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The objective of the research is to explore the aim, application and strategy perceived as important in the development of an outbound open innovation policy for exploitation of intellectual creation, design and creativity in Malaysian public universities (MPUs). Under existing intellectual property, innovation and commercialization policies, a large portion of intellectual design, creation and creativity in MPUs remain unexploited. Hence, the need to develop a new set of aim, application and strategy to promote the exploitation of intellectual design, creation and creativity in MPUs. The research conducts a survey involving respondents representing the Technology Licensing Office of 15 MPUs. The research also analysed outbound open innovation policies from five universities in Australia, UK, US and South Africa. These policies provide the basis in the development of the survey instrument of the research. The survey instrument contains nine items outlining the aim, application and strategy for exploitation of an outbound open innovation policy. The survey findings indicate that eight of the items are perceived as important for the development of the policy. The findings of the survey provide a beneficial input for the development of an outbound open innovation policy for exploitation of intellectual design, creation and creativity in MPU.

Language teaching is a profession which is international in character. Language teachers often work and study in foreign countries, and distance education has become very important in the education of language teachers. Drawing on two international surveys, this paper explores language teacher education by distance from the perspective of students (i.e. trainee or practicing language teachers) and teacher-educators in such distance programs. There are significant educational advantages for language teachers who choose to study by distance, and e-learning technologies have enhanced these benefits. This paper also includes an in-depth analysis of the qualitative survey responses from two individual students, highlighting an individualized perspective on the data that complements the "collective" analysis, and provides additional insights into how student experiences of such programs can vary widely, and how such disparities may be addressed.

There is an urgent need to improve elementary and secondary school classroom practices across India and the scale of this challenge is argued to demand new approaches to teacher professional learning. Massive Open Online Courses (MOOCs) represent one such approach and one that, in the context of this study, is considered to provide a means by which to transcend traditional training processes and disrupt conventional pedagogic practices. This paper offers a critical review of a large-scale MOOC deployed in English, and then in Hindi, to support targeted sustainable capacity building within an education development initiative (TESS-India) across seven states in India. The study draws on multiple sources of participant data to identify and examine features, which stimulated a buzz around the MOOCs, leading to over 40,000 registrations and a completion rate of approximately 50% for each of the two MOOCs.

Background: The decline of young people's wellbeing in the UK and elsewhere has become an increasing focus for attention. In this context, it is encouraging to note some evidence suggesting that participation in extracurricular activities may have potential to improve wellbeing. However, the considerable conceptual and methodological challenges involved in the measurement of constructs within this non-traditional assessment domain should be recognised. Purpose: Against this backdrop, we report on the development of a survey to measure the contribution of taking part in extracurricular activities on young people's subjective wellbeing and associated soft skills. Methods: Participants (N = 4,638) were a sample of young people enrolled in a well-known extracurricular award programme in the UK: The Duke of Edinburgh's Award (DofE). They completed a self-report survey which had been developed to address key areas relevant to the DofE and wellbeing, such as: resilience and overcoming adversity, confidence and self-esteem, and working with others and communication. Data were analysed quantitatively. Findings: Factor analysis confirmed a reliable three-factor structure of the measure, which produced patterns of results comparable to existing research on wellbeing. The identified factors were 'General Wellbeing', 'Resilience and Confidence', and 'Communication (including Leadership and Teamwork)'. Participants largely reported that taking part in DofE activities had improved their wellbeing through increasing confidence, responsibility and their ability to face challenges. Conclusions: We suggest that both the survey outlined here and the process of development could be used to facilitate more reliable and valid measurements of wellbeing and related soft skills outside of traditional classroom settings. The findings, whilst relating here specifically to the DofE in the UK, will be of interest to policymakers, school leaders and educators internationally who are considering what young people need to build and maintain wellbeing, and thus thrive in life.

In the past decades, income inequality has risen in most developed countries. There is growing interest among economists in international comparisons of economic and educational mobility. This is aided by the availability of internationally comparable, large-scale data. The present paper aims to make three contributions. First, we introduce the Japan Child Panel Survey (JCPS), the first longitudinal survey of school-age children that includes cognitive and non-cognitive measures, and plentiful household information. The JCPS was developed to measure dynamic inter-relationships among children's academic and social outcomes, their family background, and local policy and environment, in a way that allows comparison of the results with international data. Second, based on JCPS data, we present selected results of the dynamics of inequality in multiple indicators of children's educational and behavioral outcomes. We found that changes in cognitive achievement across parental income groups, the degree of mobility of cognitive test scores, and the correlation between the difficulty score and parental education in Japan are similar to those of other countries, such as the United States, United Kingdom, Australia, and Germany. Finally we discuss issues underlying the globalization of education research based on our experiences with the JCPS. We discuss reasons and strategies for further globalization of education research in Japan, and propose suggestions as to how Japanese education research can move toward better international collaboration, particularly in research on economic and educational mobility.

In the media literacy literature, the challenges associated with assessment have, to a great extent, been ignored. The purpose of this mixed methods study was therefore to explore the views of media literacy scholars and professionals on assessment challenges through qualitative interviews (n = 10) with the intent of using this information to develop a quantitative survey to validate and extend the qualitative findings with a larger sample of media literacy professionals and scholars from around the world (n = 133). The findings offer an overview of the assessment challenges encountered by these participants.

This study examines the factors influencing student teachers' use of information and communication technology (ICT) to teach mathematics. Data collection involved questionnaire surveys and individual follow-up semi-structured interviews of student teachers concerning the factors that they felt had hindered or promoted their development in the use of ICT. This study shows that this particular group of student teachers is committed to using ICT in their teaching; they are mostly confident and mostly believe in the value of ICT in mathematics teaching. However, findings indicate that the barriers inhibiting the student teachers' use relate to poor access to facilities, limited encouragement from mentors and the other teachers in mathematics department and irregular use of ICT of existing teachers in teaching, lack of links in the scheme of work, and time constraint.

