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Introduction: The aim of this study was to gain consensus among young people with a stoma due to inflammatory bowel disease (IBD) on the priorities for the content of an intervention for the self‐management of stoma‐related distress. The current identification and management of distress in young people with a stoma is often suboptimal in clinical settings and there is a need for improved support resources. Methods: Two consensus group meetings were carried out via online video conferencing, using nominal group technique. Participants generated, rated on a Likert scale and discussed, topics for inclusion in a future self‐management intervention. Results: Nineteen young people, aged 19–33, with a stoma due to IBD took part in one of two group meetings. Participants were located across England, Scotland, and Northern Ireland. Twenty‐nine topics were generated by participants, seven of which reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7‐point Likert scale. These were: receiving advice from young people with lived experience of stoma surgery; advice on/addressing concerns about romantic relationships, sex and intimacy; information about fertility and pregnancy related to stoma surgery; stoma 'hacks', for example, useful everyday tips regarding clothing, making bag changes easier and so forth; reflecting on and recognising own emotional response to surgery; tips on managing the stoma during the night; and processing trauma related to the illness and surgery journey. Conclusions: Findings extend previous research on young people's experiences of stoma surgery, by generating consensus on young people's priorities for managing distress related to surgery and living with a stoma. These priorities include topics not previously reported in the literature, including the need for information about fertility and pregnancy. Findings will inform the development of a self‐management resource for young people with an IBD stoma and have relevance for the clinical management of stoma‐related distress in this population. Patient or Public Contribution: Three patient contributors are co‐authors on this paper, having contributed to the study design, interpretation of results and writing of the manuscript. The study's Patient and Public Involvement and Engagement advisory group also had an integral role in the study. They met with the research team for four 2‐h virtual meetings, giving input on the aims and purpose of the study, recruitment methods, and interpretation of findings. The group also advised on the age range for participants. The views of young people with a stoma are the central component of the study reported in this paper, which aims to gain consensus among young people with an IBD stoma on their priorities for the content of a resource to self‐manage distress related to stoma surgery. [ABSTRACT FROM AUTHOR]

Background: The external beam radiotherapy (EBRT) applied for prostate cancer (PCa) has been one of the most important and hottest research fields over recent decades. This study aimed to explore the research hotspots of EBRT in PCa and help the researchers have a clear and intuitive reference basis for later researches. Methods: The literature scientometric analysis related to "EBRT applied for PCa" was conducted via the Web of Science Core Collection from 2010 to 2019. The Microsoft Office Excel 2019 and CiteSpace V. 5.7.R1 software were introduced for visualizing and analyzing the data. Results: A total of 7860 relevant papers were extracted and downloaded. A total of 7828 papers were extracted and analyzed after data cleansing by CiteSpace. The tendency of published papers was comprehensively increasing from 2010 to 2019. Among all 73 countries/regions, USA published the most papers, accounting for 39%, which was the most active contributor with most publications. Australia (Centrality: 0.18), England (Centrality: 0.12) were cooperating most cohesively with other countries. Univ Toronto was the most productive institute (229), while Harvard Univ (Centrality: 0.67) had extensive collaborations with other institutes. The International journal of Radiation Oncology Biology Physics had the largest number of publications and the highest number of co‐citations. Briganti A had the largest volume of publications. D'Amico AV had the highest number of co‐citations. Four latest and largest clusters were identified as oligometastases, salvage therapy (SRT), prostate‐specific membrane antigen (PSMA), and hypofractionation. Thirteen references became strongest burst citations lasting until 2019. The studies of "oligometastases," "SRT," "PSMA," "hypofractionation," "postoperative radiotherapy," and "dose and fraction regimen changes" were prevailing in the recent years. Conclusion: The "oligometastases," "SRT," "PSMA," "hypofractionation," "postoperative radiotherapy," and "dose and fraction regimen changes" may be the state‐of‐art research frontiers, and related studies will advance in this field over time. [ABSTRACT FROM AUTHOR]

Introduction: Associations between structural inequalities and health are well established. However, there is limited work examining this link in relation to mental health, or that centres public perspectives. This study explores people's experience and sense‐making of inequality in their daily lives, with particular consideration of impacts on mental health. Methods: We conducted a peer research study. Participants had to live in one of two London Boroughs and have an interest in inequalities and mental health. Using social media, newsletters, local organisations and our peer researchers' contacts, we recruited 30 participants who took photos representing their experience of inequality and discussed them during semi‐structured interviews. Data were analysed using reflexive thematic analysis. Results: Three themes were identified in this study: (1) inequalities are unjust, multilayered and intertwined with mental health. Accounts demonstrated a deep understanding of inequalities and their link to mental health outcomes, describing inequalities as 'suffering' and 'not good for anyone'. Financial, housing, immigration and healthcare problems exacerbated poor mental health, with racism, gender‐based violence and job loss also contributing factors for both poor mental health and experiences of inequality; (2) inequalities exclude and have far‐reaching mental health consequences, impacting personal sense of belonging and perceived societal value and (3) moving forwards—addressing long‐standing inequality and poor public mental health necessitated coping and resilience strategies that are often unacknowledged and undervalued by support systems. Conclusion: Lived experience expertise was central in this study, creating an innovative methodological approach. To improve public mental health, we must address the everyday, painful structural inequalities experienced by many as commonplace and unfair. New policies and strategies must be found that involve communities, redistributing resources and power, building on a collective knowledge base, to coproduce actions combatting inequalities and improving population mental health. Patient or Public Contribution: This study was peer‐led, designed and carried out by researchers who had experiences of poor mental health. Six authors of the paper worked as peer researchers on this study. [ABSTRACT FROM AUTHOR]

Effective conservation decisions rely on accurate survey data, but methods can be resource‐intensive and risk false negative results. Presence of the threatened hazel dormouse (England, UK) is typically confirmed by looking for its nest in survey tubes, over a 6‐month period. As an alternative, environmental DNA (eDNA) surveys have proven benefits in efficiency and accuracy for other taxa, but generally rely on the extraction and amplification of DNA from water, soil or sediment, which are not yet dependable samples for rare terrestrial mammals like the hazel dormouse.At a known occupancy site, paper‐lined survey tubes were used to capture a DNA sample. Like other species of rodent, the hazel dormouse excretes urine freely, and this was highlighted by ultraviolet torch, swabbed from the paper, extracted and hazel dormouse eDNA amplified by quantitative polymerase chain reaction (qPCR).Hazel dormouse presence was confirmed in this way in three out of 50 tubes within 8 days. Detection by conventional nest survey occurred on day 63 when a hazel dormouse nest was found in a single survey tube. We calculate that amplification of eDNA left behind in tubes increased survey efficiency here at least 12‐fold.Synthesis and applications. In this study we demonstrate that eDNA swabbed from a clean substrate placed in survey apparatus can significantly hasten the detection of a rare species. This method has the potential to broaden the application of eDNA to other terrestrial vertebrates, including surveys at large spatiotemporal scales. Beyond presence/absence, the non‐invasive DNA sample could also offer insights into sex ratio, abundance, behaviour and population genetics. [ABSTRACT FROM AUTHOR]

