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Aim: To gain staff feedback on the implementation and impact of a novel ambulatory monitoring system to support coronavirus patient management on an isolation ward. Design: Qualitative service evaluation. Methods: Semi‐structured interviews were conducted with 15 multidisciplinary isolation ward staff in the United Kingdom between July 2020 and May 2021. Interviews were audio‐recorded, transcribed and analysed using thematic analysis. Findings: Adopting Innovation to Assist Patient Safety was identified as the overriding theme. Three interlinked sub‐themes represent facets of how the system supported patient safety. Patient Selection was developed throughout the pandemic, as clinical staff became more confident in choosing which patients would benefit most. Trust In the System described how nurses coped with discrepancies between the ambulatory system and ward observation machines. Finally, Resource Management examined how, once trust was built, staff perceived the ambulatory system assisted with caseload management. This supported efficient personal protective equipment resource use by reducing the number of isolation room entries. Despite these reported benefits, face‐to‐face contact was still highly valued, despite the risk of coronavirus exposure. Conclusion: Hospital wards should consider using ambulatory monitoring systems to support caseload management and patient safety. Patients in isolation rooms or at high risk of deterioration may particularly benefit from this additional monitoring. However, these systems should be seen as an adjunct to nursing care, not a replacement. Implications for the Profession and/or Patient Care: Nurses valued ambulatory monitoring as a means of ensuring the safety of patients at risk of deterioration and prioritizing their workload. Impact: The findings of this research will be useful to all those developing or considering implementation of ambulatory monitoring systems in hospital wards. Reporting Method: This manuscript follows the Consolidated criteria for Reporting Qualitative Research (COREQ) guidelines with inclusion of relevant SQUIRE guidelines for reporting quality improvement. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are well-established risk factors for COVID-19 severity; however, less is known about the role of sedentary behaviors such as television (TV) viewing. The purpose of this brief report was to determine whether lower TV viewing time may mitigate the risk of severe COVID-19 in individuals with excess weight. Methods: We analyzed 329,751 UK Biobank participants to investigate the independent and combined associations of BMI and self-reported TV viewing time with odds of severe COVID-19 (inpatient COVID-19 or COVID-19 death). Results: Between March 16 and December 8, 2020, there were 1648 instances of severe COVID-19. Per 1-unit (hours per day) increase in TV viewing time, the odds of severe COVID-19 increased by 5% (adjusted odds ratio = 1.05, 95% confidence interval = 1.02–1.08). Compared with normal-weight individuals with low (≤1 h/d) TV viewing time, the odds ratios for overweight individuals with low and high (≥4 h/d) TV viewing time were 1.17 (0.89–1.55) and 1.66 (1.31–2.11), respectively. For individuals with obesity, the respective ORs for low and high TV viewing time were 2.18 (1.61–2.95) and 2.14 (1.69–2.73). Conclusion: Higher TV viewing time was associated with higher odds of severe COVID-19 independent of BMI and moderate to vigorous physical activity. Additionally, low TV viewing time may partly attenuate the elevated odds associated with overweight, but not obesity. [ABSTRACT FROM AUTHOR]

Simple Summary: For dogs and their owners to live in harmony, owner expectations and the behaviour of their dogs need to be aligned. Limited socialisation can contribute to the development of undesirable behaviours, so the reduced socialisation opportunities for many puppies during the COVID-19 lockdown is a concern. This United Kingdom/Republic of Ireland study used data collected between May 2016 and November 2022 to examine the impact of age and lockdown phase (pre-, during, and post-) on the types of socialisation experiences of 8-to-19-week-old puppies and the recency of socialisation experiences of 6-month-old puppies. The findings showed that puppies under 19-weeks had more types of experiences as they aged, and during pre-lockdown compared to post-lockdown, but not between other lockdown phases. Most 6-month-old puppies had met new adults or dogs, familiar dogs, or children within the last 1–7 days, regardless of lockdown phase. However, during lockdown, 6-month-old puppies experienced longer periods between meeting new adults in their homes. Overall, lockdown had a smaller impact on socialisation experiences than expected, but the quantity and quality of these experiences may have been affected. Future research will explore whether these early-life experiences relate to adult behaviour as the dogs in the study grow older. Limited socialisation can contribute to the development of undesirable dog behaviours. The COVID-19 lockdown potentially limited socialisation opportunities, which may negatively impact the future behaviour of puppies raised during lockdown. Data were gathered from longitudinal study participants in the United Kingdom/Republic of Ireland via multiple questionnaires between May 2016 and November 2022. The impact of age and lockdown phase (pre-, during, and post-) on the types of socialisation experiences of 8-to-19-week-old puppies and the recency of socialisation experiences of approximately 6-month-old puppies were examined. Puppies under 19-weeks had significantly more types of socialisation experiences (from a predefined list) as they aged, and pre-lockdown compared to post-lockdown, but not between other lockdown phases. Most 6-month-old puppies had met a new adult or dog outside the household, a familiar dog, and/or a child within the last 1–7 days, and this was similar between lockdown phases. During lockdown, 6-month-old puppies experienced longer periods between meeting a new adult in their home. Puppies were hypothesised to have had fewer experiences during lockdown, but this was not found. However, the quantity and quality of these experiences may have been affected. Future research within this longitudinal study will explore relationships between the timing and type of experiences had by puppies and their subsequent behaviour. [ABSTRACT FROM AUTHOR]

Some patients with COVID-19 develop symptoms after the acute infection, known as 'Long COVID'. We examined whether or not confirmation of COVID-19 infection status could act as a nocebo, using data from questionnaires distributed to the Avon Longitudinal Study of Parents and Children cohort. We examined associations between confirmation of COVID-19 infection status (confirmed by a positive test vs unconfirmed) and reporting of Long COVID symptoms. We explored the roles of sex and anxiety as potential moderators. There was no clear evidence of a strong association between confirmation of COVID-19 infection status and the Long COVID composite score, physical or psychological symptoms or duration of symptoms. There was no clear evidence of moderation by sex or anxiety. We therefore found no evidence of a nocebo effect. Our data suggest that this psychological mechanism does not play a role in the medical symptomatology experienced by patients with Long COVID. [ABSTRACT FROM AUTHOR]

