Using the Behaviour Change Wheel to develop an intervention to improve conversations about recovery on the stroke unit.

Background: Understanding recovery is important for patients with stroke and their families, including how much recovery is expected and how long it might take. These conversations can however be uncomfortable for stroke unit staff, particularly when they involve breaking bad news. This study aimed to begin development of a novel complex intervention to improve conversations about recovery on stroke units.

A meta-analysis of epigenome-wide association studies of ultra-processed food consumption with DNA methylation in European children.

Background/objective: There is limited knowledge on how diet affects the epigenome of children. Ultra-processed food (UPF) consumption is emerging as an important factor impacting health, but mechanisms need to be uncovered. We therefore aimed to assess the association between UPF consumption and DNA methylation in children.

Taking a partnership approach to embed physical activity in local policy and practice: a Bradford District case study.

Background: Supportive policy is an important component of a whole-systems approach to increasing physical activity and reducing inequalities. There is a growing body of literature surrounding the design and effectiveness of national policy approaches to physical activity, but evidence related to local-level approaches is lacking. The aim of this study was to examine 'what works', and identify factors underpinning change, focused on work to embed physical activity in local policy and practice in Bradford, UK.

Personalised care planning for older people with frailty: a review of factors influencing implementation.

Background: Frailty increases vulnerability to major health changes because of seemingly small health problems. It affects around 10% of people aged over 65.Older adults with frailty frequently have multiple long-term conditions, personal challenges, and social problems.

JU:MP leads: sparking physical activity leadership and supporting positive youth development in a deprived community.

Introduction: Physical activity interventions in deprived communities should acknowledge the social, political, and cultural context in which they are delivered. Targeted young leaders programs can harness positive youth development principles and address these concerns by engaging underrepresented young people and developing them as physical activity leaders who can support local delivery efforts. Community-based Youth Leadership development programs are under-researched, and little is known about how to develop young people from deprived communities as physical activity leaders.

Implementation and impact of NHS-funded tobacco dependence services in England: a mixed-method evaluation protocol.

Introduction: Tobacco smoking remains a leading cause of ill-health, premature mortality and a driver of health inequalities. To support smokers in England, a comprehensive approach to treating tobacco dependence is being implemented. This includes offering support to all people admitted to hospitals, as well as women and pregnant people within NHS settings.

Navigating UK internal medicine training applications: 10 essential tips.

Internal medicine training applications in the UK have become increasingly competitive. This article provides ten tips for optimizing internal medicine training applications covering portfolio development, teaching experience, project selection, and interview preparation. We outline strategies for maximizing application scores through efficient resource allocation, effective project selection, and structured interview preparation.

Trends and Outcomes of Laparoscopic Surgery in Low-Resource Settings: Lessons From Two African Healthcare Systems-A Narrative Review.

Introduction: Laparoscopic surgery (LS) has been a promising development in surgical practice globally ever since its introduction. LS has exhibited many an advantage, including bettering patient outcomes, lowering the risk of postoperative infection, and displaying economical affluence. However, its implementation in the African continent still faces various challenges.

Evaluating causal associations of chronotype with pregnancy and perinatal outcomes and its interactions with insomnia and sleep duration: a mendelian randomization study.

Background: Observational studies suggested chronotype was associated with pregnancy and perinatal outcomes. Whether these associations are causal is unclear. Our aims are to use Mendelian randomization (MR) to explore (1) associations of evening preference with stillbirth, miscarriage, gestational diabetes, hypertensive disorders of pregnancy, perinatal depression, preterm birth and offspring birthweight; and (2) differences in associations of insomnia and sleep duration with those outcomes between chronotype preferences.

Association of exposure to second-hand smoke during childhood with blood DNA methylation.

Introduction: By recent estimates, 40% of children worldwide are exposed to second-hand smoke (SHS), which has been associated with adverse health outcomes. While numerous studies have linked maternal smoking during pregnancy (MSDP) to widespread differences in child blood DNA methylation (DNAm), research specifically examining postnatal SHS exposure remains sparse. To address this gap, we conducted epigenome-wide meta-analyses to identify associations of postnatal SHS and child blood DNAm.

A bad migrant: An autoethnographic case study of racism in Australian HIV care.

