Retaining the general practitioner workforce in England : what matters to GPs? A cross-sectional study

Background: The general practice (GP) workforce in England is in crisis, reflected in increasing rates of early retirement and intentions to reduce hours of working. This study aimed to investigate underlying factors and how these might be mitigated. Methods: GPs in central England were invited to participate in an on-line survey exploring career plans and views and experiences of work-related pressures. Quantitative data were analysed using logistic regression analysis and principal components analysis. Qualitative data were analysed using a thematic framework approach. Results: Of 1,192 GPs who participated, 978 (82.0 %) stated that they intend to leave general practice, take a career break and/or reduce clinical hours of work within the next five years. This included 488 (41.9 %) who intend to leave practice, and almost a quarter (279; 23.2 %) intending to take a career break. Only 67 (5.6 %) planned to increase their hours of clinical work. For participants planning to leave practice, the issues that most influenced intentions were volume and intensity of workload, time spent on “unimportant tasks”, introduction of seven-day working and lack of job satisfaction. Four hundred fifty five participants responded to open questions (39128 words in total). The main themes were the cumulative impact of work-related pressures, the changing and growing nature of the workload, and the consequent stress. Reducing workload intensity, workload volume, administrative activities, with increased time for patient care, no out-of-hour commitments, more flexible working conditions and greater clinical autonomy were identified as the most important requirements to address the workforce crisis. In addition, incentive payments, increased pay and protected time for education and training were also rated as important. Conclusions: New models of professionalism and organisational arrangements may be needed to address the issues described here. Without urgent action, the GP workforce crisis in England seems set to worsen

Model of Inspiring Media

Scholars have increasingly explored the ways that media content can touch, move, and inspire audiences, leading to numerous beneficial outcomes including increased feelings of connectedness to and heightened motivations for doing good for others. Although this line of inquiry is relatively new, sufficient evidence and patterns of results have emerged such that a clearer picture of the inspiring media experience is coming into focus. This article has two primary goals. First, we seek to synthesize the existing research into a working and evolving model of inspiring media experiences reflecting five interrelated and symbiotic elements: exposure, message factors, responses, outcomes, and personal/situational factors. The model also identifies theoretical mechanisms underlying the previously observed positive effects. Secondly, the article explores situations in which, and precipitating factors present, when these hoped-for outcomes either fail to materialize or result in negative or maladaptive responses and outcomes. Ultimately, the model is proposed as a heuristic roadmap for future scholarship and as an invitation for critique and collaboration in the emerging field of positive media psychology

Profiling the Audience for Self-Transcendent Media: A National Survey

This article reports the findings from a national survey of self-transcendent (or inspiring) media audience members in the United States. Exposure to self-transcendent content is socially significant because, theoretically, it can orient users towards matters beyond themselves, ultimately promoting connections with others and altruistic behaviors. However, to date, little is known about the daily audiences for such fare. Four primary questions guided the investigation: (1) What are the media sources and contents identified as “inspiring” by the audience?, (2) Who makes up the current U.S. audience for self-transcendent media content?, (3) What personality traits and viewer characteristics are associated with self-transcendent media consumption?, and (4) What prosocial and altruistic behaviors are associated with self-transcendent media consumption? To address these questions, a nationally representative survey (n = 3,006) was conducted. The findings are discussed in relation to the growing body of scholarship on positive media psychology

Exploring the Spirit in U.S. Audiences: The Role of the Virtue of Transcendence in Inspiring Media Consumption

Little is yet known about audiences who routinely seek out media content that is inspirational in nature. The current study expands the research on inspirational media by utilizing a nationally representative sample of U.S. audiences (n = 2,016) to explore relationships between inspiring media exposure, trait transcendence, and self-transcendent emotions. Results show that media content is a reliable source for everyday self-transcendent emotional experiences in U.S. audiences. These experiences are most frequently encountered by persons with high levels of trait spirituality and gratitude. The profile of U.S. audiences that seek out inspiring media is discussed

Utilization of care among drug resistant epilepsy patients with symptoms of anxiety and depression

AbstractPurposeEpilepsy patients have a significantly higher rate of anxiety and depression than the general population, and psychiatric disease is particularly prevalent among drug resistant epilepsy patients. Symptoms of anxiety and depression might serve as a barrier to appropriate epilepsy care.The aim of this study was to determine if drug resistant epilepsy patients with symptoms of anxiety and/or depression receive different epilepsy management than controls.MethodWe identified 83 patients with drug resistant focal epilepsy seen at the Penn Epilepsy Center. Upon enrollment, all patients completed 3 self-report scales and a neuropsychiatric inventory and were grouped into those with symptoms of anxiety and/or depression and controls. Each patient's medical records were retrospectively reviewed for 1–2 years, and objective measures of outpatient and inpatient epilepsy management were assessed.ResultsAt baseline, 53% (n=43) of patients screened positive for symptoms of anxiety and/or depression. The remaining 47% (n=38) served as controls. Patients with anxiety and/or depression symptoms had more missed outpatient visits per year compared to controls (median 0.84 vs. 0.48, p=0.02). Patients with symptoms of both anxiety and depression were more likely to undergo an inpatient admission or procedure (56% vs. 24%, p=0.02).ConclusionFor most measures of epilepsy management, symptoms of anxiety and/or depression do not alter epilepsy care; however, drug resistant epilepsy patients with anxiety and/or depression symptoms may be more likely to miss outpatient appointments, and those with the highest burden of psychiatric symptoms may be admitted more frequently for inpatient services compared to controls

Self-Transcendent Emotions and Social Media: Exploring the Content and Consumers of Inspirational Facebook Posts

