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Background: While some people with mild cognitive impairment (MCI) progress to dementia, many others show no progression. The aim of this study was to identify factors associated with risk of dementia development in this population. Method: A large naturalistic retrospective cohort study was assembled from mental healthcare records in a south London catchment. Patients were selected at first recorded diagnosis of MCI and subsequent dementia diagnosis was ascertained from case notes or death certificate, excluding those with dementia diagnoses and deaths within 6 months of MCI diagnosis. A range of demographic and clinical characteristics were ascertained around MCI diagnosis and Cox proportional hazards models were used to investigate independent predictors of dementia, focussing on neuropsychiatric symptoms, contextual factors, and antidepressant treatment. Results: Of 2250 patients with MCI, 236 (10.5%) developed dementia at least 6 months after MCI diagnosis. Aside from older age, lower cognitive function, and activities of daily living impairment, impaired social relationships and recorded loneliness were associated with a higher risk of developing dementia. Patients of Black (compared to White) ethnicity were at a lower risk. For depression and antidepressant receipt, only tricyclic use compared to no antidepressant use was associated with an increased dementia risk. Conclusions: No evidence was found for co‐morbid affective disorders or different antidepressant classes as risk factors for dementia development following MCI diagnosis, but loneliness and social impairment were independent predictors and would be worth evaluating as targets for interventions to delay progression. Key points: Of 2250 patients with MCI, 10.5% received a recorded dementia diagnosis at least 6 months after MCI diagnosis.Older age, lower cognitive function and impaired ADLs were associated with dementia development.Problems with social relationships and loneliness led to a higher risk of developing dementia.Affective disorder diagnoses, antidepressant treatment, and choice of antidepressant did not affect dementia risk. [ABSTRACT FROM AUTHOR]

Globally, foodborne illness is a significant public health challenge. Food safety inspection plays a crucial role in the regulation of food businesses to prevent foodborne illnesses. To be an effective health protection measure, however, food safety inspections must facilitate the thorough evaluation of food safety risks. Our research examined how food safety inspectors from Australia, Ireland, New Zealand, the UK, and the U.S. assessed food contamination control during food premise inspections. Data were collected via an online survey of environmental health practitioners who routinely conduct food safety inspections. The findings indicated that inspectors are generally aware of food safety hazards that can be present at food businesses and have deployed a variety of relevant data-gathering methods to inform their examination of the extent of contamination control. The findings also indicated a prevailing methodological incongruence stemming from the absence of a robust inspection methodology. We propose that these shortcomings be addressed by solutions that are formulated based on established hazard analysis critical control point (HACCP) principles and qualitative field research. The development of a clear and appropriate methodology will support food safety inspections to provide a robust and reliable means for evaluating food safety risk and ultimately reduce the incidence and burden of foodborne illness. [ABSTRACT FROM AUTHOR]

Objective: The United Kingdom Eating Disorders Genetics Initiative (EDGI UK), part of the National Institute for Health and Care Research (NIHR) Mental Health BioResource, aims to deepen our understanding of the environmental and genetic etiology of eating disorders. EDGI UK launched in February 2020 and is partnered with the UK eating disorders charity, Beat. Multiple EDGI branches exist worldwide. This article serves the dual function of providing an in‐depth description of our study protocol and of describing our initial sample including demographics, diagnoses, and physical and psychiatric comorbidities. Method: EDGI UK recruits via media and clinical services. Anyone living in England, at least 16 years old, with a lifetime probable or clinical eating disorder is eligible to sign up online: edgiuk.org. Participants complete online questionnaires, donate a saliva sample for genetic analysis, and consent to medical record linkage and recontact for future studies. Results: As of September 2022, EDGI UK recruited 7435 survey participants: 98% female, 93.1% white, 97.8% cisgender, 65.9% heterosexual, and 52.1% have a university degree. Over half (57.8%) of these participants have returned their saliva DNA kit. The most common diagnoses are anorexia nervosa (48.3%), purging disorder (37.8%), bulimia nervosa (37.5%), binge‐eating disorder (15.8%), and atypical anorexia nervosa (7.8%). Conclusion: EDGI UK is the largest UK eating disorders study and efforts to increase its diversity are underway. It offers a unique opportunity to accelerate eating disorder research. Researchers and participants with lived experience can collaborate on projects with unparalleled sample size. Public Significance Statement: Eating disorders are debilitating and costly for society but are under‐researched due to underfunding. EDGI UK is one of the largest eating disorder studies worldwide with ongoing recruitment. The collected data constitute a resource for secondary analysis. We will combine data from all international EDGI branches and the NIHR BioResource to facilitate research that improves our understanding of eating disorders and their comorbidities. [ABSTRACT FROM AUTHOR]

Risks of contralateral kidney abnormalities and chronic kidney disease necessitate follow-up for unilateral multicystic dysplastic kidneys (MCDK). A nationwide survey of senior UK pediatricians was conducted. Of the 60 responses obtained, 62% routinely perform a dimercaptosuccinic acid scan to confirm diagnosis. Eight percent routinely perform a cystogram to investigate contralateral vesicoureteric reflux. Sixty-two percent would routinely measure renal function (frequency ranging from once only to "every 2 years"). Twenty-five percent recalled MCDK nephrectomy being performed within the previous 5 years. Respondents voiced concerns that national guidance may result in an overcautious approach but could balance consensus and safe variation, and offer families choice and reassurance. The mean estimated cost of follow-up from birth to 18 years ranged from £258 to £3854. Results demonstrate significant variation in management, highlighting the need for a clear pathway to decrease unwanted variability and to ensure those at high risk of renal sequelae are recognized early, without undue investigatory burden. [ABSTRACT FROM AUTHOR]

Delayed antibiotic prescribing in primary care can be a useful strategy to help manage patient expectations and reduce antibiotic consumption. This project surveyed GP practices in Cornwall and Isles of Scilly Integrated Care System to identify current approaches to the use of delayed antibiotic prescriptions, as well as the incentives and barriers to implementation. [ABSTRACT FROM AUTHOR]

