GP views on their role in bullying disclosure by children and young people in the community:a cross-sectional qualitative study in English primary care

Background: Bullying among children and young people (CYP) is a major public health concern which can lead to physical and mental health consequences. CYP may disclose bullying, and seek help from, their general practitioner (GP). However, there is currently little research on GPs’ views and perceptions on their role in dealing with disclosures of bullying in primary care.Aim: To explore GPs’ views about their role in dealing with disclosures of bullying by CYP, especially factors that have an impact on GPs’ roles.Design & Setting: Semi-structured interviews were conducted with GPs in primary care in England. Method: Purposive sampling was used to achieve variation in GP age, professional status in practice, profile of the patients served by the practice, practice size and location, and whether the GPs considered Conclusion: GPs feel they have a role to play in managing and supporting the health of CYP who disclose bullying during consultations. However, they feel ill equipped in dealing with these disclosures due to lack of professional development opportunities and guidance on treating and managing the health consequences of bullying

Evaluating the relative importance of precipitation, temperature and land-cover change in the hydrologic response to extreme meteorological drought conditions over the North American High Plains

Drought is a natural disaster that may become more common in the future under climate change. It involves changes to temperature, precipitation and/or land cover, but the relative contributions of each of these factors to overall drought severity is not clear. Here we apply a high-resolution integrated hydrologic model of the High Plains to explore the individual importance of each of these factors and the feedbacks between them. The model was constructed using ParFlow-CLM, which represents surface and subsurface processes in detail with physically based equations. Numerical experiments were run to perturb vegetation, precipitation and temperature separately and in combination. Results show that decreased precipitation caused larger anomalies in evapotranspiration, soil moisture, stream flow and water table levels than increased temperature or disturbed land cover did. However, these factors are not linearly additive when applied in combination; some effects of multifactor runs came from interactions between temperature, precipitation and land cover. Spatial scale was important in characterizing impacts, as unpredictable and nonlinear impacts at small scales aggregate to predictable, linear large-scale behavior.National Energy Research Scientific Computing Center (NERSC), a US Department of Energy Office of Science User Facility [DE-AC02-05CH11231]; National Science Foundation through its Water Sustainability and Climate (WSC) program; NSF [1204787]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Simulating the sensitivity of evapotranspiration and streamflow to large-scale groundwater depletion

Groundwater pumping has caused marked aquifer storage declines over the past century. In addition to threatening the viability of groundwater-dependent economic activities, storage losses reshape the hydrologic landscape, shifting groundwater surface water exchanges and surface water availability. A more comprehensive understanding of modern groundwater-depleted systems is needed as we strive for improved simulations and more efficient water resources management. Here, we begin to address this gap by evaluating the impact of 100 years of groundwater declines across the continental United States on simulated watershed behavior. Subsurface storage losses reverberate throughout hydrologic systems, decreasing streamflow and evapotranspiration. Evapotranspiration declines are focused in water-limited periods and shallow groundwater regions. Streamflow losses are widespread and intensify along drainage networks, often occurring far from the point of groundwater abstraction. Our integrated approach illustrates the sensitivity of land surface simulations to groundwater storage levels and a path toward evaluating these connections in large-scale models.U.S. Department of Energy Office of Science, Offices of Advanced Scientific Computing Research and Biological and Environmental Sciences IDEAS project; Sustainable Systems Scientific Focus Area [DE-AC02-05CH11231]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

The use of carer perspectives and expert consensus to define key components of a biopsychosocial support intervention for stroke carers

