Search

There is an expectation that medical students in the UK will be able to demonstrate conversancy with social science relevant to medicine and health, including the means by which the relevant bodies of knowledge are generated through the use of social science research methods. This paper explores the structural and pedagogical challenges and opportunities posed by this demand. To achieve this a small scale research project seeking to establish the "state of the art" with respect to teaching and learning about these research methods was implemented. It was found that there is little formal reporting of practice in the literature and that this is a field largely unsupported with materials and resources. However, there were some common features in the ways that practitioners approach, organise and deliver the provision; and it was found that almost all the provision takes place in the early part of medical education. It is suggested that continuing problems with the status of social sciences, lack of clarity about whether the purpose is to enrich medicine with knowledge about health and generated by the social sciences, and/or explore the ontological and epistemological tensions between natural and social sciences coupled with the status of social scientists in medical education, may limit capacity to develop the field.

Conducting social science research is a complex process, and social science students face a number of learning challenges in order to develop their skills. Moreover, new sources and types of data including so-called big data are providing new opportunities for research, but also pose methodological challenges. In this article, we explore a task-based learning approach for teaching social science research methods. We draw on evidence from two case study learning tasks: (i) the collection and analysis of Twitter data; and (ii) designing and conducting a face-to-face and online survey. The students were guided to co-lead the tasks, apply their knowledge and then to critically reflect. The pedagogical framework of task-based learning provides opportunities to embed learning in new ways by integrating knowledge, practice and critical reflection. Task-based learning can create a dynamic learning environment and can empower students to develop their identities as researchers.

While the time-honoured one-to-one supervisory model of higher research degree training has its advantages, recent research suggests that the model also has significant drawbacks, including its hierarchical nature. Nevertheless, this pedagogical model remains the default for higher research pedagogy. Using the discipline of music as a case study, where growing interest in practice-based research has lately demanded considerable fluidity in supervisory practices, this research explores the benefits and challenges of one-to-one models of supervision. Drawing on semi-structured interviews, dialogue forums, survey data, the extant literature and observations of practices at selected higher music education institutions in Australia, the UK, Belgium and the Netherlands, it recommends and suggests ways to implement more "horizontal" approaches to research pedagogy. The findings of this research may improve teaching and learning experiences and outcomes in higher research degrees in music and the creative arts, and stimulate a reflection of supervisory approaches more generally across the sector.

There is a growing need to design learning experiences in higher education that develop collaborative and mediated social writing practices. A wiki way of learning addresses these needs. This paper reports findings from a case study involving 58 postgraduate students who in small groups participated over eight weeks in a mediated collaborative writing project with and through wiki contexts. The project was not assessed but designed for task-based domain learning. Evaluation of the project was conducted using data drawn from multiple sources collected before, during and after the project. Findings show that participation in the project had a positive relationship with student exam performance, and web familiarity. Patterns of individual and group wiki project participation, and sex differences in participation, are discussed.

Hearing loss and dementia are common in long-term care home (LTCH) residents, causing communication difficulties and worsened behavioural symptoms. Hearing support provided to residents with dementia requires improvement. This study is the first to use the Behaviour Change Wheel (BCW) to identify barriers and propose interventions to improve the provision of hearing support by LTCH staff. Semi-structured interviews with 10 staff members were conducted. Transcripts were analysed according to the BCW's Theoretical Domains Framework alongside reflective thematic analysis. Relevant intervention functions and exemplar interventions were proposed. Staff believed hearing support to be beneficial to residents (Beliefs about Consequences) but lacked knowledge of hearing loss management (Knowledge). Poor collaborations between LTCHs and audiology (Environmental Context and Resources), led to despondency, and apprehension about traditional hearing aids for residents (Optimism). Despite feeling responsible for hearing support, staff lacked personal accountability (Social/Professional Role and Identity). Future interventions should include staff Training (on hearing support), Education (on the consequences of unsupported hearing loss), Enablement (dementia-friendly hearing devices), Incentivisation and Modelling (of Hearing Champions) and Environmental Restructuring (flexible audiology appointments to take place within the LTCH). Interventions should be multi-faceted to boost the capabilities, opportunities and motivations of LTCH staff. Hearing support for care home residents with dementia: Long-term care staff report inadequate knowledge and awareness of how to support residents' hearing needs and a lack of personal accountability for providing hearing support. They also report poor collaborations with audiologists and apprehension about traditional hearing aids. Barriers to hearing support stem from gaps in the capabilities, opportunities and motivations of staff, therefore, interventions should be designed to target all three constructs. Interventions to aid hearing support provision should target staffs' education, training, enablement, persuasion, modelling, incentivisation and environmental restructuring to boost staff capabilities, opportunities and motivations to provide hearing support. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To better understand the detrimental effects of domestic violence and abuse on children and young people • To acknowledge the importance of having independent domestic violence advocates in children’s hospitals • To reflect on how you can enhance your practice with regard to domestic violence and abuse. Domestic violence and abuse (DVA) has detrimental effects on the health and well-being of children and young people exposed to it, whether they witness or experience it. The introduction of independent domestic violence advocates in UK hospitals has enhanced the safety of victims of DVA. In 2020-2021 an independent domestic violence advocate post was piloted at a children’s hospital for one year, the advocate’s role being to train hospital staff and support women who had experienced DVA. A service evaluation showed that the training and support provided by the independent domestic violence advocate had benefits for women, children and staff. It also confirmed that the commissioning of services for children exposed to DVA is often underfunded and overshadowed by the provision of support to adults. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to uncover perspectives on the COVID‐19 pandemic and the responses implemented by the UK and Scottish Governments to help control the spread of infection. Such understanding could help to inform future responses to pandemics at individual, community and national levels. Method: Q methodology was used to elicit perspectives from people in England and Scotland with different experiences of the pandemic including public health officials, key workers, those on furlough, those who were unvaccinated or vaccinated to different levels, those who were 'shielding' because they were at higher risk and people with different scientific expertise. Participants rank‐ordered phrases about different aspects of COVID‐19 according to their viewpoint. Factor analysis was then conducted in conjunction with interview material from the same respondents. Results: A four‐factor solution was statistically supported and was interpretable alongside the qualitative accounts of participants loading on these factors. These four perspectives are titled Dangerous and Unaccountable Leadership, Fear and Anger at Policy and Public responses, Governing Through a Crisis and Injustices Exposed. Conclusion: The four perspectives demonstrate plurality and nuance in views on COVID‐19 and the associated policies and restrictions, going beyond a binary narrative that has been apparent in popular and social media. The four perspectives include some areas of common ground, as well as disagreement. We argue that understanding the detail of different perspectives might be used to build cohesion around policy initiatives in future. Patient or Public Contribution: The development of the statement set, which is rank‐ordered by participants in a Q study, and factor interpretations were informed by views of the general public. The statement set was initially developed using existing publicly available material based on members of the general public experiencing the pandemic first hand. It was then piloted with members of the public experiencing different challenges as a result of COVID‐19 and the subsequent lockdown and updated based on feedback. Finally, interpretations of the identified factors were presented publicly and edited according to their feedback. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic (2020–2021) resulted in isolation due to social distancing rules and lockdowns, during which technology was used to enable families and friends to maintain contact. Despite loneliness being high in parents, little is known about which parents are more likely to experience loneliness and strategies to support them. Method: This mixed‐methods study examines which parents were lonely during the pandemic and how digital technologies were used to reduce loneliness and social isolation. Data were collected during the first UK lockdown from May to July 2020 via an online survey (N = 145) and follow‐up interviews (n = 13). Results: Loneliness reported during lockdown was greater than retrospective reporting of loneliness for all respondents, but it was higher in single parents, those caring for children with specific needs, and those with lower household incomes before and during lockdown. Parents rapidly adapted to and experimented with using technology for social connection during the lockdown, which helped to reduce feelings of isolation and loneliness. Video calling was found to be useful for making connections and enhancing social presence, but parents also experienced anxieties and difficulties with its use. There were mixed views about technology use; some were keen to continue using technology for socializing after the lockdown ended, but for others, it was only a temporary measure. Conclusion: Although technology was invaluable during the pandemic, it was not a panacea, and the way parents used it was influenced by their approach to technology and existing social behaviors and networks. [ABSTRACT FROM AUTHOR]

