Correction to: Working Overtime: Altered Functional Connectivity in Working Memory Following Regular Cannabis Use in Young Adults

International Journal of Mental Health and Addiction - The caption for Fig. 1 was incorrect in this article as originally published.     

Mapping alcohol and tobacco tax interventions for health in the UK: a qualitative framework analysis

BackgroundAlcohol and tobacco use undermine population health, generating substantial costs. Increasing price is an effective means to reduce consumption and tax is a key harm reduction tool. In the UK, alcohol and tobacco tax are managed within fiscal policy, which does not necessarily prioritise health promotion. We aimed to map the objectives and options for alcohol and tobacco tax change in the UK, including the potential for greater coordination to improve health.MethodsWe did five semi-structured interviews with ten participants selected for their expertise in alcohol or tobacco tax policy. Interviews occurred in pairs (ie, one alcohol and one tobacco expert in each interview) to elicit comparison between substances and were supported by a rapid literature review of tax options. Participants were from government, arms-length governmental organisations, and advocacy groups. Informed by a rapid literature review, comparative framework analysis of alcohol and tobacco tax policy objectives, options, and factors pertaining to coordination between tobacco and alcohol was done.FindingsParticipants raised common health objectives (reducing consumption, harm, inequalities) and fiscal objectives (raising revenue, mitigating societal costs). Drawing on options identified in the rapid review, participants discussed common tax options to achieve these objectives: tax rate increases (sudden rises, annual increases, minimum thresholds), changing tax structures (taxing products differently, tax proportional to harm), levies (taxing retailers and manufacturers), and revenue hypothecation (for prevention or treatment of addiction, local services). Participants were positive about policy exchange across alcohol and tobacco and modelling the combined effect of tax changes, but uncertain about formally linking tax policy across substances.InterpretationRaising tax is often considered to improve health by making products less affordable, but a tax regime that raises additional revenue can support prevention and treatment services and mitigate the social and economic costs of consumption. An unresolved issue for policy debate is who should pay this revenue and how revenue would be maintained if the health objective of falling consumption were met. Although more input from fiscal policymakers would deepen findings, our rapid review and interview approach facilitated discussion across alcohol and tobacco, and use of the framework approach ensured consistent analysis.FundingNational Institute of Health Research Public Health Research programme.     

The relationship between mindfulness,pain intensity,pain catastrophizing,depression, and quality of life among cancer survivors living with chronic neuropathic pain

Purpose

This study aims to examine if mindfulness is associated with pain catastrophizing, depression, disability, and health-related quality of life (HRQOL) in cancer survivors with chronic neuropathic pain (CNP).

Method

We conducted a cross-sectional survey with cancer survivors experiencing CNP. Participants (n?=?76) were men (24 %) and women (76 %) with an average age of 56.5 years (SD?=?9.4). Participants were at least 1 year post-treatment, with no evidence of cancer, and with symptoms of neuropathic pain for more than three months. Participants completed the Five Facets Mindfulness Questionnaire (FFMQ), along with measures of pain intensity, pain catastrophizing, pain interference, depression, and HRQOL.

Results

Mindfulness was negatively correlated with pain intensity, pain catastrophizing, pain interference, and depression, and it was positively correlated with mental health-related HRQOL. Regression analyses demonstrated that mindfulness was a negative predictor of pain intensity and depression and a positive predictor of mental HRQOL after controlling for pain catastrophizing, age, and gender. The two mindfulness facets that were most consistently associated with better outcomes were non-judging and acting with awareness. Mindfulness significantly moderated the relationships between pain intensity and pain catastrophizing and between pain intensity and pain interference.

Conclusion

It appears that mindfulness mitigates the impact of pain experiences in cancer survivors experiencing CNP post-treatment.

Implications for cancer survivors

This study suggests that mindfulness is associated with better adjustment to CNP. This provides the foundation to explore whether mindfulness-based interventions improve quality of life among cancer survivors living with CNP.

     

Validating a quality of life rating scale for idiopathic parkinsonism: Parkinson's Impact Scale (PIMS)

The signs and symptoms of idiopathic parkinsonism (IP, Parkinson's disease) are most commonly documented using one or more rating scales that assess physical limitations due to illness and drug side-effects with some attention being paid to depression. Scant attention has been paid to the impact of these limitations on a patient's life. Nurses in the Parkinson Foundation of Canada Clinical Assistance/ Outreach Programmes have designed a Quality of Life Rating Scale (Parkinson's Impact Scale, PIMS) to measure the impact of IP on 10 aspects of a patient's emotional, social and economic life. The scale had to fit onto one side of an 8 x 11 in. piece of paper, take a patient less than 10 min to complete, take fluctuations in symptoms ('on/off' attacks) into account, have unambiguous guidelines for the definition of each item, and a simple scoring system. A study was carried out to assess the reliability and validity of the scale. Nurses in nine Movement Disorder Clinics and one Outreach Programme participated. A total of 167 patients were asked to use the scale on three separate occasions, 1 month apart, without referring to the scores they had assigned to the scale in the previous month. Factor analysis identified four factors among the items in the scale: psychological, social, physical and financial. Internal consistency was 89.8% and the test-retest reliability was 72%. Construct validity was assessed by comparing factor scores and a global score between non-fluctuating patients and fluctuating patients in their 'off' state. The scores were significantly higher in the more severe 'off' state (p < 0.0001).     

Evaluation of midwife-led care provided at the Royal Bournemouth Hospital

OBJECTIVE: To compare the outcome of care given to women 'booking' for delivery in a midwife-led maternity unit with that for comparable women 'booking' for care in a consultant obstetric unit. DESIGN AND METHOD: Prospective cohort study with a quasi-experimental design and data extracted from case notes. SETTING: East Dorset, midwife-led maternity unit at Royal Bournemouth Hospital and consultant-led maternity unit at Poole General Hospital. SUBJECTS: Two cohorts of women who satisfied the criteria for 'booking' at the Royal Bournemouth Hospital. Of these 794 'booked' at Bournemouth from 1 November 1992 to 30 June 1993 and 705 'booked' at Poole over the same period. MAIN PROCESS AND OUTCOME MEASURES: Care given, morbidity in women and their babies, transfers during the antenatal period and in labour. FINDINGS: Of the women who initially 'booked' for Bournemouth, 62.3% actually delivered there, 27.1% transferred before labour and a further 9.2% transferred during labour. No differences were seen between those 'booked' for Bournemouth or Poole in the proportions of low birthweight babies, babies who were transferred to special care or babies who had congenital abnormality. Higher proportions of babies whose mothers 'booked' for delivery in Poole were resuscitated and had one minute Apgar scores below seven but there was no difference in the five minute scores. Similar proportions of women had perineal tears but fewer of the women 'booked' for delivery in Bournemouth had an episiotomy. 'Booking' for Poole was associated with higher rates of induction and augmentation of labour and greater use of anesthesia. 'Booking' for Bournemouth was associated with a shorter first stage and a longer third stage of labour. Women 'booked' for delivery in Bournemouth were no more likely to be delivered by a midwife than those 'booked' for Poole. CONCLUSIONS: There was very little difference between the groups of women who initially 'booked' for delivery at the two units. There were differences in the patterns of care received, but no major differences in the outcome for the women or their babies were detected.