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Reports on the Sixth Annual Conference of the Learning and Skills Research Network (Learning and Skills Development Agency) held at the University of Warwick, UK, in December 2002. Presents an overview of keynote speeches and reviews selected conference papers reporting on current research in the learning and skills sector.

This paper takes a cross-disciplinary perspective in examining the views and practices of public engagement with research by UK academics. Using a mixed method approach consisting of a survey questionnaire and interviews, the paper identifies the range of audience groups that can potentially be engaged with by academics, and shows that some audiences are more relevant to particular disciplinary groups than others. The paper also identifies the various public engagement activities undertaken by academics and finds that some academics are using creative ways of engaging the public, such as using the services of public relations firms to help in disseminating their research in traditional media outlets, and also by using social media. Essentially, the study reveals that some academics feel the pressure of engaging particular audiences at the expense of those that are relevant to them and that, academics in the main, are opposed to the notion of mandating public engagement as part of appraisal systems.

Background: Moral distress is recognized as an international problem that contributes to decreased work productivity, job dissatisfaction and intent to leave for adult Critical Care nurses. Aim: To explore Critical Care nurses moral distress levels using the Moral Distress Scale Revised (MDS‐R) and its relationship with intention to stay. The study reported in this paper was part of a larger study that also investigated Critical Care nurses' work environment in Canada and the Midlands region of the UK. Study design: During January to August 2017 a cross‐sectional survey was distributed to adult Critical Care nurses in the Midlands region of the UK. Methods: Surveys were distributed to adult Critical Care Registered Nurses in the Midlands region of the UK examining moral distress levels and intention to stay in Critical Care, the organization (NHS Trust) and in the nursing profession. Results: Two hundred sixty‐six number of a potential sample of 1066 Critical Care nurses completed the survey (25% response rate). Age and moral distress were significantly positively correlated with intention to stay on their current unit (r = 0.16, P =.05), indicating older nurses were more likely to stay in the critical care unit. Moral distress was negatively correlated with intent to stay scores, showing critical care nurses with higher levels of moral distress were less likely to stay on their unit (r = −0.20, P =.02). Moral distress was also significantly negatively correlated with intention to stay with their current employer (r = −0.28, P <.001). Nurses that stated they had high rates of moral distress were more likely to consider leaving their current employer. Conclusion: Moral distress appears to be an issue among adult Critical Care nurses requiring further exploration and development of effective strategies to reduce this phenomenon and stabilize the workforce by reducing turnover. Relevance to clinical practice: By identifying the top causes of moral distress, tools and strategies can be developed to allow the Critical Care nurse to work within an ethically safe clinical environment and reduce the turnover of experienced adult Critical Care nurses. [ABSTRACT FROM AUTHOR]

Introduction: Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods: A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues. Results: The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination. Conclusion: Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption. [ABSTRACT FROM AUTHOR]

The importance of support to breastfeeding success is well established, as are the difficulties many mothers face in accessing the support they need. With the majority of UK mothers now accessing social media for support, Breastfeeding Support Facebook (BSF) groups have increased exponentially. BSF groups vary in type (local or national/international) and in moderation—overseen by breastfeeding mothers and by midwives or trained lactation specialists. Some groups aimed at supporting mothers in a specific geographical area also have associated face‐to‐face groups, facilitated as either professional or peer support. Little is currently known about these specific local groups, their prevalence, impact or value to mothers. This paper examines mothers' experiences of using local BSF groups and why they value them as part of a larger study exploring the impact of midwife moderation on these groups. An online survey consisting of open and closed questions was completed by 2028 mothers. Findings identified that local BSF groups are widely used and highly valued for their connection with local face‐to‐face services and other mothers. They offer access to expertise and shared experience in a format mothers find convenient and timely, improving confidence and self‐efficacy. Local BSF groups enable the formation of support networks and development of breastfeeding knowledge that mothers credit with increased well‐being, motivation and breastfeeding duration. As such, they have the potential to add value to local face‐to‐face services and improve breastfeeding experiences and knowledge in communities. The findings have important implications to support the development of integrated online interventions to improve public health. [ABSTRACT FROM AUTHOR]

This paper presents findings from a scoping review of curriculum delivery methods for research teaching in undergraduate social work education. The review was conducted by a working group of the JUC SWEC research committee following the introduction of a new degree by the Social Work Reform Board. The paper draws on data from a mixedmethods study, in which five models of research teaching were identified by a qualitative study, together with findings, which mapped how commonly the models were adopted, from a survey of sixty universities of all four countries of the UK. These models are discussed in relation to anticipated learning outcomes: research-informed teaching; educated consumers of research; research-mindedness; research capacity and reflective practitioner researchers. It is less than a decade since the Economic and Social Research Council (the government research council for the social sciences) first recognised social work as a distinct discipline; in this period, social work educators have taken innovative approaches to underpin teaching and practice learning by research. The study implications are that a larger study should provide evidence for the learning outcomes associated with different approaches. [ABSTRACT FROM AUTHOR]

This paper summarises lessons learned in relation to an ongoing study to collect feedback on e-government systems that have been implemented to e-enable several core administrative functions in the UK as part of the I-MEET project. Previous work summarises findings from surveys of users of such systems and this paper reports on the experience of surveying providers. An extensive survey was designed and administered to explore provider perspectives on the e-government application in general, system aspects, cost, implementation, prerequisites (e.g. policy support), various dimensions of effects, and the respondent's overall opinion of the system. The survey found a complex mix of internal and external contacted service providers and commissioners, each of whom has a different set of success measures for a service, and shared services (such as common web site providers) that were not obvious but could result in correlated observations. These findings provide signposts for future researchers to potential pitfalls. Nevertheless, when complete, the integration by the I-MEET project of user and provider perspectives will give policy makers the opportunity to balance the scale, complexity and expense of electronically delivered transactions on the government side with the usability and satisfaction from the user perspective, revealing linkages between aspects of both. [ABSTRACT FROM AUTHOR]

The article discusses a study which investigated the use of the Hirsch's (h)-index in measuring the quality of the output of health services researchers. Topics discussed include the increase in the h-index of qualitative researchers and statisticians, the calculation of pairwise Spearman's rank correlations for the number of publications, number of citations and 10-index and the results of a quantile regression to predict the median, 90th and 95th quantiles for h-index.

