Evaluation of GHA’s youth diversionary programme

To assist with funding decisions in this area and to build an evidence base, GHA commissioned an evaluation of a selection of its youth diversionary programmes in 2007

Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening

OBJECTIVES: To investigate the psychosocial impact for women of a diagnosis of Chlamydia trachomatis and discuss the implications for the proposed UK chlamydia screening programme. DESIGN: Qualitative study with semistructured interviews. Interview transcripts analysed to identify recurrent themes. PARTICIPANTS: Seventeen women with a current or recent diagnosis of chlamydia. SETTING: A family planning clinic and a genitourinary medicine clinic in Glasgow. RESULTS: Three themes were identified: perceptions of stigma associated with sexually transmitted infection, uncertainty about reproductive health after diagnosis, and anxieties regarding partner's reaction to diagnosis. Most women had not previously perceived sexually transmitted infections as personally relevant; this was a function of stereotypical beliefs about who was "at risk" of sexually transmitted infection. These beliefs were pervasive and negatively affected reactions to diagnosis and produced anxiety about disclosure of the condition to others (particularly sexual partners) and future reproductive morbidity. This anxiety, given the uncertain natural history of chlamydia, may prove difficult to dispel. CONCLUSIONS: There are three primary areas of concern for women after a diagnosis of chlamydia which need to be examined in the proposed screening programme. Information provided should normalise and destigmatise chlamydial infection and positively promote genitourinary medicine services. Support services should be available because notification of partner can cause anxiety. Uncertainty about future reproductive morbidity may be inevitable; staff providing screening will require guidance in providing advice under such conditions

What is the excess risk of infertility in women after genital chlamydia infection? A systematic review of the evidence

Methods: Twelve databases were searched, limited to peer-reviewed literature published from January 1970 to September 2007. Conference abstracts and reference lists from reviews published since 2000 and from key articles were hand-searched. Studies were selected for review if they met the following criteria: (1) the study population comprised women of child-bearing age (defined as 15–45 years) and incorporated a comparison group of women documented as "chlamydia negative"; (2) the study outcomes included either infertility or successful pregnancy; and (3) the study design was one of the following: cohort, randomised controlled trial, "before and after" study, screening trial and systematic review. Studies were excluded if they described genital infections that either did not include Chlamydia trachomatis or described genital chlamydial co-infection, in which no data were available for C trachomatis infection alone. Results: 3349 studies were identified by the search. One study satisfied the inclusion criteria, a longitudinal investigation measuring pregnancy rates in adolescent women with and without current chlamydial infection at baseline. That study reported no significant difference in subsequent pregnancy rates; however, it had serious methodological limitations, which restricted its conclusions. Conclusions: This systematic review demonstrates the absence of valid evidence on the attributable risk of post-infective tubal factor infertility after genital chlamydial infection. The findings contribute empirical data to the growing debate surrounding previous assumptions about the natural history of chlamydial infection in women

Can we evaluate population screening strategies in UK general practice? A pilot randomised controlled trial comparing postal and opportunistic screening for genital chlamydial infection

STUDY OBJECTIVE: To assess whether opportunistic and postal screening strategies for Chlamydia trachomatis can be compared with usual care in a randomised trial in general practice DESIGN: Feasibility study for a randomised controlled trial. SETTING: Three West of Scotland general medical practices: one rural, one urban/deprived and one urban/affluent. PARTICIPANTS: 600 women aged 16-30 years, 200 from each of three participating practices selected at random from a sample of West of Scotland practices that had expressed interest in the study. The women could opt out of the study. Those who did not were randomly assigned to one of three groups: postal screening, opportunistic screening or usual care. MAIN RESULTS: 38% (85/221) of the approached practices expressed interest in the study. Data were collected successfully from the 3 participating practices, although intensive support was required. There were considerable workload implications for staff, both in relation to implementing the screening strategies and managing the research process. 124 of the 600 women opted out of the study. During the four-month study period, 55% (81/146) of the control group attended their practice but none was offered screening. 59% (80/136) women in the opportunistic group attended their practice of whom 55% (44/80) were offered screening. Of those, 64% (28/44) accepted, representing 21% of the opportunistic group. 48% (59/124) of the postal group returned samples. CONCLUSION: A randomised controlled trial comparing postal and opportunistic screening for chlamydial infection in general practice is feasible, though resource intensive. There may be problems with generalising from screening trials in which patients may opt out from the offer of screening