Introduction: Major trauma centre (MTC) care has been associated with improved outcomes for injured patients. English ambulance services and trauma networks currently use a range of triage tools to select patients for bypass to MTCs. A standardised national triage tool may improve triage accuracy, cost-effectiveness and the reproducibility of decision-making. Methods: We conducted an expert consensus process to derive and develop a major trauma triage tool for use in English trauma networks. A web-based Delphi survey was conducted to identify and confirm candidate triage tool predictors of major trauma. Facilitated roundtable consensus meetings were convened to confirm the proposed triage tool’s purpose, target diagnostic threshold, scope, intended population and structure, as well as the individual triage tool predictors and cut points. Public and patient involvement (PPI) focus groups were held to ensure triage tool acceptability to service users. Results: The Delphi survey reached consensus on nine triage variables in two domains, from 109 candidate variables after three rounds. Following a review of the relevant evidence during the consensus meetings, iterative rounds of discussion achieved consensus on the following aspects of the triage tool: reference standard, scope, target diagnostic accuracy and intended population. A three-step tool comprising physiology, anatomical injury and clinical judgement domains, with triage variables assessed in parallel, was recommended. The triage tool was received favourably by PPI focus groups. Conclusions: This paper presents a new expert consensus derived major trauma triage tool with defined purpose, scope, intended population, structure, constituent variables, variable definitions and thresholds. Prospective evaluation is required to determine clinical and cost-effectiveness, acceptability and usability. [ABSTRACT FROM AUTHOR]

Background: Few studies have explored the potential educational value of immersive 360° video in continuing education. This study explored the potential value of immersive 360° video as an acceptable educational method in a continuing education module in nursing. Method: A convergent parallel mixed methods design was adopted. The setting was a nursing and midwifery school at a university. The 11 participants were RNs. Data were collected at three time points with surveys and focus groups. Results: Participants found educational value in the triggering of a deep reflective process, supported by a subsequent classroom discussion. Further, there were nuances and complexities to be considered, with a need to tailor material toward high-acuity, low-frequency, or challenging clinical events when considering content. Conclusion: Immersive 360° videos are a potentially useful method for providing continuing education; however, the content must be tailored to students' learning needs. A reflective model may provide a valuable structure for discussions after the use of immersive 360° video. [J Contin Educ Nurs. 2024;55(5):261–268.] [ABSTRACT FROM AUTHOR]

This initial article delves into the methodology, methods and theories, while the subsequent article will centre on the discoveries, discussion and conclusion. The study aimed to address the research question: how do men perceive their engagement in the self-management of non-cancer-related lymphoedema? An interpretivist qualitative methodology was employed, utilising an online survey based on the validated lymphoedema quality of life tool (LYMQoL). The data underwent inductive narrative inquiry. The study incorporated theories such as hegemonic masculinity and the health, illness, men and masculinities (HIMM) framework. The findings will be detailed in the second article in this series. This article has delineated the objective, methodologyand methods, employing a qualitative interpretivist approach through narrative inquiry. The study incorporated masculinity theories, including hegemonic masculinity and HIMM. The second article will present the findings and their significance within the broader literature. [ABSTRACT FROM AUTHOR]

Minoritised individuals (people identifying as belonging to groups experiencing socially constructed power inequalities) frequently experience mental health inequalities. Mental health services have often, intentionally or inadvertently, perpetuated these inequalities due to historic and ongoing systemic discrimination. To reduce inequalities, mental health services must address ongoing systemic discrimination and improve cultural-sensitivity of clinical staff. One method of improving clinician cultural-sensitivity is through reflective practice groups. This project evaluates a staff Equality Diversity and Inclusion (EDI) reflective space within a community psychological therapies team. A mixed methods approach of survey feedback and semi-structured interviews was used. Staff found the reflective space beneficial for improving their clinical skills relating to issues of EDI and helpful for their own wellbeing. Staff also found the EDI reflective space both acceptable and feasible and were keen to attend future sessions. However, some clinicians highlighted challenges relating to fear of judgment and evaluation from others. Findings are discussed in relation to the growing body of evidence of the usefulness of staff reflective spaces in healthcare generally, and provide specific support for the implementation of EDI reflective spaces. Guidance for developing an EDI staff reflective space for healthcare staff are discussed, alongside limitations and possible future research directions. [ABSTRACT FROM AUTHOR]

Purpose: Recovery Colleges were developed to support the recovery of people with mental health difficulties through courses co-produced by professionals and people with lived experience. This study aims to examine the use of Recovery Colleges to support people with dementia. Design/methodology/approach: A survey was circulated to UK Recovery College and memory service staff, exploring provision, delivery and attendance of dementia courses. Open responses provided insight into participant views about recovery in post-diagnostic support and the practicalities of running dementia courses. Findings: A total of 51 Recovery College staff and 210 memory service staff completed the survey. Twelve Recovery College dementia courses were identified across the UK. Three categories emerged from the qualitative data: post-diagnostic support, recovery in the context of dementia, challenges and areas of innovation. Originality/value: This study highlights the benefits and practicalities of running Recovery College courses with people with dementia. Peer-to-peer learning was seen as valuable in post-diagnostic support but opinions were divided about the term recovery in dementia. [ABSTRACT FROM AUTHOR]

