The Impact of Mental Illness and Intellectual Disability Information on General Public Perceptions of a Person Convicted of a Child Sex Offence

A person convicted of sex offences (PCSO) is confronted with several challenges upon re-entry to the community, often facing difficulties accessing housing and employment, and experiencing stigmatisation, hostility and harassment from community members. Given the importance of community support for successful reintegration, we examined differences in public (N = 117) attitudes toward a PCSO against a child (PCSO-C) with mental illness or intellectual disability compared to a neurotypical PCSO-C in an online survey. At present, differences in attitudes towards these groups has not been explored. Results indicated the PCSO-Cs with intellectual disability or mental illness were seen to pose less risk of sexual reoffending and prompted higher levels of reintegration comfort than the neurotypical PCSO-C. Participants' prior personal exposure to mental illness or intellectual disability was unrelated to attitudes, but those who believed that PCSOs in general have a low capacity for change attributed greater risk of sexual reoffending, greater risk of future harm to children, higher levels of blame and lower reintegration comfort, regardless of MI and ID information. Female participants also perceived greater risk of future harm to adults, and older participants estimated higher risk of sexual reoffending than younger participants. Findings have implications for community acceptance of PCSO-Cs and jury decision-making processes and highlight the importance of public education regarding neurodiverse PCSO-Cs and PCSO capacity for change to encourage knowledge-based judgements.

Dual-task decrements in mono-, bi- and multilingual participants: Evidence for multilingual advantage

Evidence suggests that language processing in bilinguals is less left-lateralized than in monolinguals. We explored dual-task decrement (DTD) for mono-, bi- and multilinguals in a verbal-motor dual-task paradigm. We expected monolinguals to show greater DTD than bilingual participants, who would show greater DTD than multilingual participants. Fifty right-handed participants (18 monolingual, 16 bilingual, 16 multilingual) completed verbal fluency and manual motor tasks in isolation and concurrently. Tasks were completed twice in isolation (left-handed, right-handed) and twice as dual-tasks (left-handed, right-handed); participants' motor-executing hands served proxy for hemispheric activation. Results supported the hypotheses. Completing dual-tasks incurred greater cost for manual motor tasks than for verbal fluency tasks. Negative cost of performing dual-tasks diminished as number of languages spoken increased; in fact, multilingual individuals demonstrated a dual-task advantage in both tasks when using the right hand, strongest in the verbal task. Dual-tasking had the greatest negative impact on verbal fluency of monolingual participants when the motor task was completed with the right hand; for bi- and multi-lingual participants, the greatest negative impact on verbal fluency was seen when the motor task was completed with the left hand. Results provide support for the bi-lateralization of language function in bi- and multilingual individuals.

Exploring the effects of COVID-19 restrictions on wellbeing across different styles of lockdown

Countries have instigated different restrictions in response to the COVID-19 pandemic. For instance, nationwide, strict “lockdown” in Scotland was enacted with breaches punishable by law, whereas restrictions in Japan allowed for travel and interaction, with citizens requested rather than required to conform. We explored the impact of these differential strategies on health behaviours and wellbeing. In February 2021, 138 Scottish and 139 Japanese participants reported their demographic information, pandemic-induced health behaviour-change (alcohol consumption, diet, perceived sleep quality, physical activity), negative mood, and perceived social isolation. Scottish participants’ health behaviours were characterised by greater change (typically negative), most likely due to greater lifestyle disruption, whereas Japanese participants’ behaviours were more-stable. Negative changes to health behaviours were typically associated with poorer mental wellbeing and isolation. Interestingly though, Japanese participants reported greater negative mood but not isolation despite the less-restrictive lockdown. Taken together, different lockdown styles led to different changes in health behaviours.

Emoji Identification and Emoji Effects on Sentence Emotionality in ASD-Diagnosed Adults and Neurotypical Controls

We investigated ASD-diagnosed adults' and neurotypical (NT) controls' processing of emoji and emoji influence on the emotionality of otherwise-neutral sentences. Study 1 participants categorised emoji representing the six basic emotions using a fixed-set of emotional adjectives. Results showed that ASD-diagnosed participants' classifications of fearful, sad, and surprised emoji were more diverse and less 'typical' than NT controls' responses. Study 2 participants read emotionally-neutral sentences; half paired with sentence-final happy emoji, half with sad emoji. Participants rated sentence + emoji stimuli for emotional valence. ASD-diagnosed and NT participants rated sentences + happy emoji as equally-positive, however, ASD-diagnosed participants rated sentences + sad emoji as more-negative than NT participants. We must acknowledge differential perceptions and effects of emoji, and emoji-text inter-relationships, when working with neurodiverse stakeholders.

