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In response to the heightened risk that coronavirus disease 2019 (COVID-19) poses to the health and lives of people with obesity, in 2020 the U.K. government launched a new package of policies intended to stimulate weight loss among the country's population. In this article, I present a critical discourse analysis of the policy paper which announced these new measures. I identify the discourses that are used to represent things, people, and processes in this policy text. These discourses are interpreted in terms of broadly neoliberal ideologies of public health management. Taken together, the discourses identified contribute to a broadly neoliberal ideology of public health management. It is argued that the policy paper represents an instance of "lifestyle drift," as it initially appears to engage with social and economic determinants of health but ultimately neglects these in favor of focusing on individual lifestyle factors, particularly in the shape of individuals' "choices." [ABSTRACT FROM AUTHOR]

As a UK-based group of female postgraduate researchers, the authors explored their experiences during COVID-19 pandemic through multivocal inquiry via a feminist collaborative autoethnographic project. In this paper, we use the Listening Guide as a tool to revisit and (re)analyse data from the aforementioned project, displaying findings in the form of voice poems. In utilising the Listening Guide, we discovered that listening is less of an exercise and more an art form. While the structured approach of the LG helped to enhance our understandings of wider individual experiences of disability and womanhood, identities that all authors inhabit, we were surprised to find that despite our established mutual trust and superficially similar experiences, we were unable to find emotional resonance through data that wasn't our own voice. We also found that the traditional stepped process of the LG that incorporates four listens to the data left our interpretations feeling flat. Through reflexivity and the novel collaborative approach we undertook in this analysis, we identified and implemented an augmentation of the Listening Guide process. In this paper, we propose an additional fifth listen, focusing on emotion, to facilitate a more holistic analysis of voice data. We explore how the fifth listen assisted the (re)construction of individual and collective identities, helping us to reshape our understandings. Finally, we elucidate the positives and pitfalls we experienced in the Listening Guide as a data analysis tool, recommending to other researchers the adoption of an iterative, flexible and reflexive approach in using it during collaborative research. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to develop a typology of firms operating in a peripheral economy. A three-way typology is presented which builds on previous studies, distinguishing between the 'pure agglomeration'," 'industrial complex' and 'social network' models. This typology is refined and applied to the Mersey Dee area, a cross-border region within the UK with a dispersed, segmented economy. Two case studies of firms located in the Mersey Dee are explored to test the typology and examine how these firms related to their places and to other firms and institutions, in the context of rapidly changing market conditions due to COVID-19 and Brexit. The findings confirm the typology and establish a clear contrast between firm types operating in a peripheral economy such as the Mersey Dee, providing relevant insights into the contributions they can make and how balanced regional development policies could support the heterogeneity and richness of their place-based economies. These approaches will differ from the traditional agglomeration or cluster model, typically advocated to build sustainable economic centres. Further research is recommended through comparator case studies of similar regions internationally, within the typology presented. [ABSTRACT FROM AUTHOR]

As a UK-based group of female postgraduate researchers, the authors explored their experiences during COVID-19 pandemic through multivocal inquiry via a feminist collaborative autoethnographic project. In this paper, we use the Listening Guide as a tool to revisit and (re)analyse data from the aforementioned project, displaying findings in the form of voice poems. In utilising the Listening Guide, we discovered that listening is less of an exercise and more an art form. While the structured approach of the LG helped to enhance our understandings of wider individual experiences of disability and womanhood, identities that all authors inhabit, we were surprised to find that despite our established mutual trust and superficially similar experiences, we were unable to find emotional resonance through data that wasn't our own voice. We also found that the traditional stepped process of the LG that incorporates four listens to the data left our interpretations feeling flat. Through reflexivity and the novel collaborative approach we undertook in this analysis, we identified and implemented an augmentation of the Listening Guide process. In this paper, we propose an additional fifth listen, focusing on emotion, to facilitate a more holistic analysis of voice data. We explore how the fifth listen assisted the (re)construction of individual and collective identities, helping us to reshape our understandings. Finally, we elucidate the positives and pitfalls we experienced in the Listening Guide as a data analysis tool, recommending to other researchers the adoption of an iterative, flexible and reflexive approach in using it during collaborative research. [ABSTRACT FROM AUTHOR]

UK community finance institutions play an important role in deprived neighbourhoods by serving households and businesses unable to access mainstream finance. This paper analyses the short-term effects of the Coronavirus pandemic on the activities and sustainability of the community finance sector by analysing longitudinal survey data for 40 providers and follow-up interviews with 25 organisations. COVID-19 resulted in an acceleration of the shift to online service delivery and temporary and permanent branch closures among community finance institutions. Further, the demand for, and volume and value of lending fell significantly during the first lockdown only recovering by the end of the summer 2020. This resulted in lower income, greater costs and lower regulatory ratios. Smaller providers in a weak financial position with more financially vulnerable customers were worst affected by the pandemic. We argue the pandemic may reduce access to finance for the financially excluded through the intensification of the shift to online services and by increasing the risk of providers serving the poorest folding or being merged with larger providers. [ABSTRACT FROM AUTHOR]

The UK's National Health Service (NHS) COVID-19 contact tracing app was announced to the British public on 12th April 2020. The UK government endorsed the app as a public health intervention that would improve public health, protect the NHS and 'save lives'. On 5th May 2020 the technology was released for trial on the Isle of Wight. However, the trial was halted in June 2020, reportedly due to technological issues. The app was later remodelled and launched to the public in September 2020. The rapid development, trial and discontinuation of the app over a short period of a few months meant that the mobilisation and effect of the discourses associated with the app could be traced relatively easily. In this paper we aimed to explore how these discourses were constructed in the media, and their effect on actors – in particular, those who developed and those who trialled the app. Promissory discourses were prevalent, the trajectory of which aligned with theories developed in the sociology of expectations. We describe this trajectory, and then interpret its implications in terms of infectious disease public health practices and responsibilities. [ABSTRACT FROM AUTHOR]