Sexual violence (SV) experienced by higher education students is a prevalent public health problem. Collecting data on SV through self-report surveys in higher education institutions (HEIs) is essential for estimating the scope of the problem, the first step to adequately resourcing and implementing prevention and response programming and policies. However, in the United Kingdom, data is limited. We used data from the cross-sectional Oxford Understanding Relationships, Sex, Power, Abuse and Consent Experiences survey, administered to all students at a university in the United Kingdom in May 2021 (n = 25,820), to estimate the past year prevalence of SV. We analyzed data from respondents who answered at least one question on SV (n = 1,318) and found that 20.5% of respondents experienced at least one act of attempted or forced sexual touching or rape, and 52.7% of respondents experienced at least one act of sexual harassment (SH). We found that women experienced the highest rates of SV. Attempted forced sexual touching was far more common than forced sexual touching, or rape. Sexist remarks or jokes were the most common act of SH. Most acts of SV took place at the university. These findings reveal that the prevalence of SV in HEIs in the United Kingdom could be far higher than what is experienced in the general population. While this study reflects the context in only one institution, it underlines the need for continued monitoring to develop rigorous, evidence-based, and targeted prevention and response strategies. [ABSTRACT FROM AUTHOR]

Background: Telehealth for paediatric speech and language therapy became one of the most salient modes of service delivery during the COVID‐19 pandemic. Evidence for speech and language therapy services via telehealth in comparison to face‐to‐face delivery demonstrates promising outcomes, and studies have begun to explore practitioner and client experiences. However, across the literature, many critical elements of services are overlooked, and there is a need to frame the evidence base within a theoretical model that can draw out practical implications that consider the range of factors having an impact on clinical implementation in real‐world contexts. The APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria offer such a model. The current study explored practising UK speech and language therapists' (SLTs) clinical experience of telehealth through the lens of the APEASE criteria and aimed to identify recommendations for future service provision from the practitioner perspective. Methods: An online survey structured using the APEASE criteria was developed in collaboration with the UK Royal College of Speech and Language Therapists. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using reflexive thematic analysis. Results: Four hundred and thirty‐eight qualified and practicing UK paediatric SLTs completed the survey. Telehealth was broadly acceptable and practicable to SLTs yet there remains some uncertainty about its efficacy and cost‐effectiveness compared to face‐to‐face interventions and how equitable it is for different population groups. SLTs reported that effective implementation of telehealth services was dependent upon several contextual factors; affordability was a perceived barrier to clients having access to telehealth resources, intervention via telehealth was perceived as more acceptable than assessment, and whilst many SLTs welcomed aspects of telehealth, there were concerns about the physical and mental health consequences for practitioners. Six themes for the future development of telehealth in paediatric speech and language therapy were identified: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. Conclusions: Outcomes highlight promising, concerning and uncertain aspects of telehealth in paediatric speech and language therapy. SLTs value a flexible and tailored approach to service delivery and recommend that effective leadership, clear communication, ongoing policy and guidance development, upskilling of users and careful evaluation of impact are required to ensure optimal implementation. The APEASE criteria offer a valuable opportunity to enhance and streamline practice and research to ensure sustainable implementation of telehealth in the paediatric speech and language therapy services of tomorrow. WHAT THIS PAPER ADDS: What is already known on this subject: The COVID‐19 pandemic led to the increased use of telehealth as a main mode of service delivery in paediatric speech and language therapy. Pre‐COVID‐19, evidence for the use of telehealth in this field included small‐scale experimental studies that reported on children with particular disorders and explored telehealth outcomes in comparison to face‐to‐face delivery. The realities of at‐scale clinical practice were not well‐represented, and critical elements of service such as cost‐effectiveness were often overlooked in the paediatric literature. Furthermore, despite emerging global evidence for temporary telehealth responses to the crisis in speech and language therapy, the long‐term and future use of telehealth remains unclear. What this paper adds to existing knowledge: The current study applied the lens of the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria, which were used in this case to consider socioeconomic, ecological and cultural factors to capture an overarching understanding of the use of telehealth in paediatric speech and language therapy, and to inform the role of telehealth in future, longer‐term and at‐scale service development. Results indicated emerging trends in UK paediatric speech and language therapists' (SLTs') perceptions of telehealth and SLTs perceived a hybrid approach to service delivery, combining mostly face‐to‐face services with some telehealth, was likely to continue in the future. We identified six themes to guide the future development of telehealth in paediatric speech and language therapy services: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. What are the potential or actual clinical implications of this work?: UK SLTs believe that speech and language therapy services using telehealth should be reflective, tailored and flexible to meet the requirements and circumstances of the children, young people and families served, as well as the physical and emotional needs of practitioners. SLTs recommend that this service development is clearly communicated to all stakeholders and suggested that those using telehealth should be supported through appropriate training, and ongoing effectiveness should be monitored. Telehealth is here to stay and the APEASE criteria offer a unique opportunity to ensure sustainable models of service delivery; to support co‐ordinated leadership at the local, national and international levels and the development of policy and clinical guidance. [ABSTRACT FROM AUTHOR]

The Access Consortium New Active Substance Work-Sharing Initiative, or "Access" for simplicity, allows regulatory authorities (RAs) of the Access Consortium countries to jointly review applications for the registration of new active substances or for new indications. Using a survey developed by the pharmaceutical industry trade associations of the five Access Consortium countries—Australia, Canada, Singapore, Switzerland, and the United Kingdom (UK)—this study gathered insights into the perceptions and experiences of the Access pathway held by affiliates of pharmaceutical companies. Understanding industry perceptions of Access is important for the success of the initiative, as participation is voluntary. Findings indicate that affiliates who participated in Access had mostly positive experiences with this pathway; most affiliates were satisfied with their interactions with the Access RAs and appeared willing to continue to participate in the initiative. Affiliates' reasons for not having yet participated in Access included a lack of opportunity to do so and perceived barriers, such as the Access pathway being too complicated to manage. Recommendations to improve Access cover six key areas: ensure predictability, increase guidance and transparency, streamline processes, maintain flexibility, increase harmonization, and advance RA-industry cooperation. This study should facilitate informed discussions among relevant stakeholders on how to improve Access to maximize efficiencies, accelerate approvals, and improve patient access to innovative medicines. [ABSTRACT FROM AUTHOR]

