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In this qualitative study, we research what constitutes the relationships between conceptions of quality and value associated with higher education as experienced by prospective employers of business graduates. Quality and value in higher education are often linked though the relationship is unclear. Employers are an important and under-researched stakeholder group on the demand side of higher education. Data are generated by interviewing prospective employers of business graduates from a UK university. Interviews are analysed using a phenomenographic method to determine the qualitatively different ways in which actors make sense of the relationships between quality and value. Understanding prospective employers' conceptions of the relationships is important given the competitive pressures on universities and businesses. The research reinforces the experiential and idiosyncratic relationships between quality and value in higher education. Three conceptions of what constitutes quality and value in higher education are discussed: (a) quality is an antecedent of value; (b) quality is simple while value is complex; and (c) quality is internal to HE while value is created in the customer domain. The research outcomes provide important insights for researchers and practitioners through clearer understanding of how quality and value are related for this important stakeholder group.

Objective: To undertake a content analysis of human papillomavirus (HPV) vaccine communication materials available to young people. Design: Content analysis. Setting: Majority English-speaking countries. Methods: Between March and April 2020, a web engine was utilised to search for and retrieve relevant communication materials. Content analysis was used to describe how the following key issues were covered: (1) side effects, (2) safety, (3) practicalities related to receiving the HPV vaccine and (4) gender-specific information. Results: A total of 44 separate communication materials were retrieved, predominantly videos, webpages and leaflets. There was a focus on mild side effects of the vaccine (43.2%), with less frequent reference being made to moderate or serious side effects (22.7%). Reassurance concerning the safety profile of vaccine was communicated by referencing the widespread use of the HPV vaccine (31.8%). Information regarding formal criteria for entry into the vaccination programme emphasised country-specific eligibility criteria (59.1%), the setting in which vaccination was offered (38.6%) and the number of doses required (38.6%). Content intended to improve young people's experiences of receiving the HPV vaccine was less often provided (22.7%). Gender-specific content usually related to specific HPV-related diseases (52.3%) and/or the availability of cervical cancer screening programmes (52.3%). Conclusion: A variety of different communication tools were retrieved encompassing a wide variety of formats and content, reflective of different vaccination programmes and the varied priorities of organisations producing the materials. Findings will inform the co-production of a tailored educational package to improve access to information by populations of young people identified as having lower HPV vaccine uptake.

Teaching staff report poorer mental health and wellbeing than the general working population. Intervention to address this issue is imperative, as poor wellbeing is associated with burnout, presenteeism, and adverse student mental health outcomes. The Wellbeing in Secondary Education (WISE) intervention is a secondary school-based programme aimed at improving the mental health and wellbeing of teachers and students. There are three components: awareness-raising for staff; a peer support service delivered by staff trained in Mental Health First Aid (MHFA); and Schools and Colleges Mental Health First Aid (MHFA) training for teachers. A cluster randomised controlled trial with integrated process and economic evaluation was conducted with 25 secondary schools in the UK (2016-2018). The intervention was largely ineffective in improving teacher mental health and wellbeing. This paper reports process evaluation data on acceptability to help understand this outcome. It adopts a complex systems perspective, exploring how acceptability is a dynamic and contextually contingent concept. Data sources were as follows: interviews with funders (n = 3); interviews with MHFA trainers (n = 6); focus groups with peer supporters (n = 8); interviews with headteachers (n = 12); and focus groups with teachers trained in Schools and Colleges MHFA (n = 7). Results indicated that WISE intervention components were largely acceptable. Initially, the school system was responsive, as it had reached a 'tipping point' and was prepared to address teacher mental health. However, as the intervention interacted with the complexities of the school context, acceptability became more ambiguous. The intervention was seen to be largely inadequate in addressing the structural determinants of teacher mental health and wellbeing (e.g. complex student and staff needs, workload, and system culture). Future teacher mental health interventions need to focus on coupling skills training and support with whole school elements that tackle the systemic drivers of the problem.

This study explores the place of play in KS1 classrooms and the perspectives of teachers and headteachers in adopting play-based practices at the start of primary schooling. Data were collected from a survey of KS1 teachers asking for their views of play as an integral part of KS1 pedagogy. This was followed by interviews with eleven headteachers of schools where a play-based approach is embedded. Findings revealed that whilst teachers were in favour of play in KS1, policy constraints and, in particular, the beliefs of their own headteachers, very often acted as a barrier to the implementation of play in their school. The interviews with the headteachers of schools where a play-based approach is encouraged, reveal the influences on their thinking and beliefs, which include the advocacy of their own teachers.

Background: Students often simultaneously deal with shifting support networks, stressful life changes and psychological distress which may affect academic achievement. Methods: 285 students completed the General Health Questionnaire (GHQ-12) to assess depression and the Computerized Life Events Assessment Record (CLEAR), to establish life events and supportive relationships. Module grades were used to measure academic achievement. A general linear model was used with student grade as the dependent variable and life events, depression and supportive relationships as independent variables. Confounding variables included age and sex. Results: A three-way interaction between life events, depression and lack of supportive relationships was found. It indicated the performance of depressed students depended on whether they had supportive relationships and that this interaction also depended on whether they had experienced a life event in the past year. Conclusions: Universities need to provide more support to students with life stress as they transition into university life.

The present study used quantitative and qualitative methods to explore how lonely young people are seen from others' perspectives, in terms of their personality, behavior, and life circumstances. Data were drawn from the Environmental Risk Longitudinal Twin Study, a cohort of 2,232 individuals born in the U.K. in the mid-1990s. When participants were aged 18, they provided self-reports of loneliness, and informant ratings of loneliness were provided by interviewers, as well as participants' parents and siblings. Interviewers further provided Big Five personality ratings and detailed written notes in which they documented their perceptions of the participants and their reflections on the content of the interview. In the quantitative section of the article, regression analyses were used to examine the perceptibility of loneliness and how participants' loneliness related to their perceived personality traits. The informant ratings of participants' loneliness showed good agreement with self-reports. Furthermore, loneliness was associated with lower perceived conscientiousness, agreeableness, and extroversion and higher perceived neuroticism. Within-twin pair analyses indicated that these associations were partly explained by common underlying genetic influences. In the qualitative section of the study, the loneliest 5% of study participants (N = 108) were selected, and thematic analysis was applied to the study interviewers' notes about those participants. Three themes were identified and named: "uncomfortable in own skin," "clustering of risk," and "difficulties accessing social resources." These results add depth to the current conceptualization of loneliness and emphasize the complexity and intersectional nature of the circumstances severely lonely young adults live in.

Research into what is effective leadership in different cultures provides guidance for leaders moving from one culture to another (House et al, 2014). There is a paucity of empirical research into how culture impacts effective educational leadership in culturally diverse communities, which provides the direction and focus for this study. The cultural backgrounds of staff can impact what they expect about: (1) how leaders communicate; (2) what actions help build trust and collaboration; and (3) how decisions can or should be made (Hofstede, 1991; Meyer, 2014). This study analyses the extent to which school leaders adapt their behaviours in response to the cultures of their staff. Findings suggest that leaders in schools do adapt their actions, most often using different communication styles but also methods of building collaboration and trust, and decision-making structures. Culture impacts what are effective leadership practices (Dorfman et al, 2012) and educational leaders need to understand these potential impacts if they work in culturally diverse communities. This is important to consider for school leaders and leadership preparation programmes.

