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Purpose: To determine whether menstrual-cycle symptoms are associated with sleep in elite female athletes. Methods: Sleep was assessed for a minimum of 25 nights (range = 25–31) using activity monitoring and sleep diaries. Menstrual-cycle symptoms were collected over the same duration in 12 elite female professional soccer players. Generalized estimating equations were used to examine the relationship between the day of the menstrual cycle (from day 1) and total menstrual-cycle symptoms on sleep characteristics. Results: There was a significant relationship between sleep duration and the day of the menstrual cycle (P =.042) and total symptoms reported that day (P <.001), with sleep duration increasing by 21 minutes for every symptom reported. There was a negative day × symptom interaction on sleep duration (P =.004), indicating that with increased symptoms, the day of the menstrual cycle had a smaller relationship with sleep duration. Sleep efficiency (P =.950), wake after sleep onset (P =.217), and subjective sleep quality (P =.080) were not related to the day of the menstrual cycle. The total symptoms reported had no relationship with sleep efficiency (P =.220), subjective sleep quality (P =.502), or sleep latency (P =.740) but did significantly relate to wake after sleep onset (P <.001), with a significant day × symptom interaction (P <.001). Conclusions: Sleep duration increased from day 1 of the menstrual cycle and was associated with the number of menstrual-cycle symptoms reported. All other sleep metrics remained unchanged; however, total symptoms reported were related to wake after sleep onset. Monitoring and managing menstrual-cycle symptoms should be encouraged due to a potential relationship with sleep characteristics. [ABSTRACT FROM AUTHOR]

Background: Integrated curriculum interventions have been suggested as an effective means to increase physical activity (PA) and health. The feasibility of such approaches in children living in deprivation is unknown. This study sought to pilot an integrated curriculum pedometer intervention in children living in deprivation on school-based PA, body fatness, resting blood pressure, motor skills, and well-being. Methods: Using a pilot cluster randomized intervention design, children (6–7 y old, n = 64) from 2 schools in central England undertook: (1) 10-week integrated curriculum intervention or (2) control (regular school-based activity). School-based PA, body fatness, resting blood pressure, motor skills, and well-being were assessed preintervention and postintervention. Results: For the intervention group, PA was higher on school days when children had physical education lessons or there were physically active integrated curriculum activities. Body fatness significantly decreased, and well-being and perceived physical competence increased, pre–post for the intervention group compared with the control group. Accelerometer-derived PA, motor skills, and resting blood pressure were not significantly different pre–post for intervention or control groups. Conclusions: A 10-week integrated curriculum PA intervention is feasible to conduct and can positively impact aspects of health in 6- to 7-year-old children in England. [ABSTRACT FROM AUTHOR]

Dementia-friendly communities (DFCs) are a policy-endorsed approach to community engagement in England that promotes social inclusion to enable people affected by dementia to live well. Research suggests that physical activity is beneficial in encouraging social connection and improving health. A mixed method sequential study design in England involving a national survey (n = 31) and semistructured interviews (n = 65) in three DFCs was carried out. The aim was to understand how DFCs enable people affected by dementia to participate in physical activities. An evaluation framework for DFCs was used to organize and interpret the data, and analysis was informed by the inclusive (social) citizen lens. Findings showed that DFCs offered a range of adapted dementia-inclusive and dementia-specific activities; however, people were not routinely offered information at time of diagnosis. Local authorities (councils) were key to enable access to information and infrastructure change to support sustainable inclusion within their local community. [ABSTRACT FROM AUTHOR]

William Leybourn (1626 – 1716) was a printer, author, teacher, surveyor, and mathematician. The occupation of “printer” is often associated with passivity: a simple artisan whose sole focus is to bring books to sale and therefore a stranger to the knowledge contained within the books. This paper seeks to revisit this view, showing that William Leybourn was the exact opposite of a passive printer. He introduced to the English public the works of crucial protagonists of the European scientific community (including the works of Galileo Galilei), promoted debates among scholars and natural philosophers, and presented complex topics previously reserved for academic disputations in a manner accessible to a more general audience. Employing both traditional historical research and tools in Digital Humanities, the paper discusses Leybourn’s works as an example of a conceptually and methodologically novel approach to the study of intellectual networks. This bottom-up approach recenters traditionally peripheral figures, such as Leybourn, and reveals crucial social, economic, and political aspects of early modern European cultural and intellectual debates.

