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Background. Between 2015 and 2020, 1,578 care homes in the UK closed, displacing nearly 50,000 older and disabled people with very significant care and support needs. It is widely thought that relocation can have a significant impact on the health and well-being of older people. Yet, evidence is limited due to sensitivity and logistical difficulties with data collection. This study aimed to review the published literature in order to (i) identify evidence on the costs, consequences, and wider impacts of care home closures, for older people, family members, care home staff, and local authorities and (ii) understand the causes of and processes surrounding the closure of residential care homes in the UK. Methods. Eight electronic databases (Medline, Embase, Web of Science, Scopus, ASSIA, HMIC, AgeInfo, and SPP) were searched from 1st January 2000 to 9th February 2023; Google and Google Scholar were searched for guidance/policy documents from the grey literature. Data on the objectives, methods, and main results were extracted, and the findings were narratively reported. Results. Eighteen records, comprising guidance documents and academic publications (quantitative, qualitative, and mixed-method approaches), met the inclusion criteria. We found a lack of good quality evidence on costs of closure and no consideration of outcomes for staff. Studies reporting on outcomes for residents suggest there may not be any long-term adverse effects on their health, in contrast to often-expressed views that care home closures result in harm. Conclusion. Future research should consider the stress and anxiety experienced by staff and families as relevant outcomes and show caution with respect to the use of proxy reporting of resident health outcomes. Given that a sizable portion of the costs associated with care home closure falls on local authorities, an evidence-based approach to closures that includes an assessment of cost-effectiveness will help to improve future outcomes and guide the most efficient use of limited public resources. [ABSTRACT FROM AUTHOR]

The last three census data highlighted that UK Bangladeshi communities have the worst health outcomes. This includes a higher risk of type two diabetes and heart diseases; both are risk factors for developing vascular dementia. However, little is known about Bangladeshi community members' understandings of dementia, including cultural myths. This paper focuses on the cultural myths, superstitions, and stigma surrounding dementia in an English Bangladeshi community from the direct experiences of people living with dementia, their caregivers, and the views of dementia service providers/stakeholders. This qualitative research was undertaken with three distinct participant groups using semistructured interviews (n = 25), who were recruited from community settings. The first and second participant groups explored the experiences of people with dementia (n = 10) and their family caregivers (n = 10). The third group examined stakeholders'/service providers' views (n = 5). Interviews were recorded digitally and transcribed verbatim. Findings were reached using an interpretive approach, emphasising the sense people make in their own lives and experiences and how they frame and understand dementia. The study revealed that participants with dementia and their caregivers have "alternative" knowledge about dementia and do not necessarily understand dementia in a Westernised scientific/biomedical context. Misconceptions about dementia and belief in various myths and superstitions can lead people to go to spiritual healers or practice traditional remedies rather than to their GPs, delaying their dementia diagnosis. This paper concludes that there is a lack of awareness among the Bangladeshi participants and a need for targeted awareness about dementia to help dispel cultural myths and combat the stigma surrounding dementia within the Bangladeshi community. [ABSTRACT FROM AUTHOR]

Predicting the status of train delays, a complex and dynamic problem, is crucial for railway enterprises and passengers. This paper proposes a novel hybrid deep learning model composed of convolutional neural networks (CNN) and temporal convolutional networks (TCN), named the CNN + TCN model, for predicting train delays in railway systems. First, we construct 3D data containing the spatiotemporal characteristics of real-world train data. Then, the CNN + TCN model employs a 3D CNN component, which is fed into the constructed 3D data to mine the spatiotemporal characteristics, and a TCN component that captures the temporal characteristics in railway operation data. Furthermore, the characteristic variables corresponding to the two components are selected. Finally, the model is evaluated by leveraging data from two railway lines in the United Kingdom. Numerical results show that the CNN + TCN model has greater accuracy and convergence performance in train delay prediction. [ABSTRACT FROM AUTHOR]

Background. Cancer diagnosis is a complex and multifaceted process that can be stressful and anxiety-provoking for patients. Evidence-based tools and information aids that can be used for guiding and supporting patients during cancer investigations and after diagnosis are limited. This paper presents a user-centred codesign project that aims to develop a cancer pathway support tool for patients, carers, and healthcare professionals. Method. A mixed-method codesign approach was used including prototype development (January–March 2022), three online codesign workshops (April–June 2022), one-to-one feedback, and beta testing informed by the standardised Theoretical Framework of Acceptability (TFA) questionnaire (July–October 2022). Nine individuals with lived experience of cancer contributed to the project and are referred to as codesigners. Results. The codesigners valued the potential importance of a tool that can be used by the patients and carers if they want specific information about cancer investigations, diagnosis, and treatment. The ability to select what they need as opposed to long leaflets and generating their own questions for the healthcare providers were highlighted as important aspects of improving patient care. The tool was collectively designed to provide clear definitions of the cancer care pathway and easily accessible links from trusted resources and includes practical information to minimise the burden that can be experienced from preparation for appointments and tests. Beta testing results with a small sample of potential users including patients, carers, and healthcare providers (n = 23) showed high acceptability of the guide (range = 7–35, mean = 28.52, and standard deviation = 3.88) based on the TFA questionnaire. Conclusion. A cancer pathway support tool called "Your Cancer Pathway Support Guide (YCPSG)" was developed as a result of an iterative codesign process aiming to improve patient experience and outcomes for people referred on a suspected cancer pathway or who have been diagnosed with cancer. The tool provides information and support in both digital and PDF formats. Further studies are needed to evaluate the potential impact of "Your Cancer Pathway Support Guide" on patient outcomes and experience and the wider system. [ABSTRACT FROM AUTHOR]

The academic and policy-oriented literature increasingly quantifies the wider effects of energy policy on the macroeconomy. However, the spillovers from economic policies to energy use are less frequently recognised, meaning that many policymakers who strive to improve productivity whilst simultaneously targeting emission reduction fail to consider these interactions. This paper addresses this issue by using simulation results generated by introducing an exogenous increase in labour productivity in a computable general equilibrium model calibrated with data from the United Kingdom. Theoretical analysis suggests that increasing labour productivity can have positive or negative effects on employment levels and energy use. However, the simulation results show that in the context of a developed open economy, improved labour efficiency will increase employment, a key policy objective, but simultaneously increase energy use. A key policy implication is that this work highlights the need for policy frameworks that explicitly acknowledge and quantify the interconnections between national economic policy strategies and energy policy objectives. Secondly, it shows that in practice, policies to reduce carbon emissions need to be strengthened alongside policies to improve productivity successfully implemented. [ABSTRACT FROM AUTHOR]