Background: Globally, it is estimated that one in three adults live with two or more long‐term conditions (multiple long‐term conditions, MLTCs), that require self‐management. People who experience socioeconomic deprivation face significant health inequalities due to a range of interrelated characteristics that lead to a lack of resources and opportunities. Previous research with underserved populations indicate low levels of trust towards primary care providers and potential barriers for developing patient‐healthcare professional relationships. The purpose of this paper is to explore the barriers and facilitators to self‐managing MLTCs, amongst people who experience socioeconomic deprivation. Methods: Semistructured one‐to‐one interviews with adults (n = 28) living in London and Sheffield, United Kingdom with MLTCs who are experiencing socioeconomic deprivation. Participants were recruited through general practices, community channels and social media. Data were analysed in NVivo using reflexive thematic analysis methods. Findings: Four analytical themes were developed: (1) challenges in accessing healthcare services, financial assistance, and cultural awareness; (2) empowerment and disempowerment through technology, including digital exclusion, and use of technology; (3) impact and causes of exclusion on self‐management, including social isolation, area‐based and economic exclusion, and health‐related stigma and (4) adapting self‐management strategies, including cost‐effective, and culturally/lifestyle appropriate strategies. Conclusions: Future health interventions and services need to be developed with consideration of the combined complexities of managing MLTCs while experiencing socioeconomic deprivation. Increased awareness in practitioners and commissioners of the complexities surrounding the lives of people experiencing socioeconomic deprivation, and the need for targeted strategies to promote self‐management of MLTCs are of great importance. Patient or Public Contribution: A patient advisory group contributed to all stages of the study, including providing important feedback on study documents (topic guides and recruitment materials), as well as providing critical insights surrounding the interpretation of interview data. [ABSTRACT FROM AUTHOR]

Introduction: In England, primary care networks (PCNs) offer opportunities to improve access to and sustainability of general practice through collaboration between groups of practices to provide care with a broader range of practitioner roles. However, there are concerns that these changes may undermine continuity of care. Our study investigates what the organisational shift to PCNs means for continuity of care. Methods: The paper uses thematic analysis of qualitative data from interviews with general practitioners and other healthcare professionals (HCPs, n = 33) in 19 practices in five PCNs, and their patients (n = 35). Three patient cohorts within each participating practice were recruited, based on anticipated higher or lower needs for continuity of care: patients over 65 years with polypharmacy, patients with anxiety or depression and 'working age' adults aged between 18 and 45 years. Findings: Patients and clinicians perceived changes to continuity in PCNs in our study. Larger‐scale care provision in PCNs required better care coordination and information‐sharing processes, aimed at improving care for 'vulnerable' patients in target groups. However, new working arrangements and ways of delivering care in PCNs undermine HCPs' ability to maintain continuity through ongoing relationships with patients. Patients experience this in terms of reduced availability of their preferred clinician, inefficiencies in care and unfamiliarity of new staff, roles and processes. Conclusions: New practitioners need to be effectively integrated to support effective team‐based care. However, for patients, especially those not deemed 'vulnerable', this may not be sufficient to counter the loss of relationship with their practice. Therefore, caution is required in relation to designating patients as in need of, or not in need of continuity. Rather, continuity for all patients could be maintained through a dynamic understanding of the need for it as fluctuating and situational and by supporting clinicians to provide follow‐up care. Patient and Public Involvement (PPI): A PPI group was recruited and consulted during the study for feedback on the study design, recruitment materials and interpretation of findings. [ABSTRACT FROM AUTHOR]

Accounting for the values placed on nature by the public is key to successful policies in reversing ongoing biodiversity declines. However, biodiversity values are rarely included in policy decisions, resulting in poorer outcomes for people and nature.Our paper addresses an important evidence gap related to the non‐availability of values for appraising large‐scale policies and investment programmes for species recovery and habitat improvement at the national level.We use a stated preference choice modelling approach to estimate household preferences and Willingness to Pay for species recovery and habitat improvement over a wide range of habitats in England.The framing of our stated preference study is crucial to the evidence we develop. Within the study, we define species recovery as incremental improvements to habitat quality and present respondents with choices between conservation policy options that improve different habitat types. We then use the response data to estimate values for habitat quality improvements, and the associated improvements to species presence and abundance. We are thus able to estimate economic benefits for 'wild species recovery' simultaneously across a wide range of habitat types.Willingness to pay values for habitat improvement was found to be highest for improvements from 'moderate' to 'full' species recovery by 2042; and for habitat types which have relatively low current extents in England, such as lowland fens.Policy Implications: biodiversity policy designers can make use of stated preference methods to guide decisions over which aspects of biodiversity targets to focus more resources on, since this enables policy to reflect public preferences, and thus engages higher public support for conservation. In our specific data and context, this implies prioritising the restoration of species recovery to high levels and focussing resources on scarcer rather than more abundant habitat types. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Climatic changes can cause unpredictability in flood regimes that traditional flood risk management (FRM) approaches may struggle with. Therefore, flood resilience is seen as a supplementation to these approaches, putting a larger emphasis on flood acceptance and minimising consequences. An (emergent) group contributing towards flood resilience is civil society. This paper examines how civil society contributions can be furthered and guided in the Netherlands as well as exploring potential limitations in doing so. To achieve this, England is used as a good practice example due to a more developed and defined role for civil society being present here. Data were collected on both actual (England and the Netherlands) and potential (The Netherlands) civil society contributions. These were compared to identify potential avenues for Dutch civil society contributions to flood resilience that can be further investigated. The research shows that the most promising avenues are improving advocacy from citizens, improving local flood awareness and developing relationships between FRM authorities and existing citizen groups that can be harnessed and mobilised to support flood resilience. Additionally, the research also provides insights into potential limitations for transferring resilience approaches from one context to another beyond the cases discussed in this publication. [ABSTRACT FROM AUTHOR]

The article reports on the international, interdisciplinary conference, Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives, to be held in Cumbria in June 2017. Topics to be discussed during the conference include illuminate socio-cultural, political and economic ifluences on infant and child feeding practices, nature of relationships within families, and increasing understandings of breastfeeding as a bio-psychosocial activity.

The Becoming Breastfeeding Friendly (BBF) in Great Britain study was conducted during 2017–2019 comprising three country studies: BBF England, Wales and Scotland. It was part of an international project being coordinated during the same period by the Yale School of Public Health across five world regions to inform countries and guide policies to improve the environment for the promotion, protection and support of breastfeeding. This paper reports on the application of the BBF process that is based on an implementation science approach, across the countries that constitute Great Britain (England, Wales and Scotland). The process involves assessing 54 benchmarks across eight interlocking gears that drive a country's 'engine' towards a sustainable policy approach to supporting, promoting and protecting breastfeeding. It takes a consensus‐oriented approach to the evaluation of benchmarks and the development of recommendations. This paper provides a critical overview of how the process was conducted, the findings and recommendations that emerged and how these were managed. We draw on critical theory as a theoretical framework for explaining the different outcomes for each country and some considerations for future action. Key messages: Undertaking an international, comparable approach to develop evidence‐based policy recommendations for scaling up the breastfeeding environment can provide useful data on which to draw explanations and conclusions on national variation.The findings from the BBF process across England, Scotland and Wales suggest that improving breastfeeding in Great Britain is dependent on the degree of political will and having a coordinated national breastfeeding strategy in place or not, along with access to robust breastfeeding data.A critical theory lens helps to bring to light some differences in the research and policy process that can explain differences between countries in the United Kingdom. [ABSTRACT FROM AUTHOR]

