A Longitudinal Study of the Effects of Childhood Trauma on Symptoms and Functioning of People with Severe Mental Health Problems

This study examines the relationship between childhood trauma and the psychiatric symptoms and psychosocial functioning of adults with severe mental health problems. Participants (n = 31) were recruited from the caseloads of community mental health services in Northern Ireland and assessed at baseline, 9 months, and 18 months. More than half had a history of childhood trauma (n = 17). There were no differences between the no childhood trauma (n = 14) and childhood trauma groups on psychiatric symptoms, but a significant relationship was found between trauma history and all aspects of social functioning. Those with no history of trauma showed improved psychosocial functioning over time, whereas those with a history of trauma deteriorated. These findings have implications for current service provision.

A Census-based longitudinal study of variations in survival amongst residents of nursing and residential homes in Northern Ireland

Background: despite the intensive services provided to residents of care homes, information on death rates is not routinely available for this population in the UK. Objective: to quantify mortality rates across the care home population of Northern Ireland, and assess variation by type of care home and resident characteristics. Design: a prospective, Census-based cohort study, with 5-year follow-up. Participants: all 9,072 residents of care homes for people aged 65 and over at the time of the 2001 census with a special emphasis on the 2,112 residents admitted during the year preceding census day. Measurements: age, sex, self-reported health, marital status, residence (not in care home, residential home, dual registered home, nursing home), elderly mentally infirm care provision. Results: the median survival among nursing home residents was 2.33 years (95% CI 2.25–2.59), for dual registered homes 2.75 (95% CI 2.42–3.17) and for residential homes 4.51 (95% CI 3.92–4.92) years. Age, sex and self-reported health showed weaker associations in the sicker populations in nursing homes compared to those in residential care or among the non-institutionalised. Conclusions: the high mortality in care homes indicates that places in care homes are reserved for the most severely ill and dependent. Death rates may not be an appropriate care quality measure for this population, but may serve as a useful adjunct for clinical staff and the planning of care home provision.

Bridging and Linking in a Divided Society: A Social Capital Case Study from Northern Ireland

This paper reports the results of research into social capital levels in the Central Housing Community Network, part of the community consultation structure of the Northern Ireland Housing Executive. Membership of the forum increased the bonding, bridging and linking social capital of its members and appeared to improve community relations, although that was not its stated purpose. However, the empirical link between social capital and the quality of community relations remains unproven. The research provides an example of the state creating a positive space for interaction with civil society through consultation on service delivery issues. In an international policy environment where ‘mixed’ communities are the ideal, the potential of service-based forums to contribute to community cohesion may have been underestimated.

From stress to distress: Conceptualizing the British family farming patriarchal way of life

‘Rural stress’ and ‘farming stress’ are terms that have become commonly appropriated by British health-based academic disciplines, the medical profession and social support networks, especially since the agricultural ‘crises’ of B.S.E. and Foot and Mouth Disease. Looking beyond the media headlines, it is apparent that the terms in fact are colloquial catch-alls for visible psychological and physiological outcomes shown by individuals. Seldom have the underlying causes and origins of presentable medical outcomes been probed, particularly within the context of the patriarchal and traditionally patrilineal way of life which family forms of farming business activity in Britain encapsulate. Thus, this paper argues that insufficient attention has been paid to the conceptualization of the terms. They have become both over-used and ill-defined in their application to British family farm individuals and their life situations. A conceptual framework is outlined that attempts to shift the stress research agenda into the unilluminated spaces of the family farming ‘way of life’ and focus instead on ‘distress’. Drawing upon theorization from agricultural and feminist geography together with cultural approaches from rural geography, four distinct clusters of distress originate from the thoughts of individuals and the social practices now required to enact patriarchal family farming gender identities. These are explored using case study evidence from ethnographic repeated life history interviews with members of seven farming families in Powys, Mid Wales, an area dominated by family forms of farming business. Future research agendas need to be based firmly on the distressing reality of patriarchal family farming and also be inclusive of those who, having rejected the associated way of life, now lie beyond the farm gate.

From Aspiration to Action: A Learning Intentions Model to Promote Critical Engagement with Science in the Print-Based Media

Science programmes which prepare students to read critically and respond thoughtfully to science-based reports in the media could play an important role in promoting informed participation in the public debate about issues relating to science, technology and society. Evidence based guidance about the practice and pattern of use of science-based media in the classroom is limited. This study sought to identify learning intentions that teachers believe ought to underpin the development of programmes of study designed to achieve this end-result. Teachers views of knowledge, skills and attitudes required to engage critically with science-based news served as a basis for this study. Teachers developed a pedagogical model by selecting appropriate statements of learning intentions, grouping these into coherent and manageable themes and coding them according to perceived level of difficulty. The model is largely compatible with current curricular provision in the UK, highlights opportunities for interdisciplinary collaboration and illustrates the developmental nature of the topic.

