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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]

Objectives: People with psychosis delay accessing recommended treatments, resulting in poor healthcare outcomes and increased risk of relapse. Means of improving help‐seeking and help‐acceptance could reduce duration of untreated psychosis (DUP). This study examined the role of attachment style in help‐seeking and help‐acceptance in psychosis. Design: We used an experimental design to test the effect of attachment imagery priming on help‐seeking and help‐acceptance intentions, in a sample with self‐reported psychosis. The independent variables were attachment imagery condition (secure vs. avoidant) and time (pre‐ vs. post‐prime). The dependent variables were state paranoia, help‐seeking intentions and help‐acceptance intentions. Methods: We used an online research platform to recruit people with psychosis (n = 61). Participants were randomly allocated to the secure or avoidant attachment priming condition. All completed measures of state paranoia, help‐seeking, and help‐acceptance, before and after priming. Results: In comparison with the avoidant condition, secure attachment imagery resulted in reduced paranoia and increased help‐seeking and acceptance intentions, all with large effect sizes. Conclusions: This is the first study to use an experimental design to assess the role of attachment style in help‐seeking and help‐acceptance in a clinical sample. Attachment style is causally linked to behavioural intentions that contribute to DUP. Clinicians should assess attachment and help‐seeking and acceptance, highlight these in formulation, and prioritise in treatment planning. Interventions that enhance help‐seeking and acceptance could improve access to recommended treatments and reduce DUP. [ABSTRACT FROM AUTHOR]

Background: Social connections between medical students provide a key basis for learning and support. These connections, and associated social identity, may be patterned by ethnicity, and students often perform similarly academically to those they connect with. The mechanisms that underpin the formation of these connections and the role that they play are not fully understood. This study explored how medical students connect with each other, and the potential impact of this on their academic attainment and well‐being, with a focus on students with minoritised ethnic identities. Methods: A mixed methods study combining (1) a survey to establish the number and strength of connections formed by Years 1 and 2 medical students with both minoritised and non‐minoritised ethnicities and (2) semi‐structured interviews to understand how connections were formed, whether this was shaped by ethnicity and the role of connections in supporting students with their learning and well‐being. Results: One hundred fifty‐one students (15.5% response rate) completed the survey. Students connected regularly with three to four peers with the goal of supporting learning and 71.9% of students reported a sense of social identification with this group. There was no statistical difference between ethnically minoritised and White students on either of these measures (t = 0.1, p = 0.92, χ2 = 2.9, p = 0.56). Interviews with 19 students found that social connections were shaped by perceptions of their self‐identity and the need to find 'equilibrium' by forming relationships with compatible others. The education environment, including its ethnic diversity, impacted on the opportunities to make connections. Students who were ethnically minoritised reported encountering challenges, especially in the clinical environment, and described the burden of these for them. Discussion: Curriculum designers should consider the time and space that is afforded to student interaction during course development, as finding compatible others with whom students can socially connect is important to balancing well‐being with academic performance. Bull et al. analyze students' experiences to show that they seek individuals with whom they feel compatible to maintain 'equilibrium' and support both academic performance and wellbeing. [ABSTRACT FROM AUTHOR]

Background: No consensus exists on how molar incisor hypomineralisation (MIH) should be covered by the undergraduate dental curricula. Aim: To assess the current teaching and assessment of MIH in the UK. Design: A piloted questionnaire regarding the teaching and assessment of MIH was disseminated to paediatric, restorative and orthodontic teaching leads in each UK dental school (n = 16). Data were analysed using descriptive statistics, chi‐squared and Kruskal–Wallis tests. Results: Response rates from paediatric, restorative and orthodontic teams were 75% (n = 12), 44% (n = 7) and 54% (n = 8), respectively. Prevention of caries, preformed metal crowns, anterior resin composites and vital bleaching were taught significantly more by paediatric teams (p =.006). Quality of life and resin infiltration were absent from restorative teaching. Orthodontic teaching focussed on the timing of first permanent molar extractions. Paediatric teams were mainly responsible for assessment. Risk factors, differential diagnoses for MIH and defining clinical features were more likely to be assessed by paediatric teams than by others (p =.006). All specialities reported that students were prepared to manage MIH. Conclusion: Molar incisor hypomineralisation is primarily taught and assessed by paediatric teams. No evidence of multidisciplinary or transitional teaching/assessment existed between specialities. Developing robust guidance regarding MIH learning in the UK undergraduate curricula may help improve consistency. [ABSTRACT FROM AUTHOR]

Objective: To assess rates of traversing barriers to care to access optimal clinical outcomes in people with migraine internationally. Background: People in need of medical care for migraine should consult a health care professional knowledgeable in migraine management, obtain an accurate diagnosis, and receive an individualized treatment plan, which includes scientific society guideline-recommended treatments where appropriate. Methods: The Chronic Migraine Epidemiology and Outcomes-International (CaMEO-I) Study was a cross-sectional, web-based survey conducted from July 2021 through March 2022 in Canada, France, Germany, Japan, the United Kingdom, and the United States (US). Respondents who met modified International Classification of Headache Disorders, 3rd edition, criteria for migraine and had Migraine Disability Assessment Scale (MIDAS) scores of ≥ 6 (i.e., mild, moderate, or severe disability) were deemed to need medical care and were included in this analysis. Minimally effective treatment required that participants were currently consulting a health care professional for headache (barrier 1), reported an accurate diagnosis (barrier 2), and reported use of minimally appropriate pharmacologic treatment (barrier 3; based on American Headache Society 2021 Consensus Statement recommendations). Proportions of respondents who successfully traversed each barrier were calculated, and chi-square tests were used to assess overall difference among countries. Results: Among 14,492 respondents with migraine, 8,330 had MIDAS scores of ≥ 6, were deemed in need of medical care, and were included in this analysis. Current headache consultation was reported by 35.1% (2926/8330) of respondents. Compared with the US, consultation rates and diagnosis rates were statistically significantly lower in all other countries except France where they were statistically significantly higher. Total appropriate treatment rates were also statistically significantly lower in all other countries compared with the US except France, which did not differ from the US. All 3 barriers were traversed by only 11.5% (955/8330) of respondents, with differences among countries (P < 0.001). Conclusions: Of people with migraine in need of medical care for migraine, less than 15% traverse all 3 barriers to care. Although rates of consultation, diagnosis, and treatment differed among countries, improvements are needed in all countries studied to reduce the global burden of migraine. Trial registration: NA. [ABSTRACT FROM AUTHOR]

Objectives To evaluate a strategy designed to optimize care and increase uptake of urate-lowering therapy (ULT) during hospitalizations for gout flares. Methods We conducted a prospective cohort study to evaluate a strategy that combined optimal in-hospital gout management with a nurse-led, follow-up appointment, followed by handover to primary care. Outcomes, including ULT initiation, urate target attainment and re-hospitalization rates, were compared between patients hospitalized for flares in the 12 months post-implementation and a retrospective cohort of hospitalized patients from 12 months pre-implementation. Results One hundred and nineteen and 108 patients, respectively, were hospitalized for gout flares in the 12 months pre- and post-implementation. For patients with 6-month follow-up data available (n  = 94 and n  = 97, respectively), the proportion newly initiated on ULT increased from 49.2% pre-implementation to 92.3% post-implementation (age/sex-adjusted odds ratio [aOR] 11.5; 95% CI 4.36, 30.5; P  < 0.001). After implementation, more patients achieved a serum urate ≤360 μmol/l within 6 months of discharge (10.6% pre-implementation vs 26.8% post-implementation; aOR 3.04; 95% CI 1.36, 6.78; P  = 0.007). The proportion of patients re-hospitalized for flares was 14.9% pre-implementation vs 9.3% post-implementation (aOR 0.53; 95% CI 0.22, 1.32; P  = 0.18). Conclusion Over 90% of patients were initiated on ULT after implementing a strategy to optimize hospital gout care. Despite increased initiation of ULT during flares, recurrent hospitalizations were not more frequent following implementation. Significant relative improvements in urate target attainment were observed post-implementation; however, for the majority of hospitalized gout patients to achieve urate targets, closer primary–secondary care integration is still needed. [ABSTRACT FROM AUTHOR]

