An evaluation of nursing students' perceptions on the efficacy of high fidelity clinical simulation to enhance their confidence, understanding and competence in managing psychiatric emergencies

Aims: This study aimed to evaluate final year mental health nursing students’ perceptions on the efficacy of using immersive high fidelity simulation to enhance their confidence, understanding and competence in managing psychiatric emergencies

Impact of glass shape on time taken to drink a soft drink: A laboratory-based experiment.

BACKGROUND: Glassware design may affect drinking behaviour for alcoholic beverages, with glass shape and size influencing drinking speed and amount consumed. Uncertainty remains both about the extent to which these effects are restricted to alcohol and the underlying mechanisms. The primary aim of the current study was to examine the effect of differently shaped glasses on time taken to drink a soft drink. The secondary aim was to develop hypotheses about mechanisms concerning micro-drinking behaviours and perceptual effects. METHOD: In a single-session experiment, 162 participants were randomised to receive 330ml of carbonated apple juice in a glass that was either inward-sloped, straight-sided, or outward-sloped. The primary outcome measure was total drinking time. Secondary outcome measures included micro-drinking behaviours (sip size, sip duration, interval duration), and perceptual measures (midpoint bias, drink enjoyment). RESULTS: Participants drank 21.4% faster from the outward-sloped glass than from the straight-sided glass [95%CI: 0.2%,38.0%] in adjusted models. They were also 18.2% faster from the inward-sloped glass than the straight-sided glass, but this did not reach statistical significance with wide confidence intervals also consistent with slower drinking [95%CI: -3.8%,35.6%]. Larger sips were associated with faster drinking times (Pearson's r(162) = -.45, p < .001). The direction of effects suggested sips were larger from the outward-sloped and inward-sloped glasses, compared to the straight-sided glass (15.1%, 95%CI: -4.3%,38.0%; 19.4%, 95%CI: -0.5%,43.6%, respectively). There were no significant differences between glasses in mean sip or interval duration. Bias in midpoint estimation was greater for the outward-sloped glass (12.9ml, 95%CI: 6.6ml,19.2ml) than for the straight-sided glass, although the degree of bias was not associated with total drinking time (Pearson's r(162) = 0.01, p = .87). DISCUSSION: Individuals drank a soft drink more quickly from an outward-sloped glass, relative to a straight-sided glass. Micro-drinking behaviours, such as sip size, are promising candidates for underlying mechanisms

Glassware design and drinking behaviours: a review of impact and mechanisms using a new typology of drinking behaviours.

Much of the global burden of disease is attributable to unhealthy behaviour, including excessive consumption of alcohol and sugar-sweetened beverages. Developing effective methods to change these drinking behaviours could inform policies to improve population health. In line with an increasing interest in environmental-level interventions - i.e., changing the environment in which a behaviour occurs in order to change the behaviour of interest - this review first describes the existing evidence of the impact of glassware design (including capacity and shape) on drinking behaviours (e.g., at the 'micro' level - including sip size, as well as at the macro level - including amount consumed). The roles of two sets of possible underlying mechanisms - perception and affordance - are also explored. Finally, this review sets out a provisional typology of drinking behaviours to enable more systematic approaches to the study of these behaviours. While there is a paucity of evidence - in particular on measures of consumption - this growing evidence base suggests promising targets for novel interventions involving glassware design to reduce the consumption of drinks that harm health.Trial registration: ISRCTN.org identifier: ISRCTN10456720

Communicating evidence about the environment's role in obesity and support for government policies to tackle obesity: a systematic review with meta-analysis.

Public support for many policies that tackle obesity by changing environments is low. This may reflect commonly held causal beliefs about obesity, namely that it is due to failures of self-control rather than environmental influences. Several studies have sought to increase public support by changing these and similar causal beliefs, with mixed results. The current review is the first systematic synthesis of these studies. Searches of PsycInfo, Medline, Web of Science, Scopus, and Open Grey yielded 20 eligible studies (N = 8977) from 11,776 abstracts. Eligible studies were controlled experiments with an intervention group that communicated information about the environment's role in obesity, and a measure of support for environment-based obesity policies. The protocol was prospectively registered on PROSPERO. Meta-analyses showed no evidence that communicating information about the environment's influence on obesity changed policy support or the belief that the environment influences obesity. A likely explanation for this null effect is the ineffectiveness of interventions that were designed to change the belief that the environment influences obesity. The possibility remains, however, that the association observed between beliefs about the causes of obesity and attitudes towards obesity policies is correlational and not causal

Order of meals at the counter and distance between options affect student cafeteria vegetarian sales

Altering the order in which meals are presented at cafeteria counters has been proposed as a way of lowering meat consumption, but remains largely untested. To address this, we undertook two experimental studies involving 105,143 meal selections in the cafeterias of a British university. Placing vegetarian options first on the counter consistently increased their sales when choices were widely separated (>1.5 m; vegetarian sales as a percentage of total meal sales increased by 4.6 and 6.2 percentage points) but there was no evidence of an effect when the options were close together (<1.0 m). This suggests that order effects depend on the physical distance between options.This work was supported by E.E.G.’s NERC studentship grant number NE/L002507/1 and A.B.’s Royal Society Wolfson Research Merit awar

A prospective cohort study measuring cost-benefit analysis of the Otago Exercise Programme in Community Dwelling Adults with Rheumatoid Arthritis