The emergence of COVID-19 impacted teaching across the globe and this study is the first to examine the impact it had on the delivery of training within policing by seeking to address how police services in the United Kingdom adapted their delivery during the pandemic. The study achieves this by focussing on 3 aims (1) How did police services in the United Kingdom adapt delivery of training and education during the COVID-19 pandemic? (2) What was the impact of the adaptations? For example, what worked and what did not? (3) What can be done in preparedness for future significant interruptions in police training and education? In pursuing these aims, the study identifies reliance on predominately pedagogic approaches such as increased use of the National Centre for Applied Learning Technologies (NCALT), instructor led power-point presentations and pre-recorded material, undermining engagement and motivation towards training amongst officers. Discussion outlines proposals for improving present police training and in future pandemics. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the effectiveness of UK government COVID-19 safe offices policy to increase stair use in a higher education setting during the COVID-19 pandemic. Methods: Automated counts at 3 ground floor staircases and the elevator entrances were used to estimate stair to elevator use ratio for ascent and descent from/to the ground floor of a university building at baseline (January to March 2020), first and second intervention months (October 2020, November 2020, respectively). Stair promoting signage and a 1-way system was implemented, in line with government policy. Results: At baseline, stair to elevator use ratio for ascent from and descent to the ground floor was 1.36 (0.02) and 1.88 (0.02) people, respectively. The ratio significantly increased in the first intervention month to 2.64 (0.09) and 3.96 (0.22) people for ascent and descent, respectively. However, the ratio decreased between the first and second intervention months to 1.63 (0.06) and 3.05 (0.52) people for ascent and descent, respectively. Conclusion: The UK government COVID-19 policy was effective at increasing stair use in a higher education setting. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To explore the use and uptake of video group consultations (VGCs) by UK general practice staff during the COVID-19 pandemic • To enhance your awareness of the potential use of VGCs in your clinical setting • To recognise that the use of VGCs is dependent on funding, organisational support, general practice priorities and understanding of the model. Background: Video group consultations (VGCs) are one approach to delivering care using a virtual platform for a group of patients with the same or similar health conditions. However, little is known about the use and uptake of VGCs in the UK. Aim: To describe the use and uptake of VGCs by UK general practice staff during the coronavirus disease 2019 pandemic. Method: A cross-sectional design using an online questionnaire. Data analysis adopted the principles of content analysis and demographic data were analysed descriptively. Findings: A total of 36 participants completed the questionnaire across nine UK regions and representing 36 general practices. A lack of standardisation regarding the use and uptake of VGCs across UK general practices was identified, hindering implementation, scale-up and delivery. Conclusion: While the VGC model looks promising, further research is needed to demonstrate its use and uptake, developing a more robust evidence base for implementation. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has affected many industries, and reports indicate that this includes the illicit drug market. Recent research suggests that the homeless are particularly vulnerable during the pandemic, and the UK Government has acted to house rough sleepers. Research is scarce regarding homeless people's experiences of the illicit drug market. This study aims to explore homeless people's experiences of the drug supply in the UK during COVID-19. Design/methodology/approach: Eight homeless people who use illicit drugs, residing in hostels for homeless people in Southampton, participated in semi-structured one-on-one telephone-based interviews. Findings: A thematic analysis revealed five themes: availability of drugs, presence of dealers, quality of drugs, finances and personal experiences. Participants reported varying experiences of the drug supply, with lockdown measures expressed as the main reason for reduced supplies, as users found it difficult to find dealers and generate income for purchasing drugs. Research limitations/implications: The results may lack generalisability to the wider population, such as rough sleepers and drug dealers, suggesting a need for further research into people's experiences of the drug supply during COVID-19. Research on this topic could be more in-depth through the use of research methods that are convenient for the homeless population. Practical implications: Services should invest in harm reduction services and encourage homeless people who use drugs to engage in substitution treatment. Homeless services should provide psychological support for homeless people who use drugs. Social implications: The changes in homeless people's behaviour following the pandemic may have implications for their interactions with the rest of society (e.g. begging in town centres may reduce). These changes in behaviour may also change the way society can best support homeless people. Originality/value: The results are partially consistent with other research findings about the illicit drug supply; however, they also suggest that some individuals experienced minimal change in the illicit drug supply. [ABSTRACT FROM AUTHOR]

For people with social anxiety, ongoing exposure to feared situations is crucial for both treatment and the prevention of relapse. The COVID‐19 pandemic—with prolonged, often enforced, reductions in people's social contact—reduced such exposure and may thus have exacerbated social anxiety symptoms. In this three‐wave longitudinal study (N = 212) we explored whether people's membership in multiple groups could protect against anticipatory anxiety for, and avoidance of, social situations. In line with our predictions, pre‐pandemic multiple group memberships reduced anticipatory anxiety and avoidance at Waves 1 and 2 (June and August 2020). Controlling for participants' pre‐pandemic multiple group memberships, maintained group memberships (from pre‐pandemic to Wave 2) predicted lower Wave 2 anticipatory anxiety and avoidance, and lower Wave 2 anticipatory anxiety predicted reduced social anxiety symptoms at Wave 3. These findings are discussed with an emphasis on how social identity theorising and cognitive behavioural approaches to social anxiety can be successfully integrated. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had far-reaching effects, not only on public health but also on the global economy, social interactions, and daily life. It has highlighted the importance of global cooperation and the need for more investment in public health and emergency preparedness. The pandemic also exposed weaknesses in many countries' educational management systems; it has forced many higher education institutions to adopt new teaching and learning methods to minimize the risk of transmission. This resulted in the need for comparative studies to evaluate the effectiveness of different pedagogical responses and to find common ground on the most effective practices and responses that would help higher education institutions better prepare for similar challenges in the future. The present study provides a comparative study and outcomes through a record of the pedagogical responses by higher education authorities in two completely different contexts (Algeria and the UK). The authors of the paper adopted a desktop analysis approach through valid and first-hand reliable sources like government and university official releases. This research methodology would involve a systematic and rigorous approach to data collection and analysis to ensure the reliability and validity of the research findings. Through coding and thematic analysis of the collected data, the researchers concluded that the efficiency of the responses and decisions adopted by higher education institutions varied depending on a range of factors such as the institution's resources, infrastructure, and student population. However, the pandemic highlighted the need for agile and serious responses to ensure the safety and well-being of students and the campus community. [ABSTRACT FROM AUTHOR]

This paper investigates how pronouns were used by UK government speakers to allocate responsibility to themselves and others in all 92 daily televised COVID-19 briefings that were held between March and June 2020. We identified the referent for every use of the first-person plural pronoun (1PL) as 'inclusive', 'exclusive', or 'ambiguous' and analysed the transitivity patterns in which these pronouns act as Participants. We argue that the UK government uses the inherent ambiguity of this pronoun to strategically mitigate their own responsibility for controlling the spread of the virus, while increasing the amount of responsibility to the general public. In doing so, we propose a transparent and replicable systematic method for identifying the referents of pronouns, which may be useful to other discourse analysts faced with the challenging task of pronoun resolution. [ABSTRACT FROM AUTHOR]

Background: Services for patients with kidney disease underwent radical adaptations in response to the COVID-19 pandemic. We undertook an online national survey of UK kidney centres to understand the nature, range, and degree of variation in these changes and to explore factors contributing to differing practice. Methods: The survey was designed by a multidisciplinary team of kidney professionals, service users and researchers. It enquired about centre services and staffing, including psychosocial provision, and changes to these in response to the COVID-19 pandemic. Links to the survey were sent to all 68 UK kidney centres and remained active from December 2021 to April 2022, and a revised version to nurses in late 2022 for additional data. Quantitative data were analysed descriptively. Content analysis on free-text responses identified common themes. Results: Analysable responses were received from 41 out of the 68 UK centres (60%), with partial data from an additional 7 (11%). Adaptations were system-wide and affected all aspects of service provision. Some changes were almost universal such as virtual consultations for outpatient appointments, with significant variation in others. Outpatient activity varied from fully maintained to suspended. Many centres reduced peritoneal dialysis access provision but in some this was increased. Centres considered that changes to transplant surgical services and for patients with advanced CKD approaching end-stage kidney disease had the greatest impact on patients. Few centres implemented adjustments aimed at vulnerable and underrepresented groups, including the frail elderly, people with language and communication needs, and those with mental health needs. Communication issues were attributed to rapid evolution of the pandemic, changing planning guidance and lack of resources. Staffing shortages, involving all staff groups particularly nurses, mainly due to COVID-19 infection and redeployment, were compounded by deficiencies in staffing establishments and high vacancy levels. Centres cited three main lessons influencing future service delivery, the need for service redesign, improvements in communication, and better support for staff. Conclusion: Kidney centre responses to the pandemic involved adaptations across the whole service. Though some changes were almost universal, there was wide variation in other areas. Exploring the role of centre characteristics may help planning for potential future severe service disruptions. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether Covid19 had a tangible effect on urology training in Wales. There has been no Welsh data available concerning how training has changed during the covid pandemic. This survey evaluated the overall impact on training, with the primary aims to identify changes in clinical and academic activities and evaluate a trainees' wellbeing during the crisis. Materials and methods: Online questionnaires were sent to all Urology Trainees; n = 20 (83% response) working in the Welsh deanery in the United Kingdom, asking about changes in training particularly within operating list, out-patient clinics, diagnostic activities, educational courses, teaching sessions and examinations. Results: Across Wales trainees experienced a reduction in operating procedures, clinics and teaching courses. Due to a redesign of services, there was only a minimal impact on training for cancer diagnostics and Multi-Disciplinary Team (MDT) meetings. The majority of trainees felt their index procedures and ability to complete training will be affected. Conclusion: Cancer work, including cancer related theatre lists, diagnostics and MDT were maintained. Trainees lacked confidence that they would reach their operative competencies and struggle to successfully complete training. Following BAPIO discussion, we suggest that training programmes readjust to focus on areas where exposure has been lacking. [ABSTRACT FROM AUTHOR]