Child safeguarding services intervene when a child is at risk of serious emotional or physical harm. Oxfordshire County Council is implementing a new approach to child safeguarding (Family Solutions Plus [FSP]) with a greater focus on whole family support and reducing the need for foster care. We sampled two cohorts of children closed within 1 year and examined the time spent in services. The sample included 474 children entering services before the new model's implementation and 561 children after. A greater proportion of children receiving FSP required a single care plan before their case was closed (85.9%; 69.4%, p < 0.001) and only experienced the lowest level plan (74.5%; 61.8%, p < 0.001). On average, this group spent less time in services for the period being observed (MD = 17.58, 95% confidence interval = 6.19, 28.96). At this early stage, no significant reduction in the number of children requiring foster care was seen (5.5%; 3.9%, p = 0.23). These initial findings suggest a potential association of FSP with a reduced number and level of care plans as well as length of time. Local authorities in England may investigate further whether FSP is a potentially useful model in improving safeguarding services. [ABSTRACT FROM AUTHOR]

Open research practices seek to enhance the transparency and reproducibility of research. While there is evidence of increased uptake in these practices, such as study preregistration and open data, facilitated by new infrastructure and policies, little research has assessed general uptake of such practices across psychology university researchers. The current study estimates psychologists' level of engagement in open research practices across universities in the United Kingdom and Ireland, while also assessing possible explanatory factors that may impact their engagement. Data were collected from 602 psychology researchers in the United Kingdom and Ireland on the extent to which they have implemented various practices (e.g., use of preprints, preregistration, open data, open materials). Here we present the summarized descriptive results, as well as considering differences between various categories of researcher (e.g., career stage, subdiscipline, methodology), and examining the relationship between researcher's practices and their self‐reported capability, opportunity, and motivation (COM‐B) to engage in open research practices. Results show that while there is considerable variability in engagement of open research practices, differences across career stage and subdiscipline of psychology are small by comparison. We observed consistent differences according to respondent's research methodology and based on the presence of institutional support for open research. COM‐B dimensions were collectively significant predictors of engagement in open research, with automatic motivation emerging as a consistently strong predictor. We discuss these findings, outline some of the challenges experienced in this study, and offer suggestions and recommendations for future research. Estimating the prevalence of responsible research practices is important to assess sustained behaviour change in research reform, tailor educational training initiatives, and to understand potential factors that might impact engagement. [ABSTRACT FROM AUTHOR]

Aims With an ageing population, the presence of asymptomatic valvular heart disease (VHD) in the community remains unknown. The aim of this study is to determine the prevalence and associated factors of asymptomatic VHD in individuals ≥60 years old and to evaluate the feasibility of echocardiographic screening for VHD in this population. Methods and results This was a prospective cohort study conducted between 2007 and 2016 in the UK. Asymptomatic patients with no prior indication for echocardiography were invited to participate and evaluated with a health questionnaire, clinical examination, and transthoracic echocardiography. A total of 10,000 individuals were invited through their general practices. A total of 5429 volunteered to participate, of whom 4237 were eligible for inclusion. VHD was diagnosed in more than a quarter of patients (28.2%). The most common types of VHD were regurgitation of the tricuspid (13.8%), mitral (12.8%), and aortic (8.3%) valves (trivial regurgitation was not included). The rate of prevalence of clinically significant VHD was 2.4% (2.2% moderate and 0.2% severe), with mitral and aortic regurgitation being the most common. The only parameter associated with significant VHD was age (odds ratio 1.07 per 1 year increment, 95% confidence interval 1.05–1.09, P < 0.001). The number needed to scan to diagnose one clinically significant case of VHD is 42 for individuals ≥60 and 15 for those ≥75 years old. Conclusion Asymptomatic VHD is present in a significant proportion of otherwise healthy individuals without known VHD over 60 years old. Age is strongly associated with an increased incidence of significant VHD. [ABSTRACT FROM AUTHOR]

Widening participation outcomes in admissions to UK medical schools have not changed 2007–2018, partly due to inequity in selection. This study models the effects of changing selection, using a novel method of contextualising applicants, on widening participation. We studied 1084 English school leaver applicants to a single medical school over two years, using data from their public exams taken 2 years pre-application (GCSE) and recent admissions test (UCAT). Widening participation was defined by postcode. We modelled two shortlists for a pre-determined number of 500; one ranked on UCAT total score, and the other on a metric that contextualised applicants' GCSE grades against their schools' average GCSE performance. There was a significant difference in the postcode-defined widening participation characteristics of the two shortlists; 46% by contextualisation and 32.2% by UCAT (Chisquare p < 0.00001). As widening participation covers 42% of postcodes, the "contextualise everyone" method achieves equity. Conventionally, contextual admissions identify individuals belonging to under-represented groups and gives them preferential treatment. Changing the rules for everyone, by using a relative attainment instead of simple absolute attainment metric, benefits from treating applicants equally; and could promote equity through widening participation. [ABSTRACT FROM AUTHOR]

Simple Summary: We evaluated a novel proprietary murine B7-H3 antibody 8H8 for flow cytometric analyses of patients with acute myeloid leukemia (AML). The results showed substantial B7-H3 expression in a significant proportion of AML cases, particularly in the M5 group and in those with intermediate or poor risk profiles. The correlation between high B7-H3 expression and poorer overall and progression-free survival suggests that B7-H3 may serve as an additional promising negative prognostic marker to be considered in treatment decisions in AML. Despite recent advances in immunophenotyping, the prognosis of acute myeloid leukemia (AML) is still mainly estimated using age and genetic markers. As the genetic heterogeneity of AML patients is high, flow cytometry-based classification with appropriate biomarkers can efficiently complement risk stratification and treatment selection. An increased expression of B7-H3 (CD276), an immune checkpoint protein, has been reported and associated with poor prognosis. However, the available data are limited and heterogeneous. Here, we used a novel, proprietary murine anti-B7-H3 8H8 antibody for the flow cytometric analysis of B7-H3 expression in AML blasts from 77 patients. Our antibody reliably detected substantial B7-H3 expression in 62.3% of AML patients. B7-H3 expression was higher in the monocytic French–American–British (FAB) M5 group and in intermediate and poor risk patients according to the European Leukemia Network. Using receiver operating characteristics (ROCs), we identified a specific fluorescence intensity cut-off of 4.45 to discriminate between B7-H3high and B7-H3low expression. High B7-H3 expression was associated with shorter overall survival (OS) and progression-free survival (PFS). In conclusion, we have developed a novel B7-H3 antibody that serves as a new tool for the detection of B7-H3 expression in AML and may help to facilitate risk stratification and treatment selection in AML patients. [ABSTRACT FROM AUTHOR]

Background: There is evidence available worldwide that nursing, medical and dental students sustain sharps injuries during their programmes of study. However, there is lack of evidence and research relating to the many students of other healthcare professions who may encounter sharps instruments. Aim/objective: The aim of the study was to identify the extent, type and impact of sharps injuries sustained by pre-registration healthcare students. Methods: An online survey was administered to 3372 healthcare students at a University in the United Kingdom. Findings/results: Some healthcare students other than nursing, medical and dentistry had sustained a sharps injury. The most common device involved were glass ampoules. The common causes were equipment and carelessness. Some healthcare students sustained psychological impacts following the sharps injury. Discussion: Sharps injuries are common amongst some healthcare students and there is scope for more education for these groups of students relating to the risks, safe handling, reporting and prevention of sharps injuries. [ABSTRACT FROM AUTHOR]

Although reduced working time and furlough policy initiatives are widely regarded as important for economic and business reasons, little is known about their impacts on workers' mental health at the onset of COVID-19 pandemic. Using data from the UK Household Longitudinal Panel Study data from 2018 to February 2020 and April 2020 and change score analysis, this study aims to compare mental health changes between those who worked reduced hours, were furloughed and left/lost paid work. The results suggest that at the onset of COVID-19 reduced working time and furlough can protect workers' mental health, but only for men not for women. The gender differences remain significant even after controlling for housework and childcare responsibilities at the onset of COVID-19. These results highlight the importance of distributing paid work more equitably and formulating gender-sensitive labour market policies in protection of workers' mental health. [ABSTRACT FROM AUTHOR]