The number of children with mental health problems is ever-growing; as a result, nearly 850,000 children in the UK are believed to have clinically significant problems, and only a quarter show evidence of mental illness. Family members often have a hard time dealing with children with mental health problems. As a result, digital mental health interventions are becoming popular for people seeking professional mental health services. Previous studies in this area have also shown that parents who are divorced or working away from home struggle to maintain contact with their children. This lack of communication between the parents and their children can worsen the children's mental health conditions and prevent early diagnosis. Human-centred design thinking is applied step by step in this paper to provide an intuitive understanding of the design process. Five stages of the design thinking process were examined to follow a correct path. The results were promising, and the feedback received assured that the product helps parents to better monitor their children's mental health and provides support when needed. The design thinking process was followed in concordance with the user needs identified from previous studies in this area, which led to a working solution that benefits both parents and children in tackling these problems. [ABSTRACT FROM AUTHOR]

Formaldehyde is commonly used as an alkylating agent in the pharmaceutical industry. Consequently, its residual level in drug substances and/or their intermediates needs to be accurately quantified. Formaldehyde is a small, volatile molecule with a weak chromophore (the carbonyl group), and its direct analysis by GC-FID and HPLC-UV is difficult. For these reasons, the majority of papers found in the literature are based upon a derivatisation process (most commonly using the desensitised explosive 2,4-dinitrophenylhydrazine) prior to the analysis of formaldehyde. A novel high-performance liquid chromatography (HPLC) method with UV detection for its quantification in a pharmaceutical is described in this paper. The method proposed herein is based upon a derivatisation reaction between formaldehyde and 4-methylbenzenesulfonohydrazide (MBSH) before analysis by HPLC-UV. Selectivity, linearity, limit of quantification, accuracy, repeatability, intermediate precision, and solution stability were successfully assessed as per ICH guideline Q2(R1), and the method has also been validated in a good manufacturing practice (GMP) laboratory in the UK. [ABSTRACT FROM AUTHOR]

Ballroom dancing has been standardized in the United Kingdom since the beginning of the 20th century, and it has been competitive by WDC to form competitive ballroom dancing. Later, under the vigorous promotion of WDSF, it became a competitive sport recognized by the International Olympic Committee. In the process of teaching experiments, dancers' wrong movements in sports dance training are inevitable. If they are not corrected in time, it will not only reduce the effect of dance expression, but also directly affect the improvement of sports performance. The dance images are often disturbed by many factors such as imaging equipment and the external environment during the process of acquisition, compression, transmission and storage, resulting in image distortion. Image distortion is mainly manifested in that the image structure information is submerged by noise, and the distorted image can no longer truly reflect the original image information, which brings difficulties to the post-processing of the image. In this paper, the image denoising method based on partial differential equation and its application in sports dance training are deeply studied. [ABSTRACT FROM AUTHOR]

Although the literature revealed the challenges and drivers to implement Building Information Modeling (BIM) in the building design industry in general, to date, there are few established methods and processes to overcome challenges of BIM adoption in building design, especially in sustainable building design for managing the project. At the present, BIM adoption in building design at micro level, that is, the level of architects, mainly focuses on barriers with little attention to method and the process of implementing BIM. Moreover, there is lack of a robust research method, that is, mixed method, to systematically investigate the process of implementing micro-level BIM in building design, which is related to the factors, such as challenges and drivers to the challenges of BIM adoption. Furthermore, several studies have looked into micro-level BIM adoption in architecture firms, but few of them focused on sustainable design. This emphasizes a need to investigate and explore micro-level BIM implementation challenges alongside its drivers in building design and present methods and processes generated from architects' perspectives to address the challenges during sustainable design for the project management, which is the aim of this paper. The research investigation was through a questionnaire that is followed by interviews with the leading architectural firms within the UK. The research reported in this paper is to present a clear view of challenges to micro-level BIM adoption and a framework/road-map to address the key challenges in managing sustainable building design projects, which are related to cultural resistance and culture change, top-down management support, current key challenges and drivers, and client and project managers' interests. The methods and processes that enhanced the framework can be instantly adopted for building design and for architectural companies including small- and medium-sized enterprises (SMEs). [ABSTRACT FROM AUTHOR]

Objectives. The bibliometric analysis uses the citation count of an article to measure its impact in the scientific community, yet there is still no comprehensive summary of gastric disease researches via bibliometric analysis. We aimed to evaluate the situations and trends of the most cited articles in gastric disease via bibliometric analysis and to provide physicians a practical guide in assessing the most influential articles written on this subject. Methods. The 100 top-cited articles in gastric disease were compiled using Web of Science. The articles selected were evaluated for their number of citations, year of publication, country of origin, type of study, and others. Results. The database had 484,281 articles published between 1965 and 2019. The most cited article received 4,017 citations and the least received 604, with a mean of 1,149 citations. We classified the articles into seven categories: gastric cancer (n = 53), Helicobacter pylori (n = 17), ulcer (n = 7), gastrointestinal stromal tumors (n = 6), gastritis (n = 5), gastric bypass surgery (n = 2), and others (n = 10). Altogether, 69 of the articles were from the USA (n = 41), the UK (n = 17), and Japan (n = 11). Among all the institutions, Royal Perth Hospital led the list with 5 articles. One-quarter of authors owned three or more of these top-cited articles. The 100 papers were published in 33 journals, and most of them were clinical researches (n = 47). Conclusions. Our study provides a historical perspective for the scientific progress of gastric disease, and the articles of significant findings that contributed great impact on the prevention and treatment of gastric disease had been identified. [ABSTRACT FROM AUTHOR]

Recently, several studies adopted bibliometric methodology to estimate the development of the field of public administration (PA). However, only a small scope of journals was covered in their analyses. Few of those investigated the evolution of the entire field. To make a progress, this paper included a 19-year timespan, 53 journals, and more than 20,000 items for analysis in a bibliometric way. Both the activity and the quality indicators of research results were applied from the bibliometric perspective with 3-year and 5-year citation windows at three aggregation levels including journal, country, and institution by using publications in PA indexed in Social Sciences Citation Index (SSCI). "Resident" journal is proposed as a new concept to explore differences between traditional and emerging research forces. The results suggest that resident journals maintain a large advantage over other journals in terms of higher quality journal indicators and citation impact indicators. Moreover, international and national collaboration shows a growth tendency, especially for the international type. The majority of active institutions are from the US and the UK, which indicates their dominant position over others. This study provides more comprehensive comparisons through large-scale data and acknowledged methods to explore the development of PA field research. [ABSTRACT FROM AUTHOR]

This study employs the CRM measurement model to the context of customer relationship management (CRM). It is aimed at indirectly examining the relationships between various resources of CRM and business performance. Additionally, this study is aimed at contributing to marketing research by placing an emphasis on CRM technology and their impact on performance. Through collecting secondary data, the direct and indirect effects of CRM resources and capabilities on business performance are examined within a sample of 6 case companies in the UK grocery market during 2015~2017. Additional measure of CRM capability is aggregated into the firm level to examine its relationship with their corporate performance. Furthermore, capability is categorized through defining the intention of initiating CRM programme. The results find a positive relationship between both CRM resources and their capabilities and performance. Besides, interactive capability is most essential for companies to enhance their CRM. Lastly, the interaction between technology and other resource is significantly associated with business performance. Managers may improve their CRM programs and eliminate side effects more effectively by concentrating on one type of resource to strengthen their most common CRM capability. This paper bridges significant gaps in the current literature through combining RBV and DC perspective, meanwhile, taking a capability view of CRM. Under a contemporary CRM measurement model, it examines how the possession of important CRM resource influences business performance in UK supermarket. [ABSTRACT FROM AUTHOR]

