Soviet Navy Reactions to the Falkland Islands Conflict

Since 1982 a number of articles concerning the 1982 Falkland Islands conflict have appeared in the naval press of the Soviet Union. One Soviet commentator has described the Falklands conflict as a local war in the South Atlantic

Differential Effects of Word-Repetition Rate on Cognitive Defusion of Believability and Discomfort of Negative Self-Referential Thoughts Postintervention and at One-Month Follow-Up

Objective: The word repetition technique is used in acceptance and commitment therapy as a method of facilitating cognitive defusion from distressing thoughts. The present study conducted a randomised trial to manipulate the rate of word repetition and evaluate its impact on the efficacy of cognitive defusion. Method: Thirty-two participants repeated a self-chosen negative self-evaluative word for 30 seconds at the rates of one word per 0.5-, 1-, or 2-seconds. Visual analogue scales were used to measure the associated levels of believability and discomfort at pre- and immediately postrepetition, and 1 month later. Results: Both believability and discomfort were significantly reduced immediately after word repetition in the 0.5-seconds and 1-second conditions. There was a significantly greater reduction in Discomfort in the 1-second condition in comparison to the 2-second condition. The 1-second condition alone maintained significant reductions in both believability and discomfort at 1-month follow up. Conclusion: Differences in the cognitive defusion of distressing thoughts appear to be influenced by word repetition rate with repetition rates of one word per 0.5 and 1 seconds somewhat more effective for treating distressing private experiences associated with problem words

Risk factors associated with biochemically detected and hospitalised acute kidney injury in patients prescribed renin angiotensin system inhibitors

Acknowledgments: The authors would like to thank Claire MacDonald from NHS Greater Glasgow and Clyde Safe Haven for technical assistance with the project. Funding: This work was funded by the Chief Scientist Office Scotland (grant HICG/1/1)Peer reviewedPostprin

Comparing uptake across breast, cervical and bowel screening at an individual level:a retrospective cohort study

Funding: CR-UK through its National Awareness & Early Diagnosis Initiative C9227/A17676.Background We investigated demographic and clinical predictors of lower participation in bowel screening relative to breast and cervical screening. Methods Data linkage study of routinely collected clinical data from 430,591 women registered with general practices in the Greater Glasgow & Clyde Health Board. Participation in the screening programmes was measured by attendance at breast or cervical screening or the return of a bowel screening kit. Results 72.6% of 159,993 women invited attended breast screening, 80.7% of 309,899 women invited attended cervical screening and 61.7% of 180,408 women invited completed bowel screening. Of the 68,324 women invited to participate in all three screening programmes during the study period, 52.1% participated in all three while 7.2% participated in none. Women who participated in breast (OR = 3.34 (3.21, 3.47), p < 0.001) or cervical (OR = 3.48 (3.32, 3.65), p < 0.001) were more likely to participate in bowel screening. Conclusion Participation in bowel screening was lower than breast or cervical for this population although the same demographic factors were associated with uptake, namely lower social deprivation, increasing age, low levels of comorbidity and prior non-malignant neoplasms. As women who complete breast and cervical are more likely to also complete bowel screening, interventions at these procedures to encourage bowel screening participation should be explored.Publisher PDFPeer reviewe

Healthcare disparities for women hospitalised with myocardial infarction and angina