Good nutrition in the early years of life is vitally important for a child's development, growth and health. Children's diets in the United Kingdom are known to be poor, particularly among socially disadvantaged groups, and there is a need for timely and appropriate interventions that support parents to improve the diets of young children. The Medical Research Council has highlighted the importance of conducting developmental and exploratory research prior to undertaking full-scale trials to evaluate complex interventions, but have provided very limited detailed guidance on the conduct of these initial phases of research. This paper describes the initial developmental stage and the conduct of an exploratory randomised controlled trial undertaken to determine the feasibility and acceptability of a family-centred early years' nutrition intervention. Choosing Healthy Eating when Really Young ( CHERRY) is a programme for families with children aged 18 months to 5 years, delivered in children's centres in one urban ( Islington) and one rural ( Cornwall) location in the United Kingdom. In the development stage, a mixed-methods approach was used to investigate the nature of the problem and options for support. A detailed review of the evidence informed the theoretical basis of the study and the creation of a logic model. In the feasibility and pilot testing stage of the exploratory trial, 16 children's centres, with a sample of 394 families were recruited onto the study. We hope that the methodology, which we present in this paper, will inform and assist other researchers in conducting community-based, exploratory nutrition research in early years settings. [ABSTRACT FROM AUTHOR]

This paper presents the findings of an audit of research teaching in UK-qualifying social work education. The audit was part of a wider ESRC-funded study that provides baseline data for setting progress objectives towards building research capacity in the discipline and profession. This paper offers observations from the audit, based on a survey of undergraduate and postgraduate (Masters) qualifying social work programmes across all four countries, with in-depth enquiry into a smaller sample from each. The survey examined what research methods were taught, how, where, when and by whom. Most importantly, it considered why these choices were made, and the challenges and possibilities were presented for building research capacity and research-mindedness at qualifying level. The audit highlighted a range of factors that contributed to the marginalisation of research teaching. These included not only lack of time, staff skill and resource, but also more fundamental reservations and resistance on the part of educators, students and practitioners towards engaging with research. It is suggested that at the heart of such ambivalence lies a fundamental debate about the nature of the social work discipline, and the relationship between research and practice. [ABSTRACT FROM PUBLISHER]

The article discusses a research paper which focuses on how computer-aided facilities management (CAFM) can be applied for intelligent buildings operation based on questionnaire survey in United Kingdom. It investigates definitions of Intelligent buildings (IBs) and the extension of CAFM to IBs concepts including the opportunities that such integrated systems will provide to facilities management (FM) professionals. It gives experience-based suggestions for both demand and supply sides of the service procurement to gain the feasible benefits and avoid hindering obstacles. It informs on the results of findings which showed variation in the understanding of the concept of IBs and the application of CAFM and provides insight to the current and future tools for the mobile aspects of FM.

Background: There are significant challenges across the research pathway, including participant recruitment. This paper aims to explore the impact of clinician recruitment decision-making on sampling for a national mental health survey. Method: Clinical teams in 20 English mental healthcare provider organisations screened caseload lists, opting-out people whom, in their judgement, should not be approached to participate in a survey about stigma and discrimination. The reasons for each individual opted-out were requested. We assess these reasons against study recruitment criteria and investigated the impact of variations in opt-out rates on response rates and study findings. Results: Over 4 years (2009-2012), 37% (28,592 people) of the total eligible sampling frame were excluded. Exclusions comprised three categories: clinical teams did not screen their lists within recruitment period (12,392 people: 44%); protocol-specified exclusions (8364 people: 29%); clinician opt-outs queried by research team (other reasons were given) (7836, 28%). Response rates were influenced by decision-making variations. Conclusions: Large numbers of people were denied the opportunity to choose for themselves whether to participate or not in the Viewpoint Survey. The clinical research community, and their employing organisations, require support to better understand the value of research and best practice for research recruitment. [ABSTRACT FROM AUTHOR]

Purpose Research suggests that 85 per cent of health research is avoidably wasted. The research and development management community has an important role in the research process and can contribute to improving the quality and value of research. Al-Shahi Salman et al. (2014) identified ways in which the community can contribute towards the reduction of research waste by increasing the efficiency of recruitment and retention of research participants, data management and data sharing in studies, and promoting the integration of research into practice. The paper aims to discuss these issues.Design/methodology/approach A project undertaken between May 2016 and May 2017 explored the perspective, and contribution, towards reducing research waste amongst the research and development management community. The study identified those categories of research waste the community felt were the most important and of the most value to address. It also examined spheres of influence and barriers to addressing research waste.Findings The most important and highest value categories of research waste to address were: implementation of research in practice, prioritisation of research, and design, conduct and analysis of research. The research and development management community’s level of influence in those areas was low. The categories where the community felt they had most influence, with the exception of design, conduct and analysis of research, were generally those they thought were less important and valuable, i.e. research taking place to time and target, public and patient involvement, and administration.Originality/value Waste in research is a significant area of waste in health care expenditure. This study has provided a better understanding of research waste for the research management community. The research and development management community can take a leadership role in formulating an action plan and identifying measures of success in reducing waste in research. [ABSTRACT FROM AUTHOR]

Background:The European Disability Strategy (2010–2020) seeks to significantly raise the proportion of people with disabilities working in the open labour market. The ERGO WORK project is a collaboration of academic and industrial partners in six European countries, focused on understanding and tackling barriers to workplace inclusion for workers with disabilities. Methods:This study sought to explore the perceptions and needs of stakeholders in terms of workplace adaptation to the needs of employees with disabilities. An exploratory online survey was completed by 480 participants across six countries. Results:The analysis suggests that workplaces could be further improved to meet the needs of employees with considerable scope for training within companies to raise awareness about employees’ needs, employers’ obligations and workplace adaptation. Conclusions:This snapshot suggests there is still a gap between intent and reality in workplace inclusion and further strategies are needed to improve the opportunities for employees with disabilities. The paper argues that ergonomics may have a key role to play in tackling these challenges and adapting the workplace environment and job design to suit the needs of individual employees.Implications for rehabilitationThis study suggests there is considerable scope for workplace adaptation and improvements to meet the needs of employees with disabilities.Employers need and want further specialist practitioner guidance to facilitate workplace inclusion and support adaptation to individual needs.Organisations would benefit from training to raise awareness about potential solutions and approaches that would support more widespread employment of people with disabilities. [ABSTRACT FROM PUBLISHER]

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

Purpose - The purpose of this paper is to investigate to what extent urban regeneration programmes were targeted at the most deprived geographical areas and populations within the boundaries of nine local authorities (LAs) in the North West of England. Design/methodology/approach - For each of the nine LAs, area-level and individual survey data were used in estimating the proportions of the more deprived neighbourhoods and individuals included in (or excluded from) regeneration target populations after 1995. Findings - The area-level approach found that, in general, the more deprived neighbourhoods within local authority districts had been included in a main regeneration programme target area. However there was evidence of inconsistent coverage between LA areas, as well as some cases of very deprived local areas having no involvement at all in major regeneration programmes since 1995. Additional analysis of available survey data found that substantial numbers of residents with one or more individual indicators of deprivation (not in full-time employment, not owning home, in difficult financial situation) had not been included in a regeneration target population. Research limitations/implications - The basic nature of the measures of regeneration and deprivation used in the study reflect its status as the first stage of a wider project investigating the association between regeneration activity, social exclusion and health. Practical implications - The findings of the study highlight the requirement for evaluators of a regeneration programme to consider how successful the intervention has been in targeting those residents for whom it was initially designed. This should precede any measurement of the programme outputs and their impact upon the "well-being" of the targeted community. Originality/value - The study is original in its use of both aggregated and individual level data in its consideration of how regeneration targets "need". [ABSTRACT FROM AUTHOR]

