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The value of embracing a physically active lifestyle has been well documented in recent times. However, despite this knowledge, physical activity levels in many western societies remain worryingly low in both adult and youth populations. Habit formation in youth is a key indicator of engagement in physical activity as an adult; therefore, maximising opportunities to develop motivation in young people is vitally important to increase the likelihood of maintaining physical activity habits as an adult. A key factor for the development of motivation is school-based physical education. This review considers the current landscape of physical education as a vehicle for physical activity promotion, and suggests that a change of approach that moves away from physical education focusing solely on sport techniques is long overdue. A culturally relevant curriculum that includes lifestyle sports, with a focus on mastery and enjoyment through a meaningful experiences approach, is proposed as a viable update to current practice.

The purpose of the study: The aim of this study is to identify the prevalence of participants in physical activities, the motivation needed by the students to engage in the activity, challenges encountered by the implementors, health benefits, and recommendations and suggestions needed for the improvement of the implementation. Materials and methods: Using Arksey and O'Malley's (2005) scoping review framework, a systematic analysis of the data of different articles was conducted. Results: It was found out that the implementation of active recreational activities offers different health benefits to the youth, physical literacy and orientation and motivation played a vital role in the implementation of the recreational activities. Conclusions: Therefore, the implementation of the active recreational activities must be strengthened in schools not just for the sake of participation but because they are motivated to. And the engagement of these activities must not only limit to school grounds but also engaged even at home and in the community.

The transition into higher education stretches students socially, academically and within their personal lives requiring adaptation and development of resilience. For many, such demands may lead to decreased mental wellbeing and, for some, mental ill-health. This project aimed to trial simple mental health awareness and well-being tasks with first year undergraduate students, and to determine whether students find these interventions beneficial and worthy of embedding as transition activities within the first-year curriculum. Four activities were trialled with 185 first-year students who reported the activities as beneficial. All activities caused an overall increase in student knowledge of how to maintain good mental well-being. In the light of this project's findings, such activities are recommended for embedding into the first-year curriculum and throughout higher education. [Note: The citation (v15 n1 2020) shown on the first page of the PDF is incorrect. The correct citation is v16 n1 2021.]

This study aimed to explore international student food choices in a semirural setting using participatory photovoice techniques. Eighteen international students took photographs over 7-10 days of a typical food week and then attended a workshop where they completed three photography display and captioning tasks. Ten themes emerged linked to the food choices made by international students. These themes were aligned to a social determinants of health model and findings are discussed in the context of improving international students' food experiences through focusing on individual lifestyles, social networks and living and learning environments.

This specially themed ""Getting of Wisdom," Learning in Later Life" Edition of the "Australian Journal of Adult Learning" ("AJAL") is not so much concerned with the issue of ageing itself, but more about quality of life regardless of age. It is about taking, but also giving back as best as possible at any age. This special issue is a result of the one week "The Getting of Wisdom Exchange", a collaboration between around 100 adult education practitioners and researchers from ten countries from Australia, New Zealand, Asia and Europe. In this issue, papers are presented from Sweden, Ireland, Aotearoa/New Zealand, Australia, Slovenia, Poland, Germany, Portugal and the United Kingdom. Papers cover different topics and open questions about various issues in older people's learning.

In the UK policies such as the Children's Plan 2008-2020 through to Promoting the Emotional Health of Children and Young People (2010) identify that professionals such as teachers, youth workers, social workers and youth offending specialists, do not have the necessary underpinning knowledge to adequately support children and young people's emotional well-being. Further that these professionals fail to recognise when a child or young person may need additional help. These findings suggest that gaining knowledge and understanding of emotional well-being for children and young people is a key requirement for those working in this field. This paper is an evaluation of an initiative that saw a partnership of developing joint learning materials from expert emotional well-being organisations being delivered as part of an undergraduate award at a traditional Higher Educational (HE) Institution. The evaluation showed that the introduction of interactive, e-learning materials, supplemented with role play and scenario based learning and running concurrently alongside work experiences enabled students to acquire and apply knowledge and understanding of emotional well-being for children and young people to real situations, and thus bridged the "practice-theory gap".

The tendency for the press and public to over-react on safety. The need to balance risk against benefit. The difference between hazard and risk. Preventative or protective steps (control measures) to reduce the risk from particular hazards. Examples in school science, including the use of eye protection and alternative strategies, if eye protection is not available. The ability of teachers to supervise a class dependent on the size of the class. The need for supervision dependent on the nature of the practical activity and the risk involved in it, as well as the nature of the class, and the skills and behaviour of the students. (Contains 1 footnote.)

Children from low-income families are more likely than other children to have serious health problems. And, as Anne Case and Christina Paxson show, childhood health problems can prevent poor children from achieving economic success as adults. Income-related disparities in childhood health are evident at birth or even before, and the disparities grow more pronounced as children grow older. Not only do poor children have more severe health problems than wealthier children, but they fare less well than wealthier children who have the same problems. They also receive less and lower-quality medical care for their problems. And poor families may be less well equipped to manage their children's health problems, which could worsen their effects. The available U.S. data sets do not allow researchers to track individuals' health and economic well-being from birth into adulthood, but three British data sets are producing growing evidence that health in childhood is a determinant of educational attainment, which in turn affects adults' employment opportunities and wages. Children in poor health are also more likely to have poor health as adults, and their health as adults adversely affects their economic status. Case and Paxson note that eliminating income-related disparities in health problems in childhood would do little to reduce earnings disparities between richer and poorer adults. However, they emphasize that, for children in poor health, improvement in physical condition in childhood would lead to substantial improvement in economic circumstances. The authors cite several areas, including expanded prenatal care, maternal smoking cessation programs, and nutrition programs, as deserving particular attention. They contend that increased access to health care is not sufficient to improve children's health. The next wave of policies should focus on improving the quality of health care and strengthening the ability of parents to manage their children's health problems.