Ischaemic heart disease persists as the leading global cause of death. Myocardial infarction (MI) accounts for a large proportion of death due to cardiovascular disease. Between 2007 and 2016, age-sex standardised mortality for MI in Scotland has fallen by 42.5% from 129 to 74 per 100,000 population – a trend also apparent in other countries. Despite improvements in survival, considerable disparities exist according to sexin terms of delivery of guideline-recommended treatments and outcomes following MI suggesting women may be disadvantaged. Use of high-sensitivity troponin assays with sex-specific thresholds increases the detection of MI in women. However, women are less likely to undergo percutaneous coronary revascularisation (PCI) and are more often subject to underutilisation of evidence-based secondary preventative pharmacotherapy. Differences in adoption of invasive management may, in part, be explained by a perception held by clinicians and patients that outcomes are worse for women receiving PCI, as well as differences in symptoms and baseline risk profile which may impact clinical decision-making. Adverse events post-MI, including cardiogenic shock, heart failure and death, remain more common in women than in men, most notably in those with ST-elevation myocardial infarction (STEMI). Whether sex remains an independent predictor of adverse events despite adjustments for the higher risk-profile of women, notably age, is less clear. We hypothesised that sex-related differences in demographics and comorbidity underpin disparities in management and outcomes of women and men hospitalised with MI or angina. We investigated this hypothesis by analysis of a contemporary secondary care electronic registry (e-Registry) using electronic patient records (EPRs) for patients admitted to a complex regional healthcare network.PostprintPeer reviewe

Consultant-led UK paediatric palliative care services: Professional configuration, services, funding

Objectives: To systematically gather information on the professional team members, services provided, funding sources and population served for all consultant-led specialised paediatric palliative care (SPPC) teams in the UK. Methods: Two-part online survey. Results: Survey 1: All 17 medical leads from hospital-based or hospice-based SPPC teams responded to the survey (100% response rate). Only six services met the NICE guidance for minimum SPPC team. All services reported providing symptom management, specialist nursing care, end-of-life planning and care, and supporting discharges and transfers to home or hospice for the child's final days-hours. Most services also provided care coordination (n=14), bereavement support (n=13), clinical psychology (n=10) and social work-welfare support (n=9). Thirteen had one or more posts partially or fully funded by a charity. Survey 2: Nine finance leads provided detailed resource/funding information, finding a range of statutory and charity funding sources. Only one of the National Health Service (NHS)-based services fully funded by the NHS. Conclusions: One-third of services met the minimum criteria of professional team as defined by NICE. Most services relied on charity funding to fund part or all of one professional post and only one NHS-based service received all its funding directly from the NHS

Screening Women in Glasgow: Comparing uptake across cancer screening programmes at an individual patient level

Introduction Population-based screening has been shown to reduce cancer specific mortality. Within Scotland, three national screening programmes exist: breast, cervical and bowel. Despite being a common and preventable form of cancer, the uptake for bowel cancer screening among women lags behind that for breast and cervical cancer. Objectives and Approach Since the benefits of screening accrue with participation, it is important to understand why differences in screening uptake exist. In this study, data on women aged 24-74 in the Greater Glasgow and Clyde Health Board, invited to take part in one or more screening programme during the period 2009-2013, were linked to demographic and medical data. Uptake was determined based on the presence of a screening attendance or result; the impact of age, deprivation and co-morbidity on uptake was determined using logistic regression for each individual programme, and for the cohort of women invited to participate in all three programmes. Results Overall, 430,591 women were invited to take part in one or more screening programme during the study period. The uptake for bowel screening was, at 61.7%, lower than that seen in either the breast (72.6%) or cervical (80.7%) programme. Despite these differences, the same demographic factors were associated with uptake of each individual screening programme: older women and those living in affluent areas were most likely to attend. Medical factors did differentially influence uptake, those with multi-morbid illness being less likely to participate in breast and bowel, but not the cervical programme. For the 68,324 women invited to participate in all programmes, 52.1% took part in all three while 7.2% participated in none. Conclusion/Implications Uptake of bowel screening was confirmed as lower than uptake of other programmes, although all were similarly impacted by demographic, clinical and socioeconomic factors. Individuals were more likely to complete bowel screening if they participate in another programme, suggesting these may serve as a vehicle for improving bowel screening uptake

End of life care for infants, children and young people (ENHANCE): Protocol for a mixed methods evaluation of current practice in the United Kingdom [version 1; peer review: 2 approved]

