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Background: Rapid diagnostic clinics (RDCs) provide a streamlined holistic pathway for patients presenting with non-site specific (NSS) symptoms concerning of malignancy. The current study aimed to: 1) assess the prevalence of anxiety and depression, and 2) identify a combination of patient characteristics and symptoms associated with severe anxiety and depression at Guy's and St Thomas' Foundation Trust (GSTT) RDC in Southeast London. Additionally, we compared standard statistical methods with machine learning algorithms for predicting severe anxiety and depression. Methods: Patients seen at GSTT RDC between June 2019 and January 2023 completed the General Anxiety Disorder Questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-8) questionnaires, at baseline. We used logistic regression (LR) and 2 machine learning (ML) algorithms (random forest (RF), support vector machine (SVM)) to predict risk of severe anxiety and severe depression. The models were constructed using a set of sociodemographic and clinical variables. Results: A total of 1734 patients completed GAD-7 and PHQ-8 questionnaires. Of these, the mean age was 59 years (Standard Deviation: 15.5), and 61.5% (n:1067) were female. Prevalence of severe anxiety (GAD-7 score ≥15) was 13.8% and severe depression (PHQ-8 score≥20) was 9.3%. LR showed that a combination of previous mental health condition (PMH, Adjusted Odds Rario (AOR) 3.28; 95% confidence interval (CI) 2.36-4.56), symptom duration >6 months (AOR 2.20; 95%CI 1.28-3.77), weight loss (AOR 1.88; 95% CI 1.362.61), progressive pain (AOR 1.71; 95%CI 1.26-2.32), and fatigue (AOR 1.36; 95%CI 1.01-1.84), was positively associated with severe anxiety. Likewise, a combination PMH condition (AOR 3.95; 95%CI 2.17-5.75), fatigue (AOR 2.11; 95%CI 1.47-3.01), symptom duration >6 months (AOR 1.98; 95%CI 1.06-3.68), weight loss (AOR 1.66; 95%CI 1.13-2.44), and progressive pain (AOR 1.50; 95%CI 1.04-2.16), was positively associated with severe depression. LR and SVM had highest accuracy levels for severe anxiety (LR: 86%, SVM: 85%) and severe depression (SVM: 89%, LR: 86%). Conclusion: High prevalence of severe anxiety and severe depression was found. PMH, fatigue, weight loss, progressive pain, and symptoms >6 months emerged as combined risk factors for both these psychological comorbidities. RDCs offer an opportunity to alleviate distress in patients with concerning symptoms by expediting diagnostic evaluations. [ABSTRACT FROM AUTHOR]

Objectives: Since the onset of COVID-19 pandemic, additional risk factors affecting family caregivers' mental health have arisen. Therefore, personal stress coping strategies and family dynamics became important factors in reducing the impact of the pandemic on family caregivers' mental health. The present research aimed to estimate the association between COVID-19 stressors and family caregiving burden. Moreover, moderating effects of emotion dysregulation and family functioning on this association were investigated. Methods: This study analyzed data collected in April 2021 from 154 family caregivers (M age = 38.79, SD age = 9.36, range = 22–64) recruited through Amazon's Mechanical Turk (MTurk). The impact of COVID-19 stressors on family caregiving burden was tested, and moderating impacts of emotion dysregulation and family functioning were also investigated. Results: Both COVID-19 stress exposure and stress appraisal were positively associated with family caregiving burden. Emotion dysregulation and problematic family functioning were also positively associated with family caregiving burden. A significant moderating effect of emotion dysregulation was found, such that family caregivers with higher emotion dysregulation were likely to feel more caregiving burden when they experienced more COVID-19 stressors. Significance of results: The current research highlighted the role of emotion regulation in reducing the negative impact of COVID-19 stressors on family caregiving burden. The research also emphasizes the need for intervention programs to improve emotion regulation strategies to decrease family caregiving burden during the pandemic. [ABSTRACT FROM AUTHOR]

Objective: The present study provides descriptive results on parents' mental health, ambiguous loss, stress, and parent–child relationship as well as child stress and children's emotion regulation abilities. Additionally, we present initial psychometric results and preliminary regression findings from a quantitative ambiguous loss measure. Background: The COVID‐19 pandemic has led to more than one million deaths in the United States and subsequent mental health difficulties for parents and children. Method: Data were collected from 134 participants (MParentAge = 39.1 years; 54.5% women; MChildAge = 9.4 years) in early May 2021. Analyses examined group differences of longitudinal findings over a year‐long period, parents' gender, and financial needs. Results: Moderate levels of COVID‐19–specific stress as well as general stress in both parents and children were found. Women reported higher levels of closeness among the parent–child dyad, and parents whose financial needs were not met reported significantly higher levels of anxiety and depression. A liner regression indicated that 44.3% of the variance in ambiguous loss can be explained by COVID‐19 specific stress and depression. Conclusion: Individuals and families are still experiencing difficulties after the COVID‐19 pandemic, as seen through the descriptives presented. Additionally, ambiguous loss can be predicted by these experiences. Implications: Long‐term information about individual and family experiences after a year of the COVID‐19 pandemic highlights important experiences of generalized stress in both parents and children. [ABSTRACT FROM AUTHOR]