Intimate Partner Stalking/Pursuit: A Pathophysiology of Attachment Style

Approximately half of stalking victims were previously in an intimate relationship with the perpetrator, and attachment style is strongly correlated with intimate partner stalking (IPS). In the first study to investigate polyvagal theory in IPS, we examined 58 adult participants' attachment style, sex, history of IPS, vagal tone activity (i.e., heart rate variability; HRV), and cognitive processing disruptions (i.e., Stroop performance) in either participants who wished a relationship or in those who wished to maintain a relationship post-break-up. Results showed that males were more likely to perpetrate IPS than females. Anxious-style participants were more likely to have perpetrated IPS, showed greater cognitive disruption and HRV than avoidant-style participants. Our results support theories that attachment is a biological imperative with neurobiological implications that can be indexed physiologically and cognitively. This study is the first to demonstrate a pathophysiology of attachment style to IPS, in a replicable way. IPS is discussed as reflective of disordered arousal and related to anxiety. Recommendations for further research and clinically-relevant interventions are presented.

Social isolation during COVID-19 lockdown impairs cognitive function

Studies examining the effect of social isolation on cognitive function typically involve older adults and/or specialist groups (e.g., expeditions). We considered the effects of COVID‐19‐induced social isolation on cognitive function within a representative sample of the general population. We additionally considered how participants ‘shielding’ due to underlying health complications, or living alone, performed. We predicted that performance would be poorest under strictest, most‐isolating conditions. At five timepoints over 13 weeks, participants (N = 342; aged 18–72 years) completed online tasks measuring attention, memory, decision‐making, time‐estimation, and learning. Participants indicated their mood as ‘lockdown’ was eased. Performance typically improved as opportunities for social contact increased. Interactions between participant sub‐groups and timepoint demonstrated that performance was shaped by individuals' social isolation levels. Social isolation is linked to cognitive decline in the absence of ageing covariates. The impact of social isolation on cognitive function should be considered when implementing prolonged pandemic‐related restrictive conditions.

Changes in Diet, Sleep, and Physical Activity Are Associated With Differences in Negative Mood During COVID-19 Lockdown

The United Kingdom and Scottish governments instigated a societal lockdown in response to the COVID-19 pandemic. Subsequently, many experienced substantial lifestyle changes alongside the stresses of potentially catching the virus or experiencing bereavement. Stressful situations and poorer health behaviors (e.g., higher alcohol consumption, unhealthy diet, poorer sleep quality, physical inactivity) are frequently linked to poor mental health. Our objective was to examine changes in health behaviors and their relationship with negative mood during COVID-19 lockdown. We also considered associations between health behaviors and socio-demographic differences and COVID-19-induced changes. 399 participants completed a questionnaire asking about their personal situation and health behaviors during lockdown as well as a negative mood scale. The significance threshold for all analyses was α = 0.05. Poorer diet was linked to more-negative mood, and to changes to working status. Poorer sleep quality was linked with more-negative mood, and with 'shielding' from the virus. Being less physically active was related to more-negative mood and student status, whereas being more physically active was linked to having or suspecting COVID-19 infection within the household. Increased alcohol consumption was linked to living with children, but not to negative mood. Changes to diet, sleep quality, and physical activity related to differences in negative mood during COVID-19 lockdown. This study adds to reports on poor mental health during lockdown and identifies lifestyle restrictions and changes to health behaviors which may, to some extent, be responsible for higher negative mood. Our data suggests that it is advisable to maintain or improve health behaviors during pandemic-associated restrictions.

Testing the limits of contextual constraint: Interactions with word frequency and parafoveal preview during fluent reading

Contextual constraint is a key factor affecting a word's fixation duration and its likelihood of being fixated during reading. Previous research has generally demonstrated additive effects of predictability and frequency in fixation times. Studies examining the role of parafoveal preview have shown that greater preview benefit is obtained from more predictable and higher frequency words versus less predictable and lower frequency words. In two experiments, we investigated effects of target word predictability, frequency and parafoveal preview. A 3 (Predictability: low, medium, high) × 2 (Frequency: low, high) design was used with Preview (valid, invalid) manipulated between experiments. With valid previews, we found main effects of Predictability and Frequency in both fixation time and fixation probability measures, including an interaction in early fixation measures. With invalid preview, we again found main effects of Predictability and Frequency in fixation times, but no evidence of an interaction. Fixation probability showed a weak Predictability effect and Predictability-Frequency interaction. Predictability interacted with Preview in early fixation time and fixation probability measures. Our findings suggest that high levels of contextual constraint exert an early influence during lexical processing in reading. Results are discussed in terms of models of language processing and eye movement control.

