Search

The COVID-19 Psychological Wellbeing Study was designed and implemented as a rapid survey of the psychosocial impacts of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known as COVID-19 in residents across the United Kingdom. This study utilised a longitudinal design to collect online survey based data. The aim of this paper was to describe (1) the rationale behind the study and the corresponding selection of constructs to be assessed; (2) the study design and methodology; (3) the resultant sociodemographic characteristics of the full sample; (4) how the baseline survey data compares to the UK adult population (using data from the Census) on a variety of sociodemographic variables; (5) the ongoing efforts for weekly and monthly longitudinal assessments of the baseline cohort; and (6) outline future research directions. We believe the study is in a unique position to make a significant contribution to the growing body of literature to help understand the psychological impact of this pandemic and inform future clinical and research directions that the UK will implement in response to COVID-19. [ABSTRACT FROM AUTHOR]

Jonathan Shay argued that social, relational, and institutional contexts were central to understanding moral injury and conceptualised moral injury as a normative response to the betrayal of an individual's understanding of what is right by a more senior/authoritative "other". Using the conceptual lens of moral injury, this paper investigates academic staff experiences of HE during the COVID-19 pandemic and explores the rapid transition back to face-to-face teaching that took place in autumn 2020. To collect data, we used an online survey that opened in January 2021 and ran until the end of March 2021. A total of 663 complete questionnaires were received across the survey period. The questionnaire was comprised of ten topic-related questions, each of which included follow-up sub-questions and also invited participants to write in additional information. The majority of participants felt that during the course of the COVID-19 pandemic, they had acted in ways that put their own health and wellbeing at risk. Of those who had acted in ways that put their health and wellbeing at risk, they believed that their senior management were the most responsible for them acting in such ways, followed by the UK government. Qualitative data showed a systemic absence of leadership in the sector during the time, a sense of betrayal of staff and students by senior management and the government, and feelings of compulsion to act in ways which put lives at risk. On the basis of these results, we argue that there could be synergies between the situation facing healthcare staff and academics during the pandemic. Many of the experiences of HE academic staff during the pandemic reported to us in this research are resonant with the concepts of betrayal and moral injury and resulted in affective responses which we understand here in relation to feelings of guilt, shame, and anger, leading ultimately to poor mental health and wellbeing. This paper discusses implications for the HE sector going forward. [ABSTRACT FROM AUTHOR]

Critical agency (CA) refers to an individual's feeling of power in relation to social inequalities. Research has demonstrated that high CA is associated with positive adolescent outcomes, however, less is known about what supports are important for its development. Moreover, a large majority of the literature is based on studies from the US and various countries in Africa; although the UK is saturated with inequalities there is little research within a UK context. In this paper we examine (a) the validity of using an existing measure of CA with a sample of UK adolescents and (b) the extent to which resilience supports account for variance in CA. Our analysis identified two distinct factors of CA: justice-oriented and community-oriented. High CA in both factors was explained by resilience supports associated with peer relationships (p < 0.01). Our findings push us towards new relational, ecological ways of understanding adolescent CA. We close by instantiating a translational framework for those devising policies in support of youth resilience and CA. [ABSTRACT FROM AUTHOR]

Aim: The aim of the paper is to enhance understanding of how members of the public make sense of the Covid-19 vaccines and to understand the factors influencing their attitudes towards such artefacts of pandemic governance. Methods: The paper draws on 23 online in-depth interviews with members of the UK public and builds on relevant literature to examine participants' perceptions of the benefits and risks of Covid-19 vaccines, the sources that have shaped their attitudes, and the level of trust they have towards the government's handling of the pandemic through vaccines. Results: The findings indicate that participants generally felt that the benefits of having the vaccine outweigh the risks and that Covid-19 vaccines are a crucial mechanism for enabling society to return to normal. Vaccine acceptance was, for some, strongly linked to a sense of social responsibility and the duty to protect others. However, some participants expressed concerns with regard to the side-effects of Covid-19 vaccines and their perceived potential impact on fertility and DNA makeup. Participants used various sources of information to learn about Covid-19 vaccines and understand their function, benefits, and risks. The majority of participants criticised the government's response during the early stages of the pandemic yet felt positive about the vaccine rollout. Conclusion: Just as with any other vaccination programme, the success of the Covid-19 immunisation campaigns does not only depend on the efficacy of the vaccines themselves or the ability to secure access to them, but also on a myriad of other factors which include public compliance and trust in governments and health authorities. To support an effective immunisation campaign that is capable of bringing the pandemic to an end, governments need to understand public concerns, garner trust, and devise adequate strategies for engaging the public and building more resilient societies. [ABSTRACT FROM AUTHOR]

A number of studies—including our own—find a mid-life dip in well-being. Yet several papers in the psychology literature claim that the evidence of a U-shape is "overblown" and if there is such a thing that any such decline is "trivial". Others have claimed that the evidence of a U-shape "is not as robust and generalizable as is often assumed," or simply "wrong." We identify 409 studies, mostly published in peer reviewed journals that find U-shapes that these researchers apparently were unaware of. We use data for Europe from the Eurobarometer Surveys (EB), 1980–2019; the Gallup World Poll (GWP), 2005–2019 and the UK's Annual Population Survey, 2016–2019 and the Census Bureau's Household Pulse Survey of August 2021, to examine U-shapes in age in well-being. We find remarkably strong and consistent evidence across countries of statistically significant and non-trivial U-shapes in age with and without socio-economic controls. We show that studies cited by psychologists claiming there are no U-shapes are in error; we reexamine their data and find differently. The effects of the mid-life dip we find are comparable to major life events such as losing a spouse or becoming unemployed. This decline is comparable to half of the unprecedented fall in well-being observed in the UK in 2020 and 2021, during the Covid19 pandemic and lockdown, which is hardly "inconsequential" as claimed. [ABSTRACT FROM AUTHOR]

In March 2020, the UK was placed in lockdown following the spread of the Covid-19 virus. Just as legitimate workplaces made changes to enable their employees to work from home, the illicit drugs trade also made alternative arrangements, adapting its supply models to ensure continuity of operations. Based upon qualitative interviews with 46 practitioners, this paper assesses how front-line professionals have experienced and perceived the impact of Covid-19 on child criminal exploitation and County Lines drug supply in the UK. Throughout the paper, we highlight perceived adaptations to the County Lines supply model, the impact of lockdown restrictions on detection and law enforcement activities aimed at County Lines, and on efforts to safeguard children and young people from criminal exploitation. Our participants generally believed that the pandemic had induced shifts to County Lines that reflected an ongoing evolution of the drug supply model and changes in understanding or attention because of Covid-19 restrictions, rather than a complete reconstitution of the model itself. Practitioners perceived that Covid-19 has had, and continues to have, a significant impact on some young people's vulnerability to exploitation, on the way in which police and frontline practitioners respond to County Lines and child criminal exploitation, and on the way illegal drugs are being moved and sold. [ABSTRACT FROM AUTHOR]

