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Supporting neurodivergent‐inclusive workplaces is an increasingly important consideration in Human Resource Management (HRM). While a strengths‐based approach to neurodivergence has been advocated, empirical evidence regarding the effectiveness of HRM practices that support high‐quality employment outcomes for neurodivergent people is lacking. Drawing on a nationally representative sample of over 25,000 people in the United Kingdom, we examine the influence of neurodivergence on multiple employment outcomes, including employment status, underemployment, employment precarity, job tenure, and hourly wages. We theorize and empirically examine how flexible‐ and homeworking practices moderate the effects of neurodivergence on employment outcomes. Our findings show that neurodivergent people are twice as likely to be in precarious employment and more than 10 times as likely to be in temporary employment compared to neurotypical people. Neurodivergent individuals are also significantly more likely to experience underemployment and have lower employment tenure; however, controlling for other factors, we find no significant differences in hourly wages. We find that flexible working practices can substantially improve employment outcomes for neurodivergent people, raising significant questions regarding the role of HRM in enabling more neurodiverse workplaces. We critically reflect on the implications of our findings for policy, practice, and future research. [ABSTRACT FROM AUTHOR]

Despite the importance of a thriving workforce in sustaining organizational success, prior research pays little attention to how individualized human resource (HR) practices can help individual employees to thrive at work. Drawing on the theoretical underpinnings of conservation of resources theory, we investigate whether, how, and when development idiosyncratic deals (i‐deals) can contribute to individual thriving. We contend that possessing development i‐deals will motivate individuals to engage in approach job crafting, which in turn promotes their experience of thriving at work. We further contend that high‐quality leader–member exchange will enhance the function of development i‐deals in triggering approach job crafting and subsequent thriving experiences. Results from a two‐wave survey involving 278 managers in a pharmaceutical firm in China and a three‐wave survey among 178 managers working in various organizations in the UK support our hypotheses. Our findings provide new insights for practitioners seeking to design customized HR practices to support a thriving workforce. [ABSTRACT FROM AUTHOR]

Asynchronous video interviews (AVIs) are a form of one‐way, technology‐mediated selection interview that can help streamline and increase flexibility in the hiring process and are used to hire millions of applicants per year. Although applicant reactions to AVIs in general tend to be more negative than with traditional interview modalities, AVIs can differ widely in how they are designed. For instance, applicants can be provided with more or less preparation time, response length, rerecording options, or rely on different question formats. This study examines how AVI design features impact applicant reactions, as well as the moderating role played by applicant age and gender. Data from 27,809 real job applicant's AVI experiences were collected in 11 countries (69.3% English‐speaking) from 33 companies and relating to 72 types of positions. Data were fitted with linear mixed‐effects models to account for nesting. Results showed that allowing more preparation time and offering the opportunity to rerecord responses were related to more favorable reactions, while including more questions was related to more negative reactions. Applicants above the age of 31 reacted especially negatively to AVIs with more questions while those below the age of 30 preferred being allocated longer maximum response lengths. Women reacted more positively to increased preparation time. These findings might help both AVI vendors and hiring organizations design AVIs that facilitate a positive applicant experience. Our research also expands knowledge on applicant reactions to interviews, highlights crucial differences from traditional formats, and calls for integrating applicant characteristics into current theoretical frameworks on applicant reactions to AVIs. [ABSTRACT FROM AUTHOR]

Employees play a central role in organizational functioning and representation. HR managers thus strive to create an attractive employer image that stimulates employees' attachment and ambassadorship. However, presently, there is limited research about how employees perceive and react toward their organization's employer brand. More importantly, the studies available have focused on content attributes only (i.e., instrumental and symbolic image dimensions). This has resulted in limited (content‐based) understanding of the construct and failure to incorporate its branding‐related aspects (process attributes) which represent the crux of employer branding theory. Thus, using the HRM system strength theory and employer branding literature, this article examines three process characteristics (i.e., employer brand distinctiveness, consistency, and consensus) vis‐à‐vis instrumental and symbolic content attributes to understand employee reactions (i.e., employer attractiveness, organizational identification, and employee ambassadorship). Data were collected at two times through Prolific Academic with 254 UK and US employees. Results suggest that employer brand process attributes are valuable sources to enhance employees' identification with their organization. Moreover, distinctiveness and consistency seem especially instrumental in enhancing employees' attractiveness perceptions and display of positive ambassadorship. In addition, the process attributes explain significant incremental and unique variance beyond content attributes in employee reactions. [ABSTRACT FROM AUTHOR]

Introduction Peri-operative medicine is becoming increasingly relevant in the context of managing frail patients with cancer. This paper outlines how demographic shifts in populations are affecting cancer incidence and frailty rates, the relevance this holds to the management of cancer care, and the outcome measures that should be used to gauge best clinical practice to ensure patient-centred care. Methods A targeted literature review was conducted using the search terms 'surgical oncology', 'outcomes', 'frailty', 'quality of life' and 'end of life' from 10 to 17 June 2024. Articles were reviewed by all authors and core themes from the literature review were identified. Core themes were then discussed by the authors to construct a narrative review. Results The review identified several core themes in relation to patient-centred outcome measures for oncological surgery. The UK population is ageing and consequently, the number of older people being diagnosed with cancer is increasing. There is much evidence to show that older patients have poorer outcomes in terms of mortality and postoperative complications across all types and severities of cancer. Traditional outcome measures such as 30-day mortality, duration of stay and recurrence rates fail to capture the outcomes that are most pertinent to this patient cohort. These include patient quality of life and treatment burden. We discuss the measurement of quality of life through the use of patient-reported outcome measures and their limitations. We also highlight the need for patient-centred, holistic care with the use of tools such as comprehensive geriatric assessment, which have been shown to improve patient outcomes. Discussion There is need for a greater emphasis on quality-of-life measures alongside mortality and patient-reported outcome measures. We argue that holistic care approaches should play a greater role in enabling the measurement of outcome states beyond simply dead or alive. [ABSTRACT FROM AUTHOR]

Aims: There is conflicting evidence regarding whether excess adiposity without metabolic abnormalities reflects a truly benign phenotype. This study evaluated the independent and joint associations of the presence of excess adiposity and metabolic abnormalities on arterial stiffness. Materials and Methods: Participants in UK Biobank with body mass index (BMI) and arterial stiffness index (ASI) recorded between 2006 and 2010, free from cardiovascular diseases and not underweight (BMI <18.5 kg/m2) were included. The primary outcome was severity of ASI analysed using multivariate‐adjusted linear regression. Results: Of 162 590 participants, 42.5% were overweight and 24.4% were obese. Within the normal BMI strata, 50.7% had ≥1 metabolic abnormality. Compared to individuals with normal BMI and no metabolic abnormality (reference group), increased BMI or metabolic abnormalities were similarly associated with higher ASI: normal BMI with metabolic abnormalities (adjusted β‐coefficient and 95% CI, 0.35; 0.30–0.40); overweight without metabolic abnormalities (0.32; 0.26–0.37). Individuals with obesity and no metabolic abnormality had higher ASI (0.65; 0.57–0.74) but was lower than individuals with overweight and metabolic abnormalities (0.80; 0.75–0.84). Individuals with obesity and metabolic abnormalities had the highest ASI (1.07; 1.02–1.12) among all six metabolic combinations, p < 0.001 for each versus reference group. Sensitivity analysis suggested higher ASI with increasing number of metabolic abnormalities within BMI categories and higher ASI in the presence of abdominal obesity within metabolic categories. Conclusions: Excess adiposity and metabolic abnormalities are independently associated with increased arterial stiffness to a similar degree, suggesting that metabolically healthy individuals with overweight and obesity are not benign groups. This reinforces the need to prevent excess adiposity and consider primary prevention strategies even before metabolic abnormalities emerge. [ABSTRACT FROM AUTHOR]

