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Aim: To investigate the mental well‐being of early career nurses working in the United Kingdom during the COVID‐19 pandemic, with a particular emphasis on symptoms related to post‐traumatic stress disorder. Design: A longitudinal survey study. Methods: Data were acquired at three timepoints during the COVID‐19 pandemic (between May 2020 and March 2021) to determine whether symptoms of post‐traumatic stress disorder persisted over time. Quantitative measures of well‐being were supplemented with survey data on the nurses' experiences of working during the pandemic. Results: Twenty‐seven per cent of participants suffered from persistent symptoms of post‐traumatic stress while working as nurses during the pandemic. The nurses' baseline resilience, as well as their perception of the quality of their work environment, were significant negative predictors of symptoms of post‐traumatic stress. Participants identified a range of strategies that would have helped them during the crisis, including visible, consistent and empathetic leadership, adequate training and a supportive work environment. Conclusion: The context of the pandemic has highlighted the vulnerability of the psychological well‐being of early career nurses in the workforce. Immediate implementation of some of the more simple interventions suggested in this paper would provide early career nurses with rapid support. More complex support mechanisms should be given immediate consideration, with a view to implementation in the longer term. Implications for the Profession: This study contributes new knowledge about the psychological well‐being of early career nurses working during the pandemic and suggests support mechanisms that will be crucial for the retention of these nurses in the profession. A measurement of resilience may be useful for determining the appropriate level of support to provide to early career nurses. Impact: Early career nurses are vulnerable to attrition from the profession. This could be exacerbated if the psychological well‐being of these nurses is not being supported.Around 25% of early career nurses suffered from persistent symptoms of post‐traumatic stress disorder while working as nurses during the height of the pandemic, which is a novel finding compared to other longitudinal studies.Understanding the psychological well‐being of early career nurses working during a crisis period (such as a pandemic) equips nurse managers with appropriate strategies to improve nurses' emotional health and to enhance their retention within the workforce.The current findings may be of interest to clinical practitioners who have responsibility for the retention of nursing staff. No patient or public contribution. One of the authors is a statistician. [ABSTRACT FROM AUTHOR]

This paper investigates the relationship between social participation and subjective health. Using individual‐level data from the British Household Panel Survey, we show that being an active member of a social or sport organisation increases self‐rated physical and psychological health. For men, the benefits of social interaction work primarily via physical pathways, while women report a more psychosocial channel. We separate the main results by occupation and document some heterogeneity. Manual workers find more physical and psychological relief via social involvement, whereas non‐manual workers are more likely to take relief from sport participation. Interestingly, as the number of associations in which the individual is active increases, the incremental increase in social benefits diminishes. Our findings point to the importance of promoting social and sport activities in health communication and policy making. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life is included in the economic evaluation of health services by measuring the preference for health states, i.e. health state utilities. However, most intervention studies include a disease-specific, not a utility, instrument. Consequently, there has been increasing use of statistical mapping algorithms which permit utilities to be estimated from a disease-specific instrument. The present paper provides such algorithms between the MacNew Heart Disease Quality of Life Questionnaire (MacNew) instrument and six multi-attribute utility (MAU) instruments, the Euroqol (EQ-5D), the Short Form 6D (SF-6D), the Health Utilities Index (HUI) 3, the Quality of Wellbeing (QWB), the 15D (15 Dimension) and the Assessment of Quality of Life (AQoL-8D). Methods: Heart disease patients and members of the healthy public were recruited from six countries. Non-parametric rank tests were used to compare subgroup utilities and MacNew scores. Mapping algorithms were estimated using three separate statistical techniques. Results: Mapping algorithms achieved a high degree of precision. Based on the mean absolute error and the intra class correlation the preferred mapping is MacNew into SF-6D or 15D. Using the R squared statistic the preferred mapping is MacNew into AQoL-8D. Implications for research: The algorithms reported in this paper enable MacNew data to be mapped into utilities predicted from any of six instruments. This permits studies which have included the MacNew to be used in cost utility analyses which, in turn, allows the comparison of services with interventions across the health system. [ABSTRACT FROM AUTHOR]

