Daily Relationship Functioning and Disordered Eating Behaviors Among Sexual Minority Women in Same-Sex Relationships.

BACKGROUND AND PURPOSE: The present study aimed to examine associations between different types of relationship functioning and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships-an at-risk population that has not been assessed in this context. METHODS: Participants included 321 young sexual minority women (Mage = 27.56, SD = 3.67) in same-sex relationships who completed surveys assessing their daily relationship functioning and DEB use each day for a 14-day daily diary period. Multilevel structural equation modeling was used to examine daily-, person-, and couple-level associations among women's daily relationship functioning (general relationship functioning, positive and negative relational behaviors they and, separately, their partners engaged in) and DEBs (overeating, loss of control eating, emotional eating, and dietary restriction). RESULTS: Results generally indicated that more positive and less negative daily relationship functioning across all assessed constructs was associated with less same-day emotional eating. In contrast, associations between all daily relationship functioning constructs and loss of control eating were not significant, nor were any relationship functioning-DEB associations at the couple level. More circumscribed patterns of association were identified for associations between the relationship functioning constructs, and overeating and dietary restriction. CONCLUSIONS: Collectively, these findings provide insight into how aspects of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term, and directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence-base and care for this historically overlooked and underserved population.

The present study examined associations between different types of relationship functioning (e.g., general relationship functioning, positive and negative relational behaviors that participants and their partners engaged in during their interactions with one another) and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships. Results generally indicated that on days when women reported more positive and less negative daily relationship functioning, they also reported less emotional eating that day. In contrast, associations between different types of daily relationship functioning and loss of control eating were not significant. Furthermore, associations between different types of daily relationship functioning relative to overeating and dietary restriction varied based on the type of relationship functioning and DEB under consideration. Collectively, these findings provide insight into how different types of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term. These findings also provide directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence base and care for this historically overlooked and underserved population.

Loneliness and the COVID-19 pandemic: implications for practice.

Loneliness is a complex universal human experience. A variety of evidence indicates that prolonged loneliness can have a negative effect on an individual's long-term physical and psychological outcomes. Empirical evidence and systematic reviews show strong links between loneliness and ill health, particularly cardiovascular disease and mental health. Loneliness is increasing in frequency and severity. The issue of loneliness has been part of UK Government mandates since 2018; however, evidence suggests that, due to the pandemic, the need to focus on the issue may be even more significant. Assessing for loneliness can be challenging and many people do not want to report their feelings of loneliness. Interventions should aim to be preventive and help people create meaningful interactions. Useful interventions include person-centred interventions, cognitive therapy and group intervention therapy. There is a need for more evidence-based loneliness interventions. A knowledge of local and voluntary sectors is vital so health professionals can effectively support their patients.

Transforming nursing care for children with serious long-term conditions: A mixed methods exploration of the impact of Roald Dahl Specialist Nurses in the United Kingdom.

PURPOSE: A new model of paediatric nursing, funded initially by a charitable organisation working in partnership with UK healthcare providers, was implemented to support children living with serious long-term conditions. This study explored, from the perspective of multiple stakeholders, the impact of services provided by 21 'Roald Dahl Specialist Nurses' (RDSN) within 14 NHS Trust hospitals. DESIGN AND METHODS: A Mixed Methods Exploratory design commenced with interviews with RDSNs (n = 21) and their managers (n = 15), alongside a medical clinician questionnaire (n = 17). Initial themes (constructivist grounded theory) were validated through four RDSN focus groups, and informed development of an online survey of parents (n = 159) and children (n = 32). Findings related to impact were integrated using a six-step triangulation protocol. RESULTS: Zones of significant impact included: Improving quality and experience of care; Improved efficiencies and cost-effectiveness; Provision of holistic family-centred care; and Impactful leadership and innovation. The RDSNs forged networks across inter-agency boundaries to safeguard the child and enhance the family experience of care. RDSNs delivered improvements across a range of metrics, and were valued for their emotional support, care navigation and advocacy. CONCLUSIONS: Children living with serious long-term conditions have complex needs. Regardless of the specialty, location, organisation or service focus, this new model of care crosses organisational and inter-agency boundaries to ensure that the healthcare delivered has maximum impact. It has a profoundly positive impact on families. PRACTICE IMPLICATIONS: This integrated and family-centred model of care is strongly recommended for children with complex needs crossing organisational divides.

