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Aims This study aimed to: i) identify current teaching practice and approaches to embedding environmental sustainability (ES) in the undergraduate dental curriculum in the UK and Republic of Ireland (ROI); and ii) uncover existing barriers and drivers to incorporating ES in dental education.Methods A questionnaire was developed and distributed to all dental schools in the UK and ROI in the form of an online survey. The intended respondents were deans, heads of schools, directors of education, or senior academics of all dental schools in the UK and ROI that deliver undergraduate dentistry/dental surgery programmes.Results In total, 18 dental schools responded to the survey, representing a response rate of 100% from the intended respondents. Note 56% of dental schools do not currently teach ES. Time constraints and a lack of knowledge and learning resources were the most reported barriers.Conclusion Currently, ES is not taught in most dental schools in the UK and ROI. Many schools face challenges in finalising the delivery modalities of ES teaching, particularly in clinical environments. Numerous barriers have been identified that complicate embedding this topic in the curriculum. Positively, universities, staff, students and the recently published learning outcomes are driving impactful change across the sector., (© 2024. The Author(s).)

The world's elderly population is growing at a rapid pace. This has led to an increase in demand on the health and welfare systems due to age-related disorders, with musculoskeletal complaints driving the need for rehabilitation services. However, there are concerns about health services' ability to meet this demand. While chiropractic care is gaining recognition for its benefits in treating older adults with musculoskeletal disorders, there is limited scientific literature on chiropractors' role and experiences in this area. To bridge this gap, we interviewed 21 chiropractors in Great Britain, the Netherlands, Norway, and Sweden. Inductive qualitative content analysis was used to analyse the interviews, and despite differences in integration and regulation between the countries, several common facilitators and barriers in caring for and managing older patients with musculoskeletal complaints emerged. While participants expressed optimism about future collaborations with other healthcare professionals and the integration of chiropractic into national healthcare systems, they also highlighted significant concerns regarding the existing healthcare infrastructure. The participants also felt that chiropractors, with their non-surgical and holistic approach, were well-positioned to be the primary point of contact for older patients. However, there were some common barriers, such as the affordability of care, limited integration of chiropractic, and the need to prioritise musculoskeletal complaints within public healthcare. Our findings suggest that chiropractors experience their clinical competencies as an underutilised resource in the available healthcare systems and that they could contribute to and potentially reduce the escalating burden of musculoskeletal complaints and associated costs among older patients. Additionally, our findings highlight the desire among the participants to foster collaboration among healthcare professionals and integrate chiropractic into the national public healthcare system. Integrating chiropractors as allied health professionals was also perceived to improve coordinated, patient-centred healthcare for older adults., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Bergström et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: National and international amalgamation of genomic data offers opportunity for research and audit, including analyses enabling improved classification of variants of uncertain significance. Review of individual-level data from National Health Service (NHS) testing of cancer susceptibility genes (2002-2023) submitted to the National Disease Registration Service revealed heterogeneity across participating laboratories regarding (1) the structure, quality and completeness of submitted data, and (2) the ease with which that data could be assembled locally for submission., Methods: In May 2023, we undertook a closed online survey of 51 clinical scientists who provided consensus responses representing all 17 of 17 NHS molecular genetic laboratories in England and Wales which undertake NHS diagnostic analyses of cancer susceptibility genes. The survey included 18 questions relating to 'next-generation sequencing workflow' (11), 'variant classification' (3) and 'phenotypical context' (4)., Results: Widely differing processes were reported for transfer of variant data into their local LIMS (Laboratory Information Management System), for the formatting in which the variants are stored in the LIMS and which classes of variants are retained in the local LIMS. Differing local provisions and workflow for variant classifications were also reported, including the resources provided and the mechanisms by which classifications are stored., Conclusion: The survey responses illustrate heterogeneous laboratory workflow for preparation of genomic variant data from local LIMS for centralised submission. Workflow is often labour-intensive and inefficient, involving multiple manual steps which introduce opportunities for error. These survey findings and adoption of the concomitant recommendations may support improvement in laboratory dataflows, better facilitating submission of data for central amalgamation., Competing Interests: Competing interests: MD and TM have received honoraria from AstraZeneca and MSD for contributions as expert assessors in the GenQA/EMQN GTACT schemes: Ensuring accurate classification of BRCA1, BRCA2 and other HRR gene variants. ACA is the creator of BOADICEA, licensed by Cambridge Enterprise, and receives royalties from Cambridge University. TPM is a council member for the UK Cancer Genetics Group, and has received honoraria from AstraZeneca and Novartis, and consulting fees from Roche as an Expert Advisor for the National Molecular Tumour Board (Ireland). DME was co-applicant on an AstraZeneca Research Grant (2021–2023), is on the University of Southampton Executive Board and is the Non-Executive Director of UHS NHS Foundation Trust. CT has received honoraria from AstraZeneca and MSD for educational activities and scientific boards, which are donated in full to charity., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Introduction This paper explores the declared and formal and informal taught endodontic curriculum within an undergraduate dental programme in the UK as part of a wider study, which also investigates the learned curriculum. Management of the dental pulp was chosen due to the availability of clear internationally recognised guidelines.Method The declared curriculum was identified through existing course guides and seminar and practical session plans. The formal taught curriculum was identified by cataloguing all lectures, practical teaching sessions, seminars and handouts available to dental students. Questionnaires using clinical vignettes were used to explore the informal taught curriculum.Results Valid responses to the questionnaire were received from 25/40 (62.5%) clinical supervisors. Disparities between national guidelines and the declared and taught curriculum were primarily due to broad learning objectives and disparate information from lectures and supervising clinicians. Although the majority of formal teaching aligned with national guidelines, the main deviation occurred within the informal taught curriculum.Conclusion This study highlights disparities between current evidence-based guidelines and the declared and taught curriculum in relation to pulp management in a UK dental school. Recommendations are that all policies, procedures and protocols are updated and aligned to a contemporaneous evidence base annually, plus engagement with clinical lecturers, to enable more standardised teaching., (© 2024. The Author(s), under exclusive licence to the British Dental Association.)