Aim. The purpose of this study was to identify and characterize the 100 most cited articles on cone beam computed tomography (CBCT). Materials and Methods. A comprehensive list of citation classics in CBCT was generated by searching the Scopus database without year or language restrictions. The top 100 articles were retrieved after reading abstracts or full texts. The following study variables were evaluated: number of citations, citation density, journal name, impact factor, category and quartile of journals, publication year, authors with their affiliations, article type, and topics covered. Results. The citation number ranged from 86 to 624, with a mean of 161.9 citations per article. The top 100 articles were distributed in 29 journals, and the journal with the most articles was Dentomaxillofacial Radiology (n=16). The articles were published between 1998 and 2012, and eight authors published more than 3 papers. The USA produced the most papers (n=38), followed by the UK (n=12). King's college London Dental Institute led the list of classics, with 8 articles. Conclusions. This is the first citation analysis to provide a detailed list of the most influential articles on CBCT and helps to recognize the quality of the works, discoveries, and trends steering the field. [ABSTRACT FROM AUTHOR]

CAV (connected and autonomous vehicle) is a crucial part of intelligent transportation systems. CAVs utilize both sensors and communication components to make driving decisions. A large number of companies, research organizations, and governments have researched extensively on the development of CAVs. The increasing number of autonomous and connected functions however means that CAVs are exposed to more cyber security vulnerabilities. Unlike computer cyber security attacks, cyber attacks to CAVs could lead to not only information leakage but also physical damage. According to the UK CAV Cyber Security Principles, preventing CAVs from cyber security attacks need to be considered at the beginning of CAV development. In this paper, a large set of potential cyber attacks are collected and investigated from the aspects of target assets, risks, and consequences. Severity of each type of attacks is then analysed based on clearly defined new set of criteria. The levels of severity for the attacks can be categorized as critical, important, moderate, and minor. Mitigation methods including prevention, reduction, transference, acceptance, and contingency are then suggested. It is found that remote control, fake vision on cameras, hidden objects to LiDAR and Radar, spoofing attack to GNSS, and fake identity in cloud authority are the most dangerous and of the highest vulnerabilities in CAV cyber security. [ABSTRACT FROM AUTHOR]

Following the outbreak of the COVID-19 pandemic, public-health measures introduced to stem the spread of the disease caused profound changes to patterns of daily-life communication. This paper presents the results of an online survey conducted to document adult cochlear-implant (CI) users' perceived listening difficulties under four communication scenarios commonly experienced during the pandemic, specifically when talking: with someone wearing a facemask, under social/physical distancing guidelines, via telephone, and via video call. Results from ninety-four respondents indicated that people considered their in-person listening experiences in some common everyday scenarios to have been significantly worsened by the introduction of mask-wearing and physical distancing. Participants reported experiencing an array of listening difficulties, including reduced speech intelligibility and increased listening effort, which resulted in many people actively avoiding certain communication scenarios at least some of the time. Participants also found listening effortful during remote communication, which became rapidly more prevalent following the outbreak of the pandemic. Potential solutions identified by participants to ease the burden of everyday listening with a CI may have applicability beyond the context of the COVID-19 pandemic. Specifically, the results emphasized the importance of visual cues, including lipreading and live speech-to-text transcriptions, to improve in-person and remote communication for people with a CI. [ABSTRACT FROM AUTHOR]

The most widespread approach to transport appraisal is to combine cost-benefit analysis (CBA) with environmental assessments and public consultations. However, large-scale transport projects such as the HS2 high-speed rail system in the UK seem to have pushed this approach beyond its limits, leading to broad discontent with the appraisal process. There is a need both to develop new methods capable of integrating a wide range of perspectives in a systematic manner and to test these for large-scale projects. Multicriteria analysis (MCA) has proven useful in supporting transport decision-making by including a broader set of criteria in the appraisal process. Multiactor multicriteria analysis (MAMCA) has extended this approach to include multiple actors and stakeholders in the judgment and decision-making process. This paper builds on the MAMCA method and demonstrates its practicability and usability by applying it to the case of HS2. The purpose of this paper is not to reach a definitive conclusion on the desirability of various project options, but to complement existing transport appraisal methods by making different perspectives explicit. For example, the results for this case show contrasting views for different groups of transport professionals: a favorable assessment of HS2 among transport planners employed in government, but an unfavorable assessment among transport researchers with a background in sustainability. In terms of contribution to the development of data collection methods, this research demonstrates the usefulness of conducting semistructured interviews in conjunction with an online questionnaire for the assessment and weighting process within MCA. Because MCA results are expressed in terms of relative desirability of projects, the approach also effectively systematizes the inclusion and assessment of multiple options. Overall, the proposed method enhances the capacity to analyze conflicting views in large-scale transport project appraisal processes. [ABSTRACT FROM AUTHOR]

Traffic safety has always been an important issue in sustainable transportation development, and the prediction of traffic accident severity remains a crucial challenging issue in the domain of traffic safety. A huge variety of forecasting models have been proposed to meet this challenge. These models gradually evolved from linear to nonlinear forms and from traditional statistical regression models to current popular machine learning models. Recently, a machine learning algorithm called Deep Forests based on the decision tree ensemble has aroused widespread concern, which was proposed for the first time by a research team of Nanjing University. This algorithm was proved to be more accurate and robust in comparison with other machine learning algorithms. Motivated by this benefit, this study employs the UK road safety dataset to propose a novel method for predicting the severity of traffic accidents based on the Deep Forests algorithm. To verify the superiority of our proposed method, several other machine learning algorithm-based perdition models were implemented to predict traffic accident severity with the same dataset, and the prediction results show that the Deep Forests algorithm present good stability, fewer hyper-parameters, and the highest accuracy under different level of training data volume. It is expected that the findings from this study would be helpful for the establishment or improvement of effective traffic safety system within a sustainable transportation system, which is of great significance for helping government managers to establish timely proactive strategies in traffic accident prevention and effectively improve road traffic safety. [ABSTRACT FROM AUTHOR]

Renewable energy has become popular compared with traditional energy like coal. The relative demand for renewable energy compared to traditional energy is an important index to determine the energy supply structure. Forecasting the relative demand index has become quite essential. Data mining methods like decision trees are quite effective in such time series forecasting, but theory behind them is rarely discussed in research. In this paper, some theories are explored about decision trees including the behavior of bias, variance, and squared prediction error using trees and the prediction interval analysis. After that, real UK grid data are used in interval forecasting application. In the renewable energy ratio forecasting application, the ratio of renewable energy supply over that of traditional energy can be dynamically forecasted with an interval coverage accuracy higher than 80% and a small width around 22, which is similar to its standard deviation. [ABSTRACT FROM AUTHOR]

