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The causes of CHD are complex and often unknown, leading parents to ask how and why this has happened. Genetic counselling has been shown to benefit these parents by providing information and support; however, most parents currently do not receive this service. This study aimed to develop a brochure to determine whether an information resource could improve parents’ knowledge about CHD causation and inheritance and increase psychosocial functioning.
Methods:
In development, the resource was assessed against several readability scales and piloted. Parents of children attending preadmission clinic for surgery were included. Assessments occurred pre- and post-receiving the information resource using a purpose-designed knowledge measure and validated psychological measures.
Results:
Participant’s (n = 52) knowledge scores increased significantly from the pre-questionnaire (
${\overline x}\, = \,5/10$
, sd = 2.086) to post-questionnaire (
$\overline x\, = \,7.88/10$
, sd = 2.094, p < 0.001), with all aware that CHD can be caused by genetic factors after reading the brochure. Perceived personal control also increased from pre- (
$\overline x\, = \,11.856/18$
, sd = 4.339) to post-brochure (
$\overline x\, = \,14.644/18$
, sd = 3.733, p < 0.001), and many reported reduced feelings of guilt. No negative emotional response to the brochure was reported. The information provided was considered relevant (88%), reassuring (86%), and 88% would recommend the brochure to other parents. However, some wanted more emotional support and assistance in what to tell their child.
Conclusions:
Use of the information resource significantly enhanced parents’ knowledge of CHD causation and increased their psychosocial functioning. It is a valuable resource in the absence of genetic counselling; however, it should not replace formal genetic counselling when required.
Sperm donation in the United Kingdom was first described as a treatment in 1945 in Mary Barton’s article in the British Medical Journal (BMJ) [1]. Before and since that publication, innumerable children have been born as a result of either formal or informal sperm donation. Sperm freezing has been undertaken in animal work e.g. cattle for many years, and advances in the reliability of freezing and thawing techniques paved the way for the formation of sperm ‘banks’. In the United Kingdom in 1990, the storage of human gametes became a licensable activity through the Human Fertilisation and Embryology Act regulated by the Authority (HFEA) [2].
Reproductive medicine and surgery is a major subspecialty in the practice of obstetrics and gynaecology. This textbook provides an introduction to the field of subfertility and reproductive endocrinology, with contributions written by leading experts in the field. This book is based on and compliments a training programme run jointly by the British Fertility Society and the Royal College of Obstetricians and Gynaecologists, making it an indispensable handbook for medical trainees. It will also appeal to clinicians embarking on a career in obstetrics and gynaecology who want an excellent grounding in this area. Specialist nurses will also find the book a valuable resource, and scientists specialising in reproductive medicine and embryology will gain insight into the related clinical areas.
This article looks at the ways in which the Panacea Society – a heterodox, millenarian group based in Bedford during the inter-war years – spread its ideas: through personal, familial and shared belief networks across the British empire; by building new modes of attracting adherents, in particular a global healing ministry; and by shipping its publications widely. It then examines how the society appealed to its (white) members in the empire in three ways: through its theology, which put Britain at the centre of the world; by presuming the necessity and existence of a ‘Greater Britain’ and the British empire, while in so many other quarters these entities were being questioned in the wake of World War I; and by a deliberately cultivated and nostalgic notion of ‘Englishness’. The Panacea Society continued and developed the idea of the British empire as providential at a time when the idea no longer held currency in most circles. The article draws on the rich resource of letters in the Panacea Society archive to contribute to an emerging area of scholarship on migrants’ experience in the early twentieth-century British empire (especially the dominions) and their sense of identity, in this case both religious and British.
We report on the first open-label, parallel group randomised controlled trial of automated appointment reminders in a psychosis community service in the UK. Ninety-five patients were randomly allocated to receiving/not receiving automated messaging reminders 7 days and 1 day before appointments. All ‘Attended’ and ‘Missed’ appointment outcomes over 6 months were analysed using cluster regression analysis. Reminded appointments were significantly more frequently attended than non-reminded appointments (unadjusted odds ratio (OR) = 3.54, 95% CI 1.36–9.22, P = 0.01; adjusted OR = 2.95, 95% CI 1.05–8.85, P < 0.05). Automated messaging reminders can provide a robust strategy for promoting engagement with psychosis services.
Declaration of interest
The authors have no competing financial interests to declare in relation to the current work. Sarah McAllister was supported by a King's Undergraduate Research Fellowship.
Cyathostomins are ubiquitous nematodes of horses. Once ingested, they can spend a substantial time as encysted larvae in the intestinal wall. The larvae can comprise up to 90% of the total burden, with up to several million worms reported in individuals. These stages can emerge in large numbers to cause life-threatening colitis. Direct methods for detection of encysted larval burdens in live horses do not exist. Previously, two antigen complexes were identified as promising markers for infection. A component of these, cyathostomin gut associated larval antigen-1 (Cy-GALA-1), was identified following immunoscreening of a complementary DNA library. Serum immunoglobulin G(T) (IgG(T)) responses to Cy-GALA-1 were shown to inform on larval infection. Sequence analysis of polymerase chain reaction products amplified from individual worms indicated that Cy-GALA-1 was derived from Cyathostomum pateratum. As cyathostomin infections always comprise multiple species, a diagnostic test must account for this. Here, segments of the Cy-gala gene were isolated from four common species, Cyathostomum catinatum, Cylicocyclus ashworthi, Cylicostephanus goldi and Cylicostephanus longibursatus, and the associated proteins expressed in recombinant form. The specificity and immunogenicity of each protein was confirmed. Each protein was assessed by enzyme linked immuno sorbent assay (ELISA) for its ability for informing on the presence of encysted larval infection and the level of burden.
