Tokophobia and fear of birth: a workshop consensus statement on current issues and recommendations for future research.

Objective: To discuss and develop a statement on the current state of the evidence and opinion in Fear of Childbirth (FoC) and Tokophobia (Tocophobia), and to provide recommendations. Background: A group met in 2019 to discuss the state of clinical and academic knowledge relating to FoC/Tokophobia. Five key areas were agreed as the focus of the meeting. Methods: 12 internationally acknowledged experts, in this or a closely related area (e.g. PTSD) met to discuss their understanding of the evidence for FoC/ Tokophobia and current practice. The consensus described in this paper constitutes the expression of the general opinion of the participants and does not necessarily imply unanimity. Keys points: Work focussed on tokophobia is recent and there remains a wide range of issues, which were addressed in the workshop including complexity in defining prevalence, a theoretical lack of understanding, which creates challenge for robust assessment and the identification of risk factors. An improved aetiological and developmental understanding of the tokophobia is required to underpin appropriate, effective and evidence-based interventions. Evaluation of pathways of care and relevant interventions, should be a focus of future research. Conclusion: Significant gaps remain within the FoC/tokophobia knowledge base. Further research is necessary.

Sodium cationization can disrupt the intramolecular hydrogen bond that mediates the sunscreen activity of oxybenzone.

A key decay pathway by which organic sunscreen molecules dissipate harmful UV energy involves excited-state hydrogen atom transfer between proximal enol and keto functional groups. Structural modifications of this molecular architecture have the potential to block ultrafast decay processes, and hence promote direct excited-state molecular dissociation, profoundly affecting the efficiency of an organic sunscreen. Herein, we investigate the binding of alkali metal cations to a prototype organic sunscreen molecule, oxybenzone, using IR characterization. Mass-selective IR action spectroscopy was conducted at the free electron laser for infrared experiments, FELIX (600-1800 cm-1), on complexes of Na+, K+ and Rb+ bound to oxybenzone. The IR spectra reveal that K+ and Rb+ adopt binding positions away from the key OH intermolecular hydrogen bond, while the smaller Na+ cation binds directly between the keto and enol oxygens, thus breaking the intramolecular hydrogen bond. UV laser photodissociation spectroscopy was also performed on the series of complexes, with the Na+ complex displaying a distinctive electronic spectrum compared to those of K+ and Rb+, in line with the IR spectroscopy results. TD-DFT calculations reveal that the origin of the changes in the electronic spectra can be linked to rupture of the intramolecular bond in the sodium cationized complex. The implications of our results for the performance of sunscreens in mixtures and environments with high concentrations of metal cations are discussed.

Unravelling the Keto-Enol Tautomer Dependent Photochemistry and Degradation Pathways of the Protonated UVA Filter Avobenzone.

Avobenzone (AB) is a widely used UVA filter known to undergo irreversible photodegradation. Here, we investigate the detailed pathways by which AB photodegrades by applying UV laser-interfaced mass spectrometry to protonated AB ions. Gas-phase infrared multiple-photon dissociation (IRMPD) spectra obtained with the free electron laser for infrared experiments, FELIX, (600-1800 cm-1) are also presented to confirm the geometric structures. The UV gas-phase absorption spectrum (2.5-5 eV) of protonated AB contains bands that correspond to selective excitation of either the enol or diketo forms, allowing us to probe the resulting, tautomer-dependent photochemistry. Numerous photofragments (i.e., photodegradants) are directly identified for the first time, with m/z 135 and 161 dominating, and m/z 146 and 177 also appearing prominently. Analysis of the production spectra of these photofragments reveals that that strong enol to keto photoisomerism is occurring, and that protonation significantly disrupts the stability of the enol (UVA active) tautomer. Close comparison of fragment ion yields with the TD-DFT-calculated absorption spectra give detailed information on the location and identity of the dissociative excited state surfaces, and thus provide new insight into the photodegradation pathways of avobenzone, and photoisomerization of the wider class of ß-diketone containing molecules.

Experience Focussed Counselling with Voice Hearers as a Trauma-Sensitive Approach. Results of a Qualitative Thematic Enquiry.