Cluster randomized trial design, where groups of participants are randomized instead of individual participants, is increasingly being used in long-term care research. The purpose of this review was to determine the characteristics of cluster randomized trials in long-term care facilities. A medical librarian conducted the literature search. Two independent reviewers reviewed each paper. Studies were included if the design was cluster randomized and participants were from long-term care facilities. For each included study, two independent data extractors captured data on study attributes, including: journal, location, year published, author discipline, funding, methodology, number of participants, and intervention target. The literature search yielded 7,679 unique studies, with 195 studies meeting the selection criteria and being included for data extraction. The included studies were published between 1976 and 2017, with 53% of studies published after 2009. The term cluster randomized was in the title of only 45% of the studies. The studies were conducted worldwide; the United States had the largest number of studies (23%), followed by the United Kingdom (18%). Ten percent of studies were published in journals with an impact factor >10. The most frequent discipline of the first and last authors was medicine (34%), followed by nursing (17%). Forty-nine percent of the studies had government funding, while only 20% had medical industry funding. In studies with <1000 residents, 85% of the studies obtained consent from the resident and/or their proxy, while in studies with ≥ 1000 residents, it was 31%. The most frequent intervention targets were infection (13%), falls/fracture (13%), and behavior/physical restraint (13%). Cluster randomized controlled trials in long-term care have a unique set of characteristics. Results of this review will provide guidance to researchers conducting studies in long-term care facilities. [ABSTRACT FROM AUTHOR]

This paper examines the impact that climate change may have on the lodging of oats in the Republic of Ireland and the UK. Through the consideration of a novel lodging model representing the motion of an oat plant due to the interaction of wind and rain and integrating future predictions of wind and rainfall due to climate change, appropriate conclusions have been made. In order to provide meteorological data for the lodging model, wind and rainfall inputs are analysed using 30 years' time series corresponding to peak lodging months (June and July) from 38 meteorological stations in the United Kingdom and the Irish Republic, which enables the relevant probability density functions (PDFs) to be established. Moreover, climate data for the next six decades in the British Isles produced by UK climate change projections (UKCP18) are analysed, and future wind and rainfall PDFs are obtained. It is observed that the predicted changes likely to occur during the key growing period (June to July) in the next 30 years are in keeping with variations, which can occur due to different husbandry treatments/plant varieties. In addition, the utility of a double exponential function for representing the rainfall probability has been observed with appropriate values for the constants given. [ABSTRACT FROM AUTHOR]

The number of people living with dementia is growing, leading to increasing pressure upon care providers. The mechanisms to reduce symptoms of dementia can take many forms and have the aim of improving the wellbeing and quality of life of the person living with dementia and those who care for them. Besides the person who has dementia, the condition has a profound impact upon their loved ones and carers. One therapeutic approach is the use of music, an area recognised as having potential benefit, but requiring further research. The present paper reports upon a mixed methods cohort study that examines the use of a musical mobile app as a way to promote song-task association in people living with dementia. The study took place in care home environments in the UK. A total of fourteen participants (N = 14) were recruited. Quantitative measurements were taken on a daily basis prior to, and during, use of the mobile app over several weeks. Metrics came from the complete Self-Assessment Manikin scale (arousal, valence, and dominance), and a subset of three from the Quality of Life in Alzheimer's Disease questionnaire (physical health, memory, and life as a whole). Subsequently, semistructured interviews were conducted with staff at the care home to assess the impact of the app upon their role and the residents they care for. No significant differences were found in the combined quantitative measures for the ten (n = 10) sets of responses sufficient to be analysed. However, the qualitative results suggest that use of the mobile app produced positive changes in terms of behaviour, ability, and routine in the life of residents living with dementia. These findings contribute to the growing body of evidence-based research in the field of musical therapies for reducing symptoms of dementia and highlight elements where further study is warranted. [ABSTRACT FROM AUTHOR]

In 2019, the Manchester Centre for Audiology and Deafness celebrates its 100th anniversary. To mark the centenary, this special issue is a collection of papers that showcases current research in Manchester Centre for Audiology and Deafness. The Editorial provides a brief history and description of the Centre and an overview of the special issue. [ABSTRACT FROM AUTHOR]

The air quality in classrooms significantly impacts school children's health and learning performance. It has been reported worldwide that classroom air quality does not meet the required standard and actions are pledged for improvement. However, it poses a challenge for decision-making in terms of prioritising taking-up measures. The aim of this study is to propose a method of identifying the action measures for improving classroom air quality and prioritising them. Case studies in the UK and China were conducted, and the key measures were identified through literature studies, open-ended questionnaire surveys, and workshop discussions, which are classified into three categories: B1, policy; B2, technology; and B3, information sharing. The analytical hierarchy process (AHP) is applied in the prioritisation of the action measures. A total of 138 teachers and parents from China and the UK participated in this case study. The genetic algorithm-optimised Hadamard product (GAOHP) method is applied to justify the consistency ratio (CR) within the required threshold value in order to ensure the consistency of the subjective perception and the accuracy of comparative weights. The results show that item B2, technology, is the most desired measure by both Chinese and British parents and teachers, despite the deviation from the optimal choice in China and the UK. Among the proposed action measures, the UK respondents strongly expected air purifiers with natural ventilation as opposed to their Chinese counterparts preferring to share the real-time status of classroom air quality. Our work will provide strong support for the subsequent selection of indoor air quality improvement strategies for schools. [ABSTRACT FROM AUTHOR]

Background. Actinic keratosis (AK) is a common premalignant skin condition. Its diagnosis is based on a clinical and sometimes dermoscopic examination, but, in some situations, a skin biopsy may be necessary. Dynamic optical coherence tomography (D-OCT) can often bypass this need, by noninvasive evaluation of skin morphology. Early and effective treatment of AKs is important to prevent the progression to invasive squamous cell carcinoma (iSCC). Tirbanibulin 1% ointment, a new topical field therapy for AKs, has recently been introduced. Objectives. The aim of this study was to evaluate the efficacy and safety of tirbanibulin 1% ointment for the field treatment of nonhyperkeratotic, nonhypertrophic AKs (Olsen grade 1) on the face and/or scalp in adults, using D-OCT technology. Methods. Patients, presenting multiple, mild to moderate AKs on the face and scalp, in treatment with tirbanibulin 1% ointment for five consecutive days of an area measuring 25 cm2, were evaluated with videodermoscopy (V-track Vidix 4.0) and D-OCT (VivoSight Dx, Michelson Diagnostics Ltd., Kent, England, United Kingdom), as normal clinical practice. The lesions were staged according to the Olsen classification, excluding the most aggressive lesions. Results. We retrospectively evaluated 50 patients (27 males and 23 females, mean age 76 ± 7.9 years). At 57 days posttreatment, the complete clearance rate was 68% (n = 34) and partial clearance rate was 76% (n = 38). D-OCT showed markedly improved morphology, including a better recognizable dermal-epidermal junction (DEJ), associated with reduced inflammation. The most common adverse events reported were erythema and scaling, which were mostly mild and self-limiting. Conclusions. This study demonstrated that tirbanibulin may be considered an effective and well-tolerated treatment option for nonhyperkeratotic, nonhypertrophic AKs. It showed a favorable safety profile, with mostly mild adverse events. D-OCT can be considered a useful tool for personalizing AK treatment and monitoring. [ABSTRACT FROM AUTHOR]