Introduction: Co‐production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co‐production and how to operationalize it. The current paper describes the development of a co‐production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. Methods: The strategy used Appreciative Inquiry (AI), an approach following a five‐step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in‐depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co‐production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. Results: Nine principles for how to do co‐production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long‐term; co‐production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. Conclusion: The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co‐production. This documentation of one approach to operationalizing co‐production serves to avert any misappropriations of the term 'co‐production' by listening to service users, stakeholders and other relevant groups, to develop trust and long‐term relationships, and build on the learning that already exists amongst such groups. Patient or Public Contribution: The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co‐production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process. [ABSTRACT FROM AUTHOR]

Austerity policies have affected local government for over a decade challenging their financial resilience to cope with further financial shocks. Using a financial resilience framework, this paper examines whether lower tier authorities behave in the same way as their higher tier counterparts when it comes to financial resilience to shocks. From a detailed field study of three lower tier (district) authorities in English local government, it is concluded that they do not have the capacity to 'Bounce Forwards'. They can only 'Bounce Back' in the short term and even that is becoming increasingly difficult. [ABSTRACT FROM AUTHOR]

Background: Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom‐heard voices, to ensure that a range of voices are heard and that research is meaningful to them. Objective: We explored how researchers involve and engage seldom‐heard communities around big data research. Methods: This is a qualitative study. Researchers who had experience of involving or engaging seldom‐heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio‐recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. Results: The analysis highlighted the complexity of involving and engaging seldom‐heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. Conclusion: The study offers researchers a better understanding of how to involve and engage seldom‐heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project‐specific and dependent on the public contributors, researchers' needs, resources and time available. Patient and Public Involvement: Two public contributors are authors of the paper and they were involved in the study design, analysis and writing. [ABSTRACT FROM AUTHOR]

This paper assesses the relationship between decision utility and experienced utility of recreational nature visits. The former is measured as the travel cost to reach that site as routinely used by the travel cost method (TCM), and the latter is operationalized through visit‐related subjective well‐being (SWB). As such, the analysis is a test of convergent validity by examining whether ex ante TCM‐based assessment of recreational value reflecting decision utility corresponds to stated ex post SWB, reflecting experienced utility. It explores to what extent utility revealed by counts of nature visits are associated with self‐reported, visit‐related SWB relating to that same visited site. The analysis uses two existing datasets providing information on (i) 3672 recreational visits to green/blue spaces in England over the course of four years and (ii) 5937 recreational visits to bluespace sites across 14 European countries over one year. Results show a positive association between travel cost and visit‐related SWB while controlling for trip frequency and a large set of covariates, suggesting convergent validity of the two utility concepts. A breakdown by travel mode suggests this relationship only holds for trips involving motorized transport and is not present for habitual, chore‐like walking visits to the recreational site. [ABSTRACT FROM AUTHOR]

Background: Co‐production is predicated on equal power‐sharing and responsibility in research partnerships. However, relatively few accounts exist that explore the subjective experience of how co‐researchers achieve such equality, from the perspectives of public contributors and researchers. Aim: This paper aims to provide a unique insight into the process of co‐production, by weaving personal reflections with principles to evaluate the impact arising from co‐produced knowledge. It is based upon participatory research that was initiated by a 'lay' person, on behalf of a community organization, seeking support for Somali families who are affected by autism. The paper explores the evolving partnerships that began with community theatre and qualitative research and leading to extensive dissemination and impact, all of which has been jointly owned and negotiated by the co‐researchers and community organizations. Discussion: Initially, this paper reflects on the process, drawing on principles defined for co‐production in health research and combining it with the co‐researcher's personal reflections of their experiences as insiders and outsiders, stepping in and out of each other's worlds. The value of reciprocity, flexibility and continuous reflection is illustrated. The latter part of the paper explores the impact of this co‐produced knowledge using a theoretical framework, to assess the specific impacts and its broader transformative potential. It demonstrates how (1) opportunities for all partners to be equitably involved to the maximum degree possible throughout the research process can affect social change and (2) co‐produced research can become a catalyst that is dynamic and complex, achieving multi‐layered impact. [ABSTRACT FROM AUTHOR]

Background: Looked after children and care leavers (denoted as LAC) are often described as a 'hard to reach' group of young people, and their voices are rarely sought to inform academic research. Methods: This paper reports on experiences and reflections of a group of children and young people and academic researchers who developed a Patient and Public Involvement (PPI) group that was set up in the context of an ongoing health service intervention trial with LAC. Setting and participants: Eighteen qualitative semi‐structured interviews were conducted with seven LAC, the participation officer within a North East Children in Care Council and the four researchers involved in developing and facilitating the PPI group. PPI sessions (n = 9) each approximately 1 hour in length were conducted over an 18‐month period. Analysis: The qualitative interviews were transcribed verbatim. Thematic analysis was used to analyse the data, and direct quotes are used within the paper. Main outcomes: The LAC used the PPI group to produce a 5‐minute video to highlight why they think young people should be involved in research. Overall findings suggested that it was feasible to develop a research‐related PPI group with LAC. Findings from the research were used to co‐develop 'top tips' of working with vulnerable young people such as looked after children. Conclusion: This paper has shown that PPI with LAC can be done if a co‐production approach to research is taken. It also suggests that assumptions regarding the capabilities of young people as researchers need to be re‐evaluated. [ABSTRACT FROM AUTHOR]

A twice-daily record of barometric pressure exists for Durham Observatory (54.768 °N, 1.584 °W, barometer cistern 107.3 m above mean sea level, MSL) from 23 July 1843 to 31 December 1960 and is published here for the first time. The Durham record, which is 98.7% complete, is by far the longest digital barometric pressure series in northern England and fills a very large temporal and spatial gap in the International Surface Pressure Database (ISPD: Cram et al, [2015] Geoscience Data Journal, 2, 31-46). In what is believed to be the first study of its kind, the record has been independently quality-controlled against the NOAA-CIRES-DOE Twentieth Century Reanalysis version 3 (20CRv3; Slivinski et al., [2019] Quarterly Journal of the Royal Meteorological Society, 145, 2876; Slivinski et al., [2021] Journal of Climate, 34, 1417-1438), which did not include the Durham records in its assimilation set. This paper describes the instruments used and their exposure, the sources of the record, digitization work undertaken to generate the digital time series (including quality control assessments using 20CRv3) and reduction to mean sea level pressure from station level observations, and examines consistency over the period of record against 20CRv3, concluding with a summary of monthly and annual means and extremes over the 117 year series and the details of the new dataset. [ABSTRACT FROM AUTHOR]

LINKED CONTENT: This article is linked to Dhanda et al papers. To view these articles, visit https://doi.org/10.1111/apt.17307 and https://doi.org/10.1111/apt.17335 [ABSTRACT FROM AUTHOR]

This paper unpacks new firm exit in a novel way. It theorizes that, even after controlling for a wide range of human capital and other factors, access to, and the management of, an overdraft facility powerfully influences the exit chances of a new firm. It then unpacks exits, distinguishing between new firms that exit leaving no debts (pure exiters) and those that exit leaving a debt (defaulters). A second distinction is between those exiting in the short‐ and the longer‐run. Using a bank‐based dataset, comprising nearly 6,000 new businesses in England and Wales tracked over a decade, it shows that, although there are similarities, financial management plays an important, but very different, role in explaining exit across the four groups. Overall, new firms with an overdraft have lower exit rates than those without, but the reverse is the case for defaulters. A second finding is that, although exceeding the terms of an overdraft enhances short‐run survival, it lowers survival in the longer‐run. These results highlight the powerful insights provided by private information held by the bank that is not normally available to academic researchers. [ABSTRACT FROM AUTHOR]

