Becoming known: Disclosure and exposure of (in)visible difference.

Bodily or physical differences constitute a class of potentially stigmatized characteristics. The existing literature confirms that those with appearance altering or disfiguring conditions (“visible differences”) may experience both felt and enacted stigma and seek to conceal their difference. Furthermore, issues relating to the disclosure or revelation of visible difference are frequently cited. The present study used qualitative methods to explore participants’ experiences of having disclosed otherwise unknown or hidden visible differences to others and considered these experiences within the context of existing theories of the disclosure of stigmatized characteristics. Semistructured interviews were conducted with 15 participants who had a variety of visible differences. The data were analyzed through inductive thematic analysis with the resultant themes indicating participants’ concerns and anxieties related to disclosing their differences, variable levels of agency within, preparation for, and control over the disclosure scenario, the importance of their difference being seen by others, and the personal and interpersonal changes that disclosure could facilitate. In consideration of participants’ experiences of the disclosure of visible difference and the applicability of existing models of disclosure to this scenario, a working framework that incorporates the specific issues relevant to the disclosure of visible differences is proposed. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Exploring and measuring the perceived impact of visible difference upon romantic relationships

Appearance altering or disfiguring conditions can lead to a variety of ‘visible differences.’ The presence of a visible difference may impact negatively upon an individual’s well-being and be associated with psychosocial difficulties, including social anxiety, anxiety, depression, reduced quality of life, unfavourable self-perceptions, and challenging interpersonal interactions. One domain that may be impacted is that of visible difference, appearance concern, and intimate, romantic relationships. This topic has, however, received relatively little attention in the literature. This thesis aimed to address this gap in the literature. This was done via the adoption of a pragmatic, mixed-methods approach, and the execution of three empirical research studies. First, a qualitative exploration was undertaken, involving semi-structured interviews with 22 participants with a variety of visible differences. Three intimacy-specific themes were generated through thematic analysis. These revealed a multitude of impacts, understandings, and experiences connected to this topic. As no measure of these existed, the themes were utilised in the development of draft items in order to create a research scale (named ‘CARRIS’) measuring appearance distress within a romantic context. Data were collected from participants with visible difference and a final sample of n=253 contributed to the second study, an exploratory factor analysis. This helped refine the scale into a parsimonious, three-factor, form, begin the validation process, and indicated some between-group differences. The final study involved the administration of the refined scale and the collection of fresh data from a final sample of n=144 participants in order to confirm the structure of the scale via confirmatory factor analysis. CARRIS’ four-week test-retest reliability (n=49) was also assessed.This thesis explored visible difference and intimate and romantic life. It indicated this as an important component of participants’ experiences of and adjustment to visible difference. It generated, evaluated, and began the validation of a new measure of appearance distress within a romantic context, and introduced the theoretical and clinical implications of such work

“The elephant in the room”: Disclosing facial differences

Due to high visibility and low public awareness, people with facial differences (FD) frequently face decisions about whether to explain or disclose their FD. Although disclosure of concealable stigma has been frequently researched, little work has examined disclosure from the perspectives of people with FD, whose stigma is often not concealable. Thematic analysis was used to explore semistructured interviews of adults (n = 16) with diverse FDs. Disclosure approaches varied dependent on the discloser, the disclosee, and the context. Two themes illustrated participants’ approaches to (non)disclosure: agentic and autonomous. Agentic described when participants felt they had no choice in explaining or not explaining their condition, which fell into subthemes of forced disclosure, forced nondisclosure, and unauthorized disclosure. Those who used autonomous approaches made the deliberate decision to disclose or not disclose their FD to others. Autonomous subthemes included social avoidance, concealment, false disclosure, selective disclosure, indiscriminate disclosure, and broadcasting. Three experiential themes—misunderstanding, connection, and empowerment—characterized antecedents, experiences with, and consequences of (non)disclosure. Agentic (non)disclosure and autonomous (non)disclosure were frequently associated with the misunderstanding theme, while autonomous disclosure involved themes of connection and empowerment and was thus experienced as more beneficial. Participants’ advice was to allow people with FD disclosure autonomy. Improved social representation of people with FDs, public awareness, and stigma reduction will help remove the onus of disclosure from individuals with F