• Lipoprotein(a) is an independent risk factor for cardiovascular disease and to understand the availability and application of Lp(a) measurement across UK lipid clinics, we undertook a national survey. • 60% of lipid clinics performed lipoprotein(a) testing once per patient and graded cardiovascular risk according to the lipoprotein(a) reference ranges recommended by HEART UK while cascade testing was performed on levels ≥200nmol/L. • Most lipid clinics reported lipoprotein(a) in mass units (mg/dL or mg/L) with no traceability to the WHO/IFCC reference material and only a third of lipid clinics used reagents that minimise sensitivity to the effect of lipoprotein(a) isoform size. • National effort is required to provide universal access to Lipoprotein(a) measurement and to harmonise the clinical application of this data. Lipoprotein(a) is an independent risk factor for cardiovascular disease and its use is recommended in national and international guidelines for cardiovascular disease risk stratification. We undertook a survey to understand the availability and application of lipoprotein(a) measurement across UK lipid clinics. Fifty-three out of an estimated 200 lipid clinics (27%) provided responses. Eighty-one percent of 53 clinics had access to lipoprotein(a) measurement. Twenty-seven clinics disclosed the number of lipoprotein(a) tests ordered annually with approximately half of the clinics (52%) requesting 0-250 tests per year. Sixty percent measured lipoprotein(a) once per patient and the leading indication was a personal or family history of premature history of cardiovascular disease in those <60 years old. Sixty-three percent of clinics that provided comments with lipoprotein(a) results graded cardiovascular risk as per the HEART UK consensus statement. Sixty percent of clinics performed family cascade testing on lipoprotein(a) results ≥200 nmol/L. Lipoprotein(a) was reported in nmol/L, mg/dL, or mg/L by 48%, 24%, and 28% of responding clinics, respectively. National effort is required to provide universal access to lipoprotein(a) measurement and to harmonise the clinical application of this data. [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]

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]

This study examined predictors of access to early support amongst families of 0-6-year-old children with suspected or diagnosed developmental disabilities in the United Kingdom. Using survey data from 673 families, multiple regression models were fitted for three outcomes: intervention access, access to early support sources, and unmet need for early support sources. Developmental disability diagnosis and caregiver educational level were associated with intervention access and early support access. Early support access was also associated with child physical health, adaptive skills, caregiver ethnicity, informal support, and statutory statement of special educational needs. Unmet need for early support was associated with economic deprivation, the number of household caregivers, and informal support. Multiple factors influence access to early support. Key implications include enhancing processes for formal identification of need, addressing socioeconomic disparities (e.g., reducing inequalities, increasing funding for services), and providing more accessible services (e.g., coordinating support across services, flexible service provision). [ABSTRACT FROM AUTHOR]

Background: A dedicated intensive care dietitian, as part of the intensive care unit (ICU) multidisciplinary team, contributes to improved delivery of nutrition support. The Paediatric Critical Care Society recommends a minimum dietetic staffing to critical‐care bed ratio of 1:10, led by an Agenda for Change (AfC) Band 7. Methods: A cross‐sectional study was conducted using an electronic survey that was available for 12 weeks. The Paediatric Intensive Care Audit Network database was used to identify all hospitals with paediatric intensive care unit (PICU) beds (n = 28). Results: Only 14% (n = 4/28) of trusts met the recommended 1:10 dietitian to bed ratio. PICU dietetic whole time equivalent was 0.7 ± 0.4, with a staff to bed ratio of 1:23.7 ± 10.7, compared to adult staff to bed ratio of 1:24.7. Some 92.8% (n = 26/28) had a AfC Band 7 Lead and only 7% (n = 2/28) had an AfC Band 8a Lead compared to adult services where 12.5% (n = 15/122) had an AfC Band 8a (p < 0.05). Conclusions: There is a significant disparity between adult versus paediatric services with regard to seniority of dietitians. Dietitians in well‐resourced centres were more likely to review patients without the need for a referral, which may improve nutrition outcomes. Highlights: Having a paediatric dietitian as part of a multidisciplinary team in paediatric intensive care units (PICU) predicts optimal enteral energy and protein intake.PICUs within the UK and Republic of Ireland do not meet minimum dietetic staffing standards.There is a significant disparity in seniority levels between adult and paediatric dietetic staff in critical care. [ABSTRACT FROM AUTHOR]

Background: There have been recurring UK initiatives to increase nurse research capability but little robust evaluation of long-term effectiveness. More nurses undertake doctorates, yet few lead major funded projects. Previous research suggests potential explanations but the perspectives of nurse lead-investigators themselves have not been examined. Aim: To explore the perceptions of nurse lead-investigators about what has helped or hindered them to lead funded research projects. Methods: Lead investigators of research projects from major UK funders (1 Apr 2017–Sept 2022) were identified from publicly available data. University profiles were screened to identify registered nurses. Entire population was approached (no sample size calculation required). Consenting participants completed an online survey (five open questions). Results: A total of 65 nurse-lead investigators were identified, 36 (55%) completed the survey (20 December 2022 to 17 February 2023). Participants identified Building (multi-disciplinary) collaborations and mentorship as having been most important to their success. High-quality mentoring was also identified as most important in helping novice nurse researchers become leaders. Participants highlighted the critical importance of being supported by individuals with a track record of funding success and benefits of being situated in research-supportive environments. Lack of career pathway/ infrastructure and being unable to pursue research due to competing clinical/teaching priorities were identified as most unhelpful to this group AND the most common reasons for peers not going on to lead research. Conclusions: Ensuring access to mentors with an established track record is an important component of schemes to increase research capability in nurses. Funded, protected time for research and career structures that reward the significant skill development required to succeed in a competitive, multi-disciplinary funding arena is important. Impact: Interdisciplinary collaboration and mentorship by experienced researchers are critical to success and should be incorporated into future interventions to increase research capability in nurses. No patient or public contribution (as exploring a professional issue). [ABSTRACT FROM AUTHOR]