The University of Warwick's FutureLearn MOOC "Literature and Mental Health: Reading for Wellbeing," which began its first presentation February 2016, was identified as an opportunity to conduct some research into the course subject area, "reading for wellbeing" or "bibliotherapy". Since 2013, a substantial body of literature has emerged in the field of MOOC-related research, with the MOOC becoming both the subject of and vehicle for research. The research approach adopted in "Literature and Mental Health" was influenced by other, recent research studies conducted within MOOCs, and particularly by the first presentation of Monash University's "Mindfulness for Wellbeing and Peak Performance" FutureLearn MOOC, which distributed a stress survey to its learners in the first and final weeks of the course, to assess the efficacy of the course's mindfulness practices. A number of reasons for trialling the use of this MOOC as a research tool were identified at the project's outset. MOOCs give researchers access to large numbers of possible research participants, making MOOC research an attractive prospect, while the opportunity to gather valuable, potentially publishable data from free online courses may help to justify the time and resources expended during the production of new MOOCs. Several additional benefits of in-MOOC research were discovered during the process, including the potential for research activities to enrich the learner experience. However, a number of challenges and limitations were also encountered during the development of the study; the inevitable self-selection bias among MOOC learners, and the difficulty of establishing a control group within the MOOC activities, posed impediments to the gathering of useful, publishable data. Although we were aware of other MOOCs which had been used as vehicles for research, the process of adapting "Literature and Mental Health" for this research study was nonetheless an illuminating and instructive experience. The purpose of this paper is to reflect on that experience, and to consider the lessons learned during the process which may be useful in informing future research studies conducted via Massive Open Online Courses.

In this paper, I examine whether generalized trust and education, as well as social security policies of welfare state institutions matter for cross-national differences in subjective well-being (SWB), because knowledge on this issue is still lacking. For this purpose I integrated the insights of two sociological theories: Social Function Production theory and Actor-Centred Institutionalism. Based on these theoretical notions we derived several hypotheses, which I tested using multilevel analysis of the data from the European Social Survey (2006), in a sample of 37,237 respondents from 22 European countries. My findings indicate that various extensiveness of social security policies matter for the level of SWB, and for the impact of education on SWB. I found negative impact of low education on SWB in all countries, except in Northern and Western European countries. This might suggest that social security policies of the latter countries have diminished the negative impact of low education on SWB. Moreover, my findings indicate positive relationship between individual education and generalized trust; as well as between generalized trust and SWB in countries with all five types of social security policies.

Learners were separated into groups representing the interests of parties that typically negotiate environmental affairs in real world scenarios (conservationists, scientists, politicians, NGOs, stakeholders), and tasked with preparing role-play simulations using a variety of flipped learning techniques. Learners' carbon footprints were monitored pre and post intervention, and CO2 emission scores were used as a proxy for their behaviour towards the environment. Five role-play simulations were run overall. These were integrated with case studies associated with fisheries issues, and climate change. Anonymous participant surveys indicated that learners responded positively to the intervention, and participants' CO[subscript 2] emission scores improved significantly (T[subscript 1,59] = 2.723, p = 0.009). In the context of environmental sciences, learners that engage in the integrated role-play and case study approach may benefit from flipped learning techniques to prepare their simulations, and gain confidence from self-actualizing moments of achievement when they realize an improvement in their environmental behaviour.

With an increasing number of young people across the Gulf States now having access to the internet, the online safety of these adolescents is of concern. In a survey of 115 adolescents from the Gulf States, it was found that, although there are many benefits to young people, the risks of online usage are not fully understood by teenagers or their parents. Perceptions of ways to keep safe online may be articulated, but the online behaviour of many youngsters seems to be at variance with their responses. The more sophisticated UK youngsters differ somewhat in their usage and this may be a path that Gulf adolescents take in future, therefore lessons may be learnt from the UK and other countries with longer online experiences.

A number of recent surveys of public opinion claim that there is now widespread acceptance of the need for sustainable development, and that the general public, through its social and consumer activity is already successfully engaged. However, in all this, the focus has primarily been on individual and family behaviours such as recycling and reducing energy use. Such surveys do not focus on the increasingly common community-based and social movements which operate in more complex, intractable, and inevitably political, arenas where shifts in government policy and funding, and business values and practice, are the goal. It is not just consumer surveys that have these blind spots; much education practice exhibits it too. Formal and informal education have followed a similar pattern by focusing on individual actions rather than more strategic, and overtly political, developing a coherent social movement around sustainability. Pressure groups campaign for changes in the curriculum, but what is missing is a systematic engagement in the community by formal education, and by researchers. As society gradually "learns its way forward", shifting its values, norms, beliefs, and strategies towards a more sustainable model of development, it offers an array of opportunities for learners of all ages to witness, critique, be inspired by and become a part of the changes taking place around them. If we are fully to understand the effectiveness of such community-based programmes and initiatives, and help these grow and develop, then educators and educational researchers need to be much more intimately involved than they currently are.

Conole and Alevizou's social media typology (Conole and Alevizou, 2010) includes amongst its ten categories: media sharing; conversational arenas and chat; social networking and blogging. These are all media with which language learners are increasingly engaging (Lamy and Zourou, 2013). Social networking tools, in particular, which encourage informal, social communication have been identified as suitable for supporting language learning and their use is growing quickly. This paper reviews research on using social media for informal language learning. It will then discuss a small qualitative case study of Welsh learners' practices in using such resources. Welsh is a minority UK language spoken by around a fifth of the population of Wales. Unlike a majority language there is no need for English speakers in Wales to learn Welsh in order to communicate with Welsh speakers as all UK Welsh speakers are bilingual. Nevertheless there is great interest among adults in Wales and from Welsh families across the UK in learning Welsh. However there are two particular challenges: the small numbers of speakers (around 611,000), and their very uneven distribution. These two factors make it difficult for learners outside Welsh speaking "hotspots" to hear and practice Welsh. Social media has the potential to support Welsh language learning by providing resources wherever the learner is (particularly if they live in a non-Welsh speaking area or outside Wales completely) and by supporting web-based learning communities. The study reported here is concerned with the extent to which this potential is being exploited in practice. It employed interviews and a small survey to study the practices of learners at all stages of their language learning. It was found that learners used social media widely but those at different stages used social media somewhat differently, with beginners browsing to make contacts and gather information, listening to the language and watching Welsh programmes via the internet whilst some advanced learners set up practice groups, lead sub-communities and source and provide resources both on- and off-line.