Det er en sammenheng mellom bachelorstudentenes karakterpoeng fra videregående skole og resultater til eksamen i anatomi, fysiologi, biokjemi (AFB). Enkelte studenter med lavere opptakskarakterer enn landsgjennomsnittet oppnådde bedre eksamensresultat enn det nasjonale gjennomsnittsresultatet i AFB for 2016. Hensikten med studien var å undersøke hvordan bachelorstudenter i sykepleie med lave opptakspoeng og gode eksamensresultater i AFB lærte og tilegnet seg emnet. Studien har et kvalitativ forskningsdesign og det ble gjennomført semistrukturerte intervju av 12 bachelorstudenter i sykepleie, som ble analysert ved hjelp av innholdsanalyse. Funnene er beskrevet ut fra tre hovedkategorier: A) Relevansen til sykepleieryrket styrker læring, B) tilhørighet har betydning for læring, og C) læring skjer i samarbeid med andre. Vi fant at studentene lærte AFB mer inngående i samhandling med andre studenter. Samlinger på campus er viktig for studenters læring, til tross for at det er stort fokus på fleksible utdanninger og digitale pedagogiske metoder. Selvstendig arbeid kombinert med læring i et sosialt studentfellesskap, oppgis som motivasjonsfaktorer til målrettet arbeid med studiene. Studentene erfarer mestringsforventning, i et miljø som preges av anerkjennelse og samtidig gir opplevelse av tilhørighet. Studentene vektlegger studienes relevans sett i lys av det profesjonsyrket som de utdanner seg til, som en betydningsfull motivasjonsfaktor for læring.publishedVersio

The theoretical and practical determination of clinical cut-offs for the British Sign Language versions of PHQ-9 and GAD-7.

BACKGROUND: The PHQ-9 and the GAD-7 assess depression and anxiety respectively. There are standardised, reliability-tested versions in BSL (British Sign Language) that are used with Deaf users of the IAPT service. The aim of this study is to determine their appropriate clinical cut-offs when used with Deaf people who sign and to examine the operating characteristics for PHQ-9 BSL and GAD-7 BSL with a clinical Deaf population. METHODS: Two datasets were compared: (i) dataset (n = 502) from a specialist IAPT service for Deaf people; and (ii) dataset (n = 85) from our existing study of Deaf people who self-reported having no mental health difficulties. Parameter estimates, with the precision of AUC value, sensitivity, specificity, positive predicted value (ppv) and negative predicted value (npv), were carried out to provide the details of the clinical cut-offs. Three statistical choices were included: Maximising (Youden: maximising sensitivity + specificity), Equalising (Sensitivity = Specificity) and Prioritising treatment (False Negative twice as bad as False Positive). Standard measures (as defined by IAPT) were applied to examine caseness, recovery, reliable change and reliable recovery for the first dataset. RESULTS: The clinical cut-offs for PHQ-9 BSL and GAD-7 BSL are 8 and 6 respectively. This compares with the original English version cut-offs in the hearing population of 10 and 8 respectively. The three different statistical choices for calculating clinical cut-offs all showed a lower clinical cut-off for the Deaf population with respect to the PHQ-9 BSL and GAD-7 BSL with the exception of the Maximising criteria when used with the PHQ-9 BSL. Applying the new clinical cut-offs, the percentage of Deaf BSL IAPT service users showing reliable recovery is 54.0 % compared to 63.7 % using the cut-off scores used for English speaking hearing people. These compare favourably with national IAPT data for the general population. CONCLUSIONS: The correct clinical cut-offs for the PHQ-9 BSL and GAD-7 BSL enable meaningful measures of clinical effectiveness and facilitate appropriate access to treatment when required

The community mental health team fidelity scale: A measure of program fidelity of social networks interventions for severe mental illness

Open dialogue (OD) is a multi-component therapeutic and organizational intervention for crisis and continuing community mental health care with a therapeutic focus on clients’ social networks. The development and implementation of this model of care in the United Kingdom requires considerable contextual adaptations which need to be assessed to support effective implementation. Program fidelity–the extent to which core components of an intervention are delivered as intended by an intervention protocol at all levels–is crucial for these adaptations. Aims: To develop, pilot, and implement a program fidelity measure for community mental health services providing OD and ‘treatment as usual’ (TAU) or standard NHS crisis and community care. Methods: Measure structure, content, and scoring were developed and refined through an iterative process of discussion between the research team and OD experts. Measure was piloted in the 6 OD and 6 TAU services participating in a large-scale research program. Results: Initial data suggests that the Community Mental Health Team Fidelity Scale (COM-FIDE) is a potentially reliable and feasible measure of the fidelity of community mental health services and specific OD components of such services

The contributions of family care-givers at end of life: A national post-bereavement census survey of cancer carers' hours of care and expenditures.

BACKGROUND: Family members provide vital care at end of life, enabling patients to remain at home. Such informal care contributes significantly to the economy while supporting patients' preferences and government policy. However, the value of care-givers' contributions is often underestimated or overlooked in evaluations. Without information on the activities and expenditures involved in informal care-giving, it is impossible to provide an accurate assessment of carers' contribution to end-of-life care. AIM: The aim of this study was to investigate the contributions and expenditure of informal, family care-giving in end-of-life cancer care. DESIGN: A national census survey of English cancer carers was conducted. Survey packs were mailed to 5271 people who registered the death of a relative to cancer during 1-16 May 2015. Data were collected on decedents' health and situation, care support given, financial expenditure resulting from care, carer well-being and general background information. RESULTS: In all, 1504 completed surveys were returned (28.5%). Over 90% of respondents reported spending time on care-giving in the last 3 months of the decedent's life, contributing a median 69 h 30 min of care-giving each week. Those who reported details of expenditure (72.5%) spent a median £370 in the last 3 months of the decedent's life. CONCLUSION: Carers contribute a great deal of time and money for day-to-day support and care of patients. This study has yielded a unique, population-level data set of end-of-life care-giving and future analyses will provide estimates of the economic value of family care-givers' contributions