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Objectives In line with the aims of this special issue, the purpose of this paper is to forward a position on the concept of sport parenting expertise through the presentation of six key postulates. Design Literature review and position statement. Method By adopting methods associated with an academic position paper, a statement is presented that we believe encapsulates sport parenting expertise. Six key postulates of parenting expertise, formulated from critically reviewing and interpreting relevant literature, are then presented. Results We propose that sport parenting expertise is dependent on the degree to which parents demonstrate a range of competencies; namely that parents, (a) select appropriate sporting opportunities and provide necessary types of support, (b) understand and apply appropriate parenting styles, (c) manage the emotional demands of competitions, (d) foster healthy relationships with significant others, (e) manage organizational and developmental demands associated with sport participation, and, (f) adapt their involvement to different stages of their child's athletic career. Conclusion Expertise in sport parenting requires parents to develop knowledge and utilize a range of intrapersonal, interpersonal, and organizational skills in order to support their child, manage themselves, and operate effectively in the wider youth sport environment. Recommendations for applied researchers to further investigate these postulates and substantiate the components of sport parenting expertise are offered. [ABSTRACT FROM AUTHOR]

Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic. Arksey and O′Malley's scoping review framework. A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach. Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner. An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of ' leaving no one behind' in post-pandemic and future responses. [ABSTRACT FROM AUTHOR]

• Latent class analyses identify 15 types of drinking in Great Britain in 2019. • Alcohol consumption varies substantially across types of occasion. • Occasions that span the off-trade and on-trade involve particularly heavy drinking. • Heavy drinking is common across most occasion types, but so is moderate drinking. • Most heavy drinking takes place in off-trade only drinking occasions. This paper aimed to (i) update a previous typology of British alcohol drinking occasions using a more recent and expanded dataset and revised modelling procedure, and (ii) estimate the average consumption level, prevalence of heavy drinking, and distribution of all alcohol consumption and heavy drinking within and across occasion types. The paper uses a cross-sectional latent class analysis of event-level diary data that includes characteristics of 43,089 drinking occasions in 2019 reported by 17,821 adult drinkers in Great Britain. The latent class indicators are characteristics of off-trade only (e.g. home), on-trade only (e.g. bar) and mixed trade (e.g. home and bar) drinking occasions. These describe companions, locations, purpose, motivation, accompanying activities, timings, consumption volume in units (1 UK unit = 8g ethanol) and beverages consumed. The analysis identified four off-trade only, eight on-trade only and three mixed-trade occasion types (i.e. latent classes). Mean consumption per occasion varied between 4.4 units in Family meals to 17.7 units in Big nights out with pre-loading. It exceeded ten units in all mixed-trade occasion types and in Off-trade get togethers, Big nights out and Male friends at the pub. Three off-trade types accounted for 50.8% of all alcohol consumed and 51.8% of heavy drinking occasions: Quiet drink at home alone, Evening at home with partner and Off-trade get togethers. For thirteen out of fifteen occasion types, more than 25% of occasions involved heavy drinking. Conversely, 41.7% of Big nights out and 16.4% of Big nights out with preloading were not heavy drinking occasions. Alcohol consumption varies substantially across and within fifteen types of drinking occasion in Great Britain. Heavy drinking is common in most occasion types. However, moderate drinking is also common in occasion types often characterised as heavy drinking practices. Mixed-trade drinking occasions are particularly likely to involve heavy drinking. [ABSTRACT FROM AUTHOR]

• Many mental health disorders first emerge during early childhood or adolescence. • Wait times for children's mental health services have been an international and widespread problem. • Long wait times prolong the emotional distress of children and/or adolescents and their caregivers which can exacerbate mental health difficulties. • The majority of research in this area has been conducted in the United Kingdom and Canada and focus on one waitlist strategy. • Common strategies include alternative service delivery models, increasing system capacity, and improving intake and assessment processes. Background: Although many mental health disorders first emerge during early childhood or adolescence, there is a significant gap between demand and availability of mental health resources, leading to long waitlists for services. Objective: The objective of this scoping review was to identify and characterize the research literature related to the range of waitlist management strategies that have been implemented in outpatient child and adolescent mental health care. Methods: Electronic databases reviewed included: Medline (Ovid), Embase (Ovid), PubMed, PsychINFO, SCOPUS, CINAHL, and ISI Web of Science. Grey literature databases included: OpenGrey, Conference Papers Index, and Proquest Digital Dissertations. Articles were screened by two reviewers in two steps: first by title and abstract, then full text level. Data were extracted using an a-priori developed data extraction framework, which was piloted and modified iteratively. Results: A total of 119 papers related to waitlist interventions in child and adolescent mental health were reviewed. Of these 119 papers, 11% were reviews, summary, or theoretical papers; 8% used a randomized control trial design and 2.5% were trial protocols. Most studies used less rigorous designs, such as uncontrolled before-and- after designs. The large majority focused on just one waitlist strategy each. The most commonly used approaches included: prioritization/triage and initial assessment; brief consultation and advice or brief therapy approaches; group-based models; interim services; increasing capacity; and strategies to decrease non-attendance. Most studies were conducted in the United Kingdom or Canada. Discussion: While mental health systems are complex, most studies examining waitlist initiatives explored the implementation of single initiatives. It is unlikely that a single waitlist strategy can be effective in managing wait times for children's mental health. Rather, consistent and systemic approaches to address wait times that consider the impact of the reduction approach on the patient, the program, and the community are needed. [ABSTRACT FROM AUTHOR]

Synthetic cannabinoids (i.e. Spice) are a major public health problem in UK prisons, however, research in this area is limited. Here we aimed to draw comparisons between people with and without experience of using synthetic cannabinoids in prison, to characterise the features of, and motivations for use within this setting and evaluate support for different treatment interventions. Questionnaires were administered to 122 people in a category-B prison for adult males in England between July 2022 and March 2023. Participants were asked questions related to their sociodemographic and custodial characteristics, use of synthetic cannabinoids (and other drugs) inside and outside of prison and psychological distress was measured via the Brief Symptom Inventory (BSI-18). Those that had ever used synthetic cannabinoids in prison completed additional questions related to features of use, motivations for use and support for various interventions. In total 46.7 % (n = 57) of participants reported use of synthetic cannabinoids in prison and this group experienced significantly greater levels of psychological distress compared to those reporting no use (mean (± standard deviation) BSI-18 scores = 23.7 (±16.7) vs 12.8 (±13.6), p < 0.001). Participants mostly reported using paper-based preparations (77.4 %) and use via e-cigarettes (75.9 %). The most strongly endorsed motivations for use included to alleviate boredom (91.1 % strongly agree/agree), to make the sentence pass faster (89.3 % strongly agree/agree) and to cope with stress (80.4 % strongly agree/agree). The interventions that received most support were strategies to better manage time and medication to manage withdrawal. The use of synthetic cannabinoids in UK prisons typically involves the use of paper-based preparations via e-cigarettes, and use is associated with greater levels of psychological distress. Motivations for use were mostly pragmatic (e.g. to alleviate boredom or cope with stress) and interventions should prioritise increasing the time individuals spend out of cells and in meaningful activity. [ABSTRACT FROM AUTHOR]