This study was conducted to designing a model of vocational training programs for disables. For this purpose desk review was carried out and the vocational training models/programs of Israel, U.K., Vietnam, Japan and Thailand were analyzed to form a conceptual framework of the model. Keeping in view the local conditions/requirements a model of vocational training program was proposed. The proposed model involved the vocational training [VT] plan for the job of cashier for mild group, receptionist for moderate and computer operator for severe group. It specified the type of disability as well involved in the training plan. The model recommended the vocational training of three levels of disability; mild, moderate and severe irrespective to the type. The model consisted of details of structure, objectives, professional support involved, vocational training plan and syllabus/activities, evaluation and on job training, etc. International practices regarding VT mixed with the national existing situations were critically analyzed during desk review and finally a plan of VT for disables was proposed. A survey was conducted via a questionnaire to get opinion of the heads and senior vocational instructors of Federal Government vocational training and rehabilitation centers for PWDs. The collected data was statistically analyzed to quantify the suggestions on proposed model. The major findings included that all stakeholders considered VT helpful in rehabilitation of PWDs. All heads and vocational instructors are willing to adopt this model, minimum or no extra funds are needed in its implementation, the vocational teacher employed in the centers can easily manage to adopt this model at their centers because no extra training is required for the staff and they all endorse the VT plan proposed in this model. A vocational training model is required to reduce socio-economic gap and to set professional standards by developing human resources trained in trades. The syllabus, activities and methodology proposed for the vocational training of the students at special education centers for the disables was agreed upon by the experts. It was recommended that vocational training model on various jobs for specific disabilities may be developed. Vocational training model for after school youth may also be developed on similar pattern. It was recommended that vocational training must be implemented through ODL for the training of PWDs in acquiring vocational skills if there is no vocational skill training teacher or resources available at the centers. In this way a large number of individuals who are taking education at special education centers and institutions can take benefits from VET [vocational education and training] programs at a time with minimal cost provided at their door steps or at institutions.

Digital badging as a trend in education is now recognised. It offers a way to reward and motivate, providing evidence of skills and achievements. Badged Open Courses (BOCs) were piloted by The Open University (OU) in 2013. The project built on research into the motivations and profiles of learners using free educational resources which the OU makes available through its OpenLearn platform (Law, Perryman & Law, 2013). This research found that an increasing proportion of learners are keen to have their informal learning achievements recognised (Law & Law, 2014). Based on these data, a suite of free BOCs, assessed through the deployment of Moodle quizzes, was launched. This paper reports on evaluation of the BOCs and what we now know of the strategic importance of informal learning recognition. The initiative aligns with University strategies to provide accessible routes into formal learning for those who might not otherwise have the opportunity.

This paper explores experiences at the interface of research and policy through the lens of informal learning. The paper contends that in order to further social justice it is essential to value the informal learning that takes place outside the confines of educational institutions. However, it also demonstrates the difficulties in getting policymakers to take this issue seriously. Formal education, in its fixity around the neo-liberal human subject, will inevitably reproduce the values and assumptions that have created an unequal society in the first place. To achieve social change, what constitutes learning and where and how it happens must be rethought. The paper reflects on three research studies--two achieved, one imagined--which help to reveal the extent and nature of young white working-class informal learning. These findings challenge their positioning as abject, deficit and hating learning. It discusses the policy interest in these studies and the current move of white working-class masculinity to the centre of political debate. It argues that despite the nominal attention to such working-class lives, their informal learning was and is deflected and ignored by policymakers. It is not a question of educating policymakers better, but that policy actively chooses this blinkered stance because a shadow body of unrecognised informal learners helps to shore up the status of their privileged qualified peers. The paper concludes that rather than pursuing familiar research pathways, partnership working and micro levels of research combined with alternative forms of communication and agitation may better serve to support young people's "own" fight for social justice.

Mobile and participatory cultures have led to widespread change in the way we communicate; emphasizing user generated content and digital multimedia. In this environment, informal learning may occur through digital and networked activities, with literacy no longer limited to alphabetic and character-based texts. This article explores adult learners' new literacies within the context of a digital mobile storytelling project. A qualitative approach is used to explore the artifacts and practices of nine adult participants who comprise the study. Participants created a range of fiction, non-fiction, poetry and diary-style content in a variety of modes and media. Outcomes from content analysis, interview and survey methods depict mobile digital literacies as characteristically situated, experiential and multimodal. The mobile and participatory nature of this project was catalytic to participants' imaginative re-interpretation of the world around them as sources for meaning making and transformation. This paper contributes a case example of mobile learning with adults in a community setting.

Although the importance of self-esteem in educational achievement is contested, it remains a significant touchstone of multicultural religious education. This study set out to establish differences in demographics and attitudes between high self-esteem and low self-esteem Buddhist teenagers who are a small religious minority in Britain. Low self-esteem teens expressed less well-being, more worry in relationships with their family and friends, low motivation in school, more supernatural beliefs, more introversion, felt Buddhism irrelevant and used the internet more. Self-esteem was not linked to religious values or environmental concern. Narrow focus on self-esteem as an educational aim risks the known weaknesses of multiculturalism that have since been overcome in pluralist education. The limited usefulness of the self-esteem concept does however reveal ways forward for teachers of minority education, introverts and sustainability.

Access to current research materials, pedagogical best practices, and relevant knowledge has become problematic as journal subscription costs have increased. Increasing delays in the traditional publication timeline, coupled with high subscription costs, have resulted in a diminished ability for IS faculty and their students to access the most relevant research in a timely manner, an issue felt most acutely in developing nations. As IS educators seeks to increase the dissemination of their work and ensure that students have the most updated knowledge, one option is publishing in open-access (OA) journals. However, a lack of knowledge, inconsistent quality perceptions, the presence of predatory journals, and publication fees have negatively affected IS researchers' support for OA publishing. This study surveyed 68 IS scholars and found that IS scholars do not publish in OA journals due to concerns about fees, quality, prestige, and impact factors. This study found more similarities than differences between junior- and senior-level IS scholars, with junior faculty members placing more emphasis on the speed of publication than their senior colleagues do. By understanding the underlying reasons that IS faculty are favoring OA options, the study hopes to shed light on the reliance on traditional journal publication models that restrict the distribution of intellectual property. If the OA approach were embraced by more journals, IS faculty members and their students benefit through expeditious access to relevant content to support faculty professional development, instruction, and research.

