UK Countries Research Articles

The impact of excess body weight on employment outcomes: A systematic review of the evidence

BackgroundExcess body weight has been recognised as an important factor in influencing labour market outcomes. Several hypotheses explain the causal effect of excess body weight on employment outcomes, including productivity, labour supply, and discrimination. In this review, we provide a systematic synthesis of the evidence on the causal impact of excess body weight on labour market outcomes worldwide. MethodsWe searched Econ Lit, and Web of Science databases for relevant studies published from 1st Jan 2010–20 th Jan 2023. Studies were included if they were either longitudinal analysis, pooled cross-sectional or cross-sectional studies if they used instrumental variable methodology based on Mendelian Randomisation. Only studies with measures of body weight and employment outcomes were included. ResultsThe number of potentially relevant studies constituted 4321 hits. A total of 59 studies met the inclusion criteria and were qualitatively reviewed by the authors. Most of the included studies were conducted in the USA (N=18), followed by the UK (N=9), Germany (N=6), Finland (N=4), and non-EU countries (N=22). Evidence from the included studies suggests that the effect of excess weight differs by gender, ethnicity, country, and time period. White women with excess weight in the USA, the UK, Germany, Canada, and in the EU (multi-country analyses) are less likely to be employed, and when employed they face lower wages compared to normal weight counterparts. For men there is no effect of excess weight on employment outcomes or the magnitude of the effect is much smaller or even positive in some cases. ConclusionsThis review has shown that despite ample research on the relationship between excess weight and employment status and wages, robust causal evidence of the effects of excess weight on employment outcomes remains scarce and relies significantly on strong statistical and theoretical assumptions. Further research into these relationships outside of USA and Western Europe context is needed.

Northern Ireland and the United Kingdom Internal Market

Post-Brexit Northern Ireland occupies a unique position in the internal market of the United Kingdom due, primarily, to the Protocol on Ireland / Northern Ireland, or Windsor Framework. Agreed as part of the UK-EU Withdrawal Agreement, the Protocol/Windsor Framework provides that EU Single Market rules concerning the free movement of goods, customs, VAT, state aid and energy markets, continue to apply in Northern Ireland, despite it having formally left the EU along with the rest of the UK. To allow for the domestic implementation of the novel arrangements for post-Brexit Northern Ireland, set out in the Protocol/Windsor Framework, the UK Internal Market (UKIM) Act 2020 includes a series of specific provisions that except goods entering and leaving Northern Ireland from the ‘market access principles’ established by the UKIM Act 2020 in certain circumstances. This commentary introduces the UKIM Act 2020 then presents a review of its provisions that are specifically dedicated to post-Brexit Northern Ireland. Written in September 2023 the analysis then provides an assessment of the implications of measures agreed between the UK and EU laid down in the Windsor Framework texts which were published in February of this year. Based on the analysis of the UKIM Act 2020 set against the backdrop of the Protocol, then Windsor Framework, the commentary argues that the position of Northern Ireland post-Brexit is not only newly unique but also newly consequential for those both inside and outside its borders.

Net-Zero Heroes? Climate Change Mitigation Efforts and Strategies across Australian Group-of-Eight Universities

Businesses are increasingly declaring their operations to be “carbon neutral” or “net-zero”. But how real are these claims? We investigated the climate mitigation efforts of the eight leading universities in Australia and discovered that the actual emission reductions lag behind the net-zero rhetoric. In the last ten years, most universities increased energy consumption, while reported emissions plateaued. The energy consumption and greenhouse gas emissions of Group-of-Eight (Go8) universities were influenced by size and population growth, climate of the campus location, and energy efficiencies. The Go8 universities experienced, on average, a 25% increase in student numbers in the last decade, and most increased their energy consumption. However, Scope 1 (direct emissions) and Scope 2 (emissions from electricity consumption) remained stable for most universities from 2011 to 2019 and decreased on a per-capita basis, indicating some level of improved efficiencies. Almost all Go8 universities have net-zero commitments and aim to achieve this by similar measures: power purchase agreements (PPAs) for electricity consumption, and carbon offsets for remaining emissions. Most universities lack a strategy for direct or measurable targets regarding energy or emissions reductions along their value chain. Unlike the UK or other countries, Australia has no standardised emission reporting requirements for Scope 3 emissions (other indirect emissions). This has led to rudimentary and haphazard reporting, limiting comparability between universities. Only one university had a more complete Scope 3 inventory, and these Scope 3 emissions were five times greater than their combined Scope 1 and 2 emissions, indicating a potential for substantial under-reporting of emissions. This highlights the need for more rigorous, consistent, and sector-specific emissions accounting, especially on indirect emissions, and for an overhaul of net-zero accreditation.