Second-hand smoke (SHS) exposure is high among UK Bangladeshi and Pakistani populations, reflecting higher male smoking prevalence and fewer home smoking restrictions than the general population. The Muslim Communities Learning About Second-hand Smoke (MCLASS) study explored the feasibility and acceptability of implementing SHS education in 14 UK mosques. Religious teachers (RTs) in seven intervention mosques were trained and provided with a culturally appropriate educational package. After the intervention, mosque leaders, RTs and congregants' experiences and perceptions of the intervention were explored through interviews and focus group discussions. Delivery of the intervention varied across mosques. Facilitators and barriers included: mosque diversity (congregation size, organizational structure, educational activities, women's role and involvement); degree of trust between researchers and personnel; and views on SHS. Most participants thought mosques' involvement in SHS health promotion was appropriate, but the perceived importance of SHS differed. We found that a health promotion programme delivered within Islamic religious settings that engages RTs in the process of facilitation, can be acceptable and feasible, but care must be taken to explore the culture and ethos of the institution, including its organizational structure, management committee, RTs and congregation.

Health risk appraisals (HRA) are a common type of workplace health promotion programme offered by American employers. In the United Kingdom, evidence of their effectiveness for promoting health behaviour change remains inconclusive. This randomized controlled trial examined the effects of two HRA interventions on lifestyle parameters, mental health and work ability in a UK context. A total of 180 employees were randomized into one of three groups: Group A (HRA augmented with health promotion and education activities), Group B (HRA only) and Group C (control, no intervention). After 12 months, changes in mean scoring in 10 lifestyle, mental health and work ability indices were compared, Groups A and B demonstrated non-significant improvements in 70% and 80%, respectively, compared with controls (40%). Odds ratios revealed that, compared with the control group, Group A was 29.2 (95% CI: 9.22-92.27) times more likely to report a perceived change in lifestyle behaviour; Group B 4.4 times (95% CI: 1.65-11.44). In conclusion, participation in the HRA was associated with a higher likelihood of perceived lifestyle behaviour change which was further increased in the augmented HRA group, thereby providing preliminary evidence that HRA and augmented HRA in particular may help UK employees make positive healthy lifestyle changes.

"Health" has become a major concern of policy makers internationally in recent years, especially where and when it is reduced to a measurable and, therefore, comparable commodity/"quality": weight and obesity levels. Schools in many countries have increasingly been charged with responsibility for safeguarding children's health, ensuring that they eat the right foods, exercise sufficiently, and either lose or maintain "ideal weight". The authors are concerned to highlight that the success of any educational strategy is likely to depend as much on what schools or teachers do, as on what students themselves bring to the "learner encounter" in the way of cultural predispositions and levels of socio-economic, financial and political resource. Drawing on data from research examining the impact of new "health imperatives" on schools within the United Kingdom, they explore connections between the corporal and corporeal, and the recontextualising processes that occur as health imperatives flow across and within multiple sites of discourse and are translated into pedagogies and school policies which may have impact upon the subjectivities of young people. Concepts drawn from Bernstein and others that have become central to the authors' work illustrate how individual pupils' needs, interests, abilities and desires are interrelated with, and affected by, the various cultural settings and pedagogies they experience at home, at school, in their peer groups and other social settings. (Contains 2 notes and 2 figures.)

Skin cancer is an increasing problem in Europe, America and Australasia, although largely preventable by avoiding excessive ultraviolet (UV) exposure. This paper presents the findings of a systematic review of qualitative research about the prevention of skin cancer attributable to UV exposure. The aim is to understand elements that may contribute to the successful or unsuccessful conveyance of skin cancer prevention messages and their uptake by the public. A systematic review was undertaken using evidence identified through searching electronic bibliographic databases and Web sites and reference list checks. Predefined inclusion and exclusion criteria were used. Sixteen study reports (relating to 15 separate studies) were included from the United Kingdom, United States, Australia, Canada and New Zealand. Each included study was quality appraised, and the findings were extracted into an evidence table. A coding scheme, framed by the Health Belief Model, was developed by the reviewers and informed analysis and synthesis. This showed that most people perceived their susceptibility to skin cancer, and its severity, as low. While benefits of adopting changed behaviour were acknowledged, there were substantial barriers to this, including positive perceptions of a tan as healthy and attractive and the hassle of covering up or using sunscreen. Peers, parents and media may offer "cues to action" that encourage adoption of preventative behaviour and finally self-efficacy or the perceived ability to make such changes. Effective health education messages will need to address the barriers to adopting protective behaviours identified through this review.

Teenage pregnancy prevention programmes targeted at young women have received considerable attention from researchers and programme developers. However, to date, relatively limited information is available on preventing teenage fatherhood or improving outcomes for young fathers. A notable gap is concerned with understanding the forms of sexual health programmes that are most effective from the perspective of young men. We conducted a systematic mapping to identify studies involving young men aimed at preventing teenage pregnancy, improving outcomes for teenage fathers or exploring the perspectives of young men around pregnancy and fatherhood. We searched a wide range of electronic databases from January 1996 to August 2008. Three quantitative and 15 qualitative studies were identified, of which nine were UK based. Key themes related to the inappropriateness of current sexual health promotion to respond to the needs of young men. While young men often possessed very similar ideals to young women, existing programmes were problematic when they negatively stereotyped young men and ineffectively addressed models of masculinity or the difficulties young men may have forming meaningful relationships. Further investigations are required on programme development for young men, particularly on sexual health promotion interventions for "looked-after" young men and those from unstable childhoods.