Purpose: Whole-of-school approaches to physical activity (PA) promotion are recommended internationally, but there remains little descriptive research detailing the implementation of such approaches, especially at the secondary level. The purpose of this case study, which drew upon a social-ecological perspective, was to examine a whole-of-school approach used by one secondary school in England. Method: Participants (N = 30) included three members of the school's senior leadership team, eight teachers, 15 students, and four parents. Data were collected during 5 months using open-ended questionnaires that all participants completed, 14 staff interviews with staff, three focus groups with students, six observations, and attendance records from various PA opportunities. Results: Thematic analysis identified five key PA opportunities and uncovered four themes in relation to these opportunities: Student Autonomy, Support from Leadership, New School, and Physical Education Time. Discussion/Conclusion: This study highlights the importance of targeting multiple levels of influence when implementing whole-of-school PA programming. [ABSTRACT FROM AUTHOR]

BACKGROUND: Interest in modifiable risk factors (MRFs) for dementia is high, given the personal, social, and economic impact of the disorder, especially in ageing societies such as the United Kingdom. Exploring the population attributable fraction (PAF) of dementia attributable to MRFs and how this may have changed over time remains unclear. Unravelling the temporal dynamics of MRFs is crucial for informing the development of evidence-based and effective public health policies. This investigation examined the temporal trajectories of MRFs for dementia in England. METHODS: We used data from the English Longitudinal Study of Ageing, a panel study over eight waves collected between 2004 and 2019 (76,904 interviews in total). We calculated the PAFs for twelve MRFs (including six early- to mid-life factors and six late-life factors), as recommended by the Lancet Commission, and the individual weighted PAFs (IW-PAFs) for each risk factor. Temporal trends were analysed to understand the changes in the overall PAF and IW-PAF over the study period. Subgroup analyses were conducted by sex and socioeconomic status (SES). RESULTS: The overall PAF for dementia MRFs changed from 46.73% in 2004/2005 to 36.79% in 2018/2019, though this trend was not statistically significant. During 2004-2019, hypertension, with an average IW-PAF of 8.21%, was the primary modifiable determinant of dementia, followed by obesity (6.16%), social isolation (5.61%), hearing loss (4.81%), depression (4.72%), low education (4.63%), physical inactivity (3.26%), diabetes mellitus (2.49%), smoking (2.0%), excessive alcohol consumption (1.16%), air pollution (0.42%), and traumatic brain injury (TBI) (0.26%). During 2004-2019, only IW-PAFs of low education, social isolation, and smoking showed significant decreasing trends, while IW-PAFs of other factors either did not change significantly or increased (including TBI, diabetes mellitus, and air pollution). Upon sex-specific disaggregation, a higher overall PAF for MRFs was found among women, predominantly associated with later-life risk factors, most notably social isolation, depression, and physical inactivity. Additionally, hearing loss, classified as an early- to mid-life factor, played a supplementary role in the identified sex disparity. A comparable discrepancy was evident upon PAF evaluation by SES, with lower income groups experiencing a higher dementia risk, largely tied to later-life factors such as social isolation, physical inactivity, depression, and smoking. Early- to mid-life factors, in particular, low education and obesity, were also observed to contribute to the SES-associated divergence in dementia risk. Temporal PAF and IW-PAF trends, stratified by sex and SES, revealed that MRF PAF gaps across sex or SES categories have persisted or increased. CONCLUSIONS: In England, there was little change over time in the proportion of dementia attributable to known modifiable risk factors. The observed trends underscore the continuing relevance of these risk factors and the need for targeted public health strategies to address them.