Improving hospital-based opioid substitution therapy (iHOST): protocol for a mixed-methods evaluation

Background Opioid substitution therapy is associated with improved health and social outcomes for people who use heroin and other illicit opioids. It is typically managed in the community and is not always continued when people are admitted to hospital. This causes opioid withdrawal, discharge against medical advice, and increased costs. We are establishing a project called iHOST (improving hospital opioid substitution therapy) to address these problems. This is an applied health research project in which we will develop and evaluate an intervention that aims to improve opioid substitution therapy in three acute hospitals in England. The intervention was developed in collaboration with stakeholders including people who use opioids, hospital staff, and other professionals who work with this group. It includes five components: (1) a card that patients can use to help hospital clinicians confirm their opioid substitution therapy, (2) a helpline for patients and staff, (3) an online training module for staff, (4) a clinical guideline for managing opioid withdrawal in hospital, and (5) ‘champion’ roles at each hospital. Methods We will do a mixed-methods study including a quasi-experimental quantitative study and a qualitative process evaluation. The primary outcomes for the quantitative study are discharge against medical advice and emergency readmission within 28 days. We will do a difference-in-difference analysis comparing changes in these outcomes for patients at iHOST sites with changes for patients at control hospitals. The process evaluation will use in-depth interviews, focus groups, and site observations with people who use opioids and staff. We will assess acceptability of the intervention, barriers and facilitators to implementation, and contextual factors impacting outcomes. Impact We anticipate that iHOST will improve care for hospital patients who use illicit opioids and/or are receiving community-based opioid substitution therapy. Depending on the results, we will promote the intervention at hospitals across the UK. Dissemination, including through publication, will inform hospital-based services for people who use drugs both in the UK and other countries.

Intersectional discrimination and mental health inequalities: a qualitative study of young women’s experiences in Scotland

BackgroundIn 2021, Scotland became the first UK country to launch a Women’s Health Plan. This policy signals increasing commitment to broader ambitions surrounding gender equality in health. Research shows a connection between discrimination and health, representing a contributor to health inequalities. There remains sparse evidence on how certain groups experience discrimination that could be useful for policymaking. This research set out to address this evidence gap through exploring how discrimination shapes young women’s experiences of mental health and inequalities in Scotland.MethodsWe interviewed women aged 16-25 years (n=28), living in Scotland, UK, adopting an intersectional approach to recruitment and data analysis. We used a semi-structured topic guide to facilitate open discussion about discrimination and health. Transcripts were analysed by two researchers using Thematic Analysis and NVivo software.FindingsWe identified three themes that illuminate intersectional discrimination and the impact on mental health. The first outlines how experiences of discrimination in school, work and public spaces (and the anticipation of such) creates stress leading to mental health problems, particularly for participants from ethnic minority groups. The second highlights the lack of support for mental health, both at structural and interpersonal levels, which was viewed by young women as a form of intersectional discrimination, largely because of their gender and age. Finally, we developed a mid-level theory termed the ‘chain of dismissal’ that displays that for both physical or mental health symptoms, young women’s concerns are immediately “written off” as anxiety-related and in turn a natural attribute of young women. These themes show that discrimination has the potential to amplify mental health problems for young women and is a likely contributor to health inequalities.ConclusionsStructural disadvantages such as racism intersect with gender and age to compound the experience of discrimination for marginalised young women. To improve mental health and reduce health inequalities for young women, multi-level approaches are needed, with strong consideration of how the structural and cultural landscape as well as assumptions made by healthcare professionals have critical implications for young women’s health.

