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Background: The impact of coronavirus disease 2019 extends far beyond the immediate burden on healthcare systems caused by hospitalisation of patients with the disease itself., Objective: To investigate the impact of the coronavirus disease 2019 pandemic on the referral rate of patients to the suspected head and neck cancer two-week-wait clinic., Methods: A multicentre retrospective study was performed investigating data collected for all patients attending the suspected head and neck cancer two-week-wait clinic in ENT departments in the West Midlands., Results: A total of 509 fast-track referrals were received from February to April in 2019, compared to 399 referrals in 2020. April 2020 saw a 62.4 per cent reduction in referral rate compared to April 2019., Conclusion: The coronavirus disease 2019 pandemic has resulted in changes to health-seeking behaviours, and healthcare provision and delivery. Urgent policy interventions may be required to compensate for the hidden impact that the coronavirus disease 2019 pandemic has had on those with cancer.

Introduction: Evolution of a patient-reported symptom-based risk stratification system to redesign the suspected head and neck cancer (HNC) referral pathway (EVEREST-HN) will use a broad and open approach to the nomenclature and symptomatology. It aims to capture and utilise the patient reported symptoms in a modern way to identify patients’ clinical problems more effectively and risk stratify the patient. Method: The review followed the PRISMA checklist for scoping reviews. A search strategy was carried out using Medline, Embase and Web of Science between January 1st 2012 and October 31st 2023. All titles, abstracts and full paper were screened for eligibility, papers were assessed for inclusion using predetermined criteria. Data was extracted pertaining to the aims, type of study, cancer type, numbers of patients included and symptoms, presenting complaints or signs and symptoms. Results: There were 9,331 publications identified in the searches, following title screening 350 abstracts were reviewed for inclusion and 120 were considered for eligibility for the review. 48 publications met the eligibility criteria and were included in the final review. Data from almost 11,000 HNC patients was included. Twenty-one of the publications were from the UK, most were retrospective examination of patient records. Data was extracted and charted according to the anatomical area of the head and neck where the symptoms are subjectively and objectively found, and presented according to lay terms for symptoms, clinical terms for symptoms and the language of objective clinical findings. Discussion: Symptoms of HNC are common presenting complaints, interpreting these along with clinical history, examination and risk factors will inform a clinician’s decision to refer as suspected cancer. UK Head and Neck specialists believe a different way of triaging the referrals is needed to assess the clinical risk of an undiagnosed HNC. EVEREST-HN aims to achieve this using the patient history of their symptoms. This review has highlighted issues in terms of what is considered a symptom, a presenting complaint and a clinical finding or sign. [ABSTRACT FROM AUTHOR]

This research note reinvestigates Abdellaoui et al.'s (2019) findings that genetically selective migration may lead to persistent and accumulating socioeconomic and health inequalities between types (coal mining or non-coal mining) of places in the United Kingdom. Their migration measure classified migrants who moved to the same type of place (coal mining to coal mining or non-coal mining to non-coal mining) into "stay" categories, preventing them from distinguishing migrants from nonmigrants. We reinvestigate the question of genetically selective migration by examining migration patterns between places rather than place types and find genetic selectivity in whether people migrate and where. For example, we find evidence of positive selection: people with genetic variants correlated with better education moved from non-coal mining to coal mining places with our measure of migration. Such findings were obscured in earlier work that could not distinguish nonmigrants from migrants. [ABSTRACT FROM AUTHOR]

Purpose: Resilience can protect against workplace stress, benefit psychological wellbeing and promote effective clinical practice in mental health professionals. The purpose of this study was to consider the feasibility and acceptability of resilience training for trainee mental health professionals based on the skills-based model of personal resilience (Baker et al., 2021). The study also aimed to explore the impact of the training on resilience, wellbeing and burnout. Design/methodology/approach: In a within-subject 10-week follow-up study, mixed methods were used to evaluate the one-day resilience training for trainee mental health professionals working in services in the UK. Findings: The intervention was found to be acceptable to attendees, with high levels of satisfaction reported. Resilience was evaluated through self-report measures at three-time points. Resilience scores at follow-up were significantly higher than pre- and post-intervention scores. The secondary outcomes of wellbeing and burnout did not significantly improve. Research limitations/implications: Preliminary support was found for the feasibility and acceptability of resilience training for trainee mental health practitioners. Audience-specific adaptations and follow-up groups to aid skills practice and implementation may further enhance benefits to resilience. Resilience interventions may supplement practitioner training to improve resilience. Resilience is associated with higher wellbeing and lower burnout. The impact of resilience training on overall wellbeing and burnout remains uncertain; however, newly learned resilience skills may take time to benefit wellbeing. Originality/value: A key contribution of this study is to provide evidence regarding the feasibility of implementing the skills-based model of personal resilience, outlined in Baker et al. (2021), in a learning environment. [ABSTRACT FROM AUTHOR]

