Where's the harm? A social marketing approach to reframing 'problem' drinking cultures

Alcohol consumption is often linked to a broad range of social and health problems, yet alcohol also plays a fundamental role in social bonding between people. This paper considers the potential of social marketing to contribute to alcohol consumption reduction and reframe social norms that encourage 'problem' drinking. Based on qualitative research with a variety of Scottish drinkers, the paper emphasises how and why a better understanding of the culturally bound meanings of alcohol (e.g. social identity, self-concept) are of crucial importance to inform any social marketing approach to reframing excessive drinking

Development and evaluation of an early detection intervention for mouth cancer using a mass media approach

Scotland has a high incidence of mouth cancer, but public awareness and knowledge are low compared with other cancers. The West of Scotland Cancer Awareness Project sought to increase public awareness and knowledge of mouth cancer and to encourage early detection of symptoms among an at-risk population of people aged over 40 years from lower socio-economic groups using a mass media approach. The media campaign aimed to increase people’s feelings of personal risk, while also enhancing feelings of efficacy and control. To achieve this, a testimonial approach (using real people to tell their own stories) was adopted

Guided Goal Setting in Therapy Towards Being Fully Functioning

This qualitative study considered whether the provision of a framework of potential goals based on Rogers’ idea of the fully functioning person would be of any benefit to therapy clients in their goal setting process. It also considered addressed whether client goal setting was methodologically acceptable to integrative therapists who used Rogers’ non-directive principles as the foundation to their approach. We provided a goal setting instrument to 9 therapists and 23 of their clients, enabling them to define therapy goals, and feedback on the process. The clients set their goals using the instruments, before having at least six sessions with their therapist. We then sought joint views on the process from the therapists through a questionnaire or an interview. The data from the responses were analyzed using Thematic Analysis. The majority of the therapists considered that guided goal setting using a description of the ‘fully functioning’ individual was helpful. In terms of the applicability of goal setting to an integrative approach based on non-directive, person-centered principles, the results were mixed and in some cases contrary to those expected. For example, some of the more directive therapists disliked guided goal setting processes, whilst the more non-directive therapists appreciated the approach

Developing the Foundations for a Learning-Based Humanistic Therapy

This study addressed the possibility of integrating learning theory into humanistic counseling. We consider that such an approach may enable client self-counseling either between sessions or after therapy has finished. Carl Rogers was a keen advocate of person-centered learning facilitation in the classroom and his principles of learning provide a natural start-point for a humanistic therapy based on learning theory. A variety of other learning processes also lend themselves to a learning based therapy such as establishing client learning goals based on self-efficacy, enabling the client to understand their own learning processes and blocks to learning, encouraging the client to access their own learning resources, and then enabling long-term learning. A case study was therefore designed to test some of these processes in a therapeutic setting. A White, British, middle-aged female was recruited for the case study. During the course of six sessions, the content of which was analyzed using thematic analysis, a selection of learning processes were applied to the humanistic therapeutic process. In summary, it was established that facilitated learning processes could provide a practically acceptable basis for humanistic counseling, and these processes are offered here as the foundation to a model of “therapeutic learning.

Positron Emission Tomography Techniques to Measure Active Inflammation, Fibrosis and Angiogenesis in Hypertensive Heart Failure

Heart failure, which is responsible for a high number of deaths worldwide, can develop due to chronic hypertension. Heart failure can involve and progress through several different pathways, including: fibrosis, inflammation, and angiogenesis. Early and specific detection of changes in the myocardium during the transition to heart failure can be made via the use of molecular imaging techniques, including positron emission tomography (PET). Traditional cardiovascular PET techniques, such as myocardial perfusion imaging and sympathetic innervation imaging, have been established at the clinical level but are often lacking in pathway and target specificity that is important for assessment of heart failure. Therefore, there is a need to identify new PET imaging markers of inflammation, fibrosis and angiogenesis that could aid diagnosis, staging and treatment of hypertensive heart failure. This review will provide an overview of key mechanisms underlying hypertensive heart failure and will present the latest developments in PET probes for detection of cardiovascular inflammation, fibrosis and angiogenesis. Currently, selective PET probes for detection of angiogenesis remain elusive but promising PET probes for specific targeting of inflammation and fibrosis are rapidly progressing into clinical use

Letter on “Sharing trial results directly with trial participants and other stakeholders after the SARS-CoV-2 pandemic hit the UK:experience from the ActWELL trial

Acknowledgements We would like to thank our ActWELL participants who attended the events for their interest and enthusiasm in making the events a success. We would like to thank Susan MacAskill for giving us permission to use a quote from her email to us. We are also grateful to the technical support who got us through all events, Cormac Staunton (of stauntonmedia.ie). We would also like to acknowledge and thank Dr Katie Gillies and Dr Seonaidh Cotton for their contribution to the design of the evaluation survey. HSRU is core funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. This work was supported by The Scottish Government, grant number BC/ Screening/17/01.Peer reviewedPublisher PD

Development of a fixative protocol using formaldehyde and gluteraldehyde for preservation of microbial art on agar plates.