How humans interact with nature affects the health of both people and ecosystems. Yet, long‐term data on nature engagement are scarce because traditional survey methods are expensive, time consuming and require commitment over multiple years. Digital data sources (e.g. aggregated data from online searches) have major potential as a supplementary source of information and, in the absence of available data, as a proxy for more direct measurement of nature engagement.Using Google Trends, we created a list of refined and relevant search terms relating to diverse outdoor spaces and activities. We then compared trends in Google search volumes in England across both a 1‐year and 10‐year period to those from Google Community Mobility Reports, and from nationally representative survey data (Natural England's People and Nature Survey and the Monitor of Engagement with the Natural Environment).Search, survey and mobility data all support a general increase in public engagement with nature since 2009, and a more substantial increase during, or following, the initial national 'lockdown' period of the COVID‐19 pandemic in England. Search volumes increased for many urban and rural outdoor green spaces (e.g. woodlands), blue spaces (e.g. reservoirs), exercise activities (e.g. walking, running and hiking) and explicitly nature‐based activities (e.g. fishing, wild swimming and encouraging wildlife).Overall, volumes of Google searches were more closely related with longer‐term (10‐year) trends from survey data, than shorter‐term changes during the COVID‐19 pandemic. There were statistically significant relationships between search volumes, survey data (self‐reported past behaviour) and mobility data (movement trends) for around half of comparisons. Of these, an average of 13–44% of variation in the data was explained.The findings show that Google Trends provides valuable information about public engagement with nature, which can help to supplement existing survey data by providing new insights about behavioural trends. The paper also provides a proof of concept for using Google Trends to understand changes in public engagement with nature, which could be applied to the many countries that lack long‐term survey monitoring. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Background: Obesity rates are higher among people of lower socioeconomic status. While numerous health behaviour interventions targeting obesity exist, they are more successful at engaging higher socioeconomic status populations, leaving those in less affluent circumstances with poorer outcomes. This highlights a need for more tailored interventions. The aim of this study was to enhance an existing weight loss course for adults living in low socioeconomic communities. Methods: The Behaviour Change Wheel approach was followed to design an add‐on intervention to an existing local authority‐run weight loss group, informed by mixed‐methods research and stakeholder engagement. Results: The COM‐B analysis of qualitative data revealed that changes were required to psychological capability, physical and social opportunity and reflective motivation to enable dietary goal‐setting behaviours. The resulting SMART‐C booklet included 6 weeks of dietary goal setting, with weekly behavioural contract and review. Conclusion: This paper details the development of the theory‐ and evidence‐informed SMART‐C intervention. This is the first report of the Behaviour Change Wheel being used to design an add‐on tool to enhance existing weight loss services. The process benefitted from a further checking stage with stakeholders. [ABSTRACT FROM AUTHOR]

Cangialosi, Alegría, and Colmenero have made a comment on a paper of ours [Polym. Eng. Sci. 2022:1–13], in which we discussed the concern that the enthalpy recovery data reported by Cangialosi and co‐workers [Phys. Rev. Lett. 2013;111(9):095701] for polystyrene aged up to 15 K below glass transition temperature was anomalous and contradicted existing experimental results from the literature over a similar range of aging conditions. Their response shifts the focus away from the raised questions about their experimental results and attempts to invalidate the data that we cited in support of our argument. Here we respond to the comment and add additional analysis that suggests the structural recovery response of glassy materials exhibits smooth behavior over the full range of measurements, up to 7 or 8 logarithmic decades. We do this by referring to the work on the intrinsic isotherm down‐jump and memory responses of poly(vinyl acetate) between 40°C and 15°C over six logarithmic decades by Kovacs [Fortsch. Hochpolym. Fo. 1963;3(1/2):394–508], the small‐strain tensile creep of poly(vinyl chloride) quenched from 90°C to 40°C (approximately 40°C below Tg) over seven logarithmic decades from Struik [Polym Eng. Sci., 1977;17:165–173], and the volume recovery behavior for aging times up to 3 months in a temperature range between 95°C and −50°C by Greiner and Schwarzl [Rheol. Acta. 1984;23(4):378–395]. We also add discussion that an isothermal aging procedure using a vacuum oven is highly vulnerable to temperature errors due to the problem of good temperature control when the heat transfer mechanism is primarily radiative. [ABSTRACT FROM AUTHOR]

Both England and the Netherlands have seen efforts to liberalise their audit markets for local government in recent decades. According to economic theory, these should benefit buyers as increased competition produces lower prices and improved quality. Increasing the number of competing audit firms in markets traditionally dominated by few large firms is widely seen as a key ingredient to this process. However, liberalisation has taken different paths in England, compared to the Netherlands. In England, a national‐level collaborative purchasing arrangement has seen a small number of large firms competing, whilst in the Netherlands, a free market has led to the withdrawal by Big‐4 firms and rapidly growing market share by mid‐tier and small firms. In this paper, we analyse contrasting market developments in local public audit in England and the Netherlands and accordingly analyse the underlying factors through applying an established framework for market analysis from industrial economics, Porter's five forces framework, together with an institutional logics approach to further understand the factors involved. We find the Porter framework a useful tool to identify structural differences between markets but one that requires further analysis to explain underlying dynamics, which in the case of Dutch and English local public audit markets is effectively provided by the use of concepts from institutional logics including a historical contingency analysis. [ABSTRACT FROM AUTHOR]

Background and context: Breastfeeding peer support is valued by women, but UK trials have not demonstrated efficacy. The ABA feasibility trial offered proactive peer support underpinned by behaviour change theory and an assets‐based approach to women having their first baby, regardless of feeding intention. This paper explores women's and infant feeding helpers' (IFHs) views of the different components of the ABA intervention. Setting and participants: Trained IFHs offered 50 women an antenatal meeting to discuss infant feeding and identify community assets in two English sites—one with a paid peer support service and the other volunteer‐led. Postnatally, daily contact was offered for the first 2 weeks, followed by less frequent contact until 5 months. Methods: Interviews with 21 women and focus groups/interviews with 13 IFHs were analysed using thematic and framework methods. Results: Five themes are reported highlighting that women talked positively about the antenatal meeting, mapping their network of support, receiving proactive contact from their IFH, keeping in touch using text messaging and access to local groups. The face‐to‐face antenatal visit facilitated regular text‐based communication both in pregnancy and in the early weeks after birth. Volunteer IFHs were supportive of and enthusiastic about the intervention, whereas some of the paid IFHs disliked some intervention components and struggled with the distances to travel to participants. Conclusions: This proactive community assets‐based approach with a woman‐centred focus was acceptable to women and IFHs and is a promising intervention warranting further research as to its effect on infant feeding outcomes. [ABSTRACT FROM AUTHOR]

