‘How Belfast got the blues’: Towards an alternative history

This article offers a revisionist history of a key period of Belfast and Northern Ireland’s music scene in the 1960s: the emergence of Them and Van Morrison and the attendant ‘legend’ of the group’s residency in the city’s Maritime Hotel. This formative moment is, somewhat surprisingly, under-explored in popular music studies, and the article seeks to address this relative absence. Van Morrison’s biographies are a vital resource here, and—via discourse analysis—we trace the emergence of a dominant narrative and assess its ideological implications, before moving on to analyse Them’s breakthrough single and related promotional materials. In so doing, we connect the scene that the group both emerged from and represented, to broader popular musical trends, as well as considering how the story of Them’s emergence is supported and framed in contemporary heritage initiatives. The article argues that the myth of Them, Morrison and the Maritime has obscured other ways of approaching the period, and we conclude with a counterhistory by considering an earlier blues/jazz scene in the city and how this might shape an orthodox narrative

Health optimisation for patients with obesity before elective orthopaedic surgery: a qualitative study of professionals’ views on restrictive approaches and future practice

Background: Preoperative health optimisation for elective surgery entails supporting patients to improve their health in preparation for their treatment and recovery. While there is consensus that this process should address obesity, approaches vary across England. Despite guidance from the National Institute for Health and Care Excellence to the contrary, restrictive approaches with body mass index thresholds for referral to arthroplasty are in use. This qualitative study aimed to investigate the views of professionals on the current use and future implications of these policies. Methods: Semi-structured interviews were conducted with 20 professionals including clinicians, commissioners, policymakers, and health service managers, with experience of developing and/or implementing health optimisation policies for elective arthroplasty. Participants were sampled from areas in England with and without restrictive policies. We undertook thematic analysis of the interview data. Results: Participants described pre-surgical health optimisation as an important trigger for health improvement but identified current resourcing and inadequacies in provision of weight management support as significant barriers to success. Participants expressed concerns about the appropriateness and fairness of including obesity as a determinant to restrict access to surgery. They described short-term financial pressures underlying the use of restrictive body mass index thresholds and a lack of an evidence base, such that policies amounted to rationing and risked exacerbations of health inequalities. The study identified four priorities for improvements to future health optimisation practices: developing and implementing national guidance with flexibility for local variation, initiating patient engagement in primary care with onward integration across all services, improving resourcing to support effective equitable impact, and addressing wider determinants of obesity through societal change. Conclusions: Overall, participants had limited expectations of the impact of health optimisation policies on obesity without additional support, investment, and national guideline implementation. They raised strong concerns over current restrictive approaches. We conclude that addressing concerns around weight management support service availability and impacts on health inequalities is essential for shaping effective health optimisation policies. Future policy direction should support health optimisation to be offered early (ideally in primary care). Health optimisation interventions should be non-restrictive, inclusive, and well-monitored, particularly around equality impact

E-Health for Individualized Prevention of Eating Disorders

In the field of illness prevention, it is becoming increasingly important that effective treatments be broadly disseminated and easily accessible to large populations located over wide geographical areas. The internet offers many opportunities to improve illness prevention and has become an important tool for both providers and users. An increasing number of users are looking for help on web-pages, in forums and chat rooms, to access information and exchange experiences with other users or counselors. Appetite for Life is an Internet-based program for the prevention of eating disorders (ED) in college students. It provides individualized support to students at-risk of developing an ED. Depending on initial screening results, specific program modules are recommended to the user, matching their individual needs. The program contains a web-page with psychoeducational information on ED, an anonymous forum to receive and provide peer support, a supportive monitoring and feedback program and a chat platform, which can be used to communicate with professional counselors and other users. If needed, users can be referred to face-to-face counseling

Epidemiology of adult overweight recording and management by UK GPs:a systematic review

Supplementary Table: Key components of included studies. A table detailing key components of included studies. (PDF 99 kb

Epidemiology of adult overweight recording and management by UK GPs:a systematic review

BackgroundPrimary care guidelines for managing adult overweight/obesity recommend routine measurement of body mass index (BMI) and the offer of weight management interventions. Many studies state that this is rarely done, but the extent to which overweight/obesity is recognised, considered, and documented in routine care has not been determined.AimTo identify the epidemiology of adult overweight documentation and management by UK GPs.Design and settingA systematic review of studies since 2006 from eight electronic databases and grey literature.MethodIncluded studies measured the proportion of adult patients with documented BMI or weight loss intervention offers in routine primary care in the UK. A narrative synthesis reports the prevalence and pattern of the outcomes.ResultsIn total, 2845 articles were identified, and seven were included; four with UK-wide data and three with regional-level data. The proportion of patients with a documented BMI was 58–79% (28–37% within a year). For overweight/obese patients alone, 43–52% had a recent BMI record, and 15–42% had a documented intervention offer. BMI documentation was positively associated with older age, female sex, higher BMI, coexistent chronic disease, and higher deprivation.ConclusionBMI is under-recorded and weight loss interventions are under-referred for primary care adult patients in the UK despite the obesity register in the Quality and Outcomes Framework (QOF). The review identified likely underserved groups such as younger males and otherwise healthy overweight/obese individuals to whom attention should now be directed. The proposed amendment to the obesity register QOF could prompt improvements but has not been adopted for 2017.</jats:sec

A sweeter way of teaching health and safety

The underpinning educational theory for practical work is that of experimental learning or 'learning by and through doing'. Hands-on practical work promotes learning as it provides students with an opportunity to put theory into practice. There are many hazards with practical work, each with an associated risk that students will encounter while they are working in the laboratory and, therefore, adequate instruction should be given before students carry out any practical work. Getting students to engage with this in the past has been difficult due to the dryness of the material. Here we show how every students sweet tooth can be used to teach them risk assessment, experimental design and embedding health and safety as part of their scientific culture

What effect have NHS commissioners’ policies for body mass index had on access to knee replacement surgery in England?:An interrupted time series analysis from the National Joint Registry

ObjectiveTo assess the impact of local commissioners' policies for body mass index on access to knee replacement surgery in England.MethodsA Natural Experimental Study using interrupted time series and difference-in-differences analysis. We used National Joint Registry for England data linked to the 2015 Index of Multiple Deprivation for 481,555 patients who had primary knee replacement surgery in England between January 2009 and December 2019. Clinical Commissioning Group policies introduced before June 2018 to alter access to knee replacement for patients who were overweight or obese were considered the intervention. The main outcome measures were rate per 100,000 of primary knee replacement surgery and patient demographics (body mass index, Index of Multiple Deprivation, independently-funded surgery) over time.ResultsRates of surgery had a sustained fall after the introduction of a policy (trend change of -0.98 operations per 100,000 population aged 40+, 95% confidence interval -1.22 to -0.74, PConclusionsBody mass index policy introduction was associated with decreases in the rates of knee replacement surgery across localities that introduced policies. This affected all patient groups, not just obese patients at whom the policies were targeted. Changes in patient demographics seen after policy introduction suggest these policies may increase health inequalities and further qualitative research is needed to understand their implementation and impact