Agar art bridges the gap between science and art, using microbes instead of paint. Afterwards, the art can change in response to microbial fluctuation, meaning preservation of the original art is essential. Here, formaldehyde and glutaraldehyde were investigated as preservatives, involving techniques used in healthcare settings to preserve samples. Formaldehyde was tested at 1.0%, 2.0% and 3.7%, w/v, whereas glutaraldehyde was tested at 1% and 2.5%, w/v. Both compounds and respective concentrations were tested for different time periods. Escherichia coli, Serratia marcescens, Staphlococcus aureus and Micrococcus luteus were used as bacteria for "drawing" the works of art. The effectiveness of fixation was determined using integrated densities and visual assessment. Initially, both compounds showed potential promise, albeit with a loss of bacteria. Ser. marcescens was prone to colour changes and glutaraldehyde caused discolouration of agar and bacteria. These could be caused by a pH decrease in the agar, due to residual free aldehyde groups. Reduction of this was tested using 300 mM sodium metabisulfite to neutralize excess aldehydes. This initially led to reduced bacterial loss and avoided colour changes, however measurements 24 h post-fixation showed colour loss to some bacterial clusters. This study found that, depending on the species, use of at least 2% formaldehyde for a short fixation period (typically 1 min) was the most promising approach for the preservation of art. Given the success of this with different bacteria, it would make a good starting combination for anyone trying to fix agar art; depending on the bacterial species used, methodology refinement may be needed for optimisation. This study shows successful fixation and preservation of different bacterial species on agar for the first time. The impact of this is to preserve agar art while making it safe and non-infective to those in contact with the microbial art

The cessation in pregnancy incentives trial (CPIT): study protocol for a randomized controlled trial

Background: Seventy percent of women in Scotland have at least one baby, making pregnancy an opportunity to help most young women quit smoking before their own health is irreparably compromised. By quitting during pregnancy their infants will be protected from miscarriage and still birth as well as low birth weight, asthma, attention deficit disorder and adult cardiovascular disease. In the UK, the NICE guidelines: 'How to stop smoking in pregnancy and following childbirth' (June 2010) highlighted that little evidence exists in the literature to confirm the efficacy of financial incentives to help pregnant smokers to quit. Its first research recommendation was to determine: Within a UK context, are incentives an acceptable, effective and cost-effective way to help pregnant women who smoke to quit? <p/>Design and Methods: This study is a phase II exploratory individually randomised controlled trial comparing standard care for pregnant smokers with standard care plus the additional offer of financial voucher incentives to engage with specialist cessation services and/or to quit smoking during pregnancy. Participants (n=600) will be pregnant smokers identified at maternity booking who when contacted by specialist cessation services agree to having their details passed to the NHS Smokefree Pregnancy Study Helpline to discuss the trial. The NHS Smokefree Pregnancy Study Helpline will be responsible for telephone consent and follow-up in late pregnancy. The primary outcome will be self reported smoking in late pregnancy verified by cotinine measurement. An economic evaluation will refine cost data collection and assess potential cost-effectiveness while qualitative research interviews with clients and health professionals will assess the level of acceptance of this form of incentive payment. Research questions What is the likely therapeutic efficacy? Are incentives potentially cost-effective? Is individual randomisation an efficient trial design without introducing outcome bias? Can incentives be introduced in a way that is feasible and acceptable? <p/>Discussion: This phase II trial will establish a workable design to reduce the risks associated with a future definitive phase III multicentre randomised controlled trial and establish a framework to assess the costs and benefits of financial incentives to help pregnant smokers to quit

Accuracy of the "traffic light" clinical decision rule for serious bacterial infections in young children with fever: A retrospective cohort study

Objectives To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. Design Retrospective analysis of data from a two year prospective cohort study Setting A paediatric emergency department. Participants 15 781 cases of children under 5 years of age presenting with a febrile illness. Main outcome measures Clinical features were used to categorise each febrile episodes as low, intermediate, or high probability of serious bacterial infection (green, amber, and red zones of the traffic light system); these results were checked (using standard radiological and microbiological tests) for each of the infections of interest and for any serious bacterial infection. Results After combination of the intermediate and high risk categories, the NICE traffic light system had a test sensitivity of 85.8% (95% confidence interval 83.6% to 87.7%) and specificity of 28.5% (27.8% to 29.3%) for the detection of any serious bacterial infection. Of the 1140 cases of serious bacterial infection, 157 (13.8%) were test negative (in the green zone), and, of these, 108 (68.8%) were urinary tract infections. Adding urine analysis (leucocyte esterase or nitrite positive), reported in 3653 (23.1%) episodes, to the traffic light system improved the test performance: sensitivity 92.1% (89.3% to 94.1%), specificity 22.3% (20.9% to 23.8%), and relative positive likelihood ratio 1.10 (1.06 to 1.14). Conclusion The NICE traffic light system failed to identify a substantial proportion of serious bacterial infections, particularly urinary tract infections. The addition of urine analysis significantly improved test sensitivity, making the traffic light system a more useful triage tool for the detection of serious bacterial infections in young febrile children