Digital pathology – the digitalisation of clinical histopathology services through the scanning and storage of pathology slides – has opened up new possibilities for health care in recent years, particularly in the opportunities it brings for artificial intelligence (AI)‐driven research. Recognising, however, that there is little scholarly debate on the ethics of digital pathology when used for AI research, this paper summarises what it sees as four key ethical issues to consider when deploying AI infrastructures in pathology, namely, privacy, choice, equity, and trust. The themes are inspired from the authors' experience grappling with the challenge of deploying an ethical digital pathology infrastructure to support AI research as part of the National Pathology Imaging Cooperative (NPIC), a collaborative of universities, hospital trusts, and industry partners largely located across the North of England. Though focusing on the UK case, internationally, few pathology departments have gone fully digital, and so the themes developed here offer a heuristic for ethical reflection for other departments currently making a similar transition or planning to do so in the future. We conclude by promoting the need for robust public governance mechanisms in AI‐driven digital pathology. [ABSTRACT FROM AUTHOR]

Background: Engaging with the public is a key element of health research; however, little work has examined experiences of public involvement in research dissemination. The aim of this paper was to assess the extent of public involvement, experiences of public advisers and resulting changes in the dissemination of the North West Coast Household Health Survey (HHS). Methods: Three writing groups allowed public advisers to contribute to the dissemination of the HHS. A public workshop was set up to aid the co‐production of the research evidence and discuss the experiences of public advisers involved with the survey in March 2018. A focus group with public advisers was conducted in August 2018 to understand their experiences of involvement. Data were analysed using thematic analysis and coded by two researchers. Writing groups are still on‐going. Results: Fourteen public advisers contributed via three face‐to‐face writing groups, by actively interpreting findings and helping in the write‐up of research articles and by presenting talks at the public workshop. At the workshop, seven public advisors contributed to setting priorities for data analysis from the HHS. Five public advisers took part in the focus group, which highlighted that whilst public advisers were generally satisfied with their involvement, they would like to be involved in more activities. Conclusions: Members of the public shaped the dissemination of evidence and provided guidance for future steps. Public advisers were mostly positive about their involvement in the dissemination of the HHS, but highlighted the need for more transparency and support from researchers. [ABSTRACT FROM AUTHOR]

The Twins Early Development Study (TEDS) is a longitudinal study following a cohort of twins born 1994-1996 in England and Wales. Of the 13,759 families who originally consented to take part, over 10,000 families remain enrolled in the study. The current focus of TEDS is on mental health in the mid-twenties. Making use of over 25 years of genetically sensitive data, TEDS is uniquely placed to explore the longitudinal genetic and environmental influences on common mental health disorders in early adulthood. This paper outlines recent data collection efforts supporting this work, including a cohort-wide mental health assessment at age 26 and a multi-phase Covid-19 study. It will also provide an update on data linkage efforts and the Children of TEDS (CoTEDS) project. [ABSTRACT FROM AUTHOR]

In recent years, substantial changes have been implemented to the audit regimes for local authorities in several countries. Following the abolishment of the Audit Commission, a unique regime for the audit of local authorities has emerged in England, with external audit now fully conducted by private sector audit firms. Auditor appointments for the vast majority of local authorities are now managed by a new organisation, Public Sector Audit Appointments Limited (PSAA). Drawing on the determinants of audit credibility developed by Funnell, Wade and Jupe (2016), this paper examines how local authority stakeholders in the transformed landscape of local public audit in England perceive audit credibility, including the role of PSAA and other audit stakeholders. Findings show that the impact of current arrangements is positively perceived by stakeholders in relation to auditors' technical competence and independence, at least in the short term, however significant concern is found amongst stakeholders regarding the usefulness of local public audits. Compared to Funnell et al. (2016), we ascribe these differences to the different context of audit in English local government and suggest the relative weighting of determinants of audit credibility are contingent. [ABSTRACT FROM AUTHOR]

LINKED CONTENT: This article is linked to Dhanda et al papers. To view these articles, visit https://doi.org/10.1111/apt.17307 and https://doi.org/10.1111/apt.17366 [ABSTRACT FROM AUTHOR]

Drought and water scarcity pose a risk to the economy, particularly sectors where water is a crucial input to the production process. This paper describes integrated simulations of water shortages from a dynamic national water resource systems model with a static economic input‐output (I‐O) model to assess total drought risk to the economy. To quantify the economic risks of drought and water scarcity, the analysis: (a) integrates a large ensemble of simulated meteorological droughts, propagated through a national hydrological model and water resource systems model to simulate water availability from reservoirs and groundwater; (b) assesses implications of restrictions on water availability for multiple water user categories, representing natural and human contributions to water scarcity; (c) investigates how water shortages propagate into economy‐wide direct and indirect impacts. The study focuses on England and Wales where the water supply system is considered under strain, with growing recognition of the economic risk of prolonged and widespread shortages. The direct Expected Annual Loss (EAL) to water users, averaged over an ensemble equivalent to 2800 years of synthetic daily weather, is estimated to be £11.7 million in the 2011 base‐year. Accounting for indirect economic losses results in a total EAL of £30.2 million in 2011. The most severe event simulated results in a total loss of £1.4 billion in 2011, equivalent to 0.11% of GVA. The analysis provides a framework to assess what the economically efficient level of system reliability should be, and for deciding upon appropriate water management regulations and strategic investments. Key Points: Simulated water availability from a national water resource system model are integrated with a macroeconomic model to assess drought riskThe use of a large ensemble of synthetic drought simulations supports the risk‐based analysis of direct and indirect economic lossesThe method supports national economic assessment of the implications of climate change and different water management strategies [ABSTRACT FROM AUTHOR]

This paper explores the methodological aspects of a user‐led study investigating mental health service user experiences of targeted violence and abuse (often called 'hate crime'). 'Keeping Control' was a 16‐month qualitative study, undertaken in the context of adult safeguarding reforms in England. By collecting data on service user concepts and experiences, the research sought to address a gap in research and practice knowledge relating to targeted violence, abuse and hostility against people with mental health problems. In this paper, we discuss the significance of the design and methodology used for this study, with a particular focus on the interviews with service users. The research was both user‐led and carried out in collaboration with practitioners and academics, a form of research co‐production. Our aim is to inform researchers, practitioners and policymakers about the value of user leadership in co‐productive research with practitioners, particularly for a highly sensitive and potentially distressing topic. [ABSTRACT FROM AUTHOR]

Background: A new diagnosis of complex post‐traumatic stress disorder, CPTSD, has been agreed by the World Health Organization, WHO, and evidence is needed for what psychological treatment might be effective, particularly from those with experience of the disorder. We used a novel participatory approach to explore patient views and simultaneously studied the impact on the patient researchers of the research process itself. In this paper, we report on the latter section of the study how the involvement in research of patients with CPTSD affected their mental health. Symptoms of CPTSD may include emotional dysregulation, feelings of self‐worthlessness and difficulties in relationships. Objective: The aim of this study section was to explore whether patients' mental health could be promoted through empowering them to participate in research on CPTSD. Design: The study had a qualitative, participatory design. The clinician who led the research (first author) held group meetings with patient researchers to explore the impact of the research process. The clinician also kept notes on the process in a reflective log. Setting and participants: Six patient researchers participated in research with other patients with lived experience of CPTSD in an NHS outpatient unit in a London hospital. Intervention studied: The research process itself was analysed in group meetings with researchers which the clinician recorded and transcribed. Findings: Participation in research may promote increased self‐confidence and social inclusion for those with CPTSD. Conclusion: Involvement in research may be seen as an empowering intervention because patients felt it contributed to recovery. [ABSTRACT FROM AUTHOR]