Australia is world renowned when it comes to its successful response to HIV prevention, but their HIV epidemiological trend has shifted towards the increase of new HIV diagnoses among migrants. This paper reveals a neglected determinant of migrants' health within Australian HIV care, and that is: racism. To provoke a debate on the saliency of racism, I used autoethnographic case study to analyse my encounter with racism in Australian HIV care.

"It's like being chained up": the oral mucositis experiences of children and young people with cancer, their parents, and healthcare professionals- a qualitative study.

Objective: The objective is to explore the experiences of children and young people (CYP) with cancer, their parents, and healthcare professionals (HCPs) involved in their care of oral mucositis.

Design: A qualitative study was conducted. CYP with experience of mucositis were purposively sampled, aiming for diversity in age, sex and cancer diagnosis.

Childhood exposure to non-persistent endocrine disruptors, glucocorticosteroids, and attentional function: A cross-sectional study based on the parametric g-formula.

Background: Evidence suggests that endocrine disrupting chemicals (EDCs) may perturb the hypothalamic-pituitary-adrenocortical (HPA) axis, which has a major role in brain development. We aimed to evaluate the effects of childhood exposure to organophosphate pesticides, phenols, and phthalate metabolites, on urinary glucocorticosteroids and inattention in childhood.

Methods: We used data from the Human Early-Life Exposome (HELIX) cohort (2013-2016) and the parametric g-formula to estimate associations between EDCs, glucocorticosteroids, and hit reaction time standard error (HRT-SE), a measure of inattention, and tested for possible effect modification by sex.

A scoping review of the measurement and analysis of frailty in randomised controlled trials.

Background: Frailty is of increasing interest in trials, either as a target of intervention, as an outcome or as a potential treatment modifier. However, frailty measurement is often highly variable. This scoping review assessed how frailty is quantified in randomised controlled trials (RCTs), in what context and for what purposes.

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

Background: Opioid substitution therapy (also known as 'opioid agonist therapy' or 'medication treatment of opioid use disorder') 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, patient-directed discharge, and increased costs.

Outcomes of X-Linked Agammaglobulinaemia Patients.

Background: X-linked agammaglobulinaemia (XLA), caused by mutations in BTK, is characterised by low or absent peripheral CD19 + B lymphocytes and agammaglobulinaemia. The mainstay of treatment consists of immunoglobulin replacement therapy (IgRT). As this cannot fully compensate for the immune defects in XLA, patients may therefore continue to be at risk of complications.

The association of Helicobacter pylori with adverse pregnancy outcomes in three European birth cohorts.

Background: Helicobacter pylori is a prevalent infection that may complicate pregnancy, but evidence remains limited, controversial and may not apply to all pregnant women.

Objective: This study aims to evaluate whether Helicobacter pylori is a risk factor for adverse pregnancy outcomes and to identify vulnerable subpopulations.

Study Design: Multiplex serology was utilized to measure blood levels of immunoglobulin G against eight Helicobacter pylori antigens in 1372 pregnant women from three European birth cohorts: BiB (United Kingdom), Rhea (Greece) and INMA (Spain).

Meta-Analysis: Prevalence of Frailty and Associated Adverse Events in Inflammatory Bowel Diseases.

Background: The number of adults aged over 60 years with inflammatory bowel disease (IBD) is increasing. Frailty, rather than chronological age, may be a better predictor of adverse health outcomes.

Aims: To summarise current knowledge about frailty in adults with IBD including the prevalence and associations of frailty and IBD-related adverse outcomes.

Maternal Enhanced and Critical Care (MEaCC) in Yorkshire and the Humber: regional implementation of an enhanced maternal care pathway and data collection.

Enhanced Maternity Care (EMC) is a new standard of care for women who become unwell during or shortly after pregnancy. Yorkshire and the Humber Maternity Clinical Network established the Maternal Enhanced and Critical Care Group (MEaCC) to create regional guidance with a focus on maternity staff training, development of the MEaCC database and data collection. This article describes the introduction of the MEaCC and regional data collection.

The role of NGOs and humanitarian organizations in enhancing surgical capacity in Africa: lessons learned and future directions-a narrative review.

Introduction: Significant inequities exist in surgical care accessibility across marginalized African communities. Non-governmental organizations (NGOs) and humanitarian groups are vital in supporting Africa's surgical infrastructure. This narrative review explores the current status of surgical care in Africa, highlighting NGO initiatives, past challenges, and future opportunities.