The association between the American Heart Association (AHA) Life's Essential 8 (LE8) and the risk of pancreatic cancer (PC) remains unclear. Our goal was to assess the relationships between LE8, genetic susceptibility, and PC risk. This cohort consisted of 234,102 participants from the UK Biobank. The components of LE8 include diet, nicotine exposure, sleep, physical activity, blood glucose, body mass index, blood lipids, and blood pressure. LE8 is classified into three categories: low cardiovascular health (CVH), moderate CVH, and high CVH. Measurements were made using Cox proportional risk models to estimate impact of associations between LE8, genetic susceptibility, and incidence of PC in participants. Compared to participants with low LE8 scores, those with moderate and high LE8 scores had a 53% (HR, 0.47; 95% CI, 0.39–0.57) and 70% (HR, 0.30; 95% CI, 0.22–0.41) lower risk of developing PC, respectively. Interestingly, among individuals with high genetic risk, high LE8 scores were associated with greater benefits (HR, 0.24; 95% CI, 0.15–0.40), whereas the protective effect was weaker among those with low genetic risk (HR, 0.40; 95% CI, 0.21–0.75). Participants with a high LE8 score and a low polygenic risk score (PRS) had the lowest risk of PC (HR, 0.19; 95% CI: 0.11–0.33). Furthermore, we observed a significant additive interaction between LE8 and PRS. A higher LE8 score is associated with a lower risk of PC, especially for participants with a high PRS. These findings have important implications for participants most genetically predisposed to PC and for targeted strategies for PC prevention. [ABSTRACT FROM AUTHOR]

When infants cannot directly breastfeed after birth, mothers are advised to initiate lactation through mechanical expression. Families are recommended to target an expression volume of at least 500–750 mL by Day 14 after birth, as this is considered a 'critical window' to establish milk supply. This is challenging for many mothers after a very preterm birth. This article explores the relationship of early milk quantity and later full breastmilk feeding as a 'gold standard' outcome, using statistical techniques designed for diagnostic tests. A cohort of 132 mothers of infants born at 23 + 0 to 31 + 6 weeks' gestational age submitted expressing logs on Day 4, 14 and 21 after birth and provided later feeding outcome. Using receiver operating characteristic (ROC) analysis, the following 24‐h milk quantities were identified as associated with high probability of full breastmilk at 36 weeks' post‐menstrual age (PMA): on Day 4, ≥250 g (specificity 88%; positive predictive value 88%) and on Day 21 ≥650 g (specificity 88%; positive predictive value 91%). The following values were identified as associated with low probability of full breastmilk at 36 weeks' PMA: on Day 4 <50 g (sensitivity 92%; negative predictive value 72%) and on Day 21 <250 g (sensitivity 90%; negative predictive value 70%). Participants exceeding the high thresholds had 3–4 times increased likelihood of full breastmilk, whereas those below the low thresholds had 3–5 times lower likelihood. These thresholds have potential as targets for families, to provide individualised prognostic information and to help clinicians target more intensive lactation support. Key messages: Mothers of very preterm infants who expressed at least 250 g at day four after birth had a high probability of providing later full breastmilk: 88% (95% CI: 72%–97%). This was similar for those who expressed at least 650 g at Day 21: 91% (95% CI: 77%–98%).Mothers of very preterm infants who expressed less than 50 g at day four after birth had a low probability of providing later full breastmilk: 28% (95% CI: 10%–53%). This was similar for those who expressed less than 250 g at Day 21: 30% (95% CI: 12%–54%).These thresholds may be useful for families to understand their lactation trajectories and for clinicians to target support. [ABSTRACT FROM AUTHOR]

Introduction: The medical school selection literature comes mostly from a few countries in the Global North and offers little opportunity to consider different ways of thinking and doing. Our aim, therefore, was to critically consider selection practices and their sociohistorical influences in our respective countries (Brazil, China, Singapore, South Africa and the UK), including how any perceived inequalities are addressed. Methods: This paper summarises many constructive dialogues grounded in the idea of he er butong (和而不同) (harmony with diversity), learning about and from each other. Results: Some practices were similar across the five countries, but there were differences in precise practices, attitudes and sociohistorical influences thereon. For example, in Brazil, South Africa and the UK, there is public and political acknowledgement that attainment is linked to systemic and social factors such as socio‐economic status and/or race. Selecting for medical school solely on prior attainment is recognised as unfair to less privileged societal groups. Conversely, selection via examination performance is seen as fair and promoting equality in China and Singapore, although the historical context underpinning this value differs across the two countries. The five countries differ in respect of their actions towards addressing inequality. Quotas are used to ensure the representation of certain groups in Brazil and regional representation in China. Quotas are illegal in the UK, and South Africa does not impose them, leading to the use of various, compensatory 'workarounds' to address inequality. Singapore does not take action to address inequality because all people are considered equal constitutionally. Discussion: In conclusion, medical school selection practices are firmly embedded in history, values, societal expectations and stakeholder beliefs, which vary by context. More comparisons, working from the position of acknowledging and respecting differences, would extend knowledge further and enable consideration of what permits and hinders change in different contexts. Authors from 5 countries offer guidance on how medical school selection reflects the history and values surrounding our institutions in an effort to foster understanding and change. [ABSTRACT FROM AUTHOR]

This article provides new perspectives on the transitions of children from military families. It examines the experiences and agency of a group of UK primary‐school Service children who were undergoing far‐reaching transitions while participating in an arts‐based research project. Transitions are conceived here not as events, such as school moves, but as processes of changing, the dialogical interplay between ever‐changing socio‐cultural and physical environments and the psychological work individuals undertake in response to change. This reconceptualisation of transitions shifts attention away from children's resilience, or lack thereof, and towards unique, nuanced understandings of their subjective experiences and priorities. Presenting multimodal pieces created by three children as they explored the question, 'What's it like to be a Service child in this school?', I describe their diverse and agentic responses to their changing circumstances, as they sought to mitigate anticipated and past losses and perceived disadvantage and to use their transitions as positive opportunities for self‐development. Although punctuated by observable moments of change, this transition work happened over an indefinite timescale, highlighting a need for long‐term support informed by understandings of children's agency and priorities. Such support and insight may be achieved through developing spaces for multimodal dialogue with Service children. [ABSTRACT FROM AUTHOR]

Aims: Diabetes distress is common among people with type 1 diabetes (T1D), negatively affecting quality of life, self management, and diabetes outcomes. E‐health‐based interventions could be an effective and low‐cost way to improve the psychological care for people with T1D experiencing diabetes distress. The MyREMEDY study aims to test the effectiveness of the online unguided self‐help intervention MyDiaMate in decreasing diabetes distress in adults with T1D. MyDiaMate is based on Cognitive Behavioural Therapy and consists of eight modules, each focusing on a different aspect of living with T1D that is often experienced as burdensome (e.g. hypoglycaemia, fatigue). Methods: The effectiveness of MyDiaMate will be tested through a randomised‐controlled trial across four European countries (the Netherlands, Germany, Spain and the United Kingdom). Six hundred and sixty adults (N = 165 per country) with T1D will be recruited and randomised with a balance of 2:1 into the intervention and care as usual groups. Intervention group members receive access to MyDiaMate for 6 months, care as usual group members receive access after 3 months for 3 months. Participants fill in questionnaires at 0 (baseline), 3 (effectiveness) and 6 months (follow‐up). Primary outcome is diabetes distress at 3 months. Secondary outcomes are emotional well‐being, psychological self‐efficacy in relation to diabetes, social engagement, fatigue, and glycaemic outcomes. Moreover, logdata of MyDiaMate use is passively collected. Linear mixed model analyses will be used to test the effectiveness of MyDiaMate along with identifying which user subgroup benefits most from MyDiaMate use. Trial Registration: Clinicaltrials.gov NCT06308549. [ABSTRACT FROM AUTHOR]

Aims: To explore the sexual experiences and interactions of women with type 1 diabetes to explicate an understanding of the impact of diabetes on women's sexual function. The study was conducted as part of a wider project to develop a patient‐reported outcome measure to assess sexual dysfunction (SD) in premenopausal women with type 1 diabetes. Methods: A qualitative study using face‐to‐face and virtual semi‐structured interviews was conducted with premenopausal women with type 1 diabetes who have had some difficulties related to sexual functioning. Participants were recruited from two National Health Services (NHS) sites in the UK and from social media platforms. The data were analysed to generate themes using Framework Analysis approach. Results: Eighteen women, aged 22–49, were interviewed (NHS sites n = 13; online n = 5). Five themes related to women experiences of SD were identified, these were; initiation of sexual activity, sexual confidence, sexual enjoyment, sexual engagement and sexual desire. Conclusions: SD in women with type 1 diabetes is a complex phenomenon impacting their experiences and quality of life. SD is related to multiple interacting biopsychosocial factors related to diabetes, including blood glucose levels, diabetes treatments, technologies and complications. A targeted measure of SD for women with type 1 diabetes specifically would allow for these factors to be assessed routinely in clinical care. [ABSTRACT FROM AUTHOR]