Introduction: The United Kingdom's Department for Education's advice on behaviour focuses on the power of staff and the strength of the policy in challenging behaviour, via rules, sanctions and rewards. We designed a video-feedback intervention for staff teams in a special educational setting who were working with children with intellectual disability and challenging behaviour. The intervention aimed to raise reflective capacity on relational mechanisms that offer new response possibilities in everyday practices within trans-disciplinary teams. Method: We conducted research with three teams (between five and seven participants in each). We report findings from two teams who were working with children (aged between 10 and 14) who staff identified as having behaviour that challenged. The intervention consisted of two video-feedback intervention sessions, using clips of good interactions between themselves and the child and a review. These sessions took place over three or four months. Qualitative analysis was conducted to analyse changes to the language and depictions of the children. Changes to the participants' goals during the intervention were also analysed. Results: The staff's focus on the child's challenging behaviour reduced. Children who were originally depicted as isolated became depicted in relationship with peers and staff. Participants became more curious about the child and his interactions in the school and home environment. The participant's personal goals emerged through their understandings of what it meant to be good. Conclusions: Working with staff teams using video feedback can change the interactions around the child and the relational conceptualisation of the child and family. Further adaptations to the intervention are needed to raise critical reflection on the concepts that circulate around 'behaviour' that structure policy and shape everyday practices.

Introduction: Anxiety and depression in older adults (60+ years of age) are under‐diagnosed and under‐treated. Older adults are less likely to seek help for these problems due to a lack of awareness, difficulty accessing health care due to availability or disability and fear of loss of independence. Existing points of contact between older adults and non‐traditional services, for example, the Fire and Rescue Service (FRS), could provide opportunities to support help‐seeking for mental ill‐health. The FRS conduct Home Fire Safety Visits (HFSVs) with older adults and are well positioned to provide health‐related support. This study examines a range of perspectives on the potential role of the FRS in the identification of, and signposting for, anxiety and depression in older adults. Methods: This was a qualitative study carried out using mixed methods in West Midlands, UK. Semi‐structured interviews were conducted with older adults and health and social care providers (practitioners, managers, commissioners) to explore the acceptability of the FRS expanding its role to detect and signpost for anxiety and depression in older adults. Observations examined delivery of existing HFSVs to older adults. Data were combined and analysed using a reflexive thematic approach. Results: Eighteen health and social care providers and 8 older adults were interviewed; 10 HFSVs were observed. Two overarching themes were identified: (1) Potential role for the FRS and (2) Operationalising identification of mental health problems by FRS. Interviews and observations demonstrated how HFSVs offer a suitable opportunity to start conversations about mental health. All interview participants felt that although the FRS would be well placed to deliver an intervention, they would require training, support and a referral pathway co‐produced with and supported by health and social care partners. Conclusion: A whole‐system approach is needed if the FRS are to expand HFSVs to identify mental health problems in older adults and provide signposting to appropriate services. Patient or Public Contribution: J.S. is a public co‐investigator. A Patient Advisory Group contributed to the initial funding application, design and conduct of the study, including data analysis and advice on dissemination. [ABSTRACT FROM AUTHOR]

Background: Recruitment rates to rehabilitation trials are variable among cancer survivors, and deeper investigation into the causes for declining participation is needed. The aim of this study was to qualitatively explore the experiences of people with myeloma referred for autologous stem cell transplant who were approached to take part in a physiotherapist-led exercise trial but declined. Methods: Participants were asked to participate in this qualitative study after declining to participate in a trial conducted at a UK tertiary cancer center. Semi-structured interviews were conducted. Data was analyzed inductively using reflexive thematic analysis. Results: Interviews from 18 myeloma patients (56% male, mean age 62 years) were analyzed. Four themes were identified: 1) Traveling to the specialist center is challenging, not just logistically; 2) Individualized approach valued but recall of research information variable; 3) Being less active has profound impact yet ameliorative support is lacking; and 4) Common side-effects of treatment are expected and endured but personal impact underestimated and unaddressed. Conclusion: A number of barriers to participation were identified. Travel, a commonly cited reason for declining research participation, is more than a logistical issue for cancer survivors experiencing side-effects and the time burden of clinical appointments. Expectation or knowledge of the typical side-effects from myeloma and its treatment may lead to under-reporting of concerns to care providers, despite their impact upon daily activities and quality of life. Approaches used for research recruitment should consider the timing and consequences of ongoing cancer treatment to reduce potential barriers to participation. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs) are well‐established risk factors for self‐harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co‐occurring self‐harm and depression. Methods: Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14–18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS) and the Environmental Risk (E‐Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four‐category outcome: no self‐harm or depression, self‐harm alone, depression alone and self‐harm with co‐occurring depression. A structured life course modelling approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self‐harm and depression in adolescence. Results: The majority of ACEs were associated with co‐occurring self‐harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co‐occurring self‐harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10–1.25) and MCS (1.18, 1.11–1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co‐occurring self‐harm and depression, and ACE occurrence in early childhood and adolescence was more important in the MCS. Conclusions: Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long‐term exposure to ACEs contributing to risk of self‐harm and depression in adolescence. [ABSTRACT FROM AUTHOR]

This article examines the ways in which the University of Birmingham assisted refugee academics and students from Nazi Germany and other Nazi occupied countries across Europe between 1933 and 1945. It draws on the university's rich but underused archives to explore institutional policy and to assess the influence of individual staff members in driving it. As a case study it examines and evaluates the role played by a British provincial university in supporting displaced academics before the Second World War and refugee students during the war. Analysis of the primary source material reveals the importance of personal connections and the agency of individual university staff in helping refugees. This study aids our understanding of the roles played by British universities in helping displaced scholars and identifies areas for further research. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To re-examine the evidence base that underpins the management of nasogastric tube safety in children • To recognise the consequences of delayed or missed feeds in children who receive nasogastric tube feeding • To enhance your understanding of what checks can be used to ensure a nasogastric tube is safe to use. Nasogastric tube feeding is generally considered safe provided a nasogastric aspirate with a pH ≤5.5, which indicates that the end of tube is correctly located in the stomach, can be obtained. When this is not possible, hospital attendance or admission is usually required so that an X-ray can be undertaken to check the tube’s position. This practice is based on an interpretation of the evidence that places undue importance on nasogastric aspirate pH testing before every use of a tube that is already in place, with potential negative consequences for children cared for in the community and their families. Following a re-examination of the evidence base, a revised approach is proposed in this article: when a child has a tube in place, provided its position has been confirmed as correct on initial placement using aspirate pH testing, nurses can use checks other than aspirate pH testing, alongside their clinical judgement, to determine whether it is safe and appropriate to use the tube. This proposed revised approach would reduce delayed or missed administration of fluids, feeds and medicines and enable more children to remain at home. [ABSTRACT FROM AUTHOR]