Exploring the Measurement of Markedness and Its Relationship with Other Linguistic Variables

Antonym pair members can be differentiated by each word’s markedness–that distinction attributable to the presence or absence of features at morphological or semantic levels. Morphologically marked words incorporate their unmarked counterpart with additional morphs (e.g., “unlucky” vs. “lucky”); properties used to determine semantically marked words (e.g., “short” vs. “long”) are less clearly defined. Despite extensive theoretical scrutiny, the lexical properties of markedness have received scant empirical study. The current paper employs an antonym sequencing approach to measure markedness: establishing markedness probabilities for individual words and evaluating their relationship with other lexical properties (e.g., length, frequency, valence). Regression analyses reveal that markedness probability is, as predicted, related to affixation and also strongly related to valence. Our results support the suggestion that antonym sequence is reflected in discourse, and further analysis demonstrates that markedness probabilities, derived from the antonym sequencing task, reflect the ordering of antonyms within natural language. In line with the Pollyanna Hypothesis, we argue that markedness is closely related to valence; language users demonstrate a tendency to present words evaluated positively ahead of those evaluated negatively if given the choice. Future research should consider the relationship of markedness and valence, and the influence of contextual information in determining which member of an antonym pair is marked or unmarked within discourse.

Acute shoulder injuries: A clinical review of diagnosis and management in the deployed Naval environment

Musculoskeletal injuries of the shoulder are a common presentation in primary care. Injuries to this highly mobile region can have a profound impact on the range of movement, resulting in severe functional limitation. The shoulder can also be one of the more complicated regions to examine due to its high mobility, poor localisation of pain and numerous supporting structures. This article aims to review the anatomy of the shoulder, examination technique and the pathology underlying common acute injuries in order to provide guidance to medical personnel deployed with the Royal Navy and Royal Marines.

The acutely swollen knee. Part 1: Management of atraumatic pathology

The acutely swollen knee is a common presentation of knee pathology in the Emergency Department and the primary care setting whether on board ship, a Regimental Aid Post or Medical Centre. The swollen knee has both traumatic and atraumatic (systemic) causes, all of which can be accurately diagnosed with an understanding of the underlying injury patterns and patho-anatomy. In Part One, we will be examining the management of non-traumatic causes, followed by Part Two, looking at traumatic causes, in the next issue of the Journal. A detailed clinical history combined with thorough clinical examination will establish the diagnosis, or at least the narrow differential diagnosis in the majority of cases. The uses of specialist examination techniques, diagnostic imaging and arthrocentesis can further assist the clinician in confirming the correct diagnosis and thus prescribing the appropriate treatment. This review will endeavour to give a consensus of opinion and structured guidelines in the diagnosis and initial management of patients presenting with acute or recent-onset swelling of the knee related to atraumatic pathology.

The acutely swollen knee. Part two--management of traumatic pathology

The acutely swollen knee is a common presentation of knee pathology in the emergency department and the primary care setting, whether on board ship, in a Regimental Aid Post, or in a Medical Centre. The swollen knee has both traumatic and atraumatic (systemic) causes, all of which can be accurately diagnosed with an understanding of the underlying injury patterns and patho-anatomy. In Part 2 of this paper we consider the traumatic causes and also suggest a combined approach to managing an acutely swollen knee. The taking of a detailed history combined with thorough clinical examination will establish the diagnosis or at least the narrow differential diagnosis in the majority of cases. The use of specialist examination techniques, diagnostic imaging and arthrocentesis can further assist the clinician in confirming the correct diagnosis and thus prescribing the appropriate treatment. This review will endeavour to give a consensus of opinion and structured guidelines in the diagnosis and initial management of patients presenting with acute or recent onset swelling of the knee.

Word-Initial Letters Influence Fixation Durations during Fluent Reading

The present study examined how word-initial letters influence lexical access during reading. Eye movements were monitored as participants read sentences containing target words. Three factors were independently manipulated. First, target words had either high or low constraining word-initial letter sequences (e.g., dwarf or clown, respectively). Second, targets were either high or low in frequency of occurrence (e.g., train or stain, respectively). Third, targets were embedded in either biasing or neutral contexts (i.e., targets were high or low in their predictability). This 2 (constraint) × 2 (frequency) × 2 (context) design allowed us to examine the conditions under which a word's initial letter sequence could facilitate processing. Analyses of fixation duration data revealed significant main effects of constraint, frequency, and context. Moreover, in measures taken to reflect "early" lexical processing (i.e., first and single fixation duration), there was a significant interaction between constraint and context. The overall pattern of findings suggests lexical access is facilitated by highly constraining word-initial letters. Results are discussed in comparison to recent studies of lexical features involved in word recognition during reading.