In this paper, we exploit a unique weekly longitudinal survey of adults in the UK purposefully collected to study consumption choices with respect to cultural content types during the first Covid-19 national lockdown (the "Great Lockdown"). We look for changes in the probability of consuming different cultural and creative types of content (Music, Movies, TV, Games, Books, Magazines and Audiobooks), as well as changes in the overall variety of consumption. We find that changes in consumption depend on the type of content. In particular, other things being equal, the likelihood of listening to Music and playing Games went up and the likelihood of reading Books went down. We find little statistically significant evidence of changes in the probability of consumption of the other types of content. We find that, while on average individuals increased the variety of their consumption, the statistical significance of this increase varied depending on the socio-demographic and economic characteristic of interest. In particular, we find evidence of an increase in the variety of consumption for those at the bottom of the distribution of socio-economic status, which speaks to the importance of access to culture and creativity during lockdown for this specific social class. [ABSTRACT FROM AUTHOR]

Research has shown that stress impacts on people's religious beliefs. However, several aspects of this effect remain poorly understood, for example regarding the role of prior religiosity and stress-induced anxiety. This paper explores these aspects in the context of the recent coronavirus pandemic (COVID-19). The latter has impacted dramatically on many people's well-being; hence it can be considered a highly stressful event. Through online questionnaires administered to UK (n = 140) and USA (n = 140) citizens professing either Christian faith or no religion, this paper examines the impact of the coronavirus crisis upon common people's religious beliefs. Anxiety about the coronavirus and prior religiosity showed an interaction effect upon change in religious beliefs (t(276) = 2.27, p =.024): for strong believers higher anxiety about coronavirus was associated with increased strengthening of religious beliefs (r =.249), while for non-believers higher anxiety about coronavirus was associated with increased scepticism towards religious beliefs (r = −.157). These observations are consistent with the notion that stress-induced anxiety enhances support for an individual's existing ideology already embraced before a stressful event occurs. This study sheds light on the psychological and cultural implications of the coronavirus crisis, which represents one of the most serious health emergencies in recent times. [ABSTRACT FROM AUTHOR]

The concept of the 'discouraged' borrower is well documented. In this paper, we consider whether smaller firms in the UK who have been previously rejected for bank loans have been scarred by the experience so badly that even in the presence of two exceptionally generous Covid-19 loan guarantee schemes, they still refuse to make an application. Furthermore, we also consider what happens when they do. As banks have either zero or minimal loss exposure, do they still maintain their normal strict lending protocols or do they relax their standards to fulfil the governments' objective of supporting struggling businesses through the crisis? Our findings show that 72% of previously rejected borrowers are reluctant to request loans. We find some evidence that previously scarred firms faced such severe liquidity problems that they relaxed their distrust of banks during the Covid-19 crisis. However, their share of the government-guaranteed loan portfolio was slightly lower suggesting that banks were treating each new loan application on its merits. Plain English Summary: The Covid-19 crisis hit smaller businesses so hard that even previously rejected borrowers were forced to apply for loans to keep them afloat. Previous loan rejections have not discouraged small businesses in the UK in applying for Covid-19 government-guaranteed loans. Banks have used the loan guarantee schemes to continue to supply loans to small business during the pandemic. Our paper analyses the important phenomenon of borrower scarring and discouragement, when potential debtors are self-excluded from the lending market because they have previous rejections or expect a negative bank response. We consider around 45,000 UK small businesses from 2018 to 2020. On the demand side, we find that the economic shock for small businesses during the pandemic dissipates the scarring effect. Specifically, we find that micro and small businesses had the highest loan demand in the first two quarters of the pandemic (from March 2020). On the supply side, we show that scarred borrowers were not routed onto Covid-19 government-guaranteed loan schemes. These findings show the importance of government-backed lending schemes for small businesses during crisis period. [ABSTRACT FROM AUTHOR]

A cornerstone of well-being research is that the resource-rich are happier with their lives than the resource-poor and better positioned to cope with stressful life events. This paper addresses the role of various resources—human, economic, social, and psychological capital—in life satisfaction during the coronavirus pandemic, using panel data from Germany and the United Kingdom for 2020 and 2021. Cross-sectionally, we find life satisfaction to be clearly related to all these forms of capital, with psychological capital being the strongest predictor of life satisfaction. Longitudinally, the capital endowments in 2020 did not predict changes in life satisfaction within individuals from 2020 to 2021, except for psychological capital. Our results suggest two things: first, the unfolding pandemic did not heighten well-being inequalities; and second, weathering the pandemic required psychological resources in the first place. [ABSTRACT FROM AUTHOR]

The National COVID-19 Chest Imaging Database (NCCID) is a centralized UK database of thoracic imaging and corresponding clinical data. It is made available by the National Health Service Artificial Intelligence (NHS AI) Lab to support the development of machine learning tools focused on Coronavirus Disease 2019 (COVID-19). A bespoke cleaning pipeline for NCCID, developed by the NHSx, was introduced in 2021. We present an extension to the original cleaning pipeline for the clinical data of the database. It has been adjusted to correct additional systematic inconsistencies in the raw data such as patient sex, oxygen levels and date values. The most important changes will be discussed in this paper, whilst the code and further explanations are made publicly available on GitLab. The suggested cleaning will allow global users to work with more consistent data for the development of machine learning tools without being an expert. In addition, it highlights some of the challenges when working with clinical multi-center data and includes recommendations for similar future initiatives. [ABSTRACT FROM AUTHOR]

News media plays a vital role in communicating scientific evidence to the public during the COVID-19 pandemic. Such communication is important for convincing the public to follow social distancing guidelines and to respond to health campaigns such as vaccination programmes. However, newspapers were criticised that they focus on the socio-political perspective of science, without explaining the nature of scientific works behind the government's decisions. This paper examines the connections of the nature of science categories in the COVID-19 era by four local newspapers in the United Kingdom between November 2021 to February 2022. Nature of science refers to different aspects of how science works such as aims, values, methods and social institutions of science. Considering the news media may mediate public information and perception of scientific stories, it is relevant to ask how the various British newspapers covered aspects of science during the pandemic. In the period explored, Omicron variant was initially a variant of concern, and an increasing number of scientific evidence showed that the less severity of this variant might move the country from pandemic to endemic. We explored how news articles communicate public health information by addressing how science works during the period when Omicron variants surge. A novel discourse analysis approach, epistemic network analysis is used to characterise the frequency of connections of categories of the nature of science. The connection between political factors and the professional activities of scientists, as well as that with scientific practices are more apparent in left-populated and centralist outlets than in right-populated news outlets. Among four news outlets across the political spectrum, a left-populated newspaper, the Guardian, is not consistent in representing relations of different aspects of the nature of scientific works across different stages of the public health crisis. Inconsistency of addressing aspects of scientific works and a downplay of the cognitive-epistemic nature of scientific works likely lead to failure in trust and consumption of scientific knowledge by the public in the healthcare crisis. [ABSTRACT FROM AUTHOR]