Social workers were heavily impacted by the COVID-19 pandemic. In this study, we examined the well-being, burnout and work conditions of UK children's social workers at five time points of the COVID-19 pandemic. This was a cross-sectional mixed methods study analysing data from 1,621 social workers who worked in children's services in the UK in 2020–2022. Data were collected using anonymous online surveys which included both quantitative and qualitative questions. The mental well-being of participants decreased as the pandemic progressed and work-related burnout increased. In the later stages of the pandemic, children's social workers in Northern Ireland fared better than their Great Britain counterparts in relation to their well-being and levels of burnout. Thematic analysis of qualitative data revealed four major themes: Changes in service demand and referrals, Adapted ways of working, Staff shortages and Emotional impact. The findings highlight the challenges that the children's social workers encountered during the COVID-19 pandemic and have implications for policy, practice and research. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity (PA) promotion is a core element of musculoskeletal rehabilitation. Many people with musculoskeletal conditions do not meet PA guidelines, such as those provided by the World Health Organization (WHO). This study aimed to explore the level of awareness and perspectives on the WHO PA guidelines among people with musculoskeletal conditions and identify how patients can be supported with PA in clinical practice. Methods: A mixed‐method cross‐sectional survey was conducted using a uniquely developed questionnaire, which was disseminated to patients attending outpatient physiotherapy or occupational therapy appointments. The questionnaire collected data on participant characteristics, awareness and perspectives on the WHO guidelines and suggestions for supporting patients with PA in clinical practice. Descriptive statistics and content analysis were used to analyse the quantitative and qualitative data respectively. Results: One‐hundred and two responses were included in the analysis. Forty‐two percent of respondents were aware of the guidelines, 50% knew why they existed and 53% felt they were achievable. Perspectives varied, ranging from the guidelines being positive and aiding motivation to being unachievable. Some respondents felt an individualised approach is required. Suggestions for supporting patients with PA included facilitating social support, providing education, exercise groups and personalised advice, and signposting to community services. Conclusion: There is limited awareness of the WHO PA guidelines and a variety of perspectives on the guidelines among patients with musculoskeletal conditions. There is a need to enhance the promotion of the guidelines in clinical practice, whilst considering local context and individual patient's circumstances. [ABSTRACT FROM AUTHOR]

Aim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. 'Knowing self' as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To explore the usefulness of a co‐designed wordless book showing processes of receiving COVID‐19 vaccines designed by, and for, adults with intellectual disabilities. Methods: A qualitative evaluation of the resource using mixed methods. Semi‐structured interviews were conducted with people with intellectual disabilities, carers and health professionals about resource content, and use. This was analysed thematically. A survey was circulated to intellectual disabilities networks to understand resource need, use, sharing and content. Results: Understanding the COVID‐19 vaccine was a process, not a single event using one resource. A visual resource had a place in facilitating conversations about vaccines between people with intellectual disabilities and carers. Differing perspectives were expressed regarding personal needs, existing awareness of vaccine programmes and communication preferences. Changes were suggested to improve the suggested storyline and relevance around COVID‐19 restrictions changing. Conclusion: A visual resource may help conversations about the COVID‐19 vaccine for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background: Developments in digital health have the potential to create new opportunities for healthcare professionals support delivery of palliative care. Globally, many palliative care professionals used digital health innovations to support communication with staff, patients and caregivers, during COVID-19 pandemic. However, there is limited data about the views of palliative care professionals of using digital health to support communication during the pandemic. We aimed to describe how palliative care professionals used technology to support communication (multidisciplinary team working, education and with patients and family caregivers) during the COVID-19 pandemic. Method(s): UK based palliative care healthcare professionals completed an electronic questionnaire to describe their use of digital health, during the COVID-19 pandemic, to support (1) communication within the multidisciplinary team (MDT), (2) education and (3) to support communication with patients and carers. Results: Two hundred and thirty-four palliative care professionals participated. Most (n = 227, 97%) described an increase in their use of digital health, to support communication, since the start of the COVID-19 pandemic. We identified benefits and challenges for digital health communication, which we summarised into themes, including 'a new way of working', 'developing a new approach to learning' and 'impacting care'. Conclusion(s): Since the pandemic, palliative care professionals have increased their use of digital health to support communication in clinical practice. We have identified facilitators and barriers for future practice. Further work should identify the levels of support needed for organisations to ensure that digital health interventions are meaningfully used to help palliative care professionals effectively communicate with patients, caregivers and staff. [ABSTRACT FROM AUTHOR]

Current evidence suggests understaffing is related to poor quality and missed care in a global context, but this relationship is complex. There is also a research gap for quality in mental health care in the United Kingdom that includes a wider set of patient outcomes. This paper aims to investigate RMN's perception of quality of care on their last shift, their self‐reported reasons for compromised care and potential impact on patient outcomes. A mixed methods approach, we used descriptive statistics to create a framework within which to qualitatively analyse data from the 2017 Royal College of Nursing (RCN) employment survey to consider the complex relationship between understaffing and care quality. We established three themes: 'Understaffing', 'Professional Code Expectations and Moral Distress' and 'Management'. In line with the current evidence; lack of resources and understaffing were consistently present throughout. Nurses also felt pressure from the Nursing and Midwifery Council (NMC) code of conduct which in turn instilled shame and fear for their registration when they were unable to achieve the standards expected. This was further exacerbated by poor management and supervision; leading nurses to reflect on poor outcomes for patients which compromised not only legal rights but safety of patients and staff alike. We conclude that focusing on staffing numbers alone is unlikely to improve care quality. [ABSTRACT FROM AUTHOR]

Engagement in research and publication helps medical students develop the skills to improve healthcare through evidence-based medicine. The qualitative evidence-base for the medical student experience of publishing is limited. This study aims to explore medical students' publication practices and understand their experiences of research and publication. The study is based on a mixed-methods convergent design. A survey questionnaire was distributed to medical students in UK medical schools by social media and email communication. We recruited volunteer participants through the survey and interviewed a sample whilst the survey was open. We purposively selected the sample to ensure representation from research-intensive and other universities. Survey results indicated that 21.3% (27/127) of respondents had a publication. The most common publication type was a conference abstract. The main motivation to publish was career progression and the main barriers were lack of opportunity or support to submit an article. There was no significant association between attending a research-intensive university and submitting an article. The interviews revealed that contributing to academic advancement was also a motivation to publish. Participants expressed receiving differing levels of support from supervisors and their institutions. Data from the interviews suggested that the most commonly perceived barriers identified in the survey (lack of opportunity and support to conduct and publish research) may vary in prevalence between different medical schools. Further research is required to explore how different types of support offered by medical schools affect student engagement in publishing research. [ABSTRACT FROM AUTHOR]

Aim: To capture and retain healthcare staff in postgraduate courses relevant to individual career aspirations, service requirements and continuous practice development (CPD) within an English UK university. Design: Two virtual career clinics for postgraduate practitioners to engage in CPD offers within the university. An online post‐enrolment online survey to explore their experiences of engagement with the university. Methods: Mixed: qualitative and quantitative methods. Engaging 10 participants attended the career clinics, and 42 participants with an online survey. Results: The career clinics were well received by participants who mapped CPD requirements and individual career aspirations. The surveys exposed challenges with marketing and enrolment; however, these were mitigated with support. Four recommendations are presented within this paper applicable to the international postgraduate education of all health practitioners. [ABSTRACT FROM AUTHOR]