Purpose - This paper seeks better to conceptualise, operationalise and subsequently to test a multi-dimensional and more social view of servicescape and the direct and moderated linkages with loyalty intentions. Design/methodology/approach - A survey research method was used to study servicescapes in the context of UK restaurants. Findings - In furtherance of conceptualisation efforts, a model is developed to evaluate the linear influences of nine servicescape variables on customers' loyalty intentions. Additionally, the model appraises the impact of personal and environmental factors which moderate the servicescape-loyalty intentions relationship. Analysis of survey responses finds a number of significant associations with loyalty intentions. Practical implications - The results of the study indicate that practitioners should reflect carefully on a range of servicescape variables and judiciously manage such factors to improve the extent to which consumers are likely to foster positive intentions to be loyal. Originality/value - The paper contributes a multi-dimensional and more social framework of servicescape that is subsequently operationalised and tested. It also supplies a measure of servicescape that future researchers may find useful. [ABSTRACT FROM AUTHOR]

The article focuses on quality in terms of social research, methods and position. The aim of the Research Methods Programme is to develop the quality of Great Britain social research through a series of activities such as developing research methods, demonstrating the research application and offering workshops and courses on methods training. The usual quality research criteria for the survey research are clear and distinct. According to both qualitative and quantitative research commentators distinguish transparency as a fundamental to good research.

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

Why you should read this article: • To explore the use and uptake of video group consultations (VGCs) by UK general practice staff during the COVID-19 pandemic • To enhance your awareness of the potential use of VGCs in your clinical setting • To recognise that the use of VGCs is dependent on funding, organisational support, general practice priorities and understanding of the model. Background: Video group consultations (VGCs) are one approach to delivering care using a virtual platform for a group of patients with the same or similar health conditions. However, little is known about the use and uptake of VGCs in the UK. Aim: To describe the use and uptake of VGCs by UK general practice staff during the coronavirus disease 2019 pandemic. Method: A cross-sectional design using an online questionnaire. Data analysis adopted the principles of content analysis and demographic data were analysed descriptively. Findings: A total of 36 participants completed the questionnaire across nine UK regions and representing 36 general practices. A lack of standardisation regarding the use and uptake of VGCs across UK general practices was identified, hindering implementation, scale-up and delivery. Conclusion: While the VGC model looks promising, further research is needed to demonstrate its use and uptake, developing a more robust evidence base for implementation. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

ABSTRACT Background The first independent paediatric retrieval nurse practitioners ( RNP) in the UK and Europe were appointed in 2006 in one hospital Trust. Since then, many have been appointed around the UK but the range of responsibility and scope of the role is unknown as well as possible geographical variability. Aim The aim of this paper is to explore the role and scope of paediatric retrieval nurse practitioners in the United Kingdom ( UK). Method A two part questionnaire was sent to all RNPs identified by the regional retrieval/transport centres. Information was sought about the role and scope of RNPs and how the role may have changed since appointment. RNPs were asked to self-assess their own ability in a variety of technical and leadership skills. Conclusion The majority of respondents felt their role had expanded since appointment. RNPs reported that they would now lead the team for any critically ill infant or child where previously they were retrieving stable or high dependency patients. Other expansions of their role included being on a middle grade tier of the medical rota, asked to undertake aeromedical transfers, providing the withdrawal of care at referring centres and non-medical independent prescribing. Relevance to Practice This survey has revealed the changing role and scope of RNPs in the UK but most importantly, the increased responsibility of the roles. Over 80% of RNPs rated their leadership skills between proficient and expert on Benner's Novice to Expert Continuum (Benner, 1984). [ABSTRACT FROM AUTHOR]

AimTo explore the experiences of people with HIV (PWHIV) using general practitioner (GP) services in order to identify barriers to use.BackgroundTraditionally, GPs have little involvement in the care of PWHIV. However, as HIV becomes a chronic condition and the population of PWHIV ages, there is a need to increase this involvement. Despite high levels of GP registration, the majority of PWHIV in London report that their GP is not involved in their HIV care.MethodsThis paper presents qualitative findings from a mixed method study of PWHIV’s experiences of clinical services. Survey respondents were purposively sampled to recruit 51 PWHIV who took part in eight focus groups. Participants were asked about their experience of using GP services.FindingsThree factors emerged which mediated experiences of GP care. Competence: respondents were concerned about the potential for misdiagnosis of symptoms, lack of awareness of the health needs of PWHIV and experiences of prescribing, which could lead to drug interactions. Continuity: not being able to get appointments quickly enough, not being able to see the same doctor twice and not being able to keep the same GP when one changed address were experienced as impediments to use. Communication: lack of communication between GPs and HIV specialists led to what participants called ‘patient ping-pong’ where they found themselves acting as a go-between for different clinical specialists trying to make sense of their care.ConclusionMeaningful contact between HIV specialists and GPs is likely to allay concerns about competency as treatment and care decisions can be taken collaboratively between the GP, HIV specialist and patient. A key component of acceptable GP care for PWHIV is likely to be the application of long-term condition management approaches, which includes empowered patient self-management. [ABSTRACT FROM AUTHOR]

The paper compares earnings data from the British Household Panel Survey with those collected in the Family Resources Survey, using several measures, which account for various key aspects of the two surveys, and contrasting three different points in time (1995-1996, 2003-2004 and 2007-2008). We first perform non-parametric tests of equality at the centre of the distributions and over the whole earnings distributions. We then apply multivariate regression methods to establish whether the Family Resources Survey and British Household Panel Survey earnings data yield different results in relation to three typical uses of earnings data: the probability of being at the bottom or at the top of the distribution, the estimation of earnings functions both at the mean and at various quartiles and, using earnings as an explanatory variable, the probability of belonging to an occupational pension plan. Our analysis reveals that the two surveys have fairly similar earnings data in the first comparison year, whereas sizable and stable differences emerge in the later two comparisons. These findings are robust to the use of alternative definitions of earnings. They suggest the important role that is played by non-response and attrition between the first and the second comparison time points, and that played by 'learning-by-doing' effects in later data collections. [ABSTRACT FROM AUTHOR]