Ovulatory disorders can arise from any level of the hypothalamic-pituitary-ovarian axis. Ovulatory dysfunction may result from a lack of available oocytes or of follicles. Pelvic imaging, which is often undertaken at the time of examination by transvaginal ultrasound scan, can confirm normal pelvic organs and also provide an assessment of ovarian morphology, in particular polycystic appearance. Semen analysis for the male partner must be considered an absolute minimum. It is important to consider tubal patency if ovulation induction is planned and, in women with risk factors for tubal disease, prior assessment should be considered mandatory either by laparoscopy or contrast imaging. Liaison with endocrine colleagues is recommended when more complex endocrine disorders are involved. General fertility advice is important, including advice (for both partners) on weight management, smoking, alcohol and drugs, as is confirming an up-to-date smear result and female folic acid supplementation.
The research reported in this article investigated the nature and the purpose of older people's social interactions in their local neighbourhood shops. Data were collected through face-to-face interviews with and observation of 11 shoppers, aged 67 years and older, and six shopkeepers. Classic grounded theory analysis method revealed a previously uncharted psycho-social process associated with these interactions entitled by the authors as Civic Socialising; it highlights that older people's interactions in their local neighbourhood shops embody authentication of themselves as individuals and as community members, and their co-construction and co-preservation of the milieu of their local neighbourhood shopping precinct with a view to sustaining their ongoing autonomy. The new conceptual theory Civic Socialising highlights that older people can be proactive, resilient and capable, dimensions integral to human fulfilment, and demonstrates that older people can play an active role in their communities where the environment is enabling. The new conceptual theory Civic Socialising has significance for the way we determine and view older people's social relationships. Crucially, in light of a burgeoning older population world-wide, it is clear that policy makers and social planners must ensure that older people can continue to interact in their communities if ageing in place is to be a satisfying and cost-effective experience. Without such consideration, ageing in place could well create dependency and despondency.
Fe bioavailability can be manipulated by the nutritional composition of a meal. Ascorbic acid and unidentified components of meat, fish and poultry, but particularly beef, all appear to enhance the absorption of non-haem Fe. The aim of the present study is to identify whether extracts of green-lipped mussels (GLM; Perna canaliculus) enhance non-haem Fe absorption in Caco-2 cells and to compare the effect with that of beef. Raw GLM and raw beef homogenates were digested in vitro with pepsin at pH 2, and pancreatin and bile salts at pH 7. Tracer 55Fe was used to measure cellular Fe uptake. Ascorbic acid was used as a positive control and egg albumin, exposed to the same in vitro digestion process, was used as a negative control. Caco-2 cell monolayers were incubated with treatments for 60 min. All values were standardised per μg of GLM, egg albumin, beef or ascorbic acid. The results showed that ascorbic acid enhanced non-haem Fe absorption to the highest degree. Beef and GLM digestates both significantly enhanced Fe absorption compared with egg albumin. In conclusion, GLM digestate significantly enhances non-haem Fe uptake in Caco-2 cells with a similar magnitude to that of beef.
This paper reports one component of an evaluation of the different forms, types and models of local authority social services' care-management for older people that have emerged in England since 1993. It was undertaken at a time of a growing debate about whether care-management differentiated those with simple from complex needs, and whether for the latter a multi-disciplinary approach was required. A sample representative of different approaches to care-management was selected from a national survey of local authorities to explore the associations between types of care-management and case-mix, the services received by the clients, and the use of staff time. The paper addresses the categorisation of the types of care-management and the differences associated with these. The care-management teams were distinguished by whether they used a ‘targeted approach’, had ‘specialist older people's teams’, or used other arrangements. It was found that those with a targeted approach undertook more multi-disciplinary assessments, provided more assistance to older people with mental health problems, and that their staff spent significantly less time in direct contact with users and carers. Conversely, those with specialist older people's teams had more users in receipt of occupational therapy services. Further research is required to explore the influence of these different arrangements on the wellbeing of service users and their carers.
This paper describes a pilot study to evaluate the effectiveness of a school-based parenting programme combining the use of both affective (related to feelings) and behavioural strategies. In this paper we describe the intervention, its evaluation and a summary of the quantitative information gathered. The three pre-eminent ways in which parents appeared to have benefited from this particular programme included (1) the support they received in their parenting role from other parents, including a mirroring of problems, (2) the regaining of a sense of control in the parental role, in part through an increase in their capacity to think about matters calmly, and also through the provision of new tools with which to do the job of parenting, and (3) an increased ability to empathize and identify with their children, and a better understanding of the factors which motivate children to behave in particular ways. The capacity to think about matters calmly and the ability to empathize and identify with children appeared to be important factors in the reduction of inappropriate and unhelpful parenting practices such as shouting and smacking. It is suggested that empathy in particular is central to effective parenting, and that these results support the suggestion that there is an important added benefit for parents from programmes which combine behavioural and affective strategies focusing on feelings, relationships within the family, and the parents' own experience of being parented. The limitations of the data are discussed with reference to its reliability and validity, and the need for further research using grounded theory with other groups of parents.