Economic shocks create insolvency law-making space, generating opportunities for legal reform that may be absent in good times. Policymakers may suddenly acquire a mandate to resource institutions or drive through a change in the law where in good times such reforms were likely to be foiled by interest group capture, or simply unlikely to get sufficient political traction. A crisis, then, is an opportunity for the well-prepared insolvency policymaker. Insolvency rule-making in crisis conditions is, however, plainly also risky. Making best use of the opportunity implies making more than temporary changes to the regime. But design choices made mid-crisis will almost inevitably be influenced by the features of the crisis itself, generating a risk that the result of the reform effort will be distorted law, ill-suited to the achievement of the lawmaker's objectives in the long run. This paper considers the permanent restructuring law reforms enacted in the UK during the first wave of the Covid-19 pandemic. At first glance, these reforms appear to exemplify the case of the well-prepared policymaker, poised to drive through carefully planned changes to the law when the opportunity arises. On closer inspection, however, a different picture emerges. The permanent measures, which were enacted in a fast-track legislative process, departed from the Government's pre-pandemic plan in material and undesirable ways. In some cases, these deviations mean that the original objective has not been achieved at all; in others, the objective has been at least partially achieved, but at unnecessary cost. Overall, the UK experience appears to better exemplify the risks of attempting insolvency law reform in a crisis, than the opportunities that a crisis affords to an insolvency policymaker. [ABSTRACT FROM AUTHOR]

Purpose: Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. Methods: We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Results: Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health. Conclusion: There is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities. [ABSTRACT FROM AUTHOR]

Multi-state models are used to describe how individuals transition through different states over time. The distribution of the time spent in different states, referred to as 'length of stay', is often of interest. Methods for estimating expected length of stay in a given state are well established. The focus of this paper is on the distribution of the time spent in different states conditional on the complete pathway taken through the states, which we call 'conditional length of stay'. This work is motivated by questions about length of stay in hospital wards and intensive care units among patients hospitalised due to Covid-19. Conditional length of stay estimates are useful as a way of summarising individuals' transitions through the multi-state model, and also as inputs to mathematical models used in planning hospital capacity requirements. We describe non-parametric methods for estimating conditional length of stay distributions in a multi-state model in the presence of censoring, including conditional expected length of stay (CELOS). Methods are described for an illness-death model and then for the more complex motivating example. The methods are assessed using a simulation study and shown to give unbiased estimates of CELOS, whereas naive estimates of CELOS based on empirical averages are biased in the presence of censoring. The methods are applied to estimate conditional length of stay distributions for individuals hospitalised due to Covid-19 in the UK, using data on 42,980 individuals hospitalised from March to July 2020 from the COVID19 Clinical Information Network. [ABSTRACT FROM AUTHOR]

Aim: As individuals adjust to new 'norms' and ways of living during the COVID-19 lockdown, there is a continuing need for up-to-date information and guidance. Evidence suggests that frequent media exposure is related to a higher prevalence of mental health problems, especially anxiety and depression. The aim of this study was to determine whether COVID-19 related media consumption is associated with changes in mental health outcomes. Methods: This paper presents baseline data from the COVID-19 Psychological Wellbeing Study. The cross-sectional study data was collected using an online survey following the Generalised Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), with some other basic information collected. Logistic regression analysis was used to examine the influence of socio-demographic and media specific factors on anxiety and depression. Results: The study suggested that media usage is statistically significantly associated with anxiety and depression on the GAD-7 and PHQ-9 scales with excessive media exposure related to higher anxiety and depression scores. Conclusion: This study indicated that higher media consumption was associated with higher levels of anxiety and depression. Worldwide it should be acknowledged that excessive media consumption, particularly social media relating to COVID-19, can have an effect on mental health. However, as this was a cross-sectional study we cannot infer any directionality as we cannot infer cause and effect; therefore, future research involving longitudinal data collection and analyses of variables over time is warranted. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) global pandemic poses the threat of overwhelming healthcare systems with unprecedented demands for intensive care resources. Managing these demands cannot be effectively conducted without a nationwide collective effort that relies on data to forecast hospital demands on the national, regional, hospital and individual levels. To this end, we developed the COVID-19 Capacity Planning and Analysis System (CPAS)—a machine learning-based system for hospital resource planning that we have successfully deployed at individual hospitals and across regions in the UK in coordination with NHS Digital. In this paper, we discuss the main challenges of deploying a machine learning-based decision support system at national scale, and explain how CPAS addresses these challenges by (1) defining the appropriate learning problem, (2) combining bottom-up and top-down analytical approaches, (3) using state-of-the-art machine learning algorithms, (4) integrating heterogeneous data sources, and (5) presenting the result with an interactive and transparent interface. CPAS is one of the first machine learning-based systems to be deployed in hospitals on a national scale to address the COVID-19 pandemic—we conclude the paper with a summary of the lessons learned from this experience. [ABSTRACT FROM AUTHOR]

The COVID-19 epidemic has raised major issues with regard to modelling and forecasting outcomes such as cases, deaths and hospitalisations. In particular, the forecasting of area-specific counts of infectious disease poses problems when counts are changing rapidly and there are infection hotspots, as in epidemic situations. Such forecasts are of central importance for prioritizing interventions or making severity designations for different areas. In this paper, we consider different specifications of autoregressive dependence in incidence counts as these may considerably impact on adaptivity in epidemic situations. In particular, we introduce parameters to allow temporal adaptivity in autoregressive dependence. A case study considers COVID-19 data for 144 English local authorities during the UK epidemic second wave in late 2020 and early 2021, which demonstrate geographical clustering in new cases—linked to the then emergent alpha variant. The model allows for both spatial and time variation in autoregressive effects. We assess sensitivity in short-term predictions and fit to specification (spatial vs space-time autoregression, linear vs log-linear, and form of space decay), and show improved one-step ahead and in-sample prediction using space-time autoregression including temporal adaptivity. [ABSTRACT FROM AUTHOR]

This paper explores ethical debates associated with the UK COVID-19 contact tracing app that occurred in the public news media and broader public policy, and in doing so, takes ethics debate as an object for sociological study. The research question was: how did UK national newspaper news articles and grey literature frame the ethical issues about the app, and how did stakeholders associated with the development and/or governance of the app reflect on this? We examined the predominance of different ethical issues in news articles and grey literature, and triangulated this using stakeholder interview data. Findings illustrate how news articles exceptionalised ethical debate around the app compared to the way they portrayed ethical issues relating to 'manual' contact tracing. They also narrowed the debate around specific privacy concerns. This was reflected in the grey literature, and interviewees perceived this to have emerged from a 'privacy lobby'. We discuss the findings, and argue that this limited public ethics narrative masked broader ethical issues. [ABSTRACT FROM AUTHOR]

In April 2020, close to the start of the first U.K. COVID-19 lockdown, the U.K. government announced the development of a COVID-19 contact tracing app, which was later trialled on the U.K. island, the Isle of Wight, in May/June 2020. United Kingdom surveys found general support for the development of such an app, which seemed strongly influenced by public trust. Institutions developing the app were called upon to fulfil the commitment to public trust by acting with trustworthiness. Such calls presuppose that public trust associated with the app can emerge if the conditions for trustworthiness are met and that public trust is simplistic, i.e., linearly the sum of each member of the publics' individual – U.K. government trust relationship. Drawing on a synthesis of the trust literature and fifteen interviews with members of the public trialling the app on the Isle of Wight, this paper aims to explore what trust mechanisms and relationships are at play when thinking about public trust in the context of the U.K. COVID-19 app. We argue that public trust is a complex social phenomenon and not linearly correlated with institutional trustworthiness. As such, attention needs to widen from calls for trustworthy infrastructures as a way to build public trust, to a deeper understanding of those doing the trusting; in particular, what or whom do people place their trust in (or not) when considering whether using the app and why. An understanding of this will help when trying to secure public trust during the implementation of necessary public health measures. [ABSTRACT FROM AUTHOR]

