Objective The aim of the study was to investigate overall stress, workstress and health in general dental practitioners (GDPs). Design, setting and subjects A nationwide anonymous crosssectional survey was undertaken using stratified random sampling of 2,441 GDPs in the UK. Main outcome measures Measures included perceived stress, Work Stress Inventory for Dentists, job dissatisfaction, measures of health symptoms and health behaviour, dental and demographic information. Results The main findings were that perceived stress was significantly correlated with measures of dental stress. Work-related factors: fragility of dentist-patient relationship, time and scheduling pressures, staff and technical problems, job dissatisfaction, percentage NHS, and number of hours worked per week together explained nearly a half of GDPs overall stress in their life (linear multiple regression, adjusted r 2 = 0.48, F (2, 2404) = 509.68, P < 0.0001). Health behaviours such as alcohol use was associated with work stress (r = 0.18, P < 0.001) and over a third of GDPs were overweight or obese. Sixty per cent of GDPs reported being nervy, tense or depressed, 58.3% reported headache, 60% reported difficulty in sleeping and 48.2% reported feeling tired for no apparent reason. These were all related to work stress (one way analysis of variance, F (1,2211) = 241.53 P < 0.0001, F (1,2214) = 86.17 P < 0.0001; F (1, 2215) = 125.55 P < 0.0001; F (1,2211) = 209.67 P < 0.0001 respectively). Levels of minor psychiatric symptoms were high, with 32.0% of cases identified. The amount of backache was also high (reported by 68.3% of GDPs). Conclusion A high percentage of NHS dentistry was associated with high levels of overall stress in GDPs' lives, indicating that the nature of NHS dentistry should be carefully investigated to try to improve GDPs working conditions. A comparatively large number of dentists reported high levels of psychological stress symptoms, such as being nervy, tense and depressed, showing minor psychiatric symptoms, with alcohol use being related to stress. Other factors reported which were not related to stress but may be related to the actual practice of dentistry were that a third of dentists were overweight or obese and over 60% reported backache. Overall, these findings indicate the stressful nature of dentistry and difficulties in working conditions. The next step should be to develop interventions to help dentists to reduce stress in the dental surgery.

BackgroundVaccination is one of the cornerstones of controlling an influenza pandemic. To optimise vaccination rates in the general population, ways of identifying determinants that influence decisions to have or not to have a vaccination need to be understood. Therefore, this study aimed to predict intention to have a swine influenza vaccination in an adult population in the UK. An extension of the Theory of Planned Behaviour provided the theoretical framework for the study.MethodsThree hundred and sixty two adults from the UK, who were not in vaccination priority groups, completed either an online (n = 306) or pen and paper (n = 56) questionnaire. Data were collected from 30th October 2009, just after swine flu vaccination became available in the UK, and concluded on 31st December 2009. The main outcome of interest was future swine flu vaccination intentions.ResultsThe extended Theory of Planned Behaviour predicted 60% of adults' intention to have a swine flu vaccination with attitude, subjective norm, perceived control, anticipating feelings of regret (the impact of missing a vaccination opportunity), intention to have a seasonal vaccine this year, one perceived barrier: "I cannot be bothered to get a swine flu vaccination" and two perceived benefits: "vaccination decreases my chance of getting swine flu or its complications" and "if I get vaccinated for swine flu, I will decrease the frequency of having to consult my doctor," being significant predictors of intention. Black British were less likely to intend to have a vaccination compared to Asian or White respondents.ConclusionsTheoretical frameworks which identify determinants that influence decisions to have a pandemic influenza vaccination are useful. The implications of this research are discussed with a view to maximising any future pandemic influenza vaccination uptake using theoretically-driven applications.

The study examined the role of illness perceptions and self-efficacy in diabetic regimen adherence and metabolic control among young patients with Insulin Dependent Diabetes Mellitus (IDDM). Sixty-four outpatients with Insulin Dependent Diabetes completed measures of illness perceptions, generalised and diabetes specific selfefficacy and a self-report measure of adherence. Metabolic control (HbAlc) was also assessed. Control, identity and consequences components of illness perceptions were significantly correlated with self-efficacy expectancies. Control beliefs were consistently associated with self-reported adherence across all treatment aspects and accounted for 39% of the predicted variance in total adherence. The associations of the other psychological predictors examined, varied depending on the regimen area. Multiple regression analysis showed that 30.8% of the variance in HbAlc assays was explained by patients' diabetes specific self-efficacy, consequences and identity. Our findings suggest that patients' beliefs are useful predictors of physiological and behavioural outcomes in diabetes self-management and should thus be the focus of routine clinical assessments and future interventions.

BackgroundThe outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses.Methods328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumptionResults26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p < .001). 36% reported reduced public transport use (48% Malaysia, 22% Europe, p < .001), 39% flight cancellations (56% Malaysia, 17% Europe, p < .001). 8% had purchased preparatory materials (e.g. face masks: 8% Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p < .001). 63% of Europeans, 19% of Malaysians had discussed the pandemic with friends (p < .001). Groups seen as at 'high risk' of infection included the immune compromised (mentioned by 87% respondents), pig farmers (70%), elderly (57%), prostitutes/highly sexually active (53%), and the homeless (53%). In data collected only in Europe, 64% greatly underestimated the mortality rates of seasonal flu, 26% believed seasonal flu vaccination gave protection against swine flu. 7% had reduced/stopped eating pork. 3% had purchased anti-viral drugs for use at home, while 32% intended to do so if the pandemic worsened.ConclusionInitial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless) are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.