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The world in 2010 is a very different place to 1987 when Bhugra's paper on homophobia was published. Huge shifts have occurred in society's attitudes to gender, sex, sexuality and identity - notably by the internet, changes in HIV treatment, media representation of homosexuality and feminism and the role of women in society. This paper updates the literature review on homophobia revisiting society's assumptions about homosexuals. Changes are discussed in the context of definitions of homophobia, socio-cultural and politico-legal perspectives and homophobia and medicine. New current assumptions are drawn up and offered as a way of understanding both development and limitations - whilst there has been a reduction in the fear associated with gay men and women, discrimination remains. Newer issues such as internalised homophobia, globalisation and mainstream representations of homosexuality add complexity to this ongoing concern. [ABSTRACT FROM AUTHOR]

Background: Medicine is one of the most inaccessible professions in the United Kingdom (UK). The Plant a Seed (PAS) series was created to address this; it is an online pre-recorded three-part video series to "Inspire", "Educate" and "Motivate" pupils from widening participation backgrounds on Medicine. We explored the impact of PAS on pupils' knowledge, skills and attitude to Medicine. Methods: We conducted a national pretest-posttest study of Years 7–9 pupils in the UK. 503 schools were invited to PAS, following ethics approval. Consented pupils viewed all three episodes asynchronously and completed a pre-and post-series Likert scale confidence questionnaire, which evaluated their knowledge, skills and attitudes to a medical career. A Shapiro-Wilk test showed the lack of a normal distribution (p < 0.05); therefore, a Wilcoxon signed-rank test statistically compared pretest-posttest results of each pupil. Results: 70 pupils in Years 7–9 from 2 schools participated in this study. PAS was shown to significantly increase pupils' knowledge of the role and life of a doctor, medicine as a degree, admissions requirements, and careers in medicine (p < 0.05). There was a significant increase in pupils believing they could study medicine. The intervention did not significantly increase the desire for pupils to study medicine (p = 0.187). Conclusion: PAS significantly improved pupils' knowledge, skills and confidence demonstrating the need and benefit to enrolment of the programme at scale. It did not significantly increase the number of pupils wishing to study medicine. Analysis at scale is required to evaluate the effectiveness of PAS as a key intervention to break down barriers to medicine. [ABSTRACT FROM AUTHOR]

Background: The Friends and Family Test (FFT) was introduced into general practices in England in 2015 to provide staff with information on patients' views of their experience of care.Aim: To examine the views of practice staff and patients of the FFT, how the results are used, and to recommend improvements.Design and Setting: A qualitative study of a national representative sample of 42 general practices.Method: Semi-structured interviews with 43 clinicians, 48 practice managers, and 27 patient representatives. Interviews were audiotaped, transcribed, and analysed thematically.Results: Although the FFT imposed little extra work on practices, it was judged to provide little additional insight over existing methods and to have had minimal impact on improving quality. Staff lacked confidence in the accuracy of the results given the lack of a representative sample and the risk of bias. The FFT question was judged to be inappropriate as in many areas there was no alternative practice for patients to choose, patients' individual needs would not be the same as those of their friends and relatives, and an overall assessment failed to identify any specific aspects of good- or poor-quality care. Despite being intended to support local quality improvement, there was widespread unease about the FFT, with many responders perceiving it as a tool for national bodies to monitor general practices.Conclusion: If the use of a single-item questionnaire is to continue, changes should be made to the wording. It should be focused on stimulating local quality improvement, and practice staff should be supported to use the results effectively. [ABSTRACT FROM AUTHOR]

In order to improve the provision of spinal surgery in the United Kingdom, the number of Specialist Spinal Surgeons and Surgeons with an Interest in Spinal Surgery needs to increase by 25% from the existing 175 surgeons. A survey of Specialist Orthopaedic Registrars was performed, which quantifies the predicted shortfall in the number intending to practise spinal surgery. The attitudes towards and perceptions of this field were obtained to identify factors that could be discouraging an interest in spine surgery. [ABSTRACT FROM AUTHOR]