The individual approach of the Hearing Voices Movement, Experience Focussed Counselling or Making Sense of Voices, claims a strong life context and trauma focus. This qualitative study represented the first to explore whether Experience Focussed Counselling with voice hearers, when compared to Treatment As Usual, could be considered trauma-sensitive. Twenty-five semi-structured interviews with voice hearers and mental health professionals in routine German mental health settings were analysed as part of an Applied Thematic Analysis. Overall themes identified were: trauma related; dealing with emotions; process of working with voices; intra- and interpersonal life; and coping related. Experience Focussed Counselling was considered helpful in understanding and working on unresolved trauma-related areas of distress. The same did not apply to Treatment As Usual. Findings support Experience Focussed Counselling as a trauma-sensitive intervention in hearing voices. Frontline mental health staff can potentially support voice hearers in identifying and working on trauma-related voices and emotions.

Development and validation of a new bariatric-specific health-related quality of life instrument ''bariatric and obesity-specific survey (BOSS)''.

BACKGROUND: There is a lack of a psychometrically robust bariatric-specific health-related quality of life (HRQOL) tool. AIM: A single centre, prospective study to develop and validate a new bariatric-specific 81-item self-report HRQOL instrument called the Bariatric and Obesity-Specific Survey (BOSS). MATERIALS AND METHODS: Data were collected from 236 participants. Of these 83 patients were under consideration for bariatric surgery (Group 1) 68 patients had undergone a bariatric procedure (Group 2) and 85 normal healthy participants (Group 3). At baseline, participants were asked to complete the Short Form Health survey (SF-36), Hospital Anxiety and Depression (HADS) scale, Moorehead-Ardelt Quality of life Questionnaire (M-A QoLQ II), and a demographic data sheet. Two weeks following the completion of these five questionnaires, participants were asked to complete BOSS once more along with a feedback sheet. RESULTS: Exploratory factor analysis revealed a multidimensional instrument consisting of 42 items distributed over six domains that addressed various HRQOL aspects and dimensions pertinent to bariatric surgery, and relevant to morbidly obese patients. Further psychometric analysis showed that BOSS has adequate internal consistency reliability (Cronbach α = 0.970), test re-test reliability (ICC = 0.926), construct validity, criterion validity, face validity and acceptability. CONCLUSION: BOSS thus appears to be a valid and reliable multidimensional instrument that provides a clinically useful and relevant measure to assess HRQOL in patients undergoing bariatric surgery.

Regional analgesia techniques for total knee replacement.

PURPOSE OF REVIEW: Pain following total knee arthroplasty is a challenging task for healthcare providers. Concurrently, fast recovery and early ambulation are required to regain function and to prevent postoperative complications. Ideal postoperative analgesia provides sufficient pain relief with minimal opioid consumption and preservation of motor strength. Regional analgesia techniques are broadly used to answer these expectations. Femoral nerve blocks are performed frequently but have suggested disadvantages, such as motor weakness. The use of lumbar epidurals is questioned because of the risk of epidural hematoma. Relatively new techniques, such as local infiltration analgesia or adductor canal blocks, are increasingly discussed. The present review discusses new findings and weight between known benefits and risks of all of these techniques for total knee arthroplasty. RECENT FINDINGS: Femoral nerve blocks are the gold standard for total knee arthroplasty. The standard use of additional sciatic nerve blocks remains controversial. Lumbar epidurals possess an unfavourable risk/benefit ratio because of increased rate of epidural hematoma in orthopaedic patients and should be reserved for lower limb amputation; peripheral regional techniques provide comparable pain control, greater satisfaction and less risk than epidural analgesia. Although motor weakness might be greater with femoral nerve blocks compared with no regional analgesia, new data point towards a similar risk of falls after total knee arthroplasty with or without peripheral nerve blocks. Local infiltration analgesia and adductor canal blockade are promising recent techniques to gain adequate pain control with a minimum of undesired side-effects. SUMMARY: Femoral nerve blocks are still the gold standard for an effective analgesia approach in knee arthroplasty and should be supplemented (if needed) by oral opioids. An additional sciatic nerve blockade is still controversial and should be an individual decision. Large-scale studies are needed to reinforce the promising results of newer regional techniques, such as local infiltration analgesia and adductor canal block.

Assessment of the quality of life of vulnerable young males with severe emotional and behaviour difficulties in a residential setting.

Sixty-four looked after and accommodated males aged 13-16 had an assessment of their quality of life using Paediatric Quality of Life Inventory (PedsQL) and Quality of Life in Care (QOLIC). The participants were from a Scottish residential centre for young people with severe emotional and behavioural difficulties. The total sample of 64 participants consists of two distinct groups: residential group (n = 33) and a secure care group (n = 31). Over 3 observations the aim of the study was to identify similarities and differences between the groups and to establish the sensitivity of the PedsQL and the PedsQL in care module (QOLIC) as a measurement instrument for Quality of Life (QoL) in adolescent males. Overall there was a nonsignificant increase in the quality of life of these young people at the centre as measured by PedsQL and QOLIC over 3 observations. No significant differences were detected in the quality of life scores between the two groups using the QOLIC.