This paper presents two studies which address an underdeveloped area within acculturation research: majority members' perceptions of cultural change. Specifically, drawing on the theory of cultural inertia, we explored how majority members react to perceptions of recent majority culture and minority cultures change. A path model was hypothesised whereby British and English majority members' perceptions that their British (Study 1, N = 266) and English (Study 2, N = 292) cultures are changing due to the presence of minority cultures was positively associated with symbolic threat, and through this with greater prejudice towards minorities living in the UK/England. However, participants' perceptions that minority cultures are changing due to influence from the majority culture were negatively associated with symbolic threat, and through this with less prejudice towards minorities. These findings were supported across different operationalizations of prejudice (i.e., social distance and positive/negative affect) and even when controlling for another recently introduced concept of meta-perceptions – that is, majority members' perceptions of whether minority members prefer majority members to maintain their culture and/or adopt to the minority cultures. Findings call for a greater focus on studying the intergroup consequences of majority members' perceptions of cultural change. [ABSTRACT FROM AUTHOR]

The social identity approach to leadership posits that leaders' effectiveness depends on their ability to represent, advance, create, and embed a shared sense of social identity among their followers. Although significant progress has been made in investigating the benefits of identity leadership in adult sports, research in youth sports is still in its infancy. One reason is the lack of a youth-centric inventory that adequately measures identity leadership in this population. To bridge this gap, we developed and validated a long (16 items) and short (5 items) version of the Identity Leadership Inventory for Youth Sport (ILI-Y or ILI-Y-Short-Form) through five studies conducted in three phases of research. Data were primarily collected in football in the United Kingdom, involving a total of 1096 participants. Results of Phase I of this study provided little to no evidence that the ILI – originally developed for adults – was understandable (Study 1) and had factor validity and internal consistency (Study 2) in a sample of youth athletes. Therefore, in Phase II, the ILI was revised, leading to the development of the ILI-Y, which was understandable for youth athletes (Study 3). Results from Phase II (Study 4) also indicated that the ILI-Y exhibited a unidimensional factor structure, which was subsequently confirmed in Phase III (Study 5). This last phase offered additional evidence for the discriminant, criterion, and incremental validity of the ILI-Y and its short form, along with their measurement invariance across genders and age groups, and internal consistency. This study provides sports psychology researchers and practitioners with a valid measure to assess identity leadership in youth sports. • This mixed-method paper reports on five studies with 1096 participants. • We validated an inventory for measuring identity leadership in youth sports. • Identity leadership in youth sports is positively associated with key outcomes. [ABSTRACT FROM AUTHOR]

The cancer-specific health-related quality of life (HRQoL) questionnaire of the European Organisation for Research and Treatment of Cancer (EORTC), the EORTC QLQ-C30, is a frequently applied questionnaire to assess cancer patients' self-reported health used as part of research and clinical practice. Normative data obtained from the general population can facilitate the interpretation of these data. Despite its frequent application, no detailed EORTC QLQ-C30 normative data have yet been published for the United Kingdom (UK). This study presents detailed EORTC QLQ-C30 normative data for the United Kingdom overall and by sex and age. The data are drawn from a larger published, international, cross-sectional online survey. For the recruitment, the sample was stratified by sex (males, females) and age in five age groups with a sample size of n = 100 per subgroup. A total of N = 1026 UK respondents completed the survey (n = 517 females, n = 509 males). There were no clear subgroup patterns by sex or age; however, older patients tended to show higher (i.e., better) scores in emotional and social functioning; they also reported some of the lowest (i.e., best) scores for symptoms, such as insomnia, appetite loss, diarrhoea, nausea/vomiting or financial difficulties. This paper provides EORTC QLQ-C30 general population normative data for the UK, further stratified by sex and age. These data will greatly support the interpretation of EORTC QLQ-C30 scale scores obtained from UK cancer patients, and also enable comparison with other detailed national normative datasets collected in the same project, across several other European countries and the US. • EORTC QLQ-C30 is a cancer quality of life (QoL) tool for functioning and symptoms. • Normative QoL data collected from 1026 respondents in UK general population. • No clear patterns, generally oldest had better functioning and fewer symptoms. • Look-up tables for EORTC QLQ-C30 scales for the UK general population. • Interpretation aid for data from individual and groups of UK cancer patients. [ABSTRACT FROM AUTHOR]

In this multi-study paper, we adopted a mixed methods approach to examine the motivational profiles of sub-elite student footballers participating in UK university sport, in relation to their wellbeing, burnout, and drop-out intentions. In Study 1 we used a cross-sectional survey design to collect quantitative measures of motivational regulations, wellbeing, burnout, and drop-out intentions in 260 (n = 129 female) and (n = 131 male) sub-elite university footballers from UK universities (M age = 20.7 y, SD = 1.5 y). Latent profile analysis revealed five distinct motivational regulation profiles that we deemed ranged from less to more motivationally adaptive in the following order: High-controlled, Amotivated (n = 27), Very-low Motivation (n = 32), Average Motivation (n = 104), High-autonomous, High-controlled (n = 38), and High-autonomous, Low-controlled (n = 59). Wald chi-square tests revealed between-profile differences in wellbeing (χ2 = 115, p <.001), burnout (reduced accomplishment: χ2 = 74, p <.001, exhaustion: χ2 = 34, p <.001, devaluation: χ2 = 121, p <.001), and drop-out intentions (university football: χ2 = 40, p <.001, football in general: χ2 = 91, p <.001). Pairwise comparisons suggested more adaptive motivational profiles had higher wellbeing, and lower burnout and drop-out intentions, than less adaptive profiles. Subsequently, in Study 2 we qualitatively explored the experiences of footballers from the different motivational profiles. We purposefully sampled 2–4 participants from each of the five motivational profiles to take part in focus groups, resulting in a total of 15 participants (M age = 21.6 y, SD = 1.41 y; n = 8 female, n = 7 male). Results revealed commonalities across the motivational profiles, including that while motivation was complex, individualized, dynamic and interactive in nature; a central, underlying motivator for all players was their passion for football. However, results also suggested that compared to those from less motivationally adaptive profiles, those from more adaptive profiles tended to perceive the environment more positively and tended to feel more valued by those around them. Thus, protecting players' passion for football and helping them feel more valued within their university-sport environment may support players in remaining in, or moving towards, more adaptive motivational regulation profiles and experiencing associated positive outcomes. • The motivational profiles of sub-elite student footballers participating in UK university sport were examined. • Underpinned by critical realism, a multi-study mixed methods approach was adopted. • Adaptive motivational regulation profiles were associated with positive outcomes (Study 1). • A passion for football and feeling valued within the university sport environment were key themes (Study 2). [ABSTRACT FROM AUTHOR]