AADCd is an ultrarare, underdiagnosed neurometabolic disorder for which a screening test (3-OMD dosing on dried blood spot (DBS)) and targeted gene therapy (authorized in the EU and the UK) are available. Therefore, it is mandatory to raise awareness of presenting symptoms and signs among practitioners. Delivering scientifically sound information to promote screening of patients with the correct cluster of symptoms and signs would be critical. Materials and Methods. In light of the lack of sound evidence on this issue, expert opinion level of evidence was elicited with the Delphi method. Fourteen steering committee members invited a panel of 29 Italian experts to express their opinions on a series of crucial but controversial topics related to using 3-OMD DBS as a screening method in AADCd. Clusters of symptoms and signs were divided into typical or atypical, depending on age groups. Inclusion in newborn screening programs and the usefulness of a clinical score were investigated. A five-point Likert scale was used to rate the level of priority attributed to each statement. Results. The following statements reached the highest priority: testing pediatric patients with hypotonia, developmental delay, movement disorders, and oculogyric crises; inclusion of 3-OMD dosing on DBS in neonatal screening programs; development of a clinical score to support patients’ selection for 3-OMD screening; among atypical phenotypes based on clinical characteristics of Italian patients: testing patients with intellectual disability and parkinsonism-dystonia. Discussion. Clusters of symptoms and signs can be used to prioritize testing with 3-OMD DBS. A clinical score was rated as highly relevant for the patient’s selection. The inclusion of 3-OMD dosing in newborn screening programs was advocated with high clinical priority. [ABSTRACT FROM AUTHOR]

Psychosocial distress and poorer quality of life after renal transplantation are common in children and young people. This has implications for medication adherence and survival. Posttransplant psychology annual reviews were introduced in one Paediatric Renal Service in the UK as a means of measuring psychological distress and quality of life, as well as facilitating identification of patients and parents/carers who would benefit from psychological intervention. The process of completing posttransplant psychology annual reviews is discussed within this paper. The posttransplant psychology annual review appointments identified patients experiencing depression and/or anxiety and problems in quality of life. These assessments have led to appropriate referrals to, and engagement with, the renal psychology service as well as with community tier 3 child and adolescent mental health services. The posttransplant psychology annual review will continue to be completed at this UK site and discussions will be undertaken with other paediatric renal transplant services to consider whether these could be introduced at a national level to facilitate collection of longitudinal data regarding long-term psychosocial impact of paediatric renal transplantation and its effect on quality of life. [ABSTRACT FROM AUTHOR]

Background. There are many different haematological malignancy subtypes. Most follow chronic pathways that are uncertain and unpredictable, which may lead to feelings of anxiety and distress. The provision of information can ameliorate such difficulties, but patients are known to have unmet needs in this regard. The aim of this study is to explore experiences of information sharing among patients with chronic blood cancers and the factors impacting this process. Methods. The study is set within a UK cohort of blood cancer patients, where care is provided across 14 hospitals according to national clinical guidelines. Purposive sampling was used to identify expert participants (based on experience), and in-depth qualitative interviews were conducted with 35 patients, 10 with a relative present. The study was intended to inform practice and utilised qualitative description, with thematic content analysis and systematic data coding. Results. Experiences of information sharing varied. Most patients described this positively, but not all. Several barriers and facilitators were identified, which are discussed within five themes: (1) shock affects ability to process information, (2) the importance of time to facilitate information exchange, (3) personal relationships have an impact on meeting information needs, (4) HCP interpersonal skills are central to good information sharing, and (5) communication skills and terminology. Conclusions. Patients with chronic blood cancers prefer to engage in information sharing when they are not in a state of shock, and when they have adequate time to process material that is effectively and sensitively delivered, by HCPs they know and trust. [ABSTRACT FROM AUTHOR]

Competitive advantage significantly matters for modern construction organizations as it promotes the sustainable development and safety management of projects. UK construction organizations have greatly suffered from a lack of safety and sustainability of project management in infrastructure development projects because of the COVID-19 pandemic. Post-COVID-19 UK infrastructure development projects are uncertain in the context of organizational competitive advantage as they cannot maintain sustainable project management. This study was conducted to identify, rank, and present a framework of factors influencing the competitive advantage of UK organizations. The study design involved identifying factors from the current literature, after which the most relevant factors were filtered with the help of semi-structured interviews with 15 experts. A pilot survey was conducted then, involving 192 respondents, after which a reliability test and exploratory factor analysis (EFA) were conducted on the results. A primary questionnaire survey involving 250 respondents was conducted, after which RII and confirmatory factor analysis (CFA) were conducted on the final data. A total of five subgroups were found to be significant in the CFA, such as Resources and Policies, Quality and Delays, Motivation and Expectation, Management and Environment, and Government and Business. It is recommended based on findings that the construction organizations of the UK have to consider working on identified factors to maintain a competitive advantage in establishing sustainable project management solutions for post-COVID-19 UK infrastructure development projects. [ABSTRACT FROM AUTHOR]

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

This study proposes random-parameters multinomial logit models, with heterogeneity in means and variances, to explore the differences in the factors influencing injury severities of drivers involved in different types of two-vehicle crashes. The models are verified using crash data from the United Kingdom (UK) over three years (2016–2018). Three types of crashes are separately identified (car-car, car-truck, and truck-truck crashes). In this study, a wide variety of potential variables, including the driver, vehicle, road, and environmental characteristics, are considered, with two possible injury-severity outcomes: severe and slight injury. The results show that unobserved heterogeneity existed for young drivers in both car-car and truck-truck crash models and the 30 mph speed limit in the three separate models. Remarkably variations are observed in crashes involving different types of vehicles. The driver's age and gender, speeding, sideswipes, presence of junctions, weekdays, unlit, and weather conditions significantly impact driver-injury severities in various types of vehicle crashes. These findings are expected to help policymakers seek to improve highway safety and implement proper safety countermeasures. [ABSTRACT FROM AUTHOR]

This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients' satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients' satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country. [ABSTRACT FROM AUTHOR]

