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In response to the heightened risk that coronavirus disease 2019 (COVID-19) poses to the health and lives of people with obesity, in 2020 the U.K. government launched a new package of policies intended to stimulate weight loss among the country's population. In this article, I present a critical discourse analysis of the policy paper which announced these new measures. I identify the discourses that are used to represent things, people, and processes in this policy text. These discourses are interpreted in terms of broadly neoliberal ideologies of public health management. Taken together, the discourses identified contribute to a broadly neoliberal ideology of public health management. It is argued that the policy paper represents an instance of "lifestyle drift," as it initially appears to engage with social and economic determinants of health but ultimately neglects these in favor of focusing on individual lifestyle factors, particularly in the shape of individuals' "choices." [ABSTRACT FROM AUTHOR]

As a UK-based group of female postgraduate researchers, the authors explored their experiences during COVID-19 pandemic through multivocal inquiry via a feminist collaborative autoethnographic project. In this paper, we use the Listening Guide as a tool to revisit and (re)analyse data from the aforementioned project, displaying findings in the form of voice poems. In utilising the Listening Guide, we discovered that listening is less of an exercise and more an art form. While the structured approach of the LG helped to enhance our understandings of wider individual experiences of disability and womanhood, identities that all authors inhabit, we were surprised to find that despite our established mutual trust and superficially similar experiences, we were unable to find emotional resonance through data that wasn't our own voice. We also found that the traditional stepped process of the LG that incorporates four listens to the data left our interpretations feeling flat. Through reflexivity and the novel collaborative approach we undertook in this analysis, we identified and implemented an augmentation of the Listening Guide process. In this paper, we propose an additional fifth listen, focusing on emotion, to facilitate a more holistic analysis of voice data. We explore how the fifth listen assisted the (re)construction of individual and collective identities, helping us to reshape our understandings. Finally, we elucidate the positives and pitfalls we experienced in the Listening Guide as a data analysis tool, recommending to other researchers the adoption of an iterative, flexible and reflexive approach in using it during collaborative research. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to develop a typology of firms operating in a peripheral economy. A three-way typology is presented which builds on previous studies, distinguishing between the 'pure agglomeration'," 'industrial complex' and 'social network' models. This typology is refined and applied to the Mersey Dee area, a cross-border region within the UK with a dispersed, segmented economy. Two case studies of firms located in the Mersey Dee are explored to test the typology and examine how these firms related to their places and to other firms and institutions, in the context of rapidly changing market conditions due to COVID-19 and Brexit. The findings confirm the typology and establish a clear contrast between firm types operating in a peripheral economy such as the Mersey Dee, providing relevant insights into the contributions they can make and how balanced regional development policies could support the heterogeneity and richness of their place-based economies. These approaches will differ from the traditional agglomeration or cluster model, typically advocated to build sustainable economic centres. Further research is recommended through comparator case studies of similar regions internationally, within the typology presented. [ABSTRACT FROM AUTHOR]

As a UK-based group of female postgraduate researchers, the authors explored their experiences during COVID-19 pandemic through multivocal inquiry via a feminist collaborative autoethnographic project. In this paper, we use the Listening Guide as a tool to revisit and (re)analyse data from the aforementioned project, displaying findings in the form of voice poems. In utilising the Listening Guide, we discovered that listening is less of an exercise and more an art form. While the structured approach of the LG helped to enhance our understandings of wider individual experiences of disability and womanhood, identities that all authors inhabit, we were surprised to find that despite our established mutual trust and superficially similar experiences, we were unable to find emotional resonance through data that wasn't our own voice. We also found that the traditional stepped process of the LG that incorporates four listens to the data left our interpretations feeling flat. Through reflexivity and the novel collaborative approach we undertook in this analysis, we identified and implemented an augmentation of the Listening Guide process. In this paper, we propose an additional fifth listen, focusing on emotion, to facilitate a more holistic analysis of voice data. We explore how the fifth listen assisted the (re)construction of individual and collective identities, helping us to reshape our understandings. Finally, we elucidate the positives and pitfalls we experienced in the Listening Guide as a data analysis tool, recommending to other researchers the adoption of an iterative, flexible and reflexive approach in using it during collaborative research. [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]

This paper offers a multi-dimensional analysis of the ways and extent to which the US president and UK prime minister have securitized the Covid-19 pandemic in their public speeches. This assessment rests on, and illustrates the merits of, both an overdue theoretical consolidation of Securitization Theory's (ST) conceptualization of securitizing language, and a new methodological blueprint for the study of 'securitizing semantic repertoire'. Comparing and contrasting the two leaders' respective securitizing semantic repertoires adopted in the early months of the coronavirus outbreak shows that securitizing language, while very limited, has been more intense in the UK, whose repertoire was structured by a biopolitical imperative to 'save lives' in contrast to the US repertoire centred on the 'war' metaphor. [ABSTRACT FROM AUTHOR]

During the 1990s, three Directives were enacted that aimed to harmonise the regulation of medical devices within the European Union (EU). Custom-made devices (CMDs) were subject to Council Directive 93/42/EEC of 14 June 1993 concerning medical devices (Medical Device Directive [MDD]), which was given effect in the UK by the Medical Devices Regulations 2002 (UK MDR 2002). Regulation (EU) 2017/745 (Medical Device Regulation [EU MDR]) replaced the MDD and was transposed into the Medical Devices (Amendment etc.) (EU Exit) Regulations 2019 in the UK. The UK left the EU on 31 January 2020 and entered an 11-month implementation period (IP), during which any new EU legislation that was enacted also took effect in the UK. The EU MDR was scheduled to be fully implemented on 26 May 2020 (during the IP) but this was deferred for one year, until 26 May 2021 (after the IP had concluded), as a result of the coronavirus disease 2019 (COVID-19) pandemic. Consequently, the EU MDR was removed from the UK statute book by a further amendment to the UK MDR 2002, the Medical Devices (Amendment etc.) (EU Exit) Regulations 2020. Since 1 January 2021, CMDs manufactured in Great Britain can conform to either the UK MDR 2002 (as amended) or the EU MDR (until 30 June 2023) while devices manufactured in Northern Ireland are subject to the EU MDR alone. CMDs must be supplied with a statement, a label and, depending on the risk class, instructions for use; this paper answers ten questions regarding this documentation following these legislative changes. [ABSTRACT FROM AUTHOR]