Accountancy students’ perceptions of the quality of teaching and learning experiences in two UK business schools: implications for generic skills development

PurposeFocusing on the quality of teaching and learning, this study aims to explore the perceptions of accountancy students in two emerging UK Higher Education Institutions (HEIs) of the quality of their learning experiences and the impact of these experiences on generic skills development.Design/methodology/approachA questionnaire survey was used to collect the data. OLS regression was used to test the hypothesis regarding the impact of student learning experiences (lecturer ability, assessment and curriculum) on generic skills development.FindingsStudents value the lecturer as the most important determinant of the quality of their experience. They rated their assessment programme very positively, and the curriculum suggests that students tend to experience a deep blended approach to learning. They also felt that they acquired a wide range of soft competency skills such as those associated with research, critical thinking and time management. Multivariate findings indicate that lecturer ability and curriculum contribute significantly and positively to generic skills development.Practical implicationsThe study provides a benchmark for international accounting and business educators in any efforts to assess the efficacy of HE delivery since the pandemic. By implication, it enables the identification of enhancements to the previous character of delivery and hence offers the means to direct improvements to the student experience. Such improvements can then be seen in the National Student Survey (NSS) scores, thereby positively contributing to the next Teaching Excellence Framework. Additionally, such tangible enhancements in NSS scores may be advantageous to HEIs, in the UK and other Western countries, in their efforts to recruit international students on whom they place great reliance for increased revenue, to their international business education programmes.Originality/valueThis study addresses the research gap surrounding the link between teaching and learning approaches in accounting and the development of generic skills. Furthermore, acknowledging that the COVID-19 pandemic with its imposed structural change in the HE teaching and learning environment ushered in a new model of curriculum delivery, this study reflects on the pre-COVID-19 scenario and gathers student perceptions of their teaching and learning experiences before the changes necessitated by lockdowns. It therefore brings the opportunity to anchor future research exploring the post-COVID-19 environment and secure comparative analyses.

Border-Crossing Experience in Refugee Tales IV

The year 2021 witnessed the publication of the latest volume of Refugee Tales, which chronologically coincided with the seventieth anniversary of the adoption of the 1951 Refugee Convention by the UK and other countries. This collection is the fourth volume of the Refugee Tales Project, which began in 2015 with a yearly meeting to walk and share stories by victims of detention, with the main goal of abolishing indefinite detention in the UK. The Refugee Tales Project, which exposes the humanitarian crisis involved in displacement, refugeehood, and detention, is primarily a spatial project that is concerned with borders and boundary crossings. The centrality of space can be seen reflected in the stories collected in Refugee Tales IV, which also reveal a sustained interest in the dimension of time. In this context, the present study addresses borders and border-crossing in the literary voicing of migrants’ experience as these migrants interact with spatial and temporal planes, with the aim of exploring such an interaction in a selection of narratives from Refugee Tales IV. This analysis examines the selected tales from the perspectives of the treatment of space, time, and the disoriented perception of both, considering how the articulation of these parameters contributes to the exposure of the injustices in detention and refugeehood.

Recognition of emotions in German laughter across cultures

Laughter conveys a wide range of information relevant for social interaction. In previous research we have shown that laughter can convey information about the sender’s emotional state, however other research did not find such an effect. This paper aims to replicate our previous study using participant samples of diverse cultural backgrounds. 161 participants from Poland, the UK, India, Hong Kong, and other countries classified 121 spontaneously emitted German laughter sounds according to the laughter type, i.e., joyful, schadenfreude, and tickling laughter. Results showed that all participant groups classified the laughter sounds above chance level, and that there is a slight ingroup advantage for Western listeners. This suggests that classification of laughter according to the sender’s emotional state is possible across different cultures, and that there might be a small advantage for classifying laughter of close cultural proximity.