Although guilt is often considered the most prevalent emotional outcome of work–family conflict (WFC), most work–family research focuses on family‐related guilt stemming from work interference with family, rather than job‐related guilt stemming from family interference with work (FIW). In addition, there is little understanding of how different employee social groups experience the implications of FIW in their daily lives. To address these research gaps, this study explores the relationship between daily FIW and job‐related guilt, and its subsequent impact on job satisfaction. It also investigates variation in these relationships by (1) gender and (2) the intersection of gender and ethnicity. Bayesian multilevel structural equation modeling using data from 5‐day diary surveys from 210 solicitors in Britain shows daily FIW is associated with higher job‐related guilt and subsequently lower job satisfaction. The relationship is stronger for women than men in general, but is also stronger for South Asian women than white British women (and men), and for South Asian men than white British men. This suggests that studies focusing on single social group characteristics (e.g., gender) are likely to obscure intersectional effects that might produce significant within‐group variation. The findings also highlight the importance of integrating workplace inequality arguments into theorization of WFC. [ABSTRACT FROM AUTHOR]

It is proposed that an approach to difference through repetition, inspired by the writing of Gilles Deleuze, provides a conceptual approach to understand the endurance of urban life in medieval England. Perceptions of urban decline in later medieval England are contradicted by the persistence of urban places and communities. A tension, whereby persistence implies repetition yet decline implies discontinuity and difference, is evident. By developing a framework for understanding medieval urbanity as a series of repetitive processes of differentiation, this paper outlines how we might shift our approach to understanding past urban lives, with implications for how we engage with critical issues in urban studies, including the multiplicity, resilience and sustainability of urban lives. [ABSTRACT FROM AUTHOR]

Background: Festivals play an important role in improving death and grief literacy, enabling members of the public to engage with these often-sensitive topics. Good Grief Weston festival was co-designed and delivered with the community in Weston-super-Mare, a coastal town in South-West England with high levels of socioeconomic disadvantage but rich community assets. It was held in person over 8 days in May 2023. Objectives: To evaluate the reach and impact of Good Grief Weston festival and gather data to inform future festivals. Design: Mixed methods evaluation (survey and focus groups). Methods: Online and paper surveys assessing participants' characteristics and experiences were administrated during and after the festival. Survey participants who indicated their willingness to participate were invited to attend a focus group. Focus groups were recorded, transcribed and analysed using thematic analysis. Data were collected by trained community co-researchers. Results: Approximately 3000 people attended the festival. Of 204 completed surveys, 64.5% were from women, age range ⩽15 to ⩾75 years; 88.2% identified as White; 14.9% deaf, disabled/with a chronic condition; 18.9% neurodivergent; 9.0% gay, bisexual or queer. Festival participants were entertained (70.9%), inspired (68.5%), felt part of a like-minded community (54.3%), talked to someone new (49.2%), learnt about grief/bereavement (34.3%), shared or expressed experiences (30.3%) and found out about local support (19.7%). 71.3% reported that they felt more confident talking about grief after attending. Median experience rating was 5 (IQR 0; possible range 1 = poor to 5 = excellent). In free-text comments, participants expressed appreciation for the festival and described benefits in attending. Two focus groups were conducted (n = 8 participants, all women), lasting c.1.5 h. Focus groups added rich descriptions of the festival's value, and data to inform the next festival. Conclusion: Findings suggest festivals of this nature can play a central role in a public health approach. Plain language summary: What was the impact of Good Grief Weston festival? Why was the study done? Previous studies have shown that many people feel unsupported by their community after the death of a loved one. We designed a festival to improve knowledge and support for bereaved people. We did this study to assess how the festival affected the people who attended. What did the researchers do? The team included researchers and people and organisations from the local community. Together, we designed and ran a festival on the topic of death, grief and bereavement in Weston-super-Mare, a coastal town with areas of high deprivation. The festival took place over an eight-day period in May 2023 and included creative, interactive and educational events. The team collected feedback on attendees' experiences of the festival. We did this using online and paper feedback forms, postcards, and focus groups to collect as many opinions as possible. What did the researchers find? We found that a wide range of people attended the festival. Most people who took part in the research rated the festival as 'excellent'. They told us they learnt about grief and bereavement and found out about local support services. Attendees met new people, shared their experiences, and felt that the festival built community spirit. They also made suggestions to improve any future festivals. What do the findings mean? The findings show that in-person festivals can effectively engage the public on the topic of death, grief and bereavement. They can also help develop connections between people and organisations in communities. These connections and learning opportunities may help communities to support their members through bereavement. [ABSTRACT FROM AUTHOR]