This paper reports on a feasibility study for an evaluation of a UK primary school‐based prevention programme that addresses multiple forms of abuse and neglect, identifying research design and ethical issues and exploring research practice. For this feasibility study, 194 children aged 6–11 years completed a baseline survey and 113 did so following the intervention. Eight focus groups were undertaken with 52 children and nine interviews with school staff. We highlight key considerations for conducting large‐scale mixed‐method research on sensitive topics with younger children, a focus that is largely absent from the extant research methods literature. The feasibility study showed that younger children can contribute their views on sensitive topics in ways that are measurable, replicable and reliable, contesting ideas that certain topics are too sensitive to explore with younger children. [ABSTRACT FROM AUTHOR]

Co-design involves engaging with the end-user in the design process and may help reduce the barriers to assistive technology use. Previous research has used co-design in the provision of assistive technology, but no research has looked at applying it within a healthcare setting. This service evaluation examines the use of co-design in providing customized assistive devices within a current UK healthcare based Rehabilitation Engineering department. This evaluation reports on three case studies. Individuals identified a range of challenges in daily living. The participants worked with the clinician in trialling prototypes and providing feedback to develop custom devices. A mixed-method approach of questionnaires and semi-structured interviews were used to evaluate the devices provided and the co-design approach. The resources required to provide the device were also calculated. Five different devices were developed, which were able to overcome the challenges identified. Results indicated participants were satisfied with both the devices and service provided. Participants expressed other benefits including increased independence, increased positive emotions and reduced mental load. Participants indicated they liked being involved in the design process and their feedback helped ensure the devices were customized to their needs. The use of co-design was able to produce customized assistive device that met the needs of the individuals within a current healthcare service. Further work is required to assess the feasibility of utilising a co-design approach for the provision of other custom assistive technology in the future and explore if this can overcome the barriers to assistive technology use. End-user involvement, the design process can help enable customized assistive devices to be provided that better meet the user's needs. The custom assistive devices provided not only helped the individuals overcome the challenges identified but had wider reaching benefits for the individuals physical and mental health and wellbeing. End-users valued being able to input into the co-design process and working closely with the clinician in developing the device. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well‐being for staff experiencing perimenopausal and menopausal symptoms at work. Design: It is widely acknowledged that perimenopause and menopause symptoms are experienced by a large percentage of the female workforce. There is a lack of research into how nurses are supported through menopause (Cronin et al. Issues in Mental Health Nursing, 42, 2021, 541–548). The perimenopause and menopause transition can be a challenging time where many may require symptom management and support (RCN, The Menopause and Work: Guidance for RCN Representatives, 2020). This paper presents a case study research (CSR) approach to examine one healthcare organization. Methods: CSR design was used: A survey distributed to all staff employed, a review of the available documentation on menopause and interviews with managers from different levels of the organization. The COREQ consolidated criteria was used for reporting the qualitative research reported this study. Results: The case study generated both quantitative and qualitative data using surveys, interviews and documentation. Data from the organization (n = 6905) showed a majority female workforce of 81.9% with 40.6% aged between 41 and 55 years old, meaning a third of the organization working through perimenopause and menopause. Survey responses (n = 167) collected biographical and psychometric data on the prevalence of perimenopausal and menopausal symptoms. Seven managers were interviewed highlighting two themes: Access to support and culture of menopause and 13 documents from the organization on menopause were analysed for content. The study design permitted an iterative approach to data collection and providing an in‐depth understanding of the needs and support for those experiencing perimenopause and menopause. The findings help healthcare organizations to understand their workforce and take in to account the larger numbers of female employees particularly nurses with the need to provide person‐centred support mechanisms and an organizational approach for all employees. [ABSTRACT FROM AUTHOR]

The social work profession was heavily impacted by the COVID-19 pandemic. In this study, we examined the well-being, working conditions and intentions to leave the social work profession among a sample of UK older people's social workers. This was a cross-sectional mixed methods study analysing data from 426 social workers who worked in older people's services in the UK at five time points of the pandemic spanning 2020–2022. Data were collected using anonymous online surveys which included both quantitative and qualitative questions. The mental well-being of participants decreased as the pandemic progressed and this decline was associated with intentions to leave the profession. Thematic analysis of qualitative data revealed two major themes: Practice challenges and Staff well-being. The findings highlight the nature of stressors related to internal related practice demands, and external health and social care service stressors encountered during the COVID-19 pandemic and have implications for policy, practice and research in older people's social work. [ABSTRACT FROM AUTHOR]

Hearing aid verification with real-ear measurement (REM) is recommended in clinical practice. Improvements, over time, in accuracy of manufacturers' initial fit mean the benefit of routine REM for new adult users is unclear. This registered, double-blinded, randomized, mixed-methods clinical trial aimed to (i) determine whether new adult hearing aid users prefer initial or real-ear fit and (ii) investigate the reasons for preferences. New adult hearing aid users (n = 45) were each fitted with two programs: the initial fit and real-ear fit, both with adjustments based on immediate feedback from the patient. Participants were asked to complete daily paired-comparisons of the two programs with a magnitude estimation of the preference, one for each of clarity/comfort in quiet/noise as well as overall preference. The results revealed gain adjustment requests were low in number and small in magnitude. Deviation from NAL-NL2 targets (after adjustment for a 65 dB SPL input) was close to zero, except at high frequencies where real-ear fits were around 3 dB closer to target. There was no difference in clarity ratings between programs, but comfort ratings favored initial fit. Overall, 10 participants (22%) expressed a preference for real-ear fit. Reasons for preference were primarily based on comfort with the initial fit and clarity with real-ear fit. It may be acceptable to fit new adult users with mild-to-moderate hearing loss without the need for REMs, if the primary outcome of interest is user preference. It remains to be seen if the findings generalize to other fitting software, other outcome measures and more severe hearing loss. [ABSTRACT FROM AUTHOR]