The commercialisation of schools is a controversial issue, but very little is known about the actual situation in UK schools. The aim of this study was to investigate, with particular reference to health education and health promotion, commercial activities and their regulation in primary schools in the Yorkshire and Humber region of the UK. A questionnaire was sent to a random sample of 650 headteachers with respondents being asked whether a range of commercial activities had been present in their school during the previous 20 months. They also indicated whether the school had any policies on the types of activity covered by the questionnaire. The results showed that four types of commercial activity had been present in over 50% of responding schools. These were voucher/token collection schemes, business linked competitions/contests, business linked sports coaching and sponsorship. Voucher/token collection schemes were found to be the most common form of activity, with 85% of schools having participated in at least one of these initiatives. Only 4% of schools had any policies on the types of activity covered in the questionnaire. Further research in the UK on commercial activities in schools is recommended. (Contains 4 tables and 3 figures.)

This is a comprehensive review of policies and research regarding body mass index (BMI) screening in schools in the United Kingdom and the United States. Although there are potential benefits to conducting screenings in schools, there is also the potential to do harm to the children who are identified as overweight. School administrators need to consider a number of factors discussed in this article before making a decision about committing resources to BMI screening. (Contains 1 table.)

Identifying ways to increase and sustain active living among young people represents a priority for health promotion interventions. This qualitative study explored the experiences of adolescent boys and girls in the United Kingdom (aged 14-15 years) who had made the transition from inactivity to active participation in physical education (PE). The setting was a secondary school that had modified the PE programme, with the aim of increasing participation rates. Thirty-one, self-identified, formerly "PE adverse" students were interviewed in focus groups in the school setting. Previously, respondents felt that they had been constructed as physically marginal individuals. Having a physically "marginal body" was perceived as being detrimental to emotional health. The new PE resulted in respondents possessing a performing and achieving physical identity. Boys gained a sense of security in their physical identity and cultural change had removed the aggression from interacting with other physically active peers. Girls spoke of increased self-confidence, including acquiring the psychological resources to participate in community-based activities. Effective health promotion interventions for inactive adolescents are likely to move beyond solely endorsing the benefits of physical activity or increasing choice and instead address the potential emotional risks and value of participation from the adolescents' perspective.

In relation to health promotion and education, the use of post-positivist and constructivist approaches has been gathering strength in recent years. Despite this emerging tradition, little has been done to explore what this sort of approach actually represents, particularly in terms of health promotion in schools, professional organizations and wider society. Acknowledging this, it is suggested that more researchers in this area should be adopting qualitative approaches--including semi-structured interviews, focus groups, story/dialogue workshops and developmental schemes of health education--in order to uncover the hidden meaning of "health promotion", particularly in the school context. This paper therefore attempts to challenge the idea that traditionalist paradigms of positivist research are capable of appropriately representing the nature and complexity of the health promotion issues. In this paper, methodological and theoretical frameworks that can enable researchers to understand health promotion from the perspective of students, teachers and school "stakeholders" are suggested. Particular attention is given to a discussion of the potential value of designing and implementing programmes of health education or promotion using a critical pedagogical approach within schools in the UK. It is argued that programmes using a critical pedagogical and reflective approach, and which are aimed at social transformation, would be of enormous benefit to both researchers and educational/health professionals who are seeking to understand the complexity of health promotion issues from the perspective of children and adolescents.

This study aimed to understand how psychological factors affect regular exercise in older adults, hypothesising that trait self-control mediates the relationship between motivation types (intrinsic, extrinsic, and amotivation) and exercise time. In this cross-sectional study, 430 older adults (mean age = 68.8 ± 6.72) completed questionnaires regarding their perceived trait self-control, motivation towards leisure activities, and level of physical activity. A Bayesian mediation analysis was performed, controlling for demographics. We documented positive direct (c′ = 0.021, 95%CI [0.001, 0.043]) and indirect (ab = 0.028, 95%CI [0.014, 0.043]) effects of intrinsic motivation on exercise, a fully mediated indirect effect of extrinsic motivation on exercise (ab = 0.027, 95%CI [0.011, 0.046]), and negative direct (c′ = −0.281, 95%CI [−0.368, −0.194]) and indirect (ab = −0.161, 95%CI [−0.221, −0.105]) effects of amotivation on exercise. There was no direct association between extrinsic motivation and exercise (c′ = 0.013, 95% CI [−0.013, 0.037]). In conclusion, trait self-control mediates motivation to influence exercise behaviour in older adults. Intrinsically motivated individuals resist sedentary living and show higher self-control, while extrinsically motivated ones rely on self-control and are more susceptible to non-adherence during mental fatigue. High amotivation is linked to less exercise and reduced self-control, suggesting potential non-compliance with structured exercise interventions. [ABSTRACT FROM AUTHOR]