This study provides a basis for deepening understandings of approaches which offer effective and enhanced learning experiences for predominantly East Asian international students following provision alongside local students in UK general further education colleges. A mixed methods approach employed a largely quantitative questionnaire to access the views of 25 international students, 22 of whom were Chinese nationals, and to identify four participants (two Chinese, one Japanese and one Maldivian) for subsequent semi-structured interviews. This fieldwork was supported by the collection of college achievement data for the international students and for the local students who had studied directly alongside them. The outcomes indicate that the international students achieved at least as well as the local students in relation to academic outcomes, and that they valued teachers who allowed their cultural experiences to directly contribute to classroom learning. The study also highlights the importance of inter-cultural activities. More prosaically, the outcomes also suggest that important concerns for these international students were that they should receive clarity in answers to their questions as part of the processes of learning, as well as the resolution of ostensibly more peripheral issues such as the quality and type of food available in the college catering outlets.

The first cohort of a new MSc programme is due to complete the course in August 2014. During the three-year online course students conduct several pieces of action research in their classrooms. There is little research specifically related to classroom practice in the pre-tertiary psychology classroom. The following describes the rationale and context of the MSc in the Teaching of Psychology and reports on three students' final year research. The first considers the benefits of Psychology Applied Learning Scenarios (PALS) as applied to an A-level Psychology lesson. This is followed by research on the academic impact the flipped classroom can have on AS and A-level progress and the perceptions of this teaching technique learners have. Finally a plenary designed to develop critical thinking skills and meet the criteria for an "outstanding" lesson is discussed. Conducting action research into one's own teaching produces reflective, self-critical practitioners and these skills are also transmitted to their own students.

Purpose: Resistance training is often performed in a traditional training style using deliberate relatively longer repetition durations or in an explosive training style using maximal intended velocities and relatively shorter repetition durations. Both improve strength, "power" (impulsivity), and speed. This study compared explosive and traditional training over a 6-week intervention in 30 healthy young adult male recreational soccer players. Method: Full body supervised resistance training was performed 2 times a week using 3 sets of each exercise at 80% of one repetition maximum to momentary failure. Outcomes were Smith machine squat 1 repetition maximum, 10 meter sprint time, and countermovement jump. Results: Both groups significantly improved all outcomes based on 95% confidence intervals not crossing zero. There were no between-group differences for squat 1 RM (TRAD = 6.3[5.1 to 7.6] kg, EXP = 5.2[3.9 to 6.4] kg) or 10 meter sprint (TRAD = -0.05[-0.07 to -0.04] s, EXP = -0.05[-0.06 to -0.03] s). Explosive group had a significantly greater increase in countermovement jump compared to the traditional group (TRAD = 0.7[0.3 to 1.1] cm, EXP = 1.3[0.9 to 1.7] cm). Conclusion: Both the traditional training and explosive training performed to momentary failure produced significant improvements in strength, speed, and jump performance. Strength gains are similar independent of intended movement speed. However, speed and jump performance changes are marginal with resistance training.

Introduction: Limited epidemiologic data has suggested direct associations between hair pigment, race, and incidence of alopecia areata (AA). Here, we examine the relationship between natural hair color, race, and the lifetime risk alopecia. Methods: In this case–control study, we included UK Biobank patients of all races and self-reported hair color with diagnoses of AA, androgenetic alopecia (AGA), or scarring alopecia (SA). Multivariable logistic regression was used to detect differences in lifetime risk. Results: Findings reveal a significantly increased risk of AA among individuals with black hair compared to dark brown hair (OR 1.71 [95% CI 1.22–2.38], p < 0.001). Those with red or blonde hair showed a decreased risk of AA (0.74 [0.56–0.97]; 0.62 [0.41–0.95], p < 0.05). No racial differences in AA prevalence were observed among individuals with black hair. Conclusions: Darker hair colors may be associated with a higher risk of AA, lighter hair colors with a lower risk, and differences in hair color could contribute to previously noted racial variations in AA incidence, potentially influencing dermatologists' perspectives on the disease's epidemiology. [ABSTRACT FROM AUTHOR]

This systematic review, part funded by Network Rail Ltd (UK), considers the role of transportation corridors in habitat connectivity within temperate climates, through verge habitat, surrounding matrix, movement along and across the corridor, the wider landscape context and management practices. PICO terms were developed for the bibliographic search on 15/11/22 using Web of Science (all databases), yielding 168 studies for review. The risk of bias was minimised by excluding non-peer reviewed papers. Large and exotic taxa were excluded due to a focus on temperate zones, as were studies on invasive species and climate change where the primary focus was not ecological connectivity. Emergent themes were used to structure the paper. Results indicate that transportation corridors have significant potential for habitat connectivity, especially for generalist and open-specialist species, which favour early to mid-successional habitats. However, physiology is a key determinant in dispersal ability. Vegetation management should consider representative communities rather than individual species. Gaps exist in the range of taxa studied, understanding of seasonal variations and lifecycle stages supported in verges, survival factors such as predation and disease and changes to community structure. Rail environments are under-represented and there is limited knowledge on the relative impacts of vegetation management regimes. [ABSTRACT FROM AUTHOR]

The impact of campaigns on electoral performance is conditioned in part by contextual effects. The popularity equilibrium model has proven to be an important guide to how the electoral effects of local campaigns vary by a party's existing level of popularity. Such an equilibrium can, however be disturbed by an electoral shock—a rare event which fundamentally challenges the foundations that underpin predictability in elections. This article analyses the impact of the electoral shock of the UK's 2016 referendum on EU membership on campaign effects in the subsequent elections of 2017 and 2019. Using a novel theoretical and methodological approach, it shows that while there were observable effects of the Leave vote already present before the referendum, the geography of the effectiveness of Labour and Conservative local campaigns was altered after the referendum. However, it was not until the 2019 election that the shock of the 2016 Leave vote became a particularly important predictor of the electoral efficacy of both parties' campaigns. [ABSTRACT FROM AUTHOR]

Objectives: To describe the clinical signs and outcome of a large cohort of dogs presenting with neurological signs secondary to Neospora caninum infection. Materials and Methods: Retrospective review of cases presenting to two UK referral centres with neurological signs secondary to N. caninum infection between 2014 and 2023. Presenting signs, diagnostic test results, treatment, short‐ and long‐term outcome analysed. Results: A total of 1690 cases were assessed for eligibility. Forty‐four cases with a diagnosis of neosporosis were obtained. Three cases were then excluded due to non‐neurological presentations (two hepatitis and one myocarditis). A total of 41 cases were included in the study. Cerebello‐vestibular signs predominated; however, presenting clinical signs were varied and the neurolocalisation was often multifocal in nature (46.3%), making neosporosis an important differential diagnosis for meningoencephalitis of unknown origin. Complete clinical improvement was rare (5.6%), and relapses were common (27.8% cases with follow‐up). Clinical Significance: Neosporosis remains an important differential diagnosis for dogs at any age presenting with multifocal neurological signs. The outcome is considered poor and relapse rate is high. [ABSTRACT FROM AUTHOR]