Background: Participant involvement in research studies is not a new concept, yet barriers to implementation remain and application varies. This is particularly true for pandemic response research studies, where timeframes are condensed, pressure is high and the value and inclusion of participant involvement can be overlooked. The SIREN Participant Involvement Panel (PIP) provides a case study for participant involvement in pandemic research, working in partnership with people who the research is for and about. Methods: SIREN and the British Society for Immunology (BSI) recruited and ran two phases of the PIP, involving 15 members in total over a 16-month period. Phase 1 ran between January and August 2022 and Phase 2 between October 2022 and March 2023. Activity figures including recruitment interest and PIP meeting attendance were recorded. To evaluate how the PIP has influenced SIREN, feedback was collected from (a) researchers presenting at the PIP and (b) PIP members themselves. Evaluation at the end of Phase 1 informed our approach to Phase 2. Thematic grouping was planned to identify key lessons learned. Results: Applications increased from n = 30 to n = 485 between Phase 1 and Phase 2 of the PIP, a more than 15-fold increase. The SIREN PIP positively impacted the design, implementation and evaluation phases of the study and sub-studies. Feedback from PIP members themselves was positive, with members highlighting that they found the role rewarding and felt valued. Learnings from the PIP have been condensed into five key themes for applying to future pandemic response research studies: the importance of dedicated resources; recruiting the right panel; understanding motivations for participant involvement; providing flexible options for involvement and enabling the early involvement of participants. Conclusions: The SIREN PIP has demonstrated the value of actively involving people who research is for and about. The PIP has provided an active feedback mechanism for research and demonstrated a positive influence on both SIREN study researchers and PIP members themselves. This paper makes the case for participant involvement in future pandemic research studies. Future work should include improved training for researchers and we would support the development of a national PIP forum as part of future pandemic research preparedness. Plain English summary: The SARS-Cov2 Immunity & Reinfection Evaluation (SIREN) study was set-up at speed during the early stages of the pandemic to help answer key questions about COVID-19 and inform the national pandemic response. It has provided valuable insight into COVID-19 infections, reinfections, and how well the vaccines work. SIREN helped to find these answers by regularly testing over 44,000 healthcare staff working at 135 NHS organisations. To support participant retention, SIREN established a Participant Involvement Panel (PIP) involving 15 SIREN participants to date. PIP members provide guidance and feedback to SIREN researchers on key research priorities, changes to the study and strategies for maximising participant engagement. This paper provides insight into how the PIP was set-up, run and the resources required from the perspective of the PIP and SIREN researchers. Lessons learned from establishing the PIP are summarised to help inform future pandemic response research studies. The paper adds to the evidence base, and makes the case for, the valuable role participant involvement can play in pandemic response research studies. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic had a significant impact on the operations and functionality of the public transport sector in the UK. This paper reflects on the experience of this sector through the pandemic period, and considers recommendations for any future mitigations required for either new COVID-19 waves or a different public health emergency. Methods: Semi-structured interviews were carried out with public transport experts, organisational leaders, workers and passengers in two phases: Phase 1 from January to May 2021, and Phase 2 from December 2021 to February 2022. Interviews were analysed thematically. Results: Using the 'What? So What? Now What?' reflective model, ideas are drawn out to describe (a) what changes occurred, (b) what effects these changes had on service provision as well as perceptions of risk and mitigation and (c) what lessons have been learned and how these findings can feed into pandemic preparedness for the future. Respondent reflections focussed on the importance of communication, leadership, and maintaining compliance. Conclusions: The wealth of experience gained through the COVID-19 pandemic in the public transport sector is extremely valuable. Through reflection on this experience, specific recommendations are made relating to these factors, covering: maintaining links across industry, access to information and data, understanding of mitigation effectiveness, improving messaging, challenges of behavioural mitigations, and clear lines of accountability. The recommendations made on the basis of this reflective process will help to improve public health strategy within the public transport sector. [ABSTRACT FROM AUTHOR]

Background: The World Health Organisation declared the novel Coronavirus disease (COVID-19) a global pandemic on 11th March 2020. Since then, the world has been firmly in its grip. At the time of writing, there were more than 767,972,961 million confirmed cases and over 6,950,655 million deaths. While the main policy focus has been on controlling the virus and ensuring vaccine roll-out and uptake, the population mental health impacts of the pandemic are expected to be long-term, with certain population groups affected more than others. Methods: The overall objectives of our 'Coronavirus: Mental Health and the Pandemic' study were to explore UK adults' experiences of the Coronavirus pandemic and to gain insights into the mental health impacts, population-level changes over time, current and future mental health needs, and how these can best be addressed. The wider mixed-methods study consisted of repeated cross-sectional surveys and embedded qualitative sub-studies including in-depth interviews and focus group discussions with the wider UK adult population. For this particular inequalities and mental health sub-study, we used mixed methods data from our cross-sectional surveys and we carried out three Focus Group Discussions with a maximum variation sample from across the UK adult population. The discussions covered the broader topic of 'Inequalities and mental health during the Coronavirus pandemic in the UK' and took place online between April and August 2020. Focus Groups transcripts were analysed using thematic analysis in NVIVO. Cross-sectional survey data were analysed using STATA for descriptive statistics. Results: Three broad main themes emerged, each supporting a number of sub-themes: (1) Impacts of the pandemic; (2) Moving forward: needs and recommendations; (3) Coping mechanisms and resilience. Findings showed that participants described their experiences of the pandemic in relation to its impact on themselves and on different groups of people. Their experiences illustrated how the pandemic and subsequent measures had exacerbated existing inequalities and created new ones, and triggered various emotional responses. Participants also described their coping strategies and what worked and did not work for them, as well as support needs and recommendations for moving forward through, and out of, the pandemic; all of which are valuable learnings to be considered in policy making for improving mental health and for ensuring future preparedness. Conclusions: The pandemic is taking a long-term toll on the nations' mental health which will continue to have impacts for years to come. It is therefore crucial to learn the vital lessons learned from this pandemic. Specific as well as whole-government policies need to respond to this, address inequalities and the different needs across the life-course and across society, and take a holistic approach to mental health improvement across the UK. [ABSTRACT FROM AUTHOR]

Introduction: During the SARS-CoV-2 pandemic, maternity care has been substantially altered to reduce transmission of the SARS-CoV-2 virus. Many antenatal services are now restricted or delivered online, and visiting has been restricted during labour and in the postnatal period. Methods: We conducted an online survey from 1st August to 31st December 2020 to investigate the experiences of women who were pregnant or breastfeeding in the UK during the SARS-CoV-2 pandemic. The survey included 55 open and closed questions and required 5 min to complete. We publicised the survey using social media. Results: We received 96 responses, including 66 currently pregnant women and 22 women who were pregnant during the pandemic. The response rate was 70.1% of survey views. We found mixed experiences of the impact of the pandemic on antenatal and perinatal care, notably with some women feeling visiting restrictions were insufficient and others feeling they were too strict. Twenty-nine women received no information about COVID-19, and 6 women found it very difficult to find information. Thirty-nine women would have liked to have more information about breastfeeding after a pregnancy affected by COVID-19, and 37 women wanted more information about antibody persistence and transfer. Discussion: Additional support is required for pregnant and lactating women during the current pandemic. Provision of information and support, including via social media, may improve women's experiences of pregnancy in the current environment. Significance: Maternity services in the UK have been significantly restructured to prevent transmission of the SARS-CoV-2 virus, including restrictions to in-person antenatal care, and perinatal visiting. It is not fully known how these changes are perceived by pregnant and breastfeeding women. Reactions to changes in antenatal care are mixed, including whether restrictions were too lenient or too strict. Most women underwent online antenatal care in addition in-person visits. Some received no information about COVID-19, and a significant proportion of women would have liked more information, particularly regarding antibody transfer and benefits of breastfeeding during the pandemic. [ABSTRACT FROM AUTHOR]