This paper explores the difficulties encountered by researchers attempting to measure the prevalence of negative workplace behaviours and how these might be overcome. Drawing on the first stage of a major ESRC-funded study of workplace behaviours in Britain, we demonstrate the importance of improved sampling and data collection methods. We show how judicious use of qualitative data derived from cognitive testing of survey questions can improve substantially the reliability and validity of data. In particular, we explain how a battery of questions devised by social psychologists and used as a standard measure in surveys was tested and revised following a series of 60 in-depth interviews. These revisions ranged from fairly minor changes in wording, in order to make questions better understood, to the elimination of questions which our qualitative work persuaded us were not capturing data in the way that other researchers might have assumed they did. [ABSTRACT FROM AUTHOR]

There has been recent increasing interest in reflective practice within physiotherapy education as a method for reducing the ‘theory-practice gap’ and as a means of articulating, exposing and developing knowledge embedded in practice. Several contrasting theories have been developed to explain the role, place, purpose and definition of reflection in learning and teaching; however, much of the research to date has relied on theoretical debate rather than high quality empirical evidence. The aim of this paper was therefore, to report how a group of United Kingdom (UK) based physiotherapy Professional Practice Coordinators ( n ?=?33) with their unique insight into the concept from both the academic and clinical perspective viewed and interpreted the use of reflective practice within their physiotherapy curriculum. Consent for the study was obtained via the professional body (The Chartered Society of Physiotherapists) (CSP) and data was collected via postal questionnaire. Results indicated a diversity of experience in respondents both in terms of their role as Coordinator and their training in reflective practice. There was also no clear consensus regarding facilitative models or assessment methods even though the majority of coordinators believed that reflective practice should be considered to be a central component of physiotherapy teaching strategies. The results of this survey provide a focus for further empirical research into reflective practice as part of the physiotherapy curricula, while advancing the understanding of reflective practice from a broader perspective and clarifying the benefits to students, teachers, patients and practitioners. [ABSTRACT FROM AUTHOR]

Aims and objectives: Surveillance of wound infection including signs of infection alongside antimicrobial usage (types, duration, frequency) can highlight knowledge gaps and inconsistencies. This manuscript aims to highlight these, identify and inform opportunities for practice improvement and to show impact of infection management practice may be having on the issue of antimicrobial resistance. Background: Infected wounds pose challenges to healthcare professionals. Balancing risk of wound deterioration and progression to systemic infection with appropriate use of antimicrobials is necessary to minimise development of resistance. Methods: Analysis consisted of a practice survey of 9661 wounds across 70 community sites over a period of one week. Data were collected from projects between 2017 and 2020. The form was available to providers within the UK, Ireland, Norway, Denmark, Sweden and Finland. EQUATOR research guidelines were followed; STROBE checklist for observational research reporting was completed. Results: Infection rates of 8.9% were reported from wounds assessed. These data indicate inconsistencies with diagnosis across practice with non‐specialists more likely to be unsure of wound infection. Greater confidence in infection identification was observed as number of signs increased. Inconsistencies were also observed in appropriate treatment; antimicrobials were used in 35% of wounds considered not infected and not used in 41% of wounds that were identified as infected. Conclusions: This investigation of infection management practice of over 9000 wounds provides an insight into diagnosis and treatment of infection. Inconsistencies in diagnosis and treatment of wound infections reported highlight the need for increased education, awareness of diagnosis and treatment of infection. Relevance to clinical practice: Variability in management of infected wounds highlights opportunities to aid more effective diagnosis and treatment of infected wounds. Incorporation of support tools or evidence‐based pathways into practice may enhance confidence in management of local infection, balanced with appropriate use, potentially minimising resistance and improving outcomes. [ABSTRACT FROM AUTHOR]

Objective. The aim of this exploratory study was to ascertain the current educational status of pharmacogenomics (PGx) within the present and future UK pharmacy profession, in addition to ascertaining future educational and infrastructure needs of pharmacists to adopt PGx into practice. Methods. A 35-question survey was sent electronically to practicing pharmacists, preregistration pharmacists, and Master of Pharmacy (MPharm) students throughout the UK between April 2018 and May 2019. Responses were anonymous and analysed using GraphPad Prism 8 and SPSS statistics 26. Results. In total, 264 participants, where data could be used for analysis, responded to the survey. This comprised 196 practicing pharmacists and 68 preregistration pharmacists/MPharm students. The findings demonstrated variation in undergraduate level exposure to PGx between those who had qualified within the past 10 years and those who had qualified over 10 years ago. Over 60% of qualified pharmacists did not feel confident in identifying drugs that require PGx testing. Nearly three quarters of respondents cited that PGx guidelines were needed to help facilitate a PGx service, although 63.6% also stated that they had previously never looked for a PGx recommendation. Most respondents cited PGx as a low or medium learning priority. Conclusion. Our survey suggests that further education is required to prepare the UK pharmacy workforce for the advent of PGx. A focus on the provision of, and education around, PGx guidelines is needed. In addition, the disparity identified between pharmacists at different stages of their career will need to be addressed with tailored and targeted educational packages. [ABSTRACT FROM AUTHOR]

Introduction: Perinatal palliative care services are increasingly available globally, offering a range of clinical and psychological support services to families during pregnancy, in the neonatal period and following the death of a baby with a life‐limiting or life‐threatening condition. Little is understood about the role of children's hospice care and how it contributes to effective perinatal palliative care. Design: The study aims to answer the question "what is the role of children's hospices in the provision of perinatal palliative care and advance care planning in the United Kingdom?" Methods: An electronic survey was sent to all 54 children's hospices in the United Kingdom between May and June 2022. Results: Thirty hospices responded, representing 54% of the sector. All regions of all four counties are represented. Numbers of referrals to hospices for perinatal palliative care have increased significantly over the last 5 years. Hospices provide a range of services for families and babies, usually from the point of diagnosis or recognition of a life‐limiting or life‐threatening condition, underpinned with counseling and emotional support. Hospices worked with a range of professionals and services, most commonly fetal medicine and neonatal services. Advance care plans were an important element of effective perinatal palliative care, strengthening parent–professional and interprofessional relationships. Conclusion: Children's hospice services play an important and growing role in the perinatal care of babies and families following the diagnosis or recognition of a life‐limiting or life‐threatening condition. The family‐centered approach to care, from a broad, biopsychosocial perspective means that hospices make a unique and meaningful contribution to both the clinical and psychological needs of families. Clinical relevance: The family‐centered approach to care, from a broad, biopsychosocial perspective means that hospices make an important contribution to both the clinical needs of babies, and psychological needs of families antenatally, in the neonatal period and after death. [ABSTRACT FROM AUTHOR]

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

In this paper, queuing theory is tested through an examination of the occupational attainment of six groups of non-whites in London and New York. Workers in the dominant economy are distinguished from those in the niche economy and emphasis is placed on the former. Black male immigrants in New York and black female immigrants in London hold more favorable occupational status. These results reflect differences in (1) the presence of indigenous minorities--African Americans and Puerto Ricans--in New York but not London, and (2) the relatively low position of indigenous minority males compared to the relatively middling position of indigenous minority females in New York's labor queue. [ABSTRACT FROM AUTHOR]