Introduction: Parent/carers of disabled children want timely and personalized support. Research suggests that technology may address some limitations associated with traditional methods of communication with therapists (e.g. letter, telephone). This exploratory study examined United Kingdom (UK) parents and carers views on the use of digital technology (i.e. computers/phones) in supporting their child and the potential for its greater use in the care of children with complex needs. Methods: An online survey was distributed via special schools and support forums/networks. Questions explored use of and attitudes to digital technology in the care of children with complex needs. Descriptive statistical analyses and content analyses were undertaken on the data. Results: Respondents were 43 parents/carers whose children used rehabilitation services prior to the COVID-19 pandemic. The majority used digital technology frequently to support their child and saw the potential for greater use in rehabilitation services – provided this was not at the expense of in-person therapist contact. Conclusion: Parents and carers held positive views of digital technology as a tool to support their child and enhance rehabilitation services. Recommendations include regular service consultation on parental/child attitudes to digital service delivery and longitudinal studies to assess related health outcomes. [ABSTRACT FROM AUTHOR]

Background: The UK has an informed choice testing policy for prostate cancer. The prostate-specific antigen (PSA) blood test is available for free to any man aged ≥50 years who requests it and has been informed of the harms and benefits. This policy leads to differences in PSA testing rates, which can exacerbate health inequalities. Aim: To assess whether Prostate Cancer UK’s risk checker helps men at risk of prostate cancer make an informed choice about the PSA test. Design & setting: Mixed-methods study in the UK. Method: In total, 1181 men at risk, their partners, and clinical experts participated in surveys, focus groups, and one-to-one interviews. Data on risk checker completions by sociodemographic factors were analysed over time. Data from general practices that sent the risk checker to their patients were collected and analysed for service monitoring purposes. Results: There was a strong assumption that testing must be good, and therefore a need to emphasise the pros and cons of the test and that having it was the patient’s decision. Men believed their GP would invite them for PSA testing. On the impact of the risk checker, 79.6% of men who completed it had at least one prostate cancer risk factor; the average time they interacted with the information in the tool was 9 minutes 28 seconds; and 75.7% felt the tool had equipped them to make an informed choice. Conclusion: Online decision-making tools, such as the risk checker, can help reach men at high risk of prostate cancer and support them in making an informed choice about the PSA test. [ABSTRACT FROM AUTHOR]

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

(1) Background: Preterm premature rupture of membranes (PPROM) has been associated with increased perinatal morbidity, but the effect of PPROM on respiratory disease has not been previously quantified. We hypothesised that PPROM would be associated with a higher incidence of invasive ventilation. (2) Methods: A retrospective cohort study at the Neonatal Unit at King's College Hospital NHS Foundation Trust, London, UK, was conducted on infants born before 37 weeks of gestation. PPROM was defined as the rupture of membranes for >48 h. (3) Results: We reviewed 1901 infants (434 with PPROM) with a median (IQR) gestational age of 32.4 (28.7–35.0) weeks. The median (IQR) duration of rupture of membranes in the infants with PPROM was 129 (78–293) h. The incidence of invasive ventilation was 56% in the infants with PPROM and 46% in the infants without PPROM (p < 0.001). Following regression analysis, PPROM was significantly related to a higher incidence of invasive ventilation (odds ratio: 1.48; 95% CI: 1.13–1.92, adjusted p = 0.004) after adjusting for birth weight [odds ratio = 0.34; 95% CI: 0.33–0.43, adjusted p < 0.001], Apgar score at 10 min [odds ratio =0.61; 95% CI: 0.56–0.66, adjusted p < 0.001] and antenatal corticosteroid use (adjusted p = 0.939). (4) Conclusions: PPROM was associated with a 1.48-fold higher risk of needing invasive ventilation. [ABSTRACT FROM AUTHOR]

Victims of intimate partner violence (IPV) are frequently blamed and disbelieved, which may affect their willingness to report their abuse experiences. This vignette-based online experiment examines whether victim attractiveness (attractive vs. unattractive) and the type of abuse suffered (psychological vs. psychological plus physical abuse) may impact attributions of victim blame or victim credibility. The final sample included 167 UK residents (79% females) aged between 18 and 66 years (M = 33.17, SD = 11.26). Results indicated that the attractive victim was judged as being more credible than the unattractive victim. Results are discussed in light of societal attitudes toward IPV. [ABSTRACT FROM AUTHOR]

Background: Experiencing childbirth as traumatic is common and can have long-lasting negative consequences for women's mental health. However, fostering a sense of social identity has been shown to protect psychological wellbeing and mental health during life transitions, such as entering parenthood. This study therefore investigated the relationship between traumatic childbirth and first-time mothers' social identity and their psychological wellbeing, and more specifically whether strength of identity as a first-time mother protected psychological wellbeing following traumatic childbirth. Method: Women over the age of 18 who were living in the UK and had given birth to their first child in the past nine months were recruited to the study from clinical and community settings. They completed digital self-report questionnaires about their birth experience, social identity, mental health, and psychological wellbeing. Women who perceived themselves to have had a traumatic birth (the trauma group; N = 84) were compared to women who did not perceive themselves to have had a traumatic birth (the control group, N = 39). T-tests and chi square tests assessed preliminary group differences before multivariate analyses of covariance controlled for covariates. Post-hoc tests identified the direction of differences. Multiple regression and moderation analyses analysed interaction effects. Results: The trauma group had significantly lower psychological wellbeing (mean = 41.5, 95% CI [39.4–43.7], p =.008, partial η2 = 0.059), compared to the control group (mean = 48.4, 95% CI [45.3–51.5]), but the two groups did not differ in the strength of their first-time mother identity, which was high across both groups. Strength of identity did not moderate the relationship between traumatic childbirth and psychological wellbeing. Giving birth by caesarean section independently reduced the strength of the first-time mother identity (p =.017, partial η2 = 0.049). All analyses controlled for emotional and practical support, perceptions of healthcare staff, and mode of birth. Conclusions: Having a traumatic birth was associated with lower psychological wellbeing, and the strength of first-time mother identity does not appear to moderate this relationship. Factors such as mode of birth may be more important. Further research, including longitudinal designs, is needed to understand the relationship between these constructs and identify more effective ways of protecting first-time mothers' mental health. [ABSTRACT FROM AUTHOR]

Objective: To identify cortical and subcortical volume, thickness and cortical area features and the networks they constituted related to anxiety in Parkinson's disease (PD) using structural magnetic resonance imaging (sMRI), and to integrate multimodal features based on machine learning to identify PD-related anxiety. Methods: A total of 219 patients with PD were retrospectively enrolled in the study. 291 sMRI features including cortical volume, subcortical volume, cortical thickness, and cortical area, as well as 17 clinical features, were extracted. Graph theory analysis was used to explore structural networks. A support vector machine (SVM) combination model, which used both sMRI and clinical features to identify participants with PD-related anxiety, was developed and evaluated. The performance of SVM models were evaluated. The mean impact value (MIV) of the feature importance evaluation algorithm was used to rank the relative importance of sMRI features and clinical features within the model. Results: 17 significant sMRI variables associated with PD-related anxiety was used to build a brain structural network. And seven sMRI and 5 clinical features with statistically significant differences were incorporated into the SVM model. The comprehensive model achieved higher performance than clinical features or sMRI features did alone, with an accuracy of 0.88, a precision of 0.86, a sensitivity of 0.81, an F1-Score of 0.83, a macro-average of 0.85, a weightedaverage of 0.92, an AUC of 0.88, and a result of 10-fold cross-validation of 0.91 in test set. The sMRI feature right medialorbitofrontal thickness had the highest impact on the prediction model. Conclusion: We identified the brain structural features and networks related to anxiety in PD, and developed and internally validated a comprehensive model with multimodal features in identifying. [ABSTRACT FROM AUTHOR]