This study examines the effects of different cigarette package warnings in Australia, Canada and the United Kingdom up to 5 years post-implementation. The data came from the International Tobacco Control Surveys. Measures included salience of warnings, cognitive responses, forgoing cigarettes and avoiding warnings. Although salience of the UK warnings was higher than the Australian and Canadian pictorial warnings, this did not lead to greater levels of cognitive reactions, forgoing or avoiding. There was no difference in ratings between the Australian and UK warnings for cognitive responses and forgoing, but the Canadian warnings were responded to more strongly. Avoidance of the Australian warnings was greater than to UK ones, but less than to the Canadian warnings. The impact of warnings declined over time in all three countries. Declines were comparable between Australia and the United Kingdom on all measures except avoiding, where Australia had a greater rate of decline; and for salience where the decline was slower in Canada. Having two rotating sets of warnings does not appear to reduce wear-out over a single set of warnings. Warning size may be more important than warning type in preventing wear-out, although both probably contribute interactively.

Background: Sickle cell disease (SCD), a genetic blood disorder that affects red blood cells and oxygen delivery to body tissues, is characterized by haemolytic anaemia, pain episodes, fatigue, and end-organ damage with acute and chronic dimensions. Caring for patients with SCD imposes a high burden on informal caregivers. This study aims to capture the impact on health-related quality of life (HRQoL) and economic burden of caregiving for patients with SCD. Methods: Validated instruments of HRQoL (EQ-5D-5L, Carer Quality of Life-7 dimensions [CarerQol-7D]) and productivity (Work Productivity and Activity Impairment Questionnaire: Specific Health Problem [WPAI: SHP]) were administered via a cross-sectional online survey to caregivers in the United Kingdom (UK) and France. Demographics, HRQoL, and economic burden data were analyzed using descriptive statistics. Economic burden was determined using country-specific minimum and average wage values. Subgroup analysis examined caregivers with and without SCD. Results: Sixty-nine caregivers were recruited (UK, 43; France, 26), 83% were female, and 22% had SCD themselves. The mean (SD) caregiver EQ-5D-5L score was 0.66 (0.28) (UK, 0.62; France, 0.73), and the mean CarerQol-7D score was 80.69 (24.40) (UK, 78.72 [25.79]; France, 83.97 [22.01]). Mental health problems were reported in 72% and 70% of caregivers measured using the EQ-5D-5L and CarerQol-7D, respectively. Financial problems were reported by 68% of caregivers, with mean annual minimum wage productivity losses of £4209 and €3485, increasing to £5391 and €9319 for average wages. Sensitivity analysis determined additional HRQoL decrements for caregivers with and without, SCD. Conclusion: Caring for patients with SCD impacts the HRQoL and economic burden of caregivers. Further research to support the complex needs of SCD caregivers is required. Plain English summary: Caregivers play an important role in the lives of the people with sickle cell disease that they care for; however, their mental and physical health and their finances can be affected, particularly if their ability to work is impacted. The extent to which caring for a person with sickle cell disease impacts caregivers is not fully understood. In this study, 69 caregivers of a family member, partner, or friend with sickle cell disease in the United Kingdom or France completed an online survey to share their experiences about how caring for someone with sickle cell disease can impact a caregiver's quality of life and financial well-being. Caregiving negatively affected the quality of life of caregivers compared with people in the general population and caused a large financial and social burden. Around 70% of caregivers reported having mental health problems, 68% reported financial problems, and lost work hours and lost income were not uncommon. More research is needed to understand the specific needs of caregivers of people with sickle cell disease and how best to support them. [ABSTRACT FROM AUTHOR]

Background: Care home staff are key providers of palliative and end-of-life care. Yet, little is known about how care home characteristics can influence care leader's confidence in their ability to provide optimal palliative and end-of-life care. Aim: To understand the influence of care home registration type (nursing, residential or dual registered) and size on senior care leader's confidence to provide palliative and end-of-life care. Design: An explanatory sequential mixed methods study comprising an online cross-sectional survey (including the Palliative Care Self-Efficacy Scale) and qualitative individual interviews. Analysis of survey data used a multivariate logistic regression and qualitative interview data used Framework Analysis. A 'Following the Thread' method was undertaken for data integration. Setting/participants: UK care home senior care leaders, purposively sampled by registration type, size and geographical location. Results: The online survey (N = 107) results indicated that nursing home senior care leaders had higher confidence scores on the Palliative Care Self-Efficacy Scale than residential care home leaders (aOR: 3.85, 95% CI 1.20-12.31, p = 0.02). Care home size did not show effect when adjusting for registration type (medium - aOR 1.71, 95% CI 0.59–4.97, p = 0.33; large – aOR 0.65, 95% CI 0.18–2.30, p = 0.5). Interviews (n = 27) identified three themes that promote confidence, (1) 'feelings of preparedness' stemming from staff expertise and experience and care home infrastructure, (2) 'partnership working' with external services as a valued member of the multidisciplinary team, and (3) a shared language developed from end-of-life care guidance. Conclusion: Care home senior care leader's confidence is influenced by care home characteristics, particularly availability of on-site registered nurses and the infrastructure of large care homes. All care home leaders benefit from training, working with external, multidisciplinary teams and use of guidance. However, mechanisms to achieve this differed by care home type and size. Further exploration is needed on successful integration of palliative care services and interventions to enhance confidence in residential care homes. [ABSTRACT FROM AUTHOR]