Equality in cleft and craniofacial care

This review examines the issue of equality of care amongst those with cleft lip and/or palate in the European Union (EU) and beyond. Issues of equality both between and within national populations are considered, and it is argued that those from countries with smaller healthcare expenditure and who are from marginalised groups are at the greatest risk of, and affected most severely by, healthcare inequalities. The socioeconomic impact of inequality is also discussed. Having reviewed these topics, the goals and activities of the European Cleft and Craniofacial Initiative for Equality in Care Action, formed pursuant to an award from the EU’s European Cooperation in Science and Technology, are introduced. Constituted of an open network of clinicians and researchers committed to exploring and reducing such inequalities, the ongoing Action is formed of multiple working groups examining these issues within the EU and has organised training schools, conferences and short-term scientific missions concerned with these issues. These activities are discussed along with the future directions of the Action, the impact it has had to date and the benefits of the European Cooperation in Science and Technology award

Thermodynamics of highly interacting blend PCHMA/dPS by TOF-SANS

We investigate the thermodynamics of a highly interacting blend of poly(cyclohexyl methacrylate)/deuterated poly(styrene) (PCHMA/dPS) with small-angle neutron scattering (SANS). This system is experimentally challenging due to the proximity of the blend phase boundary (>200 °C) and degradation temperatures. To achieve the large wavenumber q-range and flux required for kinetic experiments, we employ a SANS diffractometer in time-of-flight (TOF) mode at a reactor source and ancillary microscopy, calorimetry, and thermal gravimetric analysis. Isothermal SANS data are well described by random-phase approximation (RPA), yielding the second derivative of the free energy of mixing (G″), the effective interaction (χ̅) parameter, and extrapolated spinodal temperatures. Instead of the Cahn–Hilliard–Cook (CHC) framework, temperature (T)-jump experiments within the one-phase region are found to be well described by the RPA at all temperatures away from the glass transition temperature, providing effectively near-equilibrium results. We employ CHC theory to estimate the blend mobility and G″(T) conditions where such an approximation holds. TOF-SANS is then used to precisely resolve G″(T) and χ̅(T) during T-jumps in intervals of a few seconds and overall timescales of a few minutes. PCHMA/dPS emerges as a highly interacting partially miscible blend, with a steep dependence of G″(T) [mol/cm3] = −0.00228 + 1.1821/T [K], which we benchmark against previously reported highly interacting lower critical solution temperature (LCST) polymer blends

Drug Facilitated Sexual Assault: Detection and Stability of Benzodiazepines in Spiked Drinks Using Gas Chromatography-Mass Spectrometry

Benzodiazepines are detected in a significant number of drug facilitated sexual assaults (DFSA). Whilst blood and urine from the victim are routinely analysed, due to the delay in reporting DFSA cases and the short half lives of most of these drugs in blood and urine, drug detection in such samples is problematic. Consideration of the drinks involved and analysis for drugs may start to address this. Here we have reconstructed the ‘spiking’ of three benzodiazepines (diazepam, flunitrazepam and temazepam) into five drinks, an alcopop (flavoured alcoholic drink), a beer, a white wine, a spirit, and a fruit based non-alcoholic drink (J2O) chosen as representative of those drinks commonly used by women in 16–24 year old age group. Using a validated GC-MS method for the simultaneous detection of these drugs in the drinks we have studied the storage stability of the benzodiazepines under two different storage conditions, uncontrolled room temperature and refrigerator (4°C) over a 25 day period. All drugs could be detected in all beverages over this time period. Diazepam was found to be stable in all of the beverages, except the J2O, under both storage conditions. Flunitrazepam and temazepam were found not to be stable but were detectable (97% loss of temazepam and 39% loss of flunitrazepam from J2O). The recommendations from this study are that there should be a policy change and that drinks thought to be involved in DFSA cases should be collected and analysed wherever possible to support other evidence types

Factor structure and factorial invariance of the strengths and difficulties questionnaire among children of prisoners and their parents

