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Summary: The optimal treatment and organization of care for people with obesity is one of the greatest challenges facing today's health services. While surgery and pharmacotherapy offer effective treatment options for some people with obesity, behavioral interventions are important to support long‐term behavioral change. However, little is known about the most effective components of behavioral interventions, and this is especially the case for people with complex or severe obesity (i.e. body mass index [BMI] > 35 kg/m2). Accordingly, the current rapid review aimed to identify which behavior change techniques (BCTs) are effective for weight loss in adults with (severe) obesity. A secondary aim was to review the effects of BCTs on dietary behaviors and physical activity, and psychological outcomes, recognizing that behavioral interventions commonly target these. A search of Scopus, Ovid Medline, and Web of Science resulted in 1227 results, with 22 reviews eligible for inclusion. The most commonly reported BCTs were self‐monitoring and goal setting, but these had variable effects on weight in adults with obesity. Combining these BCTs with other self‐regulatory techniques led to increased weight loss. Further, for adults with severe obesity, so‐called 'nudge' techniques and self‐regulatory techniques were associated with greater weight loss. Three reviews also found that while self‐monitoring increased physical activity, behavioral commitments increased changes to dietary behaviors. BCTs were not associated with psychological well‐being. The review confirms that behavioral interventions have an impact in weight management, including for individuals with more complex or severe obesity, but highlights the need for further investigation of their use within clinical settings. [ABSTRACT FROM AUTHOR]

Background: The term 'care‐experienced' refers to anyone who is currently in care or has been in care at any stage in their life. A complex interplay of factors leads to care‐experienced children and young people (CECYP) experiencing poorer oral health and access to dental care than their peers. A rapid review of the co‐production of health and social care research with vulnerable children and young people (CYP) was carried out to inform the development of a co‐produced research project exploring the oral health behaviours and access to dental services of CECYP. Here, 'co‐production' refers to the involvement of CYP in the planning or conduct of research with explicit roles in which they generate ideas, evidence and research outputs. Aim: To learn how to meaningfully involve vulnerable CYP in the co‐production of health and social science research. Objectives: To identify: Different approaches to facilitating the engagement of vulnerable CYP in co‐production of health and social science research; different activities carried out in such approaches, challenges to engaging vulnerable CYP in co‐production of health and social science research and ways to overcome them and areas of best practice in relation to research co‐production with vulnerable CYP. Search Strategy: A rapid review of peer‐reviewed articles was conducted in six databases (MEDLINE, Embase, SocINDEX, CINAHL, PsycINFO and Web of Science) and grey literature to identify studies that engaged vulnerable CYP in co‐approaches to health and social research. Main Results: Of 1394 documents identified in the search, 40 were included and analysed. A number of different approaches to co‐production were used in the studies. The CYP was involved in a range of activities, chiefly the development of data collection tools, data collection and dissemination. Individual challenges for CYP and researchers, practical and institutional factors and ethical considerations impacted the success of co‐production. Discussion and Conclusion: Co‐production of health and social science with vulnerable CYP presents challenges to researchers and CYP calling for all to demonstrate reflexivity and awareness of biases, strengths and limitations. Used appropriately and well, co‐production offers benefits to researchers and CYP and can contribute to research that reflects the needs of vulnerable CYP. Adherence to the key principles of inclusion, safeguarding, respect and well‐being facilitates this approach. Patient and Public Contribution: Members of our patient and public involvement and stakeholder groups contributed to the interpretation of the review findings. This manuscript was written together with a young care leaver, Skye Boswell, who is one of the authors. She contributed to the preparation of the manuscript, reviewing the findings and their interpretation. [ABSTRACT FROM AUTHOR]

