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Effectiveness and acceptability of interventions to improve faecal immunochemical test (FIT) return in both asymptomatic (screening) and symptomatic populations: protocol for a systematic review of qualitative and quantitative evidence
Get PDFIntroduction
Colorectal cancer (CRC) is the fourth most common cancer in the UK and second leading cause of cancer-related deaths. The faecal immunochemical test (FIT) is a non-invasive home-based test used for both symptomatic assessment and population-based screening. However, approximately 30% of screening FIT kits and 10% of symptomatic FIT kits are never returned. Under-served populations, including ethnic minorities, socioeconomically deprived communities and those with mental health conditions, experience particularly low FIT return rates, contributing to health inequalities in CRC outcomes. This systematic review aims to synthesise evidence on the effectiveness and acceptability of interventions to improve FIT returns in both asymptomatic screening and symptomatic populations, with particular focus on under-served communities.
Methods and analysis
We will conduct a systematic review of qualitative and quantitative evidence. We will search Scopus, MedLine via Ovid, CINAHL via Ebsco and Cochrane Central Register of Controlled Trials from September 2010 onwards, supplemented by reference screening and trial registry searches. Eligible studies will include randomised controlled trials, quasi-experimental studies, observational studies, qualitative studies, mixed-methods studies and implementation studies examining FIT interventions in screening or symptomatic populations. Two reviewers will independently screen search results for eligible studies. Data extraction will capture study characteristics, population demographics, intervention components and outcomes including FIT return rates, acceptability, feasibility and implementation factors. Quantitative data will undergo systematic tabulation and meta-analysis where appropriate, with narrative synthesis for heterogeneous studies. Qualitative data will be analysed using framework-based thematic analysis, mapping findings to both the theoretical domains framework and theoretical framework of acceptability. A mixed-methods synthesis will integrate quantitative and qualitative findings to identify intervention characteristics, implementation strategies and contextual factors associated with improved outcomes across different population groups.
Ethics and dissemination
Ethics approval is not required as this systematic review will analyse published studies. Findings will be disseminated through peer-reviewed publication and conference presentations.
PROSPERO registration number
CRD420251111663
Developing a Framework to Analyse Master’s Students’ Projection of Authority through Written Argument at a UK University: Insights from a Pilot Study
Get PDFThis article will discuss a pilot study used to develop a novel framework to analyse master’s students’ projection of authority in argumentative academic writing. The projection of authority will be presented as a vital component of student success, as it allows the student to make a meaningful contribution to the disciplinary discourse community. If students fail to project authority in their writing, they run the risk of producing written work which is characterised by description rather than evaluation. The pilot analysis of five student essays from the BAWE corpus resulted in the creation of a triadic framework for the analysis of textual authority focusing on the following aspects: 1) The way students construct written argument 2) The way students negotiate the argument in the context of a disciplinary conversation 3) The way students position themselves in relation to the argument and how they project an authorial sel
Investigations into a ternary liquid-liquid-solid extraction system for partitioning of lithium, with a view to potential isotopic enrichment applications
Get PDFExosome-mediated delivery of microRNAs by root-knot nematodes
Get PDFPlant-parasitic nematodes secrete molecules to manipulate their hosts, but little is known about their mode of delivery and packaging. Here, we describe microRNA-containing exosomes that are secreted by root-knot nematodes and systemically increase host susceptibility. By revealing a novel mode of nematode-plant communication, our findings outline a mechanism for the delivery of nematode patho-molecules, offering a new target for disrupting parasitism at the level of vesicle-mediated delivery
Rapid economic impact assessment of nature-based solutions: Illustration of a co-constructed approach
Get PDFAmongst the multiple advantages attributed to nature-based solutions (NBS) over conventional and grey infrastructure, is their characterisation as economically efficient, i.e. that the benefits that they generate outweigh their costs. However, surprisingly little attention has been paid so far to generating quantified evidence to support this claim in the form of comprehensive cost-benefit analysis informing actual and specific environmental decisions in given territories. In the absence of such evidence, current enthusiasm for NBS might result in unfavourable decisions, disappointment and abandonment. In this paper, we illustrate a co-constructed approach developed in close collaboration with policy-makers and involving a range of stakeholders. This approach formally evaluates the well-being impacts of adopting NBS versus non-NBS alternatives for the mitigation of agricultural impacts in the ecologically stressed Mar Menor lagoon (Spain), building-up the evidence base of the economic efficiency of NBS. More importantly, the paper illustrates how to undertake rapid economic impact assessments that, when exposed and co-constructed with a range of stakeholders in participatory processes, can support complex policy decisions in response to climate and environmental emergencies in ways that are robust, transparent and socially acceptable. By maintaining scientific rigor while simplifying data demands, rapid co-constructed economic impact assessments can not only integrate ecosystem services and economic efficiency reasoning into environmental governance but can also serve as boundary objects for consensus building, awareness raising and collective experiential learning. This is of particularly critical importance in times of growing polarisation over environmental challenges