This paper offers a multi-dimensional analysis of the ways and extent to which the US president and UK prime minister have securitized the Covid-19 pandemic in their public speeches. This assessment rests on, and illustrates the merits of, both an overdue theoretical consolidation of Securitization Theory's (ST) conceptualization of securitizing language, and a new methodological blueprint for the study of 'securitizing semantic repertoire'. Comparing and contrasting the two leaders' respective securitizing semantic repertoires adopted in the early months of the coronavirus outbreak shows that securitizing language, while very limited, has been more intense in the UK, whose repertoire was structured by a biopolitical imperative to 'save lives' in contrast to the US repertoire centred on the 'war' metaphor. [ABSTRACT FROM AUTHOR]

During the 1990s, three Directives were enacted that aimed to harmonise the regulation of medical devices within the European Union (EU). Custom-made devices (CMDs) were subject to Council Directive 93/42/EEC of 14 June 1993 concerning medical devices (Medical Device Directive [MDD]), which was given effect in the UK by the Medical Devices Regulations 2002 (UK MDR 2002). Regulation (EU) 2017/745 (Medical Device Regulation [EU MDR]) replaced the MDD and was transposed into the Medical Devices (Amendment etc.) (EU Exit) Regulations 2019 in the UK. The UK left the EU on 31 January 2020 and entered an 11-month implementation period (IP), during which any new EU legislation that was enacted also took effect in the UK. The EU MDR was scheduled to be fully implemented on 26 May 2020 (during the IP) but this was deferred for one year, until 26 May 2021 (after the IP had concluded), as a result of the coronavirus disease 2019 (COVID-19) pandemic. Consequently, the EU MDR was removed from the UK statute book by a further amendment to the UK MDR 2002, the Medical Devices (Amendment etc.) (EU Exit) Regulations 2020. Since 1 January 2021, CMDs manufactured in Great Britain can conform to either the UK MDR 2002 (as amended) or the EU MDR (until 30 June 2023) while devices manufactured in Northern Ireland are subject to the EU MDR alone. CMDs must be supplied with a statement, a label and, depending on the risk class, instructions for use; this paper answers ten questions regarding this documentation following these legislative changes. [ABSTRACT FROM AUTHOR]

COVID-19 lockdown and social distancing measures have restricted funerals and memorial events and have limited the face-to-face social networks that grieving people might normally be able to draw upon for emotional support. However, while there is considerable expert informed speculation about the impacts of grief and "COVID bereavement", detailed accounts of experiences of bereavement and bereavement support during the pandemic have the potential to enrich and provide nuance and subtlety to the evidence base. This paper draws on diary accounts of bereavement support volunteers in the UK, who have been providing support for the bereaved through these challenging times. These reveal layers of complexity to the experiences of loss, grief and bereavement during these extraordinary times. However, they also point to a number of additional themes that lend a more positive valence to the suspension of normal social expectations and memorial practices associated with the pandemic, which, we argue should be reflected upon for their potential to address the discontents of contemporary governance of end of life and bereavement. [ABSTRACT FROM AUTHOR]

In the recent COVID-19 pandemic, a wide range of epidemiological modelling approaches were used to predict the effective reproduction number, R(t), and other COVID-19-related measures such as the daily rate of exponential growth, r(t). These candidate models use different modelling approaches or differing assumptions about spatial or age-mixing, and some capture genuine uncertainty in scientific understanding of disease dynamics. Combining estimates using appropriate statistical methodology from multiple candidate models is important to better understand the variation of these outcome measures to help inform decision-making. In this paper, we combine estimates for specific UK nations/regions using random-effects meta-analyses techniques, utilising the restricted maximum-likelihood (REML) method to estimate the heterogeneity variance parameter, and two approaches to calculate the confidence interval for the combined estimate: the standard Wald-type and the Knapp and Hartung (KNHA) method. As estimates in this setting are derived using model predictions, each with varying degrees of uncertainty, equal-weighting is favoured over the standard inverse-variance weighting to avoid potential up-weighting of models providing estimates with lower levels of uncertainty that are not fully accounting for inherent uncertainties. Both equally-weighted models using REML alone and REML+KNHA approaches were found to provide similar variation for R(t) and r(t), with both approaches providing wider, and therefore more conservative, confidence intervals around the combined estimate compared to the standard inverse-variance weighting approach. Utilising these meta-analysis techniques has allowed for statistically robust combined estimates to be calculated for key COVID-19 outcome measures. This in turn allows timely and informed decision-making based on all available information. [ABSTRACT FROM AUTHOR]

The story of carriage cleaners has been sadly neglected in the history of railway workers. The work has low pay, it is sometimes unpleasant, and it is also physically tough. This panorama paper explores some of the literature surrounding the history of carriage cleaners from the earliest records in the nineteenth century, through the two world wars, up to the early days of privatisation. The focus is on female carriage cleaners, exploring the reasons why their work has been hidden from history and putting forward an argument as to why more attention should be drawn to it. Despite its low pay and poor working conditions, cleaning work is found at an important nexus of the railway economy, ensuring that the spaces of railway travel remain sanitary and functional. Given their importance for the operation of the railway transport system, it is surprising that cleaners remain largely invisible. [ABSTRACT FROM AUTHOR]

At times of crisis, existing institutional arrangements of societies are thrown into question. Crises that occur in multiple societies simultaneously present rare opportunities for comparative empirical analysis. Social theory can reveal the framing conditions of the responses to crises and the sources of variations between them. This paper compares the immediate responses of the Australian, UK and US governments to the global COVID-19 pandemic, particularly with regard to financing lockdowns, and points out significant differences between the three approaches. Drawing on Polanyi's method of institutional analysis, we compare the responses of these same national groups to an earlier crisis, the Japanese prisoner of war camps during the Second World War, to show similar patterns of integration recurring eight decades apart. This analysis shows that aspects of moral economies that are not usually apparent can become pronounced during crises, and points to the importance of enduring social imaginaries. [ABSTRACT FROM AUTHOR]

Introduction: Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods: A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues. Results: The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination. Conclusion: Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption. [ABSTRACT FROM AUTHOR]