Averting incidents of patient self-harm is an ongoing challenge in acute inpatient mental health settings. Novel technologies that do not require continuous human visual monitoring and that maintain patient privacy may support staff in managing patient safety and intervening proactively to prevent self-harm incidents. To assess the effect of implementing a contact-free vision-based patient monitoring and management (VBPMM) system on the rate of bedroom self-harm incidents. A mixed methods non-randomized controlled before-and-after evaluation was conducted over 24 months on one female and one male acute inpatient mental health ward with the VBPMM system. The rates of bedroom self-harm, and of bedroom ligatures specifically, before and after implementation were investigated using quantitative methods. Qualitative methods were also used to explore the perceived effectiveness of the system and its acceptability. A −44% relative percentage change in bedroom self-harm incidents and a −48% relative percentage change in bedroom ligatures incidents were observed in the observational wards with the VBPMM system. Staff and patient responses gave insights into system acceptability and the ways in which these reductions may have been achieved. The results indicate that using the VBPMM system helped staff to reduce self-harm incidents, including ligatures, in bedrooms. [ABSTRACT FROM AUTHOR]

Background: Statutory options for restricting alcohol advertising include limiting it to product‐orientated information and requiring health warnings. We assess the impact of removing positive contextual factors from alcohol advertising and including a health warning among adults in the United Kingdom (UK). Methods: We conducted a 2 × 2 online between‐group experiment with adults (18+) (n = 2421) recruited from a non‐probability research panel in the United Kingdom. Participants were randomized to see an alcohol (vodka) advertisement (advert) which varied by context (no context vs. imagery depicting positive social interactions around alcohol) and message (multiple text health warning vs. "drink responsibly"). The multiple text health warning, based on recent legislation in Ireland, comprised three separate warnings (liver disease, cancers, drinking during pregnancy) and a web address for alcohol‐related information and support. The "drink responsibly" control reflected the self‐regulatory messages commonly used by alcohol companies. Participants rated the advert on 7‐point scales for advert attractiveness, product appeal, trial intentions, perceived harm, and whether it made drinking alcohol seem enjoyable. Results: Removing the positive social context reduced positive advert and product reactions (difference in estimated marginal means [EMM]: −1.57 [makes drinking alcohol seem enjoyable] to −0.23 [intention to try]). Including the multiple text health warning also reduced positive advert and product reactions (difference in EMM: −0.55 [advert attractiveness] to −0.25 [intention to try]) and increased perceived product harm (difference in EMM: +0.25). There were no interactions between advert context and message for any outcome. Conclusions: Restricting content and including a multiple text health warning (compared to a "drink responsibly" message) may attenuate the persuasive impact of alcohol advertising and increase perceived product harm. Further research is needed to examine different degrees of content restrictions, alternative warning content and design, generalizability to different alcohol products and advert formats, and whether the impact of content controls varies among population subgroups. [ABSTRACT FROM AUTHOR]

Background: The evidence on the relationship between adiposity and disease outcomes in paediatric Crohn's disease (CD) is limited and lacks consensus. Aim: To investigate the relationship between (a) body mass index (BMI) and clinical CD outcomes (hospitalisation, surgery, disease behaviour, biologic use, extra-intestinal manifestations (EIMs)) and (b) the age of CD onset with clinical outcomes. Design: Clinical outcomes were examined in CD patients diagnosed at age <17 years and enroled in the National Institute for Health Research IBD-UK BioResource at a median age of 24 years. All outcomes and BMI were recorded at the time of enrolment. Participants were categorised into normal (<25 kg/m2) and high (≥25 kg/m2) BMI. Age at disease diagnosis was categorised into pre-puberty/early puberty (<11 years), puberty (11–14 years) and post-puberty (15–17 years). Spearman rank correlation was used to test the associations between continuous variables and chi-square test to compare categorical variables. Results: 848 participants with CD were included (51.8% males) and median age at diagnosis was 14 years. Participants with high BMI experienced a greater frequency of EIMs (P = 0.05) than those with low BMI (1 type of EIM: 18.5% vs. 13.2%, respectively; ≥2 types of EIMs: 7.8% vs. 5.6%, respectively). Age at diagnosis and BMI showed weak correlations with corticosteroid use (ρ = 0.08, P = 0.03 and ρ = −0.09, P = 0.01; respectively). An early diagnosis (<11 years) was associated with higher occurrence of stenosing and penetrating disease behaviour (P = 0.01) and hospitalisations (P < 0.001). Conclusions: A higher BMI and an earlier age of disease onset are associated with worse CD clinical presentation. [ABSTRACT FROM AUTHOR]

Aim: Few previous studies have investigated the impact of multiple types of electronic devices on health status, and the moderating effects of gender, age, and BMI. Our aim is to examine the relationships between the use of four types of electronics and three health status indicators in a middle-aged and elderly population, and how these relationships varied by gender, age, and BMI. Subject and methods: Using data from 376,806 participants aged 40–69 years in the UK Biobank, we conducted a multivariate linear regression to estimate the association between electronic device use and health status. Electronics use was categorized as TV watching, computer use, computer gaming, and mobile phone use, and health status included self-rated health (SRH), multisite chronic pain (MCP), and total physical activity (TPA). Interaction terms were utilized to assess whether the above associations were modified by BMI, gender, and age. Further stratified analysis was performed to explore the role of gender, age, and BMI. Results: Higher levels of TV watching (BSRH = 0.056, BMCP = 0.044, BTPA= −1.795), computer use (BSRH = 0.007, BTPA= −3.469), and computer gaming (BSRH = 0.055, BMCP = 0.058, BTPA= −6.076) were consistently associated with poorer health status (all P < 0.05). Contrastingly, earlier exposure to mobile phones (BSRH = −0.048, BTPA= 0.933, BMCP = 0.056) was inconsistent with health (all P < 0.05). Additionally, BMI (Bcomputer use-SRH= 0.0026, Bphone-SRH= 0.0049, BTV-MCP= 0.0031, and BTV-TPA= −0.0584) exacerbated the negative effects of electronics use, and male (Bphone-SRH = −0.0414, Bphone-MCP = −0.0537, Bphone-TPA= 2.8873) were healthier with earlier exposure to mobile phones (all P < 0.05). Conclusion: Our findings suggest that the adverse health effects associated with watching TV, computer use, and computer gaming were consistent and were moderated by BMI, gender, and age, which advances a comprehensive understanding of the association between multiple types of electronic devices and health status, and provides new perspectives for future research. [ABSTRACT FROM AUTHOR]

Background: Remote forms of breastfeeding support, such as helplines and social media, offer a flexible and convenient form of support to offer help at critical points, e.g., when the risk of breastfeeding cessation is high. Currently, there is little known about who accesses different forms of remote breastfeeding support and what factors impact overall satisfaction. As part of an evaluation of the UK National Breastfeeding Helpline (NBH) (which offers breastfeeding support via a helpline and online media), we aimed to (a) understand who accesses different forms of NBH support, and (b) identify key factors associated with overall satisfaction for helpline and online media support. Methods: All service users who contacted the NBH between November 2021 and March 2022 were invited to participate in the evaluation via an online survey. Survey questions explored the type and timing of support, reasons for the contact, attitudes towards the help and support received, impact of the support on breastfeeding experiences and demographic factors. Chi-squared and Mann–Whitney tests explored variations in who accessed the helpline or online media. Multiple linear regression models were fitted to explore the factors related to the service users' 'overall satisfaction'. The quantitive data were combined with qualitative comments into descriptive themes. Results: Overall, online media users were significantly more likely to be younger, White, multiparous, less educated and have English as a first language compared to those who contact the helpline. Similar factors that significantly influenced overall satisfaction for both support models were the service being easy to access, receiving helpful information that met expectations, resolving breastfeeding issues, and feeling reassured and more confident. Significant factors for the helpline were callers feeling understood and more knowledgeable about breastfeeding following the call, being able to put into practice the information provided, feeling encouraged to continue breastfeeding, feeling that the volunteer gave the support that was needed, and seeking out additional support. Conclusions: Online and helpline forms of breastfeeding support suit different demographics and call purposes. While optimal breastfeeding support needs to be accessible, flexible and instrumental, helpline users need real-time relational support to deal with more complex challenges. [ABSTRACT FROM AUTHOR]