Medical students providing support to clinical teams during Covid-19 may have been an opportunity for service and learning. We aimed to understand why the reported educational impact has been mixed to inform future placements. We conducted a cross-sectional survey of medical students at UK medical schools during the first Covid-19 'lockdown' period in the UK (March–July 2020). Analysis was informed by the conceptual framework of service and learning. 1245 medical students from 37 UK medical schools responded. 57% of respondents provided clinical support across a variety of roles and reported benefits including increased preparedness for foundation year one compared to those who did not (p < 0.0001). However, not every individual's experience was equal. For some, roles complemented the curriculum and provided opportunities for clinical skill development, reflection, and meaningful contribution to the health service. For others, the relevance of their role to their education was limited; these roles typically focused on service provision, with few opportunities to develop. The conceptual framework of service and learning can help explain why student experiences have been heterogeneous. We highlight how this conceptual framework can be used to inform clinical placements in the future, in particular the risks, benefits, and structures. Practice points There was a benefit for most students who provided clinical support compared to those who did not during Covid-19. Most students found clinical support roles more beneficial than clinical placements and most final years wanted their final year clinical placements replaced by a formal role within a clinical team. Not every student's experience of clinical support was equal. The conceptual framework of service and learning can help explain this heterogeneity. The most beneficial roles for students complemented the curriculum and provided opportunities for clinical skill development, reflective practice, and meaningful contribution to the health service. There is an added benefit of combining service and learning if done correctly, and we can use this to inform the structure of clinical placements going forwards. However, there are risks, and we discuss principles of good practice and provide our own considerations. [ABSTRACT FROM AUTHOR]

Although domestic cats are susceptible to infection with SARS-CoV-2, the role of the virus in causing feline disease is less well defined. We conducted a large-scale study to identify SARS-CoV-2 infections in UK pet cats, using active and passive surveillance. Remnant feline respiratory swab samples, submitted for other pathogen testing between May 2021 and February 2023, were screened using RT-qPCR. In addition, we appealed to veterinarians for swab samples from cats suspected of having clinical SARS-CoV-2 infections. Bespoke testing for SARS-CoV-2 neutralising antibodies was also performed, on request, in suspected cases. One RT-qPCR-positive cat was identified by active surveillance (1/549, 0.18%), during the Delta wave (1/175, 0.57%). Passive surveillance detected one cat infected with the Alpha variant, and two of ten cats tested RT-qPCR-positive during the Delta wave. No cats tested RT-qPCR-positive after the emergence of Omicron BA.1 and its descendants although 374 were tested by active and eleven by passive surveillance. We describe four cases of SARS-CoV-2 infection in pet cats, identified by RT-qPCR and/or serology, that presented with a range of clinical signs, as well as their SARS-CoV-2 genome sequences. These cases demonstrate that, although uncommon in cats, a variety of clinical signs can occur. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic continues to present unique challenges to governments and organisations around the world, but one sector has incorporated COVID-19 into its core mission with relative ease: advertisers have acknowledged the pandemic while continuing to draw on notions of 'normality' to activate our desire to consume. As the UK's series of lockdowns have come to an end, we look back over more than a year of unusual advertising and consider how the pandemic has changed approaches to marketing and the shape of consumer culture in ways connected to ideas about what constitutes 'normal' life. Discussions of the relationship between the pandemic and consumerism have included critiques of the prioritising of profit over people, and conceptualisations of Coronavirus as a brand itself, but the politics of notions of 'normality' promoted by consumer culture demand closer consideration. This article complements existing studies and debates by examining the tensions, contradictions and morally neutral positions revealed by the advertising response to the coronavirus disease pandemic. Through an analysis of UK advertising campaigns launched during and with reference to the pandemic, this work explores key themes and strategies, including their connection to power dynamics concerning race, gender, class and capitalism. We suggest advertising during crises may offer the opportunity to critique larger dynamics and trends of consumerism, including narrow notions of the defining features of 'everyday' life. [ABSTRACT FROM AUTHOR]

UK community finance institutions play an important role in deprived neighbourhoods by serving households and businesses unable to access mainstream finance. This paper analyses the short-term effects of the Coronavirus pandemic on the activities and sustainability of the community finance sector by analysing longitudinal survey data for 40 providers and follow-up interviews with 25 organisations. COVID-19 resulted in an acceleration of the shift to online service delivery and temporary and permanent branch closures among community finance institutions. Further, the demand for, and volume and value of lending fell significantly during the first lockdown only recovering by the end of the summer 2020. This resulted in lower income, greater costs and lower regulatory ratios. Smaller providers in a weak financial position with more financially vulnerable customers were worst affected by the pandemic. We argue the pandemic may reduce access to finance for the financially excluded through the intensification of the shift to online services and by increasing the risk of providers serving the poorest folding or being merged with larger providers. [ABSTRACT FROM AUTHOR]

Both anxiety and depression have been identified as negative health outcomes associated with the distressing nature of the Covid-19 pandemic, especially among young people. Within this age demographic, trans and gender diverse people may be particularly vulnerable to pandemic-related mental health outcomes, such as anxiety and depression, due to the social challenges, gender dissonance, and poor mental health they experience. Furthermore, the social distancing measures impose several unique social and help-seeking challenges which may further contribute to the worsening of mental health. While there has been acknowledgment that vulnerable populations may be disproportionally affected by the pandemic, the experiences of trans and gender diverse youth have received very little empirical attention. To explore the mental health impact of Covid-19 on the lives of young trans and gender diverse people in the UK. In total, 243 people took part in an online survey between May and July in 2020. Eighty-two people were removed due to providing insufficient data. The analyzed dataset therefore comprised of 161 respondents ranging from 16 to 25 years (M = 20; SD = 2.68). Participants were asked how social distancing measures had impact on their social lives, mental health and access to health services. They were also asked to complete validated measures of anxiety and depression. This study found that those who experienced a greater impact of the Covid-19 outbreak and its associated social distancing measures, reported poorer mental health. Lack of social support, negative interpersonal interactions, unsupportive and non-affirming living environments and the inability to access mental health support and gender-affirming interventions were all factors that were associated with poor mental health. The findings provide specific direction for the tailoring of mental health service delivery to this population, noting the need for private, safe spaces in which young people can feel supported and have their gender identity affirmed. [ABSTRACT FROM AUTHOR]

Readability is a systematic measure of ease, with which written information can be read and understood. It can affect the reader's ability to access, comprehend, and utilize health information. This study assessed the readability of online COVID-19 information readily available to the public to engage with. At a time when organisations and institutions were rapidly providing advice and reacting to a developing pandemic, it was hypothesised that some of that haste would be associated with a lack of clarity, as measured by readability indices. N = 65 website sources containing information relating to COVID-19 were accessed and assessed for inclusion in the study. Eight readability indices, including Flesch Reading Ease and Flesch-Kincaid Grade Level, were calculated to determine readability scores for each source of information. Readability scores varied greatly between individual sources of COVID-19 information. Despite the recommendation that information be presented to the general public at a sixth-grade reading level, most websites we assessed addressing COVID-19 information and advice presented content at greater than the recommended reading level. Based on these results, a significant amount of information available on the Internet about COVID-19 will not be easily readable for many individuals attempting to use the Internet to help inform their decisions about their health and behavior. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines how human resources (HR) professionals in the UK have supported employee wellbeing during the coronavirus disease (COVID) pandemic. It considers the extent to which HR professionals were prepared for the crisis and their readiness in supporting the wellbeing of their people. Design/methodology/approach: Semi-structured interviews were conducted with 15 senior HR professionals working across the public and private sectors in the UK. Using an in-depth interview structure, the research explored how respondents both reacted to and managed the crisis in their respective organisations. Template analysis was used to analyse the data allowing a certain degree of fluidity in the establishment of ordered relationships between the themes. Findings: This study finds that business continuity plans turned out to be useless during the pandemic because they focussed on data, not people. It highlights the tension between home-working and burn-out as online presenteeism increased due to staff changing their behaviour in response to self-surveillance. The paper emphasises the importance of soft skills and authentic leadership and the tensions in respect of equity. Research limitations/implications: The study was conducted with HR professionals in the UK, not internationally. Although the sample did include HR professionals from across the public, private and third sectors, the experience may not be representative of all those working in HR. Originality/value: This research found that those organisations that had engaged in business continuity planning prior to the pandemic focussed on the retrieval and accessibility of data rather than people. This prioritises staff as a resource rather than emphasising people as an organisation's most valuable asset. Furthermore, the study found that staff worked harder and for longer periods of time as a consequence of self-imposed surveillance. Organisational responses were contradictory as despite implementing well-being strategies to promote physical and mental health, there was little evidence of an effective response to this online presenteeism. [ABSTRACT FROM AUTHOR]

Research on pandemic domestic abuse trends has produced inconsistent findings reflecting differences in definitions, data and method. This study analyses 43,488 domestic abuse crimes recorded by a UK police force. Metrics and analytic approaches are tailored to address key methodological issues in three key ways. First, it was hypothesised that reporting rates changed during lockdown, so natural language processing was used to interrogate untapped free-text information in police records to develop a novel indicator of change in reporting. Second, it was hypothesised that abuse would change differentially for those cohabiting (due to physical proximity) compared to non-cohabitees, which was assessed via a proxy measure. Third, the analytic approaches used were change-point analysis and anomaly detection: these are more independent than regression analysis for present purposes in gauging the timing and duration of significant change. However, the main findings were largely contrary to expectation: (1) domestic abuse did not increase during the first national lockdown in early 2020 but increased across a prolonged post-lockdown period, (2) the post-lockdown increase did not reflect change in reporting by victims, and; (3) the proportion of abuse between cohabiting partners, at around 40 percent of the total, did not increase significantly during or after the lockdown. The implications of these unanticipated findings are discussed. [ABSTRACT FROM AUTHOR]

The article discusses the tasks of emergency nurses in infection prevention and control in emergency departments (ED) in the U.K. Topics covered include the main pathogens linked to infection, and the importance of reducing their transmission risk to lessen the hospital stay, mortality and morbidity of patients and improving their experience. Also noted are the antimicrobial stewardship responsibility of all clinicians, and the emergency nurse's role in implementing them.