Sexual identity is fluid. But just how fluid is it? How does such fluidity vary across demographic groups? How do mainstream measures fare in capturing the fluidity? In analyzing data from the United Kingdom Household Longitudinal Study (N = 22,673 individuals, each observed twice), this research note provides new, populationwide evidence of sexual identity mobility--change and continuity in individuals' sexual orientation identification--in the United Kingdom. Overall, 6.6% of the respondents changed their sexual identity reports between 2011-2013 and 2017-2019. Sexual identity mobility follows a convex pattern over the life course, with higher mobility rates at the two ends than in the middle of the age spectrum. Sexual identity mobility is more prevalent among women, ethnic minority individuals, and the less educated. Changes in people's self-reported sexual identity are closely associated with changes in their partnership status and partner's sex. However, inferring individuals' sexual identity from their partner's sex substantially underestimates the degree of sexual fluidity compared with people's self-reported sexual identity. Our findings encourage researchers and data collectors to fully examine sexual identity mobility and consider its implications for measuring sexual identity. [ABSTRACT FROM AUTHOR]

The authors explore the relationship between language and interpersonal dynamics within supervision groups for psychoanalytically oriented child and adolescent psychotherapists working at a charitable clinical service in a large metropolitan city in the UK. Using discourse analysis, the authors identified key interpersonal functions of language in a professional supervisory setting. Results revealed linguistic processes through which power identities and dynamics were enacted and multiple opinions and perspectives negotiated during group supervision. The authors then make practical suggestions regarding the management of power differentials and interpersonal relationships to facilitate more constructive group supervision and promote better therapeutic outcomes. [ABSTRACT FROM AUTHOR]

Immigrant populations typically have lower mortality rates and longer life expectancies than their nonimmigrant counterparts. This immigrant mortality advantage has been a recurrent finding in demographic and population health research focused on contemporary waves of immigration. However, historical data suggest that European immigrants to the United States in the early twentieth century had worse health and higher rates of mortality, yet it remains unclear why a mortality advantage was absent for immigrants during this period. This article combines Vital Statistics records and Lee-Carter mortality models to analyze mortality by nativity status for the U.S. White population from 1900 to 1960, examining variation by age, sex, time, and place. Contrary to contemporary expectations of a foreign-born mortality advantage, White immigrants had higher mortality rates in the early 1900s, with the largest foreign-born disadvantage among the youngest and oldest populations. Although foreign-born and U.S.-born White mortality rates trended toward convergence over time, the foreign-born mortality penalty remained into the 1950s. A decomposition analysis finds that immigrants' concentration in cities, which had higher rates of infectious disease mortality, accounted for nearly half of the nativity difference in 1900, and this place effect declined in subsequent decades. Additional evidence, such as a spike in mortality inequalities during the 1918 influenza pandemic, suggests that common explanations for the immigrant mortality advantage may be less influential in a context of high risk from infectious disease. [ABSTRACT FROM AUTHOR]

This article2 describes a group for those bereaved following the death through suicide of a doctor. It describes why it was formed, how it links to Foulkes' matrix and, the conscious and unconscious processes which take place. This was the first gathering of a group of this kind in the United Kingdom. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the factors that influence decisions made by health professionals when assessing the pain of native English speaking and children whose English is an additional language. Background: Pain assessment in children is often poorly executed following acute injury. Whilst a range of pain assessment tools have been developed, little guidance is provided for assessing pain in children with English as an additional language. Design: Factorial survey design. Methods: Twenty minor injuries unit nurses and 20 children's nursing students participated in an electronic survey to make judgements on 12 scenarios describing a child attending a minor injuries unit following an incident, accompanied by a parent. Respondents had to decide the most important form of pain assessment, and whether they would ask a parent or an interpreter to assess the pain of the child. An open‐ended question asked about the difficulties found in making a judgement. Results: Observation of the child's behaviour was the most common pain assessment reported. The visual analogue scale was significantly associated with children with proficient English. Respondents were significantly more likely to involve parents in the assessment if they could speak English well compared to parents with poor English skills. Moreover, nursing students were significantly more likely than registered nurses to call for support from an interpreter. Thematic analysis identified three themes related to difficulties with pain assessment: contrasting approaches, differing perceptions of pain and overcoming challenges. Conclusions: The reduced ability to communicate between child, parent and healthcare professional highlights the need to identify forms of assessment based on individual cases. Relevance to clinical practice: The number of children with English as an additional language has seen a marked rise over the last decade. In situations where communication ability is reduced, assessment of pain should be tailored to meet the needs of the child. This may require timely access to interpreter services. [ABSTRACT FROM AUTHOR]