Purpose: As surgical specialties now begin the graduated return to elective activity and face-to-face clinics, this paper investigates the current head and neck outpatient practices across the United Kingdom. Methods: A cross-sectional study comprised of an online 20-item survey was distributed to members of the British Association of Head & Neck Oncologists (BAHNO). The survey was open on a web-based platform and covered topics including safety measures for patients, protective equipment for healthcare staff and protocols for the use of flexible nasendoscopy in the clinic. Results: The survey was completed by 117 participants covering 66 NHS Trusts across the UK. There was a significant reduction in face-to-face Otolaryngology, Maxillofacial and Speech and Language clinic patients when compared to pre-pandemic numbers (p < 0.0001). Risk assessments for flexible nasendoscopy were done for 69% of clinics and 58% had an established protocol. Room downtime after flexible nasendoscopy ranged from 0 to 6 h and there was a significant increase in allocated downtime after a patient had coughed/sneezed (p < 0.001). Natural ventilation existed in 36% of clinics and the majority of responders didn't know the Air Change Per Hour (ACPH) of the clinic room (77%). Where ACPH was known, it often did not match the allocated room downtime. Conclusion: There is a wide variation in outpatient activity across the United Kingdom, but adaptations are being made to try and maintain staff and patient safety. However, more can still be done by liaising with allied teams to clarify outpatient protocols. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health emergency. As a novel condition, there is no known definitive treatment for the condition, except for the use of vaccines as a control measure. In the literature, the issue of inequalities in healthcare systems has been documented as a hindrance to COVID-19 vaccination; however, the specific inequalities in healthcare systems that hinder COVID-19 vaccination are poorly understood. Guided by the fundamental cause theory (FCT), this study aims to address this gap among Black people, a minority group vulnerable to inequalities in healthcare systems. Thirty-five Black people (age range = 21-58 years) residing in either the United States of America (USA) or the United Kingdom (UK) participated in this study. Qualitative data were collected and analyzed using thematic analysis. Most USA participants and a few UK participants narrated that no inequalities in healthcare systems hinder them from receiving COVID-19 vaccines. Contrarily, most UK participants and a few USA participants narrated inequalities in healthcare systems that hinder them from receiving COVID-19 vaccines. These are mistrust of the healthcare system, health policies regarding COVID-19 vaccination, historical factors (such as historical abuse of Black bodies by health professionals), residential location, and dissatisfaction with health services. In terms of what governments must do to correct these inequalities, participants recommended the need for acknowledgment and community engagement. This is the first international collaboration to examine this problem. Important implications for theory, healthcare systems, and COVID-19 vaccination program planning are highlighted. Finally, there are members of other minority groups and vulnerable communities who are not Black people. Such groups could face unique inequalities that hinder COVID-19 vaccination. Therefore, future studies should include such groups. [ABSTRACT FROM AUTHOR]

Purpose: We sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic. Methods: In September–October 2020, we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed 3 months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Semi-structured qualitative interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and, following principles of thematic analysis, were analysed to explore changes over time in people's experience of the pandemic. Results: We interviewed 44 people, achieving diversity of demographic characteristics (73% female, 54% White British, aged 18–75) and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first theme "spectrum of adaptation" describes how participants reacted to reduced access to formal and informal support through personal coping responses or seeking new sources of help, with varying degrees of success. The second theme describes "accumulating pressures" from pandemic-related anxieties and sustained disruption to social contact and support, and to mental health treatment. The third theme "feeling overlooked" reflects participants' feeling of people with mental health conditions being ignored during the pandemic by policy-makers at all levels, which was compounded for people from ethnic minority communities or with physical health problems. Conclusion: In line with previous research, our study highlights the need to support marginalised groups who are at risk of increased inequalities, and to maintain crucial mental and physical healthcare and social care for people with existing mental health conditions, notwithstanding challenges of the pandemic. [ABSTRACT FROM AUTHOR]

By September 2022, more than 600 million cases of SARS-CoV-2 infection have been reported globally, resulting in over 6.5 million deaths. COVID-19 mortality risk estimators are often, however, developed with small unrepresentative samples and with methodological limitations. It is highly important to develop predictive tools for pulmonary embolism (PE) in COVID-19 patients as one of the most severe preventable complications of COVID-19. Early recognition can help provide life-saving targeted anti-coagulation therapy right at admission. Using a dataset of more than 800,000 COVID-19 patients from an international cohort, we propose a cost-sensitive gradient-boosted machine learning model that predicts occurrence of PE and death at admission. Logistic regression, Cox proportional hazards models, and Shapley values were used to identify key predictors for PE and death. Our prediction model had a test AUROC of 75.9% and 74.2%, and sensitivities of 67.5% and 72.7% for PE and all-cause mortality respectively on a highly diverse and held-out test set. The PE prediction model was also evaluated on patients in UK and Spain separately with test results of 74.5% AUROC, 63.5% sensitivity and 78.9% AUROC, 95.7% sensitivity. Age, sex, region of admission, comorbidities (chronic cardiac and pulmonary disease, dementia, diabetes, hypertension, cancer, obesity, smoking), and symptoms (any, confusion, chest pain, fatigue, headache, fever, muscle or joint pain, shortness of breath) were the most important clinical predictors at admission. Age, overall presence of symptoms, shortness of breath, and hypertension were found to be key predictors for PE using our extreme gradient boosted model. This analysis based on the, until now, largest global dataset for this set of problems can inform hospital prioritisation policy and guide long term clinical research and decision-making for COVID-19 patients globally. Our machine learning model developed from an international cohort can serve to better regulate hospital risk prioritisation of at-risk patients. [ABSTRACT FROM AUTHOR]

Population-representative estimates of SARS-CoV-2 infection prevalence and antibody levels in specific geographic areas at different time points are needed to optimise policy responses. However, even population-wide surveys are potentially impacted by biases arising from differences in participation rates across key groups. Here, we used spatio-temporal regression and post-stratification models to UK's national COVID-19 Infection Survey (CIS) to obtain representative estimates of PCR positivity (6,496,052 tests) and antibody prevalence (1,941,333 tests) for different regions, ages and ethnicities (7-December-2020 to 4-May-2022). Not accounting for vaccination status through post-stratification led to small underestimation of PCR positivity, but more substantial overestimations of antibody levels in the population (up to 21 percentage points), particularly in groups with low vaccine uptake in the general population. There was marked variation in the relative contribution of different areas and age-groups to each wave. Future analyses of infectious disease surveys should take into account major drivers of outcomes of interest that may also influence participation, with vaccination being an important factor to consider. Estimates of infection rates from the UK COVID-19 Infection Survey may have been biased by the characteristics of people who chose to take part. Here, the authors show that the survey population had unusually high vaccination rates and adjust infection estimates taking this into account. [ABSTRACT FROM AUTHOR]

