Offenders’ perceptions of the UK prison smoking ban

Purpose Despite overall reductions in levels of smoking in the UK, rates of offender smoking remain high. In 2016, it was announced that prisons in England and Wales would gradually introduce a smoking ban. The purpose of this paper is to explore offenders’ perceptions around the upcoming smoking ban. Design/methodology/approach A total of eight focus groups were conducted in four prisons across the North of England. Both smoking and non-smoking offenders participated in the focus groups, and thematic analysis was used to explore the findings. Findings Themes generated from the data were “freedom and rights”, “the prison environment” and “guiding support”. Participants discussed how the smoking ban was viewed as a punishment and restricted their freedom, with perceptions as to why the ban was being implemented centring around others trying to control them. Participants expressed concerns around the financial implications of the smoking ban on already stretched prison resources. Participants also recommended improving the nicotine replacement therapy on offer, and increasing the range of leisure activities within the prison to prepare for the smoking ban. Originality/value Overall, it was apparent that participants’ awareness of the smoking ban was generally poor. It is recommended that offenders need to be made more aware of the smoking cessation support they will receive and given the opportunity to ask questions about the smoking ban. Increasing offenders’ awareness of the ban may reduce stress associated with a perceived lack of choice around their smoking behaviours

Challenging the Clostridium botulinum toxin type A (BoNT/A) with a selection of microorganisms by culture methods and extended storage of used vials to assess the loss of sterility

In 2002, botulinum toxin type A (BoNT/A) was approved by the US Food and Drug Administration (FDA) for cosmetic use. However, there may be procedural differences between the ways in which a clinician handles, applies and stores the product compared to the suggested guidelines of the manufacturer for handling and storage. To this end vials (N = 12) of BoNT/A were tested for the incidence of microbial contamination followed by challenging the product with a selection of microorganisms by culture methods and by using a calcein release assay to contaminate multi-dose vials at the single concentration used for facial aesthetics. A culture, droplet method was used to count microorganisms challenged with the therapeutic product and to compare viability levels in appropriate controls as well as measuring their lytic properties via an existing cell-free system involving calcein release. Counts of test organisms within the droplets, with the product and the controls without the product were undertaken using Image J software. The result from the incidence of in-vial contamination was inconclusive. Bacterial levels between controls and product challenged groups demonstrated no differences in the growth of viable microorganisms following immediate contact (p = ≥ 0.05). The cell-free calcein release assay demonstrated differences at all time points for low levels of lysis in each case with bacterial lipid extract and were statistically significant (p = 0.011). Although these data appear to correlate with the minimum inhibitory concentration, the additives and vial integrity are also likely to contribute to the maintenance of BoNT/A sterility

Implementing Shared Decision-Making: Consider All the Consequences

The ethical argument that shared decision-making is “the right” thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The goal of this article is to hypothesize a wider set of consequences, that apply over an extended time horizon, and include outcomes at interactional, team, organizational and system levels, and to call for future research to study these possible consequences

Development of a technique for predicting the human response to an emergency situation

This paper presents development work on a new approach for predicting the human response to an emergency situation. The study builds upon an initial investigation in which 20 participants were asked to predict what actions they would take in the event of a domestic fire [1]. The development work involved a retest with an additional 20 participants to investigate the reliability of the approach. Furthermore, the analysis procedure was improved such that the results represented more accurately those which could be obtained from practical application of the approach. As found in the initial investigation, the frequencies and sequences of the reported acts had significant relationships with a study of behavior in real fires [2] (Spearman’s rho: 0.323, N=55, p<0.05) and (Spearman’s rho: 0.340, N=37, p<0.05), respectively. Further development work is required, but the results indicate that the approach may have use for predicting human behavior in emergencies

Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at ‘Self Help Services’

Objectives: There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. Setting: ‘Self Help Services’, an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. Participants: 1068 service users referred to the service for secondary care for their mental health difficulties. Interventions: Participants were triaged into one of three eTherapy programmes: ‘Living Life to the Full Interactive’ for low mood, stress and anxiety; ‘Sleepio’ for insomnia; and ‘Breaking Free Online’ for substance misuse, depending on clinical need. Primary outcomes measures: Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment. Results: Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, p&lt;0.0001; anxiety CI 077 to 1.72, p&lt;0.0001) and Sleepio (depression CI 1.19 to 4.52, p&lt;0.0001; anxiety CI 2.16 to 5.23, p&lt;0.0001) groups. Promising improvements in mental health scores were found within all three groups (all p&lt;0.0001), as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties (p&lt;0.0001). Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online. Conclusion: Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services

The longitudinal association between external locus of control, social cognition and adolescent psychopathology

Purpose To investigate the longitudinal associations between social cognitive ability an external locus of control (externality) and adolescent psychopathology. Methods 7058 participants from a prospective population-based cohort provided data on externality, social communication and emotion perception between 7 to 16 years and psychotic experiences and depressive symptoms at 12 and 18 years. Bivariate probit modelling was used to investigate associations between these risk factors and psychopathological outcomes. Results Externality was associated with psychopathology at 12 (psychotic experiences OR1.23 95%CI 1.14,1.33; depression OR1.12 95%CI 1.02,1.22) and 18 years (psychotic experiences OR1.38 95% CI1.23,1.55; depression OR1.40 95% CI1.28,1.52). Poor social communication was associated with depression at both ages (12 years OR1.22 95%CI 1.11,1.34; 18 years OR1.21 95%CI 1.10,1.33) and marginally associated with psychotic experiences. There was marginal evidence of a larger association between externality and psychotic experiences at 12 years (p=0.06) and between social communication and depression at 12 years (p=0.03). Conclusions Externality was more strongly associated with psychotic experiences. At 18 years change in externality between 8 and 16 years was associated with a larger increase in the risk of depression. Poor social communication was more strongly associated with depression