Background: The paper explores shaping public health impact assessment tools for tilapia, a novel emergent aquaculture sector in the UK. This Research Council's UK Rural Economy and Land Use project embraces technical, public health, and marketing perspectives scoping tools to assess possible impacts of the activity. Globally, aquaculture produced over 65 million tonnes of food in 2008 and will grow significantly requiring apposite global public health impact assessment tools. Methods. Quantitative and qualitative methods incorporated data from a tridisciplinary literature. Holistic tools scoped tilapia farming impact assessments. Laboratory-based tilapia production generated data on impacts in UK and Thailand along with 11 UK focus groups involving 90 consumers, 30 interviews and site visits, 9 visits to UK tilapia growers and 2 in The Netherlands. Results. The feasibility, challenges, strengths, and weaknesses of creating a tilapia Public Health Impact Assessment are analysed. Occupational and environmental health benefits and risks attached to tilapia production were identified. Conclusions. Scoping public health impacts of tilapia production is possible at different levels and forms for producers, retailers, consumers, civil society and governmental bodies that may contribute to complex and interrelated public health assessments of aquaculture projects. Our assessment framework constitutes an innovatory perspective in the field. [ABSTRACT FROM AUTHOR]

In the UK there is a huge legacy of buried utility service pipelines and cables beneath our streets and new services, such as fibre optic cables, are being added all the time. Much of this utility network is poorly mapped and recorded. It is therefore important to accurately locate and map these services to aid the installation of new, and repair and maintenance of existing, assets. This will help avoid damage to adjacent services and reduce the direct and social costs associated with finding buried utilities. This paper describes two major UK initiatives--Mapping the Underworld (MTU) and Gravity Gradient Technologies and Opportunities Programme (GG-TOP)--that aim to improve the way that we locate, map, and share information on buried utility services. MTU aims to develop a multisensor device to locate buried services, while GG-TOP aims to develop gravity gradient technology to deliver a (three orders of magnitude) step change in performance. [ABSTRACT FROM AUTHOR]

While a significant amount of work has been conducted to assess the concentration of pollutants in soils and waterways near land that has been amended with biosolids, a relatively small body of research investigating emissions to atmosphere is available in the literature. Some studies have indicated that while the CO2 emissions from soils decrease with fertiliser application, the CH4 and N2O emissions might be increased, offsetting the benefit. The objective of the research presented in this paper was to address this gap, by the use of a flux chamber technique to measure soil-atmosphere gas exchanges from the application of biosolids to land. This was done by applying three different types of biosolids to soils and measuring gases at the soil-atmosphere interface. The measurements were taken on areas with three different types of vegetation. The gases were collected using a flux chamber technique and analysed by gas chromatography. The results presented here are preliminary findings of an ongoing experiment. Insignificant variation appeared to occur between different areas of vegetation; however, small variations in gas concentrations were observed indicating a need for continued monitoring of soil-atmosphere gas exchanges to determine the long-term impacts on the atmosphere and the environment. [ABSTRACT FROM AUTHOR]

Complementary and Alternative Medicines (CAM) are used by an extensive number of patients in the UK and elsewhere. In order to understand this pattern of behavior, it is helpful to examine the characteristics of people who use CAM. This narrative review collates and evaluates the evidence concerning the demographic characteristics and health status factors associated with CAM use in community-based non-clinical populations. A systematic literature search of computerized databases was conducted, and published research papers which present evidence concerning associations between CAM use and demographic and health characteristics are discussed and evaluated. The evidence suggests that people who use CAM tend to be female, of middle age and have more education. In terms of their health, CAM users tend to have more than one medical condition, but might not be more likely than non-users to have specific conditions such as cancer or to rate their own general health as poor. The multivariate studies that have been conducted suggest that both demographic and health characteristics contribute independently to CAM use. In conclusion, demographic characteristics and factors related to an individual's health status are associated with CAM use. Future research is needed to address methodological limitations in existing studies. [ABSTRACT FROM PUBLISHER]

Alzheimer's disease is the most common form of dementia in the elderly and is a progressive neurodegenerative disorder characterised by a decline in cognitive function and also profound alterations in mood and behaviour. The pathology of the disease is characterised by the presence of extracellular amyloid peptide deposits and intracellular neurofibrillary tangles in the brain. Although many hypotheses have been put forward for the aetiology of the disease, increased inflammation and oxidative stress appear key to be features contributing to the pathology. The omega-3 polyunsaturated fats, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) have well-characterised effects on inflammation and may have neuroprotective effects in a number of neurodegenerative conditions including Alzheimer's disease. The aims of this paper are to review the neuroprotective effects of EPA and DHA in Alzheimer's disease, with special emphasis on their role in modulating oxidative stress and inflammation and also examine their potential as therapeutic agents. [ABSTRACT FROM AUTHOR]

Viral haemorrhagic septicaemia virus (VHSV) is a fish disease notifiable to the World Organisation for Animal Health. The United Kingdom is currently free from VHSV, and the introduction and onward spread of this disease could cause major economic losses in aquaculture facilities. Legislation in Great Britain requires that imports of live fish for aquaculture purposes into declared disease-free areas are of equivalent disease-free status. However, conditions on fish products are less stringent, whereby eviscerated fish or fillets can be transported from areas with disease to areas declared disease-free. Market-size rainbow trout were experimentally infected with VHSV to investigate two important factors relevant for pathogen introduction and transmission: (1) VHSV shedding, quantified by daily assessment of viral titres in tank water samples, and (2) VHSV concentrations in liquid and solid processing waste. Evisceration and filleting preclinical fish, maceration, and wastewater separation processes within a facility were mimicked, and VHSV was quantified in each fraction of the wastewater. Shedding was detected 25 hr post-challenge. Levels increased daily to peak on day 5 post-challenge, with a calculated average titre of 1.35 × 103 TCID50 mL−1 kg−1 fish, 1 day before clinical signs of disease. Preclinical fish contained virus levels in their kidney, skin, and muscle >107 TCID50 g−1. The fish had significantly higher levels in the kidney, and evisceration led to higher VHSV concentrations in the waste compared to filleting. However, there was no significant difference in levels in wastewater released from the two processes after the removal of solids, even when macerated; average titres were >104 TCID50 mL−1. The quantities of VHSV from shedding and processing can be utilised when modelling transmission and undertaking more accurate risk assessments for imports and processing of commodities, with the ultimate aim of reducing the global risk of disease from international trade and processing. [ABSTRACT FROM AUTHOR]

A range of professionals and services are often involved in supporting parents with mental health needs where there are child protection concerns. However, they do not always meet the needs of this population who tend to experience inadequate support and mistrust of services. This review aimed to synthesize parent and practitioner experiences of support for parents with both mental health needs and children's social services involvement. We performed electronic searches of the following databases: PsycINFO, CINAHL, HMIC, MEDLINE, Embase, Social Policy and Practice, Social Services Abstracts, Social Science Citation Index, OpenGrey, Social Care Online, and ProQuest. Following searching and screening, 41 studies were identified including 359 parents and 1370 practitioners. We worked with a Lived Experience Advisory Group to develop the following themes: (1) a downward spiral of service intervention; (2) working with parents, not against them; (3) support wanted versus support provided; and (4) constrained by service rigidity. We found that families were often parenting amidst trauma and adversity. However, service involvement could trigger a "downward spiral" of stressful processes over which parents felt they lacked control. Instead of improving their situations, support sometimes added to families' difficulties, worsening parents' mental health and making them feel marginalised, criticised, and retraumatised. There were, however, also examples of positive practice, where practitioners and parents developed trusting, open, and mutually respectful relationships. Practitioners often felt that they were limited in their ability to offer collaborative, holistic care because services were fragmented, underfunded, crisis driven, and inflexible. Difficulties mentioned most often by parents, such as financial issues, tended not to be a focus of available interventions. We conclude that the key issues identified must be targeted to improve support. [ABSTRACT FROM AUTHOR]