Previous research indicates that discipline identification — the level of integration of one's discipline of study into the self-concept — is associated with deep approaches to learning and academic self-efficacy. However, it is not known whether these relationships would hold in the context of learning during the COVID-19 pandemic. The present study investigates this, as well as exploring whether belonging, identity incompatibility, and virtual and in-person time spent with fellow students and with faculty act as potential antecedents of discipline identification. A cross-sectional online survey with n = 385 students in the UK was conducted during the spring term (February–May) of the 2019–2020 academic year, when UK universities were under COVID-19 restrictions. Of those students, n = 109 completed a follow-up survey during the autumn term (September–December) of the 2020–2021 academic year. Due to pandemic-related changes, the two waves of data were analysed separately using path analysis. During the spring term, identity incompatibility and discipline identification were significantly associated with both deep approaches to learning and academic self-efficacy. There were also significant indirect effects of belonging on both deep approaches to learning and academic self-efficacy via discipline identification. During the autumn term, discipline identification was again significantly associated with both academic outcomes. Identity incompatibility was significantly associated with academic self-efficacy. There were also indirect effects of identity incompatibility and belonging on deep approaches to learning via discipline identification. These results add to the literature on the importance of discipline identification and associated social-psychological processes in predicting important higher education outcomes during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

There has been concern about adolescent mental health during the pandemic. The current study examined adolescent mental health during the initial phase of the COVID-19 pandemic in the UK. Using indicator of psychological distress, wellbeing and resilience, latent profile analysis was used to identify homogeneous mental health groups among young people aged 13–24 (N = 1971). Multinomial logistic regression was then used to examine which sociodemographic and psychosocial variables predicted latent class membership. Four classes were found. The largest class (Class 1, 37.2%) was characterised by moderate symptomology and moderate wellbeing. Class 2 (34.2%) was characterised by low symptomology and high wellbeing, while Class 3 (25.4%) was characterised by moderate symptomology and high wellbeing. Finally, Class 4 was the smallest (3.2%) and was characterised by high symptomology and low wellbeing. Compared to the low symptomology, high wellbeing class, all other classes were associated with less social engagement with friends, poorer family functioning, greater somatic symptoms, and a less positive model of self. A number of unique associations between the classes and predictor variables were identified. Although around two-thirds of adolescents reported moderate-to-high symptomology, most of these individuals also reported concurrent moderate-to-high levels of wellbeing, reflecting resilience. Furthermore, these findings demonstrate how a more comprehensive picture of mental health can be gained through adopting a dual-continua conceptualisation of mental health that incorporates both pathology and well-being. In this way, at-risk youth can be identified and interventions and resources targeted appropriately. [ABSTRACT FROM AUTHOR]

Current research indicates that young adults are at a higher risk of deteriorating wellbeing during the COVID-19 pandemic compared to older adults. Drawing upon the Understanding Society COVID-19 survey, this study examined the trajectory of life satisfaction in UK emerging adults from May 2020 to September 2021 with social, health, financial, and demographic factors as covariates. The analytic sample included 880 participants (612 females, 268 males) between the ages of 18–29. Growth curve modelling was used to estimate the trajectory of life satisfaction and examine whether the covariates account for variation in the mean level and/or slopes. The trajectory of life satisfaction declined slightly between May 2020 and January 2021 and then increased to September 2021, aligning with the tightening and easing of UK COVID-19 policies. Greater perceived current financial difficulties, pre-existing mental health and physical health conditions, and higher self-reported loneliness were associated with lower life satisfaction. Being female and living with a romantic partner, more face-to-face social interactions, and higher household income were associated with more life satisfaction. Gender interacted with pre-existing mental health conditions. Women with no pre-existing mental health conditions reported the highest level of life satisfaction, while women with pre-existing mental health conditions reported the lowest level, compared to men who reported a similar level of life satisfaction regardless of their mental health. The findings from the present study contribute toward the current understanding of changes in life satisfaction throughout the pandemic among emerging adults. Implications for intervention are discussed. [ABSTRACT FROM AUTHOR]

The ever-debated question of triage and allocating the life-saving ventilator during the COVID-19 pandemic has been repeatedly raised and challenged within the ethical community after shortages propelled doctors before life and death decisions (Anderson-Shaw and Zar 2020; Huxtable 2020; Jongepier 2020; Peterson, Largent, and Karlawish 2020). The British Medical Association's ethical guidance highlighted the possibility of an initial surge of patients that would outstrip the health system's ability to deliver care "to existing standards," where utilitarian measures have to be applied, and triage decisions need to maximize "overall benefit" (British Medical Association 2020, 3) In these emergency circumstances, triage that "grades according to their needs and the probable outcomes of intervention" will prioritize or eliminate patients for treatment, and health professionals may be faced with obligations to withhold or withdraw treatments to some patients in favour of others (British Medical Association 2020, 4). This piece is a response and extension to articles published on the manner of involvement for ethics and ethicists in pandemic triage decisions, particularly examining the ability and necessity of establishing triage committees to ameliorate scarce allocation decisions for physicians. [ABSTRACT FROM AUTHOR]

We analyse the UK policy response to Covid-19 and its impact on household incomes in the UK in April and May 2020, using microsimulation methods. We estimate that households lost a substantial share of their net income of 6.9% on average. But policies protected household incomes to a substantial degree: compared to the drop in net income, GDP per capita fell by 18.9% between the first and second quarter of 2020. Earnings subsidies (the Coronavirus Job Retention Scheme) protected household finances and provided the main insurance mechanism during the crisis. Besides subsidies, Covid-related increases to state benefits, as well as the automatic stabilisers in the tax and benefit system, played an important role in mitigating the income losses. However, analysing the impact of a near-decade of austerity on the UK safety net, we find that, compared to 2011 policies, the 2020 pre-Covid tax-benefit policies would have been less effective in insuring incomes against the shocks. We also assess the potential distributional impact of introducing a Universal Basic Income (UBI) instead of the Covid emergency measures and find that a UBI would have supported the incomes of different vulnerable groups but would have provided less protection to those hit hardest by the labour market shocks. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic lockdown restrictions posed unique challenges for people living with eating disorders (EDs), particularly relating to social isolation and changes in treatment access. However, less is known about the experience of lockdown for people 'in recovery' from EDs or disordered eating (DE) (i.e., with an ED/DE history). This study explored: (i) how people with a self-reported ED/DE history responded to and managed the experience of lockdown, specifically in relation to their recovery, and (ii) coping strategies for the management of recovery. Semi-structured interviews were conducted between June and August 2020 with 20 adults with a self-reported ED/DE history living in the UK. Data were analysed using inductive thematic analysis within a critical realist framework. Three overarching themes were identified: (1) Seeking safety and stability during a pandemic, (2) Lockdown prompting realisations about recovery, and (3) Exploring self-compassion as a more adaptive approach. While most participants experienced a resurgence in ED symptoms during lockdown, many reflected on the successful management of these as reinforcing their recovery. These findings have important implications for understanding ED recovery, in addition to informing interventions to better promote recovery during the COVID-19 pandemic and beyond. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused significant negative implications for individual wellbeing and many people accessed green spaces to help them cope with the demands of national lockdown restrictions. In response, the current study used Interpretative Phenomenological Analysis (IPA) to investigate the experiences of ten UK based nature volunteers whose activities had been disrupted due to the UK COVID-19 lockdowns throughout 2020. Each nature volunteer participated in a semi-structured interview held on a virtual platform which invited them to explore their experiences in nature during the pandemic. Analysis identified three main themes. 'Sensations of nature' explored the sense of presence and oneness with nature that the volunteers felt when mindfully engaging with the sensations found in nature. 'Stability from nature' investigated the ways in which the volunteers found meaning in nature and the sense of comfort, stability and hope this provided. Finally, 'Changing relationships with nature' examined the greater environmental awareness that the volunteers experienced and the ways in which this led to a desire to give back to nature. It is argued that mindful engagement with nature enhances a sense of personal wellbeing and cultivates a connection to nature which encourages environmental concern. [ABSTRACT FROM AUTHOR]