As complex environments within which individuals and populations operate, universities present important contexts for understanding and addressing health issues. The healthy university is an example of the settings approach, which adopts a whole system perspective, aiming to make places within which people, learn, live, work and play supportive to health and well-being. The UK Healthy Universities Network has formulated an online toolkit, which includes a Self-Review Tool, intended to enable universities to assess what actions they need to take to develop as a healthy university. This paper presents findings from consultative research undertaken with students from universities in England, Scotland and Wales, which explored what they believe, represents a healthy university. Methods: Student surveys and focus groups were used to collect data across eleven universities in England, Scotland and Wales. A priori themes were used to develop our own model for a healthy university, and for the thematic coding phase of analysis. Findings: A healthy university would promote student health and well-being in every aspect of its business from its facilities and environment through to its curriculum. Access to reasonably priced healthy food and exercise facilities were key features of a healthy university for students in this study. The Self-Review Tool has provided a crucial start for universities undertaking the journey towards becoming a healthy university. In looking to the future both universities and the UK Healthy Universities Network will now need to look at what students want from their whole university experience, and consider how the Self-Review Tool can help universities embrace a more explicit conceptual framework. Conclusion: The concept of a healthy university that can tailor its facilities and supportive environments to the needs of its students will go some way to developing students who are active global citizens and who are more likely to value and prioritise health and well-being, in the short and long term through to their adult lives. [ABSTRACT FROM AUTHOR]

Background: Globally, initiation of paediatric advance care planning discussions is advocated early in the illness trajectory; however, evidence suggests it occurs at crisis points or close to end of life. Few studies have been undertaken to ascertain the prevalence and determinants of behaviour related to initiation by the healthcare professional. Method: Underpinned by the Capability, Opportunity, Motivation–Behaviour (COM‐B) model for behaviour change, a cross‐sectional online survey was conducted in United Kingdom and Ireland using a purposive sample of health professionals. Descriptive and inferential statistics were applied and nonparametric statistical analysis used. Open‐ended questions were mapped and correlations between COM‐B and demographic profiles identified. Results: Responses (n = 140): Paediatric advance care planning was viewed positively; however, initiation practices were found to be influenced by wide ranging diagnoses and disease trajectories. Whilst some tools and protocols exist, they were not used in a systematic manner, and initiation behaviour was often not guided by them. Initiation was unstandardized, individually led, guided by intuition and experience and based on a range of prerequisites. Such behaviour, combined with inconsistencies in professional development, resulted in varying practice when managing clinical deterioration. Professionals who felt adequately trained initiated more conversations (capability). Those working in palliative care specialties, hospice settings and doctors initiated more discussions (opportunity). There was no difference in Motivation between professions, clinical settings or specialisms, although 25% (n = 35) of responses indicated discomfort discussing death and 34% (n = 49) worried about families' emotional reaction. Conclusion: Although advocated, paediatric advance care planning is a complex process, commonly triggered by the physical deterioration and rarely underpinned by support tools. The COM‐B framework was useful in identifying fundamental differences in initiation behaviour; however, further research is required to explore the complexity of initiation behaviour and the system within which the care is being delivered to identify influences on initiation. [ABSTRACT FROM AUTHOR]

To explore if psychiatrists in India carry out less research as opposed to psychiatrists of Indian origin working in the United Kingdom (UK), we carried out a small-scale survey of psychiatrists practicing in India and psychiatrists of Indian origin working in the UK. In light of the findings of this survey and from the three authors' experience of teaching, training, working, and engaging in research in India and the UK, we try to answer questions such as "why do psychiatrists in India carry out less research? Should it change, and if so how? What can one learn?" Here, we do not assume or advocate that one system (East or West) has all the answers. We merely wish to discuss the place of research in psychiatric training and psychiatric practice. [ABSTRACT FROM AUTHOR]

Using an exploratory mixed‐methods approach, we examined thoughts concerning refugees reported by participants from a non‐Western country, Uganda, and the United Kingdom (total N = 113). We explored whether, due to various sociocultural, political and geographic differences, critical features of refugee migration (e.g., migration forcedness and migration‐related perils) would be viewed differently by Ugandan and UK participants. An inductive qualitative content analysis of responses in an online survey yielded 11 categories with 40 subcategories revealing several similarities between Ugandan and UK participants. For instance, similar proportions of participants from both countries acknowledged refugees' suffering before their migration and the forced nature of refugees' migration. However, we also found that more British than Ugandan participants referred to perils refugees suffer during their journeys, possibly resulting from differences in refugees' migration routes (e.g., crossing other countries, travelling by dilapidated boats, migration duration). Furthermore, Ugandan but not British participants took pride in international praise their country received for its forthcoming treatment of refugees. There were no differences regarding the extent to which Ugandan and British individuals exhibited prejudice towards refugees or experienced threats from refugees. We discuss the theoretical and practical implications of our findings for refugee integration. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper reports on a survey of mental health clinician views of including people with psychosis and negative symptoms in outcome research. A questionnaire was forwarded to clinicians (the majority of whom were mental health nurses) completing post-registration undergraduate and postgraduate degree courses in psychosocial interventions for psychosis. Fifty questionnaires were returned (a response rate of 84.7%). A total of 47% of respondents indicated that they might refrain from offering this group as potential participants to clinical trials. Thematic analysis suggests views that negative symptoms are not amenable to treatment inform such decisions. The results highlight the potential difficulties faced by researchers investigating new treatments for people with negative symptoms, and suggest further exploration of clinician views of referring this group to research and psychosocial treatments is warranted. [ABSTRACT FROM AUTHOR]

Aims: To ascertain perceptions of reasons for follow-up after cancer treatment among service users (patients and carers), primary care practitioners and specialist clinicians (doctors and specialist nurses) and to identify levels of preference for different models of follow-up and the effect of an individual’s experience on preferred models. Materials and methods: A national survey designed to meet the needs of each key respondent group was carried out after a structured literature review, an extensive consultation process and a pilot scheme. Respondents were asked to assess their degree of preference for 10 pre-selected indications for follow-up. Eight models of follow-up were also identified and respondents were asked to state their experience and preference for each type. The questionnaire was distributed nationally via the 34 cancer networks in England and was available both online and in hard copy (postal). The uptake for the electronic format was in the main by primary care practitioners and specialist clinicians. Service users preferred the paper (postal) format. The survey was also publicised through the primary care and patient partnership forums at a Cancer Network Development event. Results: In total, 2928 responses were received, comprising service users (21% of the sample), primary care practitioners (32%) and specialist clinicians (47%). Eighty-six per cent of responses were received from the 10 strategic health authorities in England, with the remaining 14% from Scotland, Wales and The Isle of Man. The responses from Scotland, Wales and the Isle of Man generally occurred where they interfaced with English cancer networks or had been engaged through word of mouth by colleagues. Among all respondents the main aims of cancer follow-up were considered to be: (1) to monitor for early complications after treatment; (2) to detect recurrences early; (3) to detect late effects of treatment. The most commonly experienced method of follow-up among all respondent groups was outpatient review with a doctor. This was considered to be the most preferred follow-up option among service users (86%). The least preferred option among service users was postal follow-up (32%). Primary care practitioners and specialist clinicians were more likely than service users to have experienced alternative methods of follow-up, such as telephone follow-up, self-triggered referral and non-specialist follow-up. These models were highly rated by those who had experience of them. Conclusions: There was a reasonable level of consensus between service users, primary care practitioners and specialist clinicians as to the reasons for follow-up. Service users seemed to have higher expectations of follow-up, particularly in relation to detecting recurrences early. As respondents were more likely to prefer a method of follow-up delivery that they had experienced than one they had not; there could be resistance to change from established methods to new methods without adequate explanation. This suggests that the communication of new methods could be critical to their successful introduction. [Copyright &y& Elsevier]