Background. Cognitive impairment is common in Parkinson's disease (PD) and associated with lower quality of life. Cognitive impairment in PD manifests differently to other dementia pathologies. Provision of optimal care requires knowledge about the support needs of this population. Methods. Eleven people with PD and cognitive impairment (PwP), 10 family caregivers, and 27 healthcare professionals were purposively sampled from across the United Kingdom. Semistructured interviews were conducted in 2019–2021, audio-recorded, transcribed, and analysed using reflexive thematic analysis. Results. Cognitive impairment in PD conveyed increased complexity for clinical management and healthcare interactions, the latter driven by multifactorial communication difficulties. Techniques that helped included slow, simple, and single messages, avoiding topic switching. Information and emotional support needs were often unmet, particularly for caregivers. Diagnostic pathways were inconsistent and awareness of cognitive impairment in PD was poor, both contributing to underdiagnosis. Many felt that PwP and cognitive impairment fell through service gaps, resulting from disjointed, nonspecific, and underresourced services. Personalised care was advocated through tailoring to individual needs of PwP and caregivers facilitated by flexibility, time and continuity within services, and supporting self-management. Conclusions. This study highlights unmet need for people with this complex condition. Clinicians should adapt their approach and communication techniques for this population and provide tailored information and support to both PwP and caregivers. Services need to be more streamlined and collaborative, providing more time and flexibility. There is a need for wider awareness and deeper understanding of this condition and its differences from other types of dementia. [ABSTRACT FROM AUTHOR]

Delayed discharge from hospital is a global healthcare problem with negative impacts on patient outcomes and the wider health system. Delays to discharge can arise when a patient remains in hospital even when they are medically fit due to nonmedical reasons such as a lack of appropriate housing or social care. However, whilst several nonmedical interventions have been developed to facilitate timely hospital discharge, there remains a lack of evidence on their impact. This study reports on findings from a mixed-methods process evaluation of a newly integrated housing and health service in two United Kingdom- (UK-) based hospitals (one mental health hospital and one general hospital). The service involved housing support coordinators (HSCs) being based within hospitals and supporting inpatients with their housing-related needs. We employed qualitative interviews with service users and hospital/housing staff (N = 16) and routine data analysis (n = 488) to understand the impact of the service and any challenges to service delivery. Service users faced different housing barriers, for example: 28.3% experienced homelessness (n = 136) whilst 80 (16.4%) faced challenges with their accommodation no longer meeting their physical needs. Service users received support for a variety of issues such as assistance with medical priority applications, support to apply for social housing, and referral to other support services. Healthcare professionals at all levels credit the service for improving hospital discharge processes and reducing stress on clinical staff, enabling them to concentrate more effectively on clinical tasks. Key to success is experienced housing staff providing patient-centred support, being integrated within a multidisciplinary team with management and oversight from the health service, and the availability of appropriate housing stock and wider services to support people after discharge. Our findings indicate that other hospitals may benefit from implementing similar housing and health integrated services. [ABSTRACT FROM AUTHOR]

Short breaks help maintain caring relationships, enabling people to remain living in their own homes and contributing significant economic benefit to public services. However, relatively little is known about the added social value generated by community-based short breaks. To address this evidence gap, we explored the feasibility of using a social return on investment (SROI) evaluation to explore a day support service in North Wales for people living with dementia and their unpaid carers. Following good practice for evaluating complex interventions, we developed a logic model based on the literature and interviews to understand the mechanisms and outcomes of the day support service. Using questionnaires, we quantified outcomes for the current service cohort, which included people living with dementia, unpaid carers, and paid companions. Seven people living with dementia, three unpaid carers, and four companions completed questionnaires. By following the SROI analysis approach, three key learning points were identified. The first was around ways to capture outcomes from all stakeholder subgroups expected to experience material change. The second concerned the importance of collecting longitudinal data. This included the need to consider how to adapt the SROI method to work with small populations. The third concerned how to value "maintenance" of wellbeing as well as improved wellbeing. [ABSTRACT FROM AUTHOR]

Objective. Those closest to the patients with low-grade glioma (LGG) often become informal caregivers (ICs). Caregiving demands can impact ICs' wellbeing, meaning they themselves may require support. We explored the nature and quality of support from informal networks for ICs of LGG patients. Methods. In this cross-sectional qualitative study, semistructured interviews were conducted with individuals from the United Kingdom who currently, or in the past five years, informally cared for someone diagnosed with an LGG. Interviews explored ICs' experiences of receiving support from informal networks. Thematic analysis was undertaken. Results. Nineteen ICs were interviewed (mean age 54.6 years; 5 males, 14 females). ICs received multiple forms of support from their informal networks: emotional (e.g., "opportunities to talk"), instrumental (e.g., "opportunities for relief"), information (e.g., "information from network contacts"), and appraisal (e.g., "comparisons with similar others"). Networks comprised strong/familiar (e.g., close friends) and weaker/unfamiliar (e.g., other ICs) ties. Supportive networks were perceived to help protect ICs' wellbeing. Participants perceived challenges such as poor understanding and unsolicited advice to weaken the quality of support. Conclusion. Informal networks can provide wide-ranging support for ICs of the LGG patients. Different supports may be sought or provided from different contacts, highlighting the importance and value of extended networks. [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. Ambulatory Care (AC), where patients receive inpatient cancer treatment on an outpatient basis, was introduced into the United Kingdom (UK) National Health Service (NHS) in 2004. Although now well established within some services, the development of AC across the NHS is yet to be described. We report findings of a scoping review that set out to understand the provenance of the clinical pathway, whilst exploring drivers for the development of AC in the UK. Methods. Using scoping review methods, database citation, and grey literature, searches were undertaken to map the storyline of AC's development internationally. The Joanna Briggs Institute guidance was followed; this included consultation with six professionals considered critical to the development of AC. Results. From the 57 records identified between 1979 and 2022, four domains were identified through a narrative synthesis that reflected the following drivers for AC: financial; optimisation of bed capacity; advances in technology and supportive care; and professional motivation to improve patient experience. Conclusion. We report the first descriptive analysis of the international development of AC, locating the UK cancer service within its commissioning, operational, and philosophical foundations. The review additionally highlights limited research exploring the experience of the AC model from the patients' perspective. [ABSTRACT FROM AUTHOR]