The evolution of advanced nursing practice: Gender, identity, power and patriarchy.

To address longstanding workforce shortages, increase efficiency and control the costs associated with the modern health-care provision, there has been a worldwide policy to promote increased flexibility within the health-care workforce. This is being done primarily by extending the 'scope of practice' of existing occupational roles into what is referred to as 'advanced' practice. The development of the advanced practice nurse (APN) has occurred within the context of a shortage of medical staff, and the need to control cost. However, the means by which substantially repurposed occupational groups such as these, are incorporated into complex, hierarchical organisations such as the UK national health service (NHS) remains poorly understood. Using modern sociological theory, the development of the APN role has been examined in terms of power, control, professional identity and gender relations. Each of the theoretical approaches used adds to the quality of the discussion, although none provide a comprehensive picture. However, when synthesised, they do provide an enhanced insight into the evolution of the role. It is argued here that by critically examining the development of the APN role, this will enable both a better understanding of, and the means to influence, its future direction of travel.

Student nurses' career intentions following placements in general practice through the advanced training practices scheme (ATPS): findings from an online survey.

BACKGROUND: The demand for General Practice services in the UK, and elsewhere, is rising quickly. In part, the increasing demand is from an aging population that requires management of multiple long-term conditions. The General Practice Nurse is increasingly taking on the role. It is acknowledged that if general practice is to be able to recruit sufficient General Practice Nurses (GPNs) to meet this increasing demand in the future, new graduate nurses must be encouraged to consider general practice as a viable career option. This research is part of a review of the Advanced Training Practice Scheme (ATPS) which supported clinical placements in participating general practices. METHODS: The aim of the study was to examine nursing students' perceptions of GP placements, and their effect upon career intentions following graduation from Sheffield Hallam University (SHU), in the UK. Interviews and an online survey were used collect data. Only the survey is reported here. The bespoke survey examined students' views of: opportunities for learning new clinical skills and consolidating existing clinical skills; the learning environment in general practice and their views on a career in general practice. RESULTS: One thousand one hundred twenty undergraduate adult-field nursing students were contacted, with a response rate of 41% (N = 462). Ninety respondents had a placement and, 92% (N = 84) viewed practice nursing positively, and 77% (N = 70) felt that the placement had transformed their views on general practice. The opportunity to participate in the management of the various aspects of chronic disease was identified by 84% (N = 76) of the students as a key new skill they had acquired. They also reported that they valued a team ethos, control over aspects of work, and the variety of health problems they encountered. CONCLUSION: The findings from this study demonstrate a positive experience arising from the provision of General Practice placements for nursing students. The use of 'targeted' placement schemes with appropriate support such as this may be seen as a viable way of exposing nursing students to General Practice nursing, and of encouraging new graduate nurses to consider General Practice nursing as a viable career option.

Examining the Lesbian, Gay, and Bisexual Identity Scale Among Members of an Alternative Sexuality Special Interest Group.