Although a great deal of research has examined the potential negative effects of Facebook, studies also show that Facebook use can lead to various positive effects. This study builds on this positive effects scholarship: together, the two studies presented herein aim to provide an understanding of the inspirational content available on Facebook and the way social media users in the United States encounter, recall, and interact with this content. Results from the quantitative content analysis in Study 1 show that inspirational Facebook posts contain similar frequencies of hope and appreciation of beauty and excellent elicitors when compared with other forms of media and social media. Results from the national survey conducted in Study 2 show that social media users are most often inspired by portrayals of kindness and overcoming obstacles and that Facebook users did not report different sharing behavior as compared with users of other social media sites

Spreading the Good News: Analyzing Socially Shared Inspirational News Content

Past research indicates that people often share awe-inspiring news online. However, little is known about the content of those stories. In this study, more broadly defined “inspirational” articles shared through The New York Times website over a 6-month period were analyzed, with the goals of describing the content and identifying characteristics that might predict inspirationality and measures of retransmission. The results provided a snapshot of content found within inspirational news stories; they also revealed that self-transcendent language use predicted the inspirationality of a news story, as well as how long an article appeared on a most shared list

Inspiration on Social Media: Applying an Entertainment Perspective to Longitudinally Explore Mental Health and Well-Being

The conditions under which social media use impacts well-being and mental health are complex. The current 10-day longitudinal quasi-experiment (student sample, N = 111) applied an entertainment theory lens to explore the effects of active posting and engaging with hedonic or inspiring Facebook content (vs. passive browsing) on young people’s eudaimonic well-being (levels of connectedness to humanity, love, compassion, presence of meaning) and mental health (anxiety and depressive symptoms). The results provide tentative evidence that finding and sharing inspiring content to a Facebook group increased love and compassion toward others over time. It also led to more compassion at the end of the study compared to participants who shared hedonic content. Although we did not find an increase in connectedness and meaningfulness over time for participants sharing content that they found inspiring, the latter also did not take away from those experiences, regardless of how they used it. Similarly, no decrease—but also no increase—in anxiety and depressive symptoms were found over time, regardless of condition. The study stresses the importance of better understanding the content young adults engage with on social media for their mental health and well-being

A comprehensive study of GRB 070125, a most energetic gamma ray burst

We present a comprehensive multiwavelength analysis of the bright, long duration gamma-ray burst GRB 070125, comprised of observations in $\gamma$-ray, X-ray, optical, millimeter and centimeter wavebands. Simultaneous fits to the optical and X-ray light curves favor a break on day 3.78, which we interpret as the jet break from a collimated outflow. Independent fits to optical and X-ray bands give similar results in the optical bands but shift the jet break to around day 10 in the X-ray light curve. We show that for the physical parameters derived for GRB 070125, inverse Compton scattering effects are important throughout the afterglow evolution. While inverse Compton scattering does not affect radio and optical bands, it may be a promising candidate to delay the jet break in the X-ray band. Radio light curves show rapid flux variations, which are interpreted as due to interstellar scintillation, and are used to derive an upper limit of $2.4 \times 10^{17}$ cm on the radius of the fireball in the lateral expansion phase of the jet. Radio light curves and spectra suggest a high synchrotron self absorption frequency indicative of the afterglow shock wave moving in a dense medium. Our broadband modeling favors a constant density profile for the circumburst medium over a wind-like profile ($R^{-2}$). However, keeping in mind the uncertainty of the parameters, it is difficult to unambiguously distinguish between the two density profiles. Our broadband fits suggest that \event is a burst with high radiative efficiency ($> 60$).Comment: 50 pages, 33 figures, sty file included, Appeared in 20 Aug 2008 edition of Astrophysical Journa

Evaluation of EPAS1 variants for association with bovine congestive heart failure [version 1; peer review: 2 approved]

Background: Bovine congestive heart failure (BCHF) has become increasingly prevalent in feedlot cattle in the Western Great Plains of North America. BCHF is an untreatable complex condition involving pulmonary hypertension that culminates in right ventricular failure and death. A protein variant of hypoxia-inducible factor 2 alpha (HIF2α, encoded by the endothelial PAS domain-containing protein 1 gene, EPAS1) was previously reported to be associated with pulmonary hypertension at altitudes exceeding 2,000 m. Our aim was to evaluate EPAS1 haplotypes for association with BCHF in feedlot cattle raised at moderate altitudes (1,200 m). Methods: Paired samples of clinical cases and unaffected controls were collected at four feedlots in Nebraska and Wyoming. Each pair (n =102) was matched for source, pen, breed type, sex, arrival date, and management conditions. Cases were identified by animal caretakers, euthanized, and diagnosis was confirmed at necropsy. Cases were derived from 30 different ranch operations, with the largest source contributing 32. Animals were tested for eight EPAS1 haplotypes encoding 36 possible different diploid combinations. Results: The common, ancestral EPAS1 haplotype encoding HIF2α with alanine (A) at position 606 and glycine (G) at position 610 was equally frequent in cases and controls (0.67). The EPAS1 variant haplotype reported to be associated with disease (encoding threonine (T) at position 606 and serine (S) at position 610) was not enriched in cases compared with controls (0.21 and 0.25, respectively). Frequencies of other EPAS1 haplotypes (e.g., encoding Q270, L362, or G671) were each less than 0.05 overall. McNemar’s test with 45 discordant pairs showed the linked T606/S610 variant was not associated with BCHF (OR = 0.73, CI 0.38 -1.4, p-value = 0.37). Conclusions: HIF2α polypeptide variants were not significantly associated with BCHF in feedlot cattle at moderate altitudes. Thus, a wider search is needed to identify genetic risk factors underlying this disease