Serving military personnel and veterans have been identified to have a high prevalence of mental health disorders. Despite this, only a significantly small number seek mental healthcare. With the UK beginning to invest further support to the armed forces community, identification of barriers and facilitators of help-seeking behaviour is needed. Corresponding literature search was conducted in PsycINFO, PsycArticles, Medline, Web of Science and EBSCO. Articles which discussed barriers and facilitators of seeking help for mental health concerns in the veteran population were included. Those which discussed serving personnel or physical problems were not included within this review. A total of 26 papers were analysed. A number of barriers and facilitators of help-seeking for a mental health issue within the veteran population were identified. Barriers included stigma, military culture of stoicism and self-reliance, as well as deployment characteristics of combat exposure and different warzone deployments. Health service difficulties such as access and lack of understanding by civilian staff were also identified. Facilitators to help combat these barriers included a campaign to dispel the stigma, including involvement of veterans and training of military personnel, as well as more accessibility and understanding from healthcare staff. While some barriers and facilitators have been identified, much of this research has been conducted within the USA and on male veterans and lacks longitudinal evidence. Further research is needed within the context of other nations and female veterans and to further indicate the facilitators of help-seeking among veterans. [Abstract copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.]

Vitamin B (cobalamin) is an essential cofactor for two metabolic pathways. It is obtained principally from food of animal origin. Cobalamin becomes bioavailable through a series of steps pertaining to its release from dietary protein, intrinsic factor-mediated absorption, haptocorrin or transcobalamin-mediated transport, cellular uptake, and two enzymatic conversions ( methionine synthase and methylmalonyl-CoA-mutase) into cofactor forms: methylcobalamin and adenosylcobalamin. Vitamin B deficiency can masquerade as a multitude of illnesses, presenting different perspectives from the point of view of the hematologist, neurologist, gastroenterologist, general physician, or dietician. Increased physician vigilance and heightened patient awareness often account for its early presentation, and testing sometimes occurs during a phase of vitamin B insufficiency before the main onset of the disease. The chosen test often depends on its availability rather than on the diagnostic performance and sensitivity to irrelevant factors interfering with vitamin B markers. Although serum B is still the most commonly used and widely available test, diagnostics by holotranscobalamin, serum methylmalonic acid, and plasma homocysteine measurements have grown in the last several years in routine practice. The lack of a robust absorption test, coupled with compromised sensitivity and specificity of other tests (intrinsic factor and gastric parietal cell antibodies), hinders determination of the cause for depleted B status. This can lead to incorrect supplementation regimes and uncertainty regarding later treatment. This review discusses currently available knowledge on vitamin B , informs the reader about the pitfalls of tests for assessing its deficiency, reviews B status in various populations at different disease stages, and provides recommendations for interpretation, treatment, and associated risks. Future directions for diagnostics of B status and health interventions are also discussed.

This presentation discusses optivote - a radio-frequency voting system which can increase interactivity in a session - it works the same way as the 'ask the audience' feature of 'Who wants to be a millionaire'. Each set consists of 32 voting handsets, a laptop loaded with the necessary software, a radio receiver and instructions. The system will work with powerpoint slides to provide a range of question types as part of a presentation. It can give immediate feedback to students on their answers and the lecturer can obtain reports about the individual responses of their students.

This presentation places the developing Welsh periodical press within the changing economic, political, and social nature of nineteenth century Wales.

Despite increased interest in the impact of external events on counsellors, surprisingly little has been written on counsellor bereavement. To address the research question: How do bereavement counsellors experience therapeutic work after the death of their parent? Interviews were conducted with four bereaved counsellors who reflected on its impact on their work. Data were analysed using Interpretative Phenomenological Analysis (IPA). Three major themes emerged; how decisions about returning to work were informed by colleagues and supervision; the benefits of returning to work and the use of ‘bracketing’; long-term implications for practice including heightened empathy with clients’ and disclosure of loss. In addition, participants felt they had insufficient guidance regarding fitness to practice. The possible limitations of the study were that self-selection may have introduced an element of bias to the results. These findings support existing literature and also revealed potential gaps in grief and loss training for counsellors and supervisors. A particular training issue for supervisors might be identifying and discussing fitness to practice issues with supervisees. There are also implications for counsellors in terms of the use of self-disclosure in therapy. Suggested further research to explore the use of self-disclosure in greater depth.

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