An editorial is presented on the plethora of advantages, such as ambidextrous hand mobility and stereopsis. It outlines improved visualization of the surgical field provided by the endoscope enables less bony auditory canal drilling and less post-operative pain, as well as limited manipulation of the chorda tympani, leading to better rates regarding post-operative dysgeusia. An overview of the studies endoscopic stapes surgery is presented.

Objectives.In this study we aimed to test the associations between area-level ethnic density and health for Pakistani and White British residents of Bradford, England. Design.The sample consisted of 8610 mothers and infant taking part in the Born in Bradford cohort. Ethnic density was measured as the percentage of Pakistani, White British or South Asian residents living in a Lower Super Output Area. Health outcomes included birth weight, preterm birth and smoking during pregnancy. Associations between ethnic density and health were tested in multilevel regression models, adjusted for individual covariates and area deprivation. Results.In the Pakistani sample, higher own ethnic density was associated with lower birth weight (β= −0.82, 95% CI: −1.63, −0.02), and higher South Asian density was associated with a lower probability of smoking during pregnancy (OR = 0.99, 95% CI: 0.98, 1.00). Pakistani women in areas with 50−70% South Asian residents were less likely to smoke than those living in areas with less than 10% South Asian residents (OR = 0.39, 95% CI: 0.16, 0.97). In the White British sample, neither birth weight nor preterm birth was associated with own ethnic density. The probability of smoking during pregnancy was lower in areas with 10−29.99% compared to <10% South Asian density (OR = 0.79, 95% CI: 0.64, 0.98). Conclusion.In this sample, ethnic density was associated with lower odds of smoking during pregnancy but not with higher birth weight or lower odds of preterm birth. Possibly, high levels of social disadvantage inhibit positive effects of ethnic density on health. [ABSTRACT FROM PUBLISHER]

Nutrient deficiencies have been implicated in anti-social behaviour in schoolchildren; hence, correcting them may improve sociability. We therefore tested the effects of vitamin, mineral and n-3 supplementation on behaviour in a 12-week double-blind randomised placebocontrolled trial in typically developing UK adolescents aged 13–16 years (n 196). Changes in erythrocyte n-3 and 6 fatty acids and some mineral and vitamin levels were measured and compared with behavioural changes, using Conners’ teacher ratings and school disciplinary records. At baseline, the children’s PUFA (n-3 and n-6), vitamin and mineral levels were low, but they improved significantly in the group treated with n-3, vitamins and minerals (P=0·0005). On the Conners disruptive behaviour scale, the group given the active supplements improved, whereas the placebo group worsened (F =5·555, d=0·35; P =0·02). The general level of disciplinary infringements was low, thus making it difficult to obtain improvements. However, throughout the school term school disciplinary infringements increased significantly (by 25 %; Bayes factor =115) in both the treated and untreated groups. However, when the subjects were split into high and low baseline infringements, the low subset increased their offences, whereas the high-misbehaviour subset appeared to improve after treatment. But it was not possible to determine whether this was merely a statistical artifact. Thus, when assessed using the validated and standardised Conners teacher tests (but less clearly when using school discipline records in a school where misbehaviour was infrequent), supplementary nutrition might have a protective effect against worsening behaviour. [ABSTRACT FROM AUTHOR]

Using the Longitudinal Study of Young People in England (LSYPE), this study examines how different combinations of aspirations, expectations and school achievement can influence students' future educational behaviour (applying to university at the age of 17-18). The study shows that students with either high aspirations or high expectations have higher school achievement than those with both low aspirations and low expectations. Furthermore, complete alignment between high aspirations, high expectations and high achievement is the most important predictor of future educational behaviour among students. However, it is also found that low expectations do not negatively impact students' future behaviour when they have high aspirations accompanied with high school achievement. Additionally, the study finds significant ethnic differences in favour of white students at GCSE level, but that these differences are reversed in relation to applying to university at the age of 17-18. [ABSTRACT FROM AUTHOR]

