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Research demonstrating student mental distress typically focuses on mental wellbeing by combining questionnaire responses from students studying a variety of disciplines [see Ibrahim, A. K., S. J. Kelly, C. E. Adams, and C. Glazebrook. 2013. "A Systematic Review of Studies of Depression Prevalence in University Students." "Journal of Psychiatric Research" 47 (3): 391-400; Bewick, B., G. Koutsopoulou, J. Miles, E. Slaa, and M. Barkham. 2010. "Changes in Undergraduate Students' Psychological Well-being as they Progress Through University." "Studies in Higher Education" 35 (6): 633-645]. Little is known about how student mental health varies as a function of degree type. Psychology students are of interest here, as Psychology is one of few degrees where mental health is a topic of study. Semi-structured interviews were conducted with 20 undergraduate psychology students with mental health difficulties from a UK University. Thematic analysis showed that previous mental health problems were a motivator for studying psychology. The delivery of taught mental health content exacerbated pre-existing symptoms, induced concern and challenged perceptions of treatments. Students also experienced unique challenges when accessing a variety of University support networks. Findings can be used to inform policy changes to improve these students' university experiences.

Objective: Breast cancer incidence is rising among Pakistani women in the United Kingdom. However, uptake of breast screening remains low. This study aimed to improve access to breast screening for British-Pakistani women by exploring their knowledge of breast cancer and the role of primary care and community networks to support screening access amongst British-Pakistani women. Methods: We undertook a secondary qualitative analysis of 18 semi-structured interviews with British-Pakistani women from East Lancashire in the United Kingdom. Anonymized transcripts of the interviews were used for a thematic analysis. Results: Three themes were identified in the interviewees' responses: (i) 'Women's knowledge of breasts and breast cancer', which described how a cultural taboo exists around Pakistani women's bodies and around breast cancer; (ii) 'Role of primary care', which detailed how General Practitioners can support informed decisions and offer a trusted and valued information source; (iii) 'Community engagement', which described the potential to disseminate breast-screening information through the whole community, including primary care providers, all family members and mosques. Conclusions: Our analysis suggested three main targets for future interventions to improve access to breast screening for British-Pakistani women: (i) co-produced strategies to increase knowledge of breasts and breast screening; (ii) greater collaboration with local General Practitioners to support women to make informed choices about screening; and (iii) community engagement involving General Practitioners and community leaders, to inform everyone – not just screening-age women – about breast cancer and screening. [ABSTRACT FROM AUTHOR]

Background: Risk stratified breast cancer screening is being considered as a means of improving the balance of benefits and harms of mammography. Stratified screening requires the communication of risk estimates. We aimed to co-develop personalised 10-year breast cancer risk communications for women attending routine mammography.Methods: We conducted think-aloud interviews on prototype breast cancer risk letters and accompanying information leaflets with women receiving breast screening through the UK National Breast Screening Programme. Risk information was redesigned following feedback from 55 women in three iterations. A deductive thematic analysis of participants' speech is presented.Results: Overall, participants appreciated receiving their breast cancer risk. Their comments focused on positive framing and presentation of the risk estimate, a desire for detail on the contribution of individual risk factors to overall risk and effective risk management strategies, and clearly signposted support pathways.Conclusion: Provision of breast cancer risk information should strive to be personal, understandable and meaningful. Risk information should be continually refined to reflect developments in risk management. Receipt of risk via letter is welcomed but concerns remain around the acceptability of informing women at higher risk in this way, highlighting a need for co-development of risk dissemination and support pathways. [ABSTRACT FROM AUTHOR]

Objectives: Previous research has largely attempted to explore breast screening experiences of South Asian women by combining opinions from Pakistani, Bangladeshi, and Indian women. This research often fails to reach the most underserved sub-groups of this population, with socioeconomic status not routinely reported, and English fluency being a participation requirement. With uptake low amongst British-Pakistani women, this study explores the experiences these women encounter when accessing the NHS Breast Screening Programme. Methods: 19 one-to-one semi-structured interviews were carried out with British-Pakistani women from East Lancashire, UK. 14 interviews were conducted via an interpreter. Results: Data were analysed using thematic analysis. Three themes were identified: 'Absence of autonomy in screening and healthcare access' describes how currently the screening service does not facilitate confidentiality or independence. Access requires third-party intervention, with language barriers preventing self-expression. 'Appraisal of information sources' makes distinctions between community and NHS communication. Whereas community communication was invaluable, NHS materials were deemed inaccessible due to translation incongruences and incomprehensible terminology. 'Personal suppositions of breast screening' explores the subjective issues associated with disengagement, including, the cultural misalignment of the service, and perceiving screening as a symptomatic service. Conclusions: British-Pakistani women face some unique challenges when accessing breast screening. To promote uptake, the service needs to address the translation of screening materials and optimize upon community networks to disseminate knowledge, including knowledge of the screening environment within the context of culture to promote informed choice about attendance. [ABSTRACT FROM AUTHOR]