Background: Although child mortality has decreased over the last few decades, around 4,500 infants and children die in the UK every year, many of whom require palliative care. There is, however, little evidence on paediatric end-of-life care services. The current National Institute for Health and Care Excellence (NICE) guidance provides recommendations about what should be offered, but these are based on low quality evidence. The ENHANCE study aims to identify and investigate the different models of existing end-of-life care provision for infants, children, and young people in the UK, including an assessment of the outcomes and experiences for children and parents, and the cost implications to families and healthcare providers. Methods: This mixed methods study will use three linked workstreams and a cross-cutting health economics theme to examine end-of-life care models in three exemplar clinical settings: infant, children and young adult cancer services (PTCs), paediatric intensive care units (PICUs), and neonatal units (NNUs). Workstream 1 (WS1) will survey current practice in each setting and will result in an outline of the different models of care used. WS2 is a qualitative comparison of the experiences of staff, parents and patients across the different models identified. WS3 is a quantitative assessment of the outcomes, resource use and costs across the different models identified. Discussion: Results from this study will contribute to an understanding of how end-of-life care can provide the greatest benefit for children at the end of their lives. It will also allow us to understand the likely benefits of additional funding in end-of-life care in terms of patient outcomes

End of life care for infants, children and young people (ENHANCE) : Protocol for a mixed methods evaluation of current practice in the United Kingdom

Background: Although child mortality has decreased over the last few decades, around 4,500 infants and children die in the UK every year, many of whom require palliative care. There is, however, little evidence on paediatric end-of-life care services. The current National Institute for Health and Care Excellence (NICE) guidance provides recommendations about what should be offered, but these are based on low quality evidence. The ENHANCE study aims to identify and investigate the different models of existing end-of-life care provision for infants, children, and young people in the UK, including an assessment of the outcomes and experiences for children and parents, and the cost implications to families and healthcare providers. Methods: This mixed methods study will use three linked workstreams and a cross-cutting health economics theme to examine end-of-life care models in three exemplar clinical settings: infant, children and young adult cancer services (PTCs), paediatric intensive care units (PICUs), and neonatal units (NNUs). Workstream 1 (WS1) will survey current practice in each setting and will result in an outline of the different models of care used. WS2 is a qualitative comparison of the experiences of staff, parents and patients across the different models identified. WS3 is a quantitative assessment of the outcomes, resource use and costs across the different models identified. Discussion: Results from this study will contribute to an understanding of how end-of-life care can provide the greatest benefit for children at the end of their lives. It will also allow us to understand the likely benefits of additional funding in end-of-life care in terms of patient outcomes

Archaeological sites as Distributed Long-term Observing Networks of the Past (DONOP)

The authors would also like to acknowledge the support of the National Science Foundation, specifically the Arctic Social Sciences Program, and RANNIS (The Icelandic Center for Research).Archaeological records provide a unique source of direct data on long-term human-environment interactions and samples of ecosystems affected by differing degrees of human impact. Distributed long-term datasets from archaeological sites provide a significant contribution to establish local, regional, and continental-scale environmental baselines and can be used to understand the implications of human decision-making and its impacts on the environment and the resources it provides for human use. Deeper temporal environmental baselines are essential for resource and environmental managers to restore biodiversity and build resilience in depleted ecosystems. Human actions are likely to have impacts that reorganize ecosystem structures by reducing diversity through processes such as niche construction. This makes data from archaeological sites key assets for the management of contemporary and future climate change scenarios because they combine information about human behavior, environmental baselines, and biological systems. Sites of this kind collectively form Distributed Long-term Observing Networks of the Past (DONOP), allowing human behavior and environmental impacts to be assessed over space and time. Behavioral perspectives are gained from direct evidence of human actions in response to environmental opportunities and change. Baseline perspectives are gained from data on species, landforms, and ecology over timescales that long predate our typically recent datasets that only record systems already disturbed by people. And biological perspectives can provide essential data for modern managers wanting to understand and utilize past diversity (i.e., trophic and/or genetic) as a way of revealing, and potentially correcting, weaknesses in our contemporary wild and domestic animal populations.PostprintPeer reviewe