The frequency-predictability interaction in reading: it depends where you're coming from

A word's frequency of occurrence and its predictability from a prior context are key factors determining how long the eyes remain on that word in normal reading. Past reaction-time and eye movement research can be distinguished by whether these variables, when combined, produce interactive or additive results, respectively. Our study addressed possible methodological limitations of prior experiments. Initial results showed additive effects of frequency and predictability. However, we additionally examined launch site (the distance from the pretarget fixation to the target) to index the extent of parafoveal target processing. Analyses revealed both additive and interactive effects on target fixations, with the nature of the interaction depending on the quality of the parafoveal preview. Target landing position and pretarget fixation time were also considered. Results were interpreted in terms of models of language processing and eye movement control. Our findings with respect to parafoveal preview and fixation time constraints aim to help parameterize eye movement behavior.

Handheld ultrasound diagnosis of extremity fractures

Hand portable ultrasound has been validated in trauma patients using the FAST technique. The machine's light and rugged design make it suitable for military deployment and they have been successfully used on deployments in Kosovo, Afghanistan and Iraq. Ultrasound is widely accepted in the diagnosis of abdominal and thoracic trauma, however, little work exists on its use in extremity trauma. Although the diagnosis of fractures usually relies on X-ray this may not be readily available at Role 1 or 2. We successfully identified long bone fractures in three patients using hand portable ultrasound during Operation Telic. The technique and ultrasound findings are described and the current literature on this technique is reviewed.

Association between anatomical features and anterior knee pain in a "fit" service population

Anterior knee pain and overuse sports type injuries have been associated with anatomical factors. Specific diagnosis in knee pain is difficult, most service patients are grouped together as "Patello-Femoral Stress Syndrome". Knee pain incidence within the service population is unknown, but thought to be greater than those presenting to General Practitioners. 293 active duty service men (100 Army and 193 Royal Navy) were interviewed and examined in relation to their knees. 138 measurements were made on each subject. 118 admitted to knee problems. Six had specific diagnoses, ranging from patellar tendonitis to ACL deficiency (with marked anterior instability). The remaining 112 individuals formed the study group and examination findings were compared with the 175 without Patello-Femoral Stress Syndrome. The results have been analysed to determine normal ranges and predictors of knee pain. Age, years in the military and results of patello-femoral compression tests were consistently significantly different between the groups. This survey provides useful information on normal values at examination. Q angle measurement was a poor predictor of knee pain. There was no clinically detectable anatomical variant that correlated with the Patello-Femoral Stress Syndrome. There was poor correlation between Tegner activity score and the perceived limitation on sport or work, as assessed on a visual analogue scale.

Three year review following bone anchor repair of acute biceps tendon insertion rupture

Three patients with acute biceps brachii tendon insertion ruptures were treated (less than 7 days post injury) using bone anchor anatomical repair. Dynamometer assessment of strength in both limbs was performed after completion of rehabilitation and again at 3.3 years after surgery. All patients were male, age 34, 35 and 53 years. Early isokinetic assessment was performed at 6, 7 and 12 months post surgery and medium assessment at 3.3 years post surgery. A full range of movement was achieved at early assessment and maintained into medium term assessment. All patients returned to their full premorbid occupation and sporting activity. Dynamometer strength of a repaired dominant limb equated to two thirds of a normal non dominant limb at early assessment, equal power was found at medium term assessment and a measurable increase in strength in both affected and unaffected arms was seen.

Middle-term results of a cementless threaded self-tapping acetabular cup

Various designs of acetabular cup are available for cementless fixation in patients undergoing total hip arthroplasty. Conflicting results have been reported in the literature about the middle to long-term outcomes with the use of these cups. We present our experience of a design of self-tapping threaded acetabular cup with metal backing (the ACSYS acetabular cup). This is a study of 41 hips with average follow up of 6.43 years. Functional grading of the hips was very satisfactory and none of the patients needed revision for aseptic loosening. No case of significant cup migration or osteolysis was noted. The paper also reviews the literature.

Orthopaedic implant removal at Royal Naval Hospital Stonehouse: a three-year review

A recent study stated that 11% of all elective orthopaedic procedures performed at a Regional Orthopaedic Unit involved removal of orthopaedic implants. Indications for certain orthopaedic implant removal remain unclear. As budgets are squeezed even tighter throughout all branches of the Royal Navy, we looked at each operation performed for orthopaedic implant removal at Royal Naval Hospital Stonehouse and questioned their effectiveness with respect to finance and working days lost for serving personnel.