• This study reviewed the prevalence of mental health disorders among Looked After Children in the UK. • Prevalence rates varied across studies. • The Strengths and Difficulties Questionnaire (SDQ) was the most frequently used tool to assess mental health. • There is still uncertainty about the scale and nature of mental health difficulties in this group. Care-experienced children and young people are more likely to experience poorer mental health relative to the general population. Some of the most highly cited literature in this area is becoming increasingly outdated, however, and as the gap between mental health service availability and provision is steadily growing, it is imperative that we understand the scale and nature of the mental health needs of this group. A systematic review of all literature published from the UK was conducted in March 2022 using APA PsycINFO, ASSIA, Cochrane Library, Medline, PubMed, Scopus, Social Policy and Practice, Social Services Abstracts, and Web of Science. Papers were included if they 1) sampled young people (aged 0 to 18 years) with care experience and, 2) used either a standard or non-standardised measurement tool, or health records to assess mental health prevalence rates (reported as a percentage). Risk of bias assessed used the QuADS tool (Harrison et al., 2021) and data was extracted. Thirty-nine studies were included and summarised. The estimated prevalence of mental health disorders of young people in care ranged from 1 to 82 %. The most frequently used tool to assess mental health was the Strengths and Difficulties Questionnaire (Goodman, 1997) and, while over half of studies utilised prevalence information from a comparator group, this was most commonly young people in the general population. The results of the systematic review demonstrate that estimates of mental health disorders among care-experienced young people in the UK vary considerably. Further consideration should be given toward what measures are used to assess mental health in this population and how we can optimally assess and characterise their support needs. [ABSTRACT FROM AUTHOR]

There is limited provision of inpatient detoxification relative to other treatments for alcohol and other drug (AOD) use. This means people often need to wait prior to detoxifying. However, waiting for healthcare is generally perceived as negative and stressful. This paper aims to understand patients' experiences of waiting for inpatient AOD detoxification to ascertain whether and how service-level policies and practices might be improved. Semi-structured telephone interviews were conducted with 32 people (20 males, 12 females; aged 25–67 years) who were waiting for inpatient detoxification. Data collection was part of a wider evaluation of a policy initiative started in 2021 to increase detoxification service capacity in England, UK. Interviews were professionally transcribed and data on waiting experiences were coded using qualitative software. Analyses were informed by new materialist thinking and undertaken via Iterative Categorisation. We found that waiting was constituted through five dimensions: i. duration; ii. support; iii. information; iv. preparations; and v. emotions. These five dimensions were multi-faceted and operated in and through wider interacting social, material, and affective forces (e.g., professional judgements, formal and informal relationships, the availability of beds and funding, bureaucratic procedures, the utility and relevance of information, and participants' diverse feelings, including desperation for treatment). Not all accounts of waiting were negative. The experience was complex, non-uniform and variable over time. Moreover, it affected how people felt and how they behaved. Changes to service-level policies and practices can potentially minimise the stress of waiting for inpatient AOD detoxification. The negative impact of waiting may be reduced if professionals more consistently engage patients in a wider range of constructive pre-treatment activities, offer regular 'check-ins' to mitigate any anxiety, explain changes in wait duration to help with planning and demonstrate fairness, and facilitate contact between those waiting to lessen feelings of isolation. [ABSTRACT FROM AUTHOR]

Over the last decades, ovarian cancer mortality in Europe has been decreasing, but disparities in trends were observed. In this paper, we analysed ovarian cancer mortality trends in Europe over the period 1990–2020 and predicted the number of deaths and rates by 2025. We extracted population and death certification data from ovarian cancer in women for 31 European countries, between 1990 and 2020 from the World Health Organization database. We computed age-standardised mortality rates (ASMR) per 100,000 women-years, based on the world standard population. We also obtained predictions for 2025 using a joinpoint regression model and calculated the number of avoided deaths over the period 1994–2025. Over the observed period, mortality from ovarian cancer showed a favourable pattern in most countries. In the EU-27, rates declined by 5.9% from 2010–2014 to 2015–2019, reaching an ASMR of 4.66/100,000. During the same period, the decline in ovarian cancer mortality was more pronounced in the EU-14 countries (−7.0%) compared to Transitional countries (−2.1%). Declines were also observed in the United Kingdom, to reach an ASMR of 5.29. Decreases in mortality from ovarian cancer are predicted until 2025, to 4.17/100,000 for the EU-27. Favourable trends in ovarian cancer mortality are expected to persist in Europe and can be mainly attributed to the increased use of oral contraceptives in subsequent generations of European women. Decreased use of menopausal Hormone Replacement Therapy and improved diagnosis and management may also have played a role. • Ovarian cancer mortality decreased over the last decade in most European countries. • Favourable trends will continue in the next 5 years. • Less favourable epidemiological situation was observed in Transitional countries. • The largest decrease of mortality in 2025 is predicted to be in Germany. • Until 2025 nearly 131,000 deaths from ovarian cancer would be avoided in EU. [ABSTRACT FROM AUTHOR]

There is ongoing debate regarding the shape of life-course trajectories in mental health. Many argue the relationship is U-shaped, with mental health declining with age to mid-life, then improving. However, I argue that these models are beset by the age–period–cohort (APC) identification problem, whereby age, cohort and year of measurement are exactly collinear and their effects cannot be meaningfully separated. This means an apparent life-course effect could be explained by cohorts. This paper critiques two sets of literature: the substantive literature regarding life-course trajectories in mental health, and the methodological literature that claims erroneously to have ‘solved’ the APC identification problem statistically (e.g. using Yang and Land's Hierarchical APC–HAPC-model). I then use a variant of the HAPC model, making strong but justified assumptions that allow the modelling of life-course trajectories in mental health (measured by the General Health Questionnaire) net of any cohort effects, using data from the British Household Panel Survey, 1991–2008. The model additionally employs a complex multilevel structure that allows the relative importance of spatial (households, local authority districts) and temporal (periods, cohorts) levels to be assessed. Mental health is found to increase throughout the life-course; this slows at mid-life before worsening again into old age, but there is no evidence of a U-shape – I argue that such findings result from confounding with cohort processes (whereby more recent cohorts have generally worse mental health). Other covariates were also evaluated; income, smoking, education, social class, urbanity, ethnicity, gender and marriage were all related to mental health, with the latter two in particular affecting life-course and cohort trajectories. The paper shows the importance of understanding APC in life-course research generally, and mental health research in particular. [ABSTRACT FROM AUTHOR]