Background: While tailored information might have the potential to motivate stroke survivors to make essential lifestyle changes and improve long-term outcomes, how this varies among different stroke populations is not yet fully understood. Method: From November 2022 to May 2023, stroke survivors in the UK, who were clinically stable, participated in a community-based, descriptive cross-sectional study. Participants rated several information themes on a Likert scale from one to five, indicating the relevance of each information group to them. Data were analysed using Wilcoxon and chi-squared tests on SPSS. Descriptive statistics were employed for examining the preferred information delivery method, timing, personnel, and frequency. Results: Seventy survivors, with an average age of 67 ± 19 (61% males), were recruited. Survivors emphasised the importance of symptoms, risk factors, and recovery information during hospital stay, while medication and lifestyle change information were more significant in the community. Subgroup analysis revealed distinct patterns: First-time stroke survivors highlighted the importance of social and financial support (acute phase median Likert score 3, chronic phase median Likert score 4; p < 0.01), while those with prior strokes emphasised information on driving and working after stroke (acute phase median Likert score 4, chronic phase median Likert score 3; p < 0.05). Survivors recruited after six months of stroke prioritised knowledge of carer support in the community (acute phase median Likert score 3.5, chronic phase median Likert score 4; p < 0.01). Conclusion: Survivors' information needs differ depending on factors such as the recovery phase, type of stroke, time since diagnosis, and the presence of a previous stroke. Considering these factors is essential when developing or providing information to stroke survivors. [ABSTRACT FROM AUTHOR]

Aims: To (1) explore the intramigration experience of HCWs within Nigeria, (2) explore the migration intention of health care workers (HCWs) in Nigeria and (3) identify the predictors of migration intention among HCWs in Nigeria. Design: Cross‐sectional study. Methods: The online survey was used to collect data from 513 HCWs in Nigeria between May and June 2023. Crude and adjusted logistic regression were used to identify factors associated with emigration intention. Analyses were performed on SPSS version 26 at a 95% confidence interval. Results: The study found that 34.4% had intramigration experience, and the rate of intention to emigrate to work in another country was 80.1%. The United Kingdom was the most preferred destination (109 HCWs), followed by Canada (92 HCWs) and the United States (82 HCWs). At the multivariate level, emigration intention was associated with the experience of burnout and duration of practice as a HCW. Nurses had higher emigration intentions than medical doctors. Conclusions: Many HCWs in Nigeria appear to have emigration intent, and nurses are more likely to be willing to migrate than doctors. The Nigerian government may want to explore strategies to reverse the emigration intent of the HCWs in Nigeria. [ABSTRACT FROM AUTHOR]

Online consultation services have the potential to reduce the workload of healthcare staff, provide timely care to patients, and improve doctor-patient relationships. The COVID-19 pandemic has accelerated the development of these services and platforms, but it remains to be seen whether the general public will continue to use them after the pandemic is under control. This research proposes a framework to examine the factors contributing to UK adults' continued usage of online healthcare consultation services after COVID-19 restrictions have been lifted. A total of 430 new users completed surveys, and the results indicate that expectation confirmation, system quality, and information quality can positively impact users' self-efficacy toward using online consultation services. This, in turn, can influence their continued usage behavior. Furthermore, the results suggest that participants' perception of health risks can moderate the relationship between self-efficacy and continued usage behavior. The strategic implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

To attract and retain a more diverse workforce, organizations embrace diversity initiatives, expressed in diversity statements on their websites. While the explicit content of diversity statements influences attitudes towards organizations, much less is known about the effect of subtle cues such as emotions. In three pre‐registered studies, we tested the effect of positive emotionality in diversity statements on attitudes towards organizations. Study 1 focused on the degree to which 600 European organizations employed emotionality in their diversity statements, finding that although their statements differed in the level of emotionality, on average, organizations avoided highly emotional words. Study 2 (N = 220 UK participants) tested the effect of original diversity statements on readers' attitudes towards an organization, demonstrating that the level of emotionality in the existing statements did not influence positive attitudes towards the organization. In Study 3 (N = 815 UK participants), we thus modified the diversity statements so that they contained high levels of positive emotionality that triggered more positive emotions and resulted in more positive attitudes towards an organization. Taken together, highly emotional words (e.g. passionate; happy; wholeheartedly) are key in diversity statements if organizations wish to increase their attractiveness among potential employees. [ABSTRACT FROM AUTHOR]

Introduction: Differential attainment is a well‐known phenomenon in medical education. Despite a strong impetus for institutions and researchers to move away from a 'student deficit model' when exploring the attainment gap, little attention has been given to understanding the experiences of Black, Asian and Minority Ethnic (BAME) medical students. Informed by the social construction of learning theory, this is the first national study to explore how multiple dimensions of the medical school environment impact academic performance of BAME undergraduate medical students across the UK. Methods: Using a sequential explanatory mixed‐methods approach, the authors conducted a survey and facilitated three focus groups across medical schools in the UK between 2020–2021. Participants self‐identified as being from BAME backgrounds. Quantitative analyses included descriptive statistics and bivariate analyses. Qualitative data were analysed using thematic analysis, subsequently identifying inductive themes. Results: Three hundred sixty‐two respondents completed the Phase 1 survey, and 17 participants participated in the Phase 2 focus groups. Although both survey and focus group participants identified facilitators to learning such as supportive relationships, students reported facing numerous barriers that they felt impeded their learning and performance. These barriers included limited access to educational resources, and undiversified curricula and medical school populations. Students also described both experiencing and witnessing various forms of racism throughout their educational journeys. Discussion: Students encountered various difficulties throughout their medical training that they felt impacted their learning and performance. This study offers novel insights into the experiences of BAME students and builds upon previous research. It also reveals the pervasive nature of racism within medical schools, highlighting the urgent need for institutional changes. Educators and institutions must go beyond merely recognising these barriers and facilitators; they must proactively innovate and adapt. In doing so, they pave the way for inclusive learning environments that truly foster a sense of belonging for BAME students. In this mixed‐methods study, @DrNariell, Machado and Blackburn explore UK BAME medical students‐ perspectives on the barriers and facilitators they experience during their training. #MedEd #MedTwitter [ABSTRACT FROM AUTHOR]

Background: Lifetime risk of fragility fractures is 50% in post-menopausal women and 20% in men aged >50 years. Identifying people at high risk facilitates early intervention and reduction of biopsychosocial morbidity associated with these fractures. Aim: To explore if bone health assessment (BHA) rates differ between women and men aged =50 years with fragility fracture risk factors. Design & setting: A primary care-based cohort study in North Staffordshire, UK. Method: Patients were identified from the Consultations in Primary Care Archive (CiPCA) database between 2002 and 2014 with one or more fragility fracture risk factors (previous fractures, falls, and prolonged steroid use). Evaluation of BHA within 12 months of presentation of the first risk factor was carried out by searching for codes for fracture risk assessment tools (FRAX and QFracture), bone density measurement, specialist service referral, or if bone-protection medication was started. Results: A total of 15 581 patients with risk factors were identified; men represented 40.4% of the cohort. The study found 1172 (7.5%) had BHA performed within 1 year of presentation, and 8.9% of women and 5.5% of men had BHAs, which was found with strong statistical evidence (χ2 = 59.88, P = 1 × 10-14). This relationship prevailed after adjusting for other covariates, such as comorbidity and number of consultations, with an odds ratio of 1.25 (95% confidence interval [CI] = 1.08 to 1.43). Conclusion: This study has shown that rates of BHA were generally low and even lower in men compared with women. Primary care clinicians should be alert to fragility fracture risk factors in both men and women to enable early assessment and intervention. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to conceptualise a research study to examine leadership as a relational concept between leaders and followers. The context is within surgical practice examining how motivated consultant surgeons are to lead junior doctors and which type of leadership style they use. From a follower perspective, the motivation of junior doctors will be explored, and their leadership preferences will be correlated with those of the actual style of consultant surgeons. Design/methodology/approach: In this paper, the authors provide a detailed description of the methods for an international quantitative research study, exploring sequentially how motivated consultant surgeons are to lead and how leadership styles impact on the motivation of junior doctors. The objectives, method and data collection of this study are explained, and the justification for each method is described. Findings: The findings for this outline study illustrate how critical it is to redefine leadership as a relational concept of leader and follower to ensure adequate support is provided to the next generation of consultant surgeons. Without consideration of the relational model of leadership, attrition will continue to be a critical issue in the medical workforce. Research limitations/implications: The research limitations are that this is a proposed quantitative study due to the need to collect a large sample of data from surgeons across the UK, Egypt and Germany. This research will have immense implications in developing new knowledge of leadership as a relational concept in medicine and healthcare. This study additionally will impact on how leadership is conceptualised in the curriculum for specialist surgical practice. Practical implications: The practical implications are that relational leadership is supportive of generating a supportive leadership culture in the workplace and generating more effective teamwork. Originality/value: To the best of the authors' knowledge, this is the first study of its kind to look at a relational model of leadership in surgical practice between consultant surgeons and surgical trainees. This study will also identify any specific country differences between the UK, Germany and Egypt. [ABSTRACT FROM AUTHOR]