Background: International data suggest that parents may have reservations about the use of silver diamine fluoride (SDF). Aim: The aims of this study were to: (1) examine the acceptance of parents/carers towards the use of SDF for the management of caries in children's primary teeth in secondary care dental settings in the UK and the United States and (2) determine which factors may affect the acceptance of the use of SDF. Design: This was a cross‐sectional questionnaire of SDF acceptability, completed by parents of young children. It was validated and adapted to local populations. Data were analysed with descriptive and inferential statistics. Results: Of the 113 Sheffield parents, 73% reported that they would accept SDF treatment of children's posterior teeth, with 58% reporting this for anterior teeth. Parents having less concern about posterior aesthetics had a statistically significant effect on reported acceptance of SDF (p =.013). In the Colorado sample (n = 104), 72% reported that they would accept SDF on posterior teeth, and 58% reported that they would accept SDF on anterior teeth. Concerns about aesthetics had an effect on decreasing SDF acceptance overall (p =.0065) in anterior (p =.023) and posterior teeth (p =.108). Conclusion: The majority of parents in the two study populations accepted the treatment using SDF. However, concern about aesthetics had an influence on acceptability. [ABSTRACT FROM AUTHOR]

Summary Introduction Methods Results Discussion Chronic pain is one of the most common and severe complications after surgery, affecting quality of life and overall wellbeing of patients. Several risk factors have been identified but the mechanisms of chronic postsurgical pain development remain unclear. This study aimed to identify single‐nucleotide polymorphisms associated with developing chronic postsurgical pain after abdominal surgery, one of the most common types of surgery.A genome‐wide association study was performed on 27,603 patients from the UK Biobank who underwent abdominal surgery. The robustness of identified loci was validated by split‐half validation analysis. Functionally related top loci were selected for expression validation in clinical samples of adhesions from patients with and without pain.One locus (rs185545327) reached genome‐wide significance for association with chronic postsurgical pain development, and 10 loci surpassed the suggestively significant threshold (p < 1 × 10‐6). In the robustness analysis, eight loci had at least nominal significance. The loci passing the suggestively significant threshold were mapped to 15 genes, of which two loci contained pain‐related genes (SRPK2, PDE4D). Although marginally approaching statistical significance in the expression validation of clinical samples, the detection rate and expression level of PDE4D were modestly higher in patients with pain compared with those in the control group.This study provides preliminary evidence for genetic risk factors implicated in chronic postsurgical pain following abdominal surgery, particularly the PDE4D gene, which has been associated with pain in previous studies. The findings add to evidence suggesting potential for the future development of a clinically applicable tool for personalised risk prediction, aiding clinicians in stratifying patients and enhancing clinical decision‐making through individualised risk assessments. [ABSTRACT FROM AUTHOR]

The idea of ‘global Britain’ became a centrepiece of Conservative Party rhetoric in the aftermath of the Brexit referendum. This article examines how this formulation may evolve in the face of renewed conflict over immigration and identity on the British right. It is argued that, in recent years, British conservatism has faced two principal long‐term challenges: first, the challenge of broadening its appeal in an increasingly diverse and multicultural Britain and, second, the challenge of a national populist insurgency emphasising white British (especially English) identity and hostility to immigration and multiculturalism. In this context, it is argued that the term ‘global Britain’ exists in implied opposition to the idea of ‘little England’ and that this binary opposition has shaped the use and reception of the global Britain concept within conservative politics. It is further argued that the usefulness of the global Britain concept relies on its capacity to be a ‘coalition magnet’ linking liberal internationalist ideas to the more nationalist mood of the contemporary British right. [ABSTRACT FROM AUTHOR]

Introduction Objectives Methods Results Discussion Conclusion Although thematic analysis of health librarianship (HL) presentations at conferences in the USA exists, no similar research has been reported focused on HL at UK conferences.To determine trends in HL conference presentations from 2017 to 2022 at three UK‐based HL conferences and the Chartered Institute of Library and Information Professionals (CILIP) conferences.Thematic analysis of conference programmes obtained from websites, the Internet Archive Wayback Machine and conference organisers.A total of 226 HL‐related conference presentations were identified across all the examined conference programmes. Eight themes emerged: being a Healthcare Librarian; Digital Working; Finding the Evidence; Generating Research; Strategic Library Management; Literacies; Other; and Using the Evidence. ‘Being a Healthcare Librarian’ (n = 54) and ‘Strategic Library Management’ (n = 53) were the most prominent cross‐conference themes.Presentations at HL‐specific conferences provide a wider range of themes than CILIP conferences, with ‘Being a Healthcare Librarian’ absent from CILIP conferences but ‘Literacies’ appearing in similar numbers at both. Differences in conference formats and the COVID‐19 pandemic likely influenced presentation numbers.HL conference themes are not directly reflected in CILIP conferences. NHS Knowledge and Library Services staff should be encouraged to undertake and disseminate original research, creating a UK evidence base for healthcare librarianship. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Conclusions Gallstone disease (GSD) is one of the widespread gastrointestinal conditions. Triglyceride‐glucose (TyG) index, a convenient surrogate for insulin resistance, may help identify and prevent gallstones. The present study aims to conduct a longitudinal study to evaluate the association between TyG index and the risk of GSD using the UK Biobank cohort.A total of 395 391 participants in the UK Biobank (median follow‐up of 12.52 years) were included. The association between TyG index and the risk of GSD was assessed through Cox models and the restricted cubic spline model, expressed by hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analysis was employed concerning age, gender, and body mass index (BMI) and also analyzed the mediating role of BMI in the effect of TyG index on incident GSD. Sensitivity analyses were further performed using a competing risks model and excluding participants who developed GSD in the first year of follow‐up to test the stability of the results.The risk of developing GSD increased in the Quartiles 2, 3, and 4 compared with Quartile 1 of TyG index (adjusted HR [aHR] 1.570 [95%CI 1.303–1.893], 1.577 [1.295–1.920], 1.489 [1.181–1.878], Ptrend < 0.001 across quartiles of TyG index). The aHR for every unit and SD increment in TyG index were 1.282 [1.100–1.494], 1.151 [1.055–1.256]. The results were consistent when participants who developed GSD in the first year of follow‐up were excluded. The restricted cubic spline regression also showed an increased risk of GSD with increasing TyG index.Increased TyG index is associated with an elevated risk of GSD. The TyG index might be an important indicator for identifying people at high risk of GSD. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the impact of the COVID‐19 pandemic on the emotional and spiritual well‐being and the resilience of advanced clinical practitioners in the United Kingdom. Background: Advanced clinical practitioners are experienced healthcare professionals educated to a master's level who demonstrate expertise, professional judgment, and autonomy across four pillars of advanced practice. Normally, in nursing and the allied health professions, advanced clinical practitioners provide clinical leadership and improve clinical continuity by providing high‐quality care to patients through complex decision‐making and managing risk. The role contributes to workforce transformation enabling organizations to meet changing population, patient, and service delivery needs. Advanced clinical practitioners' well‐being and resilience were particularly at risk during the pandemic due to the increased workload, moral distress, redeployment into other clinical areas, and isolation. Phase 1 of this study identified that advanced clinical practitioners had worryingly low levels of well‐being and resilience during the first 6 months of the pandemic. This paper reports Phase 2' findings 1 year into the pandemic. Method: Three hundred and seventy‐one respondents completed an online survey comprising three validated scales assessing resilience and emotional and spiritual well‐being. Results: One year into the pandemic, advanced clinical practitioners reported a continued decline in their well‐being, with average scores on this measure being 12 percent lower compared to prepandemic levels Differences also emerged in the scores of advanced clinical practitioners practicing in primary and secondary care services. Conclusion: Our findings showed the ongoing deleterious impact of the pandemic on the well‐being and resilience of advanced clinical practitioners. As the attention of healthcare leaders shifts to the delivery of services post‐COVID‐19, the longer‐term impact of the pandemic on the mental health and well‐being of the workforce, alongside the ongoing workforce crisis in the UK and globally, means the well‐being and resilience of advanced clinical practitioners need urgent addressing if these role holders are to continue to lead patient care, workforce transformation, and service innovation. Tailored interventions to support advanced clinical practitioners appear necessary to prevent significant workforce impact including absenteeism, long‐term stress, sickness absence, and loss to the healthcare workforce. [ABSTRACT FROM AUTHOR]