Background: The coronavirus disease 2019 pandemic led to increased pressure on health services, which, combined with variable social restrictions, led to decreased referrals for head and neck cancer. This study assessed whether there were lasting changes to head and neck cancer referrals during different stages of the pandemic response in 2020 and 2021. Methods: A retrospective review was conducted of all cases referred for suspected head and neck cancer to our institution in January 2020, April 2020, April 2021 and June 2021. Results: There was a rebound 91 per cent increase in referrals between April 2020 and April 2021 following the 59 per cent decrease in referrals between January 2020 and April 2020. Males made up 47.1 per cent of referrals in January 2020, 40 per cent in April 2020 and 37.82 per cent in April 2021. Conclusion: Further research is recommended to investigate the reasons why there is a continued decline in male referrals and the effect this has on their outcomes. [ABSTRACT FROM AUTHOR]

Objective This study aimed to assess whether workplace exposures as estimated via a COVID-19 job exposure matrix (JEM) are associated with SARS-CoV-2 in the UK. Methods Data on 244 470 participants were available from the Office for National Statistics Coronavirus Infection Survey (CIS) and 16 801 participants from the Virus Watch Cohort, restricted to workers aged 20–64 years. Analysis used logistic regression models with SARS-CoV-2 as the dependent variable for eight individual JEM domains (number of workers, nature of contacts, contact via surfaces, indoor or outdoor location, ability to social distance, use of face covering, job insecurity, and migrant workers) with adjustment for age, sex, ethnicity, index of multiple deprivation (IMD), region, household size, urban versus rural area, and health conditions. Analyses were repeated for three time periods (i) February 2020 (Virus Watch)/April 2020 (CIS) to May 2021), (ii) June 2021 to November 2021, and (iii) December 2021 to January 2022. Results Overall, higher risk classifications for the first six domains tended to be associated with an increased risk of infection, with little evidence of a relationship for domains relating to proportion of workers with job insecurity or migrant workers. By time there was a clear exposure–response relationship for these domains in the first period only. Results were largely consistent across the two UK cohorts. Conclusions An exposure–response relationship exists in the early phase of the COVID-19 pandemic for number of contacts, nature of contacts, contacts via surfaces, indoor or outdoor location, ability to social distance and use of face coverings. These associations appear to have diminished over time. [ABSTRACT FROM AUTHOR]

The UK response to Covid-19 has been unusually complex in its ever-shifting classifications of clinical vulnerability. By May 2020, 2.2 million people had been identified as 'clinically extremely vulnerable' (CEV) and were asked to 'shield' at home for over four months. To adhere to this strict guidance, they were enfolded within the patchy infrastructure of the 'shielding programme'. However, membership of the 'shielded list' has changed—often without warning or explanation—through time and across space. Drawing on policy and evidentiary documents, government speeches, reports, press conferences and media analysis of Covid-19 coverage between March 2020 and April 1, 2021, this paper traces the shifting delineations of clinical vulnerability in the UK response across three lockdowns. It argues that the complexities and confusions generated by the transience of the CEV category have fed into forms of biosociality that have been as much about making practical sense of government guidance as a form of mutual support amid crisis. This uncertainty has not eased as restrictions have been relaxed and vaccines rolled out. Instead, tracing individual immune response has become a burgeoning industry as 'the shielded' navigate the uneasy demands of taking 'personal responsibility' rather than being protected by 'the rules'. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus pandemic has swept across the United Kingdom (UK). Given the ever-evolving situation, little is known about the repercussions of coronavirus and the subsequent lockdowns for children diagnosed with Autism Spectrum Disorder (ASD). Therefore, this study explores the social-communicative impact of the first lockdown (March 2020 – July 2020) in the UK and the return to school period (September 2020 – October 2020), following prolonged disruption to routine, in children diagnosed with ASD. Methods: Parents of autistic children completed 2 separate online surveys following the first lockdown in the UK (n = 176) and also when children returned to school following the summer break (n = 54). Results: The results suggested that self-regulation skills (p <.05) and co-operation skills (p <.05) were most affected over the course of the lockdown. Children's physical activity levels were perceived to significantly increase during the return to school (p <.0001), which was associated with better social-communication outcomes (p <.05). Conclusion: Future work is needed to confirm and explore the findings. Such work could be implemented to protect and improve the social-communicative outcomes of autistic children. [ABSTRACT FROM AUTHOR]

Background: Acute myocardial injury in hospitalized patients with coronavirus disease 2019 (COVID-19) has a poor prognosis. Its associations and pathogenesis are unclear. Our aim was to assess the presence, nature, and extent of myocardial damage in hospitalized patients with troponin elevation. Methods: Across 25 hospitals in the United Kingdom, 342 patients with COVID-19 and an elevated troponin level (COVID+/troponin+) were enrolled between June 2020 and March 2021 and had a magnetic resonance imaging scan within 28 days of discharge. Two prospective control groups were recruited, comprising 64 patients with COVID-19 and normal troponin levels (COVID+/troponin-) and 113 patients without COVID-19 or elevated troponin level matched by age and cardiovascular comorbidities (COVID-/comorbidity+). Regression modeling was performed to identify predictors of major adverse cardiovascular events at 12 months. Results: Of the 519 included patients, 356 (69%) were men, with a median (interquartile range) age of 61.0 years (53.8, 68.8). The frequency of any heart abnormality, defined as left or right ventricular impairment, scar, or pericardial disease, was 2-fold greater in cases (61% [207/342]) compared with controls (36% [COVID+/troponin-] versus 31% [COVID-/comorbidity+]; P <0.001> P <0.001> P <0.01)> P <0.001),> P =0.10). Using the Lake Louise magnetic resonance imaging criteria, the prevalence of probable recent myocarditis was 6.7% (23/342) in cases compared with 1.7% (2/113) in controls without COVID-19 (P =0.045). During follow-up, 4 patients died and 34 experienced a subsequent major adverse cardiovascular event (10.2%), which was similar to controls (6.1%; P =0.70). Myocardial scar, but not previous COVID-19 infection or troponin, was an independent predictor of major adverse cardiovascular events (odds ratio, 2.25 [95% CI, 1.12-4.57]; P =0.02). Conclusions: Compared with contemporary controls, patients with COVID-19 and elevated cardiac troponin level have more ventricular impairment and myocardial scar in early convalescence. However, the proportion with myocarditis was low and scar pathogenesis was diverse, including a newly described pattern of microinfarction. Registration: URL: https://www.isrctn.com ; Unique identifier: 58667920. What Is New? * This study is the first large, multicenter, prospective, case-control study investigating the nature and extent of myocardial injury in patients hospitalized with COVID-19 and elevated cardiac troponin level imaged within 28 days of discharge with core laboratory analyses. * Patients with COVID-19 had a much lower prevalence of probable recent myocarditis than previously reported. * In patients with COVID-19, we identified a new pattern of microinfarction on cardiac magnetic resonance imaging, highlighting the prothrombotic nature of this disease. * Among hospitalized patients with COVID-19 and elevated cardiac troponin level, the presence of scar was independently associated with cardiovascular outcomes at 12 months. What Are the Clinical Implications? * We identified a lower prevalence of probable recent myocarditis than previously described and higher proportions of myocardial infarction and microinfarction in COVID-19. Myocardial scar was independently associated with cardiovascular outcomes. This is important to facilitate appropriate management decisions. [ABSTRACT FROM AUTHOR]