Objectives: Routine activity theory suggests that levels of crime are affected by peoples' activity patterns. Here, we examine if, through their impact on people's on- and off-line activities, COVID-19 restriction affected fraud committed on- and off-line during the pandemic. Our expectation was that levels of online offending would closely follow changes to mobility and online activity—with crime increasing as restrictions were imposed (and online activity increased) and declining as they were relaxed. For doorstep fraud, which has a different opportunity structure, our expectation was that the reverse would be true. Method: COVID-19 restrictions systematically disrupted people's activity patterns, creating quasi-experimental conditions well-suited to testing the effects of "interventions" on crime. We exploit those conditions using ARIMA time series models and UK data for online shopping fraud, hacking, doorstep fraud, online sales, and mobility to test hypotheses. Doorstep fraud is modelled as a non-equivalent dependent variable, allowing us to test whether findings were selective and in line with theoretical expectations. Results: After controlling for other factors, levels of crime committed online were positively associated with monthly variation in online activities and negatively associated with monthly variation in mobility. In contrast, and as expected, monthly variation in doorstep fraud was positively associated with changes in mobility. Conclusions: We find evidence consistent with routine activity theory, suggesting that disruptions to people's daily activity patterns affect levels of crime committed both on- and off-line. The theoretical implications of the findings, and the need to develop a better evidence base about what works to reduce online crime, are discussed. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) presents a severe and urgent threat to global health. In response to the COVID-19 pandemic, many countries have implemented nonpharmaceutical interventions (NPIs), including national workplace and school closures, personal protection, social distancing, contact tracing, testing, home quarantine, and isolation. To evaluate the effectiveness of these NPIs in mitigating the spread of early COVID-19 and predict the epidemic trend in the United Kingdom, we developed a compartmental model to mimic the transmission with time-varying transmission rate, contact rate, disease-induced mortality rate, proportion of quarantined close contacts, and hospitalization rate. The model was fitted to the number of confirmed new cases and daily number of deaths in five stages with a Markov Chain Monte Carlo method. We quantified the effectiveness of NPIs and found that if the transmission rate, contact rate, and hospitalization rate were approximately equal to those in the second stage of the most strict NPIs, and the proportion of quarantined close contacts increased by 3%, then the epidemic would die out as early as January 12, 2021, with around 1,533,000 final cumulative number of confirmed cases, and around 55,610 final cumulative number of deaths. [ABSTRACT FROM AUTHOR]

Background : Governments have relied on their citizens to adhere to a variety of transmission-reducing behaviours (TRBs) to suppress the Covid-19 pandemic. Understanding the psychological and sociodemographic predictors of adherence to TRBs will be heavily influenced by the particular theories used by researchers. This review aims to identify the theories and theoretical constructs used to understand adherence to TRBs during the pandemic within the UK social and legislative context. Methods: A systematic review identified studies to understand TRBs of adults in the UK during the pandemic. Identified theoretical constructs were coded to the Theoretical Domains Framework. Data are presented as a narrative summary. Results: Thirty-five studies (n = 211,209) investigated 123 TRBs, applied 13 theoretical frameworks and reported 50 sociodemographic characteristics and 129 psychological constructs. Most studies used social cognition theories to understand TRBs and employed cross-sectional designs. Risk of sampling bias was high. Relationships between constructs and TRBs varied, but in general, beliefs about the disease (e.g. severity and risk perception) and about TRBs (e.g. behavioural norms) influenced behavioural intentions and self-reported adherence. More studies than not found that older people and females were more adherent. Conclusions: Behavioural scientists in the UK generated a significant and varied body of work to understand TRBs during the pandemic. However, more use of theories that do not rely on deliberative processes to effect behaviour change and study designs better able to support causal inferences should be used in future to inform public health policy and practice. Prospero Registration: CRD42021282699. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, several governments tried to contain the spread of SARS-CoV-2, the virus that causes COVID-19, with lockdowns that prohibited leaving one's residence unless carrying out a few essential services. We investigate the relationship between limitations to mobility and mental health in the UK during the first year and a half of the pandemic using a unique combination of high-frequency mobility data from Google and monthly longitudinal data collected through the Understanding Society survey. We find a strong and statistically robust correlation between mobility data and mental health survey data and show that increased residential stationarity is associated with the deterioration of mental wellbeing even when regional COVID-19 prevalence and lockdown stringency are controlled for. The relationship is heterogeneous, as higher levels of distress are seen in young, healthy people living alone; and in women, especially if they have young children. [ABSTRACT FROM AUTHOR]

Persistent symptoms following the acute phase of COVID-19 present a major burden to both the affected and the wider community. We conducted a cohort study including over 856,840 first COVID-19 cases, 72,422 re-infections and more than 3.1 million first negative-test controls from primary care electronic health records from Spain and the UK (Sept 2020 to Jan 2022 (UK)/March 2022 (Spain)). We characterised post-acute COVID-19 symptoms and identified key symptoms associated with persistent disease. We estimated incidence rates of persisting symptoms in the general population and among COVID-19 patients over time. Subsequently, we investigated which WHO-listed symptoms were particularly differential by comparing their frequency in COVID-19 cases vs. matched test-negative controls. Lastly, we compared persistent symptoms after first infections vs. reinfections.Our study shows that the proportion of COVID-19 cases affected by persistent post-acute COVID-19 symptoms declined over the study period. Risk for altered smell/taste was consistently higher in patients with COVID-19 vs test-negative controls. Persistent symptoms were more common after reinfection than following a first infection. More research is needed into the definition of long COVID, and the effect of interventions to minimise the risk and impact of persistent symptoms. Post-acute COVID-19 condition is difficult to quantify because it includes a range of symptoms that may have other causes. In this study, the authors use primary care data from England and Catalonia, Spain, to estimate the incidence of the condition and identify symptoms that occur more frequently following infection than in uninfected controls. [ABSTRACT FROM AUTHOR]