Background: There is international interest in risk-stratification of breast screening programmes to allow women at higher risk to benefit from more frequent screening and chemoprevention. Risk-stratification also identifies women at low-risk who could be screened less frequently, as the harms of breast screening may outweigh benefits for this group. The present research aimed to elicit the views of national healthcare policy decision-makers regarding implementation of less frequent screening intervals for women at low-risk.Methods: Seventeen professionals were purposively recruited to ensure relevant professional group representation directly or indirectly associated with the UK National Screening Committee and National Institute for Health and Care Excellence (NICE) clinical guidelines. Interviews were analysed using thematic analysis.Results: Three themes are reported: (1) producing the evidence defining low-risk, describing requirements preceding implementation; (2) the impact of risk stratification on women is complicated, focusing on gaining acceptability from women; and (3) practically implementing a low-risk pathway, where feasibility questions are highlighted.Conclusions: Overall, national healthcare policy decision-makers appear to believe that risk-stratified breast screening is acceptable, in principle. It will however be essential to address key obstacles prior to implementation in national programmes. [ABSTRACT FROM AUTHOR]

Background: UK national guidelines suggest women at high-risk of breast cancer should be offered more frequent screening or preventative medications. Currently, only 1 in 6 high-risk women are identified. One route to identify more high-risk women is via multifactorial risk assessment as part of the UK's NHS Breast Screening Programme (NHSBSP). As lower socioeconomic and minority ethnic populations continue to experience barriers to screening, it is important that any new service does not exacerbate issues further. To inform service development, this study explored views of women from underserved backgrounds regarding the introduction of risk stratification into the NHSBSP.Methods: Nineteen semi-structured interviews were conducted with British-Pakistani women from low socioeconomic backgrounds from East Lancashire, UK. Fourteen interviews were conducted via an interpreter.Results: Thematic analysis produced three themes. Attitudes toward risk awareness concerns the positive views women have toward the idea of receiving personalised breast cancer risk information. Anticipated barriers to accessibility emphasises the difficulties associated with women's limited English skills for accessing information, and their I.T proficiency for completing an online risk assessment questionnaire. Acceptability of risk communication strategy highlights the diversity of opinion regarding the suitability of receiving risk results via letter, with the option for support from a healthcare professional deemed essential.Conclusions: The idea of risk stratification was favourable amongst this underserved community. To avoid exacerbating inequities, this new service should provide information in multiple languages and modalities and offer women the opportunity to speak to a healthcare professional about risk. This service should also enable completion of personal risk information via paper questionnaires, as well as online. [ABSTRACT FROM AUTHOR]

The acute effects of drinks rich in protein (PRO) versus carbohydrate (CHO) on cardiovascular hemodynamics and reactivity are uncertain. A randomized crossover design was used to compare 400-mL isoenergetic (1.1 MJ) drinks containing whey protein (PRO; 44 g) or carbohydrate (CHO; 57 g) versus 400 mL of water in 14 healthy men. The primary and secondary outcomes were changes in cardiac output, blood pressure, systemic vascular resistance (SVR) and digital volume pulse measured prior to and 30 min following consumption at rest, during 12 min of multi-stage bicycle ergometry, and 15 min postexercise. The mean change (95% confidence interval (CI)) in resting cardiac output at 30 min was greater for CHO than for PRO or water: 0.7 (0.4 to 1.0), 0.1 (-0.2 to 0.40), and 0.0 (-0.3 to 0.3) L/min ( P < 0.001), respectively; the higher cardiac output following CHO was accompanied by an increase in stroke volume and a lower SVR. The mean increments (95% CI) in cardiac output during exercise were CHO 4.7 (4.4 to 5.0), PRO 4.9 (4.6 to 5.2), and water 4.6 (4.3 to 4.9) L/min with the difference between PRO versus water being significant ( P < 0.025). There were no other statistically significant differences. In summary, a CHO-rich drink increased cardiac output and lowered SVR in the resting state compared with a PRO-rich drink or water but the effect size of changes in these variables did not differ during or after exercise between CHO and PRO. Neither protein nor carbohydrate affected blood pressure reactivity to exercise. [ABSTRACT FROM AUTHOR]

