A systematic review investigating the behaviour change strategies in interventions to prevent misuse of anabolic steroids.http://researchonline.ljmu.ac.uk/7477/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription. Astract:This review aimed to examine strategies applied in interventions to prevent image and performance enhancing drug use in the context of intervention effectiveness. Comprehensive searches identified 14 interventions that met review inclusion criteria. Interventions were predominantly educational and delivered within school sport settings, but targeted a wide range of mediating factors. Identification of effective components was limited across studies by brief or imprecise descriptions of intervention content, lack of behavioural outcome measures and short-term follow up times; however studies with components in addition to information provision may be more promising. Interventions are required outside of sport settings to reflect the transition of this form of substance use to the general population. 2 Introduction Anabolic steroidsAnabolic steroids (AS) are the most prominent of a range of substances used to modify appearance and performance known as image and performance enhancing drugs (IPEDs).Globally the lifetime prevalence of AS has been estimated at 3.3%, with higher prevalence amongst males (6.4%) (Sagoe et al., 2014b), and it is suggested that nearly one third of AS users will develop a form of dependence (Pope et al., 2014a). Although AS can be used without adverse consequences, such as when used therapeutically, risk of harm increases with the far greater doses observed when AS are used outside of clinical settings (Harmer, 2010).Additionally, the quality of illicitly produced AS cannot be controlled and those using them frequently do so as part of complex IPED regimens. This misuse of AS is associated with a range of acute and chronic adverse consequences (Pope et al., 2014b) that range greatly from cosmetic (e.g. acne) to critical (e.g. cardiovascular disease, liver function) with evidence of potential psychological harms (e.g. increased aggression, mania) (ACMD, 2010b). Harms appear to increase with long-term use, which may be characterised by polypharmacy, long or continuous cycles of use, body image disturbance and obsession with training and diet (Kanayama et al., 2009).The majority of th...

Factors that influence nurses' assessment of patient acuity and response to acute deterioration.http://researchonline.ljmu.ac.uk/8425/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription. As they are responsible for the care they provide to their patients. A part of this care is the monitoring of the patient's vital signs such as blood pressure, pulse, respiratory rate, temperature, which are fundamental in the surveillance of health deterioration.

The rate of drug-facilitated sexual assault (DFSA; when an incapacitating drug is administered surreptitiously to facilitate sexual assault) is perceived to be increasing in the United Kingdom and elsewhere, causing international concern. This article examines evidence that quantifies the contribution of drugs in instances of alleged DFSA, identifies the substances involved, and discusses the implications of these findings. Of 389 studies examined, 11 were included in this review. The only study to consider covert drugging reported that 2% of alleged DFSA cases were attributable to surreptitious drug administration. Other studies failed to remove voluntary drug consumption from their cohort, biasing results. A study by the United Kingdom's National Forensic Services found no evidence to suggest that flunitrazepam (Rohypnol) had been used for DFSA during its 3-year investigation. In the United States, flunitrazepam is used recreationally, providing a likely explanation for its presence in samples of some alleged DFSA victims.

Background Muslim women of child-bearing age make up a fair part of the UK society, however, literature addressing their health needs or experiences of health services have not been extensively researched. The term ‘Muslim’ is often combined with ethnic group identity, rather than used to refer to people distinguished by beliefs or affiliations. Muslim women commonly observe certain religious and cultural practices during their maternity journey. The little research there is in this area suggests that more could be done from a service provision perspective to support Muslim women through this significant life event. The aim of this study was to investigate Muslim women’s perceived needs and the factors that influence their health seeking decisions when engaging with maternity services located in North-West of England. Methods The study used longitudinal semi-structured interviews with seven English-speaking first-time pregnant Muslim women receiving maternity care in North-West of England. Total of 21 interview; each woman was interviewed during the antenatal (29 to 40 weeks of pregnancy), immediate postnatal (within the first 2 months after birth) and later postnatal (4 months after birth) period. Audio-recorded interviews were transcribed and thematically analysed using Braun & Clark (2006) as a guide to forming a systematic approach to handling raw data. Results Muslim women associated most aspects of the maternity journey with their religious beliefs. Religion was not the primary reason for them becoming pregnant, yet it was an aspiration for them becoming mothers. Emerging themes include: 1) a spiritual perspective; 2) expression of religious requirements; 3) perceptions of healthcare professionals. Religious values and practices provided a positive resource for women during their maternity journey. They described how healthcare professionals approached their needs, while highlighting their concerns of the negative presentation of Muslims in Western media. Conclusion Muslim women need to feel confident to express their needs within a maternity setting. Lack of awareness amongst healthcare professionals around religious values and how Muslim women may feel when expressing their needs can inhibit them getting optimal care that acknowledges their needs. The study concludes that educating healthcare professionals about Muslim women’s worldview would enhance the quality of maternity care for Muslim women.

Understanding of the choices and motivations of people who use anabolic androgenic steroids (AAS) for muscular enhancement has increased greatly in the past thirty years, along with understanding of a wide range of health harms associated with this form of drug use in the community. During this period the predominant public health intervention for this population in the UK has consistently remained the provision of injecting equipment to prevent blood borne virus (BBV) transmission. The study explored the health professionals’ and other stakeholders’ perceptions on: whether the current UK public health response is sufficient to address the needs of people who use AAS, and if not, what other needs they might have. This included an exploration of whether there were gaps in harm reduction strategies or other behavioral outcomes and interventions that were needed. Interviews with 27 stakeholders who provide support to people who use AAS in a variety of roles established consensus on the need for a range of interventions to reduce harm and risk in those that choose to use AAS, to prevent initiation, to motivate and support cessation, and to prevent relapse. Study findings indicate that while providing sterile injecting equipment remains essential, it should be considered a bare minimum. The challenge is to develop and deliver a range of harm reduction interventions that look beyond BBV prevention to provide appropriate support to who choose to use AAS at all points in their cycles of use and ultimately for those choosing the temporary or permanent cessation of use.