Highbury Hospital

This article reports on the career choice of foundation doctors going through a local foundation programme and whether they planned to take an F3 year. The authors also prospectively gathered views relating to their career choice and the need for an F3 year. Data were gathered from 193 foundation doctors training in Nottinghamshire between 2015 and 2020 through an unstructured interview process. Data were anonymised and used to learn about career pathway choices and whether they planned to take an F3 year option. Reasons for this pathway were also explored. Data showed that there was a steady increase in the proportion of trainees opting for F3 over time. The local picture in terms of trainees taking an F3 option reflects the national trend. Some trainees find foundation training a stressful time and so need to be offered support. The authors comment on the factors that make a career appealing to trainees.

Methods:The intervention was delivered through a one-day workshop (n=3) using a narrative informed intervention.Results: Pre and post measures evidence clinically significant change in the attitudes and perceptions of staff, with change evident in a positive direction.Qualitative analysis demonstrates the thickening of narratives.An increase in person-centred care plans and a decrease in the reliance of restrictive practices to safely manage perceived risks occurred throughout the day. Conclusion:The results highlight the strength of applied learning tasks centred on care aspects of the forensic nursing role to enhance changes in routine practice and to challenge stereotyped attitudes.

BackgroundPeople with dementia progressively lose abilities and are prone to falling. Exercise- and activity-based interventions hold the prospect of increasing abilities, reducing falls, and slowing decline in cognition. Current falls prevention approaches are poorly suited to people with dementia, however, and are of uncertain effectiveness. We used multiple sources, and a co-production approach, to develop a new intervention, which we will evaluate in a feasibility randomised controlled trial (RCT), with embedded adherence, process and economic analyses.MethodsWe will recruit people with mild cognitive impairment or mild dementia from memory assessment clinics, and a family member or carer. We will randomise participants between a therapy programme with high intensity supervision over 12 months, a therapy programme with moderate intensity supervision over 3 months, and brief falls assessment and advice as a control intervention. The therapy programmes will be delivered at home by mental health specialist therapists and therapy assistants. We will measure activities of daily living, falls and a battery of intermediate and distal health status outcomes, including activity, balance, cognition, mood and quality of life. The main aim is to test recruitment and retention, intervention delivery, data collection and other trial processes in advance of a planned definitive RCT. We will also study motivation and adherence, and conduct a process evaluation to help understand why results occurred using mixed methods, including a qualitative interview study and scales measuring psychological, motivation and communication variables. We will undertake an economic study, including modelling of future impact and cost to end-of-life, and a social return on investment analysis.DiscussionIn this study, we aim to better understand the practicalities of both intervention and research delivery, and to generate substantial new knowledge on motivation, adherence and the approach to economic analysis. This will enable us to refine a novel intervention to promote activity and safety after a diagnosis of dementia, which will be evaluated in a definitive randomised controlled trial.Trial registrationClinicalTrials.gov: NCT02874300; ISRCTN 10550694.

One of Carl Rogers’ six “necessary and sufficient” conditions for person-centered therapy (PCT) is the client’s state of incongruence; the Second Condition. This article begins with examining the meaning of incongruence in PCT theory. It questions the adequacy of “conditions-of-worth” as the central explanatory premise for the clients’ states of incongruence and introduces the notion of “condition of un-worth”. The Second Condition is re-evaluated by examining the PCT formulations of self, organismic experiencing and incongruence as existential touchstones. Anxiety is located on the phenomenological ground of being human indicating ontological incongruence in the face of death. Existential authenticity and PCT congruence are explored comparatively and shown as having the potential of mutually fostering one another. Non-directivity as a guiding principle for PCT practice is reflected upon in the context of the Second Condition.

Over the last three decades, demographic changes in the developed world have meant more older men find themselves in caregiving roles. Little research has been undertaken with male caregivers in dementia care. Although there is general consensus that men construe care differently to women, gender has seldom been treated as an independent variable that can inform supportive interventions. This study, underpinned by an assumption of the benefits of men's differential response to managing illness, sought to explore how facets of masculinity might relate to male caregivers’ appraisals of strain and gain in dementia care. Seventy men, currently caring for a partner with dementia, completed questionnaires exploring their gender identity (Personal Attributes Questionnaire), gender role conflict (Gender Role Conflict Scale), and appraisals of carer strain and gain (Brief Zarit Burden Interview and Caregiving Satisfaction Scale). They were also asked to provide demographic information and, since caregiver strain is significantly affected by a care-receiver's cognitive and behavioural difficulties, to complete the revised Memory and Behaviour Problems Checklist. Carers’ age and duration of caregiving was broadly representative of previous studies. A series of regression analyses revealed contrasting findings to previous studies. Gender identity did not appear important in carer's evaluations of strain or gain, and only the ‘restrictive affectionate behaviour between men’ subscale of gender role conflict had explanatory power in analyses with all strain and gain variables. Findings are discussed with regard to response bias and defended masculinity. Consideration is made about how men can successfully access services.

We study the dynamical nature of phase oscillator networks on a Bethe lattice. We derive self-consistent equations for the cavity fields (i.e. the oscillator probability distributions) by using the cavity method both in equilibrium and via an analytic approximation for non-equilibrium states. The order parameters and their evolution equations are obtained as functions of the cavity fields. The theoretical results and the accuracy of our approximations are confirmed by comparison with simulations involving direct integration of the Langevin equations describing the microscopic oscillator dynamics.

