Impact on maternity professionals of novel approaches to clinical audit feedback

We compared three approaches to feedback of clinical audit findings relating to miscarriage in 15 Scottish maternity services (printed report alone; report plus Action Planning Letter; report plus face-to-face Facilitated Action Planning). We surveyed clinicians to measure Theory of Planned Behaviour constructs (in the context of two audit criteria) before and after feedback (n=253) and assessed perceptions of the audit through in-depth interviews (n=17). Pre-feedback, clinicians had positive attitudes and strong subjective norms and intentions to comply, although perceived behavioural control was lower. Generally, positive attitudes, subjective norms and intentions increased after feedback but for one of the two criteria (providing a 7-day miscarriage service), perceived behavioural control decreased. No changes over time reached statistical significance and analysis of covariance (adjusting for pre-feedback scores) showed no consistent relationships between method of feedback and post-feedback construct scores. Interviews revealed positive perceptions of audit but frustration at lack of capacity to implement changes. While interventions which increased intensity of feedback proved feasible and acceptable to clinicians, we were unable to demonstrate that they increased intention to comply with audit criteria.This study was funded by NHS Quality Improvement Scotland

Targeting Mr Average: Participation, gender equity and school sport partnerships

The School Sport Partnership Programme (SSPP) is one strand of the national strategy for physical education and school sport in England, the physical education and school sport Club Links Strategy (PESSCL). The SSPP aims to make links between school physical education (PE) and out of school sports participation, and has a particular remit to raise the participation levels of several identified under-represented groups, of which girls and young women are one. National evaluations of the SSPP show that it is beginning to have positive impacts on young people's activity levels by increasing the range and provision of extra curricular activities (Office for Standards in Education (OFSTED), 2003, 2004, 2005; Loughborough Partnership, 2005, 2006). This paper contributes to the developing picture of the phased implementation of the programme by providing qualitative insights into the work of one school sport partnership with a particular focus on gender equity. The paper explores the ways in which gender equity issues have been explicitly addressed within the 'official texts' of the SSPP; how these have shifted over time and how teachers are responding to and making sense of these in their daily practice. Using participation observation, interview and questionnaire data, the paper explores how the coordinators are addressing the challenge of increasing the participation of girls and young women. The paper draws on Walby's (2000) conceptualisation of different kinds of feminist praxis to highlight the limitations of the coordinators' work. Two key themes from the data and their implications are addressed: the dominance of competitive sport practices and the PE professionals' views of targeting as a strategy for increasing the participation of under-represented groups. The paper concludes that coordinators work within an equality or difference discourse with little evidence of the transformative praxis needed for the programme to be truly inclusive. © 2008 Taylor & Francis

The roles of affect dysregulation and deficient affect in youth violence

Children with high dysregulated affect experience a range of emotional and behavioral problems, including aggression, delinquency, and low levels of prosocial behavior. Alongside this research, the psychopathy literature suggests that abnormally low levels of affect and emotional reactivity are associated with aggression and violence. The current study builds on prior research in the fields of affect regulation and psychopathy by testing the effects of affect dysregulation and deficient affect in predicting aggression and antisociality in 179 high-risk youth. Using structural equation modeling, results suggest that affect dysregulation and deficient affect are separate risk factors for aggression, as both constructs contributed independently to aggression while showing marginal relations with one another. Features of deficient affect, but not dysregulation, were robust predictors of violent and nonviolent offending. We discuss the importance of recognizing that diverse risk factors may lead to similar outcomes and highlight the heterogeneity in risk factors underlying aggressive behaviors

The relation of psychopathy to concurrent aggression and antisocial behavior in high-risk adolescent girls and boys

The present study examined the concurrent relationship between psychopathy characteristics as measured by the PCL:YV and aggressive and antisocial behavior in a sample of 142 high-risk adolescent girls and boys. The unique relationship between each of three PCL:YV factors (Arrogant and Deceitful Interpersonal Style, Deficient Affective Experience, and Impulsive and Irresponsible Behavioral Style) and outcomes was evaluated to determine which aspects of psychopathy are most crucially linked to aggressive and antisocial behavior in adolescents. Dependent measures were expanded to include both relational and physical forms of aggression to better capture meaningful outcomes for girls and boys. Regression analyses showed that the relationships between psychopathic features and outcomes were equivalent for boys and girls, and that deficits in affect were most consistently associated with aggression. These findings are concordant with the well established finding in developmental research showing that deficits in empathy and affect regulation are associated with aggression

Dynamical Linked Cluster Expansions: A Novel Expansion Scheme for Point-Link-Point-Interactions