Background and Aims If socio-economic disadvantage is associated with more adolescent smoking, but less participation in tertiary education, and smoking and tertiary education are both associated with heavier drinking, these may represent opposing pathways to heavy drinking. This paper examines contextual variation in the magnitude and direction of these associations. Design Comparing cohort studies. Setting United Kingdom. Participants Participants were from the 1958 National Child Development Study (NCDS58; n = 15 672), the British birth cohort study (BCS70; n = 12 735) and the West of Scotland Twenty-07 1970s cohort (T07; n = 1515). Measurements Participants self-reported daily smoking and weekly drinking in adolescence (age 16 years) and heavy drinking (> 14/21 units in past week) in early adulthood (ages 22-26 years). Parental occupational class (manual versus non-manual) indicated socio-economic background. Education beyond age 18 was coded as tertiary. Models were adjusted for parental smoking and drinking, family structure and adolescent psychiatric distress. Findings Respondents from a manual class were more likely to smoke and less likely to enter tertiary education (e.g. in NCDS58, probit coefficients were 0.201 and -0.765, respectively; P < 0.001 for both) than respondents from a non-manual class. Adolescent smokers were more likely to drink weekly in adolescence (0.346; P < 0.001) and more likely to drink heavily in early adulthood (0.178; P < 0.001) than adolescent non-smokers. Respondents who participated in tertiary education were more likely to drink heavily in early adulthood (0.110 for males, 0.182 for females; P < 0.001 for both) than respondents with no tertiary education. With some variation in magnitude, these associations were consistent across all three cohorts. Conclusions In Britain, young adults are more likely to drink heavily both if they smoke and participate in tertiary education (college and university) despite socio-economic background being associated in opposite directions with these risk factors. [ABSTRACT FROM AUTHOR]

Empirical evidence regarding the link between flexible working arrangements (FWAs) and work effort is mixed, with the literature showing that some practices are linked to more while others to less work effort. In this study, we argue that this discrepancy may be due to the existence of different types of FWA bundles with potentially distinct effects on work effort. Using Understanding Society, a British national survey, and building on theories related to social exchange, the study examines the link between employee‐centered and employer‐centered FWA bundles, and work effort. This study further tests whether these relationships differ depending on employees' family responsibilities. Based on a sample of 13,834 employees, results show that both employee‐centered and employer‐centered FWA bundles are negatively associated with work effort, and findings for the latter bundle are more pronounced. These negative associations are somewhat stronger for employees with fewer family responsibilities. We infer that employees appear to use employee‐centered FWAs for their intended purpose, that is, to balance life and job demands, while they might perceive employer‐centered FWAs as unfair, resulting in less work effort in an attempt to restore fairness. [ABSTRACT FROM AUTHOR]

The article considers the reasons for employees holding large proportions of their financial savings and investments in company stock, drawing on explanations proposed in the behavioral finance literature. Utilizing data from a survey of employees participating in the United Kingdom Save as You Earn stock options and savings scheme, it is found that substantial proportions of stock owners hold sizeable concentrations of employer stock. Several explanations for this risky behavior are tested, with familiarity, reciprocity, and inertia found to be associated with portfolio concentration. Organizational commitment and “naïve extrapolation” from recent stock prices are not. The implications for theory and practice are considered. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

Guillain‐Barré syndrome (GBS) has several enduring effects that can lead to further harm and/or lower quality of life. These effects include falling and body pain, neither of which have been fully explored. This study aims to examine the risk factors associated with falling and potential causes of body pain in a post‐GBS population. A cross‐sectional survey of 216 participants was conducted using an electronic questionnaire that included. Self‐report measures for: overall health, balance, anxiety and depression levels, body pain and demographics related to GBS experience and falls. A large proportion of individuals post‐GBS experience ongoing problems beyond those expected with ageing. Comparative tests indicated that people reporting falls in the previous 12 months had: poorer levels of mobility, poorer F‐scores, higher levels of body pain, poorer balance, poorer anxiety and depression scores and higher levels of fatigue. Gender did not appear to contribute to falls. Injuries following falls were associated with a lack of physiotherapy postdischarge and time since GBS. In a regression analysis of the identified and expected key variables, age and body pain statistically predicted falls. In over a quarter of cases reported here, respondents did not receive community physiotherapy following hospital discharge. In the midst and aftermath of COVID‐19, provision of rehabilitation needs to be recalibrated, not just for COVID patients, but the wider community with ongoing needs. Issues around well‐being and quality of life in the post‐GBS community also need further consideration. [ABSTRACT FROM AUTHOR]