Food insecurity (FI) among university students in the United States has been associated with poor mental wellbeing, but very little is known about the relationship between FI and mental wellbeing in the UK university population. Here we examined the prevalence of FI, determined potential drivers for it and its relationship with mental wellbeing and coping ability. Students studying at UK universities (n = 289) completed an online self‐reported questionnaire to obtain socio‐economic characteristics including financial status, FI status (Household Food Insecurity Access scale), mental wellbeing (Warwick‐Edinburgh Mental Wellbeing Scale) and coping ability (coping flexibility scale). FI was observed in 28% of the participants and was associated with financial independence, running out of money, borrowing money and lacking confidence to purchase healthy foods (p < 0.05). Although we cannot determine directionality, logistic regression analysis revealed those who were judged as FI were more likely to shop often (OR = 3.139 95% CI 1.533–6.429), never snacked between meals (OR = 4.261 95% CI 1.309–13.875) and the amount of food purchased was affected by perceptions of the price of food in general (OR = 2.954 95% CI 1.675–5.210). Financial instability and the inability to access nutritious food may contribute to the decrease in mental wellbeing (p < 0.01) and lower ability to cope with stressful situations (p < 0.01) in food‐insecure students although the direction of these relationships cannot be determined from this cross‐sectional study. This study has identified that there is a need to develop appropriate strategies to combat FI in university students and to improve mental health. [ABSTRACT FROM AUTHOR]

Aims: Enteral feeding is commonly used to manage a variety of medical conditions in hospitals. For people with diabetes this can present a specific challenge for glucose management. To address gaps in our understanding of modern enteral feeding outcomes and to help with the development of more specific guidance on maintaining glycaemic control, we conducted a national survey on the management of enteral feeding against the standards in the nationally adopted Joint British Diabetes Societies for Inpatient Care (JBDS) guidelines. Methods: A questionnaire was developed using the 2018 JBDS guideline as a template this questionnaire was sent out by email to all 220 UK specialist diabetes teams. Databases of Diabetes UK, the Association of British Diabetologists (ABCD) and the Diabetes Inpatient Specialist Nurse UK Group were used. Results: Twenty‐six hospitals responded, 11 had guidelines for the management of insulin with enteral feeding. There were three main feed regimens used: continuous 24‐h feeding, a single feed with one break in 24 h, or multiple feeds in 24 h. There were five regimens in common use: premixed insulin, isophane insulin, analogue basal insulin, variable rate intravenous insulin or basal bolus insulin. Overall glucose control was poor for all regimens and combinations. Continuous feed showed better glucose control than a single feed with a break, mean (±SD) glucose 12.4 mmol/L (5.6) versus 15.1 mmol/L (6.9) p < 0.005, but no group showed optimal control. Conclusions: Managing diabetes control during enteral feeding remains a challenge. Our survey showed that glucose control during this treatment is suboptimal. [ABSTRACT FROM AUTHOR]

Purpose: Many health-care professionals leave clinical practice temporarily or permanently. Interventions designed to facilitate the return of health-care professionals fail to consider returners' psychosocial needs despite their importance for patient care. This study aims to evaluate the efficacy of a psychoeducational intervention in improving personal skills and well-being among UK-based health-care professionals returning to clinical practice. Design/methodology/approach: In total, 20 health-care professionals took part in the one-day intervention and completed measures of demographics, self-efficacy, positive attitudes towards work and perceived job resources before and after the intervention. A baseline comparison group of 18 health-care professionals was also recruited. Findings: Significant associations were detected between return-to-work stage and study group. Following the intervention, participants reported improvements in self-efficacy and, generally, perceived more job resources, whereas positive attitudes towards work decreased. While none of these changes were significant, the intervention was deemed acceptable by participants. This study provides modest but promising evidence for the role of psychoeducation as a tool in supporting the psychosocial needs of returning health-care professionals. Research limitations/implications: Additional research is needed to clarify the reliability of intervention effects, its effectiveness compared to alternative interventions, and the impact across different subgroups of returning health-care professionals. Practical implications: Return-to-practice interventions should address the psychosocial needs of health-care professionals in terms of their personal skills and well-being. Psychoeducation can increase self-efficacy and perceptions of job resources among returning health-care professionals. Originality/value: This study sheds light on a relatively understudied, but fundamental area – the psychosocial challenges of health-care professionals returning to clinical practice – and further justifies the need for tailored interventions. [ABSTRACT FROM AUTHOR]

Visual impairment (V.I.) has been associated with a negative impact on activities of daily living (ADL) and navigation outside the home. Adults from minority ethnic communities are projected to make up an increasing proportion of the V.I. population in the UK, yet the evidence relating to their experiences of living with V.I. is limited. This article uses data collected by the V.I. Lives Survey, between December 2019 and November 2020. Using secondary analysis of anonymised survey data, this article explores self-reported functioning relating to ADL, navigation outside of the home, and use of technology to access information in a matched control sample of adults from minority ethnic (MEC) and white communities (WC). The findings showed that most issues relating to self-efficacy, accessibility of public environments, and technology were significantly more important to MEC than WC participants. A significantly higher proportion of MEC participants required frequent help with cooking, received support for ADL from siblings and other family members, and had their shopping delivered. WC participants were significantly more likely to receive help with shopping from their spouse/partner and use public transport as much as they liked. Future research will need to confirm these findings in a larger sample and explore the reasons for them. [ABSTRACT FROM AUTHOR]

Visual impairment has been associated with mental and physical comorbidities in older adults. Research into comorbidities within minority ethnic communities (MEC) with visual impairment is yet to be explored, despite the increase in numbers. A secondary analysis of survey data collected by UK-based sight loss charities provides the first insight into comorbid conditions in a matched control sample of 77 MEC and 77 White adults aged 18–85 years. Participants were matched based on age, gender, UK region, and urban/rural setting. Group differences were explored, and subgroup analysis was also carried out for the two largest subgroups within the MEC group: Asian (n = 46) and Black (n = 22). Response frequencies (n) and proportions (%) were calculated for all variables including eye conditions, vision difficulties, comorbid conditions, and exercise. The sample was predominantly young, and few significant differences were found. Sub-group analysis showed that Asian participants were more likely to report not doing any exercise, having bad health, and comorbidities including high blood pressure, dexterity, hearing and communication difficulties, and a recent emotional/psychological/mental health condition. Black participants, however, were more likely to report comorbidity, in particular physical conditions and mobility difficulties. [ABSTRACT FROM AUTHOR]

