A reduction in provocation inventory scores immediately after the group was more likely to occur if the participant was accompanied by a member of staff who knew them and if they had a higher score on the test of receptive vocabulary. This pattern changed with time. The implications of the results will be discussed and the relatively large amount of variance that is not accounted for will also be considered.

Higher levels of psychosocial impairment reliably predict non-response to treatment, suggesting that psychological factors have an important role in VVS. Screening individuals at diagnosis may enable identification of those at risk of non-response and delivery of targeted psychological interventions to reduce the impact of VVS and its sequelae.

PurposeThe COVID-19 pandemic resulted in immense pressure on healthcare workers (HCWs) and healthcare systems worldwide. The current multi-centre evaluation sought to explore the association between coping behaviours and levels of psychological distress among HCWs working during the initial onset of COVID-19.Design/methodology/approachBetween April and July 2020 HCWs at three urban hospitals in England were invited to complete an online survey measuring personal and professional characteristics, psychological distress and coping. A principal component analysis (PCA) identified components of coping and structural equation modelling (SEM) was used to test the relationship between components of coping and psychological distress.FindingsA total of 2,254 HCWs participated (77% female, 67% white, 66% in clinical roles). Three components for coping were retained in the PCA analysis: external strategies, internal strategies and self-criticalness/substance use. SEM indicated that internally based coping was associated with lower levels of psychological distress, whereas externally based coping and self-criticalness were associated with greater psychological distress. The final model accounted for 35% of the variance in psychological distress.Originality/valueThis multi-centre evaluation provides unique insight into the level of psychological distress among HCWs during the initial onset of the COVID-19 pandemic (2020) and associated coping strategies. Addressing self-criticalness and supporting cognitive-based internal coping strategies among HCWs may protect against prolonged exposure to psychological distress. Findings highlight the importance of developing a culture of professional resilience among this vital workforce as a whole rather than placing pressure on an individual's personal resilience.

evaluations of such methods of smoking cessation have been conducted. This study aimed to establish how successful the service is 5e10 years following counselling. Method Patients were interviewed by means of a telephone questionnaire. Their current smoking status was assessed and baseline data including previous smoking habits was recorded. The intervention group were patients who completed the programme and deemed non-smokers after 1 year. The control group were patients who were referred but failed to attend. Both groups were referred to the service between 2001 and 2005. Seventy-nine out of 202 patients were interviewed from the intervention group and 121 out of 752 patients from the control group were interviewed. Results Of those previously attending the programme, 30.4% had relapsed. Of the 69.6% of participants remaining non-smokers, 85.5% had remained non-smokers throughout this follow-up period. Participants who did not attend were more likely to remain smokers (63.3%, p¼<0.001, RR¼2.08). Of those attending the programme, 70% reported using additional methods (eg, nicotine replacement therapy) to aid cessation. However, these individuals had a higher rate of relapse (36% vs 20%, p¼0.080). Lower socio-economic status may also be linked to a higher relapse rate (p¼0.075). Baseline statistics comparing the two cohorts revealed that patients from a lower socio-economic background were less likely to have successfully attended the programme (p¼<0.001). Gender or number of pack years accumulated at the time of invitation were not significantly different between cohorts and patient age was similar (control¼59 years, intervention¼62 years). Median follow-up for both cohorts was 8 years. Conclusions This unique 5e10 year follow-up indicates that smoking cessation counselling is achieving its aim of assisting the long-term cessation of patients attending the programme. However, patients requiring further interventions such as nicotine replacement therapy and those from lower socio-economic groups have been identified as requiring additional encouragement. This may indicate areas for improvement that smoking cessation programmes should consider. It is well-established that second-hand cigarette smoke affects the health of everyone who is exposed to it. However, second-hand smoke is particularly dangerous for children, increasing their risk of developing asthma, chest infections and triggering asthma attacks. In addition, previous research shows that smoking just one cigarette in a car, even with the window open, creates a greater concentration of second-hand smoke than a whole evening's smoking in a pub. Hence, exposing children to second-hand smoke in a car is exceptionally hazardous. This study sought information regarding children's experiences of, and attitudes towards, being exposed to secondhand cigarette smoke, including exposure in cars. 1001 children aged 8e15 (51% male, 49% female) were surveyed online via a selfcompletion questionnaire between 20 and 27 January 2011. 51% of respondents had been in a ca...