Introduction: There is growing scientific and policy recognition that optimising health before a potential pregnancy (preconception health) improves reproductive outcomes and the lifelong health of future children. However, public awareness on this topic is low. We conducted a public consultation to develop language recommendations and identify and prioritise approaches to inform research and improve public awareness of preconception health. Methods: A public consultation was undertaken with people of any gender aged 18–50 years living in the United Kingdom who were not currently expecting a child. Public contributors were recruited through patient and public involvement, community and support groups, an existing cohort study, and an LGBTQ+ charity. An initial round of online group discussions (February/March 2021) explored public contributors' knowledge of preconception health, their recommendations for appropriate language, and ideas about public health approaches. In a subsequent discussion round (May 2021), language recommendations were refined and suggested approaches prioritised. Discussions were summarised based on notes taken by two researchers. Results: Fifty‐four people joined the initial discussion round (66% women, 21% men, 13% nonbinary or transgender; 55% aged 18–30 years, 30% 31–40 years, 15% 41–50 years). Of these, 36 people (67%) participated in the subsequent round. Very few had heard the term 'preconception health', understood what it means, or why and for whom it is important. They recommended avoiding unfamiliar terms without further explanation (e.g., preconception health, medical terms), using language that is positive, encouraging and gender‐sensitive where possible, and using messages that are specific, nonjudgmental and realistic. The phrases 'health and well‐being during the childbearing years', 'health and well‐being before pregnancy and parenthood' and 'planning for parenthood' resonated with most public contributors. School‐based education, social media campaigns and the National Health Service emerged as priority approaches/settings for raising awareness. Conclusion: This public consultation produced recommendations from a diverse group of people of reproductive age in the United Kingdom to improve language and prioritise approaches that increase public understanding of preconception health in ways that are relevant and appropriate to them. This should begin in schools and will require adaptation of curricula, alongside co‐development of public awareness campaigns and guidance for healthcare professionals. Patient or Public Contribution: This public consultation included a diverse group of members of the public. They were not involved in the original design of the project, but following the initial round of online group discussions, they contributed to the interpretation and refinement of the emerging concepts in a subsequent round of group meetings. After the consultation activity, public contributors formed a Public Advisory Group and have subsequently been involved in other studies on the same topic. Two public contributors (E.R. and F.F.) provided critical input in the preparation and revision of this manuscript and are co‐authors of the paper. [ABSTRACT FROM AUTHOR]

Background: Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population. Methods: Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings. Findings: Twenty‐seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education. Conclusions: The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti‐racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence‐based mental health care provisions to tackle mental health inequities. Patient and Public Involvement: This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region. [ABSTRACT FROM AUTHOR]

Introduction: The impact of multiple health conditions on bowel cancer screening is currently unknown. We explored the impact of multiple health conditions on bowel cancer screening perceptions, experience and clinical management decisions following a positive stool test. Methods: Semi‐structured qualitative interviews were conducted remotely with Bowel Screening Wales staff (n = 16) stratified by regional location and role and with screening participants (n = 19) stratified by age, gender and comorbidity. Interview topics were guided by the Common‐Sense Model. Results: Screening participants, regardless of comorbidity status, placed great emphasis on the importance of early detection of cancer and completing the bowel screening process. Screening staff emphasised comorbidities in the clinical decision‐making process; however, screening participants had low awareness of the impact that comorbidities can have on bowel screening. Participants describe how the presence of multiple health conditions can mask potential bowel symptoms and influence beliefs about follow‐up. Conclusion: Bowel screening staff try to individualise the service to meet participant needs. The potential mismatch in screening staff and participant awareness and expectations of the bowel screening and diagnostic process needs to be addressed. Clearer and more regular communication with screening participants could support the screening process, particularly for those with significant coexisting health conditions or facing time delays. The possible masking effects and misattribution of symptoms because of comorbidities highlight an opportunity for education and raising awareness for screening participants and a potential area of focus for discussions in clinical consultations and staff training. Patient and Public Contribution: Project funding included costs for patients and public contributors to be compensated for their contributions to the project, in line with current standards. A patient and public contributor was involved in the design of the study, including protocol development, and the interpretation of key findings and implications for patients, which are subsequently reflected within the manuscript. [ABSTRACT FROM AUTHOR]

The 15 Minute Challenge is an mHealth workplace wellness initiative, employing gamification to promote physical activity, aiming to enhance health outcomes and overall well-being. This retrospective cohort study evaluated the effectiveness of the program among employees at various Australian, New Zealand, and UK workplaces. Real-world data from 11,575 participants across 73 companies were analyzed. The program encouraged daily 15 min physical activity sessions over six weeks. Participants self-reported their physical activity and fitness, energy, overall health, sleep quality, and mood at baseline and 6 weeks. Program satisfaction, engagement rates, and adherence to the program were also assessed. Effectiveness was evaluated using multi-level mixed-effects linear regression analyses. The intervention showed significant increases in physical activity, with 95% of participants meeting or exceeding international physical activity guidelines, up from 57% at baseline (p < 0.05). Self-reported fitness, energy, overall health, sleep quality, and mood significantly improved (between 7.1 and 14.0% improvement; all p < 0.05). High satisfaction was reported, with 92% of participants recommending the program. The 15 Minute Challenge effectively increased physical activity levels and improved self-reported health outcomes among participating employees. The high satisfaction rates and significant health improvements highlight the potential of workplace wellness programs to combat sedentary behavior and promote a healthier, more active lifestyle. [ABSTRACT FROM AUTHOR]

Background: Stigma, lack of trust in authorities, and poor knowledge can prevent health-seeking behaviour, worsen physical and mental health, and undermine efforts to control transmission during disease outbreaks. These factors are particularly salient with diseases such as mpox, for which 96% of cases in the 2022–2023 UK outbreak were identified among gay, bisexual, queer and men who have sex with men (MSM). This study explored stigma and health-seeking behaviour in Liverpool through the lens of the recent mpox outbreak. Methods: Primary sources of data were interviews with national and regional key informants involved in the mpox response, and participatory workshops with priority populations. Workshop recruitment targeted Grindr users (geosocial dating/hookup app) and at risk MSM; immigrant, black and ethnic minority MSM; and male sex workers in Liverpool. Data were analysed using a deductive framework approach, building on the Health Stigma and Discrimination Framework. Results: Key informant interviews (n = 11) and five workshops (n = 15) were conducted. There were prevalent reports of anticipated and experienced stigma due to mpox public health messaging alongside high demand and uptake of the mpox vaccine and regular attendance at sexual health clinics. Respondents believed the limited impact of stigma on health-seeking behaviour was due to actions by the LGBTQ + community, the third sector, and local sexual health clinics. Key informants from the LGBTQ + community and primary healthcare felt their collective action to tackle mpox was undermined by central public health authorities citing under-resourcing; a reliance on goodwill; poor communication; and tokenistic engagement. Mpox communication was further challenged by a lack of evidence on disease transmission and risk. This challenge was exacerbated by the impact of the COVID-19 pandemic on the scientific community, public perceptions of infectious disease, and trust in public health authorities. Conclusions: The LGBTQ + community and local sexual health clinics took crucial actions to counter stigma and support health seeking behaviour during the 2022–2023 UK mpox outbreak. Lessons from rights based and inclusive community-led approaches during outbreaks should be heeded in the UK, working towards more meaningful and timely collaboration between affected communities, primary healthcare, and regional and national public health authorities. [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]