Detection of unusual reaction intermediates during the conversion of W(N2)2(dppe)2 to W(H)4(dppe)2 and of H2O into H2.

W(N(2))(2)(dppe-κ(2)P)(2) reacts with H(2) to form WH(3){Ph(C(6)H(4))PCH(2)CH(2)PPh(2)-κ(2)P}(dppe-κ(2)P) and then W(H)(4)(dppe-κ(2)P)(2). When para-hydrogen is used in this study, polarized hydride signals are seen for these two species. The reaction is complicated by the fact that trace amounts of water lead to the formation of H(2), PPh(2)CH(2)CH(2)Ph(2)P(O) and W(H)(3)(OH)(dppe-κ(2)P)(2), the latter of which reacts further via H(2)O elimination to form W(H)(4)(dppe-κ(2)P)(2) and [WH(3){Ph(C(6)H(4))PCH(2)CH(2)PPh(2)-κ(2)P}(dppe-κ(2)P)]. These studies demonstrate a role for the 14-electron intermediate W(dppe-κ(2)P)(2) in the CH activation reaction pathway leading to [WH(3){Ph(C(6)H(4))PCH(2)CH(2)PPh(2)-k(2)P}(dppe-k(2)P)]. UV irradiation of W(H)(4)(dppe-κ(2)P)(2) under H(2) led to phosphine dechelation and the formation of W(H)(6)(dppe-k(2)P)(dppe-k(1)P) rather than H(2) loss and W(H)(2)(dppe-κ(2)P)(2) as expected. Parallel DFT studies using the simplified model system W(N(2))(2)((Ph)HPCH(2)CH(2)PH(2)-κ(2)P)(H(2)PCH(2)CH(2)PH(2)-κ(2)P) confirm that ortho-metalation is viable via both W(dppe-κ(2)P)(2) and W(H)(2)(dppe-κ(2)P)(2) with explicit THF solvation being necessary to produce the electronic singlet-based reaction pathway that matches with the observation of para-hydrogen induced polarization in the hydride signals of [WH(3){Ph(C(6)H(4))PCH(2)CH(2)PPh(2)-κ(2)P}(dppe-κ(2)P)], W(H)(3)(OH)(dppe-κ(2)P)(2) and W(H)(4)(dppe-κ(2)P)(2) during this study. These studies therefore reveal the existence of differentiated and previously unsuspected thermal and photochemical reaction pathways in the chemistry of both W(N(2))(2)(dppe-κ(2)P)(2) and W(H)(4)(dppe-κ(2)P)(2) which have implications for their reported role in N(2) fixation.

Disordered gambling among higher-frequency gamblers: who is at risk?

BACKGROUND: When gambling opportunities are made available to the public in a given jurisdiction, some individuals participate occasionally and others more frequently. Among frequent gamblers, some individuals develop problematic involvement and some do not. This study addresses the association among demographic and social risk factors, frequency of gambling and gambling disorders. METHOD: Data from an adult community sample (n=1372) were used to identify risk factors for higher-frequency gambling and disordered gambling involvement. RESULTS: Individuals with higher intelligence, older individuals and more religious individuals were less frequent gamblers. Males, single individuals and those exposed to gambling environments (friends and family who gamble) and those who started to gamble at a younger age were more frequent gamblers. Excitement-seeking personality traits were also higher among more frequent gamblers. A different set of risk factors was associated with the likelihood of gambling disorder among these higher-frequency gamblers. These variables included mental health indicators, childhood maltreatment and parental gambling involvement. Among higher-frequency gamblers, individuals who smoke cigarettes, those with a diagnosis of alcohol or drug dependence or obsessive-compulsive disorder, those with higher anxiety or depression and those with higher impulsivity and antisocial personality traits were more likely to report gambling-related problems. These individuals were also more likely to report gambling on electronic gambling machines (e.g. slot machines). CONCLUSIONS: These data suggest a model in which higher-frequency gambling, particularly with electronic gambling machines, when combined with any type of emotional vulnerability increased the likelihood of gambling disorder.

Synovial and cartilage responsiveness to peri-operative hyaluronic acid ± dexamethasone administration following a limited injury to the rabbit stifle joint.