Against a background of stalling UK life expectancy, the COVID-19 pandemic necessitated a different way of working for public health to respond quickly to new and many demands. At the same time, public health teams had to ensure they did not concentrate on the immediate crisis at the expense of mitigating longer-term impacts of the pandemic. This was, and is, a major challenge with additional demands on an already hard-pressed workforce. This paper discusses the experience of a local public health department in responding to the pandemic and raises four key areas that influenced decisions and need to be considered in future. These are care homes issues, addressing all four harms of the pandemic, lessons for behaviour change and the need to strengthen Scotland's public health workforce. [ABSTRACT FROM AUTHOR]

In this paper, we reflect on 'scientific' governmental and media responses to Covid-19 in the UK, illuminating their negative impacts on complex and emergent touch forms/practices and people's related emotions. The scientisation of the pandemic led to the government initially placing the country in lockdown and enforcing social distancing. It thereby regulated and proscribed routine and normative touch practices in order to save lives. However, such strategies were not accompanied by an awareness that increased touch deprivation could be emotionally harmful, that lockdown could exacerbate abusive touch in the privatised familial domestic sphere, and that paid care-giver touch in other contexts, such as care homes for the elderly, could also be potentially lethal. These negative consequences are important for social workers to understand and appropriately respond to, as they disproportionately impact vulnerable and marginalised groups and are heightened for service users, who are frequently members of many disadvantaged groups simultaneously. [ABSTRACT FROM AUTHOR]

Will the UK Industrial Strategy deliver anything substantial to the North of England? This article examines the faltering steps taken to develop Local Industrial Strategies by Local Enterprise Partnerships and Mayoral Combined Authorities and argues Place Leadership and Industrial Strategy will both need to be substantially re-galvanised after COVID 19. It is also still not clear if a significant step change can be made by the Johnson Conservative government of 2019, which will have a major impact on Northern economies. Agencies' capacity to intervene in the Northern economy and deliver is a major issue, alongside stronger leadership. Analytically the paper uses theory on Multi-Sectoral Collaboration and Place Leadership to show how uniqueness of place, past and current interpersonal connections and networks can facilitate or frustrate economic development. Place leaders must create institutional arrangements, seek agreement over visions, objectives and strategies, otherwise the lack of shared information, resources, activities and capabilities lead to 'contestation' over space and action. We analyse the levels of cohesion or contestation in four different localities as each develops a Local Industrial Strategy. [ABSTRACT FROM AUTHOR]

The ongoing Covid-19 crisis and recession represent one of the biggest shocks to the UK manufacturing ecosystem yet, and comes at a time when the ecosystem was already in a worrying situation after decades of deindustrialisation, a decade of austerity and an impending 'Brexit'. The effects of this shock will also be unevenly felt due to the geography of the UK manufacturing ecosystem, amplifying the need for a successful response to ensure that places are not left (further) behind. This paper assesses the pre-Covid-19 ecosystem to ascertain the areas and industries likely to be particularly impacted by the crisis, and to understand existing issues. These issues are important to consider due to the implications for choosing strategies moving forward, for which two are appraised here. First, the reshoring of supply chains is considered in light of recent government comments, but difficulties in implementation may arise due to the highly fragmented nature of UK policy frameworks. Second, an acceleration of the 'grand challenges' approach is likely but limited by issues of connectivity in the ecosystem and small and medium-sized firm disengagement. We suggest that any strategy moving forward must strike a balance between such strategies [ABSTRACT FROM AUTHOR]

On March 23, 2020, the United Kingdom went into national lockdown to stop the spread of COVID-19. In this paper, we examine whether a policy aimed at minimizing the health consequences of the pandemic had unintended negative consequences for domestic abuse. Using data from the Metropolitan Police in England we estimate the impact of lockdown on domestic abuse in the 32 boroughs that make up the London metropolitan area. Using a before and after approach, and controlling for other factors, we show an increase in the probability of being a victim of domestic abuse during lockdown similar in magnitude to the increase experienced over the Christmas holidays. However, the overall picture masks inequalities across groups: with women, younger and older people, and people of Asian, Arab, and Middle Eastern ethnicity subject to the highest increases, reflecting vulnerabilities and existing inequalities. Of the domestic abuse-related crimes, it is the most violent crimes that saw the greatest increases during lockdown. Once lockdown restrictions are eased, rates decline but remain slightly higher than prior to lockdown up to 3 months later. The results present a clear message for policy makers: a policy adopted to alleviate one problem, even in times of crisis, must factor in the impact this may have in other areas. Failure to do so in this situation, despite existing evidence linking domestic abuse to stress, confinement, and crisis situations prior to lockdown, has resulted in an increase in domestic violence in the U.K.’s capital city, during lockdown and beyond. [ABSTRACT FROM AUTHOR]

This protocol outlines a mixed-methods study to explore the dynamics of intimacy on dating apps before, during and after the crisis years of COVID-19 in the UK; how these influenced/were influenced by different gendered and sexual cultures of relating; and their impact on personal resilience, viral risk, and wellbeing. The project examines diverse gendered and sexual cultures, examining the experiences of heterosexuals and LGBT+ communities. Through a two-stage approach involving a UK-wide quantitative survey and in-depth qualitative interviews, the study explores how dating app practices influence resilience, viral risk, and intimate norms. The project aims to generate knowledge about how app-based services can be harnessed to support the social and emotional needs of diverse gendered and sexual groups during and after COVID-19 providing valuable insights into strategies for personal resilience in the face of viral risk and social during periods of social distancing. [ABSTRACT FROM AUTHOR]

Some patients with COVID-19 develop symptoms after the acute infection, known as 'Long COVID'. We examined whether or not confirmation of COVID-19 infection status could act as a nocebo, using data from questionnaires distributed to the Avon Longitudinal Study of Parents and Children cohort. We examined associations between confirmation of COVID-19 infection status (confirmed by a positive test vs unconfirmed) and reporting of Long COVID symptoms. We explored the roles of sex and anxiety as potential moderators. There was no clear evidence of a strong association between confirmation of COVID-19 infection status and the Long COVID composite score, physical or psychological symptoms or duration of symptoms. There was no clear evidence of moderation by sex or anxiety. We therefore found no evidence of a nocebo effect. Our data suggest that this psychological mechanism does not play a role in the medical symptomatology experienced by patients with Long COVID. [ABSTRACT FROM AUTHOR]