Background: The incorporation of breast density and a polygenic risk score (PRS) into breast cancer risk prediction models can alter previously communicated risk estimates. Previous research finds that risk communication does not usually change personal risk appraisals. This study aimed to examine how women from the family history risk study appraise their breast cancer risk following communication of an updated risk estimate., Methods: In the family history risk study, 323 women attended a consultation to receive an updated breast cancer risk estimate. A subset (n = 190) completed a questionnaire, assessing their subjective breast cancer risk appraisals, satisfaction with the information provided, and cancer-related worry. One hundred and three were notified of a decreased risk, 34 an increased risk, and 53 an unchanged risk., Results: Women's subjective risk appraisals were in line with the updated risk estimates provided, with age, a PRS, and breast density explaining most of the variance in these appraisals. Those notified of an increased risk demonstrated higher subjective risk perceptions compared with those whose risk remained unchanged or decreased., Conclusions: Women's subjective breast cancer risk appraisals are amenable to change following updated risk feedback, with new information breast density and a PRS accepted and integrated into existing risk appraisals. Trust in the service, the analogies, and visual communication strategies used may have positively influenced the integration of this new information., Impact: Further research is warranted to assess whether similar patterns emerge for other illnesses and in different clinical contexts to determine the best strategies for communicating updated risk estimates., (©2024 American Association for Cancer Research.)

Background: In the past few decades, research on the association between indoor temperature and sleep has primarily used laboratory rather than field data collected in epidemiological cohorts., Methods: Secondary data on 2493 individuals aged 43 years was obtained from the National Survey of Health and Development (NSHD). Logistic regression models were used to investigate the associations between temperatures (indoor at home, spot measurement when the nurses visited during the day; and outdoor, monthly average) and self-reported sleep disturbances, adjusting for socio-demographics, health variables, housing variables, and temperature-related variables., Results: Associations were found between daytime indoor temperature with difficulty initiating (OR: 0.95, 95%CI: 0.91-0.98) and maintaining sleep (OR: 0.96, 95%CI: 0.93-0.99). Compared with neutral indoor temperatures (17-28 °C), low indoor temperature (≤17 °C) was associated with difficulty initiating sleep (OR: 1.79, 95%CI: 1.21-2.65). Stratified analysis results across tertiles showed that associations with difficulty initiating (OR: 0.87, 95%CI: 0.77-0.99) and maintaining sleep (OR: 0.88, 95%CI: 0.79-0.98) were observed respectively in the lowest (≤20 °C) and highest tertile (≥23 °C) of indoor temperature. There was no association between outdoor temperature and self-reported sleep disturbances in this study., Conclusion: In this first UK-based epidemiology study investigating temperature and sleep, self-reported sleep disturbances were associated with residential daytime indoor temperatures. Low indoor temperature had significantly higher odds ratio for difficulty initiating sleep compared with the neutral indoor temperature. A warmer indoor environment might be more suitable for sleep maintenance than sleep initiation. Indoor temperature in this study was a superior indicator of sleep disturbances than outdoor temperature. Although these findings are based on a UK sample, they may be relevant to other high-income settings with similar housing stock and climatic conditions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Identifying women aged 30-39 years at increased risk of developing breast cancer would allow them to receive screening and prevention offers. For this to be feasible, the practicalities of organising risk assessment and primary prevention must be acceptable to the healthcare professionals who would be responsible for delivery. It has been proposed that primary care providers are best placed to deliver a breast cancer risk assessment and primary prevention pathway. The present study aimed to investigate a range of primary care provider's views on the development and implementation of a breast cancer risk assessment and primary prevention pathway within primary care for women aged 30-39 years., Methods: Twenty-five primary care providers working at general practices in either Greater Manchester or Cambridgeshire and Peterborough participated in five focus groups (n = 18) and seven individual interviews. Data were analysed thematically and organised using a framework approach., Results: Three themes were developed. Challenges with delivering a breast cancer risk assessment and primary prevention pathway within primary care highlights that primary care are willing to facilitate but not lead delivery of such a pathway given the challenges with existing workload pressures and concerns about ensuring effective clinical governance. Primary care's preferred level of involvement describes the aspects of the pathway participants thought primary care could be involved in, namely co-ordinating data collection for risk assessment and calculating and communicating risk. Requirements for primary care involvement captures the need to provide a training and education package to address deficits in knowledge prior to involvement. Additionally, the reservations primary care have about being involved in the management of women identified as being at increased risk are discussed and suggestions are provided for facilitating primary care to take on this role., Conclusions: Despite optimism that primary care might lead a breast cancer risk assessment and primary prevention pathway, participants had a range of concerns that should be considered when developing such a pathway., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hindmarch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)