Recent large national and international cohorts describe the baseline characteristics and outcome of hospitalised patients with COVID-19, however there is limited granularity to these reports. We aimed to provide a detailed description of a UK COVID-19 cohort, focusing on management and outcome. We performed a retrospective single-centre analysis of clinical management and 28-day outcomes of consecutive adult inpatients with SARS-CoV-2 PCR-confirmed COVID-19 from 31 January to 16 April 2020 inclusive. In total, 316 cases were identified. Most patients were elderly (median age 75) with multiple comorbidities. One quarter were admitted from residential or nursing care. Mortality was 84 out of 316 (26.6%). Most deaths occurred in patients in whom a ceiling of inpatient treatment had been determined and for whom end of life care and specialist palliative care input was provided where appropriate. No deaths occurred in patients aged under 56 years. Decisions to initiate respiratory support were individualised after consideration of patient wishes, premorbid frailty and comorbidities. In total, 59 (18%) patients were admitted to intensive care, of which 31 (10% overall cohort) required intubation. Multiple logistic regression identified associations between death and age, frailty, and disease severity, with age as the most significant factor (odds ratio 1.07 [95% CI 1.03-1.10] per year increase, p < 0.001). These findings provide important clinical context to outcome data. Mortality was associated with increasing age. Most deaths were anticipated and occurred in patients with advance decisions on ceilings of treatment.

Countries must learn how to capitalize on their citizens' cognitive resources if they are to prosper, both economically and socially. Early interventions will be key.

Objective: To describe the factors associated with HIV testing among heterosexual black Africans aged 16-44 years living in Britain., Design: We analysed data from the second British National Survey of Sexual Attitudes and Lifestyles (Natsal 2000)-a stratified national probability sample survey conducted between 1999-2001. Data from Natsal's main and ethnic minority boost (EMB) samples were analysed. Multivariate analysis was performed using complex survey functions to account for the clustered, stratified, and differential selection probabilities inherent within the survey., Results: A total of 385 (216 women and 169 men) black African respondents were included in the study. 44.0% women and 36.4% men reported ever having had an HIV test. In univariate analysis, HIV testing was associated with being born abroad (OR 3.63), having a new partner(s) from abroad in past 5 years (OR 2.88), and attending a GUM clinic (OR 3.27) among men; and educational attainment (OR 3.50), perception of "not very much" personal risk of HIV (OR 2.75), and attending a GUM clinic (OR 2.91) among women. After adjusting for potential confounders, an increased likelihood of HIV testing was associated with being in the United Kingdom less than 5 years relative to being UK born (adjusted OR 9.49), and ever attending a GUM clinic (adj OR 5.53), for men; and educational attainment (adj OR 4.13), and low perception of HIV risk (adj OR 2.77) for women., Conclusions: Black Africans appear to have relatively high rates of HIV testing reflecting, at least partially, awareness of risk behaviours and potential exposure to HIV. Nevertheless, there remains substantial potential for health gain and innovative approaches are required to further increase timely HIV testing.

Background: Ethnic variations in the rate of diagnosed sexually transmitted infections (STIs) have been reported in many developed countries. We used data from the second British National Survey of Sexual Attitudes and Lifestyles (Natsal 2000) to investigate the frequency of high-risk sexual behaviours and adverse sexual health outcomes in five ethnic groups in Great Britain., Methods: We did a stratified probability sample survey of 11161 men and women aged 16-44 years, resident in Great Britain, using computer-assisted interviews. Additional sampling enabled us to do more detailed analyses for 949 black Caribbean, black African, Indian, and Pakistani respondents. We used logistic regression to assess reporting of STI diagnoses in the past 5 years, after controlling for demographic and behavioural variables., Findings: We noted striking variations in number of sexual partnerships by ethnic group and between men and women. Reported numbers of sexual partnerships in a lifetime were highest in black Caribbean (median 9 [IQR 4-20]) and black African (9 [3-20]) men, and in white (5 [2-9]) and black Caribbean (4 [2-7]) women. Indian and Pakistani men and women reported fewer sexual partnerships, later first intercourse, and substantially lower prevalence of diagnosed STIs than did other groups. We recorded a significant association between ethnic origin and reported STIs in the past 5 years with increased risk in sexually active black Caribbean (OR 2.74 [95% CI 1.22-6.15]) and black African (2.95 [1.45-5.99]) men compared with white men, and black Caribbean (2.41 [1.35-4.28]) women compared with white women. Odds ratios changed little after controlling for age, number of sexual partnerships, homosexual and overseas partnerships, and condom use at last sexual intercourse., Interpretation: Individual sexual behaviour is a key determinant of STI transmission risk, but alone does not explain the varying risk across ethnic groups. Our findings suggest a need for targeted and culturally competent prevention interventions.