The present study contributes to a growing body of literature developing psychometrically and theoretically grounded measures of sexual orientation minority identity. We tested psychometric properties and construct validity of a 27-item measure, the Lesbian, Gay, and Bisexual Identity Scale (LGBIS). The sample consisted of 475 adult (178 male, 237 female, 16 male-to-female, 14 female-to-male, and 30 gender queer persons) members of a special interest group, the National Coalition for Sexual Freedom. Participants completed a health needs questionnaire. Prominent findings included (1) confirmatory factor-analytic, internal consistency, and inter-correlation patterns support two LGBIS factor structures; (2) men, compared primarily to women, reported elevated scores on Acceptance Concerns, Concealment Motivation, Difficulty Process, and Negative Identity; (3) queer-identifying persons tended to report low Concealment Motivation, and high Identity Affirmation and Identity Centrality scores; (4) experimenting/fluid-identifying individuals tended toward higher Identity Uncertainty and Negative Identity, and lower Identity Centrality scores; (5) LGB community involvement was negatively associated with Concealment Motivation, Identity Uncertainty, and Negative Identity, and positively associated with Identity Superiority, Identity Affirmation, and Identity Centrality scores; and (6) Acceptance Concerns, Identity Uncertainty, and Internalized Homonegativity displayed significant positive associations with such mental health symptoms as general anxiety and posttraumatic stress. The LGBIS represents a useful approach to evaluating sexual orientation minority identity. Implications for identity theory, research, and practice are provided.

Independent and interactive associations of negative affect, restraint, and impulsivity in relation to binge eating among women.

There is growing recognition that impulsivity may serve as an underlying risk factor for binge eating. In addition, the association of impulsivity with binge eating may be moderated by other affective and cognitive risk factors. This study examined independent and interactive associations of negative affect, dietary restraint, and facets of impulsivity with binge eating. A diverse sample of 566 undergraduate women completed online questionnaires of study variables. Results revealed a three-way interaction of negative affect, dietary restraint, and attentional impulsivity in relation to binge eating. Women who were high on each of these three variables reported the greatest levels of binge eating. In addition, a two-way interaction was found for negative affect and nonplanning impulsivity in relation to binge eating, such that nonplanning impulsivity strengthened the association between negative affect and binge eating. Attentional and nonplanning facets of impulsivity may function as an underlying trait-level risk factor interacts with affective and/or cognitive risk (e.g., negative affect, dietary restraint) factors to predict elevated binge eating.

GP/GPN partner* perspectives on clinical placements for student nurses in general practice: can a community of practice help to change the prevailing culture within general practice?

BACKGROUND: The UK Government document 5 year forward view describes the need to move chronic disease management from secondary to primary care, which will require a significant increase in the numbers of General Practice Nurses (GPNs). Until recently, there has been no specific recruitment strategy to address this increased need. In recent times, a number of solutions have been suggested to address this impending GPN recruitment crisis. For example, Health Education England (HEE) commission General Practitioners (GPs), who are members of the Advanced Training Practice Scheme (ATPS), to provide placements for student nurses within general practice. METHODS: A descriptive qualitative study was undertaken, in which data were collected using semi-structured interviews with 16 GPs and 2 GPN partners*. Qualitative analysis used a framework approach and themes were cross-checked within the team and member checking was undertaken with a convenience sample of GPs. The research had ethical approval and anonymity and confidentiality were maintained. RESULTS: From the GP perspective, there were two key themes that emerged from the data. The first theme of 'fishing in the same small pond' included succession planning for the general practice workforce, the 'merry go round' of poaching staff from other practices, and the myths and misunderstandings that have grown up around general practice nursing. The second theme, 'growing your own', looked at the impact of the student nurse placements as a means to address the crisis in GPN recruitment. There was recognition of the need for cultural change in the way that GPNs are recruited, and that the ATPS was one way of helping to achieve that change. There were however a number of challenges to sustaining this cultural shift, such as the financial constrains placed upon the GP practice, and the need to function as a 'small business'. CONCLUSIONS: Despite all the challenges, the evidence is that, through the Community of Practice (CoP), the ATPS scheme is beginning to 'bear fruit', and there is a subtle but discernible move by GPs from a 'why would we?' to 'why wouldn't we?' invest in education and training for nurses in general practice. N.B. The term GPN partner* denotes a GPN who is a 'full partner' in the practice business, holding the same NHS contracts and the same status as a GP. For the purposes of the paper itself, the term GP will be used to denote both types of partner.

Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women.

BACKGROUND: Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women. OBJECTIVES: The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association. METHODS: Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who completed an online survey and reported at least one binge drinking episode as well as engaging in sexual activity in the past 30 days. RESULTS: Of these participants, 57 (53.3%) reported one or more experiences of sexual coercion in the past 30 days. Sexual coercion was associated with negative alcohol-related consequences via drinking to cope motives. Negative affect moderated the association between sexual coercion and drinking to cope motives such that the association was stronger among women with greater negative affect. Conclusions/Importance: Methods of addressing vulnerability to sexual coercion and educating young bisexual women about the association between sexual coercion and potentially problematic affective coping through alcohol use are needed.

Changing hearts and minds: examining student nurses' experiences and perceptions of a general practice placement through a 'community of practice' lens.

BACKGROUND: The recent UK Government paper 'Five year forward view' describes the need to move much patient management from secondary to primary care, and this will require a significant increase in the numbers of General Practice Nurses (GPNs). Until recently, there has been no clear recruitment strategy to address this. There have however been a number of proposed solutions to address the impending GPN recruitment crisis and to increase the numbers of new GPNs in post. General Practitioners (GPs) working in the Advanced Training Practice Scheme (ATPS) have been commissioned by Health Education England to provide placements for student nurses. This paper reports upon the findings of a study evaluating the South Yorkshire ATPS network in relation to nursing students' perceptions of general practice as a placement and a potential career option post-graduation. METHODS: Data were collected using semi-structured interviews with 18 nursing students. Qualitative data analysis used a framework approach and themes were cross-checked within the team. The research had ethical approval and anonymity and confidentiality were maintained throughout. RESULTS: Using the Communities of Practice (CoP) framework as a theoretical lens, two main themes emerged from the data: 'Myths and misunderstandings' outlined some of the misconceptions that abounded in the absence of an established CoP in general practice. These included perceptions of what constitutes a 'good' placement, an apparent lack of relevant content in the curriculum, and the widespread use of social media by students as a means of information gathering. 'Changing hearts and minds' referred to the need to positively influence the culture within general practice by addressing some of the longstanding myths. Through the fledgling CoP, the students' perceptions of the GPN role in particular were positively revised, as was the prospect of a career in general practice upon graduation. CONCLUSIONS: The CoP that is emerging through the ATPS placements appear to be gradually changing the socio-cultural landscape within general practice by enabling student nurses to experience the reality of life in general practice nursing, and to view the GPN role as a viable career option upon graduation.

Examining social support, rumination, and optimism in relation to binge eating among Caucasian and African-American college women.

PURPOSE: Binge eating is a significant concern among college age women-both Caucasian and African-American women. Research has shown that social support, coping, and optimism are associated with engaging in fewer negative health behaviors including binge eating among college students. However, the impact of sources of social support (i.e., support from family, friends, and a special person), rumination, and optimism on binge eating as a function of race/ethnicity has received less attention. The purpose of this study was to examine the association between social support, rumination, and optimism and binge eating among Caucasian and American-American women, separately. METHOD: Caucasian (n = 100) and African-American (n = 84) women from a university in the Mid-Atlantic US completed an online survey about eating behaviors and psychosocial health. RESULTS: Social support from friends was associated with less likelihood of binge eating among Caucasian women. Social support from family was associated with less likelihood of binge eating among African-American women, but greater likelihood of binge eating among Caucasian women. Rumination was associated with greater likelihood of binge eating among Caucasian and African-American women. Optimism was associated with less likelihood of binge eating among African-American women. CONCLUSIONS: These results demonstrate similarities and differences in correlates of binge eating as a function of race/ethnicity.

A daily diary study of perceived social isolation, dietary restraint, and negative affect in binge eating.