Online consultation services have the potential to reduce the workload of healthcare staff, provide timely care to patients, and improve doctor-patient relationships. The COVID-19 pandemic has accelerated the development of these services and platforms, but it remains to be seen whether the general public will continue to use them after the pandemic is under control. This research proposes a framework to examine the factors contributing to UK adults' continued usage of online healthcare consultation services after COVID-19 restrictions have been lifted. A total of 430 new users completed surveys, and the results indicate that expectation confirmation, system quality, and information quality can positively impact users' self-efficacy toward using online consultation services. This, in turn, can influence their continued usage behavior. Furthermore, the results suggest that participants' perception of health risks can moderate the relationship between self-efficacy and continued usage behavior. The strategic implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Inverse associations between dietary fiber (DF) and colorectal cancer risk are well-established. However, evidence is limited in relation to other cancer sites. This study, of 364,856 participants from the UK Biobank, aimed to evaluate the associations between total and source-specific partial DF and risk of 17 specific cancers and all cancers combined. Partial DF was derived from baseline touchscreen questionnaire data on cereal, bread, fruit, and vegetable intake. The outcomes were incident cancer at 17 sites and all cancers combined. Cox proportional hazards models were applied. Over a median 8.8-year follow-up period, 30,725 people were diagnosed with cancer. After adjusting for sociodemographic and lifestyle factors, those in the highest quintile of partial DF compared with the lowest quintile (<9.6 vs ≥19.1 g/day) had 10% lower risk of cancer overall, with the greatest risk reductions observed for cervical (hazard ratio (HR) = 0.33, 95% confidence interval (CI): 0.14; 0.82), esophageal (HR = 0.66, 95% CI: 0.52; 0.84), lung (HR = 0.67, 95% CI: 0.59; 0.76), bladder (HR = 0.72, 95% CI: 0.56; 0.91), and kidney (HR = 0.75, 95% CI: 0.61; 0.92) cancers. Associations between DF and lung cancer were observed only in current and former smokers. Higher DF intake, in particular cereal fiber and fruit and vegetable fiber, was associated with a lower risk of overall and multiple site-specific cancers. [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]

Introduction: Those with severe and enduring mental ill health are at greater risk of long‐term physical health conditions and have a reduced life expectancy as a result. Multiple factors compound this health inequality, and the need for setting research priorities in this area is highlighted with physical and mental healthcare services being separate, and limited multimorbidity research. Methods: The aim of this exercise was to work in partnership with healthcare professionals and carers, family, friends and individuals with lived experience of both mental and physical health conditions, to set research priorities to help people with mental health conditions to look after their physical health. The exercise was guided by the James Lind Alliance approach. For this, a steering group was set up, two surveys were completed and a final priority workshop was conducted. Results: This priority setting exercise guided by people's needs and lived experience has produced a set of well‐defined research topics. Initially, 555 research questions were suggested in the first survey, which were refined to 54 questions for the second survey. A priority setting workshop was then conducted to get the final 10 priorities. Conclusions: Taking these topics forward to improve services and treatment for both mental and physical ill health may in turn improve physical health and lessen the reduced life expectancy of those living with mental ill health. Patient or Public Contribution: This work was completed in collaboration with people who have lived experience of mental ill health and physical health conditions, as well as carers, family and friends. Their contribution has been significant for this work from piloting surveys, amending language used and educating the researchers and contributing to this paper. The initial work was completed with a steering group and continued with surveys and workshops. [ABSTRACT FROM AUTHOR]

Governments have adopted unprecedented measures to assist in slowing the spread of the COVID-19 pandemic, but compliance varies among individuals. This UK study uses latent profile analysis to identify four classes of individuals on factors believed to influence compliance. Those who sought health information from authoritative sources and actively sought information from multiple sources were most compliant. Profile differences in compliance and vaccination status were also primarily driven by trust in healthcare institutions over trust in government. These findings contribute to understanding compliance profiles and emphasise the importance of authoritative information and trust in healthcare systems. [ABSTRACT FROM AUTHOR]

Background: People with severe mental illness (SMI), such as schizophrenia, have higher rates of type 2 diabetes and worse outcomes, compared to those without SMI and it is not known whether diabetes self‐management interventions are effective for people who have both conditions. Research in this area has been impeded by a lack of consensus on which outcomes to prioritise in people with co‐existing SMI and diabetes. Aims: To develop a core outcome set (COS) for use in effectiveness trials of diabetes self‐management interventions in adults with both type 2 diabetes and SMI. Methods: The COS was developed in three stages: (i) identification of outcomes from systematic literature review of intervention studies, followed by multi‐stakeholder and service user workshops; (ii) rating of outcomes in a two‐round online Delphi survey; (iii) agreement of final 'core' outcomes through a stakeholder consensus workshop. Results: Seven outcomes were selected: glucose control, blood pressure, body composition (body weight, BMI, body fat), health‐related quality of life, diabetes self‐management, diabetes‐related distress and medication adherence. Conclusions: This COS is recommended for future trials of effectiveness of diabetes self‐management interventions for people with SMI and type 2 diabetes. Its use will ensure trials capture important outcomes and reduce heterogeneity so findings can be readily synthesised to inform practice and policy. [ABSTRACT FROM AUTHOR]

Introduction: Public and health professional involvement (PHPI) is essential in healthcare research yet uncommonly integrated into systematic reviews. We incorporated and evaluated PHPI in a mixed methods review of occupational therapy for self-management of rheumatoid arthritis (RA). Methods: Public partners were living with or caring for someone with RA. Our steering group comprised two public, two professionals (one occupational therapist, one rheumatologist), and one reviewer who planned the review's PHPI (August 2021). Involvement was evaluated from public and health professional (PHP) perspectives using a survey and workshops (August–October 2022) exploring reasons for involvement, challenges and learning opportunities. Results: Alongside the steering group, 16 public and 6 professionals were involved throughout the review. Five public refined the search strategy, with three assisting in subsequent review activities. PHPs helped interpret findings during three public (n = 12) and one professional workshop (n = 4). Three occupational therapists and one public co-authored (ED) publications. In evaluation, PHPs felt valued and that their involvement was well-integrated. The researchers underestimated the time required for communicating and conducting PHPI in the review. Conclusions: PHPI is worthwhile, feasible and can be integrated within a systematic review. PHP partners considered participation valuable; researchers must prioritise time to prepare and communicate PHPI activities. [ABSTRACT FROM AUTHOR]