Purpose: Stigma reduction is an important public health challenge because of the large morbidity and mortality associated with some forms of substance use. Extreme stigma can lead to dehumanisation of target groups, who are ascribed with lesser humanity. The authors examined whether there was blatant and subtle dehumanisation of people who use heroin, and if these were associated with levels of support for non-discriminatory drug policy. Design/methodology/approach: A cross-sectional online study using a UK convenience sample (n = 307 [75.2% female, mean age 28.6 ± 12.2 years]) was conducted. Participants completed assessments of blatant (Ascent of Humans [AoH] scale) and subtle (an emotion attribution task) dehumanisation and a bespoke measure assessing support for non-discriminatory drug policies. Other measures controlled for stigma towards people who use drugs (PWUD) and moral disgust. Findings: There was greater blatant dehumanisation of people who used heroin compared to the general population and other potentially stigmatised reference groups, including people who use cannabis. The authors also found evidence of subtle dehumanisation, and people who used heroin were rated as being less likely to feel uniquely human emotions, less likely to feel positive emotions and more likely to feel negative emotions. Blatant dehumanisation was associated with significantly lower probability of support for non-discriminatory drug policy. Social implications: Dehumanisation may present significant challenges for stigma reduction initiatives and in fostering public support for drug policy and treatment. Denial of the humanity of this group could be used to justify discriminatory policies or relative deprioritisation of support services in funding decisions. Activities that seek to "rehumanise" PWUD, including social inclusion, and encouraging compassionate media representations that portray the lived experiences of substance use may be useful areas of future work. Originality/value: This is the first study to investigate blatant and subtle dehumanisation of people who use heroin, and how this relates to public support for drug policy. [ABSTRACT FROM AUTHOR]

Background Rising use of foodbanks highlights food insecurity in the UK. Adverse life events (e.g. unemployment, benefit delays or sanctions) and financial strains are thought to be the drivers of foodbank use. This research aimed to explore who uses foodbanks, and factors associated with increased food insecurity. Methods We surveyed those seeking help from front line crisis providers from foodbanks (N = 270) and a comparison group from Advice Centres (ACs) (N = 245) in relation to demographics, adverse life events, financial strain and household food security. Results About 55.9% of foodbank users were women and the majority were in receipt of benefits (64.8%). Benefit delays (31.9%), changes (11.1%) and low income (19.6%) were the most common reasons given for referral. Compared to AC users, there were more foodbank users who were single men without children, unemployed, currently homeless, experiencing more financial strain and adverse life events (P = 0.001). Food insecurity was high in both populations, and more severe if they also reported financial strain and adverse life events. Conclusions Benefit-related problems appear to be a key reason for foodbank referral. By comparison with other disadvantaged groups, foodbank users experienced more financial strain, adverse life events, both increased the severity of food insecurity. [ABSTRACT FROM AUTHOR]

Introduction: Higher levels of anxiety and depression have been found to be associated with greater difficulty in stopping smoking. This raises the question as to whether mood disturbance may be associated with exposure to, and use of, quitting support. Aims: This study examined whether General Practitioner (GP) advice and/or offer of support, or stop-smoking service use differed between smokers reporting or not reporting depression/anxiety. Methods: Data came from the Smoking Toolkit Study. Participants were 1,162 English adults who reported currently smoking or having stopped within the past 12 months, aged 40+ years, surveyed between April and September 2012. Anxiety/depression was assessed by the mood disturbance item of the EuroQol five dimensions questionnaire (EQ-5D). This was compared to recall of GP quit advice and/or support, and stop-smoking aid use adjusting for age, gender, and social grade. Results/Findings: Smokers reporting depression/anxiety were more likely to recall being offered advice and support to stop smoking by their GP (OR = 1.50, 95% C.I. = 1.05–2.13). However, there were no significant differences in use of stop-smoking aids during the past year. Conclusions: Smokers reporting depression/anxiety are more likely to be offered stop-smoking support by their GPs, but this does not appear to translate into stop-smoking aid use, despite high motivation to quit. Given higher nicotine dependence in this group, mental health specific support may need to be offered, and more needs to be done to make this offer of aid attractive. [ABSTRACT FROM AUTHOR]