Healthcare workers, globally, volunteered time and skills to the COVID-19 pandemic frontline response. In March 2020, the predicted high demand for extra critical care beds led to the rapid construction of the UK National Health Service (NHS) Nightingale field hospital, London. I volunteered to develop and deliver psychological preparedness training – coined 'Psychological PPE' – to over 2300 frontline staff over an 8-week period. Existing research has identified broad themes of the impact working on the COVID-19 frontline has on healthcare workers but does not capture in-depth accounts of individuals' experiences. Using autoethnographic enquiry, this research explores my frontline experience at the NHS Nightingale during this time, and the personal impact this had on me. Reflexive thematic analysis explored themes of recognition and sacrifice, emotional lability and fragility, and the impact of transitions. Findings inform personal recovery, as well as future research and policy development pertaining to the sustainable recovery of our NHS people. [ABSTRACT FROM AUTHOR]

Pandemics are affecting tourism in many ways, and have had a major effect on international travel, the hospitality industry and tourism demand. Grounded in the protective action decision model and complexity theory, this study seeks to develop a model to explain the conditions that have led to travel avoidance in the UK in the context of the COVID-19 pandemic. To test our proposed model, we used a fuzzy-set qualitative comparative analysis of data gathered from 1,290 travelers, with semi-structured interviews conducted to confirm the configurations identified by the model. The findings indicate that effective pandemic information, effective risk communication, supplies, trust in government and trust in the media are necessary to combat travel avoidance, but the refutation of rumor and trust among traveler is not necessary to foster travel avoidance. Furthermore, qualitative follow-up interviews were conducted to obtain deeper insights into the discovered configurations and develop effective pathways to travel avoidance. [ABSTRACT FROM AUTHOR]

Although small and medium-sized enterprises (SMEs) were particularly hard hit by the coronavirus disease 2019 (COVID-19) pandemic, some performed relatively well, maintaining or increasing employment growth. We study these differences in performance through the lens of dynamic capabilities (DCs) theory, which we extend by incorporating the moderating effect of government support during COVID-19. We analyse responses from 1421 UK SMEs and find that government support and DCs positively impact employment. We also show that government support moderates the link between DCs and employment with a negative effect after the first COVID-19 lockdown. The findings highlight the role of government policy intervention in discouraging SMEs from effectively exercising DCs during a crisis and the general importance of DCs and government support in enabling SMEs to cope with shocks. [ABSTRACT FROM AUTHOR]

As one key strategy for disease prevention, SD constitutes a discursive response where Covid-19 is framed as a "scientific" problem with scientific solutions. This paper was written in May 2020, approximately two months after the UK and Ireland imposed stringent lock-down measures, including social distancing (SD). Social distancing as "Scientization": UK and Irish Policy responses to Covid-19, emotions and touch. [Extracted from the article]

Many commentators have suggested that the first 18 months of the Johnson government were characterised by a propensity to centralise power. However, few accounts have situated the administration in the historical context of the British state or systematically examined these centralising tendencies. This article attempts to address these omissions. First, through a critical assessment of the literature on authoritarian neoliberalism, the concept of 'executive centralisation' is developed within the context of the British state. Second, the article applies this revised framework to the early stages of the Johnson government. While a dominant executive is a long-standing feature of the British political system, it is argued that Johnson has pursued a multifaceted centralisation strategy facilitated by the context of Brexit and COVID-19. In identifying the role of consent in this process, the article augments scholarship on 'authoritarian neoliberalism' as a moment in neoliberal governance characterised by the ascendance of coercive governing strategies. [ABSTRACT FROM AUTHOR]

In this article I discuss the effects on the patient experience of isolation nursing during the CoronaVirus Disease (COVID)-19 pandemic. An unintended consequence of isolation nursing has been to distance patients from nurses and emphasise the technical side of nursing while at the same time reducing the relational or affective potential of nursing. Such distanced forms of nursing normalise the distal patient in hospital. I consider ways in which this new form of distanced nursing has unwittingly contributed to the continued commodification of nursing care in the British NHS. Autoethnography is used to describe and reflect on the illness experience, the experiences of caregivers and the sociocultural organisation of health care. The findings discuss three areas of the illness experience: intimate nursing care; communication; the 'distanced' patient experience. [ABSTRACT FROM AUTHOR]

Background: Reiki is a biofield therapy which is based on the explanatory model that the fields of energy and information of living systems can be influenced to promote relaxation and stimulate a healing response. Objective: To conduct a pragmatic within-subject pilot trial of a remote Reiki program for frontline healthcare workers' health-related symptoms during the COVID-19 pandemic. Methods: Healthcare professionals in the UK (eg, physicians, nurses, and paramedics) were eligible to sign up for a distance Reiki program and were also invited to participate in the research study. Eight Reiki practitioners simultaneously gave each participant Reiki remotely for 20 minutes on 4 consecutive days. Feasibility of the research was assessed, including recruitment, data completeness, acceptability and intervention fidelity, and preliminary evaluation of changes in outcome measures. Participants' stress, anxiety, pain, wellbeing, and sleep quality were evaluated with 7-point numerical rating scales. Measures were completed when signing up to receive Reiki (pre) and following the final Reiki session (post). Pre and post data were analyzed using Wilcoxon signed ranks tests. Results: Seventy-nine healthcare professionals signed up to receive Reiki and took the baseline measures. Of those, 40 completed post-measures after the 4-day intervention and were therefore included in the pre-post analysis. Most participants were female (97.5%), and the mean age was 43.9 years old (standard deviations = 11.2). The study was feasible to conduct, with satisfactory recruitment, data completeness, acceptability, and fidelity. Wilcoxon signed ranks tests revealed statistically significant decreases in stress (M = −2.33; P <.001), anxiety (M = −2.79; P <.001) and pain (M = −.79; P <.001), and significant increases in wellbeing (M = −1.79; P <.001) and sleep quality (M = −1.33; P =.019). Conclusions: The Reiki program was feasible and was associated with decreased stress, anxiety and pain, and increased wellbeing and sleep quality in frontline healthcare workers impacted by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic continues to present unique challenges to governments and organisations around the world, but one sector has incorporated COVID-19 into its core mission with relative ease: advertisers have acknowledged the pandemic while continuing to draw on notions of 'normality' to activate our desire to consume. As the UK's series of lockdowns have come to an end, we look back over more than a year of unusual advertising and consider how the pandemic has changed approaches to marketing and the shape of consumer culture in ways connected to ideas about what constitutes 'normal' life. Discussions of the relationship between the pandemic and consumerism have included critiques of the prioritising of profit over people, and conceptualisations of Coronavirus as a brand itself, but the politics of notions of 'normality' promoted by consumer culture demand closer consideration. This article complements existing studies and debates by examining the tensions, contradictions and morally neutral positions revealed by the advertising response to the coronavirus disease pandemic. Through an analysis of UK advertising campaigns launched during and with reference to the pandemic, this work explores key themes and strategies, including their connection to power dynamics concerning race, gender, class and capitalism. We suggest advertising during crises may offer the opportunity to critique larger dynamics and trends of consumerism, including narrow notions of the defining features of 'everyday' life. [ABSTRACT FROM AUTHOR]