COVID-19 lockdown and social distancing measures have restricted funerals and memorial events and have limited the face-to-face social networks that grieving people might normally be able to draw upon for emotional support. However, while there is considerable expert informed speculation about the impacts of grief and "COVID bereavement", detailed accounts of experiences of bereavement and bereavement support during the pandemic have the potential to enrich and provide nuance and subtlety to the evidence base. This paper draws on diary accounts of bereavement support volunteers in the UK, who have been providing support for the bereaved through these challenging times. These reveal layers of complexity to the experiences of loss, grief and bereavement during these extraordinary times. However, they also point to a number of additional themes that lend a more positive valence to the suspension of normal social expectations and memorial practices associated with the pandemic, which, we argue should be reflected upon for their potential to address the discontents of contemporary governance of end of life and bereavement. [ABSTRACT FROM AUTHOR]

The story of carriage cleaners has been sadly neglected in the history of railway workers. The work has low pay, it is sometimes unpleasant, and it is also physically tough. This panorama paper explores some of the literature surrounding the history of carriage cleaners from the earliest records in the nineteenth century, through the two world wars, up to the early days of privatisation. The focus is on female carriage cleaners, exploring the reasons why their work has been hidden from history and putting forward an argument as to why more attention should be drawn to it. Despite its low pay and poor working conditions, cleaning work is found at an important nexus of the railway economy, ensuring that the spaces of railway travel remain sanitary and functional. Given their importance for the operation of the railway transport system, it is surprising that cleaners remain largely invisible. [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]

Introduction: Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods: A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues. Results: The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination. Conclusion: Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption. [ABSTRACT FROM AUTHOR]

Against a background of stalling UK life expectancy, the COVID-19 pandemic necessitated a different way of working for public health to respond quickly to new and many demands. At the same time, public health teams had to ensure they did not concentrate on the immediate crisis at the expense of mitigating longer-term impacts of the pandemic. This was, and is, a major challenge with additional demands on an already hard-pressed workforce. This paper discusses the experience of a local public health department in responding to the pandemic and raises four key areas that influenced decisions and need to be considered in future. These are care homes issues, addressing all four harms of the pandemic, lessons for behaviour change and the need to strengthen Scotland's public health workforce. [ABSTRACT FROM AUTHOR]

In this paper, we reflect on 'scientific' governmental and media responses to Covid-19 in the UK, illuminating their negative impacts on complex and emergent touch forms/practices and people's related emotions. The scientisation of the pandemic led to the government initially placing the country in lockdown and enforcing social distancing. It thereby regulated and proscribed routine and normative touch practices in order to save lives. However, such strategies were not accompanied by an awareness that increased touch deprivation could be emotionally harmful, that lockdown could exacerbate abusive touch in the privatised familial domestic sphere, and that paid care-giver touch in other contexts, such as care homes for the elderly, could also be potentially lethal. These negative consequences are important for social workers to understand and appropriately respond to, as they disproportionately impact vulnerable and marginalised groups and are heightened for service users, who are frequently members of many disadvantaged groups simultaneously. [ABSTRACT FROM AUTHOR]

Will the UK Industrial Strategy deliver anything substantial to the North of England? This article examines the faltering steps taken to develop Local Industrial Strategies by Local Enterprise Partnerships and Mayoral Combined Authorities and argues Place Leadership and Industrial Strategy will both need to be substantially re-galvanised after COVID 19. It is also still not clear if a significant step change can be made by the Johnson Conservative government of 2019, which will have a major impact on Northern economies. Agencies' capacity to intervene in the Northern economy and deliver is a major issue, alongside stronger leadership. Analytically the paper uses theory on Multi-Sectoral Collaboration and Place Leadership to show how uniqueness of place, past and current interpersonal connections and networks can facilitate or frustrate economic development. Place leaders must create institutional arrangements, seek agreement over visions, objectives and strategies, otherwise the lack of shared information, resources, activities and capabilities lead to 'contestation' over space and action. We analyse the levels of cohesion or contestation in four different localities as each develops a Local Industrial Strategy. [ABSTRACT FROM AUTHOR]

The ongoing Covid-19 crisis and recession represent one of the biggest shocks to the UK manufacturing ecosystem yet, and comes at a time when the ecosystem was already in a worrying situation after decades of deindustrialisation, a decade of austerity and an impending 'Brexit'. The effects of this shock will also be unevenly felt due to the geography of the UK manufacturing ecosystem, amplifying the need for a successful response to ensure that places are not left (further) behind. This paper assesses the pre-Covid-19 ecosystem to ascertain the areas and industries likely to be particularly impacted by the crisis, and to understand existing issues. These issues are important to consider due to the implications for choosing strategies moving forward, for which two are appraised here. First, the reshoring of supply chains is considered in light of recent government comments, but difficulties in implementation may arise due to the highly fragmented nature of UK policy frameworks. Second, an acceleration of the 'grand challenges' approach is likely but limited by issues of connectivity in the ecosystem and small and medium-sized firm disengagement. We suggest that any strategy moving forward must strike a balance between such strategies [ABSTRACT FROM AUTHOR]

This protocol outlines a mixed-methods study to explore the dynamics of intimacy on dating apps before, during and after the crisis years of COVID-19 in the UK; how these influenced/were influenced by different gendered and sexual cultures of relating; and their impact on personal resilience, viral risk, and wellbeing. The project examines diverse gendered and sexual cultures, examining the experiences of heterosexuals and LGBT+ communities. Through a two-stage approach involving a UK-wide quantitative survey and in-depth qualitative interviews, the study explores how dating app practices influence resilience, viral risk, and intimate norms. The project aims to generate knowledge about how app-based services can be harnessed to support the social and emotional needs of diverse gendered and sexual groups during and after COVID-19 providing valuable insights into strategies for personal resilience in the face of viral risk and social during periods of social distancing. [ABSTRACT FROM AUTHOR]