Background. High numbers of young people are living with obesity in England, with associated negative impacts on their mental and physical health. Social prescribing involves professionals referring individuals to community‐based services to provide additional health and well‐being support. Social prescribing may be a helpful way to provide holistic support to young people living with obesity alongside weight management services. However, there is a need to better understand the availability of community‐based services that could provide this support. Aims. This study aimed to explore the process for mapping community‐based services to be part of a social prescribing offer within children's specialist weight management services in one region of England and to provide an understanding of the availability of community‐based services in this region that are accessible for this population. Method. Community‐based services providing physical activity opportunities to young people in an area local to a specialist weight management service (South Yorkshire) were mapped using a mixed methods approach, including scoping of online resources and meetings with relevant contacts. Services were identified and reviewed against criteria developed through stakeholder engagement to assess suitability for young people living with obesity. Results. A total of 933 community‐based services were identified across South Yorkshire between January and June 2023. Scoping and suitability assessment of these services took 6 months. There was often limited information provided about services, particularly relating to costs. Nineteen services met all suitability criteria. Conclusion. It requires time and capacity to identify relevant community‐based services as part of a social prescribing offering. Although a high number of services were identified, few of these were suitable for young people living with obesity. Consideration should be given to how young people can be supported to access services, as well as how services can be supported to meet the needs of young people living with severe obesity. [ABSTRACT FROM AUTHOR]

Assessment of pressure ulcer (PU) risk remains a challenge in clinical practice. The first part of this article (Martin and Holloway, 2024) discussed the evidence base underpinning the development of clinical guidelines for PUs alongside the creation of the bundle approach regarding PU prevention. This article, part two, presents the results of a clinical audit that explores compliance against a PU prevention bundle (the aSSKINg framework) in an adult community nursing setting in the south-east of England. The clinical audit was conducted between July-December 2021 and included records of 150 patients. Overall, compliance against the aSSKINg framework was poor, with only two criterion being met: equipment provision for chair and referral to the tissue viability team. Short-term recommendations are that mandatory PU training for staff in the management of PUs should be implemented, and the tissue viability nurse network should be increased. The long-term recommendation was the introduction of the aSSKINg framework as a template into the electronic patient record. [ABSTRACT FROM AUTHOR]

In 2021, vaccination against COVID-19 became mandatory for healthcare workers in England. The media coverage of the mandate was extensive and became an issue of public interest. This study aimed to understand the United Kingdom (UK) debate on mandatory COVID-19 vaccination through a framing analysis of UK media coverage. Articles written between November 2021 and April 2022 were identified from UK national newspapers: The Daily (and Sunday) Telegraph, the Times (and Sunday Times), the Guardian (and the Observer), the Independent, the Daily Mail (and Mail on Sunday), the Daily Mirror, the Daily Express, and the Sun. Articles were selected using eligibility criteria before framing analysis was undertaken. The sample included 204 articles. Safe Staffing, Treatment of Staff, Change in Covid Context, and Protect Patient Safety were identified as frames used to stimulate debate on the mandatory vaccination policy. Such frames established three broader concepts in the media: civil liberty theory, duty-based ethics, and social-vulnerability theory. This study analyzed how mandatory COVID-19 vaccination for healthcare workers in England was framed in the UK national media. The broader concepts built in the media heightened debate on the policy, creating a voluminous amount of coverage and criticism that may have played a role in the mandate's reversal. [ABSTRACT FROM AUTHOR]