Background: Regular physical activity (PA) results in extensive physical, psychological, and social benefits. Despite primary care being a key point of influence for PA behaviours in the UK, research indicates poor application of PA interventions in this context. To address this, the Royal College of General Practitioners' (RCGP) developed and implemented the Active Practice Charter (APC). The aim of the study was to evaluate the perceived impact and acceptability of the APC initiative from the perspective of primary healthcare professionals (PHPs). Methods: An online exploratory cross-sectional survey was designed to assess the perceived impact, experiences, and challenges of the APC initiative, from the perspective of PHPs. The survey was distributed by the RCGP via email to 184 registered APC practices across the UK. Results: Responses were reviewed from staff (n = 33) from 21 APC practices. Initiatives used by APC practices included: educational programmes, partnerships with PA providers, referral systems, and infrastructure investment. Perceived benefits included: increased awareness about PA, staff cohesion, and improved well-being. However, staff felt the APC had limited effect due to implementation barriers, including: a lack of engagement, time, resources, and funding. Conclusion: This is the first evaluation of any nationwide UK-based initiative engaging GP practices in promoting PA. Acknowledging the limitations in response rate, although support exists for the RCGP APC, the evaluation highlights challenges to its implementation. Nonetheless, the wide reach of the RCGP, combined with the cited staff and patient benefits, demonstrates the significant potential of the APC initiative. Given the need to address physical inactivity nationally, further development the APC offers a possible solution, with further research required to overcome the challenges to implementation. [ABSTRACT FROM AUTHOR]

This study's aim was to test associations between nutrition knowledge and obesity-related attitudes and physical activity (PA) among 3000 18–35-year-old men and women from Kenya, South Africa (SA), and the United Kingdom (UK). A cross-sectional online survey was conducted in April 2022. To estimate nutrition knowledge, dietary recommendation knowledge score was computed using the standard General Nutrition Knowledge questionnaire. Obesity-related attitudes were from the British Social Attitudes Survey. Self-reported days of vigorous and moderate PAs and walking were used. Ordinal logistic regression was employed to test all associations, while adjusting for age group, gender and a household asset score. Using simple mediation, testing was also done to ascertain whether obesity-related attitudes mediated associations between nutrition knowledge and PA. Consistently, better nutrition knowledge was associated with disagreeing that 'There is no reason to worry about obesity' (ORs ≥ 1.09), but lower odds of being against 'Providing free weight management courses' and 'Creating/improving cycle paths and pavements to encourage PA' (ORs ≤ 0.90). Better nutrition knowledge was also associated with higher vigorous PA in SA (OR = 1.09), and moderate PA (OR = 1.04) and walking (OR = 1.12) in the UK. In the combined sample, associations of nutrition knowledge with vigorous PA were fully mediated by believing that 'Obesity results from not exercising enough' (11.1% mediated). Likewise, associations of nutrition knowledge with moderate PA were fully mediated by attitude towards 'Creating or improving cycle paths and pavements to encourage PA' in the UK (38.9% mediated). Nutrition knowledge is associated with obesity-related attitudes and PA among young adults, but some relationships are country-specific. Interventions based on findings from high-income countries should be evaluated before being implemented in low-resource settings. [ABSTRACT FROM AUTHOR]

Background: Current treatments for people with obesity emphasise the need for person-centred approaches that consider complex biopsychosocial factors and value the lived experience of people when attempting to lose weight. Methods: Narrative interviews (n = 20) were conducted with people living with obesity to explore the causes of their weight gain and their expectations and engagement with treatment at a Weight Management Clinic. A mixed inductive and deductive qualitative analysis identified utterances that represented psychological constructs used to understand self-appraisal and health behaviour. A narrative analysis was used to situate these findings in the context of a participant's life story. Results: Locus of control was a dominant construct evidenced through a person's attributional style and self-efficacy. Transcripts represented a heightened sense of self-understanding and shifts in control, and styles of attribution and efficacy resulted in either stasis or self-actualisation. The Stages of Change model could be applied to narratives to ascertain a patient's motivation to access treatment. Importantly, narrative interviews also allowed for the consideration of how a person's systemic context influenced their weight. Conclusion: Narrative interaction supports both self- and shared understandings of the causes and consequences of obesity for individuals, in a non-blaming or shaming manner. It provides an opportunity to enhance engagement through tailored, person-centred treatments. [ABSTRACT FROM AUTHOR]