Background: Cold water swimming is growing in popularity, especially among women. We have previously reported that women felt that cold water swimming helps with their menstrual and menopause symptoms. But little is known about the habits of women who cold water swim. Objectives: To determine the habits of women who cold water swim. Design: This was a mixed-methods study. Methods: An online survey asked women who cold water swim about their experience of swimming and how this affected their menstrual and menopause symptoms. The survey was advertised for 2 months on social media, with a focus on advertising in cold water swimming Facebook groups. In this article, only the questions on the women's swimming habits were analyzed. Results: The analysis of 1114 women, mainly from the United Kingdom, revealed that most had been swimming for 1–5 years (79.5%). Most swim in the sea (64.4%), and only 15.5% swim alone. The majority (89.0%) swim all year around, swimming for mainly 30–60 min in the summer and 5–15 min in the winter. The women mostly swim wearing swimming costumes (skins) throughout the year. The majority of the free-text responses showed women found mental and physical benefits from cold water swimming. Conclusion: It was not surprising to learn that women swim for longer in the summer than the winter, but hearing how they feel cold water swimming helps their physical and mental health is important. With the limitations on access and safety of many wild swimming sites in the United Kingdom, it is time to ensure that cold water swimming is safer and more supported. [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhoea, or period pain, is a prevalent gynaecological condition that can result in functional interference during menstruation. Despite the significant disruption dysmenorrhoea can have on functioning and well-being, medical help-seeking rates are low. Little is known about what factors may predict help-seeking for dysmenorrhoea. Objectives: The current study aimed to test the predictive validity of the Behavioural Model of Health Services Use (BMHSU) for help-seeking behaviour in dysmenorrhoea, whereby help-seeking behaviour was operationalised as having attended to a healthcare professional for dysmenorrhoea-related care. Design: A cross-sectional observational design was used. Methods: Participants (N = 439) completed an online survey, which measured the following eight predictor variables: menstrual pain characteristics, health beliefs, self-efficacy, social support utilisation and satisfaction, perceived healthcare availability, and pain intensity and interference. Participants were also asked to report whether they had ever attended to a healthcare professional for their menstrual pain. Results: The BMHSU accounted for 8% of the variance in help-seeking behaviour. Pain interference and appointment availability were significant predictors of the variance in past help-seeking behaviour, such that those who experienced greater pain interference, and those who perceived greater availability of healthcare appointments were less likely to have visited a healthcare professional for their menstrual pain. The BMHSU had an overall 69% classification accuracy in predicting help-seeking behaviour. Conclusion: Although the BMHSU demonstrated reasonably good model fit, it does not appear to be a particularly robust model for predicting help-seeking behaviour for dysmenorrhoea. Future research should explore whether a refined BMHSU or an alternative theoretical model can provide more useful insight into this behaviour. Better understanding of the determinants of help-seeking behaviour will enable the development of interventions to promote appropriate help-seeking and improve health outcomes for individuals with menstrual pain. Plain language summary: What makes people with period pain seek help? Many people experience common period pain, which can be severe and debilitating. Even though it can make daily life difficult, not many people seek medical help for period pain. The purpose of this study was to find out why people with period pain might or might not go to a doctor for help. We used a theoretical framework called the Behavioural Model of Health Services Use to try to understand this. This framework tells us that predisposing factors like age or health beliefs, enabling factors like family support and access to healthcare, and need factors like severe symptoms, can predict whether someone will go to the doctor. We wanted to test if this way of thinking could accurately predict if someone with period pain had been to see a doctor. We asked people with period pain to fill in an online survey. We asked about things like how painful their periods were, what they believed about their menstrual health, how confident they felt in managing their pain, whether they got support from others, if they thought healthcare was available, and how much the pain affected their lives. We also asked if they had ever gone to a doctor for help with their period pain. We found that these factors were not very accurate in predicting whether people sought help for period pain. The most important predictors were how much the pain affected their lives and whether they believed that healthcare appointments were available to them. If the pain was very disruptive, and if they felt there were free appointments, people were less likely to have gone to see a doctor. This study was the first to use this way of thinking to understand help-seeking for people with period pain. In the future, researchers should test different models to see if they work better for understanding help-seeking behaviour for period pain. It is important to find ways to understand this behaviour to help people seek help for their pain when they need it. [ABSTRACT FROM AUTHOR]

Simple Summary: Healthcare professionals recognise the importance of fertility preservation and their responsibility to initiate discussions. However, despite advanced training within respective fields, discrepancies in knowledge remain regarding techniques of fertility preservation, referral pathways and existing educational resources available to patients, preventing efficient implementation of services. Further education and training regarding the methods of fertility preservation and how to refer patients to specialist services are required. Many of the personal barriers faced by healthcare professionals could be overcome through regular teaching on communication skills used for breaking bad news. (1) Background: This study aims to establish the knowledge, attitudes and current behaviours towards female fertility preservation (FP) services amongst healthcare professionals (HCPs) in the UK. (2) Methods: An online survey was advertised publicly on the social media platform Instagram between 25 February 2021 and 11 March 2021. (3) Results: In total, 415 participants fulfilled the inclusion criteria and completed the survey. The majority of HCPs discussed FP techniques either never 39.5% (n = 164), once a year 20.7% (n = 86) or once a month 17.8% (n = 74). The majority rated their knowledge of each type of FP method as 'very poor' or 'poor' and strongly disagreed 14.2% (n = 59) or disagreed 42.2% (n = 175) with the statement they 'felt confident to counsel a patient on FP'. The majority either agreed 37.8% (n = 157) or strongly agreed 22.2% (n = 92) that it was their responsibility to discuss FP and 38.1% (n = 158) agreed or strongly agreed 19.5% (n = 81) they considered the desire for future fertility when planning treatment. The majority 87.2% (n = 362) had not experienced formal training on FP. (4) Conclusions: Discrepancies in knowledge remain regarding techniques of FP, referral pathways, awareness of facilities offering services and existing educational resources. Many HCPs recognise the importance of FP and their responsibility to initiate discussions. The knowledge that FP may not delay the treatment of cancer has also improved; however, training in FP is scarce. [ABSTRACT FROM AUTHOR]

This study explores the mediating role of self-regulation in the relationship between bullying victimization and depressive symptoms among adolescents, considering the moderating effects of gender and region. A cross-sectional analysis was conducted with 3984 adolescents aged 12–18 from the United Kingdom, Hong Kong, Taiwan, and the Netherlands. Data were collected via an online survey administered through Qualtrics. The survey included validated measures such as the Illinois Bullying Scale (IBS) to measure bullying victimization, the Adolescent Self-Regulatory Inventory (ASRI) to measure self-regulation, and the Patient Health Questionnaire (PHQ) to measure depression. The SPSS macro PROCESS was employed for data analysis, with model 4 used for testing the mediating effects of self-regulation and model 1 for assessing the moderating effects of gender and region. The results demonstrated significant associations between bullying victimization, self-regulation, and depressive symptoms. Self-regulation mediated the positive association between bullying victimization and depression, with notable variations across genders and regions. Specifically, male students in Hong Kong exhibited an increased susceptibility to depression when subjected to bullying. These findings underscore the protective role of self-regulation in mitigating the adverse effects of bullying victimization on adolescent mental health. Implications for interventions and prevention strategies targeting adolescent depression are discussed. [ABSTRACT FROM AUTHOR]