Background: PROs are valuable tools in clinical care to capture patients' perspectives of their health, symptoms and quality of life. However the COVID-19 pandemic has had profound impacts on all aspects of life, in particular healthcare and research. This study explores the views of UK and Irish health professionals, third sector and pharmaceutical industry representatives and academic researchers on the impact of COVID-19 on PRO collection, use and development in clinical practice. Methods: A volunteer sample took part in a 10 question cross sectional qualitative survey, on the impact of COVID-19, administered online via Qualtrics. Demographic data was descriptively analysed, and the qualitative free text response data was subject to thematic analysis and summarised within the Strengths, Weaknesses, Opportunities and Threats (SWOT) framework. Results: Forty nine participants took part located in a range of UK settings and professions. Participants highlighted staff strengths during the pandemic including colleagues' flexibility and ability to work collaboratively and the adoption of novel communication tools. Weaknesses were a lack of staff capacity to continue or start PRO projects and insufficient digital infrastructure to continue studies online. Opportunities included the added interest in PROs as useful outcomes, the value of electronic PROs for staff and patients particularly in relation to integration into systems and the electronic patient records. However, these opportunities came with an understanding that digital exclusion may be an issue for patient groups. Threats identified included that the majority of PRO research was stopped or delayed and funding streams were cut. Conclusions: Although most PRO research was on hold during the pandemic, the consensus from participants was that PROs as meaningful outcomes were valued more than ever. From the opportunities afforded by the pandemic the development of electronic PROs and their integration into electronic patient record systems and clinical practice could be a lasting legacy from the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The recently derived Hybrid-Incidence Susceptible-Transmissible-Removed (HI-STR) prototype is a deterministic compartment model for epidemics and an alternative to the Susceptible-Infected-Removed (SIR) model. The HI-STR predicts that pathogen transmission depends on host population characteristics including population size, population density and social behaviour common within that population. The HI-STR prototype is applied to the ancestral Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) to show that the original estimates of the Coronavirus Disease 2019 (COVID-19) basic reproduction number R 0 for the United Kingdom (UK) could have been projected onto the individual states of the United States of America (USA) prior to being detected in the USA. The Imperial College London (ICL) group's estimate of R 0 for the UK is projected onto each USA state. The difference between these projections and the ICL's estimates for USA states is either not statistically significant on the paired Student t-test or not epidemiologically significant. The SARS-CoV2 Delta variant's R 0 is also projected from the UK to the USA to prove that projection can be applied to a Variant of Concern (VOC). Projection provides both a localised baseline for evaluating the implementation of an intervention policy and a mechanism for anticipating the impact of a VOC before local manifestation. [ABSTRACT FROM AUTHOR]

We study individual aversion to health and income inequality in three European countries (the United Kingdom, Germany, and Italy), its determinants and especially, the effects of exposure to three types of COVID-19 specific shocks affecting individuals' employment status, their income and health. Next, using evidence of representative samples of the population in the UK, we compare levels of health- and income-inequality aversion in the UK between the years 2016 and 2020. We document evidence of a significant increase in inequality aversion in both income and health domains. However, we show that inequality aversion is higher in the income domain than in the health domain. Furthermore, we find that inequality aversion in both domains increases in age and education and decreases in income and risk appetite. However, people directly exposed to major health shocks during the COVID-19 pandemic generally exhibited lower levels of aversion to both income and health inequality. Finally, we show that inequality aversion was significantly higher among those exposed to higher risk of COVID-19 mortality who experienced major health shocks during the pandemic. [ABSTRACT FROM AUTHOR]

The growing dissension towards the political handling of COVID-19, widespread job losses, backlash to extended lockdowns, and hesitancy surrounding the vaccine are propagating toxic far-right discourses in the UK. Moreover, the public is increasingly reliant on different social media platforms, including a growing number of participants on the far-right's fringe online networks, for all pandemic-related news and interactions. Therefore, with the proliferation of harmful far-right narratives and the public's reliance on these platforms for socialising, the pandemic environment is a breeding ground for radical ideologically-based mobilisation and social fragmentation. However, there remains a gap in understanding how these far-right online communities, during the pandemic, utilise societal insecurities to attract candidates, maintain viewership, and form a collective on social media platforms. The article aims to better understand online far-right mobilisation by examining, via a mixed-methodology qualitative content analysis and netnography, UK-centric content, narratives, and key political figures on the fringe platform, Gab. Through the dual-qualitative coding and analyses of 925 trending posts, the research outlines the platform's hate-filled media and the toxic nature of its communications. Moreover, the findings illustrate the far-right's online discursive dynamics, showcasing the dependence on Michael Hogg's uncertainty-identity mechanisms in the community's exploitation of societal insecurity. From these results, I propose a far-right mobilisation model termed Collective Anxiety, which illustrates that toxic communication is the foundation for the community's maintenance and recruitment. These observations set a precedent for hate-filled discourse on the platform and consequently have widespread policy implications that need addressing. [ABSTRACT FROM AUTHOR]

Changes in gambling advertising during national COVID-19 'lockdowns', when stay-at-home rules restricted participation in certain gambling activities, provides important context to variance in gambling behaviour during these periods. This study describes expenditure on paid-for gambling advertising during three national lockdowns, compares expenditure to pre-pandemic estimates, and compares changes in expenditure by subsector. Data come from an observational study of weekly expenditure on paid-for gambling advertising in the United Kingdom (n = 135 weeks; beginning 2019 to mid-2021), focusing on three COVID-19 lockdowns: (1) March-May 2020; (2) November-December 2020; and (3) January-March 2021. We descriptively analysed how total advertising expenditure in each lockdown (£GBP, inflation-adjusted) compared to the same time points in 2019, both overall and by subsector (bookmakers, lotteries, online bingo, online casino and poker, gaming, pools, mobile content). Gambling advertising expenditure during lockdown one was 38.5% lower than 2019 (£43.5 million[m] vs. £70.7 m, respectively), with decreases across all subsectors (range: -81.7% [bookmakers] to -2.8% [online bingo]). Total advertising expenditure in lockdown two was 49.3% higher than 2019 (£51.7 m vs. £34.6 m), with increases for 5/7 subsectors (range: -31.6% [mobile content] to + 103.8% [bookmakers]). In lockdown three, advertising expenditure was 5.9% higher than 2019 (£91.2 m vs. £86.1 m), with increases for 4/7 subsectors (range: -92.4% [pools] to + 49.2% [mobile content]). Reductions in advertising expenditure in lockdown one are congruent with self-reported reductions in overall gambling also observed during this period. Further research is needed to determine whether increased advertising expenditure in lockdowns two and three correlates with increased gambling, overall and for specific subsectors. [ABSTRACT FROM AUTHOR]

Current understanding of determinants for COVID-19-related cardiovascular and thromboembolic (CVE) complications primarily covers clinical aspects with limited knowledge on genetics and lifestyles. Here, we analysed a prospective cohort of 106,005 participants from UK Biobank with confirmed SARS-CoV-2 infection. We show that higher polygenic risk scores, indicating individual's hereditary risk, were linearly associated with increased risks of post-COVID-19 atrial fibrillation (adjusted HR 1.52 [95% CI 1.44 to 1.60] per standard deviation increase), coronary artery disease (1.57 [1.46 to 1.69]), venous thromboembolism (1.33 [1.18 to 1.50]), and ischaemic stroke (1.27 [1.05 to 1.55]). These genetic associations are robust across genders, key clinical subgroups, and during Omicron waves. However, a prior composite healthier lifestyle was consistently associated with a reduction in all outcomes. Our findings highlight that host genetics and lifestyle independently affect the occurrence of CVE complications in the acute infection phrase, which can guide tailored management of COVID-19 patients and inform population lifestyle interventions to offset the elevated cardiovascular burden post-pandemic. Cardiovascular and thromboembolic events (CVE) are common among hospitalised COVID-19 patients and are causes of many COVID-19-related deaths. Here, the authors examine whether genetic predisposition and lifestyle factors are associated with the risk of post-COVID-19 CVE using data from UK Biobank. [ABSTRACT FROM AUTHOR]