This article describes an unexpected methodological shift made in response to the COVID-19 pandemic during doctoral research, and exemplifies reflexivity in action whilst negotiating my complex positionality as both a researcher and a social worker. The first UK national lockdown was announced after I had conducted 3 months of ethnographic data collection in a local authority adult social work team, thus halting my research. As society shut down, face-to-face research was paused overnight, however, the local authority continued to provide essential services and support. Forging a path forward, I successfully gained a job practising as a social worker within the team and completed a supplementary ethics application to include auto-ethnographic data which would complement the existing ethnography. Although practicing reflexivity and analysing positionality are established and encouraged parts of ethnographic research, how a researcher actively conducts them varies and usually remains unseen. Methodologies are often presented in a sanitised and polished manner, depriving the reader of the messy yet informative reality of research. This article draws upon fieldnotes to practically illustrate and bring this reflexivity on positionality to the fore. As I move from participant-observer to complete-participant, the findings zoom in on my experience of navigating positionality, revealing a micro picture of the details and subtleties of this process. This unexpected research journey enhanced my level of intimacy with the phenomenon, the research site, and the participants. Overall, this example of enacting reflexivity helps to bridge the gap between how positionality is theorised and how it actively practiced. Finally, this article is a call for more open, deeper, and continual reflexivity on our positionality as researchers. [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]

Healthcare workers, globally, volunteered time and skills to the COVID-19 pandemic frontline response. In March 2020, the predicted high demand for extra critical care beds led to the rapid construction of the UK National Health Service (NHS) Nightingale field hospital, London. I volunteered to develop and deliver psychological preparedness training – coined 'Psychological PPE' – to over 2300 frontline staff over an 8-week period. Existing research has identified broad themes of the impact working on the COVID-19 frontline has on healthcare workers but does not capture in-depth accounts of individuals' experiences. Using autoethnographic enquiry, this research explores my frontline experience at the NHS Nightingale during this time, and the personal impact this had on me. Reflexive thematic analysis explored themes of recognition and sacrifice, emotional lability and fragility, and the impact of transitions. Findings inform personal recovery, as well as future research and policy development pertaining to the sustainable recovery of our NHS people. [ABSTRACT FROM AUTHOR]

Intimate partner femicide (IPF) and attempted intimate partner femicide (AIPF) are severe forms of violence and global phenomena occurring in all societies worldwide. However, explaining IPF and AIPF is a complex and challenging endeavor. This article delves into the evolution of IPF and AIPF in Portugal during and after COVID-19, seeking to comprehend the underlying explanatory factors through a comprehensive strain-based approach. IPF rates during the COVID-19 pandemic have remained relatively stable, comparable to those observed before the pandemic, following a pattern akin to that documented in other countries. However, a significant increase in AIPF occurred during the COVID-19 pandemic, and a slight uptick in IPF indicators was noted toward the end of the pandemic period (2022). Perpetrators faced various strains, such as separation and financial difficulties, along with experiencing emotions like anger, jealousy, anxiety, and depression, leading to instances of IPF and AIPF. The COVID-19 crisis and associated restrictions introduced additional strains, including social isolation, economic losses, anxiety, and widespread fear, which may contribute to psychological distress, stress, and depression, thereby heightening the likelihood of committing IPF and AIPF. The pandemic restrictions also resulted in limited access to support and protection services, hindering victims from seeking help. Establishing a contingency plan for use in future crises (including pandemics) is imperative to promote support for victims and prevent situations of IPF and AIPF. [ABSTRACT FROM AUTHOR]

Pandemics are affecting tourism in many ways, and have had a major effect on international travel, the hospitality industry and tourism demand. Grounded in the protective action decision model and complexity theory, this study seeks to develop a model to explain the conditions that have led to travel avoidance in the UK in the context of the COVID-19 pandemic. To test our proposed model, we used a fuzzy-set qualitative comparative analysis of data gathered from 1,290 travelers, with semi-structured interviews conducted to confirm the configurations identified by the model. The findings indicate that effective pandemic information, effective risk communication, supplies, trust in government and trust in the media are necessary to combat travel avoidance, but the refutation of rumor and trust among traveler is not necessary to foster travel avoidance. Furthermore, qualitative follow-up interviews were conducted to obtain deeper insights into the discovered configurations and develop effective pathways to travel avoidance. [ABSTRACT FROM AUTHOR]

Although small and medium-sized enterprises (SMEs) were particularly hard hit by the coronavirus disease 2019 (COVID-19) pandemic, some performed relatively well, maintaining or increasing employment growth. We study these differences in performance through the lens of dynamic capabilities (DCs) theory, which we extend by incorporating the moderating effect of government support during COVID-19. We analyse responses from 1421 UK SMEs and find that government support and DCs positively impact employment. We also show that government support moderates the link between DCs and employment with a negative effect after the first COVID-19 lockdown. The findings highlight the role of government policy intervention in discouraging SMEs from effectively exercising DCs during a crisis and the general importance of DCs and government support in enabling SMEs to cope with shocks. [ABSTRACT FROM AUTHOR]

As one key strategy for disease prevention, SD constitutes a discursive response where Covid-19 is framed as a "scientific" problem with scientific solutions. This paper was written in May 2020, approximately two months after the UK and Ireland imposed stringent lock-down measures, including social distancing (SD). Social distancing as "Scientization": UK and Irish Policy responses to Covid-19, emotions and touch. [Extracted from the article]

Many commentators have suggested that the first 18 months of the Johnson government were characterised by a propensity to centralise power. However, few accounts have situated the administration in the historical context of the British state or systematically examined these centralising tendencies. This article attempts to address these omissions. First, through a critical assessment of the literature on authoritarian neoliberalism, the concept of 'executive centralisation' is developed within the context of the British state. Second, the article applies this revised framework to the early stages of the Johnson government. While a dominant executive is a long-standing feature of the British political system, it is argued that Johnson has pursued a multifaceted centralisation strategy facilitated by the context of Brexit and COVID-19. In identifying the role of consent in this process, the article augments scholarship on 'authoritarian neoliberalism' as a moment in neoliberal governance characterised by the ascendance of coercive governing strategies. [ABSTRACT FROM AUTHOR]