This narrative review explores the barriers and facilitators that migrant women face globally. The review explored a range of studies conducted in various countries, including the United States of America (USA), the United Kingdom (UK), Canada, Australia, and the United Arab Emirates (UAE). It also specialises in the experiences of migrant women living in Sydney, Australia, and women living in Ras Al Khaimah (RAK), UAE. Cervical cancer ranks as the fourth most prevalent form of cancer among women worldwide. It is the fourteenth most common cancer among women in Australia and the fourth most common cancer in the UAE. Despite the availability of vaccinations and cervical screening initiatives in many countries, including the USA, the UK, Canada, Australia, and the UAE, migrant women living in these countries continue to experience considerable health gaps when accessing cervical cancer screening services. Addressing these disparities is crucial to ensuring everyone has equal healthcare access. An electronic search was conducted using three databases to identify articles published between 2011 and 2021. Qualitative, quantitative, and mixed-methods research studies were included in the search. The identified factors were classified into categories of barriers and facilitators of cervical screening uptake, which were then sub-categorized. This narrative review examines the awareness of cervical cancer and screening behaviours, attitudes, barriers, and facilitators associated with cervical cancer screening. According to the study, several factors pose significant obstacles for migrant women worldwide, particularly those living in the USA, the UK, Canada, and Sydney, Australia, and Emirati and non-Emirati women (migrant women) residing in RAK when it comes to undergoing cervical cancer screening. These barriers include inadequate knowledge and emotional, cultural, religious, psychological, and organisational factors. On the other hand, social support, awareness campaigns, and the availability of screening services were found to promote the uptake of cervical cancer screening. The findings from this review suggest that healthcare providers should adopt culturally sensitive approaches to enhance awareness and encourage participation in screening programs among migrant women. Based on the findings of this narrative review, it is strongly suggested that healthcare providers and policymakers prioritise developing culturally sensitive screening initiatives for migrant women. It is essential to address the psychological and emotional barriers that prevent migrant women from accessing screening services. This can be accomplished by offering education and awareness campaigns in their native languages and implementing a community-based approach to encourage social support and increase awareness of cervical cancer and screening services. Furthermore, healthcare providers and organisations should provide educational tools that address common misconceptions based on cultural and religious factors that prevent women from accessing screening services. [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]

Introduction: With the rapid growth of urbanization globally and in the UK, increasing attention is now being directed towards urban green spaces (UGS). The appeal of UGS to policymakers lies in their capacity to address multiple policy objectives, including improving physical and mental wellbeing, mitigating noncommunicable diseases (NCDs), combating climate change through carbon sequestration, providing climate adaptation measures, and enhancing biodiversity. Method: This narrative review gives an overview of the current literature and UK policy relating to urban green and blue spaces, with a particular focus on the use of UGS to increase physical activity levels. Results: UGS have a profound impact on public health, with evidence indicating their positive effect on both physical and psychological health. Thirty‐eight percent of adults in the UK do not live within 15 minutes of UGS, so policy makers at national and international level are aiming to address this gap. One reason for the health benefits of UGS is associated increased physical activity, a vital component needed to address the burden of non‐communicable disease. To effectively harness UGS to promote physical activity various factors must be considered; proximity and diversity of urban green spaces, and the presence of suitable infrastructure features. Tailoring UGS to meet the needs and preferences of different population demographics is essential, as is ensuring safety, and addressing barriers to access particularly for lower socio‐economic groups. The careful planning of UGS must avoid potential gentrification effects and displacement of vulnerable communities, whilst utilising the equigenic nature of UGS. Conclusions: To create a brighter future and capitalize on the potential of UGS, a collaborative approach is needed, involving communities, local governments, and national authorities. Primary‐care professionals, represented by organizations like the Royal College of General Practitioners (RCGP), can play a crucial role in advocating for UGS and physical activity, promoting their use, and providing guidance and support. [ABSTRACT FROM AUTHOR]

Hypertension is common and is a cause of morbidity and mortality around the world. Many affected are unaware that they have a problem, and it is found opportunistically when their blood pressure is recorded during a consultation for another problem. If the disease is inadequately treated, it can have potentially fatal outcomes. Nurses and non-medical prescribers are likely to come across patients with raised blood pressure readings during routine clinic appointments. This article hopes to give them a better understanding of the condition, its treatment and complications, with the aim of reducing the risk of serious problems and improving outcomes for all those affected by this potentially dangerous condition. [ABSTRACT FROM AUTHOR]

Background: Older people who receive care at home are likely to require support with oral health care. Community nurses, who are also referred to as district or home care nurses, have an important role with this population. This is because they are the healthcare professionals who are most likely to encounter this population, who may also not be receiving regular dental care or oral health promotion. However, few studies have explored community nursing experiences in the delivery and support of oral healthcare for older people living at home. Methods: A grounded theory approach was used to explore experiences of community nurses in the delivery and support of oral health care for older people living at home. Fifteen practising community nurses from the United Kingdom participated in one-to-one semi-structed interviews from May 2021 to December 2021. These interviews were audio-recorded, transcribed verbatim and analysed using constant comparative analysis. Ethical approval was obtained for this study prior to data collection. Results: Four categories emerged from the data to support development of the core phenomena. These four categories were: (1) Education, in relation to what community nurses knew about oral health, (2) Practice, with regards to how community nurses delivered oral health care to older people in their own home, (3) Confidence, with consideration to the extent to which this supported or impeded community nurses in providing oral healthcare to older people and (4) Motivation, in terms of the extent to which community nurses thought they could or should influence future practice improvement in the area. The core category was (C) Uncertainty as it was both present and central across all four categories and related to community nursing understanding about their specific role, and the role of other professionals, with reference to oral health of their patients. Conclusions: This study reveals community nurses' uncertainty in providing oral healthcare to older adults at home. Emphasising comprehensive and continuous oral health education can boost nurses' confidence in patient support. Interprofessional collaboration and clear role definitions with oral health professionals are crucial for improving oral health outcomes in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Parent carers of disabled children are at increased risk of physical and mental health problems. The Healthy Parent Carers (HPC) programme is a manualised peer‐led group‐based programme that aims to promote parent carer health and wellbeing. Previously, the programme had been delivered in person, with recruitment and delivery managed in a research context. This study explored implementation by two delivery partner organisations in the United Kingdom. Facilitator Training and Delivery Manuals were modified for online delivery using Zoom due to COVID‐19. Methods: The study methodology utilised the Replicating Effective Programs framework. A series of stakeholder workshops informed the development of the Implementation Logic Model and an Implementation Package. After delivering the programme, delivery partner organisations and facilitators participated in a workshop to discuss experiences of implementing the programme. A wider group of stakeholders, including commissioners, Parent Carer Forums and charity organisations representatives and researchers subsequently met to consider the sustainability and potential barriers to delivering the programme outside the research context. Results: This study explored implementation by two delivery partner organisations in the United Kingdom that were able to recruit facilitators, who we trained, and they recruited participants and delivered the programme to parent carers in different localities using Zoom. The co‐created Implementation Logic Model and Implementation Package were subsequently refined to enable the further roll‐out of the programme with other delivery partner organisations. Conclusions: This study provides insight and understanding of how the HPC programme can be implemented sustainably outside of the research context. Further research will evaluate the effectiveness of the programme and refine the implementation processes. Patient and Public Contribution: Parent carers, delivery partner organisation staff and service commissioners were consulted on the design, delivery and reporting of the research. [ABSTRACT FROM AUTHOR]