© 2019, © 2019 Taylor & Francis Group, LLC. Objective: To identify the key components of a biopsychosocial support intervention to improve mental wellbeing for informal stroke carers within the first year post-stroke based on the combined perspectives of experts in the field of psychological care after stroke and informal stroke carers themselves. Methods: After reviewing the existing literature a cross-sectional mixed-methods design was adopted comprising 1) focus groups with informal stroke carers about their psychological support needs, and 2) nominal group technique with academic and clinical stroke care experts to reach consensus on intervention priorities. Transcripts were thematically analyzed and combined with the ranked priorities from the nominal group to identify key components for intervention content. Results: Key themes for informal stroke carers were associated with: 1) changes in relationships, roles, and dynamics; 2) emotional impact and acceptance; 3) drawing on inner resources; 4) looking for information, solutions, and explanations; 5) support from others. The expert nominal group placed priority on eight ranked areas: 1) acknowledging “normal” emotions; 2) education about the effects of a stroke; 3) reactions to loss and adjustment; 4) recognizing signs and symptoms of not coping; 5) knowing how and when to access practical and emotional support; 6) strategies for taking care of own health; 7) dealing with difficult emotions; and 8) problem solving skills. Conclusions: Themes from the informal carer focus groups, and ranked priority areas will inform the development of a biopsychosocial support intervention for stroke carers to be tested in a feasibility randomized controlled trial

GPs’ views about their role when children and young people disclose a history of bullying in the community: a qualitative study

BackgroundBullying among children and young people (CYP) can lead to both physical and mental health consequences. CYP may disclose episodes of bullying and seek help from their GP. Therefore GPs have an important role in dealing with the mental and physical health consequences of bullying. However, there is currently little research on GPs’ views and perceptions on their role in dealing with bullying.AimTo explore GPs views about their role in dealing with disclosures of bullying by CYP.MethodSemi-structured interviews were conducted with GPs in England. Purposive sampling was used to achieve variation in GP demographics. Data were collected until thematic saturation was reached and analysed using the constant comparative method.ResultsData from 14 semi-structured interviews revealed three main themes: GP experience, bullying in schools and cyberbullying, and training needs. There was an encompassing feeling that dealing with disclosures of bullying came down to a GP’s clinical experience rather than guideline recommendations, which do not currently exist; and that bullying was a precipitating factor in presentations of CYP’s mental health issues. Continuing professional development opportunities are needed. Such opportunities should include both the nature and health consequences of bullying, including cyberbullying, for which GPs felt ill prepared but which was reported to affect their practice.ConclusionGPs feel they have a role to play in managing and supporting the health of CYP who disclose bullying. However, they feel ill equipped in dealing with these disclosures. There is a need for collaboration between GPs and education services to improve support

Developing a fatigue programme : protocol for the Nottingham Fatigue After Stroke (NotFAST2) study

Introduction: Post-stroke fatigue (PSF) is common and is one of the most distressing symptoms after stroke. It has a negative impact on physical, social and psychological functioning: it is also associated with poor outcomes and increased mortality. The effective management of PSF is therefore regarded as a clinical priority. Method: Mixed-methods design with three overlapping phases. Phase 1 will be a survey of existing fatigue management within the UK. In phase 2, interviews and focus groups will be conducted with stroke survivors with fatigue, carers and clinicians to determine strategies used to manage fatigue successfully. In phase 3, data from phases 1 and 2 will contribute to the co-design of a fatigue management programme with the [NotFAST2] study Patient and Public Involvement group. This will be further refined through subsequent focus groups which will include those with fatigue associated with other health conditions.Results: Survey data will be analysed using descriptive statistics. Interview and focus group data will be analysed using a framework approach.Conclusion: PSF requires a comprehensive management programme necessitating input from key stakeholders. A PSF programme will be developed which will be tested in a future randomised controlled trial

A Search for Radio Supernova Remnants in Four Irregular Galaxies

We survey four nearby irregular galaxies for radio supernova remnants (SNRs) using deep (1 sigma ~ 20 microJy), high resolution (~20 pc) VLA continuum data at 20, 6, and 3.6 cm. We identify discrete sources in these galaxies and use radio spectral indices and H alpha images to categorize them as SNRs, H II regions, or background radio galaxies. Our classifications are generally in good agreement agreement with the literature. We identify a total of 43 SNR candidates: 23 in NGC 1569, 7 in NGC 4214, 5 in NGC 2366, and 8 in NGC 4449. Only one SNR--the well-studied object J1228+441 in NGC 4449--is more luminous at 20 cm than Cas A. By comparing the total thermal flux density in each galaxy to that localized in H II regions, we conclude that a significant fraction must be in a diffuse component or in low-luminosity H II regions.Comment: Accepted by AJ. 17 pages, 9 figures. 23 additional figures will be available in the online version of the Astronomical Journa