Background: Reiki is a biofield therapy which is based on the explanatory model that the fields of energy and information of living systems can be influenced to promote relaxation and stimulate a healing response. Objective: To conduct a pragmatic within-subject pilot trial of a remote Reiki program for frontline healthcare workers' health-related symptoms during the COVID-19 pandemic. Methods: Healthcare professionals in the UK (eg, physicians, nurses, and paramedics) were eligible to sign up for a distance Reiki program and were also invited to participate in the research study. Eight Reiki practitioners simultaneously gave each participant Reiki remotely for 20 minutes on 4 consecutive days. Feasibility of the research was assessed, including recruitment, data completeness, acceptability and intervention fidelity, and preliminary evaluation of changes in outcome measures. Participants' stress, anxiety, pain, wellbeing, and sleep quality were evaluated with 7-point numerical rating scales. Measures were completed when signing up to receive Reiki (pre) and following the final Reiki session (post). Pre and post data were analyzed using Wilcoxon signed ranks tests. Results: Seventy-nine healthcare professionals signed up to receive Reiki and took the baseline measures. Of those, 40 completed post-measures after the 4-day intervention and were therefore included in the pre-post analysis. Most participants were female (97.5%), and the mean age was 43.9 years old (standard deviations = 11.2). The study was feasible to conduct, with satisfactory recruitment, data completeness, acceptability, and fidelity. Wilcoxon signed ranks tests revealed statistically significant decreases in stress (M = −2.33; P <.001), anxiety (M = −2.79; P <.001) and pain (M = −.79; P <.001), and significant increases in wellbeing (M = −1.79; P <.001) and sleep quality (M = −1.33; P =.019). Conclusions: The Reiki program was feasible and was associated with decreased stress, anxiety and pain, and increased wellbeing and sleep quality in frontline healthcare workers impacted by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Preclinical (animal) testing and human testing of drugs and vaccines are rarely considered by social scientists side by side. Where this is done, it is typically for theoretically exploring the ethics of the two situations to compare relative treatment. In contrast, we empirically explore how human clinical trial participants understand the role of animal test subjects in vaccine development. Furthermore, social science research has only concentrated on broad public opinion and the views of patients about animal research, whereas we explore the views of a public group particularly implicated in pharmaceutical development: experimental subjects. We surveyed and interviewed COVID-19 vaccine trial participants in Oxford, UK, on their views about taking part in a vaccine trial and the role of animals in trials. We found that trial participants mirrored assumptions about legitimate reasons for animal testing embedded in regulation and provided insight into (i) the nuances of public opinion on animal research; (ii) the co-production of human and animal experimental subjects; (iii) how vaccine and medicine testing, and the motivations and demographics of clinical trial participants, change in an outbreak; and (iv) what public involvement can offer to science. [ABSTRACT FROM AUTHOR]

This article discusses the development of two short plays based on qualitative data from separate research studies related to dementia, both of which were performed in the UK in 2022. The first drama (Voices from the front line) is a relatively standard piece of verbatim theatre, based on interview data and written accounts from a research study about the experiences of the dementia workforce during the COVID-19 pandemic of 2020–22. The second (The Other Side of the Wall) is based on ethnographic data from a research study carried out with people with dementia living in long-term care, and it introduces elements of invention and absurdism. In both pieces, non-professional actors co-developed the performances, drawing on the spoken words of the original research participants. Using extracts and examples from the script development process, the article attempts to chart the developmental process for a novice ethnodramatist (although experienced dementia researcher) in meeting ethical, aesthetic and methodological challenges. [ABSTRACT FROM AUTHOR]

Objective: The Covid-19 pandemic created a backlog of women awaiting an invitation for breast screening in the UK. To recover in a timely fashion, the National Health Service programme opted to issue open invitations (OI) to women rather than the standard pre-booked timed appointments (TA). Historically, OIs have been shown to result in lower uptake. The aim of this study was to make use of a natural experiment to compare uptake in groups sent an OI with those sent a TA during a period when both invitation methods were in use. Methods: Women invited for routine screening at one of the six London breast screening services from September 2020 to March 2021 were included and grouped according to the type of invitation they had received (TA or OI). The outcome was attendance within 6 months of opening the screening episode. Data were analysed by logistic regression. Results: During the period of the study, 78,192 (32.5%) women received a TA and 162,680 (67.5%) received an OI. In the TA group, 47,391 (60.6%) attended within six months of offered appointment and in the OI group 86,430 (53.1%) attended. This difference was significant (p < 0.001). The odds ratio (95% CI) for the attended outcome was 1.44 (1.33–1.55) adjusted for differences in deprivation and for invitation category (first invitation or subsequent invitation). Conclusions: This study supports the view that TA delivers a higher uptake than OI. It suggests that during this period over 12,000 women in London, who would have been expected to attend if given the standard TA, did not attend their appointment having received an OI. [ABSTRACT FROM AUTHOR]

This article uses Henri Lefebvre's Rhythmanalysis as a foundational text for researching boredom, and offers a critical analysis of UK-based media commentaries about boredom and homeworking written during 2020 and 2021. We situate the discussion within the rhythmic rupture caused by the COVID-19 pandemic and foreground rhythm as a lens for understanding reported experiences and reflections on boredom and work. For non-essential workers, lockdown offered an opportunity to reconfigure working lives away from the constraints of commutes and everyday work settings, yet our findings highlight the narrative representation and experience of a particular type of boredom and inertia known as acedia. The analysis discusses the presence of acedia and absence of rhythm across three themes: acedia and being stuck in time and space; embodiment, movement and rhythm; and the relationship between the present and the future. We conclude by considering what the experience of boredom might mean for how we reconceptualise our post-pandemic working lives. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has resulted in governments playing increasingly prominent roles as active economic agents. However, state capitalism does not necessarily serve broad developmental purposes, and rather can be directed to supporting sectional and private interests. As the literature on variegated capitalism alerts us, governments and other actors regularly devise fixes in response to a systemic crisis, but the focus, scale, and scope of the interventions vary considerably, according to the constellation of interests. Rapid progress with vaccines notwithstanding, the UK government's response to COVID-19 has been associated with much controversy, not only because of an extraordinarily high death rate, but also because of allegations of cronyism around the granting of government contracts and bailouts. We focus on the latter, investigating more closely who got bailed out. We find that badly affected sectors (e.g. hospitality, transportation) and larger employers were more likely to get bailouts. However, the latter also favored the politically influential and those who had run up debt profligately. Although, as with state capitalism, crony capitalism is most often associated with emerging markets, we conclude that the two have coalesced into a peculiarly British variety, but one that has some common features with other major liberal markets. This might suggest that the eco-systemic dominance of the latter is coming to an end, or, at the least, that this model is drifting towards one that assumes many of the features commonly associated with developing nations. [ABSTRACT FROM AUTHOR]