Parental imprisonment has been linked to a variety of adverse psychological outcomes for children and adolescents. The Strengths and Difficulties Questionnaire (SDQ) has been widely used to assess behavioural and emotional difficulties among 7-17 year olds in the general population and more recently has been utilised among samples of children of prisoners. Previous research has variously tested traditional one-, three- and five- factor solutions to the SDQ, and more recently one bifactor solution has been examined. Based on a sample of children of prisoners (N = 724) and their non-imprisoned parent or caregiver (N = 658), the aim of the present study was to simultaneously compare nine alternative factor structures, including previously tested models and alternative bifactor solutions. Tests of factorial invariance and composite reliability were also performed. The five-factor model was found to provide the best fit for the data. Tests of factorial invariance revealed that the five-factor model provided an equally acceptable, but not identical fit, among boys and girls. Composite reliability scores were low for the Conduct Problems and Peer Problems subscales. The utility of the SDQ in measuring psychological functioning in response to parental imprisonment is discussed

Evaluation of encapsulated liver cell spheroids in a fluidised-bed bioartificial liver for treatment of ischaemic acute liver failure in pigs in a translational setting.

Liver failure is an increasing problem. Donor-organ shortage results in patients dying before receiving a transplant. Since the liver can regenerate, alternative therapies providing temporary liver-support are sought. A bioartificial-liver would temporarily substitute function in liver failure buying time for liver regeneration/organ-procurement. Our aim: to develop a prototype bioartificial-liver-machine (BAL) comprising a human liver-derived cell-line, cultured to phenotypic competence and deliverable in a clinical setting to sites distant from its preparation. The objective of this study was to determine whether its use would improve functional parameters of liver failure in pigs with acute liver failure, to provide proof-of-principle. HepG2cells encapsulated in alginate-beads, proliferated in a fluidised-bed-bioreactor providing a biomass of 4-6×10(10)cells, were transported from preparation-laboratory to point-of-use operating theatre (6000miles) under perfluorodecalin at ambient temperature. Irreversible ischaemic liver failure was induced in anaesthetised pigs, after portal-systemic-shunt, by hepatic-artery-ligation. Biochemical parameters, intracranial pressure, and functional-clotting were measured in animals connected in an extracorporeal bioartificial-liver circuit. Efficacy was demonstrated comparing outcomes between animals connected to a circuit containing alginate-encapsulated cells (Cell-bead BAL), and those connected to circuit containing alginate capsules without cells (Empty-bead BAL). Cells of the biomass met regulatory standards for sterility and provenance. All animals developed progressive liver-failure after ischaemia induction. Efficacy of BAL was demonstrated since animals connected to a functional biomass (+ cells) had significantly smaller rises in intracranial pressure, lower ammonia levels, more bilirubin conjugation, improved acidosis and clotting restoration compared to animals connected to the circuit without cells. In the +cell group, human proteins accumulated in pigs' plasma. Delivery of biomass using a short-term cold-chain enabled transport and use without loss of function over 3days. Thus, a fluidised-bed bioreactor containing alginate-encapsulated HepG2cell-spheroids improved important parameters of acute liver failure in pigs. The system can readily be up-scaled and transported to point-of-use justifying development at clinical scale

Children of Prisoners: Their Situation and Role in Long-Term Crime Prevention

Studies suggest that maintaining family ties can help reduce the likelihood of reoffending, and that while parental imprisonment can increase a child’s likelihood to offend, positive responses to the situation can aid the children’s well-being, attitude and attainment. Drawing on findings from the recently completed EU-funded COPING Project on the mental health of children of prisoners, this chapter explores the factors that aid a child’s ability to cope with parental imprisonment and the actions that different stakeholders can take to support them. It identifies some of the mental health impacts at different stages of parental imprisonment, the roles played by non-imprisoned parents/carers and by schools, and suggests options for further clarifying the factors that help and hinder children of prisoners in the short and long term

Cognitive and emotional stressors of child homicide investigations on UK and Danish police investigators

In a previous paper, key differences in the form and manifestation of cognitive and emotional stress experienced by investigators of adult and child homicide were identified, along with a cursory look at how investigators commonly deal or cope with these effects. In this paper, the findings from eleven interviews with UK and Danish police officers with experience of investigating both adult and child homicides, suggest that child homicide investigations can have a profoundly different effect on police investigators that can vary between officers. The effects experienced and coping strategies employed were similar among officers in Denmark and the UK, and these included becoming more emotionally closed and engaging in regular sport and exercise. The findings hold important implications for police training and for the welfare of current and future police homicide investigators particularly where the victim is a child