Background: This paper presents an analysis of 32 narratives written by patients waiting for assessment at a transgender health clinic (THC) in England. Narratives are autobiographical free texts, designed to allow patients to describe in their own words their experiences of their gender identity and/or transition prior to a clinic appointment, as part of the assessment process. Objective: Narratives were analysed to identify actions prospective patients had taken to manage their (usually lengthy) waiting times, so that these 'coping strategies' could be shared with future patients. Design: Corpus linguistic methodology was utilized to identify common patterns across the whole corpus of text‐based data, augmented with more detailed sociolinguistic analysis of individual narratives. Results: There are broad commonalities in the way the transition experience is described across the corpus in terms of presentation of key experiences and feelings. There are specific descriptions of a number of recurring coping strategies, both positive and negative. Conclusion: The empowerment value of writing these narratives may be limited; the existence of recurring key features suggests that patients may feel they have to present their experiences in certain ways to be accepted for treatment. However, dissemination of some positive coping strategies may help future clients of THCs to better cope with waiting times, as well as assisting practitioners in THCs in supporting their patients during this wait. Patient/Public Contribution: The clinic's Service Users' Research Advisory Group contributed to formulating the objective and design of the study. Results were presented at the clinic's annual PPI conference. [ABSTRACT FROM AUTHOR]

Although breastfeeding is known to improve health, economic and environmental outcomes, breastfeeding initiation and continuation rates are low in the United Kingdom. The global WHO/UNICEF Baby Friendly Hospital Initiative (BFHI) aims to reverse declining rates of breastfeeding by shifting the culture of infant feeding care provision throughout hospital maternity settings. In the United Kingdom, the global BFHI has been adapted by UNICEF UK reflecting a paradigm shift towards the experiences of women and families using maternity services. This research used a critical ethnographic approach to explore the influence of the national UNICEF UK Baby Friendly Initiative (BFI) standards on the culture of one typical maternity service in England, over a period of 8 weeks, across four phases of data collection between 2011 and 2017. Twenty‐one staff and 26 service users were recruited and engaged in moderate‐level participant observation and/or guided interviews and conversations. Basic, organising and a final global theme emerged through thematic network analysis, describing the influence of the BFI on providing, receiving and leading infant feeding care in a hospital maternity setting. Using Antonovsky's sense of coherence construct, the findings discussed in this paper highlight how the BFI offers 'informational' (comprehensible), 'practical' (manageable) and 'emotional' (meaningful) support for both staff and service users, strengthened by effective, local leadership and a team approach. This is juxtaposed against the tensions and demands of the busy hospital maternity setting. It is recommended that ongoing infant feeding policy, practice and leadership balance relational and rational approaches for positive infant feeding care and experiences to flourish. [ABSTRACT FROM AUTHOR]

Background: The "learning health system" has been proposed to deliver better outcomes for patients and communities by analyzing routinely captured health information and feeding back results to clinical staff. This approach has been piloted in the Connected Health Cities (CHC) programme in four regions in the North of England. This paper presents the results of the evaluation of this program conducted between February and December 2018. Methods: Fifty nine semistructured interviews were completed with a mix of CHC programme staff and external partners who had contributed to the delivery of the CHC programme. Interviews were audio recorded and transcribed verbatim. This also included the review of project documentation including project reports and minutes of project group meetings, in addition to a short online survey that was completed by 31 members of CHC programme staff. Data were analyzed thematically. Results: Two overarching themes emerged through the thematic analysis of participant interview: (a) challenges in the implementation of learning health system pathways, and (b) benefits to the CHC approach for both staff and patients. In particular, time constraints in delivering an ambitious program of work, data quality, and accessibility, as well as the long‐term sustainability of the CHC programme were noted as key challenges in implementing a LHS at scale. Conclusions: The findings from this evaluation provide valuable insight into creating learning health system at scale, including the potential benefits and likely challenges. [ABSTRACT FROM AUTHOR]

As the Sendai framework recognises, understanding the nature and severity of risk is an important prerequisite to sensible risk reducing measures. The UK has been in the forefront of assessing the scale of flood risk at a national level to inform investment and policy directions but the scale of this risk, as modelled, has reduced since 2014. This paper compares the most recent modelled version of national flood risk, in the form of the Environment Agency's State of the Nation report, with loss figures quantified in terms of insurance claims data for the period 1998 to 2018. Depending on assumptions, the results show that the modelled results are between 2.06 and over 9.0 times the comparable flood losses measured in terms of the compensation paid to flood victims by insurance companies. The reasons for these differences remain unclear but several possibilities are reviewed. Many of these reasons appear implausible, but the divergence between the two sets of results should encourage the users of this data to consider carefully their assessments of the true scale of flood risk that the country faces, and perhaps promote similar comparisons in other countries. [ABSTRACT FROM AUTHOR]

Emotions such as guilt and blame are frequently reported by non-breastfeeding mothers, and fear and humiliation are experienced by breastfeeding mothers when feeding in a public context. In this paper, we present new insights into how shame-related affects, cognitions and actions are evident within breastfeeding and nonbreastfeeding women's narratives of their experiences.As part of an evaluation study of the implementation of the UNICEF UK Baby Friendly Initiative CommunityAward within two primary (community based) care trusts in North West England, 63 women with varied infant feeding experiences took part in either a focus group or an individual semi-structured interview to explore their experiences, opinions and perceptions of infant feeding. Using a framework analysis approach and drawing on Lazare's categories of shame, we consider how the nature of the event (infant feeding) and the vulnerability of the individual (mother) interact in the social context to create shame responses in some breastfeeding and non-breastfeeding mothers.Three key themes illustrate how shame is experienced and internalised through 'exposure of women's bodies and infant feeding methods', 'undermining and insufficient support' and 'perceptions of inadequate mothering'. The findings of this paper highlight how breastfeeding and non-breastfeeding women may experience judgement and condemnation in interactions with health professionals as well as within community contexts, leading to feelings of failure, inadequacy and isolation. There is a need for strategies and support that address personal, cultural, ideological and structural constraints of infant feeding. [ABSTRACT FROM AUTHOR]

Abstract: Continence is a key moment of care that can tell us about the wider care of people living with dementia within acute hospital wards. The spotlight is currently on the quality of hospital care of older people across the UK, yet concerns persist about their poor treatment, neglect, abuse, and discrimination within this setting. Thus, within hospitals, the care of people living with dementia is both a welfare issue and a human rights issue. The challenge of continence care for people living with dementia can be seen as the ‘canary in the coal mine’ for the unravelling of dignity within the acute setting. This paper draws on an ethnographic study within five hospitals in England and Wales, selected to represent a range of hospital types, geographies and socio‐economic catchments. Observational fieldwork was carried out over 154 days in acute hospitals known to admit large numbers of people living with dementia. This paper starts to fill the gap between theory and data by providing an in‐depth ethnographic analysis examining the ways in which treatment as a person is negotiated, achieved or threatened. We examine how the twin assaults on agency of a diagnosis of dementia and of incontinence threaten personhood. The acute threats to this patient group may then act to magnify perils to treatment as a person. Our findings suggest that personal dignity and the social construction of moral personhood are both threatened and maintained in such a setting. We show how empirical ethnographic data can lend weight to, and add detail to, theoretical accounts of moral personhood and dignity. [ABSTRACT FROM AUTHOR]