Background: Developing, elaborating, and consolidating positive views of the self is a plausible route to increased psychological well-being. We set out to provide an assessment of positive self-beliefs that could be used in research and clinical practice. Methods: A non-probability online survey was conducted with 2500 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. Exploratory factor analysis of a 94-item pool – generated with guidance from people with lived experience of mental health difficulties – was conducted to develop the Oxford Positive Self Scale (OxPos). The item pool was further reduced using regularised structural equation modelling (SEM) before confirmatory factor analysis. Optimal cut-off scores were developed using receiver operating characteristic curves. Additional validations were carried out with two further general population cohorts (n = 1399; n = 1693). Results: A 24-item scale was developed with an excellent model fit [robust χ2 = 995.676; df = 246; CFI = 0.956; TLI = 0.951; RMSEA = 0.049 (0.047, 0.052); SRMR = 0.031]. The scale comprises four factors: mastery; strength; enjoyment; and character. SEM indicated that the scale explains 68.6% of variance in psychological well-being. The OxPos score was negatively correlated with depression (r = −0.49), anxious avoidance (r = −0.34), paranoia (r = −0.23), hallucinations (r = −0.20), and negative self-beliefs (r = −0.50), and positively correlated with psychological well-being (r = 0.79), self-esteem (r = 0.67), and positive social comparison (r = 0.72). Internal reliability and test–retest reliability were excellent. Cut-offs by age and gender were generated. A short-form was developed, explaining 96% of the full-scale variance. Conclusions: The new open access scale provides a psychometrically robust assessment of positive cognitions that are strongly connected to psychological well-being. [ABSTRACT FROM AUTHOR]

To establish UK Physiotherapy lecturers' perceptions of online learning during the COVID-19 pandemic. A cross-sectional mixed methods electronic survey of UK higher education lecturers, actively teaching pre-registration undergraduate or postgraduate physiotherapy degrees, was conducted between October 2020 and February 2021. Data was converted into proportions with a 95% confidence interval. Likert scale questions were treated as numeric variables with the mean and standard deviation calculated for combined responses. The thematic analysis reported patterns of data extracted from open-ended questions. 96 respondents completed the survey, reporting some positive attributes attached to online learning. 81% (n = 78, 95% CI 72–88) agreed that students developed their digital skills and were able to learn conveniently at their own pace (n = 75, 78%, 95% CI 69–85). However, 62.5% (n = 60, 95% CI 23–72) of respondents felt that students were overall disadvantaged with online learning, with 72% (n = 69, 95% CI 62–80) reporting that online learning was not comparable to face-to-face to teaching. The reasons for perceived student disadvantage were categorised into three themes; 1) a lack of ability in sessions to practice handling techniques, 2) the inability to gauge student understanding and check practical skill competence and 3) the lack of student self-directed practice time. UK physiotherapy lecturers did indicate they would continue to incorporate online learning in the future (n = 84, 87.5%, 95% CI 79–93). Such responses were based on two key themes; an improved work-life balance and the perception that online learning was no more challenging than traditional on-campus delivery. UK physiotherapy lecturers reported that students were disadvantaged with online learning delivery compared to face-to-face teaching. Lecturers indicated a willingness to continue with aspects of online learning across the curriculum, despite suggesting it had a negative impact on students subject understanding. [ABSTRACT FROM AUTHOR]

Women usually conceptualize pregnancy as a normal physiological state. In contrast, formal maternity care provision tends to be focused on pathology and risk. The authors aim to explore the extent to which childbearing women apply a sickness lens to pregnancy. We have therefore examined antenatal problems spontaneously reported by 4,000 UK and Norwegian women who responded to the international social media-based Babies Born Better survey. We coded and classified the free-text comments of the respondents as either complaint or disease. We found striking differences in the rates and types of problems reported by the women. We discuss our findings by applying different perspectives of medicalization and of lay and biomedical knowledge. [ABSTRACT FROM AUTHOR]

Background: There is a workforce shortage in the children's hospice sector, but there has been little research on the specific challenges of working in this setting and on how these challenges might be alleviated. To identify appropriate interventions to improve staff wellbeing, the drivers of wellbeing in children's hospices need to be known and measured. This paper reports on the development of two measures, one for work-related rewards and one for work-related stressors, for use in children's hospice care teams. Methods: A mixed-methods, four-stage study; the first three phases focused on the development of the scales, and the last stage focused on the validation of the scales. Participants of all stages were children's hospice care team staff members in the UK. Stage 1: survey assessing the relevance and comprehensiveness of the original scale items (N = 60); Stages 2 (focus groups; N = 16) and 3 (cognitive interviews; N = 14) to assess content validity; Stage 4: UK-wide survey (N = 414) to validate the final version of the new, children's hospice-specific scales using Rasch Analysis (RA) and Confirmatory Factor Analysis (CFA). Results: Due to poor fitting indices shown in the results from the RA, five items (out of 36) were removed from the new rewards scale used in the UK-wide survey and 20 (out of 62) were removed from the new stressors scale. CFA also supported the removal of the items and showed a one-factor structure for the rewards scale and a three-factor structure for the stressors scale were adequate—the sub-scales for the stressors scale related to caring for an ill or dying child ("Child" sub-scale), working with parents and families ("Parent" sub-scale), and stressors related to organisational factors, such as team conflict and workload ("Organisation" sub-scale). Conclusions: Both of the new scales showed good psychometric properties and can be useful in clinical settings and research to assess the perceived intensity of the work-related rewards and stressors for children's hospice staff. [ABSTRACT FROM AUTHOR]

Objectives: The 2018 British HIV Association (BHIVA) Standards of Care state that people living with HIV should be questioned annually for symptoms of cognitive or memory decline. If symptoms are identified, screening should be considered and services offered if impairment is detected. We examined the availability of services, along with current practices related to the screening and management of cognitive impairment in people living with HIV, in UK HIV services. Methods: A survey was distributed via email to all UK HIV services leads on the BHIVA audit mailing list. Questions related to screening practices, referral pathways, and the management of patients with suspected cognitive impairment. Descriptive analyses were conducted on all data returned. Results: In total, 190 surveys were distributed. Of the respondents, 39 (60.6%) stated that they undertook screening for cognitive impairment in their HIV service, and 30 (47.6%) reported not offering a specific service or referral pathway. Awareness of BHIVA screening guidelines was high (49 [84.48%]), yet 15 (30.6%) respondents stated that they were not followed in their service and 41 (71.9%) felt there was a need for training on screening, assessment, and management of cognitive impairment in patients with HIV within their department. Conclusions: Despite no directive, a substantial number of HIV services surveyed are routinely screening patients for cognitive impairment without guidance on when to screen and which screening tools should be used. A UK consensus on screening, along with guidance and training for services, may help to resolve this gap in service provision. [ABSTRACT FROM AUTHOR]

The use of 'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) recommendations has come under scrutiny during the COVID-19 pandemic, and the Care Quality Commission (CQC) has issued a call for new standards, guidance and training. One group for whom new training is required is 'capacity professionals' working in and with residential care facilities. These professionals (including Independent Mental Capacity Advocates and Best Interests Assessors) typically have a social work background and have specialist training regarding the 2005 Mental Capacity Act , the provisions of which have a direct relevance to DNACPR recommendations. We report on a survey and focus groups that probed the experiences of this professional group during the pandemic. We recruited 262 participants by approaching civil society organisations in which capacity professionals are well represented; twenty-two participated in follow-on focus groups. We used manifest content analysis and descriptive statistics to analyse the results. Our findings contribute to an emerging picture of what transpired in residential care homes during the first year of the pandemic and help to provide an empirical and normative basis for the development of the new guidance and training for which the CQC has called. [ABSTRACT FROM AUTHOR]