Dementia is an umbrella term used to describe a group of symptoms characterised by behavioural changes, loss of cognitive and social functioning brought about by progressive neurological disorders. It is estimated that around one million people live with a dementia in the UK, with that figure set to rise to 1.2 million by the year 2040. We are learning more about the risk factors for developing dementia over the life course. This paper discusses the non-modifiable and modifiable risk factors for dementia and considers health promotion and health education activities that can be used by community nurses. [ABSTRACT FROM AUTHOR]

Background: Nursing competency frameworks describe the competencies; knowledge, skills and attitudes nurses should possess. Countries have their own framework. Knowledge of the content of professional competency frameworks in different countries can enhance the development of these frameworks and international collaborations. Objective: This study examines how competencies and task divisions are described in the current professional competency frameworks for registered nurses (RNs with a Bachelor's degree) in the Netherlands, Belgium, the United Kingdom (UK), Canada and the United States (US). Methods: Qualitative document analysis was conducted using the most recently published professional competency frameworks for registered nurses in the above-mentioned five countries. Results: All the competency frameworks distinguished categories of competencies. Three of the five frameworks explicitly mentioned the basis for the categorization: an adaptation of the CanMEDS model (Netherlands), European directives on the recognition of professional qualifications (Belgium) and an adapted inter-professional framework (US). Although there was variation in how competencies were grouped, we inductively identified ten generic competency domains: (1) Professional Attitude, (2) Clinical Care in Practice, (3) Communication and Collaboration, (4) Health Promotion and Prevention, (5) Organization and Planning of Care, (6) Leadership, (7) Quality and Safety of Care, (8) Training and (continuing) Education, (9) Technology and e-Health, (10) Support of Self-Management and Patient Empowerment. Country differences were found in some more specific competency descriptions. All frameworks described aspects related to the division of tasks between nurses on the one hand and physicians and other healthcare professionals on the other hand. However, these descriptions were rather limited and often imprecise. Conclusions: Although ten generic domains could be identified when analysing and comparing the competency frameworks, there are country differences in the categorizations and the details of the competencies described in the frameworks. These differences and the limited attention paid to the division of tasks might lead to cross-country differences in nursing practice and barriers to the international labour mobility of Bachelor-educated RNs. [ABSTRACT FROM AUTHOR]

Background: Reiki is a biofield therapy which is based on the explanatory model that the fields of energy and information of living systems can be influenced to promote relaxation and stimulate a healing response. Objective: To conduct a pragmatic within-subject pilot trial of a remote Reiki program for frontline healthcare workers' health-related symptoms during the COVID-19 pandemic. Methods: Healthcare professionals in the UK (eg, physicians, nurses, and paramedics) were eligible to sign up for a distance Reiki program and were also invited to participate in the research study. Eight Reiki practitioners simultaneously gave each participant Reiki remotely for 20 minutes on 4 consecutive days. Feasibility of the research was assessed, including recruitment, data completeness, acceptability and intervention fidelity, and preliminary evaluation of changes in outcome measures. Participants' stress, anxiety, pain, wellbeing, and sleep quality were evaluated with 7-point numerical rating scales. Measures were completed when signing up to receive Reiki (pre) and following the final Reiki session (post). Pre and post data were analyzed using Wilcoxon signed ranks tests. Results: Seventy-nine healthcare professionals signed up to receive Reiki and took the baseline measures. Of those, 40 completed post-measures after the 4-day intervention and were therefore included in the pre-post analysis. Most participants were female (97.5%), and the mean age was 43.9 years old (standard deviations = 11.2). The study was feasible to conduct, with satisfactory recruitment, data completeness, acceptability, and fidelity. Wilcoxon signed ranks tests revealed statistically significant decreases in stress (M = −2.33; P <.001), anxiety (M = −2.79; P <.001) and pain (M = −.79; P <.001), and significant increases in wellbeing (M = −1.79; P <.001) and sleep quality (M = −1.33; P =.019). Conclusions: The Reiki program was feasible and was associated with decreased stress, anxiety and pain, and increased wellbeing and sleep quality in frontline healthcare workers impacted by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Aim To examine trends in public awareness and knowledge of drinking guidelines in the UK since their revision in 2016, which had moved from a daily to a weekly guideline, made the guideline the same for men and women, and reduced the guideline for men by around one-third. Method Data were from a representative, repeat cross-sectional survey. We analysed changes in awareness and knowledge of drinking guidelines among 8168 adult drinkers between 2016 and 2022 and associations with sociodemographic characteristics, smoking status and level of alcohol consumption. Results The proportion of drinkers aware of guidelines declined from 86.0% (95%CI 84.0–88.0%) in 2016 to 81.7% (79.5–84.0%) in 2019, then increased during the COVID-19 pandemic, peaking at 91.6% (90.1–93.1%) in 2020. The proportion who correctly identified the guideline as a maximum of exactly 14 units/week remained at around a quarter from 2016 (25.0%, 22.4–27.5%) to 2018 (25.8%, 23.2–28.3%), whereas the proportion who gave a figure of 14 units or fewer rose from 52.1 (49.2–55.0%) to 57.4% (54.6–60.3%). However, by 2022, guideline knowledge had worsened significantly, with these figures falling to 19.7 (17.4–21.9%) and 46.5% (43.6–49.4%), respectively. Changes over time were similar across subgroups. Odds of guideline awareness and knowledge were higher among drinkers who were aged ≥35, female, more educated and from more advantaged social grades. Conclusions The majority of adult drinkers in the UK are aware of low-risk drinking guidelines. However, 6 years since their announcement, knowledge of the revised drinking guidelines remains poor. Less than a quarter know the recommended weekly limit and only around half think it is 14 units or less. Inequalities have persisted over time, such that disadvantaged groups remain less likely to know the guidelines. [ABSTRACT FROM AUTHOR]