Abstract: Health worker migration is an issue of first order concern in global health policy circles and continues to be the subject of much policy debate. In this paper, we contribute to the discussion by studying the impact of economic conditions on the migration of physicians from developing countries. To our knowledge, this is one of the first papers to do so. A major contribution of this paper is the introduction of a new panel dataset on migration to the US and the UK from 31 sub-Saharan Africa countries. The data spans the period 1975–2004. Using this data, we estimate the impact of changes in economic conditions on physician migration. In our preferred specification that allows for country-specific time trends, we find that a temporary one percentage point decline in GDP per capita increases physician migration in the next period by approximately. 3 percent. In our IV models a one percentage point decline in GDP per capita increases physician migration in the next period by between 3.4 and 3.6 percent. Overall, our results suggest a significant effect of developing country economic conditions on physician migration. [Copyright &y& Elsevier]

Abstract This paper presents the final phase of a national project exploring grading of practice in programmes leading to registration as a midwife in the United Kingdom. The aim was to develop a generic framework for grading practice, enhancing standardisation while enabling flexibility in application of current and new educational standards. A mixed method on-line survey considered existing practice assessment tools, factors contributing to robust and reliable assessment and perceptions of two assessment tools developed by the research team: a 'Lexicon Framework' and 'Rubric' , which were tested through scenarios. Participants included 170 midwifery and nursing academics, clinicians and students, representing 20 universities in the UK. Seven key themes emerged, from which an 'Evidence Based Model for Professional Practice Assessment' was developed. The proposed tools were overall positively evaluated and demonstrated a good level of reliability. A national tool to standardise midwifery practice assessment is recommended, and scope for transferability of our tools to all midwifery programmes and to nursing was identified. Other recommendations include engagement of key stakeholders in development of practice assessment documentation, and maintaining the professional purpose of grading practice as central to the process. A set of key principles for assessing practice is presented. Highlights • A national tool to standardise midwifery practice assessment is recommended. • Key stakeholders should engage in development of practice assessment documentation. • The professional purpose of grading practice should be central to the process. • Key principles and an evidence based model for assessing practice are presented. • A toolkit of generic resources supporting practice assessment is near completion. [ABSTRACT FROM AUTHOR]

Marked ethnic inequalities in COVID-19 infection and its consequences have been documented. The aim of this paper is to identify the range and nature of evidence on potential pathways which lead to ethnic inequalities in COVID-19 related health outcomes in the United Kingdom (UK). We searched six bibliographic and five grey literature databases from 1st December 2019 to 23rd February 2022 for research on pathways to ethnic inequalities in COVID-19 health outcomes in the UK. Meta-data were extracted and coded, using a framework informed by a logic model. Open Science Framework Registration: DOI 10.17605/OSF.IO/HZRB7. The search returned 10,728 records after excluding duplicates, with 123 included (83% peer-reviewed). Mortality was the most common outcome investigated (N = 79), followed by infection (N = 52). The majority of studies were quantitative (N = 93, 75%), with four qualitative studies (3%), seven academic narrative reviews (6%), nine third sector reports (7%) and five government reports (4%), and four systematic reviews or meta-analyses (3%). There were 78 studies which examined comorbidities as a pathway to mortality, infection, and severe disease. Socioeconomic inequalities (N = 67) were also commonly investigated, with considerable research into neighbourhood infrastructure (N = 38) and occupational risk (N = 28). Few studies examined barriers to healthcare (N = 6) and consequences of infection control measures (N = 10). Only 11% of eligible studies theorised racism to be a driver of inequalities and 10% (typically government/third sector reports and qualitative studies) explored this as a pathway. This systematic map identified knowledge clusters that may be amenable to subsequent systematic reviews, and critical gaps in the evidence-base requiring additional primary research. Most studies do not incorporate or conceptualise racism as the fundamental cause of ethnic inequalities and therefore the contribution to literature and policy is limited. • 123 UK studies examined pathways to ethnic inequalities in COVID-19 outcomes. • Socioeconomic inequalities and comorbidities were commonly explored as pathways. • 30% of studies aggregated ethnic groups into one broad category (e.g., non-White). • Only 11% studies considered racism as a driver of ethnic inequalities. • We provide recommendations for future research into ethnic inequalities in health. [ABSTRACT FROM AUTHOR]

• Preparing teachers for child protection and safeguarding must begin in initial teacher education. • We included 31 studies in a systematic scoping review. • In future, course developers should draw from models of rigorously evaluated courses. • Underpinning courses with trauma-informed approaches is strongly indicated. To improve educational outcomes for maltreated children, there is an urgent need to strengthen the capacity of the education workforce to respond appropriately to their needs. We conducted a systematic scoping review to synthesize current evidence about child protection and safeguarding in initial (pre-registration) teacher education with the aim of developing a knowledge base, and understanding what we — as researchers, teacher educators, and professional accreditation bodies — can and should be doing better. Thirty-one studies (reported in 38 papers) met the inclusion criteria. Studies were coded inductively against standardised criteria and critically appraised. Coding of study aims yielded three themes forming a descriptive map of research in the field: (i) studies investigating student teachers' perceptions of their preparedness to deal with child protection and safeguarding (n = 15); (ii) studies investigating preparation for child protection and safeguarding in initial teacher education courses (n = 14); and (iii) studies investigating student teachers' preferences for future training (n = 2). We identified key contents or topics covered, teaching methods and delivery modes, time allocations, and personnel involved in course delivery. Findings show that child protection and safeguarding are seldom investigated in initial teacher education, averaging only one published study per year over a 32-year search period with most studies having been conducted in Australia and the UK. Time allocated to child protection and safeguarding in initial teacher education courses varied from 1 to 16 h. Content covered was limited to several core topics with primacy given to child maltreatment subtypes, indicators, and reporting duties. Delivery methods were dominated by lectures, workshops, and discussions. Few studies had investigated the efficacy of innovative and interactive teaching strategies or online learning. We conclude that child protection and safeguarding in initial teacher education may be improved by leveraging off existing well-designed, rigorously evaluated programs, which have been found to be feasibly delivered and acceptable to future professionals. [ABSTRACT FROM AUTHOR]