Posttraumatic osteoarthritis (PTOA) can develop after an injury to the knee. Previous studies have indicated that an intra-articular (IA) injection of the potent glucocorticoid dexamethasone (DEX) may significantly prevent induction of PTOA. The aim of the present study was to investigate the effectiveness of a single IA injection of hyaluronic acid (HA), alone and in combination with DEX following a localized intra-articular injury as a PTOA-preventing treatment option. An established rabbit model of surgical injury consisting of dual intra-articular (IA) drill holes in a non-cartilaginous area of the femoral notch near the origin of the anterior cruciate ligament (ACL) to allow for bleeding into the joint space was used. Immediately following surgery, subjects were treated with HA, HA + DEX, or received no treatment. An uninjured control group was used for comparison (N = 5/group). Rabbits were sacrificed and investigated at 9 weeks post-injury. At 9 weeks post-injury, there was a significant protective capacity of the single IA treatment of DEX + HA on the histological grade of the synovial tissue, and some variable location-specific effects of HA alone and HA + DEX interactions on cartilage damage. Thus, it is possible that co-treatment with HA may interfere with the effectiveness of the DEX. In vitro friction testing indicated that DEX did not interfere with the lubricating ability of HA or synovial fluid on cartilage. These results suggest that a single IA administration of HA in combination with DEX following an IA injury is not recommended for inhibition of PTOA progression in this model.

Iridium N-heterocyclic carbene complexes as efficient catalysts for magnetization transfer from para-hydrogen.

While the characterization of materials by NMR is hugely important in the physical and biological sciences, it also plays a vital role in medical imaging. This success is all the more impressive because of the inherently low sensitivity of the method. We establish here that [Ir(H)(2)(IMes)(py)(3)]Cl undergoes both pyridine (py) loss as well as the reductive elimination of H(2). These reversible processes bring para-H(2) and py into contact in a magnetically coupled environment, delivering an 8100-fold increase in (1)H NMR signal strength relative to non-hyperpolarized py at 3 T. An apparatus that facilitates signal averaging has been built to demonstrate that the efficiency of this process is controlled by the strength of the magnetic field experienced by the complex during the magnetization transfer step. Thermodynamic and kinetic data combined with DFT calculations reveal the involvement of [Ir(H)(2)(η(2)-H(2))(IMes)(py)(2)](+), an unlikely yet key intermediate in the reaction. Deuterium labeling yields an additional 60% improvement in signal, an observation that offers insight into strategies for optimizing this approach.

Isomer selective IR-UV depletion spectroscopy of 4-fluorotoluene-NH3: evidence for π-proton-acceptor and linear hydrogen-bonded complexes.

The 4-fluorotoluene-ammonia van der Waals complex has been studied using IR-UV depletion and hole-burning spectroscopies with assignments supported by ab initio and DFT calculations of ground state binding energies and intramolecular vibrational frequencies. The experimental IR-UV depletion and hole-burning spectra presented here provide unequivocal empirical evidence that the 4FT-NH(3) complex exists in two almost equally stable conformational forms. Both isomers contribute intensity to the experimental R2PI spectrum with one responsible for bands appearing to the red of the 4FT band origin position, and the other for those appearing immediately to the blue. On the basis of comparison of computed NH stretching frequencies with those obtained from the IR-UV spectra, the red-shifted bands are assigned to a π-proton-acceptor complex featuring an NH···π-hydrogen bond, and the blue-shifted bands are assigned to an in-plane σ-complex in which the ammonia binds in the plane of the ring forming a double-hydrogen-bonded six-membered ring with the fluorine atom. Ground state interaction energies computed at the M06-2X/cc-pVTZ level were found to compare favourably with those obtained at the CCSD(T) CBS level, although the former resulted in overbinding of the π-complex compared with the in-plane conformer, a characteristic shared with MP2 level calculations. The observation of a π-complex in addition to a σ-complex is consistent with the conclusion that the electron-donating power of the methyl group is sufficiently large to counter-balance the electron-withdrawing power of the fluorine atom.

Reconsidering fear of birth: Language matters.