Objective: Qualitative research has identified personal costs and benefits for peer supporters associated with their role; however, quantitative evidence is sparse. This study used quantitative methods to explore relationships in experiences of providing peer support with constructs of empowerment, hope, recovery, quality of life and internalised stigma. Differences were examined for those in statutory versus non-statutory services; who had themselves received peer support versus those who had not and who identified having had negative experiences in clinical teams versus those without such experiences. Methods: A cross-sectional online and postal survey was undertaken in tandem with a linked consensus study. In all, 147 peer supporters were recruited from a variety of organisations across the United Kingdom. Validated questionnaires were used to examine constructs. Instruments created for the study measured peer support experiences, and personal costs and benefits involved. Correlations were calculated and results informed further regression analysis. Chi-square tests and independent samples t-tests tested group differences. Results: Peer supporters indicated they experienced almost twice as many role-related personal benefits than personal costs. Benefits included improvements to mental health and well-being, reduced use of services, increased social functioning and development of skills. Total number of personal costs experienced was significantly negatively related to peer supporters' empowerment and quality of life. There were no significant differences between the groups examined. Conclusions and Implications for Practice: An accumulation of personal costs may result in reduced quality of life; however, costs can be minimised by organisations. Limitations of the research are discussed and recommendations for future research are made including the need for longitudinal research. [ABSTRACT FROM AUTHOR]

This article reports findings among adolescents of the impact of Well London, a program of wellbeing interventions delivered across 20 deprived neighbourhoods of London using a community engagement model. Twelve hundred and fifty-four adolescents were surveyed from matched intervention and control areas. There was no significant intervention effect on the main outcome measures: unhealthy eating, physical activity, and mental health. Factors influencing the results may include the possibility that the communities defined by the cluster randomized controlled trial (CRCT) were not an accurate reflection of the adolescent’s natural community, and interactions within the school environment in particular could have led to a dilution of effect. [ABSTRACT FROM PUBLISHER]

Although we do know that out-of-pocket healthcare expenditure is relatively high in Australia, little is known about what health conditions are associated with the highest out-of-pocket expenditure, and whether the cost of healthcare acts as a barrier to care for people with different chronic conditions. Cross-sectional analysis using linear and logistic regression models applied to the Commonwealth Fund international health policy survey of adults aged 18 years and over was conducted in 2013. Adults with asthma, emphysema and chronic obstructive pulmonary disease (COPD) had 109% higher household out-of-pocket healthcare expenditure than did those with no health condition (95% CI: 50-193%); and adults with depression, anxiety and other mental health conditions had 95% higher household out-of-pocket expenditure (95% CI: 33-187%). People with a chronic condition were also more likely to forego care because of cost. People with depression, anxiety and other mental health conditions had 7.65 times higher odds of skipping healthcare (95% CI: 4.13-14.20), and people with asthma, emphysema and chronic obstructive pulmonary disease had 6.16 times higher odds of skipping healthcare (95% CI: 3.30-11.50) than did people with no health condition. People with chronic health conditions in Canada, the United Kingdom, Germany, France, Norway, Sweden and Switzerland were all significantly less likely to skip healthcare because of cost than were people with a condition in Australia. The out-of-pocket cost of healthcare in Australia acts as a barrier to accessing treatment for people with chronic health conditions, with people with mental health conditions being likely to skip care. Attention should be given to the accessibility and affordability of mental health services in Australia. [ABSTRACT FROM AUTHOR]