Background The health needs of those under probation are likely high, but they have received very little public health attention. Limited evidence exists on the public health needs and interventions to support this cohort. Methods Surveys were completed by 257 people on probation as part of a local health needs assessment. Results were compared with the general population responses from the National Survey for Wales (2021–22). Results People on probation were 4.2 times more likely to self-report not-good general health (fair, bad or very bad) than the general population (adjusted Odds Ratio [aOR] 4.2, 95% Confidence Intervals [CI] 3.2–5.4). The odds of having a mental health condition were over eight times higher than the general population (aOR 8.8, 95% CI 6.8–11.4). Prevalence of smoking (52%), drug use (60%), attention-deficit hyperactivity disorder (21%), autism (4%) and dyslexia (15%) were all higher than the general population. General Practitioner usage and hospital stays were higher, but dentist or optician usage lower than the general population (P  < 0.05). Emergency departments were accessed by 35%, with 9% frequenting them three or more times. Conclusions People on probation have poorer self-reported health, higher prevalence of unhealthy behaviours and higher accessing of reactive health services than the general population. [ABSTRACT FROM AUTHOR]

To explore longer-term health-related quality of life (HRQoL) and participation outcomes and goals of children and young people (CYP) with acquired brain injuries (ABI) and their families in a region of the UK and the impact of the COVID-19 pandemic. Cross-sectional survey of (5-18 CYP) and their parent-carers 12–43 months following ABI. Included measures of HRQoL, participation, family function and parental wellbeing and demographic and free text questions. Ninety-five responses (30% response) were received. 67% of CYP were at risk of impaired HRQoL, 72% had severely impaired participation. 53% of parent-carers reported reduced HRQoL and family functioning, 37% of parent-carers screened positive for anxiety/depression. Relationships exist between CYP participation and HRQoL and parental HRQoL and family functioning. Goals were overwhelmingly activity and participation focused. Participants described the global impact of an ABI on the CYP and family as well as the additional impact of the COVID-19 pandemic on CYP and family wellbeing. ABI significantly impacts CYP participation and both CYP and parent-carer wellbeing in the long-term, potentially further impacted by the COVID-19 pandemic. Rehabilitation interventions should address both participation and the psychological wellbeing of CYP with ABI and their parent-carers. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: The fecal immunochemical test (FIT) helps triage primary care patients at risk of colorectal cancer (CRC). Improving FIT returns has received recent attention, however uncertainty exists regarding the accurate completion of samples provided for laboratory analysis. This study aims to identify the rejection rate of returned FIT samples and determine rejection causes. Methods: FIT samples from symptomatic patients within South Yorkshire, Bassetlaw, and North Derbyshire are processed at a central laboratory. Tests requests are made from 225 GP practices, which serve an estimated 2 million population. This study describes a retrospective review of FIT samples received in the central laboratory between 01/09/19 and 31/12/22. Locally held data was interrogated in March 2023 to determine the number of FIT samples received and rejected during the study period. Documented reasons for rejection were explored to identify common themes. Results: Total FIT specimens received during the study period was 126 422. Of these, 5190 (4.1%) were rejected. Monthly rejection rates fell from 17.4% in September 2019 to 1.3% in December 2022 (P <.001). Sampling errors were the most frequent cause for FIT rejection (2151/5190), with other causes including: expired specimen; no sample collection date/ time, no request form, incomplete patient information and illegible handwriting. Conclusions: This is the first study exploring FIT rejection rates in symptomatic primary care patients, which shows improvements in rejection rates over time. Targeted interventions could improve rejection rates further, thereby reducing NHS resource use and costs and diagnostic delays. [ABSTRACT FROM AUTHOR]

Objective: Evidence on the individual and combined relationship of physical activity (PA) and fish oil supplement use on the incidence of Parkinson's disease (PD) risk remains lacking. Materials and methods: This UK population-based prospective cohort study, involving 385,275 UK Biobank participants, collected PA and fish oil supplement data via touchscreen questionnaires. Using Cox proportional hazards models and restricted cubic splines to examined the associations between use of fish oil supplements, PA and PD risk. Results: During a median 12.52-year follow-up, 2,131 participants incident PD. Analysis showed that fish oil supplement users had a lower PD risk [hazard ratio (HR), 0.89; 95% confidence interval (CI), 0.82-0.98]. The adjusted HRs for the PD incidence were 0.96 (95% CI, 0.95-0.98) for total PA; 0.93 (95% CI, 0.90-0.96) for moderate PA; 0.95 (95% CI, 0.91-0.99) for vigorous PA and 0.93 (95% CI, 0.89-0.98) for walking activity. Significant interactions were found between fish oil supplement use and total PA (P for interaction = 0.011), moderate PA (P for interaction = 0.015), and walking activity (P for interaction = 0.029) in relation to PD incidence. Conclusion: Both fish oil supplement use and PA were associated with a reduced risk of PD, and the effect of PA in reducing the risk of PD was more pronounced when fish oil supplement was used. [ABSTRACT FROM AUTHOR]

Background and aims: Opioids are now the most cited class in fatal overdoses. However, the antidote for opioid overdose—naloxone—is not always readily available. Our aim was to evaluate the feasibility of naloxone transit via drone to provide rapid access at the point of care. Methods and findings: Real‐world data pertaining to opioid overdoses, which occurred in the Teesside area of the UK 2015–2019, were extracted from the National Programme on Substance Abuse Deaths (NPSAD). The original locations of these opioid overdoses were used to compare the projected response times of ambulances with that of drones when considering the impacts of actual traffic and weather conditions, respectively; 58 cases were identified where a bystander—who could have called for and administered emergency naloxone—was likely present. Results: In 78% of cases (n = 45/58) a class C1 commercial‐off‐the‐shelf drone carrying naloxone could have reached the overdose location in 7 min—the benchmark time for the arrival of emergency services for Category 1 calls in England. With the implementation of recent advances in drone engineering, such as increased speeds and temperature‐controlled cargo cradles, it is estimated that 98% of overdoses could have been reached in this timeframe (n = 57/58). Ambulances were able to reach a significantly lower number of cases in 7 min, even when considering best‐case scenario traffic conditions (14%, n = 8/58, χ2P < 0.001). Conclusions: This study provides proof‐of‐concept that, in the Teesside area of the UK, drones are more likely than ambulance to get naloxone to the site of an opioid overdose in 7 min. [ABSTRACT FROM AUTHOR]

Background/Aims: Midwifery degrees require students to study for 3 years, during which they are assessed both academically and in practice placements. This study's aim was to explore year-by-year associations between assessment grades and students' ethnicity as they progressed through their degree. Methods: Retrospective data collected at a single university in the UK were analysed using descriptive statistics. The cohort and variables were stratified by student ethnicity, year of study and assessment grades given for academic work and placement practice assessments. Results: While Black, Asian and minority ethnic students started with lower practice assessment grades in year 1, this improved such that there was no difference in attainment by year 3. In contrast, university academic grades were consistently lower for Black, Asian and minority ethnic versus White students, and this pattern did not change throughout the degree programme. Conclusions: The likely factor in lower final degree outcomes among Black, Asian and minority ethnic students is not from practice assessments but academic performance. Targeted interventions that recognise different learning styles and educational experiences in the university environment may address and improve this inequality in attainment. [ABSTRACT FROM AUTHOR]

Objectives: The effects of the COVID‐19 pandemic on cognitive decline are not fully understood. Higher social activity and relationships have been associated with decreased risk of dementia. We hypothesised that risk of transition to dementia would increase after the start of the first national lockdown. Methods: We obtained data from the Brains for Dementia (BDR) cohort, which has collected roughly annual data on 3726 older adults with and without dementia since 2008. Data continued to be collected during the lockdowns, although by telephone and/or video call instead of in person. Individuals diagnosed with dementia at study entry were excluded from this study as were individuals with only one visit. Cognitive status was classified using the Clinical Dementia Rating (CDR) global score. Poisson regression with cubic splines to account for differences in age was used to compare the incidence of dementia before and after March 1st 2020. Results: Out of 2242 individuals, 208 individuals developed dementia before and 50 developed dementia after 01/03/20. The incidence rate ratio of developing dementia after 01/03/20 was 0.847 (0.538–1.335) p = 0.570. In our secondary analysis we found that the positive association between mild cognitive impairment (MCI) and dementia incidence decreased after 1/3/20 (interaction effect p = 0.031). Conclusion: The incidence of dementia as defined using the CDR global score did not change significantly after the first lockdown began, but we found evidence that lockdown decreased the positive association between MCI and dementia incidence. This may reflect that individuals were progressing to dementia more rapidly and thus missing the MCI stage or that assessing patients over the phone made diagnosing MCI more challenging. Key points: Large cohort study with data collected both before and during the COVID‐19 pandemic.The incidence of dementia did not appear to have increased during the pandemic.The protective measures during the COVID‐19 pandemic may have led to a more rapid decline in cognition in people who developed dementia. [ABSTRACT FROM AUTHOR]