This article explores how extravagantly visible mask-wearing relates with consumer culture. Methodologically, three purposively chosen case studies of spectacular or performative mask-wearing are used to show what the face mask can teach us about consumer culture in a pandemic. First, a Daily Mail (UK) article in which an 'elderly shopper' is shamed for wearing a sanitary towel as a face mask is used to explore the politics of disposable commodities. Second, the multiplying portraits of people wearing masks archived under Instagram's #MaskSelfie hashtag allows an examination of how consumer-citizenship is performed. Third, the presence of extremely expensive luxury designer masks, as evidenced by Rich Mnisi's Swarovski-encrusted offering, is a base for considering how virtue signalling has become a platform for luxury branding. Building on these three examples, the argument is made that waste, selfies and luxury are modalities for a pandemic commodity politics that is layered over and into the scientific citizenship signalled by the wearing of face masks. Together these create what I call a 'sci-commodity' sensibility, in which the face mask as a technology has become integrated with the modalities of consumption. This has resonance with ongoing debates about the object, subject and brand in consumer culture. [ABSTRACT FROM AUTHOR]

Preclinical (animal) testing and human testing of drugs and vaccines are rarely considered by social scientists side by side. Where this is done, it is typically for theoretically exploring the ethics of the two situations to compare relative treatment. In contrast, we empirically explore how human clinical trial participants understand the role of animal test subjects in vaccine development. Furthermore, social science research has only concentrated on broad public opinion and the views of patients about animal research, whereas we explore the views of a public group particularly implicated in pharmaceutical development: experimental subjects. We surveyed and interviewed COVID-19 vaccine trial participants in Oxford, UK, on their views about taking part in a vaccine trial and the role of animals in trials. We found that trial participants mirrored assumptions about legitimate reasons for animal testing embedded in regulation and provided insight into (i) the nuances of public opinion on animal research; (ii) the co-production of human and animal experimental subjects; (iii) how vaccine and medicine testing, and the motivations and demographics of clinical trial participants, change in an outbreak; and (iv) what public involvement can offer to science. [ABSTRACT FROM AUTHOR]

This article discusses the development of two short plays based on qualitative data from separate research studies related to dementia, both of which were performed in the UK in 2022. The first drama (Voices from the front line) is a relatively standard piece of verbatim theatre, based on interview data and written accounts from a research study about the experiences of the dementia workforce during the COVID-19 pandemic of 2020–22. The second (The Other Side of the Wall) is based on ethnographic data from a research study carried out with people with dementia living in long-term care, and it introduces elements of invention and absurdism. In both pieces, non-professional actors co-developed the performances, drawing on the spoken words of the original research participants. Using extracts and examples from the script development process, the article attempts to chart the developmental process for a novice ethnodramatist (although experienced dementia researcher) in meeting ethical, aesthetic and methodological challenges. [ABSTRACT FROM AUTHOR]

This study intends to find what are the experiences of international students semiotically adapting to unfamiliar signs in the United Kingdom before and during the COVID-19 pandemic. Semi-structured interviews were conducted with six international university students to learn about their experiences of adapting to a new country. Data were analysed using thematic analysis. Two themes were classified as dialogical self in interpersonal adaptation and linguistic elements of semiotic adaptation, each with two subthemes. Participants' experiences of merging self-constructs seem reflective of proculturation theory. The researchers termed 'language bridges' to refer to social representations dependent on language-specific signs. Some of the participants' self-constructs relied on signs not provided by the environment during the COVID-19 pandemic. Overall, proculturation offers insight into the complex psychological and social processes of adapting to unfamiliar signs. [ABSTRACT FROM AUTHOR]

Objective: The Covid-19 pandemic created a backlog of women awaiting an invitation for breast screening in the UK. To recover in a timely fashion, the National Health Service programme opted to issue open invitations (OI) to women rather than the standard pre-booked timed appointments (TA). Historically, OIs have been shown to result in lower uptake. The aim of this study was to make use of a natural experiment to compare uptake in groups sent an OI with those sent a TA during a period when both invitation methods were in use. Methods: Women invited for routine screening at one of the six London breast screening services from September 2020 to March 2021 were included and grouped according to the type of invitation they had received (TA or OI). The outcome was attendance within 6 months of opening the screening episode. Data were analysed by logistic regression. Results: During the period of the study, 78,192 (32.5%) women received a TA and 162,680 (67.5%) received an OI. In the TA group, 47,391 (60.6%) attended within six months of offered appointment and in the OI group 86,430 (53.1%) attended. This difference was significant (p < 0.001). The odds ratio (95% CI) for the attended outcome was 1.44 (1.33–1.55) adjusted for differences in deprivation and for invitation category (first invitation or subsequent invitation). Conclusions: This study supports the view that TA delivers a higher uptake than OI. It suggests that during this period over 12,000 women in London, who would have been expected to attend if given the standard TA, did not attend their appointment having received an OI. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has resulted in governments playing increasingly prominent roles as active economic agents. However, state capitalism does not necessarily serve broad developmental purposes, and rather can be directed to supporting sectional and private interests. As the literature on variegated capitalism alerts us, governments and other actors regularly devise fixes in response to a systemic crisis, but the focus, scale, and scope of the interventions vary considerably, according to the constellation of interests. Rapid progress with vaccines notwithstanding, the UK government's response to COVID-19 has been associated with much controversy, not only because of an extraordinarily high death rate, but also because of allegations of cronyism around the granting of government contracts and bailouts. We focus on the latter, investigating more closely who got bailed out. We find that badly affected sectors (e.g. hospitality, transportation) and larger employers were more likely to get bailouts. However, the latter also favored the politically influential and those who had run up debt profligately. Although, as with state capitalism, crony capitalism is most often associated with emerging markets, we conclude that the two have coalesced into a peculiarly British variety, but one that has some common features with other major liberal markets. This might suggest that the eco-systemic dominance of the latter is coming to an end, or, at the least, that this model is drifting towards one that assumes many of the features commonly associated with developing nations. [ABSTRACT FROM AUTHOR]