Patients with cancer are at increased risk of hospitalisation and mortality following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, the SARS-CoV-2 phenotype evolution in patients with cancer since 2020 has not previously been described. We therefore evaluated SARS-CoV-2 on a UK populationscale from 01/11/2020-31/08/2022, assessing case-outcome rates of hospital assessment(s), intensive care admission and mortality. We observed that the SARS-CoV-2 disease phenotype has become less severe in patients with cancer and the non-cancer population. Case-hospitalisation rates for patients with cancer dropped from 30.58% in early 2021 to 7.45% in 2022 while case-mortality rates decreased from 20.53% to 3.25%. However, the risk of hospitalisation and mortality remains 2.10x and 2.54x higher in patients with cancer, respectively. Overall, the SARS-CoV-2 disease phenotype is less severe in 2022 compared to 2020 but patients with cancer remain at higher risk than the non-cancer population. Patients with cancer must therefore be empowered to live more normal lives, to see loved ones and families, while also being safeguarded with expanded measures to reduce the risk of transmission. [ABSTRACT FROM AUTHOR]

Objective : To assess the longer term impact of the COVID-19 pandemic on the self-reported physical and mental health of people with inflammatory rheumatic diseases (IRDs). Methods: Two thousand twenty-four patients with IRDs were randomly selected from electronic health records. Survey invitations were sent (August 2021 coinciding with relaxation of UK COVID-19 restrictions) using SMS and postal approaches. Self-reported data included demographics, shielding status and physical (MSK-HQ) and mental health (PHQ8 and GAD7). Results: Six hundred thirty-nine people completed the survey (mean (SD) age 64.5 (13.1) years, 384 (60%) female). Moderate/severe impact of the pandemic on physical and mental health was reported by 250 (41%) and 241 (39%) respectively. One hundred seventy-two (29%) reported moderate/severe depression (PHQ8 ≥ 10) and 135 (22%) moderate/severe anxiety (GAD7 ≥ 10). Females reported greater impacts of the pandemic on physical health (44% vs 34%), mental health (44% vs 34%), arthritis symptoms (49% vs 36%) and lifestyle factors (weight gain and reduced exercise and physical activity) than males. The physical and mental impacts were less in people with RA compared with other IRDs. Physical health impacts did not differ between age groups, but younger patients reported greater impacts on mental health. Conclusion: The COVID-19 pandemic has had a significant impact on the physical and mental health of people with IRDs. These effects were greatest in females. Recovery needs to address the negative impact of the pandemic on lifestyle factors to minimise the long-term impacts for people with IRDs. Key Points • The pandemic had a significant impact on long term physical and mental health in almost 40% of people with IRDs. • The impact of the pandemic was greater in women for physical health, mental health and arthritis symptoms. • Many people reported negative pandemic impacts on lifestyle factors including weight and physical activity. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has been the source of large-scale disruption to the work practices of university staff, across the UK and globally. This article reports the experiences of n = 4731 professional services staff (PSS) working in UK universities and their experiences of pandemic-related work disruption. It specifically focuses on a transition to remote-working as a consequence of social restrictions and campus closures, presenting both quantitative and qualitative findings that speak to the various spatio-relational impacts of PSS working at distance from university campuses. These survey findings contribute to a new narrative of work organisation in higher education which addresses the potential of remote-working as a means for boundary crossing, social connectedness and trust relationships in universities in the immediate context and strongly anticipated post-pandemic future. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of the COVID-19 pandemic on the outcomes of the patients who underwent trauma surgery during the peak of the pandemic. Methods: The UKCoTS collected the postoperative outcomes of consecutive patients who underwent trauma surgery across 50 centres during the peak of the pandemic (April 2020) and during April 2019. Results: Patients who were operated on during 2020 were less likely to be followed up within a 30-day postoperative period (57.5% versus 75.6% p <0.001). The 30-day mortality rate was significantly higher during 2020 (7.4% versus 3.7%, p <0.001). Likewise, the 60-day mortality rate was significantly higher in 2020 than in 2019 (p <0.001). Patients who were operated on during 2020 had lower rates of 30-day postoperative complications (20.7% versus 26.4%, p <0.001). Conclusions: Postoperative mortality was higher during the first wave of the COVID-19 pandemic compared to the same period in 2019, but with lower rates of postoperative complications and reoperation. [ABSTRACT FROM AUTHOR]

This study investigates the effects of the COVID-19 pandemic on herding behaviour among investors in two well-developed markets. Utilizing daily prices of stock indexes from the period of December 5, 2017 to February 28, 2022 for USA and January 9, 2018 to February 28, 2022 for UK, we test for herding behaviour using the quantile regression approach in addition to the OLS model. We found no evidence of herding before the COVID-19 pandemic in both bullish and bearish markets for USA and UK. However, herding incidence was discovered in the USA and UK bullish market during the COVID-19 period. In the bearish market, herding behaviour was only found during the COVID-19 period in USA. The study provides policymakers and investors with information to draw significant measures in their investment portfolio management during crises and pandemics. [ABSTRACT FROM AUTHOR]

The present study explored the effects of the pandemic on individuals with Down Syndrome (DS; n = 67) compared to other groups with Special Education Needs and Disabilities (SEND; n = 48) and their Typically Developing Siblings (TDS; n = 56). In total, 115 caregivers reported on their own anxiety and worries and of their children. Anxiety levels for individuals with DS appeared to be lower compared to other SEND populations and to TDS. In terms of worries, individuals with DS worried more about social-related worries but worried less about family-related aspects compared to the other groups. In sum, individuals with DS might show less anxiety but still worried more about specific aspects related to the impact of COVID-19 pandemic on their lives. [ABSTRACT FROM AUTHOR]

Purpose: Financial adversity in times of economic recession have been shown to have an unequal effect on individuals with prior mental health problems. This study investigated the relationship between mental health groupings across the adult life-course and change in financial situation and employment status during the COVID-19 pandemic, as well as the use of financial measures to mitigate the economic shock. Methods: Using two nationally representative British birth cohorts, the National Child Development Study (1958) n = 17,415 and 1970 British Cohort Study n = 17,198, we identified 5 different life-course trajectories of psychological distress from adolescence to midlife which were similar but not identical across the two cohorts. We explored their relation to changes in financial and employment circumstances at different stages during the pandemic from May 2020 to March 2021, applying multinomial logistic regression and controlling for numerous early life covariates, including family socio-economic status (SES). In addition, we ran modified Poisson models with robust standard errors to identify whether different mental health trajectories were supported by government and used other methods to mitigate their financial situation. Results: We found that the financial circumstances of pre-pandemic trajectories of psychological distress with differential onset, severity, and chronicity across the life-course were exacerbated by the COVID-19 economic shock. The 'stable-high' (persistent severe symptoms) and 'adult-onset' (symptoms developing in 30s, but later decreasing) groups were vulnerable to job loss. Compared to pre-pandemic trajectory groupings with no, minor, or psychological distress symptoms in early adulthood, the 'stable-high', 'midlife-onset' (symptoms developing in midlife), and 'adult-onset' trajectory groups were more likely to seek support from the UK governments economic response package. However, trajectories with pre-pandemic psychological distress were also at greater risk of reducing consumption, dis-saving, relying on increased financial help from family and friends, and also taking payment holidays (agreements with lenders to pause mortgage, credit card or loan payments for a set period) and borrowing. Conclusion: This work highlights different trajectories of pre-pandemic psychological distress, compared to groups with no symptoms were more vulnerable to pandemic-related economic shock and job loss. By adopting unsustainable mitigating measures (borrowing and payment holidays) to support their financial circumstances during COVID-19, these mental health trajectories are at even more risk of lasting adverse impacts and future economic difficulties. [ABSTRACT FROM AUTHOR]