This paper explores how middle aged and older asylum applicants in the UK speak about health in relation to migratory experiences. It proposes biocredibility as a novel theoretical concept, through which the narratives of those migrating to the UK to seek asylum can be analysed. The UK government's hostile environments policies, which aim to make life uncomfortable for irregular migrants in the UK in order to drive down migration, have been criticised on legal, material and moral grounds. This paper adds to this critique. Narrative analysis of semi-structured interviews shows that the majority of the asylum applicants interviewed felt their health was poor and told of the difficulties of life in the UK. Stories of homelessness, poverty and exclusion dominated, underpinned by the erosion of their perceived trustworthiness and credibility through encounters with the Home Office. Particular personal experiences of social, political and economic strife in exile were narrated closely against stories of illness. The concept of biocredibility refers to, and provides a way of understanding, participants' propensity for creating narrative enclaves for pathographies as a discursive mechanism to add credibility to narratives of lived experience. In this way, visceral descriptions of biological suffering can function as a narrative resource. It does this firstly by providing material and social context for adverse health, thus allowing participants to attribute a socio-political cause for their illness. Secondly it interjects experiences of illness into life narratives, thus effectively communicating the significance of such experiences. Finally, it provides narrative evidence of individuals' autobiographical testimony. For discredited and marginalised asylum applicants, biocredibility can be understood to represent a strategy used to re-negotiate credibility and urges a critical consideration of the hostile and austere socio-political context in which it is observed. • In the UK hostile environment policies aim to decrease net migration. • Narrative analysis shows how this impacts asylum seekers' health. • Asylum seekers associate life in the UK with biological dysfunction. • This paper conceptualises this through a novel paradigm: Biocredibility. • Biocredibility describes the narrative biologisation of lived experience. [ABSTRACT FROM AUTHOR]

Bullying in health workplaces has a negative impact on nurses, their families, multidisciplinary teams, patient care and the profession. This paper compares the experiences of Australian and UK baccalaureate nursing students in relation to bullying and harassment during clinical placement. A secondary analysis was conducted on two primary cross-sectional studies of bullying experiences of Australian and UK nursing students. Data were collected using the Student Experience of Bullying during Clinical Placement (SEBDCP) questionnaire and analysed using descriptive and inferential statistics. The total sample was 833 Australian and 561 UK students. Australian nursing students experienced a higher rate of bullying (50.1%) than UK students (35.5%). Students identified other nurses as the main perpetrators (Aust 53%, UK 68%), although patients were the main source of physical acts of bullying. Few bullied students chose to report the episode/s. The main reason for non-reporting was fear of being victimised. Sadly, some students felt bullying and harassment was ‘part of the job’. A culture of bullying in nursing persists internationally. Nursing students are vulnerable and can question their future in the ‘caring’ profession of nursing after experiencing and/or witnessing bullying during clinical placement. Bullying requires a zero tolerance approach. Education providers must develop clearer policies and implement procedures to protect students - the future nursing workforce. [ABSTRACT FROM AUTHOR]

Socioeconomic inequalities in childhood Body Mass Index (BMI) are becoming increasingly more pronounced across the world. Although countries differ in the direction and strength of these inequalities, cross-national comparative research on this topic is rare. This paper draws on harmonized longitudinal cohort data from four wealthy countries—Germany, the Netherlands, the United Kingdom (UK), and the United States (US)—to 1) map cross-country differences in the magnitude of socioeconomic inequalities in childhood BMI, and 2) to examine cross-country differences in the role of three energy-balance-related behaviors—physical activity, screen time, and breakfast consumption—in explaining these inequalities. Children were aged 5–7 at our first timepoint and were followed up at age 8–11. We used data from the German National Educational Panel Study, the Dutch Generation R study, the UK Millennium Cohort Study and the US Early Childhood Longitudinal-Kindergarten Study. All countries revealed significant inequalities in childhood BMI. The US stood out in having the largest inequalities. Overall, inequalities between children with low versus medium educated parents were smaller than those between children with high versus medium educated parents. The role of energy-balance-related behaviors in explaining inequalities in BMI was surprisingly consistent. Across countries, physical activity did not, while screen time and breakfast consumption did play a role. The only exception was that breakfast consumption did not play a role in the US. Cross-country differences emerged in the relative contribution of each behavior in explaining inequalities in BMI: Breakfast consumption was most important in the UK, screen time explained most in Germany and the US, and breakfast consumption and screen time were equally important in the Netherlands. Our findings suggest that what constitutes the most effective policy intervention differs across countries and that these should target both children from medium as well as low educated families. • All countries showed substantial socioeconomic inequalities in childhood BMI. • In all countries, inequalities in BMI steepen over course of primary school. • Protective factors among the most advantaged seem to mainly drive inequalities. • Across most countries, underlying mechanisms for inequalities in BMI are similar. • The relative contribution of each mechanism to BMI inequalities differs per country. [ABSTRACT FROM AUTHOR]

The last few years have witnessed a growing concern with the well-being of healthcare professionals internationally because of increasing recognition of its impact on patient outcomes and staff retention. The COVID-19 pandemic, which has placed additional and substantial pressure on frontline healthcare professionals, gives added urgency to the topic. While numerous, and successful, interventions have been developed to address compromised well-being among healthcare professionals, they have not always been able to support the needs of frontline staff, specifically those working in high-pressure environments. This paper presents findings of an evaluative research study of an intervention, named the Resilience and Well-being Training Programme, developed and implemented within an Acute Assessment Unit in a hospital in the UK. The 8 week-long programme followed a combined approach (both person-directed and work-directed), with mindfulness training as well as lectures and discussions to deepen participants' understanding of organisational life. The training, delivered from January to July 2018, involved a total of 72 healthcare professionals from a wide range of levels (UK bands 2–8), trained in three cohorts. The research followed a pre-post design to explore participants' experiences of working on the Unit, the programme and its impact on themselves and their working life. The study was conducted in a large NHS district general hospital in South London, UK. Participants included healthcare assistants and nurses who had completed their preceptorship, worked in the hospital's acute assessment unit, and had undertaken the resilience and well-being training programme. The study employed mixed methods (online questionnaire, face-to-face focus groups/interviews) to collect data. Findings showed participants' positive experience with the programme, however it had limited positive impacts on aspects of compromised well-being at the personal level and a statistically significant enhancement of the quality of relationships and communication on the Unit, with medium effect size (Cohen's D). The programme had a positive impact on the culture of the Unit. Results highlight the demand for and value of programmes designed in ways that enable this group of professionals to take part, because these professionals are often not able to participate in such programmes. A strong commitment from the leadership to enable staff attendance in time-protected programmes is one approach that works well in the short-term. However, this may be challenging to accomplish and raises issues of sustainability. [ABSTRACT FROM AUTHOR]

