Nurses´ attitudes to single checking medications : before and after its use

We report nurses' attitudes towards the single checking of medications before and after the implementation of this procedure in an acute health-care setting. Data from a pre-implementation survey confirmed that some nurses held strong views against single checking. Following this survey, the hospital's medication administration policy was revised, a single checking resource manual was developed, 1–2 h nurse education sessions were held, the competencies of nurses to single check and to administer medications were assessed, and single checking was successfully piloted before hospital-wide implementation. Data from a survey conducted 18 months after the implementation indicated that nurses welcomed the single checking medication procedure, felt more confident using single checking and perceived that it made them more accountable for administering medications. The findings provide evidence that nurses' attitudes to single checking change remarkably in favour of its use with education and experience using this procedure.

‘We should change ourselves, but we can’t’: accounts of food and eating practices amongst British Pakistanis and Indians with type 2 diabetes

Objective(s). To look at food and eating practices from the perspectives of Pakistanis and Indians with type 2 diabetes, their perceptions of the barriers and facilitators to dietary change, and the social and cultural factors informing their accounts.

Method. Qualitative, interview study involving 23 Pakistanis and nine Indians with type 2 diabetes. Respondents were interviewed in their first language (Punjabi or English) by a bilingual researcher. Data collection and analysis took place concurrently with issues identified in early interviews being used to inform areas of investigation in later ones.

Results. Despite considerable diversity in the dietary advice received, respondents offered similar accounts of their food and eating practices following diagnosis. Most had continued to consume South Asian foods, especially in the evenings, despite their perceived concerns that these foods could be 'dangerous' and detrimental to their diabetes control. Respondents described such foods as 'strength-giving', and highlighted a cultural expectation to participate in acts of commensality with family/community members. Male respondents often reported limited input into food preparation. Many respondents attempted to balance the perceived risks of eating South Asian foodstuffs against those of alienating themselves from their culture and community by eating such foods in smaller amounts. This strategy could lead to a lack of satiation and is not recommended in current dietary guidelines.

Conclusions. Perceptions that South Asian foodstuffs necessarily comprise 'risky' options need to be tackled amongst patients and possibly their healthcare providers. To enable Indians and Pakistanis to manage their diabetes and identity simultaneously, guidelines should promote changes which work with their current food practices and preferences; specifically through lower fat recipes for commonly consumed dishes. Information and advice should be targeted at those responsible for food preparation, not just the person with diabetes. Community initiatives, emphasising the importance of healthy eating, are also needed.

Accounts of developing absolute pitch in young children's music education

The retrospective case study investigations highlighted the important role of parents, family members and significant others in the community in providing a nurturing environment, a variety of learning opportunities, necessary support resources, and expertise which, it is argued, contributed to the development of the participants' absolute pitch abilities.

Men's accounts of domestic violence

Domestic violence against men by their female partners is a much neglected area of attention. Sufficient data has emerged recently to suggest men suffer domestic violence more than previously acknowledged. The findings were that, overall, the men were hurt more by the emotional aspects than any physical violence. They found no dedicated support systems for male domestic violence victims.

Should I believe this? Reality monitoring of accounts of self-experienced and invented recent and distant autobiographical events

To examine personal and interpersonal reality monitoring, 240 participants wrote accounts of invented or self-experienced autobiographical events. Half the participants wrote about a distant event that happened before the age of 15 and half wrote about a recent event that happened after the age of 15. Using a yoked design, participants rated the qualitative details of their own accounts and the details of other participants’ accounts. Consistent with previous research, we found that self-experienced accounts contained more qualitative details than invented accounts, and that accounts of recent events contained more qualitative details than accounts of distant events. Participants rated their own accounts as more qualitatively detailed than other participants’ accounts, which suggests that they did not base their self-ratings solely on the written details. We discuss the practical and theoretical importance of our findings. Copyright # 2006 John Wiley & Sons, Ltd.