At present, developmental dyslexia is classified as a specific language disorder recognised by inclusive educational laws in Spain and the United Kingdom. Phonological correspondence is very different in Spanish and in English, and the difficulties they entail for native speakers are also different. The predominance of English worldwide has led to the establishment of bilingual Spanish–English educational programs in Spain in ESL or bilingual Spanish–English learning environments. Students with dyslexia face greater challenges than their classmates. A comparative study of British and Spanish students with dyslexia that uses a quantitative methodology, and a pre‐experimental ex post facto design was carried out to detect the specific linguistic problems they faced in learning their respective languages, with the objective of using the results to help foreign language teachers in Spain. The sample consisted of 29 Spanish students and 19 British. The findings show that native students from United Kingdom have specific difficulties in phonological processing and grapheme‐phoneme correspondence. Native Spanish students enrolled in foreign language programmes seem to have similar difficulties. To ensure the effectiveness of present‐day inclusive education laws in Spain, the knowledge acquired regarding the specific language‐related literacy problems of students with dyslexia must be incorporated to the current foreign language programmes. [ABSTRACT FROM AUTHOR]

Appearance‐related comparisons (A‐RCs) in body dysmorphic disorder (BDD) are under researched despite their probable role in disorder maintenance. The present study therefore aimed to explore the nature (frequency, direction and automaticity), and functions of A‐RCs in BDD. N = 43 including people with BDD (n = 23) and controls (n = 20) matched approximately on age and sex were recruited. A mixture of standardized and devised questionnaires on body image and A‐RCs were completed. A‐RCs were significantly more frequent, generally more upward (to more attractive standards of comparison), and more automatic in people with BDD relative to the control group. People with BDD also held significantly stronger agreement with beliefs about A‐RCs as serving functions of: self‐evaluation, self‐improvement, self‐enhancement, and in particular, self‐loathing (a way to confirm beliefs about physical unattractiveness) and social threat management. This research presents evidence that the nature and functions of A‐RCs in BDD have a role in this disorder's maintenance. Clinical implications, limitations, and future directions for research are discussed. [ABSTRACT FROM AUTHOR]

Studies of aversion to health inequality have found that this is often greater when health outcomes are presented as varying with socioeconomic conditions. We sought to understand better why this is by studying the cognitive appraisals made about health inequality when presented with distinct explanatory framings. Across two pre‐registered studies (N = 1321), UK and US participants judged the acceptability of life expectancy differences attributed to distinct framings: income, education, social class, neighborhood, lifestyle choices, and genetics. Health inequality was least acceptable when attributed to the four socioeconomic framings, and most acceptable for lifestyle choices and genetics. Six appraisal dimensions—complexity, malleability, inevitability, and extent driven by biological, psychological, and sociocultural causes—varied with framing and predicted views on health inequality. These dimensions could explain most of the drop in acceptability for health inequality attributed to socioeconomic factors relative to a condition with no framing. This work illustrates for the first time the cognitive appraisals and causal intuitions that link different explanatory framings to views on health inequality. These framings are viewed as least acceptable because they reduce the perceived involvement of biological causes while increasing the perception that sociocultural and psychological factors contribute to health inequality. Public significance statement: Academics use different socioeconomic variables to describe health inequalities. We show that different explanatory framings change appraisals about the causes, malleability, and inevitability of health inequalities. Socioeconomic explanations (income, education, social class, and neighborhood) reduce acceptability because they reduce the perception that health is biologically caused and increase the perceived role of socio‐cultural factors. Public support for intervention on health inequalities will be best served by framings that emphasize these differences [ABSTRACT FROM AUTHOR]

Endorsement of the employed student identity can provide social support for employed students or protection from negative intergroup comparisons. However, not much is known about what identity aspects or characteristics comprise the employed student identity and how they become important and central to that identity. Using data from 215 employed university students in the UK, we investigated two research questions (RQ's) in this mixed‐method study. RQ1. What are the identity aspects that participants ascribe to the employed student identity? RQ2. Are identity aspects that distinguish employed from non‐employed students, and are considered more suitable for employed versus non‐employed students, more central and more important to the employed students' self‐concept? A thematic analysis categorized the identity aspects that participants self‐generated into 14 distinct categories, with the most important categories being hard‐working, being organized, having motivation, and discipline. Multilevel analyses of identity aspects within individuals revealed that distinctiveness was negatively associated with the importance and centrality of aspects, whereas suitability for employed students was positively associated with the importance and centrality of aspects. We offer practical value through revealing important identity aspects which inoculate employed students against negative intergroup comparisons, and theoretical value through suggesting future avenues for employed students' identity construction. Public Significance Statement: Being an employed student carries a social cost but defining as one can help in obtaining social support or protecting from negative comparisons with non‐employed students. We identify fourteen categories of aspects that can define oneself as an employed student (e.g., motivation, hard work) with employed students experiencing those aspects which are more suitable to them as more identity‐defining, and those aspects which differentiate them from non‐employed students as less identity‐defining. [ABSTRACT FROM AUTHOR]

Objective: Antipsychotics remain the first‐line treatment for people diagnosed with psychotic disorders despite adverse effects which lead many people to stop their medication. Many stop without the support of the prescriber, who may fear relapse. The objective of this study is to better understand the process of withdrawal from antipsychotics, from the perspective of people taking antipsychotics. Design: Online survey. Methods: An international online survey elicited quantitative responses about pre‐withdrawal planning (560) and qualitative responses about what was helpful and unhelpful when withdrawing from antipsychotics (443). Responses came from users of antipsychotics in 29 countries. Results: Forty‐seven per cent did not consult their psychiatrist before discontinuing. Only 40% made preparations, most commonly making a plan, gathering information and informing family. The most frequently reported helpful factors were focussing on the benefits of getting off the drugs (including ending adverse effects and feeling more alive), information about withdrawal symptoms and how to withdraw safely, withdrawing slowly, and support from psychologists, counsellors and psychotherapists. The most common unhelpful factor was the psychiatrist/doctor, largely because of their lack of knowledge, refusal to support the patient's wishes and the threat or use of coercion. Conclusions: Evidence‐based, respectful, collaborative responses to patients' concerns about adverse effects and desires to withdraw would probably reduce relapse rates and improve long‐term outcomes. It would definitely help end pervasive breaching of the principle of informed consent and human rights legislation. [ABSTRACT FROM AUTHOR]

Introduction: People with HIV (PWH) are at an increased risk of developing cardiovascular disease (CVD) compared to HIV‐negative individuals. We sought to evaluate the adherence to medications for CVD in PWH and identify factors associated with non‐adherence to these medications. Methods: We conducted a cross‐sectional study at the University Hospitals of Leicester NHS Trust between 16 April 2019 and 8 November 2022. We recruited consecutive PWH, who were attending a routine follow‐up outpatient appointment and were prescribed at least one medication for CVD. In addition, we included urinary adherence results of patients with samples collected as part of routine clinical care. We used liquid chromatography–tandem mass spectrometry (LC–MS/MS) to assess if their prescribed medications (antihypertensives, diuretics, beta‐blockers, lipid‐lowering agents, antiplatelets, anticoagulants, antidiabetic medications) were present in the participant's urine sample. Multivariable models were used to identify demographic or clinical features that were associated with non‐adherence. Results: A total of 162 PWH were included in the analysis. Median age was 55 [interquartile range (IQR): 50–61] years, 63% were male, average time living with HIV was 15 years (IQR: 11–19) and the majority (98%) had an undetectable HIV viral load. In approximately one‐third of patients (59/162), at least one prescribed medication of interest was not detected in urine. Non‐adherence to lipid‐lowering agents was common (35/88, 40%). On multivariable logistic regression, the number of prescribed cardiovascular medications, was associated with medication non‐adherence [medication non‐adherence, per one medication increase: adjusted odds ratio (95% confidence interval) = 1.78 (1.34–2.36); p < 0.001]. Conclusion: We found sub‐optimal adherence to medications for CVD in PWH. In order to maximize the clinical benefit of statin therapy in PWH, factors requiring consideration include: improved medication adherence, awareness of polypharmacy, educational interventions and quantitative assessment of sub‐optimal adherence through chemical adherence testing. [ABSTRACT FROM AUTHOR]