Flood storage involves creating sacrificial land for water to purposefully inundate to protect land downstream. Obtaining the right or co‐operation to flood on private property remains a challenge. This paper is based on empirical qualitative research with 14 key stakeholders involved in the practice of gaining land to flood in England and Wales and the different forms of financial and economic approaches that might be used to facilitate this right. Expropriation of land, one off‐payment, annual single payment, and flood event losses compensation were explored. Availability of funding as compensation is the main driver for landowner adoption of flood storage schemes. Three funding approaches were revealed; flowage easement, full land purchase, and agricultural schemes funding diffuse storage. Rather than attempting to gain partnerships between spatially dislocated stakeholders in upper storage and lower impacted catchments success resides on the storage land and persuading landowner co‐operation. A clear enforced legal framework of ownership of land and funding mechanisms is also viewed as essential. [ABSTRACT FROM AUTHOR]

Many demographic and ecological processes generate seasonal and other periodicities. Seasonality in infectious disease transmission can result from climatic forces such as temperature and humidity; variation in contact rates as a result of migration or school calendar; or temporary surges in birth rates. Seasonal drivers of acute immunizing infections can also drive longer‐term fluctuations.Tensor decomposition has been used in many disciplines to uncover dominant trends in multi‐dimensional data. We introduce tensors as a novel method for decomposing oscillatory infectious disease time series.We illustrate the reliability of the method by applying it to simulated data. We then present decompositions of measles data from England and Wales. This paper leverages simulations as well as much‐studied data to illustrate the power of tensor decomposition to uncover dominant epidemic signals as well as variation in space and time. We then use tensor decomposition to uncover new findings and demonstrate the potential power of the method for disease incidence data. In particular, we are able to distinguish between annual and biennial signals across locations and shifts in these signals over time.Tensor decomposition is able to isolate variation in disease seasonality as a result of variation in demographic rates. The method allows us to discern variation in the strength of such signals by space and population size. Tensors provide an opportunity for a concise approach to uncovering heterogeneity in disease transmission across space and time in large datasets. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Multicomponent injection molding often combines a stiff thermoplastic material with a thermoplastic elastomer or thermoplastic vulcanite. Recently, for high‐demanding applications, a novel process has been developed to replace these thermoplastic elastomers or vulcanite with a thermoset rubber, for example, NBR or EPDM. One of the most important properties of a two component product is an adequate adhesion between both components. This paper describes a method, which combines experiments and numerical simulations to predict the adhesion strength between a thermoplastic, semicrystalline HDPE, and an EPDM thermoset rubber. This method uses numerical simulations of the interfacial temperature and the local degree of cure. The local interface temperature is combined with the results of DSC measurements to predict the degree of melting, subsequently linked to the ability to develop adhesive strength. The degree of cure is used to determine the local rubber strength. The combination of the given data will be used to predict interfacial strength. The results obtained by proposed numerical strategy have been successfully validated with experimental data on a simple plate product. POLYM. ENG. SCI., 59:1489–1498 2019. © 2019 Society of Plastics Engineers [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ultrasound in Obstetrics & Gynecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Plain Language Summary: Nearly synchronous global changes in geomagnetic polarity give both a detailed irregular pacing to geological time and provide a glimpse into heat transfer processes across the core—mantle boundary which drives the Earth's geodynamo. Although the Late Carboniferous is characterized by some well‐studied reversals, details of the tempo of polarity changes in the Early Carboniferous are unknown. This work addresses this by providing a detailed record of polarity changes over a ∼2 million year interval at around 334.5–332.5 million years ago‐from the Trowbarrow Quarry section in NW England. We demonstrate that these limestones likely preserve magnetization from close to their time of formation and record at least 31 polarity reversals. These observations support the idea that the Earth's dynamo was in a hyperactive reversing state similar to those sustained for tens of Myr in the Late Jurassic, parts of the Cambrian and the Late Ediacaran. It further corroborates a ∼200 Myr cyclicity in paleomagnetic field behavior since the Precambrian, potentially linked to variable core heat flow forced by mantle convection. The pattern of geomagnetic polarity changes during the Early Carboniferous (Mississippian) is not known in detail. This information sparsity is addressed by determining a magnetostratigraphy from the late Asbian (late Visean at ∼333 Ma) in Trowbarrow Quarry, UK. This is the stratotype section of the late Asbian and has a detailed foraminiferal zonation based on the same set of paleomagnetic samples, establishing a detailed biostratigraphy. The 195 m‐thick section was sampled at an average spacing of 1.1 m, yielding a detailed magnetostratigraphy comprising nine major magnetozone couplets, and seven submagnetozones. The section dataset has a 78% bias to normal polarity determined from 177 sampling levels. The magnetization is carried by a mixture of hematite and detrital magnetite, with 68% of specimens dominated by hematite magnetizations. The primary magnetization passes a fold test showing its age was prior to the latest Carboniferous. The hematite is inferred to be largely of detrital, eolian origin, although some reddened levels are associated with emergent surfaces, suggesting that a small fraction of hematite is associated with platform emergence. The Mississippian age magnetization is partly overprinted with Kiaman Superchron‐age and Brunhes‐age magnetizations. Using the duration of the section based on astrochronology indicates a reversal frequency of 15.7 ± 0.75 Myr−1, indicating that the geodynamo was in a hyperactive reversing state between 335 and 333 Ma. Key Points: A 195 m section, representing ∼2 Myr, yields a magnetostratigraphy comprizing nine major magnetozone couplets and seven submagnetozonesPrimary magnetizations are predominantly carried by hematite with lesser important detrital magnetite. Data pass regional fold testsA reversal frequency of 15.7 ± 0.75 Myr−1 is calculated, suggesting that the geodynamo was in a hyperactive state at ∼333 Ma [ABSTRACT FROM AUTHOR]

Background and Aim: Long Covid is often stigmatised, particularly in people who are disadvantaged within society. This may prevent them from seeking help and could lead to widening health inequalities. This coproduced study with a Community Advisory Board (CAB) of people with Long Covid aimed to understand healthcare and wider barriers and stigma experienced by people with probable Long Covid. Methods: An active case finding approach was employed to find adults with probable, but not yet clinically diagnosed, Long Covid in two localities in London (Camden and Merton) and Derbyshire, England. Interviews explored the barriers to care and the stigma faced by participants and were analysed thematically. This study forms part of the STIMULATE‐ICP Collaboration. Findings: Twenty‐three interviews were completed. Participants reported limited awareness of what Long Covid is and the available pathways to management. There was considerable self‐doubt among participants, sometimes reinforced by interactions with healthcare professionals (HCPs). Participants questioned their deservedness in seeking healthcare support for their symptoms. Hesitancy to engage with healthcare services was motivated by fear of needing more investigation and concerns regarding judgement about the ability to carry out caregiving responsibilities. It was also motivated by the complexity of the clinical presentation and fear of all symptoms being attributed to poor mental health. Participants also reported trying to avoid overburdening the health system. These difficulties were compounded by experiences of stigma and discrimination. The emerging themes reaffirmed a framework of epistemic injustice in relation to Long Covid, where creating, interpreting and conveying knowledge has varied credibility based on the teller's identity characteristics and/or the level of their interpretive resources. Conclusion: We have codeveloped recommendations based on the findings. These include early signposting to services, dedicating protected time to listening to people with Long Covid, providing a holistic approach in care pathways, and working to mitigate stigma. Regardless of the diagnosis, people experiencing new symptoms must be encouraged to seek timely medical help. Clear public health messaging is needed among communities already disadvantaged by epistemic injustice to raise awareness of Long Covid, and to share stories that encourage seeking care and to illustrate the adverse effects of stigma. Patient or Public Contribution: This study was coproduced with a CAB made up of 23 members including HCPs, people with lived experience of Long Covid and other stakeholders. [ABSTRACT FROM AUTHOR]