Introduction: Mentorship is perceived as a mechanism to enhance career progression. Within occupational therapy, there is little research to demonstrate the effectiveness of mentoring on career success and no research has explored its relevance for black and minoritised ethnic (BME) occupational therapists. This research explored the experience of mentoring for career progression from a BME perspective using a survey. Methods: An online survey was conducted with occupational therapists in the United Kingdom who identified as BME. The primary recruitment method was a convenience sample via a BME network and through its other links. Content analysis and descriptive statistics were used to analyse and report the data. Findings: In all, 54 BME occupational therapists completed the survey. Most BME therapists had never requested a BME mentor, but most wanted a BME mentor. Active allyship was viewed as an important part of mentorship when mentored by a white therapist. Conclusion: This research is the first study in occupational therapy to examine the mentoring experiences and needs of BME therapists. It is a call for action to recognise and reorient the approach and understanding of the structures and experiences of BME mentorship. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has significantly impacted the leisure sector as lockdowns and social distancing resulted in a temporary shutdown. Using large-scale UK social survey data from two waves of Understanding Society, we employ the life satisfaction valuation method to provide estimates of monetary values of the subjective well-being benefits of leisure activities. We find that well-being benefits to life satisfaction from arts events, visiting museums and moderate sports have a significant monetary value. The value of some leisure activities to domains of satisfaction is higher compared with life satisfaction. The value to leisure satisfaction is particularly high, especially arts activities. Well-being benefits of moderate and mild sport are particularly high for health satisfaction. Meanwhile, activities which involve social interaction, including arts events and moderate sport have greater relevance to job satisfaction. These findings evidence the value of leisure activities, informing arguments for public funding to support and aid recovery in the sector. [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]

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]

Dietary education is a core component of cardiac rehabilitation (CR). It is unknown how or what dietary education is delivered across the UK. We aimed to characterise practitioners who deliver dietary education in UK CR and determine the format and content of the education sessions. A fifty-four-item survey was approved by the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) committee and circulated between July and October 2021 via two emails to the BACPR mailing list and on social media. Practitioners providing dietary education within CR programmes were eligible to respond. Survey questions encompassed: practitioner job title and qualifications, resources, and the format, content and individual tailoring of diet education. Forty-nine different centres responded. Nurses (65·1 %) and dietitians (55·3 %) frequently provided dietary education. Practitioners had no nutrition-related qualifications in 46·9 % of services. Most services used credible resources to support their education, and 24·5 % used BACPR core competencies. CR programmes were mostly community based (40·8 %), lasting 8 weeks (range: 2–25) and included two (range: 1–7) diet sessions. Dietary history was assessed at the start (79·6 %) and followed up (83·7 %) by most centres; barriers to completing assessment were insufficient time, staffing or other priorities. Services mainly focused on the Mediterranean diet while topics such as malnutrition and protein intake were lower priority topics. Service improvement should focus on increasing qualifications of practitioners, standardisation of dietary assessment and improvement in protein and malnutrition screening and assessment. [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: Clinical guidelines recommend treatment by a physiotherapist for people with shoulder pain due to rotator cuff disorder. Despite this recommendation, research evidence supporting the effectiveness of treatment by a physiotherapist is uncertain. While developing a randomised controlled trial to test the effectiveness of treatment by a physiotherapist for people with shoulder pain due to rotator cuff disorders, we first aimed to understand current practice as a basis for defining usual care. Methods: An online survey was developed based on a clinical vignette used in a previous survey exploring physiotherapy practice for people with shoulder pain due to rotator cuff disorder. UK‐based physiotherapists were invited to complete the survey via X and email across professional networks. Results: One Hundred Seventy complete responses were received. 167 (98%) respondents would offer advice/education to patients with shoulder rotator cuff disorders; 146 (86%) would use isotonic exercise (including concentric/eccentric strengthening); 20 (12%) would offer a corticosteroid injection; 7 (4%) would use joint mobilisation. 168/169 (99%) would offer in‐person assessment; 115 (68%) expect to deliver treatment over three to four sessions. Fifty percent agreed there is uncertainty about the effectiveness of physiotherapy treatment for patients with shoulder rotator cuff disorders. Seventy six percent agreed that patients with this condition can recover without physiotherapy intervention. Conclusions: Exercise and advice remain the most common treatments offered by physiotherapists for people with shoulder pain due to rotator cuff disorder. Corticosteroid injections are infrequently considered. Uncertainty about the effectiveness of treatment by a physiotherapist for shoulder pain due to rotator cuff disorder is evident. [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]

Objective: Consistent symptom reporting for conditions like tinnitus that do not have an associated sign is critical for evaluating severity and intervention effectiveness, and for interpreting research findings. There is little research examining reporting of tinnitus and hearing difficulty over time. We address this here by comparing reported hearing difficulty and tinnitus at two time-points. Design: A cross-sectional study comparing symptom reporting in March 2019 and August/September 2021 using data from two online surveys of the same cohort. Although each survey was designed to address a different question, both asked about symptoms of tinnitus and hearing difficulties and enabled this exploratory analysis. Study sample: 6881 members of the UK general public aged 18+ years. Results: Inconsistent reporting was evident - many participants who reported experiencing tinnitus and/or hearing difficulties in 2019, said in 2021 that they had never had such symptoms before. Additionally, reports of new tinnitus/hearing difficulties in 2021 were unexpectedly high, equating to 18-month incidence rates of 13.6% and 11.7%, respectively. Conclusions: Psychosocial factors, expectations and context impact symptom reporting. This should be considered when treating patients and interpreting research findings. Using real-time data collection methods could thus provide a better understanding of experiences of tinnitus and hearing. [ABSTRACT FROM AUTHOR]