Background and aims: Despite its high potential for affecting sibling relationships, few studies have explored the impact of the COVID-19 pandemic on this important family dynamic. Of these, the reported evidence has been inconsistent across cultures and lacks cross-cultural comparability. For the first time, we investigated cross-cultural variability in the impact of COVID-19, and the restrictions associated with it, on sibling relationships of autistic adolescents from a Western (United Kingdom) and non-Western (Turkey) country. We also explored how British and Turkish parents intervene in negative sibling interactions—that is, sibling bullying—when witnessed. Methods: Parents of 164 British and 96 Turkish autistic adolescents, aged 9 to 20 years, were asked how they perceived the effects of COVID-19 on their children's sibling relationships, and how they were most likely to react to instances of sibling bullying. Free response data from parents were analyzed using qualitative content analysis. Results: Our findings indicated more cross-cultural similarities than differences between British and Turkish families. The majority of both British and Turkish parents indicated that COVID-19 worsened sibling relationships between their autistic and nonautistic children. An overwhelming majority of British and Turkish parents also said that they would step in directly when witnessing sibling bullying. Despite the high volume of cross-cultural similarities generally, we also found some cross-cultural differences, for instance in relation to the most common negative impact of COVID-19 on sibling relationships and the most preferred parental responses to sibling bullying. Conclusions and implication: Implications and suggestions are discussed in more detail, drawing on the Etic approach to cross-cultural psychology. [ABSTRACT FROM AUTHOR]

Aims: To examine changes in advanced nurse practitioner (ANP) well‐being, satisfaction and motivation over a four‐year period. Design: Longitudinal Cohort study. Methods: Surveys were carried out each year from 2019 to 2022 with the same cohort of ANPs in the United Kingdom (UK). The survey consisted of demographics, questions on contemporary issues in advanced practice, National Health Service (NHS) staff survey questions and validated questionnaires. A core set of questions were asked every year with some changes in response to the COVID‐19 pandemic. Results: Response rate ranged from 40% to 59% and appeared to be affected by COVID‐19. Staff satisfaction with pay and the well‐being score were stable throughout. Other questions on well‐being, job satisfaction and motivation saw statistically significant reductions after 4 years. Open‐ended questions about ongoing well‐being concerns show participants are concerned about exhaustion levels caused by workload, staffing issues, abuse from patients and colleagues' mental health. Conclusion: The findings highlight a decline in ANP well‐being, job satisfaction and motivation post‐COVID‐19. Reasons for this, explored in the qualitative data, show that ANPs have faced extremely difficult working conditions. Urgent action is required to prevent a workforce retention crisis as many nursing staff are close to retirement and may not be motivated to remain in post. Impact: This study has followed ANPs through the most challenging years the NHS has ever seen. Job satisfaction, motivation and enjoyment of the job all significantly reduced over time. In many areas, the ANP role has been used to fill medical workforce gaps, and this will become harder to do if ANPs are dissatisfied, disaffected and struggling with stress and burnout. Addressing these issues should be a priority for policymakers and managers. Patient or public contribution: None as this study focussed on staff. Staff stakeholders involved in the design and conduct of the study. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Pediatric cerebellar mutism syndrome (pCMS) can occur following resection of a posterior fossa tumor and, although some symptoms are transient, many result in long-lasting neurological deficits. A multi-disciplinary rehabilitation approach is often used in cases of pCMS; however, there have been no clinical trials to determine gold standards in rehabilitation practice in this population, which remains a research priority. The purpose of this study was to identify and compare intervention practices used in pCMS throughout the disciplines of occupational and physical therapy, speech-language pathology, and neuropsychology across geographic regions. METHODS: A 55-question e-survey was created by an international multidisciplinary research group made up of members of the Posterior Fossa Society and sent to rehabilitation professionals in pediatric neuro-oncology centers in the US, Canada, and Europe. RESULTS: Although some differences in the type of intervention used in pCMS were identified within each discipline, many of the targeted interventions including dose, frequency, and intensity were similar within disciplines across geographic regions. In addition, there were common themes identified across disciplines regarding challenges in the rehabilitation of this population. CONCLUSION: These results provide a foundation of current practices on which to build future intervention-based clinical trials. [ABSTRACT FROM AUTHOR]

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

Background: Remote forms of breastfeeding support, such as helplines and social media, offer a flexible and convenient form of support to offer help at critical points, e.g., when the risk of breastfeeding cessation is high. Currently, there is little known about who accesses different forms of remote breastfeeding support and what factors impact overall satisfaction. As part of an evaluation of the UK National Breastfeeding Helpline (NBH) (which offers breastfeeding support via a helpline and online media), we aimed to (a) understand who accesses different forms of NBH support, and (b) identify key factors associated with overall satisfaction for helpline and online media support. Methods: All service users who contacted the NBH between November 2021 and March 2022 were invited to participate in the evaluation via an online survey. Survey questions explored the type and timing of support, reasons for the contact, attitudes towards the help and support received, impact of the support on breastfeeding experiences and demographic factors. Chi-squared and Mann–Whitney tests explored variations in who accessed the helpline or online media. Multiple linear regression models were fitted to explore the factors related to the service users' 'overall satisfaction'. The quantitive data were combined with qualitative comments into descriptive themes. Results: Overall, online media users were significantly more likely to be younger, White, multiparous, less educated and have English as a first language compared to those who contact the helpline. Similar factors that significantly influenced overall satisfaction for both support models were the service being easy to access, receiving helpful information that met expectations, resolving breastfeeding issues, and feeling reassured and more confident. Significant factors for the helpline were callers feeling understood and more knowledgeable about breastfeeding following the call, being able to put into practice the information provided, feeling encouraged to continue breastfeeding, feeling that the volunteer gave the support that was needed, and seeking out additional support. Conclusions: Online and helpline forms of breastfeeding support suit different demographics and call purposes. While optimal breastfeeding support needs to be accessible, flexible and instrumental, helpline users need real-time relational support to deal with more complex challenges. [ABSTRACT FROM AUTHOR]