Dystonia is a neurological disorder characterised by involuntary muscle contractions. Pain is the primary non-motor symptom, and limited studies have investigated how dystonic pain is experienced. This study aimed to investigate how people with isolated dystonia describe their pain and compare across subgroups of dystonia. Anonymous online survey via social media asking participants to describe their pain in their own words, complete the McGill Pain Questionnaire (MPQ), and answer demographic questions. Thematic analysis identified common themes and frequencies were calculated for demographic and MPQ data. One-hundred and sixty-five respondents were included (mean age 51 years, 85% female). Thematic analysis identified four major themes "Physical sensations", "Temporal features", "Destruction", "Impact on life" with several sub-themes. The most chosen MPQ descriptor was "exhausting" followed by "tight," "sharp," "pulling," and "aching". The most common descriptors showed similar prevalence across subgroups of dystonia. As no objective tests for pain exist, pain sufferers must use language to describe their pain experience. People with isolated dystonia used sensory words combined with metaphorical language to detail temporal features of pain, as well as destructive internal battles or feelings of external forces acting upon them, and the significant toll pain has on everyday life. Pain is a common and debilitating non-motor symptom for people living with dystonia and should be discussed in a persons treatment plan. Pain sufferers use language to discuss their pain experience with others and report they don't feel well understood by others including health professionals. People with dystonic pain commonly described physical sensations, temporal features, destructive forces, and the impact on life caused by their pain. Findings suggest the experience of pain with dystonia is varied and better pain management options for people with dystonia are needed. [ABSTRACT FROM AUTHOR]

Research has identified an association between poverty and the likelihood of children suffering from abuse. What is less clear is how the experience of living in poverty links to this abuse. This qualitative study investigated individual stories of child abuse and the role of poverty in their lives. Through interpretative phenomenological analysis explanations why children had been abused were elicited from parents and professionals. Poverty as an abstract concept was articulated by parents describing their lived experience, breaking it down into its constituent parts. Social health and environmental contexts and the personal consequences of this emerged from the data. Professionals missed poverty at a macro level by focussing on the micro processes, leading to explanations of the abuse as personal inadequacy rather than systemic issues. [ABSTRACT FROM AUTHOR]

Background/Aims: Midwives are often the only professionals to examine a women after a vaginal birth. Therefore, it is important that they are trained in the detection and management of obstetric perineal trauma. This study's aim was to establish midwives' current knowledge and training in post-birth perineal trauma, including obstetric anal sphincter injuries, in the UK. Methods: An online national validated survey was distributed to UK midwives. There were 58 questions to assess midwives' knowledge and training. Univariable and multivariable analyses were conducted. Results: A total of 149 midwives participated. Only 50.3% had received training in obstetric tears. Midwives were better at classifying 3a (98.0% and 87.9% respectively) than 3b tears (79.2%, 85.9% and 84.6%) from images and descriptive text. Those who had training (P=0.02) and were a higher banding (P=0.003) were better at identifying tears. Conclusions: Although midwives' knowledge of obstetric tears was good, there was room for improvement and midwives stated that they would like more training. [ABSTRACT FROM AUTHOR]

Background Public Health registrars (SpRs) were an important component of the workforce that contributed to the COVID-19 response. This study explores their contribution and the impact the early stages of the pandemic had on their learning and training. Methods Data were collected from SpRs in the London and Kent, Surrey, Sussex training programme between July and September 2020 through a mixture of questionnaires and semi-structured interviews. A thematic analysis of interview transcripts was undertaken to identify themes. Results 35/128 SpRs responded to the survey and 11 were interviewed. SpRs were placed across a range of organizations and made a significant contribution to the COVID-19 response. Overall, SpRs learned important skills but working on the response may for some have impacted negatively on training. A number of facilitators and barriers to learning were identified. Conclusion The study findings highlight the opportunities for learning created by the pandemic. However, changing projects and the desire of SpRs to contribute to the response meant the impacts on training were mixed. Future deployment of SpRs should consider the balance of responsibility and pace when delegating work, as well as the need to supervise effectively and support remote working to maintain good mental wellbeing. [ABSTRACT FROM AUTHOR]

Purpose: Many mental health clinicians have delivered services digitally in response to the COVID-19 pandemic. Emerging research suggests that, despite some initial discomfort, therapists appear to adjust to remote working. The purpose of this study is to explore the views of clinicians working within a fully digital organisation towards digital service provision. Design/methodology/approach: Clinicians (N = 52) providing digital mental health assessments and treatments at Healios anonymously completed a mixed-methods questionnaire. Findings: In all, 85% of participants enjoyed working remotely and 71% thought they would continue to work online over the next 5–10 years. Of the participants, 40% reported low confidence in online work's efficacy before working remotely, but 96% reported confidence at the time of questionnaire completion: suggesting confidence increased with experience. An exploratory "inverted" factor analysis generated a two-factor solution, grouping clinicians into two factors based on key views. Factor 1 was predominantly characterised by satisfaction with training received and factor 2 by quality of technical experiences (encountering problems less often and greater personal confidence in resolving them). Qualitative feedback described some benefits of, and barriers to, digital service provision. Clinicians reflected on a perceived change in cultural norms, with more openness to digital services following the COVID-19 pandemic. On a personal level, teletherapy was viewed more favourably with increased personal experience. Originality/value: Clinicians' confidence in providing services digitally is discussed, with reference to how this may be affected by extent of remote working experience and availability of technical support. Staff well-being within the digital workspace is also discussed. [ABSTRACT FROM AUTHOR]

As the average age of first-time parents continues to rise, there has been a concerted effort by educators, policy makers and several reproductive health groups to improve fertility awareness. This study explored fertility knowledge of lay men and women and healthcare professionals (HCPs) using the same test instrument, providing a new and unique perspective compared with previous studies. Results were obtained from 1082 survey respondents: 347 HCPs, 319 men and 413 women, 105 of whom were trying to conceive (TTC). A total of 35 interviewees were purposively sampled to include 9 HCPs, 13 men and 13 women from the reproductive age range and of varying ethnic and educational backgrounds. Interview data were transcribed and analysed using the framework method. The proportion of HCPs correctly answering the survey knowledge questions was 47.1 (95% CI = 41.7%, 52.5%) compared to 44.4% for women (95% CI = 38.9%, 50.1%); 49.9% (95% CI = 39.0, 59.9%) for women TTC; and 32.5% (95% CI = 27.1%, 37.9%) for men. HCPs were ranked as the most trusted source for seeking fertility information. Overall HCPs did not demonstrate better fertility knowledge than lay participants, with inconsistencies regarding where responsibility lies for providing the right information to patients. HCPs need to improve their knowledge about fertility to help improve patient's fertility awareness. [ABSTRACT FROM AUTHOR]