Background: Lived experience researchers draw on their lived and living experiences to either lead on or inform research. Their personal experiences are relevant to the research topic and so they must manage the interplay of their health and healthcare experiences with the research, population, and data they work with, as well as the more general challenges of being a researcher. Lived experience researchers must navigate these dilemmas in addition to queries over their competency, due to issues relating to intersectionality and epistemic injustice. This justifies a motivation to better understand the experiences of lived experience researchers and develop appropriate and personalised supervision based on their preferences and needs. Methods: Q methodology was used to identify a collection of identity-related issues that impact lived experience researchers during PhD research in the context of the UK. These issues were presented in the form of 54 statements to 18 lived experience researchers to prioritise as topics to explore in supervision. Result: It was found that lived experiences researchers could be grouped into three distinct factors following an inverted factor analysis: Factor 1: Strengthening my identity, skills, growth, and empowerment; Factor 2: Exploring the emotional and relational link I have with the research and Factor 3: Navigating my lived and professional experiences practically and emotionally. The findings suggest that there may be three types of lived experience researchers, each with different needs from supervision, suggesting the population is heterogeneous. Conclusion: The research identified a deeper understanding of the needs of lived experience researchers and highlights the importance of personalised supervision according to the individual needs of the researcher and their preferences for supervision. The findings reinforce the importance of integrating a clinical dimension into supervision to support the needs of all lived experience researchers. Plain English summary: This research aimed to understand how to support lived experience researchers through supervision in the UK. Lived experience researchers lead and/or inform health research based on their personal experience of health and healthcare services which can lead to service provision that meets service user needs. People in these roles might be called lived experience researchers. Lived experience researchers may experience difficulties in their role as they conduct research linked to their own experiences. The research could trigger them to remember their own experiences. Other researchers might not value their knowledge and expertise as they are seen as patients and not professionals. This may be because they are viewed through their stigmatised patient identity. The support they need as lived experience researchers remains relatively unexplored. Fifty-four statements on the lived experience researcher experience were presented to 18 lived experience researchers. They were asked to prioritise these statements and arrange them on a grid according to how useful they were to them to explore in supervision. Lived experience researchers who prioritised statements similarly were grouped together. Three groups of lived experience researchers were found. The 1st group were interested in supervision that helped them develop their confidence, growth and professional skills. The 2nd group wanted to understand their personal link to the subject. The 3rd group wanted support to manage personal and professional challenges and to overcome barriers they experienced. The findings suggest different approaches are needed to personalise supervision for lived experience researchers. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to examine the prevalence and associations of mindfulness meditation use and also its perceived mental health effects during the COVID-19 pandemic. Methods: Using repeated cross-sectional data from broad online samples weighted to be representative of the adult population in Britain, we estimated the prevalence of mindfulness meditation use and employed logistic regression models to investigate sociodemographic and political associations of mindfulness meditation use and also its perceived mental health effects during the COVID-19 pandemic. Results: The findings suggest that 16 percent of adults in Britain had learnt to practice mindfulness in 2021. In covariate-adjusted regression models, having learnt to practice mindfulness was more common among young and middle-aged adults, residents in London, and respondents who voted for the Liberal Democrats. Among mindfulness meditation users who reported having practiced mindfulness during the COVID-19 pandemic, 60 percent reported that it positively affected their mental health and 24 percent reported that it negatively affected their mental health. Notably, 41 percent of respondents with children under 18 (versus 13 percent of those without minors) reported negative mental health effects. In covariate-adjusted regression models, negative mental health effects from mindfulness practice during the COVID-19 pandemic were not concentrated in any particular groups, except for respondents with children under 18. Conclusions: Mindfulness meditation has become widespread in Britain, but the results in this study suggest that mindfulness meditation use may be concentrated in certain sociodemographic and political groups. The results also suggest that practicing mindfulness during the COVID-19 pandemic had positive mental health effects for a majority of users, but approximately one-quarter of users reported negative mental health effects. It is therefore important for future research to continue monitoring the prevalence of mindfulness meditation use in society and to investigate under what circumstances, for whom, and in what ways mindfulness-based practices may have negative effects on mental health. [ABSTRACT FROM AUTHOR]

Language is central to the way people learn about the natural world. A salient concern of the biodiversity conservation arena has been to understand how language can be employed by scientists to communicate knowledge to nonexpert audiences and build ecological literacy. The use of analogy and narrative by scientists are prominent techniques. In this article, we consider how these two modes of language-based reasoning extend into ordinary conversational language use by the public, specifically when articulating everyday understanding and experiences of biodiversity. Drawing on a process of public engagement in a UK woodland environment, a typological framework based on principles of analogical and narrative reasoning is developed to characterize the precise character of processes of everyday biodiversity sense making. The implications of the framework are discussed in the context of future biodiversity research, particularly its participatory and educational dimensions. [ABSTRACT FROM AUTHOR]

Scholars have detailed the range of skills required for conservation and voiced concerns that training is not fit for purpose. Still, we have little understanding of what skills conservation education aims to teach. This study uses survey data and content analysis of online module descriptions to examine skills and methods teaching in conservation higher education across the United Kingdom and Australia. We found most conservation‐specific modules aimed to develop disciplinary and communication skills, but fewer than half aimed to develop interpersonal or project management skills. Social science methods training was absent from the core offering of over half of the conservation degrees reviewed. To prepare students for conservation careers and the complex problems they will encounter, the conservation education sector should further focus on building essential nonacademic skills and provide training on the breadth of methods that contribute to effective conservation science. This analysis can help educators to reflect on teaching aims and forge a curriculum that will best prepare students for contemporary conservation challenges. [ABSTRACT FROM AUTHOR]

Handedness is a manifestation of brain hemispheric specialization. Left-handedness occurs at increased rates in neurodevelopmental disorders. Genome-wide association studies have identified common genetic effects on handedness or brain asymmetry, which mostly involve variants outside protein-coding regions and may affect gene expression. Implicated genes include several that encode tubulins (microtubule components) or microtubule-associated proteins. Here we examine whether left-handedness is also influenced by rare coding variants (frequencies ≤ 1%), using exome data from 38,043 left-handed and 313,271 right-handed individuals from the UK Biobank. The beta-tubulin gene TUBB4B shows exome-wide significant association, with a rate of rare coding variants 2.7 times higher in left-handers than right-handers. The TUBB4B variants are mostly heterozygous missense changes, but include two frameshifts found only in left-handers. Other TUBB4B variants have been linked to sensorineural and/or ciliopathic disorders, but not the variants found here. Among genes previously implicated in autism or schizophrenia by exome screening, DSCAM and FOXP1 show evidence for rare coding variant association with left-handedness. The exome-wide heritability of left-handedness due to rare coding variants was 0.91%. This study reveals a role for rare, protein-altering variants in left-handedness, providing further evidence for the involvement of microtubules and disorder-relevant genes. Left-handedness is a common and partly heritable trait. Here, the authors perform a genome-wide screen for rare, protein-altering genetic variants associated with handedness in over 350,000 people, and implicate the tubulin gene TUBB4B. [ABSTRACT FROM AUTHOR]