Background: Restrictions during the COVID-19 pandemic have led to increased screen-viewing among children, especially during strict periods of lockdown. However, the extent to which screen-viewing patterns in UK school children have changed post lockdowns is unclear. The aim of this paper is to examine how screen-viewing changed in 10–11-year-old children over the 2020–21 COVID-19 pandemic, how this compares to before the pandemic, and the influences on screen-viewing behaviour. Methods: This is a mixed methods study with 10–11-year-olds from 50 schools in the Greater Bristol area, UK. Cross-sectional questionnaire data on minutes of weekday and weekend television (TV) viewing and total leisure screen-viewing were collected pre-COVID-19 in 2017–18 (N = 1,296) and again post-lockdowns in 2021 (N = 393). Data were modelled using Poisson mixed models, adjusted for age, gender, household education and seasonality, with interactions by gender and household education. Qualitative data were drawn from six focus groups (47 children) and 21 one-to-one parent interviews that explored screen-viewing behaviour during the pandemic and analysed using the framework method. Results: Total leisure screen-viewing was 11% (95% CI: 12%-18%) higher post-lockdown compared to pre-COVID-19 on weekdays, and 8% (95% CI: 6%-10%) on weekends, equating to around 12–15 min. TV-viewing (including streaming) was higher by 68% (95% CI: 63%-74%) on weekdays and 80% (95% CI: 75%-85%) on weekend days. Differences in both were higher for girls and children from households with lower educational attainment. Qualitative themes reflected an unavoidable increase in screen-based activities during lockdowns, the resulting habitualisation of screen-viewing post-lockdown, and the role of the parent in reducing post-2020/21 lockdown screen-viewing. Conclusions: Although screen-viewing was higher post-lockdown compared to pre-COVID-19, the high increases reported during lockdowns were not, on average, sustained post-lockdown. This may be attributed to a combination of short-term fluctuations during periods of strict restrictions, parental support in regulating post-lockdown behaviour and age-related, rather than COVID-19-specific, increases in screen-viewing. However, socio-economic differences in our sample suggest that not all families were able to break the COVID-19-related adoption of screen-viewing, and that some groups may need additional support in managing a healthy balance of screen-viewing and other activities following the lockdowns. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To learn about some adaptations to practice adopted by a low secure mental health unit during the COVID-19 pandemic • To be aware of interventions used to enable staff to continue to support patients during the COVID-19 pandemic • To appreciate that staff's experience of the adaptations to practice and the well-being support offered to them during the pandemic can be used to inform post-pandemic practice The coronavirus disease 2019 (COVID-19) pandemic significantly disrupted the work of healthcare professionals in forensic mental health settings, but also prompted them to adopt new ways of working that have benefits and challenges. A low secure mental health unit in the UK adapted its ways of working during the pandemic by providing staff who could work remotely with the necessary equipment. The unit also implemented a stepped psychological response, as recommended by The British Psychological Society, to assist its staff to continue to support patients. This article describes the unit's response to the pandemic and discusses the findings of two evaluations – staff experiences of remote working and of a group relaxation session. The findings could help inform post-pandemic practice in forensic mental health settings. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise that retrieval nurse practitioners provide safe inter-hospital transport of critically ill babies and children • To learn how paediatric retrieval nurse practitioners adapted to provide safe inter-hospital transport for adults during the coronavirus disease 2019 (COVID-19) pandemic • To identify the importance of nurses responding flexibly to the challenges of the COVID-19 pandemic within the limits of their professional competence This article explores the experiences of South Thames Retrieval Service (STRS) retrieval nurse practitioners in providing inter-hospital transfers of critically ill babies and children during the coronavirus disease 2019 (COVID-19) pandemic. As well as its usual cohort of patients, the STRS also transferred critically ill and ventilated adults. The authors present a comparative analysis of pre-pandemic and pandemic retrievals over two six-week periods, one year apart. In the first period, from December 2019 to the end of January 2020, STRS retrieval nurse practitioners transported 47 critically ill children. One year later, during the second wave of the COVID-19 pandemic, STRS retrieval nurse practitioners transported 50 critically ill children and 26 critically ill adults with COVID-19 and a premature baby who was a COVID-19 contact. The latter two groups are not usually transported by the service. All of the patients retrieved by the STRS team during the COVID-19 pandemic were safely transported. This initiative demonstrated how nurses worked flexibly during the pandemic within the limits of their professional competence. [ABSTRACT FROM AUTHOR]

The phrase 'in it together' has been used liberally since the outbreak of COVID‐19, but the extent that frontline workers felt 'in it together' is not well understood. Here, we consider the factors that built (or eroded) solidarity while working through the pandemic, and how frontline workers navigated their lives through periods of disconnection. Semi‐structured interviews with 21 frontline workers, across all sectors, were conducted in the United Kingdom and Ireland. The qualitative data were analysed systematically using reflexive thematic analysis. The three themes identified in the data were: (1) Solidarity as central to frontline experiences; (2) Leadership as absent, shallow and divisive: highlighting 'us‐them' distinctions and (3) The rise of 'us' and 'we' among colleagues. Our research offers insights into how frontline workers make sense of their experiences of solidarity and discordance during the first year of the COVID‐19 pandemic, with relevance for government and organizational policy‐makers shaping future conditions for frontline workers. [ABSTRACT FROM AUTHOR]

This research looks at the frames British and American leaders have chosen to refer to the COVID-19 crisis. After a short description of the black swan metaphor to prove that the coronavirus pandemic was not an unexpected event, but rather predicted and foreseen, the paper first illustrates how politicians found themselves using a military language when discussing such a 'crazy and horrible plague', as bellicose rhetoric serves special and legitimate purposes, thus communicating the sense of urgency and emergency. Then, I look at two frames which have come to characterize the pandemic: 'the' science and the myth of herd immunity. I first show how leaders claimed to "be guided by the science", thus causing the frustration of experts who were held responsible for all decisions made by politicians, and then I illustrate how the 'herd immunity' myth is managed in the UK and in the US, with a special focus on the idiosyncratic use Donald Trump makes of the word 'herd', which takes on an altogether different meaning from the scientific original frame. [ABSTRACT FROM AUTHOR]

Background: Coronavirus-related conspiracy theories (CT) have been found to be associated with fewer pandemic containment-focused behaviors. It is therefore important to evaluate associated cognitive factors. We aimed to obtain first endorsement rate estimates of coronavirus-related conspiracy beliefs in a German-speaking general population sample and investigate whether delusion-related reasoning biases and paranoid ideation are associated with such beliefs. Methods: We conducted a cross-sectional non-probability online study, quota-sampled for age and gender, with 1684 adults from Germany and German-speaking Switzerland. We assessed general and specific coronavirus conspiracy beliefs, reasoning biases [jumping-to-conclusions bias (JTC), liberal acceptance bias (LA), bias against disconfirmatory evidence (BADE), possibility of being mistaken (PM)], and paranoid ideation, using established experimental paradigms and self-report questionnaires. Results: Around 10% of our sample endorsed coronavirus-related CT beliefs at least strongly, and another 20% to some degree. Overall endorsement was similar to levels observed in a UK-based study (Freeman et al., 2020b). Higher levels of conspiracy belief endorsement were associated with greater JTC, greater LA, greater BADE, higher PM, and greater paranoid ideation. Associations were mostly small to moderate and best described by non-linear relationships. Conclusions: A noticeable proportion of our sample recruited in Germany and German-speaking Switzerland endorsed coronavirus conspiracy beliefs strongly or to some degree. These beliefs are associated with reasoning biases studied in delusion research. The non-probability sampling approach limits the generalizability of findings. Future longitudinal and experimental studies investigating conspiracy beliefs along the lines of reasoning are encouraged to validate reasoning aberrations as risk factors. [ABSTRACT FROM AUTHOR]