Unemployment or being at-risk of unemployment is a health risk factor. Back Onside is a physical activity programme run in Bradford (UK) by the Bradford Bulls Foundation. It is aimed at improving the mental and physical health and wellbeing of adults who are unemployed or at-risk of unemployment. The programme is delivered in a relaxed and sociable environment to help build a positive mindset towards physical activity. We conducted semistructured interviews with participants on the programme (n = 5) and external stakeholders (n = 6) between 24 June and 12 July, 2021. Data analysis was completed using the context-mechanism-outcome (CMO) framework of realist evaluation. Four CMOs were identified: (1) resocialisation following COVID-19 lockdown restrictions; (2) congruence between the programme and participants' goals; (3) engaging people in enjoyable activities; and (4) inclusive environments. We recommend future programmes to take an inclusive and relaxed approach to physical activity and be congruent with participants' goals and values to ensure participants' feel supported and adhere to the programmes. [ABSTRACT FROM AUTHOR]

In this paper, a novel classification technique for large data set of mammograms using a deep learning method is proposed. The proposed model targets a three-class classification study (normal, malignant, and benign cases). In our model we have presented two methods, namely, convolutional neural network-discrete wavelet (CNN-DW) and convolutional neural network-curvelet transform (CNN-CT). An augmented data set is generated by using mammogram patches. To enhance the contrast of mammogram images, the data set is filtered by contrast limited adaptive histogram equalization (CLAHE). In the CNN-DW method, enhanced mammogram images are decomposed as its four subbands by means of two-dimensional discrete wavelet transform (2D-DWT), while in the second method discrete curvelet transform (DCT) is used. In both methods, dense scale invariant feature (DSIFT) for all subbands is extracted. Input data matrix containing these subband features of all the mammogram patches is created that is processed as input to convolutional neural network (CNN). Softmax layer and support vector machine (SVM) layer are used to train CNN for classification. Proposed methods have been compared with existing methods in terms of accuracy rate, error rate, and various validation assessment measures. CNN-DW and CNN-CT have achieved accuracy rate of 81.83% and 83.74%, respectively. Simulation results clearly validate the significance and impact of our proposed model as compared to other well-known existing techniques. [ABSTRACT FROM AUTHOR]

Aims. This paper describes a UK survey of the choice of radiotherapy regime for the reconstructed chest wall in breast cancer patients. Questions focused on which fractionation regime consultants choose, their reasons for this, whether the type of reconstruction influences their choice, and whether bolus is used in patients who have undergone immediate reconstructive surgery. Materials and Methods. Between July 2014 and July 2015 a survey was sent by email to UK consultant radiation oncologists treating breast cancer. Results. The response rate was 73%. 67% of respondents use 40 Gray (Gy) in 15 fractions, with 22% using 50 Gy in 25 fractions and 7% using other regimes. For 90% of consultants the type of reconstruction did not influence their decision regarding choice of fractionation. 83% of respondents do not usually use a bolus for chest wall radiotherapy in patients who have had immediate reconstructive surgery. Conclusions. This survey illustrates there is variation in practice in the management of patients with breast cancer who have undergone immediate reconstructive surgery in the UK. There is a need for further research to determine which fractionation regime is optimal, whether the type of surgery is relevant, and whether bolus should be added. [ABSTRACT FROM AUTHOR]

The emotional impact of the COVID-19 pandemic and ensuing social restrictions has been profound, with widespread negative effects on mental health. We made use of the natural language processing and large-scale Twitter data to explore this in depth, identifying emotions in COVID-19 news content and user reactions to it, and how these evolved over the course of the pandemic. We focused on major UK news channels, constructing a dataset of COVID-related news tweets (tweets from news organisations) and user comments made in response to these, covering Jan 2020 to April 2021. Natural language processing was used to analyse topics and levels of anger, joy, optimism, and sadness. Overall, sadness was the most prevalent emotion in the news tweets, but this was seen to decline over the timeframe under study. In contrast, amongst user tweets, anger was the overall most prevalent emotion. Time epochs were defined according to the time course of the UK social restrictions, and some interesting effects emerged regarding these. Further, correlation analysis revealed significant positive correlations between the emotions in the news tweets and the emotions expressed amongst the user tweets made in response, across all channels studied. Results provide unique insight onto how the dominant emotions present in UK news and user tweets evolved as the pandemic unfolded. Correspondence between news and user tweet emotional content highlights the potential emotional effect of online news on users and points to strategies to combat the negative mental health impact of the pandemic. [ABSTRACT FROM AUTHOR]

An estimated 1.3 million stroke survivors living in the United Kingdom (UK) currently rely on family caregivers for daily support. The needs of stroke family caregivers are, however, not routinely assessed by most clinical services. Early identification of their needs and support is crucial to maintain their well-being and caregiver role. At present, stroke-specific caregiver screening tools are lacking. This mixed method, the multiphase study aimed to develop a Carers' Alert Thermometer for stroke family caregivers (CAT-S) by adapting the CAT, a short screening tool developed in the context of end-of-life care. Underpinned by principles of action research, qualitative and quantitative data were collected sequentially between February 2016 to December 2017 from purposive samples of stroke family caregivers (n = 76) and staff working within stroke services (n = 238) in the UK. Semistructured interviews were conducted to inform the contents of the CAT-S. Key items for inclusion were identified through a modified Delphi survey and consultation with an expert panel. The CAT-S was then piloted in North West England to test its usability and usefulness in practice to identify the needs of stroke family caregivers. Thematic and content analysis were used to analyse qualitative data. Quantitative data were analysed using descriptive statistics. The CAT-S comprises the key challenges that are experienced by stroke family caregivers. Two additional items not present on the original CAT were identified and included; training needs of family caregivers to provide care and support for caregivers' emotional needs. The CAT-S was found to be useful and acceptable by both staff and stroke family caregivers and resulted in action plans and support being provided. The CAT-S is a supportive tool for achieving person-centred care and prioritising stroke family caregivers requiring comprehensive assessments. [ABSTRACT FROM AUTHOR]

Parenting can be impacted by substance misuse, and children can be at risk of maltreatment, leading to their removal from their mothers. Successful treatment of substance abuse relies on these women gaining effective support from services. Previous research has demonstrated the impact working in this field can have on staff, including high staff turnover, vicarious trauma, and burnout. The present study further explores the experience of staff members working in a Drug and Alcohol Recovery Service in Scotland who work with mothers who have had their children removed. Six interviews with nurses and social care workers were analysed using interpretive phenomenological analysis (IPA). Two superordinate themes were developed from the data: (1) complexity and tension within working relationships and (2) emotional experiences and attempts to resolve them. Participants described the complexity of their roles, including the dual role of supporting mothers while also being involved in the child removal process by providing reports and evidence and how they respond and work with mothers after removal and conflicts with the wider system. They also highlighted their attempts to cope with the emotional impact of being part of this process and the empathy they have with mothers, especially when they are parents themselves, and described the complexities of trying to cope and manage when working in this challenging area. Clinical implications, including training needs and requirements, are discussed. [ABSTRACT FROM AUTHOR]