Cancer patients undergoing major interventions face numerous challenges, including the adverse effects of cancer and the side effects of treatment. Cancer rehabilitation is vital in ensuring cancer patients have the support they need to maximise treatment outcomes and minimise treatment-related side effects and symptoms. The Active Together service is a multi-modal rehabilitation service designed to address critical support gaps for cancer patients. The service is located and provided in Sheffield, UK, an area with higher cancer incidence and mortality rates than the national average. The service aligns with local and regional cancer care objectives and aims to improve the clinical and quality-of-life outcomes of cancer patients by using lifestyle behaviour-change techniques to address their physical, nutritional, and psychological needs. This paper describes the design and initial implementation of the Active Together service, highlighting its potential to support and benefit cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: Increased moderate to vigorous physical activity (MVPA) can improve clinical and psychosocial outcomes for people living with and beyond cancer (LWBC). This study aimed to assess the feasibility and acceptability of trial procedures in a pilot randomised controlled trial (RCT) of a theory‐driven app‐based intervention with behavioural support focused on promoting brisk walking (a form of MVPA) in people LWBC (APPROACH). Methods: Participants diagnosed with breast, prostate or colorectal cancer were recruited from a single UK hospital site. Assessments at baseline and 3 months included online questionnaires, device‐measured brisk walking (activPAL accelerometer) and self‐reported weight and height. Participants were randomised to intervention or control (care as usual). The intervention comprised a non‐cancer‐specific app to promote brisk walking (National Health Service 'Active 10') augmented with print information about habit formation, a walking planner and two behavioural support telephone calls. Feasibility and acceptability of trial procedures were explored. Initial estimates for physical activity informed a power calculation for a phase III RCT. A preliminary health economics analysis was conducted. Results: Of those medically eligible, 369/577 (64%) were willing to answer further eligibility questions and 90/148 (61%) of those eligible were enrolled. Feasibility outcomes, including retention (97%), assessment completion rates (>86%) and app download rates in the intervention group (96%), suggest that the trial procedures are acceptable and that the intervention is feasible. The phase III RCT will require 472 participants to be randomised. As expected, the preliminary health economic analyses indicate a high level of uncertainty around the cost‐effectiveness of the intervention. Conclusions: This pilot study demonstrates that a large trial of the brisk walking intervention with behavioural support is both feasible and acceptable to people LWBC. The results support progression onto a confirmatory phase III trial to determine the efficacy and cost‐effectiveness of the intervention. [ABSTRACT FROM AUTHOR]

Atmospheric methane (CH 4) is the second-most-important anthropogenic greenhouse gas and has a 20-year global warming potential 82 times greater than carbon dioxide (CO 2). Anthropogenic sources account for ∼ 60 % of global CH 4 emissions, of which 20 % come from oil and gas exploration, production and distribution. High-resolution satellite-based imaging spectrometers are becoming important tools for detecting and monitoring CH 4 point source emissions, aiding mitigation. However, validation of these satellite measurements, such as those from the commercial GHGSat satellite constellation, has so far not been documented for active leaks. Here we present the monitoring and quantification, by GHGSat's satellites, of the CH 4 emissions from an active gas leak from a downstream natural gas distribution pipeline near Cheltenham, UK, in the spring and summer of 2023 and provide the first validation of the satellite-derived emission estimates using surface-based mobile greenhouse gas surveys. We also use a Lagrangian transport model, the UK Met Office's Numerical Atmospheric-dispersion Modelling Environment (NAME), to estimate the flux from both satellite- and ground-based observation methods and assess the leak's contribution to observed concentrations at a local tall tower site (30 km away). We find GHGSat's emission estimates to be in broad agreement with those made from the in situ measurements. During the study period (March–June 2023) GHGSat's emission estimates are 236–1357 kg CH 4 h -1 , whereas the mobile surface measurements are 634–846 kg CH 4 h -1. The large variability is likely down to variations in flow through the pipe and engineering works across the 11-week period. Modelled flux estimates in NAME are 181–1243 kg CH 4 h -1 , which are lower than the satellite- and mobile-survey-derived fluxes but are within the uncertainty. After detecting the leak in March 2023, the local utility company was contacted, and the leak was fixed by mid-June 2023. Our results demonstrate that GHGSat's observations can produce flux estimates that broadly agree with surface-based mobile measurements. Validating the accuracy of the information provided by targeted, high-resolution satellite monitoring shows how it can play an important role in identifying emission sources, including unplanned fugitive releases that are inherently challenging to identify, track, and estimate their impact and duration. Rapid, widespread access to such data to inform local action to address fugitive emission sources across the oil and gas supply chain could play a significant role in reducing anthropogenic contributions to climate change. [ABSTRACT FROM AUTHOR]

Purpose: Variability in the timing of infant developmental milestones is poorly understood. We used a twin analysis to estimate genetic and environmental influences on motor development and activity levels in infancy. Method: Data were from the Gemini Study, a twin birth cohort of 2,402 families with twins born in the United Kingdom in 2007. Parents reported motor activity level for each of the twins at age 3 months using the Revised Infant Behavior Rating Scale and reported the ages at which they first sat unsupported, crawled, and walked unaided. Results: Activity level at 3 months and ages when first sitting and crawling were about equally influenced by the shared family environment (45%-54%) and genes (45%-48%). Genetic influences dominated for age when children took their first independent steps (84%). Conclusion: Aspects of the shared family environment appear to be important influences on motor activity levels and early milestones, although the timing of walking may have a stronger genetic influence. Further research to identify the specific environmental and genetic factors that promote early activity may be important for longer-term health outcomes.

Purpose: The purpose of this paper is to evaluate career impact of entrepreneurship education (EE) considering evidence drawn from a quantitative study of alumni within two UK higher education institutions (HEIs) from a retrospective perspective. The findings inform the value of the EE experience and its impact on both self-employability and wider employability career choices. This study will be of relevance to both enterprise support agencies and government policy makers. Design/methodology/approach: This research study considers evidence drawn from an online quantitative survey of EE within two UK HEIs. The survey evaluated a range of issues including course design, programme satisfaction, impact, career outcomes and respondents demographics. Over 80 respondents completed the survey in full which was analysed using a range of bivariate techniques. Findings: The evidence suggested here indicates that EE programmes provide value both in terms of helping to enable business start-ups and also in supporting other career paths, through the enterprising knowledge and skill sets graduates acquire during their specialised studies. This study contributes to the literature by recognising and measuring these contributions. For example, this study enables discernment between different EE course components and their value for different career outcomes. Research limitations/implications The study recognises the limitations of this survey data in terms of the size of the sample, number of HEIs evaluated and its point in time design. Practical implications The HEI sector must evaluate its practices and measure the effectiveness of its graduates in terms of achieving sustainable business start-up. In course design, the evidence suggested that students value both the enterprising and entrepreneurial skills and knowledge components and discern value between them in their later careers. The findings suggest that EE graduates typically experience portfolio careers with multiple occupations in different sectors and roles within both employment and self-employment. Thus it is important that EE programme design includes both enterprising and entrepreneurial components to meet the future requirements of their graduates postgraduation. Originality/value This study contributes new evidence regarding the value of EE in UK HEIs. This evidence should inform course design and policy makers regarding the value of EE in creating self-employment and creating enterprising employees.