This article uses Henri Lefebvre's Rhythmanalysis as a foundational text for researching boredom, and offers a critical analysis of UK-based media commentaries about boredom and homeworking written during 2020 and 2021. We situate the discussion within the rhythmic rupture caused by the COVID-19 pandemic and foreground rhythm as a lens for understanding reported experiences and reflections on boredom and work. For non-essential workers, lockdown offered an opportunity to reconfigure working lives away from the constraints of commutes and everyday work settings, yet our findings highlight the narrative representation and experience of a particular type of boredom and inertia known as acedia. The analysis discusses the presence of acedia and absence of rhythm across three themes: acedia and being stuck in time and space; embodiment, movement and rhythm; and the relationship between the present and the future. We conclude by considering what the experience of boredom might mean for how we reconceptualise our post-pandemic working lives. [ABSTRACT FROM AUTHOR]

Objectives: Engaging with finances has become increasingly digitalised in recent years, particularly since the COVID-19 pandemic, yet it is unknown how finance management has been affected in people living with dementia. The aim of this qualitative study was therefore to explore how digitalisation and the recent pandemic have affected finance management skills in people with dementia. Methods: Semi-structured interviews were conducted remotely with people with dementia and unpaid carers living in the UK via phone or Zoom between February and May 2022. Transcripts were coded by one of four different research team members, including two unpaid carers who were public advisers on the project. Data were analysed using inductive thematic analysis. Results: Thirty carers and people with dementia participated, and five overarching themes were identified. Managing finances has been both simplified and made more complicated by digitalising how money is spent and managed, with people with dementia and unpaid carers reporting advantages of using direct debits and debit cards, as well as digital illiteracy barriers for older relatives with dementia. Unpaid carers have received no support in managing their relative's finances, and were found to be burdened by the additional caring duties. Conclusions: Carers need to be supported in managing their relative's finances as well as with their general well-being due to taking on additional caring duties. Digital systems for finance management need to be user-friendly for people with cognitive impairment, with a need for digital literacy training for middle-aged and older adults to avoid difficulties if they develop dementia, and improved access to a computer/tablet/smart phone. [ABSTRACT FROM AUTHOR]

Diaries and other materials in the Mass Observation Archive have been characterised as intersubjective and dialogic. They have been used to study top-down and bottom-up processes, including how ordinary people respond to sociological constructs and, more broadly, the footprint of social science in the 20th century. In this article, we use the Archive's COVID-19 collections to study how attempts to govern the pandemic by mobilising ordinary people to see like an epidemiologist played out in the United Kingdom during 2020. People were asked to think in terms of populations and groups; rates, trends, and distributions; the capacity of public services; and complex systems of causation. How did they respond? How did they use the statistics, charts, maps, concepts, identities, and roles they were given? We find evidence of engagement with science plural ; confident and comfortable engagement with epidemiological terms and concepts; sceptical and reluctant engagement with epidemiological subject positions; use of both scientific and moral literacy to negotiate regulations and guidance; and use of scientific literacy to compare and judge government performance. Governing the pandemic through scientific literacy was partially successful, but in some unexpected ways. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has foregrounded the significance of time to everyday life, as the routines, pace, and speed of social relations were widely reconfigured. This article uses rhythm as an object and tool of inquiry to make sense of spatio-temporal change. We analyse the Mass Observation (MO) directive we co-commissioned on 'COVID-19 and Time', where volunteer writers reflect on whether and how time was made, experienced, and imagined differently during the early stages of the pandemic in the UK. We draw on Henri Lefebvre and Catherine Régulier's 'rhythmanalysis', taking up their theorisation of rhythm as linear and cyclical and their concepts of arrhythmia (discordant rhythms) and eurhythmia (harmonious rhythms). Our analysis highlights how MO writers articulate (a) the ruptures to their everyday rhythms across time and space, (b) their experience of 'blurred' or 'merged' time as everyday rhythms are dissolved and the pace of time is intensified or slowed, and (c) the remaking of rhythms through new practices or devices and attunements to nature. We show how rhythm enables a consideration of the spatio-temporal textures of everyday life, including their unevenness, variation, and difference. The article thus contributes to and expands recent scholarship on the social life of time, rhythm and rhythmanalysis, everyday life, and MO. [ABSTRACT FROM AUTHOR]

Background: Palliative medicine physicians may be at higher risk of burnout due to increased stressors and compromised resilience during the COVID-19 pandemic. Burnout prevalence and factors influencing this among UK and Irish palliative medicine physicians is unknown. Aim: To determine the prevalence of burnout and the degree of resilience among UK and Irish palliative medicine physicians during the COVID-19 pandemic, and associated factors. Design: Online survey using validated assessment scales assessed burnout and resilience: The Maslach Burnout Inventory Human Services Survey for Medical Personnel [MBI-HSS (MP)] and the Connor-Davidson Resilience Scale (CD-RISC). Additional tools assessed depressive symptoms, alcohol use, and quality of life. Setting/participants: Association of Palliative Medicine of UK and Ireland members actively practising in hospital, hospice or community settings. Results: There were 544 respondents from the 815 eligible participants (66.8%), 462 provided complete MBI-HSS (MP) data and were analysed. Of those 181/462 (39.2%) met burnout criteria, based on high emotional exhaustion or depersonalisation subscales of the MBI-HSS (MP). A reduced odds of burnout was observed among physicians who worked ⩽20 h/week (vs 31–40 h/week, adjusted odds ratio (aOR) 0.03, 95% confidence interval (CI) 0.002–0.56) and who had a greater perceived level of clinical support (aOR 0.70, 95% CI 0.62–0.80). Physicians with higher levels of depressive symptoms had higher odds of burnout (aOR 18.32, 95% CI 6.75–49.73). Resilience, mean (SD) CD-RISC score, was lower in physicians who met burnout criteria compared to those who did not (62.6 (11.1) vs 70.0 (11.3); p < 0.001). Conclusions: Over one-third of palliative medicine physicians meet burnout criteria. The provision of enhanced organisational and colleague support is paramount in both the current and future pandemics. [ABSTRACT FROM AUTHOR]