Factors impacting story-grammar production in children's narrative accounts of events

This thesis examined factors associated with increased story-grammar production in police interviews with children who allege abuse. These factors included the child's age, the type of question asked and the nature of the event experienced by the child. Recommendation for improving story-grammar, which in turn enhances witness credibility, were discussed. The portfolio explored how an awareness of specific responsivity factors can inform treatment recommendations and execution in rehabilitation of offenders with substance use issues. Four case studies are presented in illustration.

Increased energy intake entirely accounts for increase in body weight in women but not in men in the UK between 1986 and 2000

There is debate over the casual factors for the rise in body weight in the UK. The present study investigates whether increases between 1986 and 2000 for men and women were a result of increases in mean total energy intake, decreases in mean physical activity levels or both. Estimates of mean total energy intake in 1986 and 2000 were derived from food availability data adjusted for wastage. Estimates of mean body weight for adults aged 19–64 years were derived from nationally representative dietary surveys conducted in 1986–7 and 2000–1. Predicted body weight in 1986 and 2000 was calculated using an equation relating body weight to total energy intake and sex. Differences in predicted mean body weight and actual mean body weight between the two time points were compared. Monte Carlo simulation methods were used to assess the stability of the estimates. The predicted increase in mean body weight due to changes in total energy intake between 1986 and 2000 was 4·7 (95 % credible interval 4·2, 5·3) kg for men and 6·4 (95 % credible interval 5·9, 7·1) kg for women. Actual mean body weight increased by 7·7 kg for men and 5·4 kg for women between the two time points. We conclude that increases in mean total energy intake are sufficient to explain the increase in mean body weight for women between 1986 and 2000, but for men, the increase in mean body weight is likely to be due to a combination of increased total energy intake and reduced physical activity levels.

Adjuvant therapy, not mammographic screening, accounts for most of the observed breast cancer specific mortality reductions in Australian women since the national screening program began in 1991

There has been a 28% reduction in age-standardised breast cancer mortality in Australia since 1991 when the free national mammographic program (BreastScreen) began. Therefore, a comparative study between BreastScreen participation and breast cancer age specific mortality trends in Australia was undertaken for two time periods between 1991 and 2007, where women aged 50–59 and 60–69 years, who were invited to screen, were compared to women aged 40–49 and 70–79 years who were not invited, but who did have access to the program. There were mortality reductions in all four age groups between 1991–1992 and 2007, resulting in 5,849 (95% CI 4,979 to 6,718) fewer women dying of breast cancer than would have otherwise been the case. Women aged 40–49 years, who had the lowest BreastScreen participation (approximately 20%), had the largest mortality reduction: 44% (95% CI 34.8–51.2). Women aged 60–69 years, who had the highest BreastScreen participation (approximately 60%), had the smallest mortality reduction: 19% (95% CI 10.5–26.9). As BreastScreen participation by invited women aged 50–69 years only reached a maximum of about 55–60% in 1998–1999, a decline in mortality in Australian women cannot be attributed to BreastScreen prior to this time. Thus, almost 60% of the Australian decline in breast cancer mortality since 1991 cannot be attributed to BreastScreen. Therefore, mammographic screening cannot account for most of the reductions in breast cancer mortality that have occurred in Australian women since 1991 and may have contributed to over-diagnosis. Most, if not all, of the reductions can be attributed to the adjuvant hormonal and chemotherapy, which Australian women have increasingly received since 1986.

Does the cognitive interview promote the coherence of narrative accounts in children with and without an intellectual disability?

We examined whether the cognitive interview (CI) procedure enhanced the coherence of narrative accounts provided by children with and without intellectual disabilities (ID), matched on chronological age. Children watched a videotaped magic show; one day later, they were interviewed using the CI or a structured interview (SI). Children interviewed using the CI reported more correct details than those interviewed using the SI. Additionally, children interviewed using the CI reported more contextual background details, more logically ordered sequences, more temporal markers, and fewer inconsistencies in their stories than those interviewed using the SI. However, the CI did not increase the number of story grammar elements compared with the SI. Overall children interviewed with the CI told better stories than those interviewed with the SI. This finding provided further support for the effectiveness of the CI with vulnerable witnesses, particularly children with ID.