Introduction: Method choice is an important component of quality abortion care and qualitative research suggests that abortion stigma can influence provider preference and provision of abortion methods. This study is the first to explore the relationships between abortion providers' method preferences, their provision of medication or instrumentation abortion or both methods, and abortion stigma. Methods: We conducted secondary analysis of a survey of United Kingdom (UK) abortion providers (N = 172) to describe and compare providers' self‐reported method preferences and provision. We used multinomial logistic regression to assess the association between method preference and provider experiences of abortion stigma (measured using a revised Abortion Provider Stigma Scale (APSS)), adjusting for relevant provider and facility characteristics. Results: Almost half (52%) of providers reported that they only provided medication abortion care, while 5% only provided instrumentation abortion care and 43% provided both methods. Most (62%) preferred to provide both methods while 32% preferred to provide only medication abortion and 6% only instrumentation abortion. There was no significant difference in revised APSS scores by provider method preference or provision. Discussion: Most surveyed UK abortion providers prefer to offer both methods, but over half only provide medication abortion. This may reflect patients' preferences for medication abortion, and health system and legal constraints on instrumentation abortion. Addressing these systemic constraints on method provision could expand patient choice. Providers' method preference was not significantly associated with provider stigma but future research should consider the influence of structural stigma on method provision at the health system level. [ABSTRACT FROM AUTHOR]

Interprofessional education (IPE) can help prepare future graduates to work collaboratively in healthcare teams. Using a multiple-case study approach, we explored IPE across four United Kingdom (UK) Higher Education Institutions (HEIs) to identify factors affecting IPE implementation and outcomes. For each site, educators involved with IPE were surveyed and interviewed to explore IPE implementation. To examine outcomes, students took part in focus groups and accreditation reports published by professional regulators were explored. A total of five IPE courses were surveyed, six IPE leads were interviewed, three focus groups were conducted with students, and sixteen reports were reviewed. Regulators' standards mandating IPE and directives by the Deans were the main triggers for IPE initiation. In sites where the regulator's standards were perceived by educators as non-mandating IPE, some staff were less inclined to engage with IPE initiation, which adversely affected IPE planning and delivery. Students from such sites were less satisfied with their IPE experiences and uncertain about the purpose of IPE. Senior management (i.e. Dean) commitment and support is needed to establish IPE initiatives across the institution and cultivate a collaborative culture. The presence of a collaborative culture was associated with positive feedback from regulators and students regarding IPE. [ABSTRACT FROM AUTHOR]

Food insecurity (FI) among university students in the United States has been associated with poor mental wellbeing, but very little is known about the relationship between FI and mental wellbeing in the UK university population. Here we examined the prevalence of FI, determined potential drivers for it and its relationship with mental wellbeing and coping ability. Students studying at UK universities (n = 289) completed an online self‐reported questionnaire to obtain socio‐economic characteristics including financial status, FI status (Household Food Insecurity Access scale), mental wellbeing (Warwick‐Edinburgh Mental Wellbeing Scale) and coping ability (coping flexibility scale). FI was observed in 28% of the participants and was associated with financial independence, running out of money, borrowing money and lacking confidence to purchase healthy foods (p < 0.05). Although we cannot determine directionality, logistic regression analysis revealed those who were judged as FI were more likely to shop often (OR = 3.139 95% CI 1.533–6.429), never snacked between meals (OR = 4.261 95% CI 1.309–13.875) and the amount of food purchased was affected by perceptions of the price of food in general (OR = 2.954 95% CI 1.675–5.210). Financial instability and the inability to access nutritious food may contribute to the decrease in mental wellbeing (p < 0.01) and lower ability to cope with stressful situations (p < 0.01) in food‐insecure students although the direction of these relationships cannot be determined from this cross‐sectional study. This study has identified that there is a need to develop appropriate strategies to combat FI in university students and to improve mental health. [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]

Background: COVID‐19 created specific challenges for new and expectant parents and perinatal services. Services changed rapidly in the United Kingdom (UK), including the withdrawal of home birth services, birth center closures, and restrictions on the number of birth partners allowed in the birth room. The purpose of this study was to examine how these changes affected the experiences of LGBTQ+ parents in the UK. Methods: An online survey was conducted in April 2020 to provide real‐time data capture of new and expectant families' experiences. It was open to those in the third trimester, or to those who had given birth since the beginning of the first UK lockdown period, and their partners. The survey asked open‐ended questions about perinatal experiences. Demographic data were also collected, including sexual orientation and gender. Responses were collected from 1754 participants, including 76 who self‐identified as LGBTQ+. Results: Thematic analysis identified that LGBTQ+ new and expectant parents faced similar issues to cisgendered, heterosexual expectant parents, though additional concerns were also noted relating to support and recognition. Heterocentric policies negatively affect lesbian families. Non‐birthing co‐mothers feared invalidation as parents. Sexual minority pregnant women were more likely than heterosexual pregnant women to consider additional birth supporters and to consider freebirthing. Discussion: Service changes introduced in the pandemic were cisheteronormative, creating additional challenges for LGBTQ+ new and expectant parents and compounding existing inequalities. When planning, changing, or evaluating perinatal services, specific consideration is needed to include birthing parents who are not mothers and mothers who did not give birth. If appropriate care is not available, consequences may include impaired perinatal wellbeing and restricted birth choices. Including sexual orientation and gender in data collection enables different perspectives to be considered. [ABSTRACT FROM AUTHOR]

Background: The home literacy environment (HLE) has rarely been examined for individuals with neurodevelopmental disorders, including individuals with Williams syndrome and Down syndrome. Method: The current study surveyed carers of individuals with Down syndrome (n = 48) and Williams syndrome (n = 18) in the United Kingdom (UK). Results: The study reports that individuals with Down syndrome were rated higher in general reading skills and writing, while the Williams syndrome group scored higher for speaking. Yet, individuals with Down syndrome were more likely to engage in informal activities than instructional activities and the frequency of informal activities related to reading outcomes for those with Down syndrome but not Williams syndrome. Additionally, this study reports that age was not related to the HLE for both groups. Conclusion: This is the first study to report on the HLE of individuals with Williams syndrome and supports the key role of the HLE in the development of literacy skills for individuals with Williams syndrome and Down syndrome. [ABSTRACT FROM AUTHOR]