This article explores “literature sickness”, a term coined by the contemporary Iranian-American writer Azareen Van der Vliet Oloomi and developed, I suggest, in her novel Call Me Zebra (2018). In doing so, it aims to offer not only an account of this novel, but to consider the radical potential of the condition Van der Vliet Oloomi outlines. This potential lies in the challenge to the dualism of reality and representation posed by literature sickness, an idea I develop comparatively via Call Me Zebra and the reflections on exile and, specifically, world literature in the work of Edward Said and Erich Auerbach. To develop these ideas further, I explore key concepts relating to the politics of world literature – exile, marginalization, and dissent. I focus on the work of Pascale Casanova to show how the concept of literature sickness that I develop in my readings of the novel relates to current debates in world literature theory. I position Call Me Zebra within a wider critical debate in order to argue that this novel offers a distinctive response to the Kantian dualism evoked in much contemporary world literature theory, one that I unpack using Gilles Deleuze and Bruno Latour. Deleuze’s philosophy of literature is central to my reading of Call Me Zebra, as it has distinct parallels with Zebra’s own theoretical musings. I use Deleuze to illustrate how, in the novel, Zebra’s exile gives her an especial perspective on oppression and marginalization, revealing literature’s capacity for imagining new futures and ways of belonging, and making Call Me Zebra a paradigmatic text of literature sickness and its radical potential. [ABSTRACT FROM AUTHOR]

Careers in academic dentistry are failing to attract a new generation of academics to steer dental education and research. Dental academia is further limited by inadequacies in levels of ethnic diversity. There is a stark contrast between the diversity of graduates entering the dental profession and those in academic positions, especially in senior ranks. Dentistry is not the only field in academia, which lacks representation and lessons may be drawn from other faculties. This paper focuses on what is known about dental academia in the United Kingdom, where there are formal research training pathways. There is an emerging recognition of the requirement for action, and it is hoped this will stimulate debate and impetus for research across Europe. The terminology used throughout this piece follows the United Kingdom Cabinet Office recommendations for writing about ethnicity (Writing about ethnicity, 2021; https://www.ethnicity‐facts‐figures.service.gov.uk/style‐guide/writing‐about‐ethnicity). Where cited sources have employed less acceptable terms (Please don't call me BAME or BME!: Civil service, 2019; https://civilservice.blog.gov.uk/2019/07/08/please‐dont‐call‐me‐bame‐or‐bme/), these have been changed. [ABSTRACT FROM AUTHOR]

Background: The resource needs of health services are served by the recognition of qualifications across borders which allows professionals to migrate between countries. The movement of dentists across the European Union (EU), especially into the United Kingdom (UK), has provided a valuable boost to workforce supply. Recent changes to policy recognising overseas qualifications have brought attention to the equivalence of qualifications awarded in EU countries. Professional regulators need to be confident that dentists who qualified elsewhere have the appropriate knowledge, skills and experience to practise safely and effectively. The aim of this study was to compare UK and EU dental curricula, identify any differences, and compare the extent of pre-qualification clinical experience. Methods: This was a mixed methods study comprising a questionnaire and website searches to identify information about curricula, competences, and quality assurance arrangements in each country. The questionnaire was sent to organisations responsible for regulating dental education or dental practice in EU member states. This was supplemented with information obtained from website searches of stakeholder organisations for each country including regulators, professional associations, ministries, and providers of dental education. A map of dental training across the EU was created. Results: National learning outcomes for dental education were identified for seven countries. No national outcomes were identified 13 countries; therefore, learning outcomes were mapped at institution level only. No information about learning outcomes was available for six countries. In one country, there is no basic dental training. Clinical skills and communication were generally well represented. Management and leadership were less represented. Only eight countries referenced a need for graduates to be aware of their own limitations. In most countries, quality assurance of dental education is not undertaken by dental organisations, but by national quality assurance agencies for higher education. In many cases, it was not possible to ascertain the extent of graduates' direct clinical experience with patients. Conclusions: The findings demonstrate considerable variation in learning outcomes for dental education between countries and institutions in Europe. This presents a challenge to decision-makers responsible for national recognition and accreditation of diverse qualifications across Europe to maintain a safe, capable, international workforce; but one that this comparison of programmes helps to address. [ABSTRACT FROM AUTHOR]

This article considers the challenge posed by Gayatri Spivak to rethink world literature along postcolonial lines as an ethical encounter with alterity. Read in this way, Spivak participates in a reframing of world literature that retains the critical gains made by postcolonial theory and suggests that the work of world literary analysis ought not necessarily be de/prescriptive (classifying and ordering) but might involve a contestation of the power relations that structure the world. In developing this argument, I draw on four further perspectives: Pascale Casanova's problematic assertion of literary singularity inThe World Republic of Letters; Fredric Jameson's theorization of “third world literature” as counterpoint to Casanova's limiting understanding of national literature; Gilles Deleuze, who offers a way to rethink world literature in a process of becoming; and Édouard Glissant, whose work proposes a “relational” vision of difference that, like that of Spivak, demands an ethical, imaginative response to literature as literature. [ABSTRACT FROM AUTHOR]