While the impact of the COVID-19 pandemic on older people has been recognized, there is limited understanding of its impact on older trans and gender diverse people who often have different experiences of care and support than the general population. This article examines older trans and gender diverse people's experience of social support during the COVID-19 pandemic, based on a comparative mixed method survey administered in Australia and the United Kingdom. Using a non-probability sample of 84 participants who were connected to social media and service organizations in the United Kingdom and Australia, we found some commonalities and differences between experiences in these countries. Some participants were isolated, including almost 1 in 5 participants who said that they did not have someone they could call upon in an emergency. However, participants had rich networks of friends, partners, and family members. Religious organizations and the community also played an important role. Friends were reported as the main emergency contacts and as the main people to whom support is provided. This research supports previous findings that friends of trans and gender diverse people play an important role in well-being. [ABSTRACT FROM AUTHOR]

Background: This descriptive study assessed the completeness, agreement, and representativeness of ethnicity recording in the United Kingdom (UK) Clinical Practice Research Datalink (CPRD) primary care databases alone and, for those patients registered with a GP in England, when linked to secondary care data from Hospital Episode Statistics (HES). Methods: Ethnicity records were assessed for all patients in the May 2021 builds of the CPRD GOLD and CPRD Aurum databases for all UK patients. In analyses of the UK, English data was from combined CPRD-HES, whereas data from Northern Ireland, Scotland, and Wales drew from CPRD only. The agreement of ethnicity records per patient was assessed within each dataset (CPRD GOLD, CPRD Aurum, and HES datasets) and between datasets at the highest level ethnicity categorisation ('Asian', 'black', 'mixed', 'white', 'other'). Representativeness was assessed by comparing the ethnic distributions at the highest-level categorisation of CPRD-HES to those from the Census 2011 across the UK's devolved administrations. Additionally, CPRD-HES was compared to the experimental ethnic distributions for England and Wales from the Office for National Statistics in 2019 (ONS2019) and the English ethnic distribution from May 2021 from NHS Digital's General Practice Extraction Service Data for Pandemic Planning and Research with HES data linkage (GDPPR-HES). Results: In CPRD-HES, 81.7% of currently registered patients in the UK had ethnicity recorded in primary care. For patients with multiple ethnicity records, mismatched ethnicity within individual primary and secondary care datasets was < 10%. Of English patients with ethnicity recorded in both CPRD and HES, 93.3% of records matched at the highest-level categorisation; however, the level of agreement was markedly lower in the 'mixed' and 'other' ethnic groups. CPRD-HES was less proportionately 'white' compared to the UK Census 2011 (80.3% vs. 87.2%) and experimental ONS2019 data (80.4% vs. 84.3%). CPRD-HES was aligned with the ethnic distribution from GDPPR-HES ('white' 80.4% vs. 80.7%); however, with a smaller proportion classified as 'other' (1.1% vs. 2.8%). Conclusions: CPRD-HES has suitable representation of all ethnic categories with some overrepresentation of minority ethnic groups and a smaller proportion classified as 'other' compared to the UK general population from other data sources. CPRD-HES data is useful for studying health risks and outcomes in typically underrepresented groups. [ABSTRACT FROM AUTHOR]

This article presents the findings of a service evaluation on the role of the youth worker offered to young people in the hospital setting across the United Kingdom and what differentiates the role of the youth worker from other health-care professionals, as described by young people, parents, and members of the existing multidisciplinary team. Young people, parents, and members of multidisciplinary teams were approached by a youth worker in the hospital regarding the purpose of the evaluation and the online survey relating to their views and experiences of working with a youth worker in the hospital setting. Data were analyzed descriptively. The n value represents the total number of responses: Young people 11–25 years (n = 47), mothers/fathers (n = 16), and members of the multidisciplinary team (n = 76). The findings suggested that the youth worker was highly valued by all, with a consensus that they had a positive impact on the experiences of young people, their parents, and members of the multidisciplinary teams. Youth workers were reported as offering a more relatable style of engagement that connected with young people on a different and more informal level than other members of the multidisciplinary team. Their approach to the support provided was also different as their focus was guided by what young people valued. Youth workers acted as the bridge between young people, their parents, and the multidisciplinary team and were considered by the multidisciplinary teams to be a fundamental ingredient when working with young people in the hospital setting. The findings from this evaluation provide unique insights into the role the youth worker offers to young people in hospital settings that is different from what other health-care professionals provide, as reported by young people, parents, and the multidisciplinary team. However, further evaluation of the service should include objective outcome measures of the role and in-depth qualitative research to gain a greater and more detailed understanding of young peoples', parents', and members of the multidisciplinary team's views and experiences of what makes this role different. [ABSTRACT FROM AUTHOR]

The study aimed to explore new United Kingdom (UK) graduate physiotherapists' perceived preparedness for clinical practice to provide valuable information to support curriculum development. An online, mixed method cross-sectional questionnaire was used. Newly qualified UK physiotherapists completed a survey, capturing how physiotherapy degrees prepared them for practice against (1) UK proficiency standards and (2) cross-discipline physiotherapy related clinical skills. Respondents were asked for reflections of their degree course including teaching and effectiveness. Data were converted into proportions with a 95% confidence interval. Likert-scale questions were treated as numeric variables with the mean and standard deviation (SD) calculated for combined responses. Thematic analysis reported patterns of data extracted from open-ended questions. Of a total of 376 respondents, 365 were included in data analysis. Overall respondents perceived that courses prepared them 'well' against 12 of the 15 standards, on a Likert scale of 1–5. Respondents reported that perceived competence was 'indifferent' for manual therapy skills (mean 3.14 ± SD 1.13), red flag (3.45 ± 1.11) and clinical flag management (2.92 ± 1.16). Exercise prescription (2.42 ± 1.35), psychosocial skills (2.27 ± 1.23) and patient management (2.41 ± 1.12) were areas identified for further teaching focus. Placements were the preferred teaching method most applicable to practice followed by practical seminars. Respondents felt sufficiently prepared for practice against UK proficiency standards but not physiotherapy related clinical skills. Areas for curricula development included exercise prescription, psychology and pain management. [ABSTRACT FROM AUTHOR]

Introduction: Community development approaches are increasingly used by occupational therapists in response to occupational justice theory, which posits that both individuals and community groups may be denied access to meaningful occupations through societal powers outside their control. Previous research has found that occupational therapists feel insufficiently prepared for a role in community development and tend to use their general skill set, sometimes in combination with generic community development approaches. This study explored whether the reflective framework for community development in occupational therapy is applicable and useful for occupational therapists in the United Kingdom. Methods: A mixed methods approach was used, combining an online questionnaire and focus groups with occupational therapists who already work in community development. Findings were compared with the framework. Findings: The participants recognised most aspects of the Framework in their own practice, but some key aspects such as collaboration with the community at every stage were less prominent. They found the framework applicable to the UK context, particularly for occupational therapists inexperienced in community development practice. Conclusion: This study has highlighted community development practice by occupational therapists in the United Kingdom and concluded that the framework would support them in fulfilling this role more effectively. [ABSTRACT FROM AUTHOR]