Only recently has research begun to focus on workplace bullying within organizations outside of traditional white-collar industries, such as professional football. While this is an important development, there remains a lack of understanding around the reporting of bullying in professional sport. In this paper, the authors explore how the professional football workplace shapes perceptions of whistleblowing and unearths individual perceptions around reporting bullying behavior. We used a phenomenological approach to gain rich experiential data from eighteen male professional football players in the UK. Interview data were analyzed in accordance with the principles of Interpretative Phenomenological Analysis. Two superordinate themes were identified from the analysis, (a) professional football's influence on whistleblowing, and (b) the challenges of reporting bullying. These themes highlighted that the unique, institutionalized nature of professional football interacts with participants' ability to report bullying behavior. The participants' accounts revealed divergent perceptions around how professional football shapes the degree to which players feel they can report bullying behavior. It was apparent that the authoritarian, often abusive and intimidatory nature of professional football significantly impacts whistleblowing. Our findings demonstrate the importance of workplace context when exploring the reporting of bullying behavior. They also demonstrate the need to address organizational culture and differentiate bullying education programs to alternative workplaces. • This study explores whistleblowing in the unique context of professional football. • Professional football as a workplace influences the degree to which bullying can be reported. • Reporting bullying in professional football is especially challenging compared to other workplaces. • The professional football context and its organizations interact with an individual's ability to report bullying. • Education programs need to address the institutionalized culture of football's organizations. [ABSTRACT FROM AUTHOR]

Questions of community are central to many research settings in the social sciences. Rabinow argued that, in the wake of the Human Genome Project, an increasingly important form of collectivity would be biosociality . Biosociality recognises a central role for biomedical knowledge in constructing genetic identities and producing and reproducing social relationships. Accordingly, it is often imagined as a new form of social solidarity. We draw on observations of parent-led conferences to explore the way in which biosociality is expressed at events organised around a particular genetic syndrome – 22q11 deletion syndrome. The parent-led conferences took place within the United Kingdom between 2007 and 2010 and were observed as part of a multi-sited ethnographic study. By bringing together a geographically dispersed group of people together within the same physical location, conferences offer an ideal platform to empirically examine sociality. Durkheim used the term collective effervescence to describe the collective expression of heightened emotion. We suggest that in the case of the 22q11 deletion syndrome activities discussed in this paper, collective effervescence is a mechanism through which individuals become a collective. We argue that parent-led conferences gather individuals in one location on the basis of common biological factors, but it is the shared emotional experience of being together that consolidates and renews the connection between members. [ABSTRACT FROM AUTHOR]

Background: Around half of people aged over 70 years admitted as an emergency to general hospital have dementia, delirium or both. Dissatisfaction is often expressed about the quality of hospital care. A Medical and Mental Health Unit was developed to provide best practice care to cognitively impaired older patients. The Unit was evaluated by randomised controlled trial compared to standard care wards. Part of this evaluation involved structured non-participant observations of a random subample of participants and the recording of field notes. Objectives: The aim of this paper is to compare and contrast the behaviours of staff and patients on the Medical and Mental Health Unit and standard care wards and to provide a narrative account that helps to explain the link between structure, process and reported outcomes. Design: Field notes were analysed using the constant comparison method. Setting: A large hospital within the East Midlands region of the United Kingdom. Participants: Patient participants were aged over 65, and identified by Admissions Unit physicians as being 'confused'. Most patients had delirium or dementia. Results: Sixty observations (360 h) were made between March and December 2011. Cognitively impaired older patients had high physical and psychological needs, and were cared for in environments which were crowded, noisy and lacked privacy. Staff mostly prioritised physical over psychological needs. Person-centred care on the Medical and Mental Health Unit was mostly delivered during activity sessions or meal times by activities coordinators. Patients on this unit were able to walk around more freely than on other wards. Mental health needs were addressed more often on the Medical and Mental Health Unit than on standard care wards but most staff time was still taken up delivering physical care. More patients called out repetitively on the Unit and staff were not always able to meet the high needs of these patients. Conclusion: Care provided on the Medical and Mental Health Unit was distinctly different from standard care wards. Improvements were worthwhile, but care remained challenging and consistent good practice was difficult to maintain. Disruptive vocalisation may have been provoked by concentrating cognitively impaired patients on one ward. [ABSTRACT FROM AUTHOR]

Objectives: The Centre for Public Health (CPH), at the United Kingdom's National Institute for Health and Care Excellence (NICE) is responsible for producing national guidance relating to the promotion of good health and the prevention and treatment of disease. Given the challenges of developing guidance in this area, choosing the most appropriate topics for further study is of fundamental importance. This paper explores the current prioritisation process and describes how the Analytic Hierarchy Process (AHP), a multi criteria decision analysis (MCDA) technique, might be used to do so. Study design: A proposed approach is outlined, which was tested in a proof of concept pilot. This consisted of eight participants with experience of related NICE committees building scores for each topic together in a 'decision conference' setting. Methods: Criteria were identified and subsequently weighted to indicate the relative importance of each. Participants then collaboratively estimated the performance of each topic on each criterion. Results: Total scores for each topic were calculated, which could be ranked and used as the basis for better informed discussion for prioritising topics to recommend to the Minister for future guidance. Sensitivity analyses of the dataset found it to be robust. Conclusions: Choosing the right topics for guidance at the earliest possible time is of fundamental importance to public health guidance, and judgement is likely to play an important part in doing so. MCDA techniques offer a potentially useful approach to structuring the problem in a rational and transparent way. NICE should consider carefully whether such an approach might be worth pursuing in the future. [ABSTRACT FROM AUTHOR]

This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries have a less well developed mental model of depression for black compared with white patients. [ABSTRACT FROM AUTHOR]

Abstract: There has much debate about the extent to which professional discretion has been challenged by recent organisational changes such as through the new forms of governance associated with the introduction of the principles of the New Public Management (NPM) into health systems and other public sector services. What appears to be missing from these debates is a detailed analysis of the concept of professional discretion itself. This paper attempts to fill this gap by delineating the key concepts of professional discretion evident in the literature and exploring their significance in an empirical study of the influence of the 2004 new general medical services contract (nGMS) and the introduction of the Quality and Outcomes Framework (QOF), a prescriptive pay-for-performance system designed to standardise the quality of care provision in general medical practice in the United Kingdom. The study adopted a longitudinal design using semi-structured interviews with general practitioners (GPs, N = 62) working in the English National Health Service (NHS) between 2007 and 2009. A multi-dimensional conception of discretion was used to explore how GP discretion might have been influenced by contractual changes and in particular, QOF. The findings suggest that through a complex interplay of factors, a post-QOF reduction in GP discretion was identifiable, highlighting different potential sources of constraint such as in the social, organisational and economic dimensions of discretion. The evidence also suggested the emergence of a new form of organisational medical professionalism within general practice characterised by standardisation, bureaucracy and performance management. [Copyright &y& Elsevier]