Stress exposure often leads to poor mental health, but whether certain types of stressors predict differential levels of mental health symptoms and whether coping differentially moderates these associations remain untested. This study examined whether COVID-19 stressor types (financial-, activity-, and infection-related) differentially predicted subsequent mental health (general distress, posttraumatic stress symptoms, and positive states of mind [PSOM]) and whether different types of coping moderated these relationships. In April 2020, questionnaires assessing the impact of COVID-19 on daily life were administered to an adult sample across the United States (N = 1,546); 861 (55.7%) of whom completed questionnaires 1 month later. Nearly, all stressor types independently predicted each aspect of mental health. Behavioral disengagement moderated links between both activity- and infection-related stressors and mental health. Seeking emotional social support moderated links between infection-related stressors and both general distress and PSOM as well as activity-related stressors and general distress. Positive reappraisal moderated links between financial-related stressors and PSOM. Acceptance coping predicted better mental health but was not a significant moderator. Stressor types and coping strategies are important determinants of effects of COVID-19 on mental health; our findings suggest possible screening and intervention implications and directions for future research. [ABSTRACT FROM AUTHOR]

This research letter discusses the factors that may influence the application and acceptance rates for Higher Surgical Training (HST) in urology in the United Kingdom. The study found that while more than 50% of medical students and foundation trainees are women, the number drops significantly as doctors progress in their careers, with women making up only 12% of urology consultants. Ethnic minority doctors also face challenges, with lower pass rates in postgraduate examinations and underrepresentation in surgical leadership. The study found that gender was associated with receiving an offer for HST, favoring women, but age, ethnicity, socioeconomic status, and educational factors did not show an increased likelihood of obtaining an offer. The authors hope that these findings, along with initiatives by organizations and the NHS, will contribute to a more diverse senior workforce in urology. [Extracted from the article]

Aims: The aims of this study were to describe the demographic, socioeconomic, and educational factors associated with core surgical trainees (CSTs) who apply to and receive offers for higher surgical training (ST3) posts in Trauma & Orthopaedics (T&O)., Methods: Data collected by the UK Medical Education Database (UKMED) between 1 January 2014 and 31 December 2019 were used in this retrospective longitudinal cohort study comprising 1,960 CSTs eligible for ST3. The primary outcome measures were whether CSTs applied for a T&O ST3 post and if they were subsequently offered a post. A directed acyclic graph was used for detecting confounders and adjusting logistic regression models to calculate odds ratios (ORs), which assessed the association between the primary outcomes and relevant exposures of interest, including: age, sex, ethnicity, parental socioeconomic status (SES), domiciliary status, category of medical school, Situational Judgement Test (SJT) scores at medical school, and success in postgraduate examinations. This study followed STROBE guidelines., Results: Compared to the overall cohort of CSTs, females were significantly less likely to apply to T&O (OR 0.37, 95% CI 0.30 to 0.46; n = 155/720 female vs n = 535/1,240 male; p < 0.001). CSTs who were not UK-domiciled prior to university were nearly twice as likely to apply to T&O (OR 1.99, 95% CI 1.39 to 2.85; n = 50/205 vs not UK-domiciled vs n = 585/1,580 UK-domiciled; p < 0.001). Age, ethnicity, SES, and medical school category were not associated with applying to T&O. Applicants who identified as 'black and minority ethnic' (BME) were significantly less likely to be offered a T&O ST3 post (OR 0.70, 95% CI 0.51 to 0.97; n = 165/265 BME vs n = 265/385 white; p = 0.034). Differences in age, sex, SES, medical school category, and SJT scores were not significantly associated with being offered a T&O ST3 post., Conclusion: There is an evident disparity in sex between T&O applicants and an ethnic disparity between those who receive offers on their first attempt. Further high-quality, prospective research in the post-COVID-19 pandemic period is needed to improve equality, diversity, and inclusion in T&O training., Competing Interests: S. Fleming discloses being an executive board member for the International Orthopaedic Diversity Alliance, which is unrelated to this work. M. Spazzapan reports receiving funding from the National Institute of Healthcare Research to support 0.25 days' full-time equivalent time dedicated to research, which is related to this paper., (© 2024 Raj et al.)