The Preschool Anxiety Scale (PAS) is a parent-report scale measuring young children's anxiety symptoms involving five specific anxiety symptoms (separation anxiety, physical injury fears, social phobia, obsessive–compulsive disorder, generalized anxiety) that load on a higher-order factor representing general anxiety shared by all specific anxiety symptom subtypes. Although the PAS has been widely used to assess anxiety symptoms in young children, few studies have tested its measurement invariance for group comparisons. Using data from a sample of 2,221 children and their parents/carers in the United Kingdom, this study investigated the measurement invariance of the higher-order model of the PAS across child age (4–6 years vs. 6–7 years), gender (girls vs. boys), parental anxiety (low vs. high level), and children's living circumstances (before vs. after the removal of COVID-19 restrictions). Our findings demonstrated the good factor structure, internal consistency, and convergent validity of the higher-order model of the PAS in all subgroups and supported its configural, metric, and scalar invariance across these subgroups. Therefore, the findings suggest that the PAS is a reliable and valid instrument for assessing specific anxiety symptoms and general anxiety among young children in the United Kingdom and that comparisons can be made between the subgroups under examination. Public Significance Statement: The Preschool Anxiety Scale (PAS) is a reliable and valid instrument for assessing specific anxiety symptoms and general anxiety in young children in the United Kingdom. Furthermore, given that the findings indicate measurement invariance of the higher-order model of the PAS, the specific anxiety symptom subscales and general anxiety scale of the PAS can be compared across child age, child gender, parent/carers' anxiety levels, and children's living circumstances (e.g., before and after the removal of the COVID-19 restrictions). [ABSTRACT FROM AUTHOR]

Summary: This study evaluated the feasibility of 'Social Workers in Schools', an intervention that involved social workers being based within schools across three local authorities in England (SWIS). Schools make a large number of referrals to Children's Social Care and play an important role in recognizing risks to children and protecting them from harm, but it is unusual for social workers to be based in schools in the U.K. and to do statutory work. We evaluated the pilots on the basis of the feasibility of implementing SWIS, how promising it was in terms of reducing the need for statutory intervention, and the extent to which it be scaled. We used a mixed methods approach, with a process evaluation and a difference in differences analysis of indicative impact on key social care outcomes. In addition, we estimated the cost of implementing and maintaining SWIS. Findings: We found high levels of acceptability among those involved, and examples of how SWIS enhances the way safeguarding issues are addressed. There was also some evidence that it may reduce the need for social care interventions, though this needs ratifying with more and better data. Applications: The study suggests that SWIS is a promising intervention. Both the qualitative and quantitative findings suggest it may have the intended policy impact, but this needs to be tested on a larger scale and with a more rigorous counterfactual comparison. Such a study—a randomized-controlled trial involving 21 local authorities—was commissioned in 2020. [ABSTRACT FROM AUTHOR]

Background: Research suggests that a better awareness of how staff who directly support people with intellectual disabilities experience their working relationships, will contribute to understanding staff wellbeing and the quality of care they offer. This study aimed to gain insights into the lived experiences of support workers in supported living services in England. Method: Six support workers participated in semi‐structured interviews, about their working relationships with service‐users and colleagues. Data was analysed using interpretative phenomenological analysis. Results: Six interconnected themes emerged: The essence of good relationships; a trusting relationship as the vehicle for meeting service‐users' needs; belonging to the support team; the organisational context of relationships; the social context of relationships; 'a fine balancing act'. Conclusions: The findings provide insights into staff wellbeing, indicating that developing supportive, trusting relationships with both service‐users and colleagues, plays an important role in delivering effective care. Potential implications for service providers are discussed. [ABSTRACT FROM AUTHOR]

Background: Shared housing for adults with intellectual disabilities with staff support, is a common housing model internationally. We explored an overlooked aspect of group homes, namely the extent to which they enable a sense of 'feeling at home' for residents. Method: A diverse group of 19 housemates participated in a photovoice study. Participants took photos in their homes and discussed them in individual interviews and in groups. Data was analysed using reflexive thematic analysis. Results: Residents' experience of home was multi‐dimensional. 'Feeling at home' related to home as a site of identity cultivation (personal home); physical comfort or 'misfitting' (physical home) and home as the locus of key relationships (social home). Conclusion: Achieving a sense of 'feeling at home' requires engagement in practices of home‐making. Many of our participants required support from staff to engage in these practices. For some housemates their experience of home was conditional and precarious. [ABSTRACT FROM AUTHOR]

Background: Previous research identifies organisational culture as one of a number of factors associated with the quality of life outcomes of group home residents' with intellectual and developmental disabilities. This study aims to elaborate on the dimensions of group home culture in settings in England. Method: Participant observations and semi‐structured interviews with staff were carried out in two group homes. Field‐notes, interview notes and transcripts were analysed using inductive thematic analysis by a researcher naïve to the project and the previous literature. Initial coding was re‐examined after sensitisation to theorised models in previous literature to identify the most parsimonious fit. The two settings were rated and compared using a five‐point Likert scale for each of the dimensions. Results: The findings describe group home culture across seven dimensions. There were mixed ratings across the different dimensions reflecting inconsistencies in culture that were reflected in staff practice. The challenge in assigning a global rating of culture in group homes, which includes interactions across multiple staff and multiple residents over time, was highlighted. Conclusion: The development of an observational measure of culture is highlighted as potentially helpful in understanding and responding to culture in services for individuals with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

