn was associated with disability. Method: Structural equation modeling was employed on data from 413 participants with chronic LBP. Results: All 3 models showed a reasonable-to-good fit with the data, with the 2 alternative models providing marginally better fit indices. Guilt, and especially social guilt, was associated with disability in all 3 models. Diagnostic uncertainty was associated with guilt, but only moderately. Low mood was also associated with guilt. Conclusions: Two newly defined factors, pain related guilt and diagnostic uncertainty, appear to be linked to disability and mood in people with LBP. The causal path of these links cannot be established in this cross sectional study. However, pain-related guilt especially appears to be important, and future research should examine whether interventions directly targeting guilt improve outcomes

The Effect of the Move More Pack on the Physical Activity of Cancer Survivors: Protocol for a Randomized Waiting List Control Trial with Process Evaluation

Background: Physical activity can improve many common side effects of cancer treatment as well as improve physical function and quality of life (QOL). In addition, physical activity can improve survival rate and reduce cancer recurrence. Despite these benefits, only 23% of cancer survivors in England are active to recommended levels. Cancer survivors are interested in lifestyle behavior change. Home-based interventions offer a promising means for changing physical activity behavior. Prediagnosis levels of physical activity and self-efficacy have been reported to be predictors of physical activity behavior change. The Move More Pack, which has undergone revision, is a printed resource with supporting Internet-based tools that aims to increase the physical activity of cancer survivors in the United Kingdom. The revised Move More Pack is underpinned by the theory of planned behavior and the social cognitive theory. Objective: The aim of this proposed study was to investigate the effect of the revised Move More Pack, supported by Internet-based tools, on physical activity, self-efficacy, and health-related QOL (HRQOL) of cancer survivors in the United Kingdom. Methods: This study is a two-arm waiting list randomized control trial with embedded process evaluation. A sample of 99 participants per arm will be recruited by invitation through an email database of cancer survivors held by UK charity Macmillan Cancer Support and an advert placed on the Macmillan Cancer Support Facebook page. Each participant is randomized to receive brief physical activity information and the UK guidelines for physical activity, or brief physical activity information and the revised Move More Pack with supporting Internet-based tools. The intervention and control arm will be followed up at 12 weeks to identify changes in self-reported physical activity, self-efficacy, and HRQOL based on Web-based questionnaires. The control arm will receive the revised Move More Pack at 12 weeks with follow-up at 24 weeks. The intervention arm is followed up at 24 weeks to determine maintenance of reported changes. Subgroup analyses will be completed based on participants’ prediagnosis level of physical activity and baseline self-efficacy as possible predictors of positive changes. Use of each component of the revised Move More Pack will be assessed using a 4-point Likert scale. Semistructured phone interviews will evaluate the use and perceived usefulness of the revised Move More Pack. Results: Participant recruitment started in March 2017. Projected completion of this study is October 2018. Conclusions: This study’s findings will identify if the proposed low-cost broad reach intervention improves physical activity, self-efficacy, and the HRQOL of cancer survivors. The process evaluation is designed to contextualize the use and perceived usefulness of the revised Move More Pack, help augment its efficient distribution, and identify potential improvements to its design

The factor structure of the Center for Epidemiological Study - Depression Scale in people with multiple sclerosis

Background: Depression is common in multiple sclerosis (MS); however, its assessment is complicated by biological processes. In this context it is important to consider the performance of depression screening measures including that their factor structure is consistent with expectation. This study sought to identify the factor structure of the Center for Epidemiological Study - Depression Scale (CES-D) in people with MS (PwMS). Methods: Participants (N = 493) were those who had consented to take part in a large three-phase longitudinal study of depression in PwMS. CES-D questionnaires completed at phase 1 of the study were utilised. An error in the questionnaire meant it was most appropriate to consider data for 19 of the 20 CES-D questionnaire items. The data was split into two samples by a random selection process to create an exploratory, model development sample and a validation sample. The first sample was subject to confirmatory factor analysis. Following examination of model fit and specification errors, the original model was modified. The revised model was tested in the confirmation sample to assess reproducibility. Results: The analysis results supported the original four factor solution for the CES-D, that is: Depressed Affect, Positive Affect, Somatic Complaints/Activity Inhibition, and Interpersonal Difficulties. Conclusions: The CES-D appears to have a coherent structure with which to examine depression in PwMS

A study of the validity and the reliability of the Geriatric Anxiety Inventory in screening for anxiety after stroke in older inpatients

Objectives: To investigate the validity and reliability of the Geriatric Anxiety Inventory in screening for anxiety in older inpatients post-stroke. Design: Longitudinal. Subjects: A total of 81 inpatients with stroke aged 65 years or older were recruited at four centres in England. Main measures: At phase 1 the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale were administered and then the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders 4th edition (phase 2). The Geriatric Anxiety Inventory was repeated a median of seven days later (phase 3). Results: Internal reliability of the Geriatric Anxiety Inventory was high (α = 0.95) and test-retest reliability acceptable (τB = 0.53). Construct validity of the Geriatric Anxiety Inventory was evident with respect to the Hospital Anxiety and Depression Scale -Anxiety subscale (τB = 0.61). At a cut off of 6/7, the sensitivity of the Geriatric Anxiety Inventory was 0.88 and specificity 0.84, with respect to Structured Clinical Interview diagnosis of anxiety. Hospital Anxiety and Depression Scale -Anxiety subscale sensitivity was 0.88, specificity 0.54 at the optimum cut off of 5/6. A comparison the areas under the curve of the Receiver Operating Characteristics for the two instruments indicated that the area under the curve of the Geriatric Anxiety Inventory was significantly larger than that of the Hospital Anxiety and Depression Scale –Anxiety subscale, supporting its superiority. Conclusions: The Geriatric Anxiety Inventory is an internally consistent, reliable (stable) and valid instrument with acceptable sensitivity and specificity to screen for anxiety in older inpatients with stroke

Stress ocupacional e alteração do Estatuto da Carreira Docente português

Este estudo foi realizado com 1162 professores, tendo como objetivo analisar a experiência de stress e a síndrome de “burnout”, antes a após a alteração do Estatuto da Carreira Docente em Portugal. Assim, foram efetuadas duas avaliações em momentos temporais distintos, assumindo-se um plano transversal de recolha de dados (2004/2005, n=689 e 2008/2009, n=473). O protocolo de avaliação incluiu medidas de fontes de stress (Questionário de Stress nos Professores, Gomes, Silva, Mourisco, Mota, & Montenegro, 2006) e de “burnout” (Inventário de “Burnout” de Maslach – Versão para Professores, Maslach, Jackson, & Leiter, 1996; Maslach, Jackson, & Schwab, 1996, Adaptação de Gomes et al., 2006). Os resultados indicaram que a experiência de stress e de “burnout” aumentou entre as duas avaliações, verificando-se em 2008/2009 aumentos em áreas relacionadas com as pressões de tempo/excesso de trabalho e com o trabalho burocrático/administrativo e, inversamente, diminuições em áreas relacionadas com as diferentes capacidades e motivações dos alunos. Quanto à predição da síndrome de “burnout”, não se verificaram alterações substanciais nas variáveis preditoras nos dois momentos. Em síntese, os resultados indicaram aumentos nas exigências profissionais dos professores, mas não se pode afirmar que tal se deva às alterações do Estatuto da Carreira Docente uma vez que não observámos alterações no stress associado à carreira docente.(undefined