This article examines the way numbers, often concerning risk, were communicated by politicians, covered by the news media and interpreted by the public during the early stages of the COVID-19 crisis in the United Kingdom. To explore this topic, we adopted a mixed-methods approach that included content analysis, comparative thematic analysis and a series of focus groups. Whilst coherency and consistency are touted as essentials in public health messaging, our textual analysis highlighted the disconnect between political communication and news media coverage. Whereas the UK government relied on vague references to curves and peaks to underpin a narrative of consistency and certainty in public health policy, the UK news media referred to specific numbers from within and outside the UK to criticise the government's approach as haphazard and lacking. This disconnect gained even more significance during our focus groups. When discussing numbers, participants referred to news media coverage rather than political messaging, using these figures to challenge the timing and nature of the UK lockdown. These findings present a significant critique of the UK government's communication during this health crisis. Instead of putting forward a coherent, homogenous and clear message to the public, the discourse around numbers and risk was diffracted, disconnected and opaque. This was largely due to the competing narratives presented by the news media. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has produced a radically changed world for everyone, but its effects on police officers has been particularly acute. Officers have been subject to increased cough and spit attacks as offenders have sought to weaponise the coronavirus, and forces have responded by encouraging officers to use enhanced methods of contamination prevention. The controversial argument of whether using 'spit hoods' is a necessary tool in policing has been resurrected, although evidence of their ineffectiveness in the fight against COVID-19 has been brought to light more recently. Drawing on interview data obtained from 18 police officers in 11 UK forces over the summer of 2020, this article draws on interview narratives discussing contamination prevention, policing the pandemic, and the use of spit hoods. [ABSTRACT FROM AUTHOR]

Background: Inhaler shortages were reported in the UK following declaration of the COVID-19 pandemic, prompting advice against stockpiling. Aim: To understand experiences and behaviours of patients with asthma requesting prescriptions from primary care during asthma medication shortages. Design & setting: UK asthma online community, between March and December 2020. Method: Thematic analysis of posts identified using search terms 'shortage', 'out of stock', 'prescribe', and 'prescription'. Results: Sixty-seven participants were identified (48 adults, two children, 17 unstated age). Factors leading to increased requests included the following: stockpiling; early ordering; realising inhalers were out of date; and doctors prescribing multiple medication items. Patients' anxieties that could lead to stockpiling included the following: fear of asthma attacks leading to admission and acquiring COVID-19 in hospital; lack of dose counters on some inhalers; and believing a lower amount of drug is delivered in the last actuations. Strategies adopted in relation to shortages or changes in treatment owing to out-of-stock medications included the following: starting stockpiling; ordering prescriptions early; contacting medical professionals for advice or alternative prescriptions; getting 'emergency prescriptions'; ordering online or privately; seeking medications in different pharmacies; contacting drug manufacturers; and keeping track of number of doses left in canisters. No evidence was found of anxiety-triggered asthma symptoms that required medications due to fear of COVID-19. Participants seemed to disregard advice against stockpiling. Conclusion: Better preparation is a key lesson from the COVID-19 pandemic. Clinicians, the pharmaceutical industry, and policymakers should use insights from this work to plan how to better manage medication shortages in future emergency situations. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has an amplified impact on vulnerable populations. Also, aspects related to health inequalities are insufficiently taught in higher education. This study aims to promote reflection in nursing students on the impact of the COVID-19 pandemic on vulnerable populations affected by health inequities. Methodology: A photovoice method was used. Undergraduate nursing students (Spain and United Kingdom) took and explained photographs using SHOWED models. Results: 108 students participated. Two-domain summary themes were created: The COVID-19 pandemic has impacted ethnic minorities and socioeconomically vulnerable groups, and Proposals to respond to the negative impact on ethnic minorities and socioeconomically vulnerable groups. Discussion: The students identified negative health scenarios by linking COVID-19 with aspects of work, salary, and housing of these two specific populations. Holistic actions were also proposed to protect their health. As future health professionals, they must recognize these communities and work to eliminate inequalities. [ABSTRACT FROM AUTHOR]

Introduction: Although studies suggest a potential link between COVID-19 and thyroid dysfunction in adults, there are insufficient data to confirm that association in children, and whether there is any effect on presentation to healthcare services. Aims: To identify whether presentations of thyroid dysfunction in children to a tertiary paediatric hospital changed as a result of the COVID-19 pandemic. Methods: A retrospective case note review was conducted of all children with abnormal thyroid function tests between 1st January 2016 and 31st December 2021 at a tertiary paediatric endocrine centre in the United Kingdom. Results: Overall, 244 children whose first presentation was within the timeframe of interest were included in this study, with a median age (range) of 11.5 (6.1, 16.8) years. Of these, 43 (18%) were hyperthyroid and 201 (82%) were hypothyroid. The greatest number of thyroid presentations occurred in 2021 (n=60, 25% of total over time period) and the fewest in 2020 (n=10, 4% of total over time period). Prior to this, the median (range) number of presentations per year was 34 (28, 39). There were no statistically significant differences in biochemistry, antibody status or other clinical characteristics between those who presented with hyperthyroidism prior to the pandemic or after. In those with hypothyroidism, baseline biochemistry was similar between the 2 groups, but the presence of other autoimmune conditions was greater pre-pandemic (17.2% vs 15.0%, p=0.03). In addition, patients were more likely to have transient thyroid dysfunction, which did not require treatment postpandemic (70.0% vs 49.6%, p=0.0086). Conclusions: Although overall rates of presentation with thyroid dysfunction have not altered since the first wave of the COVID-19 pandemic, presentations with transient thyroid dysfunction, not requiring ongoing treatment have increased. Further research regarding the relationship between COVID-19 and thyroid function in children and young people, is needed. [ABSTRACT FROM AUTHOR]

We present a method for rapid calculation of coronavirus growth rates and R-numbers tailored to publicly available UK data. We assume that the case data comprise a smooth, underlying trend which is differentiable, plus systematic errors and a non-differentiable noise term, and use bespoke data processing to remove systematic errors and noise. The approach is designed to prioritize up-to-date estimates. Our method is validated against published consensus R-numbers from the UK government and is shown to produce comparable results two weeks earlier. The case-driven approach is combined with weight-shift-scale methods to monitor trends in the epidemic and for medium-term predictions. Using case-fatality ratios, we create a narrative for trends in the UK epidemic: increased infectiousness of the B1.117 (Alpha) variant, and the effectiveness of vaccination in reducing severity of infection. For longer-term future scenarios, we base future R(t) on insight from localized spread models, which show R(t) going asymptotically to 1 after a transient, regardless of how large the R transient is. This accords with short-lived peaks observed in case data. These cannot be explained by a well-mixed model and are suggestive of spread on a localized network. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand why some nursing and midwifery students felt isolated and abandoned when taking on frontline roles during COVID-19 • To learn about the types of online support that can be offered to nursing and midwifery students • To appreciate the value of enabling nursing and midwifery students to explore personal and professional experiences in a safe non-judgemental environment Throughout the coronavirus disease 2019 (COVID-19) pandemic the Queen's University Belfast Connections (QUB Connections) project has provided online well-being support to nursing students and student midwives. The project, which was co-designed and led by students and academic staff, provided an online well-being service for students who took on front-line roles during the early part of the pandemic and for those who had to pause their studies. Insights gained from responses to an evaluation of the support sessions suggested that some students felt stigmatised, frightened, lost, isolated and abandoned during this period, but that QUB Connections gave them a sense of 'being held' and 'attended to' in a time of uncertainty. The evaluation findings are a reminder of the need to continue to help nursing and midwifery students and newly qualified staff develop self-care and support mechanisms. QUB Connections is now embedded in the university's school of nursing and midwifery pre-registration programmes to support students and those new to nursing and midwifery practice. [ABSTRACT FROM AUTHOR]