Extension of general practice training from three to four years: experiences of a vocational training programme in Southern Ireland

The aim of this study was to evaluate the experiences of trainees taking part in an extended (four-year) general practice training programme introduced in the South Eastern region of the Republic of Ireland to replace the previous traditional (three-year) programme. In a qualitative design, eight homogeneous focus groups were held to determine the value of the additional year of training. The first cohort of trainees was interviewed towards the start and at the end of their fourth year. Trainees finishing the following year were also interviewed, as were graduates from the final three-year programme. GP trainers and the four members of the programme directing team comprised two further independent focus groups. Trainees reported that the integration of hospital posts and general practice attachments over the four years was particularly beneficial. The exposure to a variety of different general practices and the opportunity to take part in specialty clinics were considered extremely useful. The fourth year of training was felt to be less pressurised than previous years. Professional and personal development was enhanced; improved readiness to practise and confidence were noted. Perceived disadvantages of extended training included a lack of acknowledgment for doctors in their fourth year and excessive emphasis placed on research during the final year of training. The addition of an extra year of vocational training improves professional and personal development and changes the learning experience for doctors. Doctors felt more confident and ready to enter independent practice at the end of the fourth year of training.

The control of social attention from 1 to 4 months

The control of social attention during early infancy was investigated in two studies. In both studies, an adult turned towards one of two targets within the infant's immediate visual field. We tested: (a) whether infants were able to follow the direction of the adult's head turn; and (b) whether following a head turn was accompanied by further gaze shifts between experimenter and target. In the first study, 1-month-olds did not demonstrate attention following at the group level. In addition, those infants who turned towards the same target remained fixed on it and did not shift attention again. In Study 2, we tested infants longitudinally at 2-4 months. At the group level, infants followed the adult's head turn at 3 and 4 months but not at 2 months. Those infants who turned towards the same target at 3 and 4 months also shifted gaze back and forth between experimenter and target. By 3 months, infants seem able to capitalize on the social environment to disengage and distribute attention more flexibly. The results support the claim that the control of social attention begins in early infancy, and are consistent with the hypothesis that following the attention of other people is dependent on the development of disengagement skills.

Folic acid use and major congenital malformations in offspring of women with epilepsy: a prospective study from the UK Epilepsy and Pregnancy Register

Objective: In the general population, folic acid supplementation during pregnancy has been demonstrated to reduce the frequency of neural tube defects (NTDs) and other major congenital malformations (MCMs). It is recommended that women with epilepsy contemplating pregnancy take supplemental folic acid because of the known antifolate effect of some antiepileptic drugs (AEDs). Here the aim was to determine the effectiveness of this practice.

Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register

Objective: To assess the relative risk of major congenital malformation (MCM) from in utero exposure to antiepileptic drug (AEDs).

From perfect to fractal transmission in spin chains

Perfect state transfer is possible in modulated spin chains [Phys. Rev. Lett. 92, 187902 (2004)], imperfections, however, are likely to corrupt the state transfer. We study the robustness of this quantum communication protocol in the presence of disorder both in the exchange couplings between the spins and in the local magnetic field. The degradation of the fidelity can be suitably expressed, as a function of the level of imperfection and the length of the chain, in a scaling form. In addition the time signal of fidelity becomes fractal. We further characterize the state transfer by analyzing the spectral properties of the Hamiltonian of the spin chain.

Are separate schools divisive? A case study from Northern Ireland

In Northern Ireland, where the majority of children are educated at schools attended mainly by coreligionists, the debate concerning the role of schools in perpetuating intergroup hostilities has recently been reignited. Against questions regarding the efficacy of community relations policy in education, the research reported in this paper employs qualitative methods to examine social identity and intergroup attitudes amongst children attending a state controlled Protestant school and the school's response to dealing with issues of diversity and difference. Findings suggest a relationship between ethnic isolation experienced by children and negative intergroup social attitudes and the discussion focuses on issues germane to the separateness of the school that are likely to contribute to strong ‘own’ group bias, stereotyping and prejudice. The implication of the school's separate status for its engagement with a policy framework for relationship building is also considered. The paper concludes with some policy reflections that are likely to have resonance beyond Northern Ireland.