Background: The prevalence of dental anxiety among a representative sample of children in the UK was determined in the Children's Dental Health survey of 2003. Aims: This paper is concerned with the extent to which children in the United Kingdom are judged by a parent or carer to be behaviourally affected by dental anxiety and the factors associated with this. Method: The information was gathered by self-completion questionnaire distributed to the parents of half of the sample of children who were also clinically examined in the dental survey. Results: Dental anxiety that was sufficient to disrupt dental attendance was reported for around 3-4% of the four age groups surveyed (5, 8, 12 and 15 years of age). Children's dental anxiety was associated with parental dental anxiety; a greater experience of invasive dental treatment and general anaesthetic; receipt of free school meals and social class. Conclusions: Whilst these findings do not necessarily indicate causal relationships, they do confirm a number of co-factors associated with dental anxiety perhaps most importantly that of anxiety with the experience of general anaesthetic for tooth extractions. [ABSTRACT FROM AUTHOR]

Background: Analysis of the Psychiatric Morbidity Survey of Great Britain showed that the prevalence of common mental disorders was lower amongst men at or above Britain's state pension age of 65, relative to younger men. Retirees below this age had consistently higher rates of mental disorders than working men. In contrast, the low prevalence of mental disorders amongst retirees aged 65 and older was similar to that of their working peers. The aim of this analysis was to investigate this pattern of results in a national sample of Australian men, and the mediating role of socio-demographic factors.Method: Data were from the Household, Income and Labour Dynamics (HILDA) in Australia survey (2003). The analyses included men aged 45-74 years who were active in the labour force (n = 1309), or retired (n = 635). Mental health was assessed using the mental health scale from the Short-Form 36 Health Questionnaire.Results: Retirees were more likely to have mental health problems than their working peers, however this difference was progressively smaller across age groups. For retirees above, though not below, the age of 55 this difference was explained by poorer physical functioning. When age at retirement was considered it was found that early retirees who were now at or approaching the conventional retirement age did not display the substantially elevated rates of mental health problems seen in their younger counterparts. Further, men who had retired at age 60 or older did not display an initially elevated rate of mental health problems.Conclusions: The association between retirement and mental health varies across older adulthood. Retired British and Australian men below the conventional retirement age of 65 are more likely to have mental health problems relative to their working peers, and retirees above this age. However, poor mental health appears to be linked to being retired below this age rather than an enduring characteristic of those who retire early. [ABSTRACT FROM AUTHOR]

Introduction: As the scope and nature of practice evolves in an ever-changing health and social care landscape, it is imperative the profession continues to expand the evidence base underpinning interventions. The Royal College of Occupational Therapists partnered with the James Lind Alliance to bring together people with lived experience, occupational therapists and other people working in the health and care sector to identify contemporary research priorities for the profession in the United Kingdom. Method: The JLA's well-established methodology was adopted. An opening consultation survey gathered unanswered questions. Analysis of responses and evidence checking preceded an initial prioritisation survey. The final prioritisation workshop drew on nominal group technique. Findings: 927 respondents submitted 2193 questions. Those within the project's scope were captured in 66 overarching summary questions using thematic analysis. These were initially ranked by 1140 respondents. 18 questions comprising the 10 most highly ranked by people with lived experience and by those with professional experience were considered by 19 participants in the final workshop. Together, they reached consensus on the Top 10 priorities. Conclusion: These research priorities provide a contemporary framework influencing and guiding future research, ensuring it addresses the issues of greatest importance to people accessing and delivering services. [ABSTRACT FROM AUTHOR]

Purpose: Stigma reduction is an important public health challenge because of the large morbidity and mortality associated with some forms of substance use. Extreme stigma can lead to dehumanisation of target groups, who are ascribed with lesser humanity. The authors examined whether there was blatant and subtle dehumanisation of people who use heroin, and if these were associated with levels of support for non-discriminatory drug policy. Design/methodology/approach: A cross-sectional online study using a UK convenience sample (n = 307 [75.2% female, mean age 28.6 ± 12.2 years]) was conducted. Participants completed assessments of blatant (Ascent of Humans [AoH] scale) and subtle (an emotion attribution task) dehumanisation and a bespoke measure assessing support for non-discriminatory drug policies. Other measures controlled for stigma towards people who use drugs (PWUD) and moral disgust. Findings: There was greater blatant dehumanisation of people who used heroin compared to the general population and other potentially stigmatised reference groups, including people who use cannabis. The authors also found evidence of subtle dehumanisation, and people who used heroin were rated as being less likely to feel uniquely human emotions, less likely to feel positive emotions and more likely to feel negative emotions. Blatant dehumanisation was associated with significantly lower probability of support for non-discriminatory drug policy. Social implications: Dehumanisation may present significant challenges for stigma reduction initiatives and in fostering public support for drug policy and treatment. Denial of the humanity of this group could be used to justify discriminatory policies or relative deprioritisation of support services in funding decisions. Activities that seek to "rehumanise" PWUD, including social inclusion, and encouraging compassionate media representations that portray the lived experiences of substance use may be useful areas of future work. Originality/value: This is the first study to investigate blatant and subtle dehumanisation of people who use heroin, and how this relates to public support for drug policy. [ABSTRACT FROM AUTHOR]

