Prevalence of deliberate self harm and attempted suicide within contemporary Goth youth subculture: longitudinal cohort study

<b>Objective</b> To investigate whether deliberate self harm is associated with contemporary Goth youth subculture. <b>Design</b> Longitudinal cohort study. <b>Setting</b> School and community based study of young people living in the Central Clydeside Conurbation, Scotland. <b>Participants</b> 1258 people aged 19, surveyed in 2002-4 and followed-up since age 11 (1994). <b>Main outcome measures</b> Lifetime prevalence of self harm and attempted suicide and their association with Goth youth subculture, before and after adjusting for confounders. <b>Results</b> Identification as belonging to the Goth subculture was strongly associated with lifetime self harm and attempted suicide, with a prevalence of 53% and 47%, respectively among the most highly identified group, and evidence for a dose-response relation. Adjusting for potential confounders did not significantly attenuate this association. Analysis of other youth subcultures showed that this effect was primarily associated with Goth subculture. <b>Conclusions</b> Identification as belonging to the Goth subculture was the best predictor of self harm and attempted suicide. Although based on small numbers, additional longitudinal analysis suggests both selection and modelling mechanisms are involved, selection mechanisms possibly being more likely

Patient reactions to a web-based cardiovascular risk calculator in type 2 diabetes: a qualitative study in primary care.

Use of risk calculators for specific diseases is increasing, with an underlying assumption that they promote risk reduction as users become better informed and motivated to take preventive action. Empirical data to support this are, however, sparse and contradictory

Public acceptability of road pricing

Final report, Department for Transpor

Value of risk scores in the decision to palliate patients withruptured abdominal aortic aneurysm

Background: The aim of this study was to develop a 48‐h mortality risk score, which included morphology data, for patients with ruptured abdominal aortic aneurysm presenting to an emergency department, and to assess its predictive accuracy and clinical effectiveness in triaging patients to immediate aneurysm repair, transfer or palliative care. Methods: Data from patients in the IMPROVE (Immediate Management of the Patient With Ruptured Aneurysm: Open Versus Endovascular Repair) randomized trial were used to develop the risk score. Variables considered included age, sex, haemodynamic markers and aortic morphology. Backwards selection was used to identify relevant predictors. Predictive performance was assessed using calibration plots and the C‐statistic. Validation of the newly developed and other previously published scores was conducted in four external populations. The net benefit of treating patients based on a risk threshold compared with treating none was quantified. Results: Data from 536 patients in the IMPROVE trial were included. The final variables retained were age, sex, haemoglobin level, serum creatinine level, systolic BP, aortic neck length and angle, and acute myocardial ischaemia. The discrimination of the score for 48‐h mortality in the IMPROVE data was reasonable (C‐statistic 0·710, 95 per cent c.i. 0·659 to 0·760), but varied in external populations (from 0·652 to 0·761). The new score outperformed other published risk scores in some, but not all, populations. An 8 (95 per cent c.i. 5 to 11) per cent improvement in the C‐statistic was estimated compared with using age alone. Conclusion: The assessed risk scores did not have sufficient accuracy to enable potentially life‐saving decisions to be made regarding intervention. Focus should therefore shift to offering repair to more patients and reducing non‐intervention rates, while respecting the wishes of the patient and family