Introduction: In the United Kingdom, fractures of the cervical dens process in older and/or frail patients are usually managed nonsurgically in a hard collar. However, hard collars can lead to complications and this management approach is now being questioned, with growing interest in maximising patients' short‐term quality‐of‐life. It is vital that patients' perspectives are considered; yet, there is a dearth of literature examining the aspect. To help inform wider decision‐making about use of collar/no collar management of dens fractures in older/frail people, we explored older/frail people's experience of the two management approaches and how they affected their perceived quality‐of‐life. Methods: We interviewed older and/or frail adults with a recent dens fracture (aged ≥65 years or with a clinical frailty score of ≥5) or their caregiver. Participants were recruited from both arms of a clinical trial comparing management using a hard collar for 12 weeks (SM) with early removal of the collar (ERC) and were interviewed following randomisation and again, 12–16 weeks later. Data were analysed using a framework approach. Results: Both participant groups (SM/ERC) reported substantial, negative quality‐of‐life (QoL) experiences, with the fall itself and lack of access to care services and information being frequent major contributory factors. Many negative experiences cut across both participant groups, including pain, fatigue, diminished autonomy and reduced involvement in personally meaningful activities. However, we identified some subtle, yet discernible, ways in which using SM/ERC reinforced or alleviated (negative) QoL impacts, with the perceived benefits/burdens to using SM/ERC varying between different individuals. Conclusion: Study findings can be used to support informed decision‐making about SM/ERC management of dens fractures in older/frail patients. Patient or Public Contribution: Public and patient involvement contributors were involved in the study design, development of interview topic guides and interpretation of study findings. [ABSTRACT FROM AUTHOR]

Introduction: Problem‐solving skills (PSS) help to provide a systematic approach to dealing with and managing complex problems. The overall aim of this study was to assess the acceptability and feasibility of developing and adapting a prison‐based PSS workbook for adults within a medium‐ and low‐secure hospital. Method: We used the Medical Research Council framework in our participatory mixed methods study incorporating an adapted survey (to identify what types of problems people experience in secure hospitals), a series of three interactive workshops (to co‐produce two case study examples for a workbook) and we gathered feedback from patients and hospital staff on the acceptability and feasibility of the workbook. Data from the survey were used to inform the case study examples, and the feedback from patients and hospital staff was descriptively summarised and the results consolidated. Results: In total, 82 (51%) patients took part in the survey; 22 patients and 49 hospital staff provided feedback on the workbook. The survey results indicated that patients regularly experience problems while in the hospital. Patients reported problems relating to restrictions of freedom and boredom. The workshops produced two case studies for the workbooks, with mainly positive patient and staff feedback. More work is required to improve the visual representation of the characters in the case studies, the amount and content of the language and the mechanism of the intervention delivery. Conclusion: The adaptation process proved acceptable and feasible to both patients and staff. The co‐production methodology for the workbook and feedback from patients and staff was an effective way of iteratively refining the materials to ensure that they were both meaningful and acceptable to staff and patients. Subsequent work is required to develop the workbook and evaluate the feasibility of the intervention delivery, recruitment rates, uptake and adherence to the PSS using a randomised controlled trial. Patient or Public Contribution: At each stage of the project consultation with patients and/or hospital staff was involved. [ABSTRACT FROM AUTHOR]

Women with obesity during pregnancy are at increased risk of excessive gestational weight gain (GWG) and other maternal and infant adverse outcomes, which all potentially increase childhood obesity. This study explored infant weight outcomes for women with a body mass index (BMI) ≥ 35 kg/m² who were offered an antenatal healthy lifestyle service. A retrospective cohort study, including linking data from two separate health care Trusts, was undertaken. Data were collected from maternity records for women with a BMI ≥ 35 kg/m2 referred to an antenatal healthy lifestyle service from 2009 to 2015. The respective child's weight outcome data was additionally collected from health and National Child Measurement Programme records. Univariate logistic regression determined the odds of childhood overweight, obesity and severe obesity according to attendance at the antenatal healthy lifestyle service, GWG and sociodemographic characteristics. Factors significant (p < 0.05) within the univariate analysis were entered into multiple logistic regression models. Among women with a BMI ≥ 35 kg/m², 30.4% of their children were obese at school entry and 13.3% severely obese. Healthy lifestyle service attendance was not associated with childhood overweight or obesity at any point within the univariate analysis. At school age multiple regression analysis showed the odds of overweight and obesity increased with excessive GWG and the odds of obesity decreased with a parent in a professional occupation, additionally having a mother who smoked in pregnancy increased severe obesity. Women should be supported to optimise their BMI before pregnancy. Additionally, rather than exclusively focusing on changing an individual's behaviour, future interventions should consider external influences such as the woman's family, friends and sociodemographic background. Key messages: Among children born to women with a body mass index (BMI) ≥ 35 kg/m2 almost 50% were classified as overweight or obese at age 5. Of these, only 15.6% had been born large for gestational age.This brief antenatal healthy lifestyle intervention provided to mothers with obesity did not significantly reduce child's overweight or obesity.Demographic factors such as household occupation and maternal smoking during pregnancy were associated with long‐term childhood obesity.More emphasis is required on interventions that support women to optimise their BMI before pregnancy.Future interventions should consider external influences on the woman for example through a socioecological framework. [ABSTRACT FROM AUTHOR]

Hybridization among related species is now recognized as common but it remains unclear how hybrid zones persist for prolonged periods. Here, we test the hypothesis that selection in different components of the life cycle may stabilize a hybrid zone. A hybrid zone occurs in southwest England between the marine mussels Mytilus edulis and M. galloprovincialis. Previous studies have found strong directional selection against alleles from M. edulis occurs among hybrids in the adult stage. Traditional hybrid zone models argue that alleles that are selected within the hybrid zone are replaced by migration from neighboring parental population into the hybrid zone. In this system, however, migration occurs out of this hybrid zone into neighboring parental populations. This hybrid zone should therefore be unstable and dissipate, yet this zone has persisted for more than 30 years. We tested and rejected the hypothesis that differences in fecundity may select for M. edulis alleles within this hybrid zone and thus counter the selection observed against these alleles among adults. We also tested the hypothesis that selection during the larval stage may counter selection against M. edulis alleles in the adult stage. We found that selection favors M. edulis alleles during the veliger stage of larval development. The direction and strength of selection during the larval stage are sufficient to counter strong selection during the adult portion of the life cycle. This hybrid zone is stabilized by opposing forms of directional selection operating in different portions of the life cycle. [ABSTRACT FROM AUTHOR]