WASTEWATER SLUDGE ASH IN THE PRODUCTION OF A NOVEL COLD MIX ASPHALT (CMA): DURABILITY, AGING AND TOXICITY CHARACTERISTICS

New Sustainable with no CO2 emission cold mix asphalt (CMA) for road and highways surfacing is successfully developed from wastewater sludge ash normally sent to landfills. The Paper reports; durability in terms of water sensitivity, aging and contamination levels of heavy metals of the new developed novel CMA containing upgraded fly and bottom ash secondary cementitious materials from United Utilities fly and bottom ashes. Road engineers currently restricted the use of conventional CMA containing conventional limestone fillers (LF) for use in walkways and light trafficked roads only, as these mixtures needs from 2 to 24 months for curing. Conventional CMA mixtures also have high voidage contents and thus low traffic bearing capacity. The durability of these mixes is low especially in the UK and European countries where the climate is predominantly wet and cold.In Germany and France, ordinary Portland cement (OPC) replaced the filler used in traditional CMA. Although this allows the new CMA to be used in roads for light and heavy trafficked loads. The materials are not environmentally friendly, as one tone of cement releases approximately one tone of CO2 emission during their manufacturing process. The results of the new developed CMA are satisfying the British and European codes of practices requirements. The new novel mixtures are also; highly cost-effective compared with the use of Hot Mix Asphalt (HMA), has no CO2 emission during mixing construction, and has no health and safety issues compared with the HMA manufacturing and application process.

What is the environmental footprint of a dental practice? A life cycle analysis (Part 1).

Introduction Growing awareness of environmental sustainability is essential. The Intergovernmental Panel on Climate Change's report stresses urgent carbon reductions to limit global warming to 1.5 °C. The NHS in all four countries of the UK aims to be net zero. Dental practices must prioritise sustainability for public health. This paper uses life cycle analysis (LCA) where possible to study a dental practice's environmental footprint.Methodology LCA methodology was used where possible to calculate the carbon footprint (CFP) of a full-time dental clinic operating 220 days/year. The Ecoinvent database and OpenLCA software were used to calculate greenhouse gas emissions, normalised factors and disability-adjusted life years. Attributional and spend-based approaches were used to analyse procurement items.Results Compared with our 2015 paper, the 2023 CFP, which used more current impact factors, shows reduced water use emissions and increased total waste emissions. Staff travel and patient travel continues to significantly impact the CFP.Discussion Addressing waste and promoting low-carbon transport within the dental practice is crucial. Procurement's impact requires detailed analysis. Normalised scores highlight the environmental impact compared to an average person.Conclusion The CFP of a dental practice was updated using more current impact factors to reinforce the high contribution of travel within the dental CFP, with an increase in the CFP of waste and a reduction in the CFP of water.

Association of air pollution and weather conditions during infection course with COVID-19 case fatality rate in the United Kingdom

Although the relationship between the environmental factors, such as weather conditions and air pollution, and COVID-19 case fatality rate (CFR) has been found, the impacts of these factors to which infected cases are exposed at different infectious stages (e.g., virus exposure time, incubation period, and at or after symptom onset) are still unknown. Understanding this link can help reduce mortality rates. During the first wave of COVID-19 in the United Kingdom (UK), the CFR varied widely between and among the four countries of the UK, allowing such differential impacts to be assessed. We developed a generalized linear mixed-effect model combined with distributed lag nonlinear models to estimate the odds ratio of the weather factors (i.e., temperature, sunlight, relative humidity, and rainfall) and air pollution (i.e., ozone, N{O}_{2}, S{O}_{2}, CO, P{M}_{10} and P{M}_{2.5}) using data between March 26, 2020 and September 15, 2020 in the UK. After retrospectively time adjusted CFR was estimated using back-projection technique, the stepwise model selection method was used to choose the best model based on Akaike information criteria and the closeness between the predicted and observed values of CFR. The risk of death reached its maximum level when the low temperature (6 °C) occurred 1 day before (OR 1.59; 95% CI 1.52–1.63), prolonged sunlight duration (11–14 h) 3 days after (OR 1.24; 95% CI 1.18–1.30) and increased P{M}_{2.5} (19 μg/m3) 1 day after the onset of symptom (OR 1.12; 95% CI 1.09–1.16). After reopening, many COVID-19 cases will be identified after their symptoms appear. The findings highlight the importance of designing different preventive measures against severe illness or death considering the time before and after symptom onset.