The author mentions his theory of monophyletic evolution of the heteromeroid aedeagus in the insect order Coleoptera and defines Heteromera as Cucujoidea with heteromeroid aedeagus, whereby a Cucujoid beetle with heteromeroid aedeagus or its modification is not a member of Clavicornia but of Heteromera and vice versa. 17 primitive and derivative alternatives of characters of adults and larvae of the Heteromera are mentioned, of which the primitive characters are also shared with the Clavicornia, logically due to ancestry. The presence (+). absence (−) or gap in our knowledge (?) of the following 44 larval characters of the 33 families of Heteromera (arranged alphabetically: Anthicidae — including Cononotidae, Eurygeniidae and Pedilidae —, Boridae. Byturidae, Cephaloidae, Cisidae or Ciidae, Colydiidae, Dacoderidae, Diphyllidae or Biphyllidae, Hemipeplidae including Mycteridae, Inopeplidae, Melandryidae, Meloidae, Merycidae, Monommidae, Mordellidae, Mycetophagidae, Nilionidae, Oedemeridae, Othniidae or Elacatidae, Perimylopidae, Prostomidae, Pterogeniidae, Pyrochroidae, Pythidae, Rhipiphoridae, Salpingidae, Scraptiidae including Anaspis, Synchroidae. Tenebrionidae — including Alleculidae, Heterotarsidae. Lagriidae and Petriidae —, Tetratomidae, Trictenotomidae, Xylophilidae or Aderidae, and Zopheridae) is compared under 11 headings (mode of life and habits, shape, size, coloration. vestiture and armature, head, sense organs, mouth parts, thorax, abdomen and spiracles) numbered as follows: 1, mode of life and habits; 2, shape; 3, size; 4, coloration; 5, setae (chaetotaxy); 6, prognathous or hypognathous; 7, coronal suture and frontal suture, latter lyre-shaped or not (together = median epicranial suture): 8. clypeal or epistomal or frontoclypeal suture; 9, clypeolabral suture; 10, epipharynx; 11, hypostomal margins or rods: 12, hypopharyngeal sclerome; 13, ocelli; 14, sensory appendix or sensorium or tactile papilla or accessory process of antenna: 15, third antennal segment more than half longer than second or less; 16, number of antennal segments; 17, antennal insertion separated from base of mandible by a visible strip or not; 18, mandibles symmetrical or asymmetrical; 19, mandibular mola present; 20, mola asperate or with tubercles; 21, armament of mola extending ventrally; 22, mola with fine transverse ridges; 23, fleshy or setose post-molar appendage and penicillus; 24, retinaculum; 25, at least one mandible with multi-dentate or multi-lobed cutting edge along inner dorsal margin; 26, maxillary cardo divided or bipartite; 27, maxillary mala toothed; 28, mala with uncus (non-dentate. spine or hook-like); 29, ligula present or absent; 30, gula distinct from submentum and not united; 31, number of leg segments and claws; 32, prothorax longer than meso- or meta-thorax; 33, prothorax wider than others; 34, abdominal segments 10 or 9; 35, ninth sternite with asperities; 36, ninth sternite composed of a series of small plates; 37, ninth sternite broad and flat, plate-like: 38, urogomphi present; 39, complex or branched urogomphi; 40, urogomphi widely separated at base; 41, tenth sternite produced into 1 or 2 pseudopods; 42, spiracles annular-biforous; 43, spiracles cribriform; and 44, spiracles provided with a series of small peripheral tubes or not. A note on the pupa of Anthicidae is also included. The gaps indicated in the paper need to be filled. In every family (at any level), the primitive and derivative groups, the primitive and derivative characters, the direction in which the transformation series is to be read (and why) must be discovered and deduced according to the known principles discussed by the author elsewhere. In a phylogenetic classification, the larvae and adults (all structural and nonstructural characters) of the primitive groups are more important than those of derivative groups as indicators of relationships and ancestries at any level in Biology. R. A. Crowson's view that the Anthicidae has evolved from Xylophilid ancestors is discussed and rejected in favour of a Pyrochroid ancestry for Anthicids, advanced by the author earlier based on his studies of primitive genera (including his discoveries of Baltic amber fossils) of these families. Finally, the author warns his readers against ‘loose use of words’, ‘ascientific’ attitudes. and ‘overstatements of their position’ by some modern workers who publish their speculations on phylogeny, relationships. affinities etc., which are carefully and nicely worded to hide their ignorance or violations of the theoretical principles of such work on phylogenetic systematics. The author also defends ‘systematics’ and ‘systematic workers’ against the existing fanaticism and prejudice.

ABSTRACTThe web with its hyperlinking is a great environment in which to put electronic journals and to encourage linking of texts. But reference links will only be used substantially if readers incorporate them into new patterns of habitual use. In doing so, many users will be in search mode and only some types of user will habitually use reference linking. There needs to be a sufficient number of references that are linked, the right processes to achieve that efficiently, and something that is worthwhile at the end of the link. Ideally users would get full text and some new business models are suggested that match what users do and the new technical possibilities. All these factors point to the need for patience among providers, rather than expecting to see instant substantial use by e‐journal users.