Introduction: Harmonising education to support workforce mobility has been a policy objective for the European Union. However, alignment across varied national contexts presents challenges in dental education. Methods: A systematic literature review with narrative synthesis. Searches of the electronic databases Embase [Ovid]; MEDLINE [Ovid]; Scopus; CINAHL; AMED and PsycINFO were conducted for relevant material published between 2000 and 2019 on undergraduate curricula, quality standards and learning outcomes in dentistry. Results: Seventy‐six papers met the inclusion criteria. Fifty‐three papers were commentaries or editorials, twenty‐one were research studies, and two were literature reviews on specific dental subfields. Eighteen of the research studies reported surveys. The literature contains extensive proposals for undergraduate curricula or learning outcomes, either broadly or for subfields of dentistry. Included papers demonstrated the importance of EU policy and educator‐led initiatives as drivers for harmonisation. There is limited evidence on the extent to which proposed pan‐European curricula or learning outcomes have been implemented. The nature and extent of dental students' clinical experience with patients is an area of variance across European Union member states. Arrangements for the quality assurance of dental education differ between countries. Discussion: Harmonisation of European dental education has engaged educators, as seen in the publication of proposed curricula and learning outcomes. However, differences remain in key areas such as clinical experience with patients, which has serious implications if graduate dentists migrate to countries where different expectations exist. Mutual recognition of professional qualifications between countries relies on education which meets certain standards, but institutional autonomy makes drawing national comparisons problematic. [ABSTRACT FROM AUTHOR]

The article focuses on the disparate culture experienced by the Caribbean population and creates discussions on creolization. It states that creolization is rooted in the New World and distinct from hybridity's problematic associations with Victorian theories of inter-racial mixing. It also explores the critical application of the term through writings of creolization's contemporary theorists and exposes its processes to reveal its relevance to European philosophies of immanence. It suggests that the link to creolization theory is vital and postcolonial identities are produced through creolization.

The purpose of this cross-fostering study was to investigate neonatal survival following exposure of pregnant rats to atosiban (1-deamino-2-d-Tyr(OEt)-4-Thr-8-Orn-oxytocin), an oxytocin antagonist. Atosiban was administered subcutaneously from days 15 to 20 of gestation at 300 mg/kg/day, and controls received vehicle alone. Parturition was observed at 30 min intervals throughout the period that births were occurring. There was no effect of treatment on number of pups born or neonatal viability. Within 1 h of birth, litter size was standardised to five males and five females, followed immediately by cross-fostering either between or within groups. Offspring from treated mothers reared by control mothers had normal survival and weight gain. There was poor survival and weight gain in offspring from control mothers reared by treated mothers. There was clear evidence that lactation was impaired in the treated females, leading to the conclusion that poor neonatal survival in offspring reared by treated mothers was attributable to a failure of milk let-down. [Copyright &y& Elsevier]

Background: People experiencing homelessness have an increased risk of hepatitis C virus (HCV) infection, with rates higher than the general population. However, their access to HCV diagnosis is limited and treatment uptake is low. Objectives: To identify and describe the barriers and facilitators for HCV screening and treatment for adults with lived experience of homelessness in highly developed countries. Methods: Bibliographic databases (Embase, MEDLINE, CINAHL and SocINDEX) and grey literature (Google, EThOS, the Health Foundation, Social Care Online, the World Health Organisation, Shelter, Crisis and Pathway) were searched. Two reviewers independently screened and appraised all studies. The Critical Appraisal Skills Programme tool and the Joanna Briggs Institute checklist were used. The analysis involved a three‐stage process: coding, theme generation and theme mapping under Penchansky and Thomas's modified access model. Results: Twelve papers/reports were included in the review. Several interacting factors influence access of people with lived experience of homelessness to HCV testing and treatment. Some mirror those identified for the general population. The precarious conditions associated with the lived experience of homelessness along with the rigidity of hospital settings and lack of awareness emerged as dominant barriers. Flexibility, outreach, effective communication, tailoring and integration of services were found to be important facilitators. Evidence from Black, Asian and minority ethnic groups is limited. Conclusions: People experiencing homelessness face multiple barriers in accessing and completing HCV treatment, relating to both their lived experience and characteristics of health systems. Although some barriers are readily amenable to change, others are more difficult to modify. The facilitators identified could inform future targeted measures to improve HCV diagnosis and treatment for people experiencing homelessness. Research is warranted into successful models to promote screening, diagnosis and treatment. Patient or Public Contribution: Our team includes a peer advocate, a hepatology nurse and a community volunteer, all with significant experience in promoting and engaging in HCV care and outreach for people experiencing homelessness. They contributed to the protocol, interpretation and reporting of the review findings. [ABSTRACT FROM AUTHOR]