Background: This cross-sectional study investigates the educational background and entry routes of otolaryngology higher surgical trainees in the UK. Method: A survey was disseminated to trainees through training programme directors and 60 responses were received. Results: Most trainees decided to pursue otolaryngology early in their training, with 50 per cent making the decision four or more years before applying for a higher surgical traineeship. Similarly, 68.3 per cent of trainees undertook otolaryngology-themed core surgical training, while two-thirds had an otolaryngology rotation during their foundation training. Most trainees (86.7 per cent) were accepted into core surgical training on their first attempt, and 71.7 per cent gained entry to higher surgical training on their first attempt. Conclusion: The findings highlight the importance of early exposure to otolaryngology and the pursuit of themed core surgical training programmes for building a competitive application. However, unsuccessful first attempts at core surgical training or higher surgical training should not discourage candidates from pursuing a career in otolaryngology. [ABSTRACT FROM AUTHOR]

Objectives: Mental health problems and persistent COVID‐19 symptoms were prevalent in the context of COVID‐19. However, despite the long‐observed association between physical symptoms and mental health problems, such association has not been adequately examined in the context of COVID‐19. Our understanding of wider patterns of risk and vulnerability factors for mental health also remains limited. This study investigated the associations between general mental health, and persistent physical symptoms, and additional risk and vulnerability factors in the context of COVID‐19. Methods: Two hundred fourteen adults, living in the UK, recruited via social media, completed the online survey and were included in the analyses. Correlation and regression analyses were conducted to examine the associations of persistent physical symptoms and risk and vulnerability factors with measures of general mental health including depressive symptoms, anxiety and insomnia. Results: 78.5% of the participants reported between 1 and 26 persistent symptoms, and about 28%–92% of them associated these symptoms with COVID‐19 infection. Persistent physical symptoms were uniquely associated with all measures of mental health, β =.19–.32. Mental health history and worries were the most prominent risk factors, |β| =.12–.43. Conclusions: People who experience more persistent physical symptoms post‐COVID‐19 have poorer mental health. It may be important to consider and discuss the recovery from COVID‐19 beyond a negative COVID‐19 test. Multidisciplinary interventions that address the complex impact of COVID‐19 for people with long COVID are needed. [ABSTRACT FROM AUTHOR]

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Background: The COVID-19 pandemic placed significant demand on the NHS, including ambulance services, but it is unclear how this affected ambulance service staff and paramedics in other clinical settings (e.g. urgent and primary care, armed services, prisons). This study aimed to measure the self-perceived preparedness and impact of the first wave of the pandemic on paramedics’ psychological stress and perceived ability to deliver care. Methods: Ambulance clinicians and paramedics working in other healthcare settings were invited to participate in a three-phase sequential online survey during the acceleration (April 2020), peak (May 2020) and deceleration (September/October 2020) phases of the first wave of COVID-19 in the United Kingdom. Recruitment used social media, Trust internal bulletins and the College of Paramedics’ communication channels, employing a convenience sampling strategy. Data were collected using purposively developed open- and closed-ended questions and the validated general health questionnaire-12 (GHQ-12). Data were analysed using multi-level linear and logistic regression models. Results: Phase 1 recruited 3717 participants, reducing to 2709 (73%) by phase 2 and 2159 (58%) by phase 3. Participants were mostly male (58%, n = 2148) and registered paramedics (n = 1992, 54%). Mean (standard deviation) GHQ-12 scores were 16.5 (5.2) during phase 1, reducing to 15.2 (6.7) by phase 3. A total of 84% of participants (n = 3112) had a GHQ-12 score ≥ 12 during the first phase, indicating psychological distress. Participants that had higher GHQ-12 scores were feeling unprepared for the pandemic, and reported a lack of confidence in using personal protective equipment and managing cardiac arrests in confirmed or suspected COVID-19 patients. Conclusions: Most participants reported psychological distress, the reasons for which are multi-factorial. Ambulance managers need to be aware of the risks to staff mental health and take action to mitigate these, to support staff in the delivery of unscheduled, emergency and urgent care under these additional pressures. [ABSTRACT FROM AUTHOR]

Background The study aimed to identify the causes of moral distress in public health professionals associated with the COVID-19 pandemic, and the potential ways of avoiding or mitigating the distress. Methods The survey was distributed to all members of the UK Faculty of Public Health between 14 December 2021 and 23 February 2022. Conventional qualitative content analysis was conducted to explore the situations in which moral distress arises, the moral judgments that led to distress and the proposed ways to address moral distress. Results A total of 629 responses were received from respondents broadly representative of the public health professional workforce. The main situations causing moral distress were national policy, guidance and law; public health advice; and workplace environments. Moral distress was precipitated by judgments about having caused injury, being unable to do good, dishonest communications and unjust prioritization. The need to improve guidance, communication and preparedness was recognized, though there was disagreement over how to achieve this. There were consistent calls for more subsidiarity, moral development and support and freedom to voice concerns. Conclusions The causes of moral distress in public health are distinct from other healthcare professions. Important proposals for addressing moral distress associated with the COVID-19 pandemic have been voiced by public health professionals themselves. [ABSTRACT FROM AUTHOR]

Background Wearing face coverings to prevent airborne viral transmission has at times been legally mandated, followed by periods when rules were relaxed. The present study tracks changes in face covering and the impacts on people's perceptions of their capabilities, opportunities and motivations. Methods Three-wave survey. At wave 1 (25 January–6 February 2022), 10 622 UK adults reported: (a) sociodemographic characteristics; (b) face covering in work, public transport and indoor leisure settings and (c) capabilities, opportunities and motivations. Measures were repeated 1–18 March 2022 and 20 May–6 June 2022. Data were analyzed descriptively, within-participants analysis of covariance (ANCOVA) and multiple linear regression. Results Face covering decreased over time as rules around the wearing of face coverings relaxed. Perceptions of capabilities, opportunities and motivations to wear face coverings were consistently associated with the actual wearing of face coverings, with marked decreases in motivations over time. Conclusions Decreases in motivations seem to explain best the reasons for declining levels of face covering. Further work is required to develop interventions to change people's motivations and promote the wearing of face coverings, should they be required in the future. [ABSTRACT FROM AUTHOR]