Abstract: Material deprivation is an important determinant of health inequalities in adults but there remains debate about the extent of its importance for adolescent wellbeing. Research has found limited evidence for an association between adolescent health and socio-economic status, leading authors to suggest that there is an ‘equalisation’ of health across socio-economic groups during the adolescent stage of the life-course. This paper explores this ‘equalisation’ hypothesis for adolescent psychological wellbeing from a geographical perspective by investigating associations between neighbourhood deprivation and self-esteem in Britain and Canada. Data from the British Youth Panel (BYP) and the National Longitudinal Survey of Children and Youth (NLSCY) on adolescents aged 11–15 for the time period 1994–2004 were used to estimate variations in low self-esteem between neighbourhoods using multilevel logistic regression. Models were extended to estimate associations between self-esteem and neighbourhood deprivation before and after adjustment for individual and family level covariates. Moderation by age, sex, urban/rural status, household income and family structure was investigated. There were no significant differences in self-esteem between the most deprived and most affluent neighbourhoods (Canada unadjusted OR = 1.00, 95% CI 0.76, 1.33; Britain unadjusted OR = 1.25, 95% CI 0.74, 2.13). The prevalence of low self-esteem was higher (in Canada) for boys in the least deprived neighbourhoods compared to other neighbourhoods. No other interactions were observed. The results presented here offer some (limited) support for the socio-economic equalisation in youth hypothesis from a geographical perspective: with specific reference to equalisation of the relationship between neighbourhood deprivation and self-esteem and psychological health in early adolescence. This contrasts with previous research in the United States but supports related work from Britain. The lack of interactions with key social and economic variables suggests that findings might apply across a range of family circumstances and different communities in Britain and Canada. Policy implications are discussed. [Copyright &y& Elsevier]

While there is considerable evidence that therapeutic landscapes have a positive impact on wellbeing, we know little about the mechanisms through which this impact occurs. In this paper we go some way toward addressing this gap. Drawing on in-depth interviews with 12 people aged between 52 and 75 years of age, who are engaged in nature-adventure activity in the UK, we focus on what they understand by 'wilderness'; their experiences of nature-adventure in wilderness settings; and the impact of these experiences on their wellbeing. Moving beyond the largely behavioural focus of laboratory-based studies prevalent within environmental psychology, we highlight the importance of understanding the role of the contextual in the therapeutic relationship. That is, how relational, embodied, social, lifecourse and/or cultural factors that are constitutive of wilderness environments impact wellbeing for those engaged in nature-adventure activity in later life. In doing so, we map out a working model of the mechanisms that impact wellbeing within this context. Our data suggest that there is no one single mechanism, rather we need to think about a range of mechanisms, often operating across a series of spectra (active/passive; safety/risk; alone/socially etc) and importantly, each are connected to place. Hence, we suggest, that where that activity takes place is instrumental for wellbeing. • Addresses critiques of Therapeutic Landscapes. • Maps out mechanisms that underpin how Therapeutic Landscapes impact wellbeing. • Explores the impact of nature-adventure activity in wilderness. • Addresses how people adapt nature-adventure activity for wellbeing in later life. • Where nature-activity takes place is instrumental for wellbeing in later life. [ABSTRACT FROM AUTHOR]

Abstract: The motor-vehicle is accountable for emitting a substantial concoction of air quality objective pollutants and carcinogenic hydrocarbons within close proximity to urbanised residential districts. The spatial extent of health impacts associated with road-transport pollutants have traditionally been explored through the examination of artificially created buffers, defined by subjective distances from specified major road links. Within this paper an alternative approach is presented using boundary statistics, which describe naturally occurring shifts of magnitude in socio-environmental and health outcomes across the wider urban area. In contrast, previous distance-threshold investigations have used arbitrarily sized buffers placed upon predetermined locations in response to environmental attributes, without considering the combined influence of additional social burdens. The demographically diverse City of Leicester, situated within the heart of the United Kingdom''s major road-transport network, was selected to showcase such methods. Descriptive multilevel modelling strategies accommodating for generalised spatial structures across Leicester, globally associated issues of deprivation, road-transport emissions and ethnic minorities with increased respiratory risks. Getis-Ord Gi* spatial pattern recognition statistics identified the existence of localised variations, with inner city neighbourhoods tending to house children of ethnic minority groups whom experience disproportionately large environmental and respiratory health burdens. Crisp polygon wombling boundary detection across Leicester appeared to broadly complement the Gi* statistics, identifying naturally occurring boundaries in road-transport emissions to result in elevated children''s respiratory admissions within a distance of 283 m (P < 0.05). The designated threshold was identified to reduce in relation to certain ethnic groups, thus suggesting environmental injustices likely prevail within the model British multicultural City of Leicester. The study''s findings have applications within healthcare management and urban planning for locating vulnerable populaces and for minimising health risks in future road network designs. [Copyright &y& Elsevier]

Abstract: Objectives: This paper compares two indirect prevalence estimation methods that offer protection beyond anonymity and are suitable for self-administration, for investigating the epidemiology of transgressive or socially sensitive behaviours. Design: In this self-report study, 513 participants (58.7% male) from sports clubs across the UK and southern Ireland were asked to complete an anonymous survey containing the recently developed Single Sample Count (SSC), along with a comparative method Unrelated Question Model (UQM), using prohibited performance-enhancing drugs/substances (PED) as sensitive and hormone-boosting herbal supplements (HS) as non-sensitive control questions. Method: The survey comprised of sections of SSC, UQM, social projection and simple network scale up methods. Respondents were asked to indicate whether they preferred the SSC or UQM for more protection and ease of completion. Results: A large discrepancy was observed in prevalence estimates for PED using the UQM (58.4%) and SSC (19.8%), but not for HS (54.9% and 54.0%, respectively). The SSC prevalence estimate for PED was in keeping with the results from social projection (13.8% in own sport; 26.1% in all sports) and network scale up (19.3% for known and suspected doping combined). A clear preference was logged for SSC. Conclusion: SSC, but not UQM, showed good concurrent validity with social projection and personal networks for PED; and good discriminant validity with HS. The observed discrepancy could be explained by strategic responding which can inflate the proportion of ‘yes’ answers in the UQM. Adaptation of the UQM for self-administration may lead to an unwanted upward response distortion via strategic responding. [Copyright &y& Elsevier]