Background: A cancer diagnosis and its treatment may be an especially isolating experience. Despite evidence that positive health behaviours can improve outcomes for people living with and beyond cancer (LWBC), no studies have examined associations between loneliness and different health behaviours in this population. This study aimed to describe the prevalence of loneliness in a large sample of UK adults LWBC and to explore whether loneliness was associated with multiple health behaviours. Methods: Participants were adults (aged ≥ 18 years) diagnosed with breast, prostate or colorectal cancer who completed the Health and Lifestyle After Cancer Survey. Loneliness was reported using the UCLA loneliness score, dichotomised into higher (≥ 6) versus lower (< 6) loneliness. Engagement in moderate-to-vigorous physical activity, dietary intake, smoking status, alcohol use, and self-reported height and weight were recorded. Behaviours were coded to reflect meeting or not meeting the World Cancer Research Fund recommendations for people LWBC. Logistic regression analyses explored associations between loneliness and health behaviours. Covariates were age, sex, ethnicity, education, marital status, living situation, cancer type, spread and treatment, time since treatment, time since diagnosis and number of comorbid conditions. Multiple imputation was used to account for missing data. Results: 5835 participants, mean age 67.4 (standard deviation = 11.8) years, completed the survey. 56% were female (n = 3266) and 44% (n = 2553) male, and 48% (n = 2786) were living with or beyond breast cancer, 32% (n = 1839) prostate, and 21% (n = 1210) colorectal. Of 5485 who completed the loneliness scale, 81% (n = 4423) of participants reported lower and 19% (n = 1035) higher loneliness. After adjustment for confounders, those reporting higher levels of loneliness had lower odds of meeting the WCRF recommendations for moderate-to-vigorous physical activity (Odds Ratio [OR] 0.78, 95% Confidence Internal [CI], 0.67, 0.97, p =.028), fruit and vegetable intake (OR 0.81, CI 0.67, 1.00, p =.046), and smoking (OR 0.62, 0.46, 0.84, p =.003). No association was observed between loneliness and the other dietary behaviours, alcohol, or body mass index. Conclusions: Loneliness is relatively common in people LWBC and may represent an unmet need. People LWBC who experience higher levels of loneliness may need additional support to improve their health behaviours. [ABSTRACT FROM AUTHOR]

Background: Acquired brain injury (ABI) and other chronic conditions are placing unprecedented pressure on healthcare systems. In the UK, 1.3 million people live with the effects of brain injury, costing the UK economy approximately £15 billion per year. As a result, there is an urgent need to adapt existing healthcare delivery to meet increasing current and future demands. A focus on wellbeing may provide an innovative opportunity to reduce the pressure on healthcare services while also supporting patients to live more meaningful lives. The overarching aims of the study are as follows: (1) evaluate the feasibility of conducting a positive psychotherapy intervention for individuals with ABI and (2) ascertain under what conditions such an intervention would merit a fully powered randomised controlled trial (RCT) compared to a standard control group (TAU). Methods and analysis: A randomised, two-arm feasibility trial involving allocation of patients to either a treatment group (positive psychotherapy) or control group (treatment as usual) group, according to a 1:1 ratio. A total of 60 participants at three sites will be recruited including 20 participants at each site. Assessments will be conducted at baseline, on completion of the 8-week intervention and 3 months following completion. These will include a range of questionnaire-based measures, psychophysiology and qualitative outcomes focusing on feasibility outcomes and participant experience. This study has been approved by the Wales Research Ethics Committee (IRAS project ID: 271,251, REC reference: 19/WA/0336). Discussion: This study will be the first to examine the feasibility of an innovative, holistic positive psychotherapy intervention for people living with ABI, focused on individual, collective and planetary wellbeing, and will enable us to determine whether to proceed to a full randomised controlled trial. Trial registration: ISRCTN12690685, registered 11th November 2020. [ABSTRACT FROM AUTHOR]

Background: Many people living with and beyond cancer (LWBC) do not meet dietary recommendations. To implement a healthier diet, people LWBC must perceive a need to improve their diet. Methods: Participants included people diagnosed with breast, prostate or colorectal cancer in the UK. Two binary logistic regression models were conducted with perceived need for dietary change as the outcome (need to improve vs. no need). Predictor variables included demographic and clinical characteristics, receipt of dietary advice, and either body mass index (BMI) or adherence to seven relevant World Cancer Research Fund (WCRF) dietary recommendations. Results: The sample included 5835 responses. Only 31% perceived a need to improve their diet. Being younger (odds ratio [OR] 0.95, 95% confidence interval [CI] = 94–0.95), female (OR = 1.33, 95% CI = 1.15–1.53), not of white ethnicity (OR = 1.8, 95% CI = 1.48–2.27), not married/cohabiting (OR = 1.32, 95% CI = 1.16–1.52) and having received dietary advice (OR = 1.36, 95% CI = 1.43–1.86) was associated with an increased odds of perceiving a need to improve diet. This association was also seen for participants with two or more comorbidities (OR = 1.31, 95% CI = 1.09–1.57), those not meeting the recommendations for fruit and vegetables (OR = 0.47, 95% CI = 0.41–0.55), fat (OR = 0.67, 95% CI = 0.58–0.77), and sugar (OR = 0.86, 95% CI = 0.75–0.98) in the dietary components model and those who had a higher BMI (OR = 1.53, 95% CI = 1.32–1.77) in the BMI model. Conclusions: Most of this sample of people LWBC did not perceive a need to improve their diet. More research is needed to understand the reasons for this and to target these reasons in dietary interventions. [ABSTRACT FROM AUTHOR]