Objectives: Our objective was to describe the prevalence of cardiovascular disease (CVD) risk factors in people of African ancestry with HIV in the UK. Methods: We conducted a cross‐sectional analysis of CVD risk factors in Black people with HIV aged ≥40 years and estimated the 10‐year CVD risk using QRISK®3‐2018. Correlations between body mass index (BMI) and CVD risk factors were described using Pearson correlation coefficients, and factors associated with 10‐year CVD risk ≥5% were described using logistic regression. Results: We included 833 Black people with HIV and a median age of 54 years; 54% were female, 50% were living with obesity (BMI ≥30 kg/m2), 61% had hypertension, and 19% had diabetes mellitus. CVD risk >5% ranged from 2% in female participants aged 40–49 years to 99% in men aged ≥60 years, and use of statins ranged from 7% in those with CVD risk <2.5% to 64% in those with CVD risk ≥20%. BMI was correlated (R2 0.1–0.2) with triglycerides and diastolic blood pressure in women and with glycated haemoglobin, systolic and diastolic blood pressure, and total:high‐density lipoprotein (HDL) cholesterol ratio in men. In both female and male participants, older age, blood pressure, diabetes mellitus, and kidney disease were strongly associated with CVD risk ≥5%, whereas obesity, total:HDL cholesterol, triglycerides, and smoking status were variably associated with CVD risk ≥5%. Conclusions: We report a high burden of CVD risk factors, including obesity, hypertension, and diabetes mellitus, in people of African ancestry with HIV in the UK. BMI‐focused interventions in these populations may improve CVD risk while also addressing other important health issues. [ABSTRACT FROM AUTHOR]

In this paper, we use the concept of 'alterity' to explore the hallmarks and transformative potential of Community Development Finance Institutions (CDFIs) in the UK consumer credit market. By providing small, short‐term personal loans to individuals on low incomes (i.e. microcredit), these lenders act as an alternative to exploitative forms of subprime lending, which have proliferated as a consequence of cuts in welfare state provision and growing income insecurity. In‐depth interviews (n = 23) were conducted with lenders and stakeholders and a typology of 'alternatives' was developed in relation to the clients of CDFIs and their role in the consumer credit market. Our contribution to knowledge is twofold: We provide a nuanced picture of 'alterity' in finance, finding that CDFIs embody multiple 'alterities' at the same time, and we extend the conversation about alternative and sustainable finance to the consumer credit market, which is an overlooked, yet critical, area. [ABSTRACT FROM AUTHOR]

Background: Ketogenic diet therapy (KDT) has been recommended as a treatment for drug‐resistant epilepsy in children and young people since 2012 in the National Institute for Health and Care Excellence Clinical Guidelines for Epilepsies. The Ketogenic Dietitians Research Network completed a survey in 2017 to assess the impact of these guidelines. Methods: An online survey was circulated to ketogenic dietitians across the UK and Ireland. The results were compared with those of the 2017 survey. Results: The number of individuals following KDT was 854, comprising an increase of 13% since 2017. Service sizes ranged widely, with 1–74 (median 16) patients on the diet. Of 36 services, 30 had a waiting list, ranging from 2 to 67 (median 9) patients. The classical diet continued to be the most common KDT used (58% of patients). Ten services reported use of a new flexible medium chain triglyceride protocol. Some 48% of patients (n = 427) had been following the KDT for over 2 years, comprising an 18% increase since 2017. Of these, 68 (15.9%) had attempted to wean off KDT but had to re‐start as a result of a deterioration in seizures. Conclusions: The number of individuals following medical KDT remains stable. Referral numbers and waiting lists remain high, highlighting that KDT is still a well‐recognised treatment option for drug‐resistant epilepsy. The types of KDT used are similar to previous years, although increasingly flexible protocols are being adopted. Longer‐term use of KDT is increasing, with a proportion of patients requiring long‐term use to maintain seizure control. Highlights: Ketogenic diets remain a well‐recognised treatment option for drug‐resistant epilepsy in the UK and Ireland with the introduction of more flexible protocols in adults and children. [ABSTRACT FROM AUTHOR]

Background: Parent involvement strongly correlates with children's educational attainment. Sociocultural shifts in parenting roles and shared responsibilities have driven an increase in the need for involvement of fathers in activities to support their children's educational development. Several factors are thought to influence father involvement in children's education; however, the most salient factors remain unclear. Aims: To examine which variables correlate with father involvement in their children's education using a combination of demographic, parent‐related and employment‐related variance. Sample: A total of 166 fathers of at least one child aged 6–17 years and residing across five industrialized Western countries participated in an online survey. Method: Hierarchical multiple regression analysis (HMRA) was performed to examine the total and incremental variance using regression models including demographic, parenting‐ and employment‐related variables linked to educational involvement. Results and Conclusions: The variables included in the current study could explain a large and statistically significant 34% of the variability in fathers' educational involvement. Of these variables, only four were statistically significant in the final model. Specifically, fathers were more likely to be engaged in their children's education when their children were younger, and when parent self‐efficacy, positive work‐to‐family interface and financial anxiety were high. The study's findings indicate that a positive work environment can help fathers better support their children's education, offering a new focus for future interventions and policies. This includes those focused on targeting work‐related constructs to optimize family functioning. [ABSTRACT FROM AUTHOR]

People with profound intellectual and multiple disabilities can be excluded from research and relatively little is known about the experiences of people with profound intellectual and multiple disabilities and their carers during COVID‐19. This paper aims to further explore the impact on this group via information provided by paid and family carers. It focuses on key areas such as access to social and health services in addition to questions about health and well‐being. In contextualising these results, some comparisons are made to impacts on other groups. This paper also explores what we might do better in future to support this population. Carers were invited to complete an online survey about their experiences and the experiences of people they supported during COVID‐19 and to suggest what might have made life better. They were invited to complete this survey at four time points (waves) between December 2020 and December 2022. This paper reports on Waves 1–3, that is to August 2022. Services for people with profound intellectual and multiple disabilities reduced during COVID‐19 and have yet to return to pre‐pandemic levels. People with profound intellectual and multiple disabilities were reported to experience increased social isolation, deteriorating mental and physical health, increased behavioural signs of distress and reduced life skills. Three areas were identified regarding what would have made life better: opportunities for social contact and activities; improved access to health and social care services, and; consistent and responsive staff. Results are explored in the context of current challenges in service provision, including staff retention and shifts in staff culture during the pandemic. [ABSTRACT FROM AUTHOR]

Policy PointsHealth care systems around the world rely on a range of methods to ensure the affordability of prescription drugs, including negotiating prices soon after drug approval and relying on formal clinical assessments that compare newly approved therapies with existing alternatives.The negotiation framework established under the Inflation Reduction Act is far more limited than other frameworks explored in this study. Adding elements from these frameworks could lead to more effective price negotiation in the United States. Context: In 2022, Congress passed the Inflation Reduction Act, which allowed Medicare, for the first time, to begin negotiating the prices for certain high‐cost brand‐name prescription drugs. Many other industrialized countries negotiate drug prices, and we sought to compare and contrast key features of the negotiation process across several health systems. We focused, in particular, on the criteria for selecting drugs for price negotiation, procedures for negotiation, factors that influence negotiated prices, and how prices are implemented. Methods: We included four G7 countries in our analysis (Canada, France, Germany, and the United Kingdom [England]), two Benelux countries (Belgium and the Netherlands), and one Scandinavian country (Norway) with long‐established frameworks for drug price negotiation. We also analyzed the Veterans Affairs Health System in the United States. For each system, we gathered relevant legislation, government publications, and guidelines to understand negotiation frameworks, and we reached out to key drug price negotiators in each system to conduct semistructured interviews. All interviews were recorded, transcribed, and coded, and data were analyzed based on an internal assessment tool that we developed. Findings: All eight systems negotiate the prices of brand‐name prescription drugs soon after approval and rely on formal clinical assessments that compare newly approved drugs with existing therapies. Systems in our study differed on characteristics such as whether the body performing clinical assessments is separate from the negotiating authority, how added health benefit is assessed, whether explicit willingness‐to‐pay thresholds are employed, and how specific approaches for priority disease areas are taken. Conclusions: High‐income countries around the world adopt different approaches to conducting price negotiations on brand‐name drugs but coalesce around a set of practices that will largely be absent from the current Medicare negotiation framework. US policymakers might consider adding some of these characteristics in the future to improve negotiation outcomes. [ABSTRACT FROM AUTHOR]

The article explores the benefits and challenges of increasing pulse consumption as part of transitioning to more sustainable diets. Topics discussed include the nutritional advantages of pulses, such as their high protein and micronutrient content, their environmental benefits like reduced greenhouse gas emissions and lower fertilizer use, and the challenges in changing dietary habits and improving the accessibility of pulses in convenient, affordable forms.