Limitations of persistent scatterer interferometry to measure small seasonal ground movements in an urban environment

London Clay, which underlies the majority of Greater London, has a high shrink–swell potential that can result in damage to foundations and surface infrastructure due to seasonal expansion and contraction of the clay. Currently, surface movement as a result of shrink–swell is not monitored in London, meaning that the magnitude and cyclicity of these movements is poorly understood. Persistent Scatterer Interferometric (PSI) Synthetic Aperture Radar data provide high-precision line-of-sight displacement measurements at a high point density across urban areas, offering the possibility of routine shrink–swell monitoring across whole cities. To test this, PSI data derived from TerraSAR-X (TSX) observations for the period from May 2011 to April 2017 were analysed for shrink–swell patterns across three areas of London in Hammersmith, Muswell Hill and Islington. A consistent cyclicity and amplitude was detected at all sites and the number of cycles is comparable with those identified in rainfall data. The amplitude of these cycles is smaller than anticipated, most probably because of the resisting effect of roads and pavements. The Cranfield University Leakage Assessment from Corrosivity and Shrinkage (LEACS) database was used to subdivide the PSI data and the average velocity and amplitude of each class statistically tested for significant differences between classes. The results show that it is not possible to statistically isolate possible soil shrink–swell movement in TSX PSI data in London

Overcoming barriers to engaging socio-economically disadvantaged populations in CHD primary prevention: a qualitative study

<p><b>Background:</b> Preventative medicine has become increasingly important in efforts to reduce the burden of chronic disease in industrialised countries. However, interventions that fail to recruit socio-economically representative samples may widen existing health inequalities. This paper explores the barriers and facilitators to engaging a socio-economically disadvantaged (SED) population in primary prevention for coronary heart disease (CHD).</p> <p><b>Methods:</b> The primary prevention element of Have a Heart Paisley (HaHP) offered risk screening to all eligible individuals. The programme employed two approaches to engaging with the community: a) a social marketing campaign and b) a community development project adopting primarily face-to-face canvassing. Individuals living in areas of SED were under-recruited via the social marketing approach, but successfully recruited via face-to-face canvassing. This paper reports on focus group discussions with participants, exploring their perceptions about and experiences of both approaches.</p> <p><b>Results:</b> Various reasons were identified for low uptake of risk screening amongst individuals living in areas of high SED in response to the social marketing campaign and a number of ways in which the face-to-face canvassing approach overcame these barriers were identified. These have been categorised into four main themes: (1) processes of engagement; (2) issues of understanding; (3) design of the screening service and (4) the priority accorded to screening. The most immediate barriers to recruitment were the invitation letter, which often failed to reach its target, and the general distrust of postal correspondence. In contrast, participants were positive about the face-to-face canvassing approach. Participants expressed a lack of knowledge and understanding about CHD and their risk of developing it and felt there was a lack of clarity in the information provided in the mailing in terms of the process and value of screening. In contrast, direct face-to-face contact meant that outreach workers could explain what to expect. Participants felt that the procedure for uptake of screening was demanding and inflexible, but that the drop-in sessions employed by the community development project had a major impact on recruitment and retention.</p> <p><b>Conclusion:</b> Socio-economically disadvantaged individuals can be hard-to-reach; engagement requires strategies tailored to the needs of the target population rather than a population-wide approach.</p&gt

A review of research into business coaching supervision

A systematic search of the coaching literature for original peer-reviewed studies into business coaching supervision yielded seven research reports. Evaluation of these studies showed them to be low in the reporting of methodological rigour. However, as an emerging area of research with great importance for the development of the profession of business coaching these studies provide valuable insights into the functions of supervision and its benefits. Gaps in knowledge and directions for future research are identified. There is a need for future research to be more rigorous in its reporting of methods and analytic procedures, small scale qualitative research that can provide insight into the issues and challenges of coaching supervision in specific contexts, and large scale quantitative research which can provide broader and generalizable understandings into the uses and benefits of supervision

On our own terms : the working conditions of internet-based sex workers in the UK