UK front of package labelling (FOPL) informs consumers on the nutrient content of food. However, FOPL does not consider food processing, and with the UK government being urged to act on ultra-processed food (UPF), whether UPF should be added to FOPL is unclear. This study compared food and drink in the UK National Diet and Nutrition Survey (NDNS) Intake24 database based on FOPL, nutrient content and NOVA classification, to understand whether UPF are covered by dietary recommendations for foods high in fat, salt and sugar. NDNS items were coded into minimally processed food (MPF), processed culinary ingredients, processed food and UPF according to the NOVA classification and FOPL traffic lights. UPF contained greater energy, fat, saturated fat (SF), total sugar (TS) and salt than MPF. UPF had a greater odds of containing red FOPL and an unhealthier overall FOPL score (OR:4·59 (95 % CI: 3·79, 5·57); OR:7·0 (95 % CI: 6·1, 8·2), respectively) and lower odds of containing green FOPL (OR:0·05 (95 % CI: 0·03, 0·10)), compared with MPFs. For items with no red FOPL, UPF still contained greater energy, fat, SF, TS and salt than MPF. However, several UPF have healthier FOPL scores. UPF had an unhealthier nutritional profile and FOPL score than MPF. For items with no red FOPL, UPF still had an unhealthier profile than MPF, with a higher energy density. Importantly, not all UPF were unhealthy according to FOPL. These results indicate partial overlap between FOPL, nutrient content and NOVA classification of UK food and drink products, with implications for UK food and drink labelling. [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]

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]

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]

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]

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

Introduction: Monitoring the evolution of COVID-19 has been essential for health decision-making. But this requires reliable numbers of the infected, dead and hospitalized, often difficult to have for multiple reasons. The use of fast and reliable estimation techniques, such as indirect surveys, is an option. Objectives: To present the CoronaSurveys project, which monitors COVID-19 by combining indirect surveys with the Network Scaleup Method (NSUM). Methodology: The system uses indirect online anonymous surveys to inquire about COVID-19, and the NSUM method to estimate cases. The system offers multi-language surveys with questions to track active cases, new cases, and fatalities, among others. Results: CoronaSurveys has been operating since March 2020, and continues to collect data, with over one hundred responses to date (over one million samples). The system has made good estimates for Spain and the United Kingdom, among other countries. Conclusion: This system is suitable in countries with limited health infrastructure or in situations of lack of knowledge about the pandemic, such as at the beginning of COVID-19, because its implementation cost is small and it requires simple devices to use it and few participants to obtain good estimates. [ABSTRACT FROM AUTHOR]

Around 3% of people are Autistic. Autistic people communicate differently from non‐Autistic people and experience the sensory world differently. There is limited evidence that Autistic people can face additional barriers to breastfeeding. We are an Autistic‐led research team that developed an online survey following consultation with the Autistic community. Autistic people from the UK who had been pregnant were eligible to take part in the survey, which focused on the entire maternity journey. A total of 193 people participated, of whom 152 had experiences of infant feeding (137 breastfeeding, 82 formula feeding). Participants were highly motivated to breastfeed, and almost half of those who breastfed found it positive always or most of the time. However, breastfeeding—and in particular the milk let‐down reflex—could result in pain and sensory difficulties, including 'feeling odd'. Expressing breastmilk always or most of the time was reported by 10% of breastfeeding participants. The intensity and unpredictability of both breast and formula feeding were challenging to manage. Parents reported that it was easy to understand how to prepare infant formula, but that it could also be a negative and anxiety‐inducing experience. Support for breast and formula feeding was often considered inadequate. When parents did access breastfeeding support, this significantly improved a range of breastfeeding experiences. However, participants recommended more tailored support and continuity of carer. To meet the needs of Autistic birthing parents, those providing infant feeding support should receive training on Autism through a neurodiversity‐affirming lens, which should be delivered by Autistic people. Key messages: Many Autistic people are highly motivated to breastfeed, regardless of challenges.Autistic people may experience sensory discomfort when breastfeeding, including from the intensity of touch between themselves and their baby. Distraction and reducing sensory burdens can help.Expressing always or most of the time was relatively common (10%), and a route to maintaining exclusive breastfeeding when directly breastfeeding was too uncomfortable.Receiving breastfeeding support was significantly associated with improvements in a range of breastfeeding experiences.Breastfeeding support for Autistic people should be offered on a one‐to‐one basis with continuity of carer. [ABSTRACT FROM AUTHOR]

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

It is widely acknowledged that compression therapy is an effective treatment option for the management of lower limb conditions; however, it is not always applied appropriately by clinicians. A lack of knowledge and clinical uncertainty, coupled with increased workload and reduced time with patients, can contribute to inappropriate decisions being made in regard to compression. This article investigates the adoption of the Hosiery Hunter® app (medi UK) and its role in guiding decision-making within clinical practice. The Hosiery Hunter® app is a novel mobile application designed to simplify the selection of medical compression hosiery for patients with lower limb conditions. Based on qualitative data from a user feedback survey, it was found that the Hosiery Hunter® app helped simplify the process of selecting the most appropriate compression therapy, saved time and provided quick and timely access to codes for prescription. All nurses surveyed agreed that they would continue using the app and would recommend it to a colleague. This article sheds light on the challenges clinicians face in the selection of compression therapy, and explores the effectiveness of adopting the Hosiery Hunter® app in support of providing appropriate, safe and effective care for all patients. [ABSTRACT FROM AUTHOR]

Background: GP trainees may not have experienced a systematic and comprehensive education in safe prescribing. Therefore, a self-assessment prescribing review was developed. Aim: To determine whether the assessment was feasible, had face validity, and did not disadvantage particular groups of participants. Design & setting: An online survey that evaluates the opinions of GPs in training of a prescribing assessment in the UK. All full-time UK trainees who started their final year of GP training in August 2019 undertook the prescribing assessment along with their trainers, after which they completed an online anonymous feedback questionnaire. Method: The questionnaire completed by trainees sought their opinions of the assessment, and collected ethnicity and disability data. The trainer questionnaire was similar but did not include any demographic information. Results: The questionnaire was completed by 1741 trainees and 1576 trainers. There was no evidence that ethnic group and disability were related to aspects of the review. Most of the trainees (76.4%, n = 1330) and trainers (82.0%, n = 1293) agreed or strongly agreed that the prescribing review was helpful for assessing and learning about the trainee's prescribing. However, most participants (63.2%, n = 1092) took >4 hours to review their prescriptions. A majority of trainees (90.2%, n = 1571) reported that completing the assessment had resulted in a change in their prescribing practice. Conclusion: The majority of trainers and trainees reported that the prescribing assessment was helpful. The study was not able to assess whether there had been an actual change in practice that resulted in an error reduction. [ABSTRACT FROM AUTHOR]