The making of anti-nuclear Scotland: activism, coalition building, energy politics and nationhood, c.1954-2008

ABSTRACT This article contributes to understanding how civil nuclear power shaped post-war British history through studying opposition to nuclear energy in Scotland. Over the second half of the twentieth century, pessimistic assessments challenged the optimism that had developed during the 1950s. Under devolution, Scottish administrations have used planning policies to block future nuclear generating plants, institutionalising a marked distinction with the rest of the UK. The origins of these differences are traced to anti-nuclear protests and the growth of a social movement coalition that linked anti-nuclear activism with growing public sentiment and electoral politics, particularly through the Scottish National Party (SNP). Reflections from oral history interviews are used to examine diverse local protest contexts supplemented by archives from the anti-nuclear movement and the SNP. During the 1970s, protests against Torness power station in East Lothian and the drilling of test bores for waste disposal in South Ayrshire were given a national orientation by SNP politicians. Over the course of the 1980s, the anti-nuclear coalition broadened through growing opposition to Torness and in response to the Chernobyl disaster. These changes encouraged a lasting symbiosis between pro-devolution and anti-nuclear sentiments which were subsequently embodied in policies pursued by devolved administrations during the 2000s.

ORTHOPOD: PREDICTING INJURY PROPORTIONALITY FROM NECK OF FEMUR FRACTURES

The need to accurately forecast the injury burden has never been higher. With an aging, ever expanding trauma population and less than half of the beds available compared to 1990, the National Health Service (NHS) is stretched to breaking point1,2.We utilised a dataset of 22,585 trauma patients across the four countries of the United Kingdom (UK) admitted to 83 hospitals between 22/08/22 – 16/10/22 to determine whether it is possible to predict the proportionality of injuries treated operatively within orthopaedic departments based on their number of Neck of Femur fracture (NOF) patients.More operations were performed for elderly hip fractures alone than for the combined totals of the next four most common fractures: ankle, distal radius, tibial shaft and forearm (6387 vs 5922). Conversely, 10 out of the 13 fracture types were not encountered by at least one hospital and 93% of hospitals encountered less than 2 fractures of a certain type.60% trauma is treated within Trauma Units (TUs) however, per unit, Major Trauma Centres (MTCs) treat approximately 43% more patients.After excluding NOF, lower limb fractures accounted for approximately 57% of fractures in all countries and ankle and distal radius fracture combined comprised more than 50% in 74% of regions.The number of hip fractures seen on average by an individual unit remains relatively consistent as does the regional variation of any given fracture; resultantly, it is possible to predict injury proportionality based off a unit's hip fracture numbers. This powerful tool could transform both resource allocation and recruitment.

FEATURES OF REGULATORY SUPPORT OF NON-FORMAL ADULT EDUCATION IN THE UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND

The article analyzes the regulatory support of non-formal adult education in the United Kingdom of Great Britain and Northern Ireland through the main types of legal acts of the governments of England, Scotland, Wales and Northern Ireland. The adult education system in this country is characterized, which is represented by formal and non-formal education institutions, associations, councils, and committees on adult education. It is emphasized that in the United Kingdom of Great Britain and Northern Ireland, the reform of adult education is aimed at the formation of the necessary professional skills; improvement of employment prospects; modernization of the existing educational system in accordance with employers’ requests; establishment of the financial support programme, which will promote the non-formal learning opportunities for the adult population. It is noted that in each country of the United Kingdom (England, Scotland, Wales and Northern Ireland), the development of non-formal adult education has specific features: a high degree of autonomy for all providers, cooperation and partnership between educational institutions and employers, etc. The non-formal education providers are also presented (non-profit, charitable, private organisations, universities, colleges, and other educational institutions). The conclusion is made that, the reform of adult education has been put front and centre by the British government; it is presented by regulatory and legal acts in each country and is aimed at promoting the lifelong learning.

Use of volunteers in early years interventions for parents: A scoping review of roles and the extent of evaluation research in this area.