Background: Palliative medicine physicians may be at higher risk of burnout due to increased stressors and compromised resilience during the COVID-19 pandemic. Burnout prevalence and factors influencing this among UK and Irish palliative medicine physicians is unknown. Aim: To determine the prevalence of burnout and the degree of resilience among UK and Irish palliative medicine physicians during the COVID-19 pandemic, and associated factors. Design: Online survey using validated assessment scales assessed burnout and resilience: The Maslach Burnout Inventory Human Services Survey for Medical Personnel [MBI-HSS (MP)] and the Connor-Davidson Resilience Scale (CD-RISC). Additional tools assessed depressive symptoms, alcohol use, and quality of life. Setting/participants: Association of Palliative Medicine of UK and Ireland members actively practising in hospital, hospice or community settings. Results: There were 544 respondents from the 815 eligible participants (66.8%), 462 provided complete MBI-HSS (MP) data and were analysed. Of those 181/462 (39.2%) met burnout criteria, based on high emotional exhaustion or depersonalisation subscales of the MBI-HSS (MP). A reduced odds of burnout was observed among physicians who worked ⩽20 h/week (vs 31–40 h/week, adjusted odds ratio (aOR) 0.03, 95% confidence interval (CI) 0.002–0.56) and who had a greater perceived level of clinical support (aOR 0.70, 95% CI 0.62–0.80). Physicians with higher levels of depressive symptoms had higher odds of burnout (aOR 18.32, 95% CI 6.75–49.73). Resilience, mean (SD) CD-RISC score, was lower in physicians who met burnout criteria compared to those who did not (62.6 (11.1) vs 70.0 (11.3); p < 0.001). Conclusions: Over one-third of palliative medicine physicians meet burnout criteria. The provision of enhanced organisational and colleague support is paramount in both the current and future pandemics. [ABSTRACT FROM AUTHOR]

Background: The need for end-of-life care in the community increased significantly during the COVID-19 pandemic. Primary care services, including general practitioners and community nurses, had a critical role in providing such care, rapidly changing their working practices to meet demand. Little is known about primary care responses to a major change in place of care towards the end of life, or the implications for future end-of-life care services. Aim: To gather general practitioner and community nurse perspectives on factors that facilitated community end-of-life care during the COVID-19 pandemic, and to use this to develop recommendations to improve future delivery of end-of-life care. Design: Qualitative interview study with thematic analysis, followed by refinement of themes and recommendations in consultation with an expert advisory group. Participants: General practitioners (n = 8) and community nurses (n = 17) working in primary care in the UK. Results: General practitioner and community nurse perspectives on factors critical to sustaining community end-of-life care were identified under three themes: (1) partnership working is key, (2) care planning for end-of-life needs improvement, and (3) importance of the physical presence of primary care professionals. Drawing on participants' experiences and behaviour change theory, recommendations are proposed to improve end-of-life care in primary care. Conclusions: To sustain and embed positive change, an increased policy focus on primary care in end-of-life care is required. Targeted interventions developed during COVID-19, including online team meetings and education, new prescribing systems and unified guidance, could increase capacity and capability of the primary care workforce to deliver community end-of-life care. [ABSTRACT FROM AUTHOR]

COVID-19 has posed serious challenges for informal carers living in the UK. This article examines some of the specific challenges facing carers and the resources they used to manage them throughout the first UK lockdown. We used a framework approach to analyse naturalistic, longitudinal data from 30 carers taking part in 96 of Mobilise's daily Virtual Cuppas between March and July 2020. We found that lack of information and social restrictions cumulatively impacted carers' sense of certainty, control and motivation. This took an emotional toll on the carers, leading to exhaustion and burden. However, carers quickly established new routines and used humour and self-care to actively manage their wellbeing. Carers received support but also provided it to those in need, including fellow members of the caregiving community, supporting an ecological approach to carer resilience. Our findings may be used to anticipate challenges and promote protective resilience resources in future lockdowns. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic placed additional demands and stressors on UK obstetric sonographers, who were required to balance parent safety and service quality, alongside staff safety. Increased pressure can negatively impact a healthcare worker's well-being and the provision of person-centred care. The aim of this study was to explore obstetric sonographers' experiences of performing pregnancy ultrasound scans during the pandemic and to assess the impact on burnout, role satisfaction and clinical practice. Methods: An online, anonymous cross-sectional survey was created to capture sonographers' experience alongside using the Oldenburg Burnout Inventory to evaluate burnout and Clinical Outcomes in Routine Evaluation 10 (CORE-10) to measure psychological distress. Results: Responses were received from 138 sonographers. Of those completing the Oldenburg Burnout Inventory (n = 89), 92.1% and 91.0% met the burnout thresholds for exhaustion and disengagement, respectively. Sonographers with a higher burnout score also perceived that COVID-19 had a greater, negative impact on their practice (p < 0.05). The mean CORE-10 score of 14.39 (standard deviation = 7.99) suggests mild psychological distress among respondents. A significant decrease in role satisfaction was reported from before to during the pandemic (p < 0.001), which was associated with higher scores for burnout and psychological distress (p < 0.001). Change in role satisfaction was correlated with sonographers' perception of safety while scanning during the pandemic (R 2 = 0.148, p < 0.001). Sixty-five sonographers (73.9%) reported they were considering leaving the profession, changing their area of practice or working hours within the next 5 years. Conclusion: Job and context-specific interventions are required to mitigate burnout and its consequences on the workforce and service provision beyond the pandemic. [ABSTRACT FROM AUTHOR]