The sex industry is increasingly operated through online technologies, whether this is selling services online through webcam or advertising, marketing or organising sex work through the Internet and digital technologies. Using data from a survey of 240 internet-based sex workers (members of the National Ugly Mug reporting scheme in the UK), we discuss the working conditions of this type of work. We look at the basic working patterns, trajectories and everyday experiences of doing sex work via an online medium and the impact this has on the lives of sex workers. For instance, we look at levels of control individuals have over their working conditions, prices, clientele and services sold, and discuss how this is mediated online and placed in relation to job satisfaction. The second key finding is the experience of different forms of crimes individuals are exposed to such as harassment and blackmail via the new technologies. We explore the relationship internet-based sex workers have with the police and discuss how current laws in the UK have detrimental effects in terms of safety and access to justice. These findings are placed in the context of the changing landscape of sex markets as the digital turn determines the nature of the majority of commercial sex encounters. These findings contribute significantly to the populist coercion/choice political debates by demonstrating levels and types of agency and autonomy experienced by some sex workers despite working in a criminalized, precarious and sometimes dangerous context

Koliko su studenti više medicinske škole u Bitoli upoznati s problemom infekcije HCV-om

Healthcare workers are at risk of occupationally-acquired viral infections such as human immunodefi ciency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV). HCV is parenterally transmitted and has been found in every part of the world. This cross-sectional study was conducted to establish the awareness and attitude about HCV infections among 210 full-time and part-time nursing students of the Medical College in Bitola, Macedonia ‘from May to June 2009. For this purpose we used a self-administered questionnaire which consisted of three parts. The fi rst included demographic data, the second included questions about causes of infection, mode of transmission, symptoms, acute and chronic hepatitis, and prevention, and the third questions about students’ attitude toward patients with suspect or confi rmed HCV infection. Full-time students showed higher HCV awareness (84 %) than part-time students (69 %). 58 % of the full-time and 79 % of the part-time students said they would not avoid professional contact with suspect or HCV infected patients. Our study has shown that even though both groups of students have a suffi cient knowledge about HCV to face future challenges, they need further education on the subject. Practical recommendations would help to reduce stigmatising behaviour still further.Zdravstveni su radnici izloženi profesionalnomu riziku od infekcije virusom humane imunodefi cijencije (HIV-om), hepatitis B virusom (HBV-om) te hepatitis C virusom (HCV-om). HCV se prenosi parenteralno i ima ga posvuda u svijetu. Ovo smo presječno ispitivanje proveli da utvrdimo koliko su studenti za medicinske tehničare i sestre upoznati s infekcijom HCV-om i saznamo njihove stavove o tome. Ispitivanje je obuhvatilo 210 redovitih i izvanrednih studenata Visoke medicinske škole u Bitoli i trajalo je od svibnja do lipnja 2009. Za ispitivanje je rabljen opširan upitnik. Odgovori su pokazali da redoviti studenti imaju bolji uvid u predmet (s 84 % točnih odgovora) od izvanrednih studenata (69 %). U pogledu stava prema pacijentima 58 % redovitih i 79 % izvanrednih studenata ne izbjegava dodir s pacijentima koji su infi cirani HCV-om. Ispitivanje je pokazalo da su studenti iz obje skupine dovoljno upoznati s infekcijom HCV-om, rizičnim čimbenicima i načinom prijenosa, ali je potrebno to znanje nadograditi

The Anti-social Behaviour, Crime and Policing Act 2014: implications for sex workers and their clients

© 2015 Taylor & Francis. The Anti-social Behaviour, Crime and Policing Act 2014 introduced new powers to deal with behaviour deemed to be ‘anti-social’. In this paper we consider how the new law could be used against sex workers and their clients and the impact this may have. Although the new powers were not intentionally designed to respond to prostitution, we suggest that they will be utilised to tackle it. We argue that the law will be used inconsistently in a way which will go directly against policy which seeks to ‘tackle demand’ and take a less punitive approach to dealing with sex workers. Despite a policy shift to see sex workers more as victims and less as offenders, we draw on existing evidence to demonstrate that the new anti-social behaviour order law will be utilised to exclude street sex workers from public spaces. We claim that a degree of ‘policy re-fraction’ will occur when the new laws are implemented by practitioners