The British Nutrition Foundation convened a roundtable event in January 2024 entitled 'Meat and the Future of Sustainable Diets: Turning Challenges into Opportunities', bringing together multi‐sector stakeholders to discuss the social, nutritional, public health and environmental aspects of meat consumption within a sustainable food system. Participants explored the challenge of the complexity of balancing nutrition and planetary goals, emphasising the need to navigate trade‐offs between various dimensions of sustainability. Whilst recognising the global nature of the issue, the roundtable primarily focussed on a UK perspective. The discussion highlighted the urgency of transforming the food system to achieve net zero, whilst ensuring broader environmental benefits, nutritional adequacy and dietary and health equity across all life stages. Concerns about poor dietary patterns, particularly among vulnerable groups were raised, with participants stressing the need for policies that promote healthy, sustainable and equitable diets without worsening inequalities. These policies should also enhance livelihoods and community wellbeing, foster resilience and support local economies. On the supply side, participants called for better data within the agri‐food system, particularly at the farm level. They advocated for a multidimensional, holistic approach that goes beyond greenhouse gas emissions to encompass wider environmental impacts and whole‐farm benefits, such as enhancing soil health, promoting biodiversity, improving water management, supporting nutrient cycling and boosting farm‐level resilience through diversified cropping systems. Roundtable participants acknowledged existing recommendations to reduce meat consumption for both environmental reasons, such as land use and greenhouse gas emissions, and health concerns, as evidence links red, particularly processed, meat consumption with increased colorectal cancer risk. Given the variation in meat consumption globally and even locally between individuals, the discussion explored the potential of targeted campaigns to reduce high meat intake, along with the role of public food procurement and the food industry in decreasing processed meat consumption. The consensus was that dietary changes must be framed within the context of a balanced diet and broader sustainability concerns. Despite some differing viewpoints on implementation, participants agreed that transitioning to healthier, more sustainable diets is a priority. Collaboration across the entire food chain, from farm to fork, with investment in innovation, robust data collection and research, alongside policy support, was emphasised as essential to achieving this goal. [ABSTRACT FROM AUTHOR]

The prevalence of obesity continues to rise, and public health dietary recommendations are not being adhered to. The transition to higher education is a period of risk for weight gain in young adults and has been demonstrated as a good time to initiate behaviour change. A genotype‐based personalised approach to dietary recommendations may motivate young adults to maintain or adopt positive dietary behaviours. The aim of the present study was to determine the efficacy of genotype‐based personalised dietary and physical activity advice on healthy eating motivation in young adults. Participants were young adults (n = 153), aged 18–25 years. Baseline measures (participant characteristics, height, weight, body mass index [BMI], body fat percentage [BF%], healthy eating motivation and physical activity) were collected. Participants were genotyped for a SNP in the FTO gene (rs99396090) and randomly allocated (stratified for genotype) to three different groups (1. Genotype‐based personalised advice: dietary and physical activity advice based on genotype, BMI and reported physical activity; 2. Non‐genotype‐based personalised advice: dietary and physical activity advice based on BMI and reported physical activity; 3. Control: no advice). A week after receipt of advice delivered via email, participants completed the healthy eating motivation questionnaire for a second time. Genotype‐based personalised dietary advice did not affect healthy eating motivation: when participants were analysed across the whole group (p = 0.417), when analysed according to those informed of a risk or non‐risk‐associated genotype (p = 0.287), or when analysed according to those with a BMI (>25 kg/m2; p = 0.336) or BF% (male >18%, female >31%; p = 0.387) outside the healthy range. There was also no significant difference in healthy eating motivation at 1‐week in the control or non‐genotype‐based advice groups. Genotype‐based personalised advice for the prevention of obesity did not affect healthy eating motivation in this group of healthy, young adults. [ABSTRACT FROM AUTHOR]

The current cost‐of‐living crisis is disproportionately affecting families experiencing poverty and is likely to be amplifying existing dietary inequalities and challenges, such as food insecurity (FI). Government policies designed to address diet inequality in the UK have historically had minimal impact on population diet and health and may have even widened existing inequalities. Therefore, the effect of nutrition policies on those experiencing FI in the context of the current cost‐of‐living crisis needs to be better understood. The aim of the Diet and Health Inequalities (DIO Food) project is to work with early years, people living on a low income and retailers to generate opportune evidence‐based research and commentary that will inform diet‐related health inequalities policy and practice. DIO Food is related to the existing Food Insecurity in people living with Obesity (FIO Food) project, which consists of four interlinked work packages (WPs1‐4). DIO Food consists of three interlinked work packages (WPs5‐7), which enhance the scope of FIO Food, and are described in this article. WP5 addresses a paucity of research on maternal and infant food insecurity in the UK, by applying a qualitative research approach to capture parents' and carers' perceptions of the relationship between the food system and other influences impacting infant feeding practice, associated with the cost‐of‐living crisis. WP6 will conduct the first‐ever cross‐retailer independent evaluation of England's high fat, sugar and salt (HFSS) product placement legislation. Researchers will analyse store‐level supermarket sales data provided by large UK retailers to produce sector‐level insights into whether HFSS legislation reduced HFSS purchasing, improved the healthiness of retailer product portfolios, and was equitable across areas with different characteristics. WP7 will support WP5 and 6, by strengthening engagement with key stakeholders, including at‐risk consumers and representatives of major supermarkets, and effectively translating research outcomes and stakeholder perspectives for policy and industry decision‐makers. [ABSTRACT FROM AUTHOR]

In 2023, 25% of adults in England, Wales and Northern Ireland experienced food insecurity. The concentration of food insecurity in both socioeconomically disadvantaged groups and households containing children raises concerns about its uneven nutritional and health impacts across different groups. In parallel with rising food insecurity over the past decade, concerns about the environmental consequences of human diets are intensifying, where urgent changes are needed to people's diets to avoid irreversible environmental damage. It is generally assumed that cost has a significant impact on people's ability to adopt more environmentally sustainable food practices. This UK Research Council‐funded project seeks to gain insights into the ways in which low‐income mothers (are able to) engage with environmentally sustainable food practices. RQ1 will examine the day‐to‐day food practices that mothers undertake for their families to offer insights into everyday food insecurity and the relevance of environmentally sustainable food practices. RQ2 will explore biographical experiences to highlight how mothers' life histories influence their familial food practices, including their current household food security and engagement with environmentally sustainable food practices. Finally, RQ3 will explore mothers' upcoming prospects of food insecurity and environmentally sustainable food practices. These research questions will be explored through a qualitative longitudinal, feminist study of 15 low‐income mothers in Sheffield, UK, combining in‐depth interviews with ethnographic elements. Gaining improved knowledge of mothers' food practices on a low income will be valuable to influence realistic, effective and meaningful philosophies, policies and practical action that prioritises equity, good nutrition and environmentally sustainable food practices. [ABSTRACT FROM AUTHOR]

Collective false alarms can cause significant disruption, costly emergency response, and distress. Yet an adequate psychological explanation for these incidents is lacking. We interviewed 39 participants and analysed multiple secondary data sources from the 2017 false alarm in Oxford Street, UK, to develop a new explanation of this phenomenon. There was evidence that awareness of recent collectively self‐relevant terrorist attacks lowered the threshold for interpreting ambiguous signals as signs of hostile threat. Interviewees also fled and hid after inferring threats from others' fear and flight responses. Cooperative behaviour was sporadic and was associated with an emergent sense of groupness that occurred in limited locations. The analysis suggests that crowd behaviour in false alarms has more in common with the meaningful behaviour typically found in real emergencies than with the image of uncontrolled 'mass panic' portrayed in news media. These findings have implications for policy in preparing the public for terrorist attacks. [ABSTRACT FROM AUTHOR]