Atmospheric methane (CH 4) concentrations have more than doubled since the beginning of the industrial age, making CH 4 the second most important anthropogenic greenhouse gas after carbon dioxide (CO 2). The oil and gas sector represents one of the major anthropogenic CH 4 emitters as it is estimated to account for 22 % of global anthropogenic CH 4 emissions. An airborne field campaign was conducted in April–May 2019 to study CH 4 emissions from offshore gas facilities in the southern North Sea with the aim of deriving emission estimates using a top-down (measurement-led) approach. We present CH 4 fluxes for six UK and five Dutch offshore platforms or platform complexes using the well-established mass balance flux method. We identify specific gas production emissions and emission processes (venting and fugitive or flaring and combustion) using observations of co-emitted ethane (C 2 H 6) and CO 2. We compare our top-down estimated fluxes with a ship-based top-down study in the Dutch sector and with bottom-up estimates from a globally gridded annual inventory, UK national annual point-source inventories, and operator-based reporting for individual Dutch facilities. In this study, we find that all the inventories, except for the operator-based facility-level reporting, underestimate measured emissions, with the largest discrepancy observed with the globally gridded inventory. Individual facility reporting, as available for Dutch sites for the specific survey date, shows better agreement with our measurement-based estimates. For all the sampled Dutch installations together, we find that our estimated flux of (122.9 ± 36.8) kg h -1 deviates by a factor of 0.64 (0.33–12) from reported values (192.8 kg h -1). Comparisons with aircraft observations in two other offshore regions (the Norwegian Sea and the Gulf of Mexico) show that measured, absolute facility-level emission rates agree with the general distribution found in other offshore basins despite different production types (oil, gas) and gas production rates, which vary by 2 orders of magnitude. Therefore, mitigation is warranted equally across geographies. [ABSTRACT FROM AUTHOR]

Background: The demands of caring for a child with a life-limiting condition can have a profound impact on parents' health and wellbeing. Currently, there is no standard procedure for identifying and addressing the support needs of these parents. Aim: To assess the suitability of the Carer Support Needs Assessment Tool (CSNAT (Paediatric)) for use with parents of children with a life-limiting condition. Design: Secondary qualitative content analysis of two qualitative datasets exploring the health, wellbeing and experiences of support of mothers and fathers of children with a life-limiting condition. Setting: A total of 30 mothers and 12 fathers were recruited via four UK children's hospices and social media. Results: Parental experiences of support mapped onto the existing domains of the CSNAT (Paediatric). One aspect of their experience, surrounding their child's educational needs, went beyond the existing domains of the CSNAT. An adapted version of the tool CSNAT (Paediatric) should include this domain. Conclusion: The CSNAT (Paediatric) is a relevant tool for the assessment of parental support needs. Further research should assess the acceptability and feasibility of implementation of the broader intervention: CSNAT-I (Paediatric). [ABSTRACT FROM AUTHOR]

Co-design involves engaging with the end-user in the design process and may help reduce the barriers to assistive technology use. Previous research has used co-design in the provision of assistive technology, but no research has looked at applying it within a healthcare setting. This service evaluation examines the use of co-design in providing customized assistive devices within a current UK healthcare based Rehabilitation Engineering department. This evaluation reports on three case studies. Individuals identified a range of challenges in daily living. The participants worked with the clinician in trialling prototypes and providing feedback to develop custom devices. A mixed-method approach of questionnaires and semi-structured interviews were used to evaluate the devices provided and the co-design approach. The resources required to provide the device were also calculated. Five different devices were developed, which were able to overcome the challenges identified. Results indicated participants were satisfied with both the devices and service provided. Participants expressed other benefits including increased independence, increased positive emotions and reduced mental load. Participants indicated they liked being involved in the design process and their feedback helped ensure the devices were customized to their needs. The use of co-design was able to produce customized assistive device that met the needs of the individuals within a current healthcare service. Further work is required to assess the feasibility of utilising a co-design approach for the provision of other custom assistive technology in the future and explore if this can overcome the barriers to assistive technology use. End-user involvement, the design process can help enable customized assistive devices to be provided that better meet the user's needs. The custom assistive devices provided not only helped the individuals overcome the challenges identified but had wider reaching benefits for the individuals physical and mental health and wellbeing. End-users valued being able to input into the co-design process and working closely with the clinician in developing the device. [ABSTRACT FROM AUTHOR]

Objective: Recent research and guidelines recommend that trainers on clinical psychology doctorate training programmes consider disclosing personal experiences of psychological distress to trainees. Disclosure is thought to promote cultures of openness, validate and normalise trainee distress, encourage trainee disclosure and help‐seeking and challenge stigmatising narratives. However, little is known about how trainers decide whether, what or how to disclose. This study aims to address that gap by exploring the processes and factors involved in trainers deciding whether or not to disclose personal experiences of psychological distress to trainees, generating findings of relevance across counselling, psychotherapy and psychology training courses. Methods: In‐depth interviews were conducted with nine trainers on UK clinical psychology doctorate programmes from around the country and analysed in accordance with constructivist grounded theory methods. Results: Findings indicated that participants valued disclosure personally and professionally but were wary of the dangers of disclosure. Disclosure decisions were made by judging the context against internally held criteria. If criteria were not met, then disclosures were not made. Outcomes, whether positive or negative, served to reinforce the value of disclosure and the importance of managing risks, creating a positive feedback loop. Conclusions: The findings of this study suggest factors that are important for trainers to consider when deciding whether or not to disclose. The six‐factor framework developed may be useful for trainers to consider within reflective practice, supervision or during guided self‐reflection in order to make safe, helpful and ethical decisions. [ABSTRACT FROM AUTHOR]

Background: Mental ill-health in older adults (aged 60 years and over) is often underdiagnosed and undertreated. Older adults are less likely to access mental health services owing to perceived stigma and fear of being a burden. Non-traditional providers of health care, such as the Fire and Rescue Services (FRS), provide a possible solution to facilitate early detection of problems and help-seeking among older adults, especially in the context of pressured statutory services. Aim: To examine whether and how FRS Home Fire Safety Visits (HFSV) could be optimised to include detection and signposting for mental health problems -- particularly anxiety and depression -- in older adults. Design & setting: This mixed-method qualitative study took place in the West Midlands, UK in 2022. Method: This study involved focus groups (n = 24) and interviews with FRS staff (n = 4) to develop an in-depth contextual understanding of he acceptability and feasibility of expanding HFSV to include identification of anxiety and depression. Results: FRS staff were open to expanding their HFSVs to include mental health, provided they had sufficient training and support from partner agencies in primary and social care settings to accept referrals for service users presenting with symptoms of anxiety and/or depression. Conclusion: The positive reputation of FRS staff and engagement with older adults suggests that HFSV could support the detection of anxiety and depression in older adults, and appropriate signposting to other services including primary care. [ABSTRACT FROM AUTHOR]

Entry into the Fellowship of Staff and Educational Development Association is through the production of a professional portfolio which evidences the applicant's achievement of the Fellowship requirements. Supporting and Leading Educational Change takes participants through the Fellowship process. The 12-week online course combines theory of educational development and change management, with group exercises and individual application to practice. Participants are educational developers who are themselves often facilitators of courses for university teachers. In this reflective case study the course tutors provide a personal reflection based on their experience of two very different cohorts. They review the cohorts to identify successful experiences and good practice. Drawing on the literature surrounding online learning, communities of practice and Lizzio's senses for student success, they situate their reflections in the context of professional development in general and in educational development in particular.