Several diseases like Sickle Cell Anemia, Thalassemia, Hereditary Spherocytosis, Malaria, and Micro-angiopathic Hemolytic Anemia can alter the normal shape of red blood cells (RBCs). The objective of this study is to gain insight into how a change in RBC deformability can affect blood heat transfer. The heat sink effect in a bifurcated vessel with two asymptotic cases (case 1: deformable and case 2: nondeformable RBCs) is being studied during hyperthermia treatment in a three-dimensional bifurcated vessel, whose wall is being subjected to constant heat flux boundary condition. Euler–Euler multiphase method along with the granular model and Kinetic theory is used to include the particle nature of RBCs during blood flow in the current model. To enhance the efficiency of the numerical model, user-defined functions (UDFs) are imported into the model from the C++ interface. The numerical model used is verified with the experimental results from (Carr and Tiruvaloor, 1989, “Enhancement of Heat Transfer in Red Cell Suspensions In Vitro Experiments,” ASME J. Biomech. Eng., 111(2), pp. 152–156; Yeleswarapu et al. 1998, “The Flow of Blood in Tubes: Theory and Experiment,” Mech. Res. Commun., 25(3), pp. 257–262). The results indicate that the deformability of RBCs can change both the flow dynamics and heat sink effect in a bifurcated vessel, which subsequently affects the efficacy and efficiency of the thermal ablation procedure. Both spatial and transient Nusselt numbers of blood flow with deformable RBCs are slightly higher compared to the one with nondeformable RBCs. [ABSTRACT FROM AUTHOR]

This article provides a systematic and localized analysis of how female anti-slavery activity in the North-East of England influenced and impacted the transatlantic campaign to abolish slavery in the West Indies and then the United States. Female anti-slavery societies in Newcastle and Darlington organized local meetings with prominent African American anti-slavery campaigners, leading regional and national conversations about abolition and wider discussions about race and slavery. This article argues that regional conceptions of race and identity were shaped by local religious dissenting cultures and the unique professional relationships formed between African American abolitionists and North-East women's societies. This study is nonetheless critical of the way white female anti-slavery activism often envisioned emancipation as a fulfilment of maternal and imperialistic duties, arguing that the notion of a 'transatlantic sisterhood' espoused by British and American female abolitionists only served to further subjugate those who had previously been enslaved, delaying any unified political response from women on both sides of the Atlantic. [ABSTRACT FROM AUTHOR]

In March and April 1390, three French knights jousted against over one hundred knights and squires who had travelled from across Europe to challenge them, but above all from England. This great tournament was held at Saint-Inglevert near to Calais, the English outpost on the northern coastline of France. Modern scholars have viewed the event through the lens of the on-going Hundred Years War. But rather than seeing this chivalric competition as an extension of the war between the two sides, it should rather be understood as part of the diplomatic engagement between Charles VI and Richard II during the 1390s, an informal opportunity for the elites to meet and form bonds that shaped the rapprochement between the two sides. Saint-Inglevert also marked an important stage on the path towards the great theatrical tournaments of the fifteenth century, helping to explain the rise in popularity of the famous pas d'armes. [ABSTRACT FROM AUTHOR]

The housing market in England is in crisis, in terms of both availability and costs of housing. Although it is not a solution for everyone, many advocates of the tiny house movement promote developing small houses that are financially affordable and environmentally sustainable. There is limited research on tiny houses, and the hidden costs of developing this type of housing have not been investigated. This paper addresses this gap through exploring the perceived transaction costs associated with developing tiny houses in England, and how these costs can be reduced. It was found that there are considerable transaction costs in different stages of the development process, including searching for information, finding suitable land, obtaining planning permission, and constructing the house. The paper concludes that tiny houses require enabling legislation in planning policy so that planning permission is easier to obtain. Also, awareness of tiny houses needs to be raised so that local planning authorities and the public understand the concept better. [ABSTRACT FROM AUTHOR]