Systematic review and meta-analysis of serotonin transporter genotype and discontinuation from antidepressant treatment

AbstractThere is evidence that 5-HTTLPR is associated with response following treatment from selective serotonin reuptake inhibitors (SSRIs). The short (S) allele has reduced serotonin transporter expression, compared to the long (L) allele, and has been reported to be associated with poorer response in Europeans, with the effect in other populations unclear. However the published literature is inconsistent. A systematic review and meta-analysis was performed to investigate the effect of 5-HTTLPR on discontinuation from antidepressant treatment. Data were obtained from 17 studies including 4309 participants. The principal outcome measure was the allelic odds ratio (OR) for the 5-HTTLPR S allele and discontinuation status. A random effects meta-analysis provided no evidence that the S allele was associated with increased odds of discontinuation from SSRIs in Europeans (OR 1.09, 95% CI 0.83–1.42, p=0.53; 10 studies, n=2504) but in East Asians there was evidence of a reduced odds of discontinuation (OR 0.28, 95% CI 0.12–0.64, p=0.002; 2 studies, n=136). There was a suggestion of small study bias (p=0.05). This meta-analysis provides no evidence of an association between 5-HTTLPR and discontinuation from antidepressant treatment in Europeans. The low number of studies in East Asian samples using SSRIs reduces confidence in our evidence that the S allele decreases the odds of discontinuation in this population. At present, there is no evidence of an association between 5-HTTLPR and discontinuation from SSRI treatment in a European population with further studies required to investigate its effects in different populations

Physiological Indicators of Task Demand, Fatigue, and Cognition in Future Digital Manufacturing Environments

As Digital Manufacturing transforms traditionally physical work into more system-monitoring tasks, new methods are required for understanding people's mental workload and prolonged capacity for focused attention. Many physiological measures have shown promise for detecting changes in cognitive state, and recent advances in sensor technology offer minimally-invasive ways to monitor our cognitive activity. Previous research in functional near-infrared spectroscopy, for example, has observed changes in cerebral hemodynamic response during periods of high demand within tasks. This work investigated the relationships among task demand, fatigue, and attention degradation in a sustained attention task, and their effect on heart rate, breathing rate, nose temperature and hemodynamic response in the prefrontal cortex and middle temporal gyrus. Analysis revealed a small but significant effect of fatigue on heart rate relative to baseline, breathing rate and hemodynamic response. Task demand had a small but significant effect on breathing rate and nose temperature, both relative to baseline, but no difference between levels of demand was observed in heart rate or hemodynamic response. Our results provide insight into what physiological data can tell us about cognitive state, ability to focus, and the impact of fatigue over time

Perinatal maternal life events and psychotic experiences in children at twelve years in a birth cohort study

Background: International studies indicate that the median prevalence of psychotic experiences in children is 7%. It has been proposed that environmental stress during pregnancy may affect the neurodevelopment of the foetus and lead to a vulnerability in the child to later stressors and psychopathology.Aim: In this study we explore the relationship between environmental stress during pregnancy and psychotic experiences in children in the general population at 12 years.Methods: We analysed a birth cohort of 5038 children from the Avon Longitudinal Study of Parents and Children. Environmental stress was measured as life event exposure. Data on life events were collected on women during their pregnancy, whilst psychotic experiences in the offspring were assessed at age 12.Results: There was a weak association between maternal exposure to life events and psychotic experiences at twelve years (crude OR 1.10 95% CI 1.02–1.18) per quartile of life event score. This association was not reduced after adjustment for socio-economic status, family history of schizophrenia, maternal education or birth weight but after adjustment for maternal anxiety and depression and smoking in early pregnancy there was no longer any evidence for an association (OR 1.01 95% CI 0.93–1.10).Conclusion: This study provides some evidence to suggest that stressful life events may affect child psychotic experiences through effects on maternal psychopathology, and possibly physiology, during pregnancy

The efficacy of protein supplementation during recovery from muscle-damaging concurrent exercise

This study investigated the effect of protein supplementation on recovery following muscle-damaging exercise, which was induced with a concurrent exercise design. Twenty-four well-trained male cyclists were randomised to three independent groups receiving 20 g protein hydrolysate, iso-caloric carbohydrate or low-calorific placebo supplementation, per serve. Supplement serves were provided twice daily, from the onset of the muscle-damaging exercise, for a total of four days and in addition to a controlled diet (6 g·kg-1·d-1 carbohydrate, 1.2 g·kg-1·d-1 protein, remainder from fat). Following the concurrent exercise session at time-point 0 h; a simulated high-intensity road cycling trial and 100 drop-jumps, recovery of outcome measures was assessed at 24, 48 and 72 h. The concurrent exercise protocol was deemed to have caused exercise-induced muscle damage (EIMD), owing to time effects (p0.05) were observed for any of the outcome measures. The present results indicate that protein supplementation does not attenuate any of the indirect indices of EIMD imposed by concurrent exercise, when employing great rigour around the provision of a quality habitual diet and the provision of appropriate supplemental controls