Background: The need for end-of-life care in the community increased significantly during the COVID-19 pandemic. Primary care services, including general practitioners and community nurses, had a critical role in providing such care, rapidly changing their working practices to meet demand. Little is known about primary care responses to a major change in place of care towards the end of life, or the implications for future end-of-life care services. Aim: To gather general practitioner and community nurse perspectives on factors that facilitated community end-of-life care during the COVID-19 pandemic, and to use this to develop recommendations to improve future delivery of end-of-life care. Design: Qualitative interview study with thematic analysis, followed by refinement of themes and recommendations in consultation with an expert advisory group. Participants: General practitioners (n = 8) and community nurses (n = 17) working in primary care in the UK. Results: General practitioner and community nurse perspectives on factors critical to sustaining community end-of-life care were identified under three themes: (1) partnership working is key, (2) care planning for end-of-life needs improvement, and (3) importance of the physical presence of primary care professionals. Drawing on participants' experiences and behaviour change theory, recommendations are proposed to improve end-of-life care in primary care. Conclusions: To sustain and embed positive change, an increased policy focus on primary care in end-of-life care is required. Targeted interventions developed during COVID-19, including online team meetings and education, new prescribing systems and unified guidance, could increase capacity and capability of the primary care workforce to deliver community end-of-life care. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic placed additional demands and stressors on UK obstetric sonographers, who were required to balance parent safety and service quality, alongside staff safety. Increased pressure can negatively impact a healthcare worker's well-being and the provision of person-centred care. The aim of this study was to explore obstetric sonographers' experiences of performing pregnancy ultrasound scans during the pandemic and to assess the impact on burnout, role satisfaction and clinical practice. Methods: An online, anonymous cross-sectional survey was created to capture sonographers' experience alongside using the Oldenburg Burnout Inventory to evaluate burnout and Clinical Outcomes in Routine Evaluation 10 (CORE-10) to measure psychological distress. Results: Responses were received from 138 sonographers. Of those completing the Oldenburg Burnout Inventory (n = 89), 92.1% and 91.0% met the burnout thresholds for exhaustion and disengagement, respectively. Sonographers with a higher burnout score also perceived that COVID-19 had a greater, negative impact on their practice (p < 0.05). The mean CORE-10 score of 14.39 (standard deviation = 7.99) suggests mild psychological distress among respondents. A significant decrease in role satisfaction was reported from before to during the pandemic (p < 0.001), which was associated with higher scores for burnout and psychological distress (p < 0.001). Change in role satisfaction was correlated with sonographers' perception of safety while scanning during the pandemic (R 2 = 0.148, p < 0.001). Sixty-five sonographers (73.9%) reported they were considering leaving the profession, changing their area of practice or working hours within the next 5 years. Conclusion: Job and context-specific interventions are required to mitigate burnout and its consequences on the workforce and service provision beyond the pandemic. [ABSTRACT FROM AUTHOR]

COVID-19 has posed serious challenges for informal carers living in the UK. This article examines some of the specific challenges facing carers and the resources they used to manage them throughout the first UK lockdown. We used a framework approach to analyse naturalistic, longitudinal data from 30 carers taking part in 96 of Mobilise's daily Virtual Cuppas between March and July 2020. We found that lack of information and social restrictions cumulatively impacted carers' sense of certainty, control and motivation. This took an emotional toll on the carers, leading to exhaustion and burden. However, carers quickly established new routines and used humour and self-care to actively manage their wellbeing. Carers received support but also provided it to those in need, including fellow members of the caregiving community, supporting an ecological approach to carer resilience. Our findings may be used to anticipate challenges and promote protective resilience resources in future lockdowns. [ABSTRACT FROM AUTHOR]

When lockdown was announced in the United Kingdom, kitchen tables transformed into offices overnight, as many National Health Service (NHS) workers adapted to new ways of working from home. To respond to the developing situation, we established a programme of weekly 'Connections' meetings where staff could be together, remotely. This article describes the evolution of our Morning Connections and Oncology Connections virtual meetings, including the content of sessions, how they were evaluated and whether they met their intention to support colleagues during a particularly challenging time, both personally and professionally, for NHS staff. [ABSTRACT FROM AUTHOR]

Objectives: Previous literature finds that having a child with a cleft lip and/or palate (CL/P) may pose social and emotional challenges for parents. For parents of children born during the Covid-19 pandemic, such challenges may be heightened. Further, novel demands brought about by the pandemic could have caused additional hardships. The aim of this study was to describe the impact of the pandemic on new parents through qualitative exploration of their experiences. Design: Semi-structured interviews were conducted with 14 parents of children born in the United Kingdom with CL/P between January and June 2020, around the start of the pandemic. Data were analysed using inductive thematic analysis. Results: Three themes, with sub-themes, were identified. The first theme, " Changes to Healthcare: The Impact of Restrictions and Reduced Contact", discussed the impact of the pandemic on perinatal care, the care received from the specialist CL/P teams, and parents' experiences of virtual consultations. The second theme, "Family Functioning During the Pandemic", covered parental anxiety, fathers' experiences, and social support. The third theme, " Surgical Prioritisation: Delays and Uncertainty", addressed changes to surgical protocols, coping with uncertainty, complications associated with delayed surgery, and how parents created positive meaning from this period. Conclusions: A range of increased and additional psychosocial impacts for parents were identified, along with several coping strategies, utilization of social support, and the positive aspects of their experiences. As the pandemic continues, close monitoring of families affected by CL/P remains imperative, particularly for those at risk of emotional distress. [ABSTRACT FROM AUTHOR]