Patterns of initiation in the poetry of Ted Hughes from 1970 to 1980

This study seeks to give a close reading of the poems in the major sequences by Ted Hughes published since 1970. The consideration of the poems centres upon the influence of initiatory religious patterns and their mythologies upon the poet's work. A key to such initiatory patterns is the primitive religious phenomenon known as shamanism. The first chapter of the thesis charts evidence of Hughes's fascination with shamanic practice and shows its pervasive and central influence from early poems such as 'Jaguar' right up to the pivotal work of Caudate. In chapters on each of the three volumes preceding Gaudete Hughes is shown as being preoccupied with shamanic questions rather than with the answers that a fully initiated shaman is able to give. Crow takes its protagonist to the very threshold of initiation, as does Prometheus on his Crag, but the need for the contextualization of the abstract experiences in the poems becomes very clear. Cave Birds is an attempt to introduce a coda of the realities of common human experience, but it is not until Gaudete that the strong mythological element in Hughes's work is disciplined into a greater, though flawed, whole. More and more Hughes seeks to transform the profane experience of our present life into a perception of the sacred. In Gaudete Lumb fails to do this with the rituals of his personal fertility cult and those around him are killed or emotionally damaged. But he himself is radically changed. The Epilogue Poems of Gaudete reflect this change and point the way away from a poetic reliance on the mechanisms of mythology to a living out of ritual in the poetry itself. Both 'Moortown' and Remains of Elmet exemplify this development in their perception of the sacredness of Nature. By Adam and the Sacred Nine the mythological element can now be presented yoked in a balanced way to the sensitivity of the poetry

The impact of Behçet's disease on intimate relationships in women: A qualitative study.

OBJECTIVE: Behçet's disease is a rare and incurable condition where the body's immune system attacks healthy tissue. Behçet's can cause blood clots and ulcerations to form in every organ and system in the body, including deep and painful genital ulceration. The psychological impact of the disease on intimacy and relationships is unexplored. This study aimed to explore how the disease impacts on female patients' intimate partner relationships. METHODS: Participants were seven female, UK patients with Behçet's disease who were in committed relationships. In depth, semi-structured interviews lasting approximately 80 minutes were conducted via video conferencing about participants' sexual functioning and intimate relationships. Data was analysed using Interpretative Phenomenological Analysis. RESULTS: Patients' sexual relationships and intimacy were impacted by issues due to lack of knowledge of symptoms (misdiagnosis of herpes), issues due to symptoms (genital manifestations, painful sex, exhaustion), difficulties communicating with medical professionals, medication, partner support, and support from fellow Behçet's patients. DISCUSSION: Female Behçet's patients are at risk of developing psychological problems with intimacy due to symptoms, lack of knowledge of symptoms, and negative impacts of medication. Intimacy needs to be discussed in medical consultations so these issues can be addressed before a lack of intimacy negatively impacts relationships

Changes in the socio-demographic patterning of late adolescent health risk behaviours during the 1990s: analysis of two West of Scotland cohort studies

Background: Substance use and sexual risk behaviour affect young people's current and future health and wellbeing in many high-income countries. Our understanding of time-trends in adolescent health-risk behaviour is largely based on routinely collected survey data in school-aged adolescents (aged 15 years or less). Less is known about changes in these behaviours among older adolescents. Methods: We compared two cohorts from the same geographical area (West of Scotland), surveyed in 1990 and 2003, to: describe time-trends in measures of smoking, drinking, illicit drug use, early sexual initiation, number of opposite sex sexual partners and experience of pregnancy at age 18-19 years, both overall and stratified by gender and socioeconomic status (SES); and examine the effect of time-trends on the patterning of behaviours by gender and SES. Our analyses adjust for slight between-cohort age differences since age was positively associated with illicit drug use and pregnancy. Results: Rates of drinking, illicit drug use, early sexual initiation and experience of greater numbers of sexual partners all increased significantly between 1990 and 2003, especially among females, leading to attenuation and, for early sexual initiation, elimination, of gender differences. Most rates increased to a similar extent regardless of SES. However, rates of current smoking decreased only among those from higher SES groups. In addition, increases in 'cannabis-only' were greater among higher SES groups while use of illicit drugs other than cannabis increased more in lower SES groups. Conclusion: Marked increases in female substance use and sexual risk behaviours have implications for the long-term health and wellbeing of young women. More effective preventive measures are needed to reduce risk behaviour uptake throughout adolescence and into early adulthood. Public health strategies should reflect both the widespread prevalence of risk behaviour in young people as well as the particular vulnerability to certain risk behaviours among those from lower SES groups