Negative affect and dietary restraint are key predictors of binge eating, yet less is known about the impact of social factors on binge eating. The study sought to replicate and extend research on the relationships between negative affect, dietary restraint, perceived social isolation and binge eating using a daily diary methodology. College women (N = 54) completed measures of dietary restraint, negative affect, perceived social isolation, and binge eating daily for 14 days. Participants completed the measures nightly each day. A series of generalized estimating equations showed that dietary restraint was associated with less binge eating while controlling for negative affect and for perceived social isolation separately. Negative affect and perceived social isolation were associated with greater binge eating while controlling for restraint in separate analyses, but only perceived social isolation was significant when modeled simultaneously. All two-way interactions between negative affect, dietary restraint, and perceived social isolation predicting binge eating were nonsignificant. This study furthers our understanding of predictors of binge eating in a nonclinical sample. Specifically, these data suggest perceived social isolation, negative affect, and dietary restraint are important variables associated with binge eating in daily life and warrant further research.

The Introduction of "Safety Science" into an Undergraduate Nursing Programme at a Large University in the United Kingdom.

Implementing safety science {a term adopted by the authors which incorporates both patient safety and human factors (Sherwood, G. (2011). Integrating quality and safety science in nursing education and practice. Journal of Research in Nursing, 16(3), 226-240. doi: 10.1177/1744987111400960)} into healthcare programmes is a major challenge facing healthcare educators worldwide (National Advisory Group on the Safety of Patients in England, 2013; World Health Organisation, 2009). Patient safety concerns relating to human factors have been well-documented over the years, and the root cause(s) of as many as 65-80 % of these events are linked to human error (Dunn et al., 2007; Reason, 2005). This paper will describe how safety science education was embedded into a pre-registration nursing programme at a large UK university. The authors argue that the processes described in this paper, may be successfully applied to other pre-registration healthcare programmes in addition to nursing.

Multi-agency perspectives on managing mangrove wetlands and the mosquitoes they produce.

A group of researchers, mosquito and coastal managers, and consultants joined together to explore issues of concern to coastal and mosquito management in mangrove forests. At a 1-day workshop in Florida, participants identified issues that are important for their roles. The issues were subsequently compiled into a matrix and the participants were asked to individually assess the importance and urgency of each. The most important issues for everyone included habitat responses to management, community attitude, public education, interaction between agencies, local connectivity, sea-level rise (SLR) loss of wetlands, and conservation. Most urgent were public education, conservation easements, local connectivity, SLR, loss of wetland, restoration, and conservation. There were differing viewpoints among the roles that appeared to be related to responsibility for and ability to influence on-ground outcomes. This is reflected in mosquito and coastal managers who viewed issues broadly and ascribed higher levels of importance and urgency to them than did researchers and consultants. We concluded that collaboration is a key issue. Barriers to collaboration include knowledge differences between agencies. Facilitators of collaboration include interaction, trust, and shared goals.

Predictors of perpetration of men's same-sex partner violence.

This study examined alcohol consumption, internalized homophobia, and outness as related to men's (N = 107) reports of the perpetration of violence against a same-sex partner. Higher typical weekly alcohol consumption, higher levels of internalized homophobia, and less outness (e.g., lower levels of disclosure of one's sexual orientation) predicted the perpetration of partner violence. In contrast to what we expected, the interaction between higher alcohol consumption and higher levels of outness about one's sexual orientation (i.e., being open to friends, family members, work colleagues) increased the likelihood of participants' reports of perpetrating physical violence. These results suggest the importance of both alcohol consumption and sexual minority stressors and their interactions in understanding men's perpetration of same-sex partner violence.

Profiles of binge eating: the interaction of depressive symptoms, eating styles, and body mass index.

Binge eating is associated with depressive symptoms, eating styles, and obesity. However, less is known about interactions between these variables and binge eating. This study examined the relationship between depressive symptoms, eating styles, body mass index, and binge eating. Individuals with a higher body mass index, who reported more depressive symptoms and more external eating, reported the greatest binge eating. Similarly, individuals with a higher body mass index who reported more depressive symptoms and more emotional eating reported the greatest binge eating. These findings demonstrate possible profiles of individuals most at risk for binge eating and associated eating disorders.