Interest in fear of childbirth has grown exponentially since the 1980s, but the landscape of birth has shifted considerably since then, with evolving feminism; moving from a patriarchal environment in a biomedical model of care to a holistic model which recognizes the birth and sexuality rights of women and birthing people. Distinguishing the spectrum of fear from low to high and severe is important rather than aggregating all individuals with fear of childbirth. However, the terms 'fear of childbirth' and 'tocophobia' have been used interchangeably. In this paper we urge clinicians to use the term 'tocophobia' with caution since it may be construed negatively and there is a limited understanding of the underpinning aetiology of tocophobia. Furthermore, using the label may be disempowering for women and birthing people making decisions about their birth. Further research is warranted to better understand the experience, refine and define the issue and meet the individual needs of people with fear of childbirth and tocophobia.

The role of the methyl group in stabilising the weak N-H...pi hydrogen bond in the 4-fluorotoluene-ammonia complex.

The 4-fluorotoluene-ammonia van der Waals complex has been studied using a combination of resonant two-photon ionisation (R2PI) spectroscopy, ab initio molecular orbital calculations and multidimensional Franck-Condon analysis. The R2PI spectrum shows two sets of features assignable to two distinct conformers: one in which the ammonia binds between the hydrogen meta to the methyl group and the fluorine atom in a planar configuration and the other a pi-bound structure involving one bond between an ammonia hydrogen and the pi-system and another between the ammonia lone pair and the slightly acidic hydrogens on the methyl group. Ground state estimated CCSD(T) interaction energies were computed at the basis-set limit: these calculations yielded very similar interaction energies for the two conformers, whilst zero point energy correction yielded a zero point binding energy for the pi-complex about 10% larger than that of the in-plane, sigma-complex. The results of multidimensional Franck-Condon simulations based on ab initio ground and excited state geometry optimisations and vibrational frequency calculations showed good agreement with experiment, with further improvements achieved using a fitting procedure. The observation of a pi-complex in addition to a sigma-complex supports the intuitive expectation that electron-donating groups should help to increase pi-density and hence stabilise pi-proton acceptor complex formation. In this case, this occurs in spite of the presence of a strongly electron-withdrawing fluorine atom.

Nanomaterials: a membrane-based synthetic approach.

Materials with nanoscopic dimensions not only have potential technological applications in areas such as device technology and drug delivery but also are of fundamental interest in that the properties of a material can change in this regime of transition between the bulk and molecular scales. In this article, a relatively new method for preparing nanomaterials, membrane-based synthesis, is reviewed. This method entails synthesis of the desired material within the pores of a nanoporous membrane. Because the membranes used contain cylindrical pores of uniform diameter, monodisperse nanocylinders of the desired material, whose dimensions can be carefully controlled, are obtained. This "template" method has been used to prepare polymers, metals, semiconductors, and other materials on a nanoscopic scale.

Metal nanotubule membranes with electrochemically switchable ion-transport selectivity.

Membranes containing cylindrical metal nanotubules that span the complete thickness of the membrane are described. The inside radius of the nanotubules can be varied at will; nanotubule radii as small as 0.8 nanometer are reported. These membranes show selective ion transport analogous to that observed in ion-exchange polymers. Ion permselectivity occurs because excess charge density can be present on the inner walls of the metal tubules. The membranes reject ions with the same sign as the excess charge and transport ions of the opposite sign. Because the sign of the excess charge on the tubule can be changed potentiostatically, a metal nanotubule membrane can be either cation selective or anion selective, depending on the potential applied to the membrane.

An excited state ab initio and multidimensional Franck-Condon analysis of the A (1)B2 <-- X (1)A1 band system of fluorobenzene.

This work combines high level ab initio calculations with multidimensional Franck-Condon calculations to refine and augment previous assignments of the lower wavenumber region of the A (1)B(2) <-- X (1)A(1) band system of fluorobenzene. The strength of the assignment has been greatly assisted by the use of zero electron kinetic energy spectroscopy in a series of pump-probe experiments where the response of the molecule to selective excitation in specific modes prior to ionization has been studied. The net result of this analysis is the reassignment of 7 of the 12 previously assigned bands in the region below about 1000 cm(-1) using a strategy that aims to trace the origins of excited state normal modes of fluorobenzene to the well-known Wilson modes of benzene by taking full account of the Duschinsky mixing that accompanies electronic excitation. Duschinsky normal mode analyses of the ground and first excited states of fluorobenzene as well as the electronic ground state of fluorobenzene cation have shown that the common use of the benzene Wilson notation to describe normal modes of this prototypical benzene derivative is highly questionable, particularly following electronic excitation and ionization.

Using hyperpolarised NMR and DFT to rationalise the unexpected hydrogenation of quinazoline to 3,4-dihydroquinazoline.

