Impacts of the Primary School Free Breakfast Initiative on socio-economic inequalities in breakfast consumption among 9–11-year-old schoolchildren in Wales

Objectives - Universal interventions may widen or narrow inequalities if disproportionately effective among higher or lower socio-economic groups. The present paper examines impacts of the Primary School Free Breakfast Initiative in Wales on inequalities in children's dietary behaviours and cognitive functioning.<p></p> Design Cluster - randomised controlled trial. Responses were linked to free school meal (FSM) entitlement via the Secure Anonymised Information Linkage databank. Impacts on inequalities were evaluated using weighted school-level regression models with interaction terms for intervention × whole-school percentage FSM entitlement and intervention × aggregated individual FSM entitlement. Individual-level regression models included interaction terms for intervention × individual FSM entitlement.<p></p> Setting - Fifty-five intervention and fifty-six wait-list control primary schools.<p></p> Subjects - Approximately 4500 children completed measures of dietary behaviours and cognitive tests at baseline and 12-month follow-up.<p></p> Results School-level models indicated that children in intervention schools ate a greater number of healthy items for breakfast than children in control schools (b = 0·25; 95 % CI 0·07, 0·44), with larger increases observed in more deprived schools (interaction term b = 1·76; 95 % CI 0·36, 3·16). An interaction between intervention and household-level deprivation was not significant. Despite no main effects on breakfast skipping, a significant interaction was observed, indicating declines in breakfast skipping in more deprived schools (interaction term b = −0·07; 95 % CI −0·15, −0·00) and households (OR = 0·67; 95 % CI 0·46, 0·98). No significant influence on inequality was observed for the remaining outcomes.<p></p> Conclusions - Universal breakfast provision may reduce socio-economic inequalities in consumption of healthy breakfast items and breakfast skipping. There was no evidence of intervention-generated inequalities in any outcomes

Changes in wave climate over the northwest European shelf seas during the last 12,000 years

Because of the depth attenuation of wave orbital velocity, wave-induced bed shear stress is much more sensitive to changes in total water depth than tidal-induced bed shear stress. The ratio between wave- and tidal-induced bed shear stress in many shelf sea regions has varied considerably over the recent geological past because of combined eustatic changes in sea level and isostatic adjustment. In order to capture the high-frequency nature of wind events, a two-dimensional spectral wave model is here applied at high temporal resolution to time slices from 12 ka BP to present using paleobathymetries of the NW European shelf seas. By contrasting paleowave climates and bed shear stress distributions with present-day conditions, the model results demonstrate that, in regions of the shelf seas that remained wet continuously over the last 12,000 years, annual root-mean-square (rms) and peak wave heights increased from 12 ka BP to present. This increase in wave height was accompanied by a large reduction in the annual rms wave- induced bed shear stress, primarily caused by a reduction in the magnitude of wave orbital velocity penetrating to the bed for increasing relative sea level. In regions of the shelf seas which remained wet over the last 12,000 years, the annual mean ratio of wave- to (M-2) tidal-induced bed shear stress decreased from 1 (at 12 ka BP) to its present-day value of 0.5. Therefore compared to present- day conditions, waves had a more important contribution to large-scale sediment transport processes in the Celtic Sea and the northwestern North Sea at 12 ka BP

Nurses\u27 Experience with Medication Errors

Medication administration is an inherent nursing task, placing nurses at significant risk for experiencing errors. A systematic literature review established that nurses experience emotional, cognitive, and physical distress effects following medication errors, positioning nurses as second victims. The purpose of the DNP Capstone Project was to evaluate the lived experiences and coping responses of pediatric direct-care nurses working in a Rocky Mountain region tertiary care facility to assess whether the nurses have unmet post-event support needs. A descriptive, non-experimental, mixed methods survey instrument was used for this study. Of the 115 direct-care nurses employed in the selected department, 82 were invited to participate in the capstone study and 66 completed the survey instrument (80.5% return rate). Data was analyzed using descriptive and correlational statistics for coping responses, category of medication error experienced, nurses\u27 perceptions of fear, shame, and guilt, and preferred support interventions. All subjects report experience with medication errors - ranging from working in a setting predisposing error to an error resulting in patient death. Nurses report fear, shame, and guilt as distress effects occurring in all medication error categories. Nurses\u27 feeling shame after an error were most likely to also report guilt (r = .82 -.97, p \u3c .001). Nurses\u27 adaptive coping responses prevail over maladaptive reactions. Nurses identified open, empathetic conversations with peers, family, and supervisors as optimal sources of support following medication error events. Recommendations include creating a formalized support process featuring effective communication education for departmental leadership to use with nurse second victims

Providing a secure base for LGBTQ young people in foster care: the role of foster carers

The experiences and needs of lesbian, gay, bisexual, trans and queer / questioning (LGBTQ) young people in care have been overlooked in England, both in policy and research. This article reports on findings from the first study of LGBTQ young people in care in England, and focuses on the nature of foster carers’ experiences and perspectives on caring for LGBTQ young people. Qualitative interviews regarding the fostering role in caring for LGBTQ young people were conducted with a sample of foster carers (n=26) and analysed thematically. Foster carers described the importance of offering LGBTQ young people not only the nurturing relationships that all children in care need, but also availability, sensitivity and acceptance to help young people manage stigma and other challenges associated with minority sexual orientation and gender identity. The Secure Base caregiving model provided a framework for analysing the different dimensions of these relationships. Understanding caregiving roles and relationships for LGBTQ young people in care has important implications for recruiting, training, matching and supporting foster carers to care for LGBTQ young people effectively