Background: Supermarkets are the primary source of food for many people yet their full potential as a setting to encourage healthy dietary-related behaviours remains underutilised. Sharing the experiences from research groups who have worked with supermarket chains to evaluate strategies that promote healthy eating could improve the efficiency of building such relationships and enhance the design quality of future research studies. Methods: A collective case study approach was used to synthesise experiences of engaging and sustaining research collaborations with national supermarket chains to test the effectiveness of health-focused in-store interventions. The collective narrative covers studies conducted in three high-income countries: Australia, the Netherlands and the United Kingdom. Results: We have distilled our experiences and lessons learned into six recommendations for conducting high quality public health research with commercial supermarket chains. These include: (i) using personal contacts, knowledge of supermarket activities and engaging executive management to establish a partnership and allowing time to build trust; (ii) using scientifically robust study designs with appropriate sample size calculations; (iii) formalising data exchange arrangements and allocating adequate resource for data extraction and re-categorisation; (iv) assessing effects at individual/households level where possible; (v) designing a mixed-methods process evaluation to measure intervention fidelity, dose and unintended consequences; and (vi) ensuring scientific independence through formal contract agreements. Conclusions: Our collective experiences of working in non-financial partnerships with national supermarket chains could be useful for other research groups looking to develop and implement supermarket studies in an efficient manner. Further evidence from real-life supermarket interventions is necessary to identify sustainable strategies that can improve population diet and maintain necessary commercial outcomes. [ABSTRACT FROM AUTHOR]

Background Animal-assisted interventions (AAIs) are increasingly common in UK health settings. The Covid-19 pandemic has impacted on their delivery, with many organizations offering AAIs virtually during lockdown periods. This small-scale survey aims to explore the impact of Covid-19 on the delivery of AAIs, and associated challenges and opportunities. Methods A cross-sectional, retrospective questionnaire survey was conducted with UK AAI providers. The anonymized survey was distributed via academic and third sector networks and social media. Descriptive statistics and free-text responses are presented. Results Thirty-six AAI providers completed the survey. Of these, 83.3% continued to deliver AAIs during the pandemic. Twenty-eight delivered AAIs remotely and highlighted associated challenges, such as clients being unable to touch the animal, and clients having restricted access to the required technology. Over half reported their animal missed face-to-face interaction. However, they also reported advantages to remote delivery, such as for those who are allergic or fearful of animals. The most commonly reported challenges of in situ delivery included difficulty maintaining distance from the client and the use of face masks, which were perceived to hinder communication. Conclusion The transition to remote delivery has highlighted challenges and opportunities. Further research could explore these in greater depth and compare the impact of different delivery modes. [ABSTRACT FROM AUTHOR]

Background The evidence for access to NHS Health Check (NHSHC) varies considerably across the country. This study examined the equity in invitation, uptake and coverage of NHSHC and impact of different invitation methods. Methods This patient-level cross-sectional study from 52 general practices in Walsall used adjusted logistic regressions to examine the association between patient characteristics (age, sex, ethnicity and deprivation) and NHSHC access. Results Over the 5-year study period, 61 464 people were eligible for NHSHC, 66% were invited, uptake was 74% and coverage was 55%. Males had lower odds of: invitation (AOR: 0.78, 95% CI: 0.75–0.81), uptake (0.73, 95% CI: 0.70–0.77) and coverage (0.69, 95% CI: 0.66–0.71). Compared with White, the 'Other' ethnicity group (mixed backgrounds, other Asians that are not South Asians and other ethnic groups) had lower odds of: invitation (0.74, 95% CI: 0.67–0.81), uptake (0.86, 95% CI: 0.75–0.98) and coverage (0.74, 95% CI: 0.68–0.81). The most deprived areas had lower odds of invitation, uptake and coverage. Opportunistic invitation had a 25-fold increase in odds of uptake. Conclusions The study has highlighted areas of inequities in access to NHSHC. The group most negatively affected were men, people from particular minority ethnic groups and people from deprived communities. Further actions are needed to reduce these inequities. [ABSTRACT FROM AUTHOR]