The UK government's Everyone In scheme, announced in March 2020, required local authorities to temporarily house all homeless individuals in their area regardless of immigration status. In providing support through safe and secure accommodation, Everyone In also provided a crucial moment of visibility for migrants experiencing homelessness. Yet, just as it provided life-changing opportunities for some, the scheme was not straightforwardly a celebratory moment for migrants. It remained embedded within a wider context of immigration governance and social inequality in the UK, which has both invisibilised migrant homelessness as a crisis and hypervisibilised migrants as undeserving, suspicious or 'illegal' subjects. In this article, we explore life-story narratives co-produced with migrants across three urban contexts that capture their experiences of homelessness before and during the pandemic. In doing so, we introduce the notion of cultivated invisibility, referring to a habitual, deeply-ingrained mode of practice through which migrants respond to and navigate their experiences of being read as 'Other', in racialised or classed terms. It is developed through conditions of material scarcity and in the course of multiple engagements with racial capitalism's various 'faces of the state' in an increasingly hostile environment for migrants. Cultivated invisibility involves staying on the move and blending into the crowd or avoiding it altogether but it also includes the experience of being unseen despite having come forward for help. Importantly, we demonstrate that cultivated invisibility becomes a cause of illegalisation, just as much as a response to it. [ABSTRACT FROM AUTHOR]

In response to the Coronavirus disease, the United Kingdom (UK) government introduced lockdown measures requiring people to isolate and adhere to social distancing. This article uses Constraints Negotiation Theory to examine effects of the lockdown on people with vision impairment (PwVI). The research is based on an online survey of 639 PwVI in the UK. The analysis was conducted using partial least squares structural equation modelling in SmartPLS. The findings show that the lockdown had a negative effect on the participation and well-being of PwVI. However, they also show that the negative effects could be negotiated by adapting activities. This emphasises the need for a more inclusive response to current or future pandemics that recognises the vulnerabilities of PwVI and helps them to overcome the challenges associated with any measures that are introduced. [ABSTRACT FROM AUTHOR]

Objectives: Previous literature finds that having a child with a cleft lip and/or palate (CL/P) may pose social and emotional challenges for parents. For parents of children born during the Covid-19 pandemic, such challenges may be heightened. Further, novel demands brought about by the pandemic could have caused additional hardships. The aim of this study was to describe the impact of the pandemic on new parents through qualitative exploration of their experiences. Design: Semi-structured interviews were conducted with 14 parents of children born in the United Kingdom with CL/P between January and June 2020, around the start of the pandemic. Data were analysed using inductive thematic analysis. Results: Three themes, with sub-themes, were identified. The first theme, " Changes to Healthcare: The Impact of Restrictions and Reduced Contact", discussed the impact of the pandemic on perinatal care, the care received from the specialist CL/P teams, and parents' experiences of virtual consultations. The second theme, "Family Functioning During the Pandemic", covered parental anxiety, fathers' experiences, and social support. The third theme, " Surgical Prioritisation: Delays and Uncertainty", addressed changes to surgical protocols, coping with uncertainty, complications associated with delayed surgery, and how parents created positive meaning from this period. Conclusions: A range of increased and additional psychosocial impacts for parents were identified, along with several coping strategies, utilization of social support, and the positive aspects of their experiences. As the pandemic continues, close monitoring of families affected by CL/P remains imperative, particularly for those at risk of emotional distress. [ABSTRACT FROM AUTHOR]

This article explores the experiences of young adults with a life-shortening condition in the first wave of the Coronavirus (COVID-19) pandemic in the UK. It presents the findings from an inclusive qualitative research study using constructivist grounded theory which aimed to examine the unintended consequences of pandemic control measures (lockdown and 'shielding') on this population. Purposive and theoretical sampling methods were used to recruit young adults with a life-shortening condition, employing a range of recruitment methods such as social media, advertising in newsletters and snowballing. Twenty-six young adults (aged 22–40 years), with a wide range of life-shortening conditions participated in the study. Seventeen participants were female and nine male. The majority identified as White British/Other and the remainder as Black British (2), Mixed Race (2) or Latin American (1). Data were generated iteratively using in-depth guided interviews and analysed collectively by an inclusive research team using the constant comparative method. The article explores a theory of embodied precariousness of living with a life-shortening condition during the first wave of the Coronavirus pandemic in relation to three categories: the rationing of life-saving treatment, the deterioration of health and retraction of healthcare provision, and the disruption of typical care arrangements. The findings show that the pandemic control measures introduced to keep people safe have intensified the precarity of this group promoting inequalities in healthcare and health outcomes. The article identifies some implications for practice to support the future management of unexpected and unwanted change. [ABSTRACT FROM AUTHOR]

Evidence suggests that the COVID-19 pandemic has increased rates of depression worldwide. Many factors have been identified to relate to this increase depression, but according to Terror Management Theory, the heightened awareness of death during the pandemic has the potential to increase depression for those with low self-esteem. This hypothesis was examined in a U.K. sample during the first national lockdown where depression, self-esteem and death-thought accessibility (DTA) were measured, and a COVID Index (COVID-19 cases and deaths on date of participation) was produced. The COVID Index was positively related to DTA. Additionally, DTA mediated the relationship between the COVID Index and depression scores when participants had low levels of self-esteem. These findings suggest that heightened existential concerns may be a neglected factor increasing depression during the pandemic. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought to the fore the need for policy makers to receive timely and ongoing scientific guidance in response to this recently emerged human infectious disease. Fitting mathematical models of infectious disease transmission to the available epidemiological data provide a key statistical tool for understanding the many quantities of interest that are not explicit in the underlying epidemiological data streams. Of these, the effective reproduction number, R , has taken on special significance in terms of the general understanding of whether the epidemic is under control (R < 1). Unfortunately, none of the epidemiological data streams are designed for modelling, hence assimilating information from multiple (often changing) sources of data is a major challenge that is particularly stark in novel disease outbreaks. Here, focusing on the dynamics of the first wave (March–June 2020), we present in some detail the inference scheme employed for calibrating the Warwick COVID-19 model to the available public health data streams, which span hospitalisations, critical care occupancy, mortality and serological testing. We then perform computational simulations, making use of the acquired parameter posterior distributions, to assess how the accuracy of short-term predictions varied over the time course of the outbreak. To conclude, we compare how refinements to data streams and model structure impact estimates of epidemiological measures, including the estimated growth rate and daily incidence. [ABSTRACT FROM AUTHOR]