This article reports on the process and findings from a small-scale qualitative research study. The study intended to develop an evidence-based care plan/pathway for children and young people in paediatric inpatient settings presenting with self-harm/suicidal behaviour. The article includes a critical review of unanticipated challenges of recruiting to the study, and the learning from this process. Data are reported from three data collection strategies. A critical review of literature and policy was undertaken. The Delphi Technique was used to generate clinician-reported evidence from healthcare professionals within a paediatric general ward caring for children and young people presenting with self-harm/suicidal behaviour. Face-to-face consultations were undertaken in order to gain greater understanding of challenges to recruitment that were encountered. Despite evidence of participants possessing sufficient knowledge to care for young people engaging in self-harm/suicidal behaviour, participants reported discomfort, fear of the consequences of their perceived knowledge gaps, and negative assumptions about the young people. This appears to have directly impacted upon the ward staff's capacity to engage in the process of developing an evidence-based care plan/pathway. Recommendations including bespoke training and support for staff working within general paediatric wards caring for young people who engage in self-harm/suicidal behaviour, accounting for the specific challenges/anxieties faced by nurses within this setting, are discussed.

Even though critical thinking is carried out in schools across the country, there is no attempt to take high-level published philosophical research into schools. This paper reports on a pilot where this was attempted. The findings suggest that this can be done successfully and moreover that the results can be contextualised so as to count towards "impact" in the Research Excellence Framework (UK). The paper suggests that this means philosophers have not only a way of developing children's confidence and reasoning, but also a way of meeting the requirements on Higher Education Institutions within the UK.

Isotopic measurements of atmospheric methane are valuable for the verification of bottom‐up atmospheric emissions inventories. The balance of sources in emissions inventories must be consistent with the δ13C‐CH4 isotopic record in the air. Long‐term records of both methane mole fraction and δ13C from five sites across the UK are presented, showing post‐2007 growth in CH4 and negative trend in δ13C, consistent with global background sites. Miller‐Tans analyses of atmospheric measurements identified that the δ13C signature of the methane source mix varied between −50.1 and −56.1‰, with less depleted δ13C signatures at sites receiving air from urban areas, consistent with an increased proportion of thermogenic sources. Isotopic signatures calculated for all sites are more enriched than those expected from the bottom‐up emissions inventory, suggesting that inventories for the UK either underestimate contributions of thermogenic/pyrogenic emissions or overestimate biogenic sources. Plain Language Summary: Methane is a powerful greenhouse gas. The UK has committed to net zero carbon emissions by 2050 and has signed the Global Methane Pledge, which aims to reduce methane emissions by 30% by 2030, compared to 2020 levels. This study analyses long‐term measurements of methane and its carbon isotope ratio (δ13C) collected by Royal Holloway, University of London, across five UK sites. The δ13C source signature value acts as a fingerprint, distinguishing between different sources of methane. Bulk regional isotopic source signatures for each site were calculated, showing that urban sites are dominated by thermogenic emissions (e.g., gas leaks) and rural sites by agricultural emissions (e.g., cattle). The data presented in this study are compared with data from the UK National Atmospheric Emissions Inventory (NAEI). According to the data that were collected by Royal Holloway, University of London, the NAEI underestimates the relative contribution of fossil fuel sources in the UK, such as gas from pipelines in domestic and industrial settings, or overestimates biogenic sources. This has important implications for the design of UK greenhouse gas reduction strategies. Key Points: Long‐term records of CH4 mole fraction and δ13C‐CH4 from five UK sites show an increase in CH4 and a decrease in δ13CThe Miller‐Tans method can be used to calculate bulk regional δ13C‐CH4 source signaturesThe relative contribution of thermogenic/pyrogenic emissions across the UK may be underestimated in inventories [ABSTRACT FROM AUTHOR]

Objectives Glucocorticoids (GCs) ('steroids') are used to treat rheumatic diseases but adverse effects are common. We aimed to explore the impact of GC therapy on health-related quality of life (HRQoL), to inform the development of a treatment-specific patient-reported outcome measure (PROM) for use in clinical trials and practice. Methods Semi-structured qualitative interviews were conducted with patients from the UK, USA and Australia, treated for a rheumatic condition with GCs in the last 2 years. Purposive sampling was used to select participants with a range of demographic and disease features. An initial conceptual framework informed interview prompts and cues. Interviews elicited GC-related physical and psychological symptoms and salient aspects of HRQoL in relation to GC therapy. Interview data were analysed inductively to develop initial individual themes and domains. Candidate questionnaire items were developed and refined. Results Sixty semi-structured qualitative interviews were conducted (UK n  = 34, USA n  = 10, Australia n  = 16). The mean age was 58 years; 39/60 were female; and 18 rheumatic diseases were represented. Some 126 individual themes were identified and organized into six domains: physical symptoms; psychological symptoms; psychological impact of steroids; impact of steroids on participation; impact of steroids on relationships; and benefits of steroids. Candidate questionnaire items were tested and refined by piloting with patient research partners, iterative rounds of cognitive interviews and linguistic translatability assessment, informing a draft questionnaire. Conclusion We describe an international qualitative study to develop candidate items for a treatment-specific PROM for patients with rheumatic diseases. A future survey will enable the validation of a final version of the PROM. [ABSTRACT FROM AUTHOR]

Background Due to limited inclusion of patients on kidney replacement therapy (KRT) in clinical trials, the effectiveness of coronavirus disease 2019 (COVID-19) therapies in this population remains unclear. We sought to address this by comparing the effectiveness of sotrovimab against molnupiravir, two commonly used treatments for non-hospitalised KRT patients with COVID-19 in the UK. Methods With the approval of National Health Service England, we used routine clinical data from 24 million patients in England within the OpenSAFELY-TPP platform linked to the UK Renal Registry (UKRR) to identify patients on KRT. A Cox proportional hazards model was used to estimate hazard ratios (HRs) of sotrovimab versus molnupiravir with regards to COVID-19-related hospitalisations or deaths in the subsequent 28 days. We also conducted a complementary analysis using data from the Scottish Renal Registry (SRR). Results Among the 2367 kidney patients treated with sotrovimab (n  = 1852) or molnupiravir (n  = 515) between 16 December 2021 and 1 August 2022 in England, 38 cases (1.6%) of COVID-19-related hospitalisations/deaths were observed. Sotrovimab was associated with substantially lower outcome risk than molnupiravir {adjusted HR 0.35 [95% confidence interval (CI) 0.17–0.71]; P  = .004}, with results remaining robust in multiple sensitivity analyses. In the SRR cohort, sotrovimab showed a trend toward lower outcome risk than molnupiravir [HR 0.39 (95% CI 0.13–1.21); P  = .106]. In both datasets, sotrovimab had no evidence of an association with other hospitalisation/death compared with molnupiravir (HRs ranged from 0.73 to 1.29; P  > .05). Conclusions In routine care of non-hospitalised patients with COVID-19 on KRT, sotrovimab was associated with a lower risk of severe COVID-19 outcomes compared with molnupiravir during Omicron waves. [ABSTRACT FROM AUTHOR]