The UK government's Everyone In scheme, announced in March 2020, required local authorities to temporarily house all homeless individuals in their area regardless of immigration status. In providing support through safe and secure accommodation, Everyone In also provided a crucial moment of visibility for migrants experiencing homelessness. Yet, just as it provided life-changing opportunities for some, the scheme was not straightforwardly a celebratory moment for migrants. It remained embedded within a wider context of immigration governance and social inequality in the UK, which has both invisibilised migrant homelessness as a crisis and hypervisibilised migrants as undeserving, suspicious or 'illegal' subjects. In this article, we explore life-story narratives co-produced with migrants across three urban contexts that capture their experiences of homelessness before and during the pandemic. In doing so, we introduce the notion of cultivated invisibility, referring to a habitual, deeply-ingrained mode of practice through which migrants respond to and navigate their experiences of being read as 'Other', in racialised or classed terms. It is developed through conditions of material scarcity and in the course of multiple engagements with racial capitalism's various 'faces of the state' in an increasingly hostile environment for migrants. Cultivated invisibility involves staying on the move and blending into the crowd or avoiding it altogether but it also includes the experience of being unseen despite having come forward for help. Importantly, we demonstrate that cultivated invisibility becomes a cause of illegalisation, just as much as a response to it. [ABSTRACT FROM AUTHOR]

In response to the Coronavirus disease, the United Kingdom (UK) government introduced lockdown measures requiring people to isolate and adhere to social distancing. This article uses Constraints Negotiation Theory to examine effects of the lockdown on people with vision impairment (PwVI). The research is based on an online survey of 639 PwVI in the UK. The analysis was conducted using partial least squares structural equation modelling in SmartPLS. The findings show that the lockdown had a negative effect on the participation and well-being of PwVI. However, they also show that the negative effects could be negotiated by adapting activities. This emphasises the need for a more inclusive response to current or future pandemics that recognises the vulnerabilities of PwVI and helps them to overcome the challenges associated with any measures that are introduced. [ABSTRACT FROM AUTHOR]

This article explores the experiences of young adults with a life-shortening condition in the first wave of the Coronavirus (COVID-19) pandemic in the UK. It presents the findings from an inclusive qualitative research study using constructivist grounded theory which aimed to examine the unintended consequences of pandemic control measures (lockdown and 'shielding') on this population. Purposive and theoretical sampling methods were used to recruit young adults with a life-shortening condition, employing a range of recruitment methods such as social media, advertising in newsletters and snowballing. Twenty-six young adults (aged 22–40 years), with a wide range of life-shortening conditions participated in the study. Seventeen participants were female and nine male. The majority identified as White British/Other and the remainder as Black British (2), Mixed Race (2) or Latin American (1). Data were generated iteratively using in-depth guided interviews and analysed collectively by an inclusive research team using the constant comparative method. The article explores a theory of embodied precariousness of living with a life-shortening condition during the first wave of the Coronavirus pandemic in relation to three categories: the rationing of life-saving treatment, the deterioration of health and retraction of healthcare provision, and the disruption of typical care arrangements. The findings show that the pandemic control measures introduced to keep people safe have intensified the precarity of this group promoting inequalities in healthcare and health outcomes. The article identifies some implications for practice to support the future management of unexpected and unwanted change. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to explore the experiences of individuals with Parkinson's through the theoretical lens of illness uncertainty during the first UK full lockdown period (March–June 2020) put in place due outbreak of the COVID-19 pandemic. Methods: Individual semi-structured interviews were carried out via telephone in May 2020 with 10 individuals with Parkinson's (six men and four women) recruited from Parkinson's UK. Interviews were recorded and transcribed verbatim, and thematic analysis was adopted to analyse the resulting data. Results: Four overarching themes emerged from the interview data: (1) COVID-19 amplifying existing fears and difficulties around the uncertainty of Parkinson's; (2) practical and psychological efforts to manage uncertainty; (3) benefit-finding as a way of acknowledging the positives of lockdown; (4) risk and future management in the context of uncertainty. Discussion: Participants reported a range of implicit and explicit strategies to cope with the 'double whammy' of uncertainty caused by having Parkinson's during a global pandemic. While these were generally successful in maintaining well-being, it is important that such successful accounts are used to help inform novel strategies and interventions targeting individuals who might need additional support. [ABSTRACT FROM AUTHOR]

Evidence suggests that the COVID-19 pandemic has increased rates of depression worldwide. Many factors have been identified to relate to this increase depression, but according to Terror Management Theory, the heightened awareness of death during the pandemic has the potential to increase depression for those with low self-esteem. This hypothesis was examined in a U.K. sample during the first national lockdown where depression, self-esteem and death-thought accessibility (DTA) were measured, and a COVID Index (COVID-19 cases and deaths on date of participation) was produced. The COVID Index was positively related to DTA. Additionally, DTA mediated the relationship between the COVID Index and depression scores when participants had low levels of self-esteem. These findings suggest that heightened existential concerns may be a neglected factor increasing depression during the pandemic. [ABSTRACT FROM AUTHOR]

Scientific advice to the UK government throughout the COVID-19 pandemic has been informed by ensembles of epidemiological models provided by members of the Scientific Pandemic Influenza group on Modelling. Among other applications, the model ensembles have been used to forecast daily incidence, deaths and hospitalizations. The models differ in approach (e.g. deterministic or agent-based) and in assumptions made about the disease and population. These differences capture genuine uncertainty in the understanding of disease dynamics and in the choice of simplifying assumptions underpinning the model. Although analyses of multi-model ensembles can be logistically challenging when time-frames are short, accounting for structural uncertainty can improve accuracy and reduce the risk of over-confidence in predictions. In this study, we compare the performance of various ensemble methods to combine short-term (14-day) COVID-19 forecasts within the context of the pandemic response. We address practical issues around the availability of model predictions and make some initial proposals to address the shortcomings of standard methods in this challenging situation. [ABSTRACT FROM AUTHOR]