Aim: To explore the oral care experiences of palliative care patients and of those who support or deliver oral care to these patients: nurses, doctors, dentists, their relatives and carers. Data Sources: An electronic search of the databases included: Embase, MEDLINE, DOSS, AMED and PsycINFO was performed. Data selection: Six articles were included in the final synthesis. Data extraction: Thematic analysis was applied by two researchers. Data synthesis: Three themes were identified: 'performing oral care', 'effects on oral health' and 'challenges in palliative care'. Conclusions: Despite similarities of oral care experiences, this review identified some differences, crucially in terms of the wider impact of oral symptoms, namely social interactions with others and challenges to oral care. This confirms the need to investigate these topics further in relation to different stakeholders, such as nurses; and to have consistent guidance to facilitate the provision of effective oral care to palliative care patients. [ABSTRACT FROM AUTHOR]

Background: Approximately 15 million people in the UK live with obesity, around 5 million of whom have severe obesity (body mass index (BMI) ≥35kg/m2). Having severe obesity markedly compromises health, well-being and quality of life, and substantially reduces life expectancy. These adverse outcomes are prevented or ameliorated by weight loss, for which sustained behavioural change is the cornerstone of treatment. Although NHS specialist 'Tier 3' Weight Management Services (T3WMS) support people with severe obesity, using individual and group-based treatment, the current evidence on optimal intervention design and outcomes is limited. Due to heterogeneity of severe obesity, there is a need to tailor treatment to address individual needs. Despite this heterogeneity, there are good reasons to suspect that a structured group-based behavioural intervention may be more effective and cost-effective for the treatment of severe obesity compared to usual care. The aims of this study are to test the feasibility of establishing and delivering a multi-centre randomised controlled clinical trial to compare a group-based behavioural intervention versus usual care in people with severe obesity. Methods: This feasibility randomised controlled study is a partially clustered multi-centre trial of PROGROUP (a novel group-based behavioural intervention) versus usual care. Adults ≥18 years of age who have been newly referred to and accepted by NHS T3WMS will be eligible if they have a BMI ≥40, or ≥35 kg/m2 with comorbidity, are suitable for group-based care and are willing to be randomised. Exclusion criteria are participation in another weight management study, planned bariatric surgery during the trial, and unwillingness or inability to attend group sessions. Outcome assessors will be blinded to treatment allocation and success of blinding will be evaluated. Clinical measures will be collected at baseline, 6 and 12 months post-randomisation. Secondary outcome measures will be self-reported and collected remotely. Process and economic evaluations will be conducted. Discussion: This randomised feasibility study has been designed to test all the required research procedures and additionally explore three key issues; the feasibility of implementing a complex trial at participating NHS T3WMS, training the multidisciplinary healthcare teams in a standard intervention, and the acceptability of a group intervention for these particularly complex patients. Trial registration: ISRCTN number 22088800. [ABSTRACT FROM AUTHOR]