The number of missing child reports exceed police investigative capacity, yet some incidents are linked with harm, making effective risk assessment essential for safeguarding. Police data likely underrepresents harm to missing children due to harm being undisclosed, and missing incidents going unreported. A better understanding of harm associated with missing children could help to develop appropriate interventions to reduce missing incidents and prevent harm. This study examined 18 months of published Child Safeguarding Practice Reviews across England – a previously overlooked resource for understanding harm to missing children – to identify the intersecting characteristics, vulnerabilities, harm types, indicators, and issues with formal guardianship (safeguarding by carers, schools, local authorities, police and health professionals). Results revealed that children were missing, vulnerable, harmed, and showed indicators of exploitation in numerous and intersecting ways. Of the missing from home or care (MFHC) cases, all but two mentioned repeat missing incidents, all mentioned missing school, 75% mentioned exclusion, and over half mentioned going missing from both home and care. All MFHC cases mentioned multiple vulnerabilities and multiple harm types. All but one of the MFHC cases mentioned multiple exploitation indicators. This highlights opportunities for guardianship including extending the police Philomena Protocol to schools for children at risk of exclusion. The constraints of formal guardians, when combined with the risks faced by some vulnerable children, can lead to inadequate supervision and support – paradoxically leaving those children simultaneously overexposed to harm yet under-served by protective services. [ABSTRACT FROM AUTHOR]

In non-endemic countries, surveillance of non-travel cases of enteric fever is important to identify carriers and reduce secondary transmission. We characterised these cases in England between 2012 and 2021 and assessed potential sources of infection to inform guidance revision. Retrospective case–case. We identified enteric fever cases from the national surveillance dataset. Non-travel cases were defined as no travel to an endemic country or travel but onset of >60 days after return. Multivariable logistic regression was used to identify factors associated with non-travel cases. We reviewed the case records of cases with unknown source of infection. Compared to travel cases, non-travel cases (7%; 225/3075) were older (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.02–1.04), asymptomatic (OR = 9.3: 95% CI: 4.3–20.3), and confirmed with Salmonella typhi infection (OR = 1.74, 95% CI: 1.26–2.4). Non-travel cases had lower odds of being of Indian (OR = 0.27, 95% CI: 0.16–0.45) or Pakistani ethnicity (OR = 0.34, 95% CI: 0.16–0.45) than White British. Surveillance questionnaires identified a possible infection source for 53%: case records review identified a further 23%: 33% secondary transmission, mostly household; 21% had overseas visitors, or travelling family; 12% were carriers (cases with enteric fever in the past), 12% travelled to endemic country outside of the 60-day window, and 22% had other possible sources. Case records differentiated between travel 60–90 days (5%) vs travel years prior to onset (7%), suggesting carrier status. Not all possible carriers were identified through the surveillance questionnaire. Therefore, we recommend additional questions to systematically capture travel history beyond 60 days to assist in classifying carrier status and to updating the source of infection. [ABSTRACT FROM AUTHOR]

This article builds on the foundations provided by the History of Parliament Trust, utilising previously unconsidered documents from the papers of the Dukes of Hamilton to chart and analyse the conduct of parliamentary elections in later eighteenth-century Lancaster. It shows that these elections were more contentious than previously thought; the full range of political issues at play in these elections, and the engagement of the freemen electorate with these; and forms of electoral management and organisation in use that were not known in the borough until now. It places these new insights in the context of Lancaster's electoral politics through the long eighteenth-century, and draws out developments in this period that played an important role in the borough's nineteenth-century elections. [ABSTRACT FROM AUTHOR]