COVID-19 has been a transformational crisis, uprooting everyday lives and causing some of the most significant health, social, and economic challenges in recent memory. Similarly, coronavirus has also forced significant political change, refocusing attention on politics and policymaking structures during a time of crisis. This shift is exemplified by scientific advisers' role at the forefront of governmental decision-making. Scientific advice has provided vital knowledge and insight into the government's pandemic responses. However, the coronavirus pandemic has also highlighted the complex nature of combining science with politics, as well as the difficulties involved in distinguishing between expert advice and political or moral choices. Such complexity warrants a reconsideration of science's impact on policymaking. Namely, from a long-term view, the growth of governmental experts started well before the coronavirus pandemic. Partly, this proliferation is driven by a desire to improve policymaking, given that there is a clear need to effectively consult, consider, and act on the advice of experts in all fields of government. Nevertheless, societal changes like a declining trust in government also mean that expert advice can increasingly be used as a tool to legitimate or depoliticise debates. Considering the complexity of fighting a global pandemic, this belies that advice must be effectively scrutinised within broader contextual or operational considerations – a government cannot simply 'follow the science'. Coronavirus highlights the need for a renewed focus on the interplay of expertise and policymaking, considering who, why, and on what basis governments are advised – as well as what lessons they draw from it. [ABSTRACT FROM AUTHOR]

Background: Active-6 is exploring how the COVID-19 pandemic has impacted physical activity behaviour among Year 6 children (aged 10–11 years) and their parents in Southwest England. Initial findings from the Active-6 project have shown a 7–8 min decrease in moderate-to-vigorous physical activity and an increase in sedentary behaviour among children following the easing of restrictions in the UK in latter half of 2021. This finding suggests that the pandemic has had a persistent impact on child physical activity behaviour. This paper explored the possible mechanisms behind these changes. Methods: Interviews with parents (n = 21), members of school staff (n = 9) and focus groups with children aged 10–11 years (n = 47) were conducted between August and December 2021 to discuss the impact of the pandemic on child physical activity behaviour. The framework method was used for analysis. Results: Five themes spanning two key stages of the pandemic were described. Three themes related to the period of lockdowns and fluctuating restrictions (March 2020 – April 2021). These included: Theme 1) Lockdown: A short-lived adventure; Theme 2) Access to facilities during restrictions; and Theme 3) The importance of the parent. A further two themes were identified related to the period following the gradual easing of restrictions in April 2021. These included: Theme 4) An overwhelming return to normal; and Theme 5) Reopening fatigue. Conclusions: The analysis suggested that feelings of novelty experienced during the initial stages of lockdown waned as restrictions were prolonged, creating an increasingly challenging period for parents and their children. However, during periods of restrictions, the importance of parental encouragement and access to appropriate facilities in the local and home environment helped facilitate physical activity. Following the easing of COVID-19 restrictions, emotional overwhelm and physical fatigue among children, stemming from a sedentary and socially isolated life in lockdown and other restrictions, were key contributors to the decreased moderate to vigorous physical activity and increased sedentary behaviour that was observed in a related quantitative study. [ABSTRACT FROM AUTHOR]

In the recent COVID-19 pandemic, a wide range of epidemiological modelling approaches were used to predict the effective reproduction number, R(t), and other COVID-19-related measures such as the daily rate of exponential growth, r(t). These candidate models use different modelling approaches or differing assumptions about spatial or age-mixing, and some capture genuine uncertainty in scientific understanding of disease dynamics. Combining estimates using appropriate statistical methodology from multiple candidate models is important to better understand the variation of these outcome measures to help inform decision-making. In this paper, we combine estimates for specific UK nations/regions using random-effects meta-analyses techniques, utilising the restricted maximum-likelihood (REML) method to estimate the heterogeneity variance parameter, and two approaches to calculate the confidence interval for the combined estimate: the standard Wald-type and the Knapp and Hartung (KNHA) method. As estimates in this setting are derived using model predictions, each with varying degrees of uncertainty, equal-weighting is favoured over the standard inverse-variance weighting to avoid potential up-weighting of models providing estimates with lower levels of uncertainty that are not fully accounting for inherent uncertainties. Both equally-weighted models using REML alone and REML+KNHA approaches were found to provide similar variation for R(t) and r(t), with both approaches providing wider, and therefore more conservative, confidence intervals around the combined estimate compared to the standard inverse-variance weighting approach. Utilising these meta-analysis techniques has allowed for statistically robust combined estimates to be calculated for key COVID-19 outcome measures. This in turn allows timely and informed decision-making based on all available information. [ABSTRACT FROM AUTHOR]

Since the onset of the Covid‐19 pandemic, the UK, like many countries, has had restrictions on social contact, and injunctions of 'social distancing'. This study aimed to generate new insights into men's experiences of loneliness during the pandemic, and consider the ramifications of these for continued/future restrictions, the easing of restrictions, and the future beyond the pandemic. Twenty qualitative interviews were conducted with men between January and March 2021. A maximum variation purpose sample frame required at least three non‐white men, three LGBTQ+men, three men with a university education, three without a university education, three 18–30 years old, and three aged 60+. Thematic analysis, focused on semantic themes, was employed as part of a 'grounded' epistemology whereby the stated perspectives of the interviewees drove the content of the study. Seven themes were constructed: (i) lost and new activities and routines; (ii) remote social interaction; (iii) narrowed social spheres; (iv) rethought and renewed recognition of what is important; (v) loneliness with a purpose; (vi) anxiety of social contact; and (vii) easier for themselves than others. Lost routines, fewer meaningful activities, and a reduction in face‐to‐face interaction, were framed as challenges to preventing loneliness. Solo‐living gay men seemed particularly negatively affected. However, many men displayed new, more covid‐safe routines and activities. Remote forms of interaction were often utilised, and though they were imperfect, were constructed as worth engaging with, and held capacity for improvement. A moral need to reduce transmission of SARS‐COV‐2, and a fear of catching it, became important features of participants lives that also affected loneliness. Men at higher risk of health complications from Covid‐19 were particularly likely to highlight anxiety of social contact. Reducing restrictions alone may not return everyone to pre‐pandemic levels of loneliness, particularly if the pandemic remains a significant public health issue. [ABSTRACT FROM AUTHOR]

Background: A high COVID-19 vaccine uptake is essential to achieve herd immunity to combat the current strain of COVID-19 and potential future variants. This review aimed to identify factors associated with public intention to receive COVID-19 vaccines until February 2021 to provide accessible data to policymakers to inform framing and targeting of messages designed to optimise vaccine uptake.Methods: Medline, Embase, CINAHL, PsycINFO, PsycARTICLES, Sociological Abstracts and Applied Social Sciences Index and Abstracts were searched for cross-sectional studies reporting data regarding COVID-19 vaccine intentions, published between 01/01/2020 and 12/02/2021. Title/abstract and full-text screening were performed independently by two authors. The Appraisal Tool for Cross-sectional Studies (AXIS) was used to assess bias and quality. Both random-effects meta-analysis and narrative synthesis were used to describe vaccine intentions and associated factors. A subgroup analysis assessing the impact of sex, sampling method and time of survey on COVID-19 vaccine intention was performed.Results: Searches identified 4739 studies, and 23 cross-sectional studies were deemed eligible for the review; 22 used online surveys and one used a mixed-methods study design. Eighteen surveys were conducted in the first half of 2020 and five were conducted in the latter half of 2020. Fifteen countries were represented, with the most common being the United States (n = 4) and the United Kingdom (n = 4) sampling 41,403 participants across all surveys. Most studies employed convenience sampling and 11 non-responder rates raised concerns over non-response bias. From the 18 studies included in the meta-analysis, the pooled proportion of survey participants willing to receive the COVID-19 vaccine was 73.3% (n = 18, 95% Confidence Interval 64.2 to 81.5%, I2 = 99.7%). Factors associated with a higher COVID-19 vaccine acceptance included greater perceived risk of COVID-19, lower level of perceived vaccine harm, higher educational attainment and household income, older age, being of White ethnicity and male sex.Conclusions: There was a high willingness to receive the COVID-19 vaccine which was influenced by sociodemographic factors and risk perceptions. The findings suggest future research should explore reasoning behind vaccine intentions for different sociodemographic groups to allow targeted communication strategies to be formulated by public health agencies.Registration: PROSPERO Registration Number: CRD42021239134. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused significant changes to police working practices involving the enhanced wearing of personal protective equipment (PPE), and ways of working inside and outside of police stations. The safety guidance released by the various government agencies has been conflicting, confusing and unhelpfully flexible, and there are significant discrepancies between some of the 43 forces of England and Wales. This article draws on primary interview data with 18 police officers from 11 UK police forces to explore the problems that officers faced in accessing appropriate PPE and the difficulties in obtaining and understanding accurate coronavirus health and safety information. [ABSTRACT FROM AUTHOR]