Background: We aimed to estimate multimorbidity trajectories and quantify socioeconomic inequalities based on childhood and adulthood socioeconomic position (SEP) in the risks and rates of multimorbidity accumulation across adulthood.Methods and Findings: Participants from the UK 1946 National Survey of Health and Development (NSHD) birth cohort study who attended the age 36 years assessment in 1982 and any one of the follow-up assessments at ages 43, 53, 63, and 69 years (N = 3,723, 51% males). Information on 18 health conditions was based on a combination of self-report, biomarkers, health records, and prescribed medications. We estimated multimorbidity trajectories and delineated socioeconomic inequalities (based on childhood and adulthood social class and highest education) in multimorbidity at each age and in longitudinal trajectories. Multimorbidity increased with age (0.7 conditions at 36 years to 3.7 at 69 years). Multimorbidity accumulation was nonlinear, accelerating with age at the rate of 0.08 conditions/year (95% CI 0.07 to 0.09, p < 0.001) at 36 to 43 years to 0.19 conditions/year (95% CI 0.18 to 0.20, p < 0.001) at 63 to 69 years. At all ages, the most socioeconomically disadvantaged had 1.2 to 1.4 times greater number of conditions on average compared to the most advantaged. The most disadvantaged by each socioeconomic indicator experienced an additional 0.39 conditions (childhood social class), 0.83 (adult social class), and 1.08 conditions (adult education) at age 69 years, independent of all other socioeconomic indicators. Adverse adulthood SEP was associated with more rapid accumulation of multimorbidity, resulting in 0.49 excess conditions in partly/unskilled compared to professional/intermediate individuals between 63 and 69 years. Disadvantaged childhood social class, independently of adulthood SEP, was associated with accelerated multimorbidity trajectories from age 53 years onwards. Study limitations include that the NSHD cohort is composed of individuals of white European heritage only, and findings may not be generalizable to the non-white British population of the same generation and did not account for other important dimensions of SEP such as income and wealth.Conclusions: In this study, we found that socioeconomically disadvantaged individuals have earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood SEP. [ABSTRACT FROM AUTHOR]

Background: Implementing task specific training is a commonly reported challenge for less experienced therapists. A potential method to improve the ability of recent graduate and student therapists is to upskill regarding task specific training via an online education resource. Purpose: To evaluate the use and acceptability of the TRAIN program as an online learning resource for physiotherapists. Methods: Data from Google Analytics was sourced to determine use of the program and details about the users. Users of the TRAIN program were also invited to complete two surveys; prior to beginning and upon completion of the program. The surveys collected information about the demographics of the users, perceptions of usefulness of the online resource and overall sentiment. Results: Almost 6000 new users interacted with the TRAIN modules during the 15‐months study period. The surveys indicated a high level of usability (mean score 9/10, SD 1.5) and clinical utility (mean score 8.8/10, SD 1.6) of the TRAIN program. Perceived knowledge and user confidence in implementing task‐specific training was higher for those users completing the post compared to those completing the pre‐module survey (knowledge 1.9 and confidence 1.7 out of 10 points higher). Recurring comments in the open‐ended feedback pertained to the usefulness, clarity, and ease of use of the TRAIN program. Discussion and Conclusion: This study provides preliminary evidence supporting the use and acceptability of the TRAIN program as an online learning resource for physiotherapists. This further contributes to the growing body of literature indicating online learning is generally a well‐received teaching tool for physiotherapists. [ABSTRACT FROM AUTHOR]

Aims: To compare the acceptability, reliability and validity of five contemporary diabetes‐specific quality of life (QoL) scales among adults with type 1 diabetes in the United Kingdom and Australia. Methods: Adults with type 1 diabetes (UK = 1139, Australia = 439) completed a cross‐sectional, online survey including ADDQoL‐19, DCP, DIDP, DSQOLS and Diabetes QoL‐Q, presented in randomised order. After completing each scale, participants rated it for clarity, relevance, ease of completion, length and comprehensiveness. We examined scale acceptability (scale completion and user ratings), response patterns, structure (exploratory and confirmatory factor analyses) and validity (convergent, concurrent, divergent and known groups). To assess cross‐country reproducibility, analyses conducted on the UK dataset were replicated in the Australian dataset. Results: Findings were largely consistent between countries. All scales were acceptable to participants: ≥90% completing all items, and ≥80% positive user ratings, except for DSQOLS' length. Scale structure was not supported for the DCP. Overall, in terms of acceptability and psychometric evaluation, the DIDP was the strongest performing scale while the ADDQoL‐19 and Diabetes QoL‐Q scales also performed well. Conclusions: These findings suggest that the recently developed brief (7 items), neutrally worded DIDP scale is acceptable to adults with type 1 diabetes and has the strongest psychometric performance. However, questionnaire selection should always be considered in the context of the research aims, study design and population, as well as the wider published evidence regarding both the development and responsiveness of the scales. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of exposure to conflicting nutritional information (CNI) through different forms of media on nutrition-related confusion and backlash among consumers in the UK.Design: Cross-sectional survey administered via Qualtrics among 18-75-year-old participants in the UK. The sample was stratified by age and gender with quotas defined according to the 2011 UK census distribution.Setting: Qualtrics' Online panel of respondents in the UK.Participants: 676 participants comprising nearly an equal number of females (n 341) and males (n 335) and a majority (58·6 %) from households whose income was <£30 000.Results: Our findings showed that nearly 40 % of respondents were exposed to some or a lot of CNI. We found that while exposure to CNI from TV and online news increased nutrition confusion, CNI from health professionals increased backlash. Exposure to CNI from social media and health websites was associated with reduced backlash. We also found that nutrition confusion and backlash were negatively associated with exercise behaviour and fruit and vegetable consumption, respectively.Conclusions: Our study supports the theoretical pathways that explain the influence of CNI exposure on nutrition-related cognitive and behavioural outcomes. Additionally, different types of online information sources are associated with these outcomes to varying degrees. In the context of obesity and diabetes rates in the UK, our findings call for (a) further experimental research into the effects of CNI on consumers' diet-related cognitions and behaviours and (b) multi-stakeholder, interdisciplinary approaches to address this problem. [ABSTRACT FROM AUTHOR]

Background The adequacy of personal protective equipment (PPE) and infection prevention and control (IPC) training in UK medical students and interim Foundation Year 1 (FiY1) doctors during the COVID-19 pandemic is unknown, as is its impact on COVID-19-related anxiety. Methods Cross-sectional, multi-centre study analysing self-reported adequacy of PPE and IPC training and correlation to a modified pandemic anxiety scale. Participants were current medical students and FiY1 doctors in the UK. Data were collected by an online survey. Results Participants reported that they received insufficient PPE information (43%) and IPC training (56%). Significantly, fewer participants identifying as women or BAME/mixed ethnicity reported receiving sufficient PPE information, compared with those identifying as men and White British/White Other, respectively. COVID-19-related anxiety was significantly higher in those without sufficient reported PPE or IPC training, in women compared with men, and in FiY1 doctors compared with medical students. Conclusions With medical students currently volunteering in and imminently returning to hospitals in an educational capacity, levels of self-reported PPE and IPC training are sub-optimal. Better training is paramount to avoid harm to patients and healthcare professionals and to reduce COVID-19-related anxiety among medical students and FiY1 doctors. [ABSTRACT FROM AUTHOR]