Early years interventions, particularly those supporting parents in the first 1001 days of their infants life, support healthy development of infants and prevent adverse experiences that can have long term negative impacts. Volunteers are often used to deliver such interventions. This scoping review aimed to explore the roles and characteristics of volunteers across early years interventions and map the evaluation in this field to identify gaps in the literature. A scoping review was conducted according to the Arksey and O'Malley Framework. Academic databases and grey literature sources were searched to identify literature evaluating volunteer-based interventions for parents in the first 1001 days of their infant's life (conception to aged two). Research conducted in the UK or comparable high-income countries since the year 2000 were identified and data relating to the volunteer role, intervention design and evaluation methods were mapped. Sixty-six articles were eligible for inclusion in the review. Volunteers were commonly involved in interventions to provide peer support for a range of parenting related matters, support breastfeeding and the mental and emotional wellbeing of parents. Volunteer roles were categorised based on their background (peers or non-peer volunteers), their responsibilities (provider of peer support, educator or providers of practical support) and the delivery style of their role (in person one to one support, group leader or remote support). Research most often involved exploring the experiences of those involved in receiving or delivering the interventions and measuring outcomes in relation to breastfeeding and parent mental wellbeing. Volunteers play a large role in the provision of early years interventions. Their varied contribution is presented through a typology that will allow comparisons of roles in future research. Further research exploring the impact on the volunteers and the organisation will support decision making around choosing a volunteer led model within early years services.

Stuck in Hospital: how can we make integrated care a reality for people with a learning disability and / or autism who experience long stays in assessment & treatment settings?

Introduction: Integrating care so that people with learning disabilities and/or autistic people can receive support at home rather than in institutional assessment and treatment units is a priority in the UK and many other countries. Despite the recognition of its importance, progress on timely and coordinated discharge has been slow. Surprisingly little previous research has engaged directly with people with learning disabilities and/or autistic people, their families or front-line care staff to understand the issues from their perspectives. This project has sought to address this gap.
 Community of Interest: Professionals, policy makers, researchers, people with a learning disability and / or autism, and family carers connected with this area of integrated care policy and practice.
 Engagement: We worked with a Reference Group of people with learning disabilities and/or autistic people and their families to co-design our approach, sense check findings and support dissemination. Reference Group members were reimbursed for any expenses, paid for their time, and received appropriate support and training for the tasks in which they are involved. The project was also designed and delivered in collaboration with a self-advocacy group.
 Overview: We initially conducted a formal review of the research and grey literature, identifying rates of delayed discharge for people with learning disabilities and/or autistic people in long-stay hospital settings, the methods used to identify such rates and the solutions proposed. 
 Next, we worked with three long-stay hospital sites from across the UK in order to conduct: 
 In-depth work with ten people with learning disabilities and/or autistic people per site, and with a family member, to understand their journey through services over time, their experience of long-stay hospital provision, how care was co-ordinated to meet their aspirations, the kinds of lives they would like to be living, and the barriers that are preventing them from leaving hospital
 Focus groups with front-line staff and interviews with a commissioners for each of the 30 people with learning disabilities and/or autistic people.
 The perspectives of social workers supporting our 30 participants, as well as of advocates and social care providers working with people leaving long-stay hospital settings
 Results: The data from the study is currently being analysed with the final report due by the end of December 2022.
 
 Insights: From our analysis to date, we have identified the following recommendations for policy & practice: see the person behind the labels; don’t make people jump through more hoops than is really needed; help hospital staff know what’s available in the community; give people the chance to try life outside; help people with the trauma they’ve experienced; and. don’t let people fall through the cracks between services.
 Next steps: Alongside completing the report, the research team have a practice guide in publication, a film highlighting main implications, and an accessible practice guide. The team are planning a follow up study with our lived experience reference group which will explore people’s quality of life post-discharge in relation to different approaches to facilitating more co-ordinated and person-centred care.

A primary care research agenda for multiple long-term conditions: a Delphi study.