Dynamical linked cluster expansions are linked cluster expansions with hopping parameter terms endowed with their own dynamics. This amounts to a generalization from 2-point to point-link-point interactions. We develop an associated graph theory with a generalized notion of connectivity and describe an algorithmic generation of the new multiple-line graphs. We indicate physical applications to spin glasses, partially annealed neural networks and SU(N) gauge Higgs systems. In particular the new expansion technique provides the possibility of avoiding the replica-trick in spin glasses. We consider variational estimates for the SU(2) Higgs model of the electroweak phase transition. The results for the transition line, obtained by dynamical linked cluster expansions, agree quite well with corresponding high precision Monte Carlo results.Comment: 41 pages, latex2e, 10 postscript figure

Structural validity of the MACI psychopathy and narcissism scales: Evidence of multidimensionality and implications for use in research and screening

This study investigated the psychometric properties and predictive validity of three self-report scales (the Psychopathy Content Scale, the Psychopathy-16 scale, and the Egotistic scale) derived from the Millon Adolescent Clinical Inventory (MACI) to screen for the presence of psychopathic and narcissistic personality characteristics. Exploratory and confirmatory factor analyses were performed in a sample of 173 clinic-referred adolescents (ages 12-17), results from which suggested that these scales are multidimensional in nature. The Psychopathy Content Scale was best captured by a two-factor structure, with personality-based items loading on one factor and antisocial/impulsive behaviors loading on the second. The most parsimonious solution for the Psychopathy-16 scale was a three-factor model, characterized by callous and egocentric features on the first two factors and antisocial behaviors on the third. The Egotistic scale of the MACI was best represented by three factors, depicting features of self-confidence, exhibitionistic tendencies, and social conceit, respectively. Regression analyses supported the multidimensionality of these scales by showing divergent patterns of association with violent and nonviolent outcomes among the factors that composed the scales

Taste changes after bariatric surgery: a systematic review

BACKGROUND: Alterations in taste perception and preferences may contribute to dietary changes and subsequent weight loss following bariatric surgery. METHODS: A systematic search was performed to identify all articles investigating gustation, olfaction, and sensory perception in both animal and human studies following bariatric procedures. RESULTS: Two hundred fifty-five articles were identified after database searches, bibliography inclusions and deduplication. Sixty-one articles were included. These articles provide evidence supporting changes in taste perception and hedonic taste following bariatric procedures. Taste sensitivity to sweet and fatty stimuli appears to increase post-operatively. Additionally, patients also have a reduced hedonic response to these stimuli. CONCLUSIONS: Available evidence suggests that there is a change in taste perception following bariatric procedures, which may contribute to long-term maintenance of weight loss following surgery

Challenges in the assessment of aggression in high-risk youth: Testing the fit of the Form-Function Aggression Measure

Recent efforts have focused on disentangling the forms (e.g., overt and relational) and functions (e.g., instrumental and reactive) of aggression. The Form-Function Aggression Measure (FFAM; Little, Jones, Henrich, & Hawley, 2003) shows promise in this regard; however, it is a new measure and its psychometric properties across different populations are unknown. The current study tested the underlying structure of the FFAM using confirmatory factor analysis in male and female high-risk adolescents (n= 381). Results indicated that none of the models tested demonstrated an acceptable fit in either males or females. However, a 6-factor model comprised of pure-overt, reactive-overt, instrumental-overt, pure-relational, reactive-relational, and instrumental-relational subtypes provided an improved fit relative to other models in both males and females. A multi-form, multi-function model equivalent to the model proposed by Little and colleagues (2003) also evidenced a relatively improved fit, highlighting the utility of disentangling form from function when examining aggression. Implications and challenges for assessing the forms and functions of aggression among high-risk adolescents are discussed

Study of resonance light scattering for remote optical probing

Enhanced scattering and fluorescence processes in the visible and UV were investigated which will enable improved remote measurements of gas properties. The theoretical relationship between scattering and fluorescence from an isolated molecule in the approach to resonance is examined through analysis of the time dependence of re-emitted light following excitation of pulsed incident light. Quantitative estimates are developed for the relative and absolute intensities of fluorescence and resonance scattering. New results are obtained for depolarization of scattering excited by light at wavelengths within a dissociative continuum. The experimental work was performed in two separate facilities. One of these utilizes argon and krypton lasers, single moded by a tilted etalon, and a 3/4 meter double monochromator. This facility was used to determine properties of the re-emission from NO2, I2 and O3 excited by visible light. The second facility involves a narrow-line dye laser, and a 3/4 meter single monochromator. The dye laser produces pulsed light with 5 nsec pulse duration and 0.005 nm spectral width