Objectives: To determine the incidence and characteristics of injury and illness in English men's and women's senior and youth international football. Methods: Time-loss injuries and illnesses, alongside match and training exposure, were collected across 8 seasons (2012–2020) in youth (U15, U16, U17, U18, U19) and senior (U20, U21, U23, senior) English men's and women's international teams. Analysis of incidence, burden, and severity of injury and illness was completed. Sex-specific comparisons were made between the senior and youth groups, and across the 8 seasons of data collection. Results: In men's international football, 535 injuries were recorded (216 senior; 319 youth) during 73,326 h of exposure. Overall, match injury incidence (31.1 ± 10.8 injuries/1000 h) and burden (454.0 ± 195.9 d absent/1000 h) were greater than training injury incidence (4.0 ± 1.0 injuries/1000 h) and burden (51.0 ± 21.8 d absent/1000 h) (both P < 0.001). In women's international football, 503 injuries were recorded (senior: 177; youth: 326) during 80,766 h of exposure and match injury incidence (27.6 ± 11.3 injuries/1000 h) and burden (506.7 ± 350.2 days absent/1000 h) were greater than training injury incidence (5.1 ± 1.8 injuries/1000 h) and burden (87.6 ± 32.8 days absent/1000 h) (both P < 0.001). In women's international football, a group × season interaction was observed for training injury incidence (P = 0.021), with the senior group recording a greater training injury incidence during the 2015–2016 season compared to the youth group (14.4 vs 5.7 injuries/1000 h; P = 0.022). There was no difference in injury severity between match and training for men's (P = 0.965) and women's (P = 0.064) international football. Conclusions: The findings provide a comprehensive examination of injury and illness in English men's and women's senior and youth international football. Practitioners will be able to benchmark their team's injury and illness incidence and characteristics to the match-play and training information provided in the present study. [ABSTRACT FROM AUTHOR]

Formula fed infants experience gastrointestinal infections at higher rates than breastfed infants, due in part to bacteria in powdered infant formula (PIF) and bacterial contamination of infant feeding equipment. The United Kingdom National Health Service (UK NHS) has adopted the World Health Organization recommendation that water used to reconstitute PIF is ≥70°C to eliminate bacteria. We used community science methods to co‐design an at home experiment and online questionnaire ('research diary') to explore the safety of PIF preparation compared to UK NHS guidelines. 200 UK‐based parents of infants aged ≤12 months were recruited; 151 provided data on PIF preparation, and 143 were included in the analysis of water temperatures used to reconstitute PIF. Only 14.9% (n = 11) of 74 PIF preparation machines produced a water temperature of ≥70°C compared with 78.3% (n = 54) of 69 kettle users (p < 0.001). The mean temperature of water dispensed by PIF preparation machines was 9°C lower than kettles (Machine M = 65.78°C, Kettle M = 75.29°C). Many parents did not always fully follow NHS safer PIF preparation guidance, and parents did not appear to understand the potential risks of PIF bacterial contamination. Parents should be advised that the water dispensed by PIF preparation machines may be below 70°C, and could result in bacteria remaining in infant formula, potentially leading to gastrointestinal infections. PIF labelling should advise that water used to prepare PIF should be ≥70°C and highight the risks of not using sufficiently hot water, per WHO Europe advice. There is an urgent need for stronger consumer protections regarding PIF preparation devices. Key points: Only 14.9% (n = 11) of 74 PIF preparation machines produced a water temperature of ≥70°C compared with 78.3% (n = 54) of 69 kettle users (p < 0.001).The mean temperature of water dispensed by PIF preparation machines was 9°C lower than kettles (Machine M = 65.78°C, Kettle M = 75.29°C).Most parents routinely washed and sterilised bottles and teats.Many parents did not always fully follow NHS safer PIF preparation guidance, including 21.8% washing their hands half the time or less, and 14.6% regularly pre‐preparing bottles.Most parents did not appear to understand the risks of PIF bacterial contamination. [ABSTRACT FROM AUTHOR]

How do organizational responses to environmental disruptions affect employees' job-related well-being? As the COVID-19 pandemic has led to new ways of working, increased health concerns, and added responsibilities, employees are facing important challenges in doing their work that can affect their job-related well-being. This study aims to understand how different types of work support (i.e., perceived organizational support and supervisor accessibility) in response to environmental disruption interact with personality traits (i.e., core self-evaluations and future focus) to influence changes in employees' affective commitment to their organization and in their job-related well-being. We develop a moderated mediation model and test it on data collected from 295 individuals working in the United Kingdom. We find that work support for the COVID-19 pandemic, both perceived organizational support and supervisor accessibility, is associated with more positive changes in employees' jobrelated well-being and that this effect is mediated by changes in employees' affective commitment to their organization. Furthermore, we find that personality traits moderate the relationships between these two types of support and changes in affective commitment to the organization, with those relationships being more positive for employees with low core self-evaluations and for those with a high future focus. [ABSTRACT FROM AUTHOR]

Background This study aimed to explore differences in users of a COVID-19 mobile vaccine van service and users of a COVID-19 static vaccination hub, and the impact of changes in national COVID-19 vaccine policy on vaccine uptake. Methods The age distribution of male and female service users in each service was compared. The average number of vaccines administered per hour per week was analysed. Results Females aged 80–89 represented 51.9% (95% CI 49.5–54.3%) of female vaccine van users compared with 2.8% (95% CI 2.5–3.1%) of female static hub users. The static hub had significantly greater proportions of female service users in all other age brackets. For males, the greatest difference was in those aged 70–79 who represented 29.8 % (95% CI 27–32.6%) of vaccine van users and 16.6% (95% CI 16–17.2%) static hub users. Fewer vaccines were administered 2–3 weeks before the COVID-19 autumn booster policy change compared with 2–3 weeks after; 1.92 versus 6.25 vaccines per hour, respectively (Mann–Whitney U = 7, n1 = 11, n2 = 8, P < 0.01 two-tailed). Conclusions These findings suggest that a mobile vaccine van service is an effective model for increasing COVID-19 vaccination uptake in elderly residents, particularly after a national policy change. [ABSTRACT FROM AUTHOR]

To compare the distribution of Higher Surgical Training (HST) applications received through the Certificate of Readiness for Higher Surgical (CREHST) route with the traditional Core Surgical Training (CST) route and to evaluate the likelihood of success in obtaining an HST post for each route across all surgical specialities. A national, retrospective cohort study was conducted to compare the proportion of applications and likelihood of success in obtaining an HST post between the two routes during the 2021–22 application cycle in the United Kingdom. Univariate statistical analysis was performed for categorical variables using the chi-squared test, or Fisher exact test. Relative risk was calculated for each route and each surgical speciality. The study included 1964 HST applicants, of which 46% (n = 904) were via the CREHST route. This proportion varied from 23% for otolaryngology to 66% for vascular surgery. The study found that 20% (n = 98) of the available HST posts were awarded to CREHST applicants, ranging from 0% for cardiothoracic surgery to 39% for vascular surgery. For most specialities, applicants from the CREHST route were significantly less likely to be awarded a training post, with relative risks ranging from 0.07 (95% CI 0.01–0.51, p < 0.0001) for otolaryngology to 0.4 (95% CI 0.25–0.79, p = 0.0032) for urology. This study provides valuable insight into the proportion and success of HST applications via the CREHST route. The findings demonstrate that the use of the CREHST route is commonplace across all surgical specialties, but the likelihood of a successful application is significantly lower when compared to the traditional CST route for most specialties. • CRESHT is an alternative route for applying to Higher Surgical Training (HST). • 46% of HST applications were via the CREHST route. • 20% of the available HST posts were awarded to CREHST applicants. • Generally, CREHST applicants were significantly less likely to obtain a HST post. [ABSTRACT FROM AUTHOR]