Scientific advice to the UK government throughout the COVID-19 pandemic has been informed by ensembles of epidemiological models provided by members of the Scientific Pandemic Influenza group on Modelling. Among other applications, the model ensembles have been used to forecast daily incidence, deaths and hospitalizations. The models differ in approach (e.g. deterministic or agent-based) and in assumptions made about the disease and population. These differences capture genuine uncertainty in the understanding of disease dynamics and in the choice of simplifying assumptions underpinning the model. Although analyses of multi-model ensembles can be logistically challenging when time-frames are short, accounting for structural uncertainty can improve accuracy and reduce the risk of over-confidence in predictions. In this study, we compare the performance of various ensemble methods to combine short-term (14-day) COVID-19 forecasts within the context of the pandemic response. We address practical issues around the availability of model predictions and make some initial proposals to address the shortcomings of standard methods in this challenging situation. [ABSTRACT FROM AUTHOR]

The UK has had a commitment to loan guarantee schemes since 1981 when it introduced the Small Firms Loan Guarantee (SFLG) scheme to address access to debt finance issues for smaller firms. Over the last 40 years, its support has been unwavering, and in the Covid-19 crisis, it once again turned to loan guarantees as a means of supporting smaller firms through the crisis-induced slump in trading activities. Of its three core Covid-19 guarantee schemes, the Bounce Back Loan (BBL) scheme was the most numerous with 1,531,095 loans issued amounting to a total of £46.5bn in lending. The BBL scheme provided a 100% capital guarantee on loans between £2,000 and £50,000, and firms were allowed to borrow up to 25% of their trading income, with a fixed interest rate of 2.5% of which the first years interest was paid by the government to the lending bank. Our findings suggest that the government losses may range between £7bn and £12bn depending on the underlying assumptions; however, we estimate Covid-19 guarantee schemes may have protected 118,639 businesses and 1,117,849 jobs. Looking to the future, we suggest that a new loan guarantee is justified that more resembles the former SFLG than the restrictive Enterprise Finance Guarantee (EFG) as more than one million small businesses will be heavily indebted and unable to borrow to invest in future growth opportunities. This would support the 'levelling-up' agenda and help prevent a post-Covid-19 low investment–low growth scenario. [ABSTRACT FROM AUTHOR]

Background: Dementia is a life-limiting illness, but the trajectory of dying can be difficult to establish and care at end of life can be variable and problematic. Methods: This UK study was carried out to explore the end-of-life-care experiences of people with dementia from the perspective of their family carers. In-depth interviews were conducted with 40 bereaved family carers of people with dementia. Results: Forty family carers (male n = 9, female n = 31) age range: 18–86 years were interviewed. Issues with poor communication were common. The hard work of caring and issues regarding unpredictability of living and dying with dementia were also commonplace within the study. Only three patients were referred for specialist palliative care support at the end of life, all of whom had a dual diagnosis of dementia and cancer. Conclusion: This qualitative study has identified that there are several gaps in the end-of-life care of people with dementia, and frequently, there is poor communication during the last year of life. The need for high-quality integrated care for people dying with dementia with appropriate support during the last year of life is identified. COVID-19 has disproportionately affected people with dementia, and in the post-pandemic era, there is an urgent need to ensure every person dying with dementia is supported to die in their preferred place and that family members are supported and enabled to be treated as the 'expert' in terms of their knowledge of their relatives' care and preferences. [ABSTRACT FROM AUTHOR]

Background: People with MS (pwMS) have had higher rates of anxiety and depression than the general population before the COVID-19 pandemic, placing them at higher risk of experiencing poor psychological wellbeing during the pandemic. Objective: To assess mental health and its social/lifestyle determinants in pwMS during the first wave of the outbreak in the United Kingdom. Methods: This is a community-based, prospective longitudinal cohort and cross-sectional case–control online questionnaire study. It includes 2010 pwMS from the UK MS Register and 380 people without MS. Results: The Hospital Anxiety and Depression Scale scores of pwMS for anxiety and depression during the outbreak did not change from the previous year. PwMS were more likely to have anxiety (using General Anxiety Disorder-7) and/or depression (using Patient Health Questionnaire-9) than controls during the outbreak (OR: 2.14, 95% CI: 1.58–2.91). PwMS felt lonelier (OR: 1.37, 95% CI: 1.04–1.80) reported worse social support (OR: 1.90, 95% CI: 1.18–3.07) and reported worsened exercise habits (OR: 1.65, 95% CI: 1.18–2.32) during the outbreak than controls. Conclusion: Early in the pandemic, pwMS remained at higher risk of experiencing anxiety and depression than the general population. It is important that multidisciplinary teams improve their support for the wellbeing of pwMS, who are vulnerable to the negative effects of the pandemic on their lifestyle and social support. [ABSTRACT FROM AUTHOR]

It has long been known that nursing work is challenging and has the potential for negative impacts. During the COVID-19 pandemic most nurses' working landscapes altered dramatically and many faced unprecedented challenges. Resilience is a contested term that has been used with increasing prevalence in healthcare with health professionals encouraging a "tool-box" of stress management techniques and resilience-building skills. Drawing on narrative interview data (n = 27) from the Impact of Covid on Nurses (ICON) qualitative study we examine how nurses conceptualized resilience during COVID-19 and the impacts this had on their mental wellbeing. We argue here that it is paramount that nurses are not blamed for experiencing workplace stress when perceived not to be resilient "enough," particularly when expressing what may be deemed to be normal and appropriate reactions given the extreme circumstances and context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Debates have grown around the initial COVID-19 response of radical right-wing governments such as those of the UK, the US and Brazil. These governments initially let the virus spread among the population and delayed the enforcement of strong social distancing measures such as a lockdown. Focusing on the UK's early response to COVID-19, this article builds on Nicos Poulantzas' Marxist theory of the state to highlight how this pandemic management doctrine stemmed from changes in the UK's capitalist class. It traces the ideological grounding of this doctrine, relating it to the rise of libertarian think tanks in British conservative circles and shifts in the policy committees in charge of pandemic preparedness. It suggests that this pandemic response is an episode of the ongoing replacement of the dominant neoliberal accumulation regime with a new libertarian-authoritarian one and examines how this latter materialises the interests of an emerging group of 'disaster capitalists'. Therefore, it takes the COVID-19 crisis as an example of how the reconfiguration of capitalist accumulation regimes articulates a new doctrine of catastrophe management, radical right-wing ideologies, libertarian-authoritarian institutions and the growing power of capitalist actors able to profit from extreme events. [ABSTRACT FROM AUTHOR]