Abstract: Background: Achieving asthma control is central to optimising patient quality of life and clinical outcome. Contemporary models of chronic disease management across a variety of countries point to the importance of micro, meso and macro level influences on patient care and outcome. However, asthma outcomes research has almost invariably concentrated on identifying and addressing patient predictors. Little is known about higher level organisational influences. Objective: This paper explores the contribution of organisational factors on poor asthma control, allowing for patient factors, at three organisational levels: the individual patient, local service deliverers, and strategic regional providers. Design, setting and participants: Prospective cross-sectional observational cohort study of 64,929 people with asthma from 1205 primary care practices spread throughout the United Kingdom (UK). Patient clinical data were recorded during a routine asthma review. Method: Data were analysed using simple descriptive, multiple regression and complex multi-level modelling techniques, accounting for practice clustering of patients. Results: Poor asthma control was associated with areas of higher deprivation [regression coefficient 0.026 (95% confidence intervals 0.006; 0.046)] and urban practice [−0.155 (−0.275; −0.035)] but not all local and regional variation was explained by the data. In contrast, patient level predictors of poor control were: short acting bronchodilator overuse [2.129 (2.091; 2.164)], days-off due to asthma [1.203 (1.148; 1.258)], PEFR<80 [0.76 (0.666; 0.854)], non-use of a self-management plan (SMP) [0.554 (0.515; 0.593)], poor inhaler technique [0.53 (0.475; 0.585)], poor medication compliance [0.385 (−0.007; 0.777)], and gender [0.314 (0.281; 0.347)]. Pattern of medication use, smoking history, age, body mass index (BMI), and health service resource use were also significant factors for predicting control. Conclusions: Targeting of health service resource requires knowledge of the factors associated with poor control of asthma symptoms. In the UK the contribution of local and regional structures appears minimal in explaining variation in asthma outcomes. However, unexplained variation in the data suggests other unrecorded factors may play a part. While patient personal characteristics (including self-management plan use, inhaler technique, medication compliance) appear to be the predominant influence the complex nature of the disease means that some, perhaps more subtle, influences are affecting the variability at all levels and this variance needs to be explored. Further research in other international contexts is required to identify the likely applicability of these findings to other health care systems. [Copyright &y& Elsevier]

The article presents a paper that examines the role of food retail environment in promoting healthy eating in Great Britain. Topics discussed include the National Diet and Nutrition Survey (NDNS) that shows high level of saturated fats and sugars and low intake of fruit and vegetables, eatwell plate as a tool used in public health to encourage healthy food and NDNS data on intakes of saturated fats, non-milk extrinsic sugars (NMES) and salt among general population in Great Britain.

• We explore young Black males' understandings of mental health, alongside informal and formal support systems in the UK. • Mental health is constructed through notions of masculinity, culture, weakness and control. • Formal support systems represent an unfamiliar and discriminatory environment for Black males and whilst informal support feels more accessible, speaking to family and friends is hindered by their constructs of mental health. • It is necessary to continue discursive investigations into unique experiences of young Black males in the UK, particularly with regards to statutory services which remains a huge barrier for helpseeking. Black males within Western society, who navigate recurrent racism and discrimination, have frequently been constructed as "high risk" for mental health difficulties. Research, particularly in the USA, has identified the barriers that Black males face in relation to seeking help, with research outlining the underutilisation of mental health services and overrepresentation of acute mental health diagnoses such as psychosis. Research within the UK has explored barriers to help-seeking amongst males in general, or adult Black males who are within the mental health or prison systems, yet to date little is known about the ways in which Black male adolescent youth outside of formal services understand mental health. Therefore, this paper offers a contribution to knowledge by examining the way in which young Black males in the UK make sense of mental health and associated systems of support. Data from ten interviews with males aged 16–18 from a South London school was collected and analysed using thematic analysis (TA). The young Black males' understandings of mental health were embedded with notions of masculinity, being in control and strong, and they understood mental health as something that is experienced by other people. Formal support for mental health difficulties was constructed as an unfamiliar and unapproachable system, that is often unkind and discriminatory towards Black males. Speaking to family and friends about mental health difficulties felt more accessible for these young males, however their construct of mental health and constructs within the community provided further silencing on using this support. This study suggests important implications for understanding the experiences of mental health and seeking support amongst Black male adolescents in the UK. [ABSTRACT FROM AUTHOR]

A growing literature has sought to tie educational attainment with later-life cognition and Alzheimer's disease outcomes. This paper leverages sibling comparisons in educational attainment as well as genetic predictors (polygenic scores) for cognition, educational attainment, and Alzheimer's disease to estimate effects of educational attainment on cognition in older age in the United Kingdom. We find that the effects of education on cognition are confounded by family background factors (~40%) and by genetics (<10%). After adjustments, we continue to find large effects of education. College graduates have cognition scores that are approximately 0.75 SD higher than those who report no credentials. We also find evidence that educational effects on cognition are smaller for those with high polygenic scores for Alzheimer's disease. • Explores associations between educational attainment and later life cognition. • Uses large scale sibling comparisons in the UK Biobank to control family background. • Examines genetic confounding by controlling for polygenic scores. • Finds both large confounding and large remaining associations between education and cognition. [ABSTRACT FROM AUTHOR]

Co-production is a process employed to solve complex issues, recognising the expertise of all stakeholders. This paper reports on co-production undertaken by nursing students, early career nurses and researchers as part of a larger study to design an intervention to increase retention of early career nurses. Mixed methods were used to evaluate the acceptability and feasibility of the co-production process in a UK university. Data were collected prospectively, concurrently and retrospectively via interview and questionnaire, between April 2018 and January 2019. Twelve co-production group members completed the questionnaire and six group members and facilitators were interviewed. Students and early career nurses reported personal benefit from participating; they developed and practised transferrable communication and problem-solving skills, believed they were able to make a difference, enjoyed contributing, found benefit from using the group as a reflective space and considered that co-production produced a credible intervention. Findings indicated co-production equipped participants to function more effectively in their nursing roles; incorporating co-production into the development of future interventions may prove beneficial. The relative novelty of this approach, and the potential application of the findings to a diverse range of geographical and organisational settings, add to the utility of the findings. • Co-production is acceptable and effective for designing nurse retention interventions 84. • Co-production helped develop skills that were transferrable to the clinical area. • Facilitators found co-production subject to competing demands and expectations. • Co-production should be considered to promote a credible retention interventions. [ABSTRACT FROM AUTHOR]