Objectives Previous research exploring therapist self-disclosure ( TSD) indicates that when therapeutically relevant and used sparingly it can have a beneficial effect for the client, particularly when the client is a member of a stigmatised population. There is a dearth of literature exploring the experience of disclosing from the perspective of the clinician. Method The current study sought to bridge this gap by utilising Interpretative Phenomenological Analysis ( IPA) to explore the experiences of lesbian, gay and bisexual ( LGB) mental health practitioners' disclosing sexual orientation to clients. Eight self-identifying LGB clinicians with experiences of disclosing sexual orientation to clients working within the NHS were interviewed for this study. Results Analysis revealed core themes around the perceived effects of disclosure vs. concealment on the clinician, client and relationship. Participants experienced an enhancing effect of the disclosure. A corresponding cost to themselves and to the relationship was feeling the need to keep their sexual orientation concealed. Conclusions This study provides a valuable insight into the experiences of LGB clinicians engaging in supportive and therapeutic relationships. The findings indicate some additional difficulties that TSD may pose for these individuals and points to the unique and contextually dependent factors involved in this disclosure and its perceived effects. [ABSTRACT FROM AUTHOR]

Social integration in older age is a key quality of life component and is associated with reduced mortality and morbidity risk. There are socio-economic differences in social integration, but the influence of different indicators of socio-economic position on long-term change in social integration at older ages is not known. This study aimed to identify profiles of social integration across adulthood and explore the impact of various socio-economic indicators at different ages. Data were drawn from the MRC National Survey of Health and Development. A latent class analysis used measures of contact with friends and family, participation in group activities and marital status at ages 36, 43 and 60-64 to identify profiles of change in social integration for men and women. One-step analyses related profiles to father's occupation-based socio-economic position, own educational attainment and head of household occupation-based socio-economic position. Four profiles of social integration were identified for men: high and maintained, married; medium and maintained, married; declining, married; and declining, unmarried. Higher head of household occupation and educational attainment were associated with greater likelihood of maintained integration. Four profiles of social integration were also identified for women: high and maintained, married; high and maintained, unmarried; declining group participation, unmarried; and declining group participation, married. Higher socio-economic position on all indicators was associated with greater likelihood of maintained integration. Lower socio-economic groups are more likely to experience declining social integration by early old age. Support to promote social integration may be particularly important for those with lower occupational grade or education. [ABSTRACT FROM AUTHOR]

Abundant U.S. research documents an 'immigrant advantage' in children's physical health. This article extends consideration to the United Kingdom, permitting examination of a broader group of immigrants from disparate regions of the world and different socioeconomic backgrounds. Drawing on birth cohort data (ages 0-5) from both countries ( n = 4,139 and n = 13,381), the analysis considers whether the children of immigrants have a physical and mental health advantage around the beginning of elementary school, and whether advantage is more pronounced among low-educated populations. Findings indicate that the children of immigrants are not uniformly healthier than those in native-born families. Rather, there is heterogeneity in the immigrant advantage across outcomes, and evidence of both greater advantage and disadvantage among children in low-educated immigrant families. [ABSTRACT FROM AUTHOR]

The relationship between cognitive style and trainee teacher conceptions of differentiation was studied to develop appropriate scaffolding of their learning. 149 trainee teachers enrolled on 1 year postgraduate initial teacher education (ITE) programmes at two UK universities completed the Cognitive Style Index (Allinson and Hayes, Journal of Management Studies, 33(1):119-135, ; Hodgkinson and Sadler-Smith, Journal of Occupational and Organisational Psychology, 76(2):243-268, ) and a questionnaire exploring their understanding of differentiation, conceptions of learning and learning preferences. A stratified sample of these trainees was also interviewed to assess their understanding and prior knowledge of differentiation and learning styles and how they would plan for these in the classroom. Responses were coded using content analysis procedures. Cognitive style was found to impact on trainees' conceptions of differentiation; for example, trainees demonstrating higher levels of analysis and intuition had a more developed understanding of differentiation than other cognitive styles. In relation to the findings, the use of a constructivist pedagogical tool: a Personal Learning Styles Pedagogy (Evans and Waring, Zhang & Sternberg (Eds.), Perspectives on the nature of intellectual styles, ) is presented to inform the reconceptualisation of ITE programmes. In so doing, the use of this tool addresses key issues raised in recent international policy debates concerning the necessary development of ITE for twenty-first century learner needs. [ABSTRACT FROM AUTHOR]