Background: Experiences of end-of-life care and early bereavement during the COVID-19 pandemic are poorly understood. Aim: To identify clinical and demographic risk factors for sub-optimal end-of-life care and pandemic-related challenges prior to death and in early bereavement, to inform clinical practice, policy and bereavement support. Design: Online national survey of adults bereaved in the UK (deaths between 16 March 2020 and 2 January 2021), recruited via media, social media, national associations and organisations. Setting/participants: 711 participants, mean age 49.5 (SD 12.9, range 18–90). 628 (88.6%) were female. Mean age of the deceased was 72.2 (SD 16.1, range miscarriage to 102 years). 311 (43.8%) deaths were from confirmed/suspected COVID-19. Results: Deaths in hospital/care home increased the likelihood of poorer experiences at the end of life; for example, being unable to visit or say goodbye as wanted (p < 0.001). COVID-19 was also associated with worse experiences before and after death; for example, feeling unsupported by healthcare professionals (p < 0.001), social isolation/loneliness (OR = 0.439; 95% CI: 0.261–0.739), and limited contact with relatives/friends (OR = 0.465; 95% CI: 0.254–0.852). Expected deaths were associated with a higher likelihood of positive end-of-life care experiences. The deceased being a partner or child also increased the likelihood of positive experiences, however being a bereaved partner strongly increased odds of social isolation/loneliness, for example, OR = 0.092 (95% CI: 0.028–0.297) partner versus distant family member. Conclusions: Four clear risk factors were found for poorer end-of-life care and pandemic-related challenges in bereavement: place, cause and expectedness of death, and relationship to the deceased. [ABSTRACT FROM AUTHOR]

The novel coronavirus disease 2019 (COVID-19) pandemic and associated mitigation strategies such as "lockdown" are having widespread adverse psychological effects, including increased levels of anxiety and depression. Most research using self-reported data highlights the pandemic's impact on the psychological well-being of females, whereas data for mental health emergency presentations may reflect the impact on male mental health more accurately. We analyzed records of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national "lockdown." We computed two binary logistic regression models to (a) compare male mental health emergencies occurring during "lockdown," 2020 (5,779) with those occurring in the same period in 2019 (N = 4,744) and (b) compare male (N = 5,779) and female (N = 7,695) mental health emergencies occurring during "lockdown." Comparisons considered the characteristics of mental health emergencies recorded by ambulance clinicians (Primary Impressions), and the socioeconomic characteristics of communities where emergencies use the Index of Multiple Deprivation. We found that during "lockdown," male emergencies were more likely to involve acute anxiety (odds ratio [OR]: 1.42) and less likely to involve intentional drug overdose (OR: 0.86) or attempted suicide (OR: 0.71) compared with 2019. Compared with females, male emergencies were more likely to involve acute behavioral disturbance (OR: 1.99) and less likely to involve anxiety (OR: 0.67), attempted suicide (OR: 0.83), or intentional drug overdose (OR: 0.76). Compared with 2019, and compared with females, males experiencing mental health emergencies during "lockdown" were more likely to present in areas of high deprivation. Understanding the presentation of male mental health emergencies could inform improved patient care pathways. [ABSTRACT FROM AUTHOR]

Following the 2019 general election, the Prime Minister claimed that leaving the EU would enable him to 'get Brexit done' and introduce policies to "level up" inequalities in a post-EU UK. There still is, however, considerable uncertainty as to exactly what the government means by this, though it seemingly includes reducing differences in economic performance and opportunities between North and South in England, how it will achieve this goal and how 'levelling up' relates to the policy objective of restoring national economic growth, and with the added complication of also seeking a transition to a zero-carbon green economy and society. This ambition to 'level up' became even more challenging as COVID-19 both further revealed and reinforced existing deep socio-spatial inequalities. A more fundamental question is whether such an ambition is realisable within the context of a capitalist economy. Even so, despite the ambiguities and uncertainties surrounding it, 'levelling up" is undoubtedly a politically important message, directed at those voters, newly converted to the Conservative vision and who caused the former 'red wall' of Labour support partially to crumble. Some of these constituencies had not returned a Conservative MP for decades, others had never before returned a Conservative to Parliament. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare teams (general practice and community nursing services) within the United Kingdom provided the majority of community end-of-life care during COVID-19, alongside specialist palliative care services. As international healthcare systems move to a period of restoration following the first phases of the pandemic, the impact of rapidly-implemented service changes and innovations across primary and specialist palliative care services must be understood. Aim: To provide detailed insights and understanding into service changes and innovation that occurred in UK primary care to deliver end-of-life care during the first phase of the COVID-19 pandemic. Design: Cross-sectional online survey. Responses were analysed using descriptive statistics and thematic analysis. Setting/participants: United Kingdom survey of general practitioners and community nurses, circulated via regional and national professional networks. Results: A total of 559 valid responses were received from 387 community nurses, 156 general practitioners and 16 'other'. Over a third of respondents (n = 224; 40.8%) experienced changes in the organisation of their team in order to provide end-of-life care in response to the COVID-19 pandemic. Three qualitative themes were identified: COVID-19 as a catalyst for change in primary palliative care; new opportunities for more responsive and technological ways of working; and pandemic factors that improved and strengthened interprofessional collaboration. Conclusion: Opportunity has arisen to incorporate cross-boundary service changes and innovations, implemented rapidly at the time of crisis, into future service delivery. Future research should focus on which service changes and innovations provide the most benefits, who for and how, within the context of increased patient need and complexity. [ABSTRACT FROM AUTHOR]