Background: There is limited literature regarding family and staff experiences of participating in clinical trials. A qualitative study was embedded in the NAVABronch feasibility trial evaluating the effectiveness of a novel mode of ventilation, neurally adjusted ventilatory assist (NAVA), in infants with acute viral bronchiolitis. Aim: The aim of this qualitative study was to explore the experiences of parents and health care practitioners (HCPs) involved in the NAVABronch Trial. Study Design: Semi‐structured interviews were conducted with two parents and two focus groups were held with six HCPs. Results: Four themes were identified from the focus groups: (1) Creating staff engagement, (2) Education to deliver NAVA, (3) Normalizing NAVA in clinical practice (4) Creating meaningful study outcomes and (5) support of parents during the trial, this theme was generated from the parent interviews. The findings indicated the need for education regarding NAVA for HCPs which would lead to increased confidence, better guidance around the use of NAVA and the need for NAVA to be normalized and embedded into the unit culture. Parents identified the need for further support around preparation for what may happen as a result of the interventions, particularly the weaning of sedation. Conclusion: Our study indicates that staff and parents had no concerns regarding the trial methods and procedures. Relevance to Clinical Practice: Conducting clinical trials in Paediatric Intensive Care Units (PICUs) is challenging and complex. There is limited literature regarding family and staff experiences of participating in clinical trials. Understanding their experiences is crucial in ensuring trial success. [ABSTRACT FROM AUTHOR]

Background: Despite increasing evidence of the potential inaccuracy and unwarranted practice of regular GRV measurement in critically in adults, this practice persists within the United Kingdom. Aim: To explore adult intensive care nurses' decision‐making around the practice of GRV measurement to guide enteral feeding. Study Design: A cross‐sectional 16 item electronic survey in four adult intensive care units (ICUs) in England and Wales. Results: Two hundred and seventy‐three responses were obtained across four ICUs with acceptable response rates for most [Unit 1 74 /127 = 58.2%; Unit 2 87/129 = 67.4%; Unit 3 77/120 = 64.1%; Unit 4 35/168 = 20.8%]. Most (243/273 (89%) reported measuring GRV 4–6 hourly, with most (223/273 82%) reporting that the main reason was to assess feed tolerance or intolerance and 37/273 (13.5%) saying their unit protocol required it. In terms of factors affecting decision‐making, volume obtained was the most important factor, followed by the condition of the patient, with aspirate colour and appearance less important. When asked how they would feel about not measuring GRV routinely, the majority (78.2%) of nurses felt worried (140/273 = 51.2%) or very worried (74/273 = 27%). Conclusions: Factors affecting the nurses' decision‐making around GRV were based largely on fear of risk (around vomiting and pulmonary aspiration) and compliance with unit protocols. Relevance to Clinical Practice: Despite increasing evidence suggesting it is unnecessary, nurses' beliefs around the value of this practice persist and it continues to be embedded into unit protocols around feeding. [ABSTRACT FROM AUTHOR]

A cross-sectional online survey was undertaken (July–August 2020) to ascertain parents' experiences during the COVID-19 pandemic of being at home with their newborn baby in the first 6 weeks. Participants (n = 371) were mostly biological mothers (n = 369, 99.4%), white British (n = 351, 94,5%), first baby (n = 186, 50%). A statistically significant positive correlation was found between maternal confidence and number of children (rho (369) = 0.295, p <.001) and baby's age at time of participation (rho (369) = 0.139, p =.009). Participants without higher educational qualifications (median = 62, SIQR = 3.5) had statistically significant higher confidence (U = 11831.500, p <.001) than participants with higher educational qualifications (median = 58, SIQR = 2). Parents of babies without health issues at birth (median, 61, SIQR = 3.5) had statistically significant higher confidence (U = 13213.500, p <.001) than parents of babies with health issues at birth (median = 58, SIQR = 5). Three qualitative themes have emerged: the impact of "no partner" restrictions; mixed emotions and lack of information and support. In conclusion, parenting during a pandemic created anxiety and fear, affected by "no partner" restrictions, not being allowed to appointments, scans, and during labor. Some parents were more confident and indicated benefits including heightening bonding with baby and partner during social distancing. IMPLICATIONS FOR PRACTICE: The strain of the pandemic on the mental health and well-being of parents could have a negative impact on future parenting. Healthcare professionals should not underestimate the potential consequences of declining perinatal mental health and should be vigilant to screen, enquire, and refer. Further research on this cohort of parents and children exploring the long-term impact of the COVID-19 pandemic on their ongoing health and wellbeing could be beneficial for future health-care policies and guidance. [ABSTRACT FROM AUTHOR]