Those endorsing or opposing the development of television aesthetics scholarship have exhibited an admirable willingness to reflect upon the rationales and motivations for formulating value judgements. However, very little equivalent attention has been afforded to processes that occur within this area: how scholars conduct analysis and develop claims for achievement in television. In addressing this lack, the following article surveys some of the meanings that 'criticism' has encompassed in Television Studies, offering 'aesthetic criticism' as a useful term to describe the work of analysis and evaluation, before moving to a series of close readings of aesthetic criticism in practice. [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]

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]

This study concerns culturally Deaf signers in the UK who use hearing aids and (i) explores motivations for hearing aid use (ii) identifies barriers and facilitators to accessing NHS hearing aid services, (iii) examines cultural competency of hearing aid clinics and (iv) identifies factors influencing effective adult hearing aid service provision. Online survey in British Sign Language and English that was informed by Deaf service users. 75 Deaf adult BSL users who wear hearing aids and use NHS hearing aid clinics. No specific reason emerged as outstandingly important for hearing aid use; however, assisting with lipreading (57%) and listening to music (52%) were rated as very/extremely important. Access issues reported were contacting clinics, poor communication with staff and lack of Deaf awareness. To be an effective and culturally competent hearing aid clinic for Deaf signers, a good understanding of Deaf culture and language was most rated as important (87%). The study is the first that explores hearing aid use and experiences of accessing hearing aid clinics from Deaf signers' perspectives. Enhancements to clinical practice are required to consider culturally Deaf people's motivations for hearing aid use and make services more BSL-friendly. [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]

Background: The Manual of dietetic practice ('Manual') is the core textbook for qualified and student dietitians. A survey was conducted to explore views on the scope, content and presentation of the Manual to inform the forthcoming edition. Methods: The survey comprised of questions on demographics, structure, content, access (print/digital), missing topics, strengths and weaknesses. It was distributed to members of the British Dietetic Association (BDA) and other relevant groups in August 2022. Responses are presented as frequencies and free text as themes. Results: Of 1179 responses, 91% were from professionals, of whom 72% were registered dietitians with a mean of 12.7 years (range: 1–44) in practice: 60% worked in the United Kingdom with 52% based in a clinical setting. The printed version was preferred: 59% professionals, 60% students, 94% professionals and 88% students were satisfied with the structure; however, 26% professionals and 22% students identified content that was lacking or outdated, including mental health and sustainability. The strengths were its comprehensive coverage and respected contributing authors. Weaknesses included the cost, size, lack of visual aids and currency. Professionals indicated the seventh edition should focus on more practical information required for clinical practice, whereas students wanted more emphasis on summarised information and visual formats. Conclusions: The survey proved a valuable method to engage with the readership to ensure the next edition reflected their requirements. Although nearly all respondents were satisfied with the scope and content, the results highlighted those topics lacking and/or outdated. Results also showed that the next edition should focus on practical information required for clinical practice, with more summarised and visual formats. Key points: This article presents the results of an online survey to explore views on the scope, content and presentation of the UK Dietetic profession's core text, Manual of dietetic practice.The survey was initiated by the editorial team who felt it important to explore ways in which the new edition of the Manual could be updated to meet the emerging needs of readers, namely qualified dietitians and students of dietetics.Over 1100 respondents completed the survey comprising 91% professionals, 72% of whom were registered dietitians who had been practicing in the UK healthcare system for an average 12 years.Thematic analysis revealed readers felt the Manual to be a highly respected text, regarded as the 'go‐to' source for guidance on the practice of clinical dietetics with comprehensive coverage and extremely knowledgeable contributing authors.However, despite its positive qualities, the Manual suffered from cumbersome updating processes meaning that its content lagged behind real‐life clinical practice.The survey proved a valuable method to engage with the readership to ensure the next edition reflected readers' requirements for updated Manual content, style and format.The editors will ensure the forthcoming seventh edition focuses on practical information required for clinical practice, with more summarised form and visual formats.Further, moving forward it is hoped that there will be more aggressive promotion of the online version of the Manual as it is a format which facilitates content update and is likely to become more widely accessed in the future. [ABSTRACT FROM AUTHOR]

Background: Little is known about changes in gastrointestinal symptoms compatible with disorders of gut‐brain interaction (DGBI) with increasing age at the population level. The objective of this study was to describe the patterns of DGBI in individuals 65 years of age and above and contrasting them with those of younger adults. Methods: A community sample of 6300 individuals ages 18 and older in the US, UK, and Canada completed an online survey. Quota‐based sampling was used to ensure equal proportion of sex and age groups (40% aged 18–39, 40% aged 40–64, 20% aged 65+) across countries, and to control education distributions. The survey included the Rome IV Diagnostic Questionnaire for DGBI, demographic questions, questionnaires measuring overall somatic symptom severity and quality of life, and questions on healthcare utilization, medications, and surgical history. Results: We included 5926 individuals in our analyses; 4700 were 18–64 years of age and 1226 were ages 65+. Symptoms compatible with at least one DGBI were less prevalent in participants ages 65+ vs. ages 18–64 years (34.1% vs. 41.3%, p < 0.0001). For symptoms compatible with upper GI DGBI, lower prevalence for most disorders was noted in the 65+ group. For lower GI DGBI, a different pattern was seen. Prevalence was lower in ages 65+ for irritable bowel syndrome and anorectal pain, but no differences from younger participants for the disorders defined by abnormal bowel habits (constipation and/or diarrhea) were seen. Fecal incontinence was the only DGBI that was more common in ages 65+. Having a DGBI was associated with reduced quality of life, more severe non‐GI somatic symptoms, and increased healthcare seeking, both in younger and older participants. Conclusion: Symptoms compatible with DGBI are common, but most of these decrease in older adults at the population level, with the exception of fecal incontinence which increases. This pattern needs to be taken into account when planning GI health care for the growing population of older adults. [ABSTRACT FROM AUTHOR]