Background: Since the inception of Counselling for Depression (CfD) in the UK as a competence‐based training course for experienced therapists, there has been remarkably little empirical work exploring the experiences and views of trainees and those involved in course delivery. Aims: This qualitative study aimed to explore trainees', trainers' and supervisors' experiences of CfD training and their perceptions and understanding of competence in the context of CfD training and assessment. Methods: Semi‐structured interviews were carried out with 19 participants recruited from two UK training courses and the BACP Practice Network. The interviews were analysed using Template Analysis. Findings: Two key themes are reported here: tensions in the CfD competence model and tensions in CfD methods of training and assessment. Participants reported challenges in adapting to the CfD model. They felt that its use drew them away from core values in their practice so that they felt their identity as a therapist was threatened. In particular, they questioned the possibility of integrating person‐centred and emotion‐focussed approaches and felt that the directivity of emotion‐focussed therapy was out of keeping with their core practice values. They also identified a number of difficulties with the CfD training and assessment; the training period was seen as an inadequate preparation for workplace practice, and the assessment process was criticised for being too narrow and was regarded as having little connection to the competence framework. Conclusion: The findings suggest a need for changes in policy and practice, specifically in regard to training and assessment. [ABSTRACT FROM AUTHOR]

Background: There is a limited amount of research assessing the effectiveness of group therapy on acute inpatient psychiatric wards, and mixed results from research assessing inpatient psychological therapies in general. Previous studies highlight challenges for conducting research on psychiatric inpatient hospitals, such as short admissions, high patient turnover, engagement challenges, acuteness of illness, overmedication and feelings of stigma and disempowerment. Aims: This service evaluation aims to assess whether weekly ward‐based interpersonal group therapy reduces short‐term psychological distress for women on an acute psychiatric inpatient ward in inner‐city London (Tower Hamlets), UK. Methods: This service evaluation compared psychological distress, as measured by the Clinical Outcomes in Routine Evaluation 10 (CORE‐10), pre‐ and post‐intervention for women attending a weekly ward‐based interpersonal therapy group between February 2023 and August 2023. Results: There were 46 participants included in the analysis. There was an 11.3% decrease in the mean CORE‐10 score post‐intervention. Four (9%) patients exhibited significant and reliable change (i.e. short‐term psychological distress reduced to a 'healthy' level). A further three (7%) patients exhibited no significant change. Short‐term psychological distress did not significantly deteriorate for any patients who attended the ward‐based interpersonal therapy group. Conclusion: It is feasible to collect pre‐ and post‐outcome data to assess psychological distress following a weekly ward‐based interpersonal therapy group over a 6‐month period, which meet acceptable a priori sample size calculations. The group appears to have an immediate positive impact for the majority (95%) of patients where short‐term psychological distress reduced or stayed the same; however, this was only significant for 16% of patients. It would be important to collect qualitative data, ideally using multiple methods or data sources for triangulation, in order to corroborate and strengthen the current findings. Practitioners cannot rely solely on the results of this study to demonstrate effectiveness of psychotherapeutic group interventions in acute inpatient settings. [ABSTRACT FROM AUTHOR]

Introduction: A record of 122.6 million people have sought refuge and asylum across the globe in 2024, exacerbated by emergencies in Ukraine, Sudan, Afghanistan and by the Israel–Hamas war. This number is set to rise to over 130 million people in refugee situations in 59 countries this year alone. With refugees suffering from higher rates of mental health difficulties than the general population, there is an urgent need to provide an expedient, socially just, transculturally informed pathway into humanistic psychological care services for these individuals. The objectives of this study were to explore how therapeutic practitioners are working effectively with displaced individuals presenting with embodied trauma, their experiences of transcultural approaches to therapeutic work and the impact of working alongside psychopharmacological medications in this commonly overprescribed client group. Method: A qualitative semi‐structured interview was operationalised with 12 therapeutic practitioners who have worked with displaced individuals, utilising reflexive thematic analysis of the data. Results: Findings highlight a critical need for an updated transculturally informed, humanistic, person‐centred pathway of care for each displaced individual. Discussion: This study offers facilitators and challenges to using a humanistic, transculturally updated assessment, formulation, treatment plan, and routine outcome measures for embodied trauma. It also considers the importance of working with a client's cultural context of origin, language, universally understood emotions, cultural strengths, preferences for therapy and use of a psychopharmacological review within a holistic constellation of care. [ABSTRACT FROM AUTHOR]

Background: Research indicates counsellors and psychotherapists receive little training around working with clients who present with religious or spiritual issues and feel unprepared to work with these clients. Aims: This paper presents part of the findings from an online survey that aimed to explore how trainee and newly qualified counsellors and psychotherapists, who identify as religious or spiritual, experienced undertaking therapeutic training in the UK. Method: This online survey collected data on how much training participants received on their courses in religion/spirituality, how this training was delivered, how satisfied they were with their training, their knowledge base and skills around religion/spirituality, and what areas relating to religion/spirituality participants would like to see incorporated into therapeutic training. The survey data were analysed using descriptive statistics and thematic analysis. Results: Over half of the participants received no training in this area, with a further third receiving minimal input. Participants reported low satisfaction rates with training received unless integrated throughout their course and identified specific knowledge gaps around religious/spiritual literacy, therapeutic skills, and awareness of religion and mental health research. Participants wanted more input on religion/spirituality in the training syllabus to increase their knowledge base and therapeutic competences. Conclusion: This research employed a non‐randomised sample, which limits the generalisability of these findings to a wider training population. Survey participants were also a highly religious/spiritual group, with 87% indicating they engaged in weekly religious/spiritual practices. Participants identified as Christian and White, and reported receiving person‐centred or integrative training. [ABSTRACT FROM AUTHOR]

Background: Adoption research has tended to focus on associated emotional and developmental challenges. There is little research on how adoptees experience counselling training and its personal and professional impact on adoptees. The aim of this qualitative study was to explore the counselling training experiences of four counsellors who were adopted as babies (under 1 year of age). Methods: One‐to‐one semi‐structured interviews were conducted with two psychodynamically trained counsellors and two integratively trained counsellors. Interpretative phenomenological analysis was used to analyse the training experiences of adoptees, and the personal and professional impact of training. Findings: Four group experiential themes were identified: disclosure; place in world; relationships; and reflexivity. Implications for Practice: The findings contribute to the growing body of research on counsellor training and provide insights into adoptees' experiences of counselling training. These insights enable improvements in the provision of such training by counselling training providers to adoptees, and in the provision of the specialist training either required or recommended to provide adoption support. The research also furthers the understanding of adoptees' experiences more generally and may also help noncounsellor adoptees deal with issues perceived as related to their adoption as well as others who face similar issues, due to their own lived experiences. Conclusion: Both modalities of counselling training helped participants deal with difficulties presented by their adoptions, in particular regarding identity and relationships, affording opportunities for growth and healing. [ABSTRACT FROM AUTHOR]

The British Association for Counselling and Psychotherapy (BACP) is the largest professional membership body within the field of counselling and psychological therapies in the UK, but there is a mismatch between its membership of >65,000 and its research impact. This article sets out a potential strategic direction as considered by an informal grouping of researchers and teachers in the field. Actionable research plans are outlined at three levels: client–practitioner, local communities, and societies. At the client–practitioner level, data‐informed practice can be readily implemented as a therapeutic aid akin to supervision, providing the potential for integrating research into everyday practice. At the community level, interdisciplinary collaborations together with a focus on equality, diversity, and inclusiveness are paths to building a community of researchers and citizens that includes marginalised populations. The importance of social justice extends to the societal level, connecting with politics at a micro and macro level, and engaging internationally to respond to actual threats (e.g., climate change). Across these three levels, high value is placed on data with its potential for informing and improving practice, but also enhancing the lives of people in communities and societies. Overall, research strategies need to be collaborative (i.e., collegial) and less singular (i.e., individually project‐based), developing cumulative knowledge around specific topics via a 'capture and build' strategy for small projects with strategic oversight by BACP. Clarity of research strategy combined with collaborative and collective action from BACP and leaders in the field can help realise the full potential of BACP's research capacity. [ABSTRACT FROM AUTHOR]

Objective: This study is part of the Student Counselling Outcomes Research and Evaluation (SCORE) initiative that is pooling university counselling service data to improve datasets and evidence for counselling in this sector. This study aimed to explore university counselling staff views about which data should be included in a national minimum data standard (MDS) to provide evidence for counselling in the sector. Method: Semi‐structured focus groups were conducted with university counselling staff including counsellors, service leaders and mental health advisors. They explored data to include in an MDS, current data collection practices, service and sector level data collection barriers. Two researchers performed content analysis involving identifying fields for inclusion. Thematic analysis was used to identify contextual issues surrounding data collection. Ten focus groups were conducted with 41 participants across 26 university counselling services. Results: Content analysis identified fields of information for the MDS within the categories of student characteristics, demographics, clinical assessment and service evaluation. Thematic analysis explored context and culture surrounding data collection, barriers and facilitators, institutional influence and ideal data collection practices. This highlights the need for service support and training around data collection, clear processes, and adequate IT infrastructure and staff resources. Discussion: These findings will inform the development of an MDS as part of the SCORE study. The next stage will involve further development of the MDS and piloting in services. The longer term aim is to implement an MDS across university counselling services, enabling the growth of evidence for the sector which may allow increased funding and service provision. [ABSTRACT FROM AUTHOR]