PHIP and SABRE hyperpolarized NMR methods are used to follow the unexpected metal-catalysed hydrogenation of quinazoline (Qu) to 3,4-dihydroquinazoline as the sole product. A solution of [IrCl(IMes)(COD)] in dichloromethane reacts with H2 and Qu to form [IrCl(H)2(IMes)(Qu)2] (2). The addition of methanol then results in its conversion to [Ir(H)2(IMes)(Qu)3]Cl (3) which catalyses the hydrogenation reaction. Density functional theory calculations are used to rationalise a proposed outer sphere mechanism in which (3) converts to [IrCl(H)2(H2)(IMes)(Qu)2]Cl (4) and neutral [Ir(H)3(IMes)(Qu)2] (6), both of which are involved in the formation of 3,4-dihydroquinazoline via the stepwise transfer of H+ and H-, with H2 identified as the reductant. Successive ligand exchange in 3 results in the production of thermodynamically stable [Ir(H)2(IMes)(3,4-dihydroquinazoline)3]Cl (5).

Replicability and stability of the multidimensional model of the Edinburgh Postnatal Depression Scale in late pregnancy.

The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool for post-natal depression (PND). Recent factor analytic investigations of the EPDS have suggested the instrument may be useful in the prediction of PND as the instrument appears to be multidimensional, thus facilitating sub-scale development for this purpose. The psychometric properties of the EPDS were evaluated in women in the third trimester of pregnancy. Confirmatory factor analyses found support for the multidimensionality of the instrument; however, there was clear variability in model fit to data suggesting previous reports of the stability of the underlying factor structure of this instrument may be over-optimistic. The potential for development of the EPDS as a predictive screening measure of PND is likely to be optimistic because of variability in the factor structure of the instrument over the course of pregnancy and in the post-natal period.

Perceptions of learning disability nurses and support staff towards people with a diagnosis of schizophrenia.

WHAT IS KNOWN ABOUT THE SUBJECT?: People with learning disability are more likely than the general population to develop schizophrenia. Personal recovery philosophies are based on positive attitudes and an optimism that recognizes and values people and their strengths and capacity to achieve goals. Little is known from previous studies about the illness perceptions of learning disability practitioners who work with people that experience both a learning disability and schizophrenia. The illness beliefs of learning disability practitioners about schizophrenia may mediate the potential for social exclusion and limit recovery outcomes. WHAT THIS STUDY/PAPER ADDS TO EXISTING KNOWLEDGE?: The findings show that the illness beliefs of learning disability practitioners and support workers regarding schizophrenia are pessimistic in terms of the consequences for people with schizophrenia and learning disability and their relatives as well as the chronic course of the illness. WHAT ARE THE IMPLICATIONS FOR CLINICAL PRACTICE?: This study identifies the nature of LD practitioner perceptions about schizophrenia and provides guidance about how personal recovery philosophies can be applied to the management of LD and schizophrenia. The beliefs of learning disability practitioners and support workers regarding schizophrenia need to be reframed to support better recovery outcomes and social inclusion for this group. The findings from this study can inform the development of training in bio-psycho-social models of schizophrenia, recovery approaches, family/carer interventions, clinical supervision, mentorship and reflection on clinical practice, which could be potentially useful strategies to help facilitate a reframing of beliefs. ABSTRACT: Background and purpose of study The prevalence of schizophrenia in people with learning disability is 3-4%. This is the first study to investigate the illness perceptions of learning disability (LD) practitioners towards people with schizophrenia. Methods Learning disability practitioners (n = 210) that work with people with LD and schizophrenia completed a modified version of the Illness Perception Questionnaire Schizophrenia Carers Version (IPQ-SCV). Descriptive and correlational analyses were conducted for all of the IPQ-SCV subscales. Results A significant positive correlation was found between consequences relative and consequences patient (0.495, P < 0.001), and a negative correlation was found between timeline episodic and timeline chronic (-0.243, P < 0.001) subscales. Discussion Consistent with previous evidence found regarding negative staff attitudes to schizophrenia recovery outcomes, course and chronicity, the current investigation has extended and confirmed these observations to staff working with individuals with comorbid schizophrenia and learning disability. Implications for practice This study identifies the nature of LD practitioner perceptions about schizophrenia and contributes to the development of the recovery philosophy in relation to the management of LD and schizophrenia. The findings inform the design of training modules in bio-psycho-social models of schizophrenia, recovery approaches, family intervention, clinical supervision and reflection. These can help LD practitioners to reframe their schizophrenia/LD illness beliefs.