Background: Cerebral palsy (CP) is one of the most common neurological disorders in children and results in lifelong physical impairments. Adults with CP have approximately the same life expectancy as their non-disabled peers, so helping them to stay healthy throughout the life course will have long-term cost benefits via reductions in hospital admissions, long-term care, and unemployment rates. Aim: To explore how adults with CP experience ageing. Design & setting: National online survey given to adults with CP in the UK. Method: The participants were adults with CP. Items for the online survey were taken from existing self-report measures, with additional items developed for the survey. Several domains of functioning were assessed including mobility, dexterity, fatigue, pain, speech, mental health, swallowing and health maintenance/self-care as well as healthcare usage. Data were analysed using χ2 to examine the relationships between the demographic variables and the survey responses. Results: The survey was completed by 395 participants, of whom 74.2% were female and approximately 59.3% aged <45 years. Responders reported having problems with mobility, pain, and fatigue with older participants reporting higher levels of pain and more mobility problems, although the correlations were fairly small. Healthcare usage was surprisingly low. Conclusion: The study found that age was associated with a decline in mobility and a higher level of pain, although the relationships were weak. It is possible that the low healthcare usage among the responders is owing to services not being available to respond to their needs. [ABSTRACT FROM AUTHOR]

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

Acute oncology services (AOS) manage acute cancerrelated presentations alongside acute medical teams. This study assessed AOS provision against national peer review measures and the burden of acute cancer-related admissions. The 2022 Society for Acute Medicine Benchmarking Audit surveyed UK hospitals, collecting hospital-level and patient-level data for all medical admissions over a 24-h period. Logistic regression models were constructed to identify differences in patient outcomes for cancer-related admissions. Most hospitals (n=120 or 91.6%) reported having an AOS. There was heterogeneity in AOS provision, with many failing to meet peer-review measures. Of the 7,116 patients, 542 (7.6%) were cancer-related admissions. Cancer-related admissions had greater clinical acuity (p<0.05), length of stay (p<0.001) and 14-day mortality (adjusted odds ratio (OR)=3.54, 95% confidence interval (CI): 2.41-5.22, p<0.001) compared with other medical admissions. Increasing availability of AOS with integration of ambulatory pathways are vital next steps to improving care for acute cancer-related admissions. [ABSTRACT FROM AUTHOR]

The use of donor human milk (DHM) where there is a shortfall of maternal milk can benefit both infant and maternal outcomes but DHM supply is not always assured. This study aimed to understand current DHM usage in UK neonatal units and potential future demand to inform service planning. An online survey was disseminated to all UK neonatal units using Smart Survey or by telephone between February and April 2022 after development alongside neonatal unit teams. Surveys were completed by 55.4% of units (108/195) from all 13 Operational Delivery Networks. Only four units reported not using DHM, and another two units only if infants are transferred on DHM feeds. There was marked diversity in DHM implementation and usage and unit protocols varied greatly. Five of six units with their own milk bank had needed to source milk from an external milk bank in the last year. Ninety units (84.9%) considered DHM was sometimes (n = 35) or always (n = 55) supportive of maternal breastfeeding, and three units (2.9%) responded that DHM was rarely supportive of breastfeeding. Usage was predicted to increase by 37 units (34.9%), and this drive was principally a result of parental preference, clinical trials and improved evidence. These findings support the assumption that UK hospital DHM demand will increase after updated recommendations from the World Health Organization (WHO) and the British Association of Perinatal Medicine. These data will assist service delivery planning, underpinned by an ongoing programme of implementation science and training development, to ensure future equity of access to DHM nationally. Key messages: Updated recommendations from World Health Organization (WHO) and British Association of Perinatal Medicine (BAPM) are likely to increase demand for donor human milk provision from human milk banks, but there have been no recent data collected on baseline usage criteria, enteral feeding guidelines and anticipated future use.This national survey of UK neonatal units highlights the variability in donor human milk (DHM) provision and reasons for demand spikes that will be helpful for modelling future services. Almost 85% of neonatal units responded that DHM availability was supportive of maternal lactation support. Responses highlighted that DHM demand is likely to increase further in the next 2 years.Understanding demand variability will help in planning nationally equitable human milk bank services and support the development of robust national service continuity planning. The study also highlights the variability in practice, often in single regions, raising concerns related to health equity, staffing limitations and uncertainty in DHM implementation. [ABSTRACT FROM AUTHOR]

Surgical site infection (SSI) is common following arterial surgery involving a groin incision. There is a lack of evidence regarding interventions to prevent groin wound SSI, therefore, a survey of vascular clinicians was undertaken to assess current opinion and practice, equipoise and feasibility of a randomised controlled trial (RCT). Participants at the Vascular Society of Great Britain and Ireland 2021 Annual Scientific Meeting were surveyed regarding three separate interventions designed to prevent SSI in the groin; impregnated incise drapes, diakylcarbomoyl chloride dressings and antibiotic impregnated collagen sponges. Results were collated via an online survey using the Research Electronic Data Capture platform. Seventy‐five participants completed the questionnaire, most were consultant vascular surgeons (50/75, 66.7%). The majority agree that groin wound SSI is a major problem (73/75, 97.3%), and would be content using either of the three interventions (51/61, 83.6%) and had clinical equipoise to randomise patients to any of the three interventions versus standard of care (70/75, 93.3%). There was some reluctance to not use impregnated incise drapes as may be considered "standard of care". Groin wound SSI is perceived as major problem in vascular surgery, and a multicentre RCT of three preventative interventions appears acceptable to vascular surgeons. [ABSTRACT FROM AUTHOR]

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

The UK has a significant and growing population of older adults with frailty and complex healthcare needs, necessitating innovative care solutions. This study aimed to explore patients' and carers' experiences of a novel integrated service that was set up to address the increasing healthcare needs of older people living with frailty. A qualitative study that combined free-text survey questions with in-depth interviews. This study is part of a larger non-randomized trial of the service, with evaluation of wellbeing and quality of life at baseline, 2 to 4 weeks, and 10 to 14 weeks. Patients (aged 65 and above) with an electronic Frailty Index in the severe range and their informal family carers participated in this study. Data were collected between April 2019 and March 2020. Free text survey responses and interview data were subjected to reflexive thematic analyses. Four themes were generated: the overall experience of the service; interactions within the service; treatment and interventions; and outcomes due to the service. Most participants wanted further follow-up and more extensive integration with other services. Most participants described their overall experience positively, especially the available time to address their full range of concerns, but opportunities to integrate the service more fully and to extend follow-up remain. [ABSTRACT FROM AUTHOR]