Blood glucose checks.

Measuring blood glucose in patients with diabetes by taking a sample of capillary blood is a safe method. It is also good for detecting hypoglycaemia or hyperglycaemia, and managing complications of diabetes.

Event-level drinking intentions, social drinking contexts, and motives affect alcohol consumption among same-sex female couples.

OBJECTIVE: Young sexual minority women (SMW; e.g., lesbian, bisexual women) are at increased risk for heavy drinking, though SMW in relationships may be at less risk than those who are single. The current study examined how SMW partners influence drinking in the moment, if own intentions predict drinking beyond partner influence and if this association is moderated by partner influence, and if own drinking motives moderate partner influence. METHOD: Young adult same-sex female couples (N = 162 couples) were recruited to participate in a 14-day daily diary study where they reported each morning their drinking intentions, motives, and behavior as well as whether their partner was present during drinking occasions. RESULTS: Findings from multilevel structural equation models revealed that own intentions and select partner influences (i.e., intentions, drinking) were uniquely linked to a greater quantity of drinking at the within-subject level. Significant interactions between own intentions and partner intentions, and between partner intentions and select drinking motives (social and enhancement) on same-day alcohol use were found at the within-subject level. CONCLUSIONS: Findings suggest that partner influences have a strong effect on drinking at the daily level, and can be strengthened or weakened when drinking for specific reasons. These findings expand on prior daily diary research on the effects of drinking motives by examining how these processes unfold in same-sex female couples and their intersection with partner intentions.

Dr. Tulp, I presume: intellectual disability and ethnicity in Rotherham.

In this article, we report on that aspect of our ongoing simulation project which focuses on the cultural needs of a 'virtual' young man living with profound and multiple intellectual disabilities, who is British Asian and receives care in a residential setting. We describe our involvement with a local agency who support families from black and minority ethnic populations and who have children with a variety of intellectual disabilities. We then go on to detail the focus group we attended and how we incorporated the data generated into a more comprehensive story for our 'virtual' young man, Ahmed.

General practice nurse trainees' perspectives on general practice nursing as a career choice: qualitative findings from a vocational training scheme in the United Kingdom (UK).

BACKGROUND: There is a shortage of general practice nurses worldwide to deal with an ever-increasing workload, and the need to attract new staff into general practice nursing is therefore vital. As part of this, a one-year Vocational Training Scheme (VTS) for new to general practice nurses was developed in 2020 by the South Yorkshire Primary Care Workforce and Training Hub. METHODS: The aim of the study was to examine the VTS trainees' views on general practice nursing as a career. A pragmatic, convenience sample of trainees was recruited. Of the 21 trainees, 17 agreed to take part in the study. Data were collected from the trainees using a series of four regular, timed, online focus groups designed to follow the trainees' trajectory on the programme over a 12-month period. The data were analysed using framework analysis. RESULTS: The timed nature of the focus groups meant that the analysis of the data was linked to the trainees' trajectory over the course of the year. Three themes were generated from the data: 'pathways into general practice'; 'learning to be a GPN'; and 'the future GPN'. In theme one, the trainees talked of the difficulties in accessing general practice as a new graduate, specifically the need for prior experience and how to get it. In the second, the transition to being a general practice nurse was discussed, and the expectation of being able to 'hit the ground running' once in post. The new graduate participants were also concerned over the opportunities for clinical supervision and support in the role after the programme. Finally, the participant s expressed concern over future opportunities for professional development and the prospects for a long-term career in general practice. CONCLUSION: To address the worldwide workforce 'crisis' in general practice nursing, sustainable career pathways are needed to encourage new graduate nurses to consider working in general practice. Starting at university, changing the culture and providing the necessary infrastructure to support ongoing professional development in general practice nursing are key to its success.