How intergroup friendship works: A longitudinal study of friendship effects on outgroup attitudes

Cross-sectional research has shown that frequency of self-disclosure to outgroup members mediates the positive relationship between intergroup friendship and outgroup attitudes. The current research investigated the relationship between self-disclosure and attitudes in more depth. New undergraduate students were asked to nominate an ingroup or outgroup friend and then report the intimacy of their disclosures to them, their anxiety and attitudes towards a series of social groups, in the first week of the semester and 6 weeks later. Intimacy of disclosure predicted more positive attitudes towards outgroups over time, but this association was only found among participants who nominated an outgroup friend. In the ingroup friend condition, a negative association was found. These associations were mediated by general intergroup anxiety. These relationships highlight the importance of integrating theories of interpersonal and intergroup relations when investigating intergroup contact. Copyright (C) 2011 John Wiley & Sons, Ltd.

Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses

Introduction: The prevalence of comorbidities in incident renal replacement therapy (RRT) patients changes with age and varies between ethnic groups. This study describes these associations and the independent effect of comorbidities on outcomes. Methods: Adult patients starting RRT between 2003 and 2008 in centres reporting to the UK Renal Registry (UKRR) with data on comorbidity (n ¼ 14,909) were included. The UKRR studied the association of comorbidity with patient demographics, treatment modality, haemoglobin, renal function at start of RRT and subsequent listing for kidney transplantation. The relationship between comorbidities and mortality at 90 days and one year after 90 days from start of RRT was explored using Cox regression. Results: Completeness of comorbidity data was 40.0% compared with 54.3% in 2003. Of patients with data, 53.8% had one or more comorbidities. Diabetes mellitus and ischaemic heart disease were the most common conditions seen in 30.1% and 22.7% of patients respectively. Current smoking was recorded for 14.5% of incident RRT patients in the 6-year period. Comorbidities became more common with increasing age in all ethnic groups although the difference between the 65–74 and 75+ age groups was not significant. Within each age group, South Asians and Blacks had lower rates of comorbidity, despite higher rates of diabetes mellitus. In multivariate survival analysis, malignancy and ischaemic/neuropathic ulcers were the strongest independent predictors of poor survival at 1 year after 90 days from the start of RRT. Conclusion: Differences in prevalence of comorbid illnesses in incident RRT patients may reflect variation in access to health care or competing risk prior to commencing treatment. At the same time, smoking rates remained high in this ‘at risk’ population. Further work on this and ways to improve comorbidity reporting should be priorities for 2010–11.

Assessing modern ground survey methods and airborne laser scanning for digital terrain modelling:A case study from the Lake District, England

This paper compares the applicability of three ground survey methods for modelling terrain: one man electronic tachymetry (TPS), real time kinematic GPS (GPS), and terrestrial laser scanning (TLS). Vertical accuracy of digital terrain models (DTMs) derived from GPS, TLS and airborne laser scanning (ALS) data is assessed. Point elevations acquired by the four methods represent two sections of a mountainous area in Cumbria, England. They were chosen so that the presence of non-terrain features is constrained to the smallest amount. The vertical accuracy of the DTMs was addressed by subtracting each DTM from TPS point elevations. The error was assessed using exploratory measures including statistics, histograms, and normal probability plots. The results showed that the internal measurement accuracy of TPS, GPS, and TLS was below a centimetre. TPS and GPS can be considered equally applicable alternatives for sampling the terrain in areas accessible on foot. The highest DTM vertical accuracy was achieved with GPS data, both on sloped terrain (RMSE 0.16. m) and flat terrain (RMSE 0.02. m). TLS surveying was the most efficient overall but veracity of terrain representation was subject to dense vegetation cover. Therefore, the DTM accuracy was the lowest for the sloped area with dense bracken (RMSE 0.52. m) although it was the second highest on the flat unobscured terrain (RMSE 0.07. m). ALS data represented the sloped terrain more realistically (RMSE 0.23. m) than the TLS. However, due to a systematic bias identified on the flat terrain the DTM accuracy was the lowest (RMSE 0.29. m) which was above the level stated by the data provider. Error distribution models were more closely approximated by normal distribution defined using median and normalized median absolute deviation which supports the use of the robust measures in DEM error modelling and its propagation. © 2012 Elsevier Ltd.

Perceived causes of prescribing errors by junior doctors in hospital inpatients:a study from the PROTECT programme

Prescribing errors are a major cause of patient safety incidents. Understanding the underlying factors is essential in developing interventions to address this problem. This study aimed to investigate the perceived causes of prescribing errors among foundation (junior) doctors in Scotland.