Assessing regional patterns of juvenile salmon growth in the Salish Sea

Early marine juvenile growth in Pacific salmon is generally positively correlated with overall survival to reproductive age. In this study, regional patterns of juvenile salmon growth are being analyzed over a two-year period (2012-2013) in the Salish Sea and surrounding waters to better assess juvenile productivity, via growth, in the Salish Sea and surrounding waters to provide us insight into possible mechanisms regulating survival. Insulin-like growth factor-1 (IGF-1), a hormone used to assess instantaneous growth in fishes, including juvenile salmon, was measured in late June and early July of 2012 and 2013 in the Strait of Georgia, Johnstone Strait, Queen Charlotte Strait, and Puget Sound. Juvenile sockeye (Oncorhynchus nerka) and pink salmon (O. gorbuscha) were collected in 2012, whereas juvenile coho (O. kisutch), Chinook (O. tshawytscha), and chum salmon (O. keta) where obtained in both years. In 2012 IGF-1 levels were highest in pink salmon from the Gulf Islands and Puget Sound; this was a unique pattern among the 5 species of juvenile salmon sampled. Coho salmon IGF-1 levels were highest in samples from the Northern Strait of Georgia. Chinook salmon IGF-1 levels were significantly higher in the Strait of Georgia than Puget Sound. The only regions where IGF-1 values were consistently low for three of the four species were Queen Charlotte Strait and Johnstone Strait. Analyses of 2013 IGF-1 levels (juvenile coho, Chinook, chum and a low number of sockeye) are underway and scheduled plans to obtain samples in late June to early July of 2014 are in place

Place matters: but does local leadership?

The arrival of New Labour into Government witnessed the prominent re-emergence of place onto the policy agenda. This heralded a range of area-based-initiatives designed to both tackle neighbourhood forms of deprivation and to re-establish a sense of identity and connection between individuals and their local community. In terms of place-making, effective and inclusive participation, representation and leadership were all identified as prerequisites for the creation of sustainable communities . But how important is local leadership and strategic vision within local public service organisations in achieving the desired place-making outcomes? This paper examines the extent to which local leadership and strategic vision represents a significant factor in promoting higher levels of satisfaction, belonging, cohesion and participation across single tier councils in England. The ensuing empirical evidence raises significant questions not only about the importance of local leadership in place-making, but also the environmental and organizational factors that shape local places

‘Do i care?’ young adults' recalled experiences of early adolescent overweight and obesity: a qualitative study

<p>Objective: Individual behaviour change to reduce obesity requires awareness of, and concern about, weight. This paper therefore describes how young adults, known to have been overweight or obese during early adolescence, recalled early adolescent weight-related awareness and concerns. Associations between recalled concerns and weight-, health- and peer-related survey responses collected during adolescence are also examined.</p> <p>Design: Qualitative semi-structured interviews with young adults; data compared with responses to self-report questionnaires obtained in adolescence.</p> <p>Participants: A total of 35 participants, purposively sub-sampled at age 24 from a longitudinal study of a school year cohort, previously surveyed at ages 11, 13 and 15. Physical measures during previous surveys allowed identification of participants with a body mass index (BMI) indicative of overweight or obesity (based on British 1990 growth reference) during early adolescence. Overall, 26 had been obese, of whom 11 had BMI99.6th centile, whereas 9 had been overweight (BMI=95th–97.9th centile).</p> <p>Measures: Qualitative interview responses describing teenage life, with prompts for school-, social- and health-related concerns. Early adolescent self-report questionnaire data on weight-worries, self-esteem, friends and victimisation (closed questions).</p> <p>Results: Most, but not all recalled having been aware of their overweight. None referred to themselves as having been obese. None recalled weight-related health worries. Recollection of early adolescent obesity varied from major concerns impacting on much of an individual's life to almost no concern, with little relation to actual severity of overweight. Recalled concerns were not clearly patterned by gender, but young adult males recalling concerns had previously reported more worries about weight, lower self-esteem, fewer friends and more victimisation in early adolescence; no such pattern was seen among females. Conclusion: The popular image of the unhappy overweight teenager was not borne out. Many obese adolescents, although well aware of their overweight recalled neither major dissatisfaction nor concern. Weight-reduction behaviours are unlikely in such circumstances.</p&gt