Background: Autistic children and young people (CYP) experience oral health (OH) inequalities. They are at high risk of dental disease and show significant levels of unmet need in relation to OH and access to dental care. Aim: This study aimed to gather evidence on the factors that influence OH behaviours, access to and delivery of dental care for autistic CYP. Design: This was a mixed‐methods narrative systematic review. Data Sources: Embase, Web of Science, Dentistry & Oral Sciences Source, MEDLINE, Psychinfo, Scopus, CINAHL, SocINDEX and grey literature were the data sources for this study. Review Methods: A systematic search was conducted for qualitative, quantitative and mixed‐methods research studies from countries with a High Development Index that related to OH behaviours, access to and delivery of dental care for autistic CYP. Results were analysed using narrative synthesis. Results: From 59 eligible studies, 9 themes were generated: (1) affordability and accessibility; (2) autism‐related factors and cognitive or motor skill differences; (3) the dental environment; (4) managing CYP's behaviour; (5) responding and adapting to the needs of the autistic CYP and their parent/carer; (6) attitude of dental health professionals (DHPs) towards autistic CYP and their parents/carers; (7) knowledge of how to care for and support CYP's OH; (8) empowerment of parents/carers and collaboration with DHPs; and (9) communication and building rapport. Conclusion: The adoption of healthy OH behaviours and access to dental care by autistic CYP is impacted by a range of factors including those intrinsically related to a diagnosis of autism, for example, communication and those often associated with autism, for example, sensory sensitivities. Access to better OH and dental care can be facilitated by responding to the individual needs of autistic CYP through accommodation, education and adaptation. This necessitates greater awareness and knowledge of autism amongst DHPs and the provision of appropriate services. More methodologically robust intervention studies are needed to identify effective ways to support autistic CYP in achieving good OH and access to dental care. Patient and Public Contribution: The review protocol was developed with members of the project patient and public involvement group who provided the autistic voice, contributing to the interpretation of the review findings and writing of the manuscript. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review was to identify and conceptualize the barriers and enablers to accessing dental services for people experiencing homelessness in the United Kingdom. Methods: A literature search for studies relevant to homelessness and dental care was conducted. The PRISMA and ENTREQ guidelines were followed. Electronic databases (EMBASE, MEDLINE, DOSS, CINAHL, SOCINDEX and PsycINFO) and grey literature sources (Electronic Theses Online Service – EThOS, Kings Fund, NICE Evidence, Open Grey, Google and the Health Foundation) were searched up to 28 August 2018. The critical appraisal was conducted using CASP and an adjusted version of a JBI Critical Appraisal tool. Thematic analysis was used to develop the themes and domains. Results: Twenty‐eight papers were included. Barriers to homeless people accessing dental care stemmed both from the lived experience of homelessness and the healthcare system. Within homelessness, the themes identified included complexity, emotions and knowledge. Regarding the healthcare system, identified themes included staff encounter, accessibility and organization issues. Conclusion: Homelessness can actively contribute to both an increased need for dental care and barriers to accessing that care. The arrangement of dental healthcare services can also act as barriers to care. This is the first systematic review to conceptualize the factors associated with access to dental care for people who are homeless. It provides a set of recommendations for overcoming the main barriers for homeless people to accessing dental care. It also offers directions for future research, policy and commissioning. [ABSTRACT FROM AUTHOR]

• Services are more likely to attract and retain youth if they are co-designed. • Services are likely to be more engaging for youth if they are personalised. • Practitioners working with youth need to be caring, open, attentive and genuine. • The service system needs to make it easy for youth to engage with services they need. • Parents/carers and peers can support young people's engagement in services. Addressing youth violence is a public health priority given its prevalence, harms and costs to society. Services designed to prevent or reduce youth violence exist. However, their effectiveness depends on youth engaging with them. To our knowledge, there is no overview of the evidence on how to support this process. This article therefore aims to identify key messages from the scientific literature about how services can best engage youth at risk of involvement in violence. We undertook a rapid review of the evidence on youth engagement in services, prioritising English language studies published from 2010- which included youth aged 10–14 years and were conducted in high-income countries. Key messages for practice relate to 12 themes: co-designing services with youth; personalising provision to youth needs and preferences; recruiting staff with suitable experience and qualities; developing positive practitioner-participant relationships; nurturing an enabling service system; creating an inviting service environment; designing interesting activities and service content; encouraging peer engagement; securing parent/carer support; exploring opportunities for service integration; proactively including marginalised groups; and exploiting digital opportunities. While we could identify key messages from the literature, more prospective empirical research is needed to test the effectiveness of strategies in isolation and combination. This includes exploring what works for whom and in what circumstances. [ABSTRACT FROM AUTHOR]