Using a mixed methods design, this study aimed to examine the impact of the COVID-19 pandemic on autistic and non-autistic adults. We conducted an online survey with 196 autistic and 228 non-autistic adults from Belgium, the Netherlands and the United Kingdom focusing on their experiences during the first period of the pandemic. Our results indicate rather diverse experiences within the group of autistic participants across all domains of life. In comparison with non-autistic adults, autistic adults reported less negative impact on their social life and more negative impact on health and support services. In the autism group, stress was mainly related to changing and unclear measures. A wide range of coping strategies were described as helpful in reducing stress during the pandemic. [ABSTRACT FROM AUTHOR]

Children and adolescents in the UK spend increasingly more time in the digital world, raising societal fears about digital risks in this age group. Professionals are not always aware of the ever-developing research or guidance available around digital safety. This gap underscores the need to understand current experiences and determinants of digital risk assessment, including clinicians' views on barriers and facilitators. A mixed-method design was used. Fifty-three clinicians working in child and adolescent mental health services (CAMHS) in South England took part in a survey; of these 12 took part in semi-structured interviews. A psychological model of behavioural change (COM-B: capabilities, opportunities, motivation and behaviour) guided the analyses. Survey data revealed that clinicians showed awareness and concerns for several digital risk issues but there appeared to be gaps in their knowledge and practice. Interview data revealed different factors influencing staff enquiry about digital risks in CAMHS. These included aspects of capabilities (knowledge and skills), opportunities (resources, organisational context and empowerment of youth), and motivations (habit change, emotional experiences, and professional identity/role). Targeting both staff-level and organisation-level barriers to digital risk assessments in CAMHS is crucial. This study informs service improvement to ensure that children and young people safely navigate the digital world. [ABSTRACT FROM AUTHOR]

The relationships among different sports, face mask use, and COVID-19 risk among high school athletes remain unknown. To evaluate the influence of sport characteristics and face mask use on the COVID-19 incidence among high school athletes. Descriptive epidemiology study. US high school athletic departments. Athletic directors. Surveys were completed regarding sport reinitiation, COVID-19 cases, and risk-reduction procedures in fall 2020. Separate mixed-effects Poisson regression models were developed to evaluate the associations between the reported COVID-19 incidence and (1) sport characteristics (indoor versus outdoor, individual versus team, contact versus noncontact) and (2) face mask use while playing (yes or no). A total of 991 schools had restarted fall sports, representing 152 484 athletes on 5854 teams. There were 2565 reported cases of COVID-19, representing a case rate of 1682 cases per 100 000 athletes and an incidence rate of 24.6 cases per 100 000 player-days. The COVID-19 incidence was lower for outdoor versus indoor sports (incidence rate ratio [IRR] = 0.54; 95% CI = 0.49, 0.60; P <.001) and noncontact versus contact sports (IRR = 0.78; 95% CI = 0.70, 0.87; P <.001), but not team versus individual sports (IRR = 0.96; 95% CI = 0.84, 1.1; P =.49). Face mask use was associated with a decreased incidence in girls' volleyball (IRR = 0.53; 95% CI = 0.37, 0.73; P <.001), boys' basketball (IRR = 0.53; 95% CI = 0.33, 0.83; P =.008), and girls' basketball (IRR = 0.36; 95% CI = 0.19, 0.63; P <.001) and approached statistical significance in football (IRR = 0.79; 95% CI = 0.59, 1.04; P =.10) and cheer or dance (IRR = 0.75; 95% CI = 0.53, 1.03; P =.081). In this nationwide survey of high school athletes, a lower COVID-19 incidence was independently associated with participation in outdoor versus indoor and noncontact versus contact sports but not team versus individual sports. Face mask use was associated with a decreased COVID-19 incidence among indoor sports and may be protective in outdoor sports with prolonged close contact among participants. [ABSTRACT FROM AUTHOR]

The British public generally adhered to COVID‐19‐related restrictions, but as the pandemic drew on, it became challenging for some populations. Parents with young children were identified as a vulnerable group. We collected rich, mixed‐methods survey data from 99 UK‐based parents (91 mothers) of children under 12, who described their lockdown transgressions. Household mixing was the most prevalent broken rule. Template analysis found that rule breaking was driven by 'ingroup‐level' prosocial motivations to protect the mental and social health of family and loved ones, and that parents were 'engaged' decision‐makers who underwent careful deliberation when deciding to break rules, making trade‐offs, bending rules, mitigating risks, reaching consensus, and reacting to perceived rule injustices. Cumulative link models found that the perceived reasonableness of rule violations was predicted by social norms. Rules were broken by parents not for antisocial reasons, but for 'ingroup‐level' prosocial reasons, linked to supporting loved ones. [ABSTRACT FROM AUTHOR]

Despite many initiatives taken by funding bodies and health care organisations, the 10/90 gap in health care and health system research between low and middle-income countries (LIMC) and high income countries is still widely recognised. We aimed to quantify the contribution of LMIC in high impact medical journals and compare the results with the previous survey conducted in 2000. Research articles were anaylsed to determine the origin of data and authorship affiliated countries in a calendar year (2017) for five journals: British Medical Journal, The Lancet, New England Journal of Medicine (NEJM), Annals of Internal Medicine and the Journal of the American Medical Association. Contributing countries were categorised into four regions; USA, UK, Other Euro-American countries (OEAC) and rest of the world (RoW). A total of 6491 articles were categorised where USA, UK and OEAC contributed 39.7%, 28.5% and 19.9% respectively. RoW countries contributed 11.9% of articles surveyed. The Lancet and NJEM had the highest numbers from RoW with 22.1% and 17.3% respectively. After 17 years, the trend remained comparable with the original survey carried out in 2000. RoW contributions increased from 6.5% to only 11.9% of the published articles from countries accounting for 88.3% of the world's population. [ABSTRACT FROM AUTHOR]

The meaning and significance of gender is currently a focus of heated and, often, polarised debate in the UK and elsewhere. This article provides a new perspective in the gender debate through focused exploration of UK-based non-binary people's perceptions of legal gender status and reform. Binary gender/sex systems, such as the legal gender system in the UK, are underpinned by cisgenderism and are challenged by those whose identity falls outside of the binary of woman and man. In contrast to most lay participants in the Future of Legal Gender (FLaG) project, the majority of non-binary participants reported support for reform (85.5% (n = 165) in favour) to the current UK legal gender system. Over half (57%, n = 110) were in favour of abolishing legal gender (i.e. the state would no longer assign a legal gender status), although this was constructed as 'an impossible dream'. Situating non-binary people's perspectives at the heart of the debate about the certification of gender offers novel insight which could have significant ramifications for how societal structures could support undoing gender in the future. [ABSTRACT FROM AUTHOR]