Although there is considerable evidence that empowering leadership is beneficial to individuals, teams, and organizations, a few studies have examined the antecedents of empowering leadership behaviour itself. To address this gap, this research examines the predictors of empowering leadership in terms of subordinate behaviours and traits. Based on signalling theory and role‐based followership theory, we predict that employee voice expressed in rational appeals is more likely to enhance managerial attributions of employee proactivity compared to emotional appeals, which leads to increased empowering leadership. Furthermore, we propose that this is especially true when the subordinate is female rather than male. To test these hypotheses, we conducted a scenario‐based experiment across two distinct cultural settings, Japan and the United Kingdom. The results from both countries support all hypotheses; our findings provide not only theoretical implications for research on empowering leadership, voice behaviour, and gender, but also several practical implications for subordinates and supervisors. [ABSTRACT FROM AUTHOR]

Scaling, to remove the effects of body size, is an important methodological approach for enabling an equitable comparison of performance differences between individuals who vary in anthropometric characteristics. Many previous studies using scaling in sport have done so based on only one or two anthropometric characteristics, with only one study to date adopting a three‐dimensional approach. To apply a three‐dimensional allometric model to rowing ergometer performance (REP) in adolescents, and to detect whether key 'scaling' parameters remain stable when scaling REP both before and after a 6‐week training intervention. Novel three‐dimensional allometric models were used, incorporating body mass, stature and waist circumference (WC) to detect the most appropriate body size dimension(s) and scaling parameters associated with REP before and after a 6‐week training intervention. Using this more flexible and sensitive three‐dimensional allometry demonstrated that, following 6‐weeks of training, there was a change in the ideal body shape associated with REP. Before training, taller, but not heavier, adolescents performed better. After 6‐weeks of training, older participants with a greater body mass but smaller WC performed better. Scaling approaches are important for evaluating performance differences between individuals of differing body size. The findings from the current study (using a novel three‐dimensional allometry approach) emphasise that relatively subtle changes in individuals' behavioural characteristics, such as changes in their training/fitness status, can result in quite dramatic changes in the body dimension characteristics and scaling parameters deemed to be key for performance in activities such as REP. Highlights: This study examined three‐dimensional allometric models of rowing ergometer performance (REP) before and after a 6‐week rowing training intervention.At baseline, stature was the most important determinant of REP.Following a 6‐week training intervention, the three‐dimensional allometric model revealed a positive effect of body mass and negative effect of waist circumference on REP.These findings highlight that allometric models are sensitive to changes over time, even in response to a relatively modest 6‐week training intervention. [ABSTRACT FROM AUTHOR]

Background: Mothers with learning disabilities are at higher risk of child removal and mental health difficulties and may face more barriers to developing attachment relationships with their children. Mothers with learning disabilities' voices are still underrepresented in research, with less known about those who are actively parenting their children. This study aimed to explore mothers' perceptions of developing emotional relationships with their children. Methods: Mothers with learning disabilities who were actively parenting were recruited via advocacy groups across the United Kingdom. Semi‐structured interviews with 10 mothers who self‐identified as having learning disabilities were analysed using thematic analysis. Findings: Three key themes were generated: (1) Understanding and Facilitating Attachment Relationships, (2) Barriers to the Attachment Relationship and (3) Bidirectional Nature of Relationships: Child Needs Mother, Mother Needs Child. Overarching experiences of powerlessness, autonomy and resilience were prominent across mothers' experiences. Conclusions: Mothers acknowledged the importance of close emotional relationships with their children. Subthemes highlighted that mothers recognised the importance of behaviours that mirrored attachment theory, including reciprocity and proximity seeking. Mother–child relationships faced varying challenges including separation and conflict between the mother's and the child's needs. Findings indicate the need to support mothers through a trauma‐informed attachment perspective, especially in the context of maternal mental health needs and where children may also have additional needs. Accessible Summary: Ten mothers with learning disabilities were asked about their relationship with their children.Mothers talked about understanding and growing bonds with their children.Mothers felt close to their children, especially when they were physically close, like hugging.Sometimes, mothers faced challenges in their relationships with their children, like when mothers were very isolated, experienced separations from their children or had problems with their own mental health.It is important for mothers with learning disabilities to feel supported and that they can trust services and professionals. [ABSTRACT FROM AUTHOR]

Understanding the dominant direction of association between cardiorespiratory fitness (CRF) and grip strength could help refine physical activity recommendations. We performed a Mendelian Randomization (MR) analysis to elucidate the bidirectional relationship between CRF and grip strength (GS). Using an inverse‐variance weighted (IVW) MR framework, we estimated the strength of the GS (exposure)‐CRF (outcome) association using genome‐wide association summary data. When examining the CRF (exposure)‐GS (outcome) association, the CRF genetic instrument was related to individual‐level GS phenotypic data in 367 693 UK Biobank participants. Several sensitivity analyses were performed (e.g., MR‐Egger, MR‐weighted median estimator and MR‐PRESSO) and both measures were scaled by body weight (w). In the direction GS‐to‐CRF, a 1‐unit increase in GSw (i.e., GS/weight) was associated with 1.70 mL/kg/min (95% confidence interval (CI): 1.14,2.27) higher CRFw (IVW model). This finding persisted across most sensitivity analyses. In the reverse direction, there was no evidence supporting an effect of CRFw on GSw, e.g., a 1‐unit increase in CRFw led to a 0.00 kg/kg (95% CI: −0.01,0.02) higher GSw (IVW model). Our finding of a dominant direction of association from greater GS to higher CRF is relevant when considering how to promote physical activity guidelines. For example, placing too much emphasis on improving/maintaining CRF is unlikely to result in maximum benefits for other fundamental components of physical fitness, particularly muscle strength. [ABSTRACT FROM AUTHOR]

The National Institute for Health and Care Research (NIHR) has significantly contributed to the growth of clinical research activities in the United Kingdom. Central to this expansion is the pivotal role of Clinical Research Practitioners (CRPs) within the healthcare organization. This narrative explores reflective practice as a dynamic tool and essential requirements for their transformation and development into competent CRPs. Additionally, this article adds to the growing literature to highlight the benefits of having a professionally registered CRP for NHS organizations. By weaving together personal insights, professional development, and the integration of acquired knowledge, the narrative illuminates the profound impact of reflective practice on the evolution of a skilled and adept CRP. This review adds to the current literature on the importance of reflective practice in improving professionalism and competency for registered CRPs. The narrative emphasizes lifelong learning and reflective practice integration in clinical research training programs. It suggests further research on workplace reflection for knowledge integration. This resource is valuable for CRPs, organizations, and policymakers, emphasizing professionalism, competency development, and reflective practice in clinical research. [ABSTRACT FROM AUTHOR]

An understanding of the prevalence and risk factors of parental mental health problems is important for early intervention and prevention measures and shaping services for parents and their children. However, large representative surveys of parental mental health problems and associated risk factors are lacking. The aim of this study was to estimate prevalence rates of parental mental health problems using a standardised measure of psychiatric morbidity (General Health Questionnaire; GHQ‐12), in a representative sample of parents and caregivers of children and young people (2–19 years) in Northern Ireland. Further, this study explored associated risk factors of parental mental health problems. A random household survey of parents and children was conducted between June 2019 and March 2020. Parental responses on demographic, economic, familial and psychological measures were collected (N = 2815) and 22% of parents and caregivers screened positive for mental health problems. The STROBE checklist for observational research was adhered to. Multivariate logistic regression indicated that being in receipt of benefits, having poor family support, a history of adverse childhood experiences, a history of exposure to politically motivated violence (the Troubles), and a child with conduct problems and poor health were all independent risk factors of increased parental mental health problems. Findings will help to inform future commissioning and development of services and broaden understanding of the correlates of parental mental health problems. [ABSTRACT FROM AUTHOR]