Multiple long-term conditions (MLTC), also known as multimorbidity, has been identified as a priority research topic globally. Research priorities from the perspectives of patients and research funders have been described. Although most care for MLTC is delivered in primary care, the priorities of academic primary care have not been identified. To identify and prioritise the academic primary care research agenda for MLTC. This was a three-phase study with primary care MLTC researchers from the UK and other high-income countries. The study consisted of: an open-ended survey question, a face-to-face workshop to elaborate questions with researchers from the UK and Ireland, and a two-round Delphi consensus survey with international multimorbidity researchers. Twenty-five primary care researchers responded to the initial open-ended survey and generated 84 potential research questions. In the subsequent workshop discussion (n = 18 participants), this list was reduced to 31 questions. The longlist of 31 research questions was included in round 1 of the Delphi; 27 of the 50 (54%) round 1 invitees and 24 of the 27 (89%) round 2 invitees took part in the Delphi. Ten questions reached final consensus. These questions focused broadly on addressing the complexity of the patient group with development of new models of care for multimorbidity, and methods and data development. These high-priority research questions offer funders and researchers a basis on which to build future grant calls and research plans. Addressing complexity in this research is needed to inform improvements in systems of care and for disease prevention.

Experiences of UK and Irish family carers of people with profound and multiple intellectual disabilities during the COVID-19 pandemic

BackgroundPeople with profound and multiple intellectual disabilities (PMID) have high and intensive support needs that ordinarily place significant strain on family carers. This was further heightened by the removal of many external supports during the COVID-19 pandemic. We sought to explore the experiences of family carers of people with PMID during the COVID-19 pandemic and understand what the longer-term impact might be on their lives.MethodsFocus group interviews (n = 32) were conducted with family carers (n = 126) from the four countries of the UK and the Republic of Ireland. Participants were asked questions relating to their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. All focus groups were conducted using the online platform, Zoom. These were audio recorded, transcribed verbatim and analysed employing inductive thematic analysis.FindingsThree main themes were generated from the data including (1.0) COVID-19 as a double-edged sword (2.0), The struggle for support (3.0), Constant nature of caring. These included 11 subthemes. (1.1) ‘COVID-19 as a catalyst for change’, (1.2) ‘Challenges during COVID-19: dealing with change’, (1.3) ‘Challenges during COVID-19: fear of COVID-19’, (1.4); ‘The online environment: the new normal’ (2.1) ‘Invisibility of male carers’, (2.2) ‘Carers supporting carers’, (2.3) ‘The only service you get is lip service: non-existent services’, (2.4); ‘Knowing your rights’ (3.1) ‘Emotional response to the caring role: Feeling devalued’, (3.2) ‘Emotional response to the caring role: Desperation of caring’, (3.3) ‘Multiple demands of the caring role.’ConclusionsThe COVID-19 pandemic presented immense challenges to family carers of people with PMID but also provided some opportunities. Families had already struggled to receive many of the supports and services to which they were entitled to only to have these removed at the onset of the pandemic. The experiences of male carers have been largely absent from the literature with this research showing they want to be included in decision making and require tailored support services. Service providers should see the end of the COVID-19 pandemic as providing opportunity to re-examine current provision and design services with family carers. As the direct threat from COVID-19 diminishes and the experiences of those who lived through this period come to the fore, there is a need to re-examine current models and provision of support to family carers to better meet their needs.

Population of invasive group A streptococci isolates from a German tertiary care center is dominated by the hypertoxigenic virulent M1UK genotype.

Hypertoxigenic Streptococcus pyogenes emm1 lineage M1UK has recently been associated with upsurges of invasive infections and scarlet fever in several countries, but whole-genome sequencing surveillance data of lineages circulating in Germany is lacking. In this study, we investigated recent iGAS isolates from our laboratory at a German tertiary care center for the presence of the M1UK lineage. Whole-genome sequencing was employed to characterize a collection of 47 consecutive non-copy isolates recovered from blood cultures (21) and tissue samples (26) in our laboratory between October 2022 and April 2023. M protein gene (emm) typing distinguished 14 different emm types, with emm1 (17) being the dominant type. Single-nucleotide polymorphism (SNP) analysis confirmed the presence of all 27 SNPs characteristic for the M1UK lineage in 14 of 17 emm1 isolates. This study has shown for the first time that M1UK is present in Germany and might constitute a driving force in the observed surge of GAS infections. This observation mirrors developments in the UK and other countries and underscores the importance of WGS surveillance to understand the epidemiology of GAS.

The misplaced embryo: legal parenthood in ‘embryo mix-up’ cases

Recently in Israel, a woman was mistakenly implanted with an embryo that is genetically related to another couple. Unfortunately, this case is not an isolated occurrence, as other cases of...