Objective: To review quality of care in births planned in midwifery-led settings, resulting in an intrapartum-related perinatal death.Design: Confidential enquiry.Setting: England, Scotland and Wales.Sample: Intrapartum stillbirths and intrapartum-related neonatal deaths in births planned in alongside midwifery units, freestanding midwifery units or at home, sampled from national perinatal surveillance data for 2015/16 (alongside midwifery units) and 2013-16 (freestanding midwifery units and home births).Methods: Multidisciplinary panels reviewed medical notes for each death, assessing and grading quality of care by consensus, with reference to national standards and guidance. Data were analysed using thematic analysis and descriptive statistics.Results: Sixty-four deaths were reviewed, 30 stillbirths and 34 neonatal deaths. At the start of labour care, 23 women were planning birth in an alongside midwifery unit, 26 in a freestanding midwifery unit and 15 at home. In 75% of deaths, improvements in care were identified that may have made a difference to the outcome for the baby. Improvements in care were identified that may have made a difference to the mother's physical and psychological health and wellbeing in 75% of deaths. Issues with care were identified around risk assessment and decisions about planning place of birth, intermittent auscultation, transfer during labour, resuscitation and neonatal transfer, follow up and local review.Conclusions: These confidential enquiry findings do not address the overall safety of midwifery-led settings for healthy women with straightforward pregnancies, but suggest areas where the safety of care can be improved. Maternity services should review their care with respect to our recommendations.Tweetable Abstract: Confidential enquiry of intrapartum-related baby deaths highlights areas where care in midwifery-led settings can be made even safer. [ABSTRACT FROM AUTHOR]

Burns are common causes of paediatric emergency care attendance; approximately ten per cent result from maltreatment. Following emergency department (ED) attendance with a burn by 232 under five‐year‐olds, 11 risk factors for maltreatment were collected via health visitor (HV) telephone surveys. Three of these risk factors (domestic violence, social care involvement and developmental impairment) were also available in ED records, and information collected was compared between the two. Non‐parametric Fisher's exact tests were applied. Fifty‐nine per cent of children lived in families with risk factors for maltreatment. Prominent risk factors known by HVs included: prior injuries (n = 55, 23.7%), carer/parent mental health problems (n = 48, 20.7%), domestic violence (n = 47, 20.3%) and social care involvement (n = 45, 19.4%). A total of 158 cases had complete data for all 11 risk factors: 49 (31.0%) lived in households with one factor, 22 (13.9%) with two factors and 27 (17.1%) with three or more risk factors. In cases where HVs recorded the following risk factors as present, EDs recorded five of 47 (10.6%) for domestic violence, ten of 45 (22.2%) with social care involvement and four of 23 (17.4%) with developmental impairment. Many risk factors that were known to HVs were not identified by EDs staff despite being part of a standardised proforma. Maltreatment risk assessment could be improved if EDs staff had access to HV information. Key Practitioner Messages: Fifty‐nine per cent of pre‐school children who attended an ED with a burn live in a family with one or more maltreatment risk factors, as identified by HV records.ED staff should be able to access a child's HV record electronically at the time of presentation, to identify known maltreatment risk factors.The lack of integration of community and acute setting health records is a barrier to comprehensive assessment and treatment decisions for children in EDs, especially in relation to safeguarding risks. [ABSTRACT FROM AUTHOR]

Primary and community care in the United Kingdom are under increasing workforce and time pressures. How these pressures affect the delivery of cancer care has rarely been explored. This service evaluation aimed to elucidate some of the views of the workforce in this sector of what work in cancer care is left undone, and what they would like to be able to offer more of. An exploratory sequential design was taken including a questionnaire and interviews asking primary and community care staff in London about their workload in cancer care. Surveys were analysed using descriptive statistics. The evaluation revealed a perception from primary and community care that there is work in cancer care that is currently being left undone. 64% of the workforce across all professions reported that they worked 10 or more hours of unpaid overtime per week. Respondents identified psychological care for people with cancer (PWC), and bereavement care for families and carers of PWC as the most common areas that were left undone. They would like to do more proactive work, in place of the current reactive 'fire‐fighting' they are doing. For example, signposting available services to PWC and access to nutritional support. There was a desire for acknowledgement of the time and workforce pressures in primary and community care, and how these are hindering the delivery of care for PWC. [ABSTRACT FROM AUTHOR]

Background: Little is known about population levels of energy expenditure, as national surveillance systems typically employ only crude measures. The National Diet and Nutrition Survey (NDNS) in the UK measured energy expenditure in a 10% subsample by gold-standard doubly labelled water (DLW).Methods: DLW-subsample participants from the NDNS (383 males, 387 females) aged 4-91 years were recruited between 2008 and 2015 (rolling programme). Height and weight were measured and body-fat percentage estimated by deuterium dilution.Results: Absolute total energy expenditure (TEE) increased steadily throughout childhood, ranging from 6.2 and 7.2 MJ/day in 4- to 7-year-olds to 9.7 and 11.7 MJ/day for 14- to 16-year-old girls and boys, respectively. TEE peaked in 17- to 27-year-old women (10.7 MJ/day) and 28- to 43-year-old men (14.4 MJ/day), before decreasing gradually in old age. Physical-activity energy expenditure (PAEE) declined steadily with age from childhood (87 kJ/day/kg in 4- to 7-year-olds) through to old age (38 kJ/day/kg in 71- to 91-year-olds). No differences were observed by time, region and macronutrient composition. Body-fat percentage was strongly inversely associated with PAEE throughout life, irrespective of expressing PAEE relative to body mass or fat-free mass. Compared with females with <30% body fat, females with >40% recorded 29 kJ/day/kg body mass and 18 kJ/day/kg fat-free mass less PAEE in analyses adjusted for age, geographical region and time of assessment. Similarly, compared with males with <25% body fat, males with >35% recorded 26 kJ/day/kg body mass and 10 kJ/day/kg fat-free mass less PAEE.Conclusions: This first nationally representative study reports levels of human-energy expenditure as measured by gold-standard methodology; values may serve as a reference for other population studies. Age, sex and body composition are the main determinants of energy expenditure. Key Messages This is the first nationally representative study of human energy expenditure, covering the UK in the period 2008-2015. Total energy expenditure (MJ/day) increases steadily with age throughout childhood and adolescence, peaks in the 3rd decade of life in women and 4th decade of life in men, before decreasing gradually in old age. Physical activity energy expenditure (kJ/day/kg or kJ/day/kg fat-free mass) declines steadily with age from childhood to old age, more steeply so in males. Body-fat percentage is strongly inversely associated with physical activity energy expenditure. We found little evidence that energy expenditure varied by geographical region, over time, or by dietary macronutrient composition. [ABSTRACT FROM AUTHOR]