Patient Perspectives on Inpatient Mealtimes: Insights on Swallowing, Mental Wellbeing and Recovery
Get PDFAlthough the prevalence of swallowing difficulties in adults with mental health conditions has been highlighted in research, the relationship between swallowing difficulties and psychosocial aspects of mealtime experiences is not known. In the context of a need for person-centred and holistic approaches to nursing and healthcare, the paucity of research relating to the impact of mealtimes on hospital wards on patient wellbeing and safety reveals a significant gap in knowledge. To understand patient views and experiences of mealtimes on inpatient mental health wards, including both positive and negative aspects affecting their wellbeing and safety, this ethically-approved study was qualitative in design and involved collaboration with service-user groups who co-designed interview questions. Participants were 13 inpatients on mental health wards for working-age adults. Interviews were conducted in person, de-identified and analysed using thematic analysis. Themes were first constructed from transcripts and then verified with service-user groups and the research team. The overarching theme of ‘heightened emotions associated with mealtimes’ encapsulated four themes: ‘experiencing anxiety and stress, connecting with others at mealtimes, loss of autonomy and choice, and experiences of swallowing difficulty’. Heightened emotions, anxiety and stress experienced during mental health ward mealtimes were counter to patients' wellbeing, which impacted on their wider recovery. Mealtime and swallowing safety, particularly when dysphagia is present, may be negatively affected by emotional pressures during mealtimes. These findings suggest a need to address barriers to wellbeing at mealtimes, and to raise awareness around integrating mealtimes into recovery pathways and person-centred care
spanishoddata: A package for accessing and working with Spanish Open Mobility Big Data
No full textWe present spanishoddata, an R package that enables fast and efficient access to Spain’s open, high-resolution origin-destination human mobility datasets, derived from anonymised mobile-phone records and released by the Ministry of Transport and Sustainable Mobility. The package directly addresses challenges of data accessibility, reproducibility, and efficient processing identified in prior studies. spanishoddata automates retrieval from the official source, performs file and schema validation, and converts the data to efficient, analysis-ready formats (DuckDB and Parquet) that enable multi-month and multi-year analysis on consumer-grade hardware. The interface handles complexities associated with these datasets, enabling a wide range of people – from data science beginners to experienced practitioners with domain expertise – to start using the data with just a few lines of code. We demonstrate the utility of the package with example applications in urban transport planning, such as assessing cycling potential or understanding mobility patterns by activity type. By simplifying data access and promoting reproducible workflows, spanishoddata lowers the barrier to entry for researchers, policymakers, transport planners or anyone seeking to leverage mobility datasets
UrbanMMCL: Urban region representations via multi-modal and multi-graph self-supervised contrastive learning
Get PDFUrban region representation learning has emerged as a fundamental approach for diverse urban analytics tasks, where each neighborhood is encoded as a dense embedding vector for effective downstream applications. However, existing approaches suffer from insufficient multi-modal alignment and inadequate spatial relationship modeling, limiting their representation quality and generalizability. To address these challenges, we propose UrbanMMCL, a novel self-supervised framework that integrates multi-modal multi-view contrastive pre-training with unified fine-tuning for comprehensive urban representation learning. UrbanMMCL employs a dual-stage architecture. First, cross-modal contrastive learning aligns diverse data modalities including remote sensing imagery, street view imagery, location encodings, and Vision–Language Model (VLM)-generated textual descriptions. Second, multi-view adaptive graph contrastive learning captures complex spatial relationships across human mobility, functional similarity, and geographic distance perspectives. The framework then fine-tunes all parameters with the learned representations for effective adaptation to downstream tasks. Comprehensive experiments demonstrate that UrbanMMCL consistently outperforms state-of-the-art methods across pollutant emission prediction, population density estimation, and land use classification with minimal fine-tuning requirements, thereby advancing foundation model development for diverse Geo-AI applications
‘How Does Nothing Show Up When I'm in So Much Agony?’: A Qualitative Study Exploring Patient Experiences of Non‐Specific Abdominal Pain in Acute Surgical Care
Get PDFIntroduction
Non-specific abdominal pain is a common and diagnostically challenging presentation in acute care, yet little is known about patient experiences within this setting. This study explores the experiences of patients attending a surgical same-day emergency care (SDEC) unit with non-specific abdominal pain.
Design
Qualitative descriptive study using inductive thematic analysis.
Methods
23 adults (aged ≥ 18 years) presenting with acute non-specific abdominal pain to a surgical SDEC in England were purposively sampled. Semi-structured interviews were conducted at least 2 weeks after discharge and thematically analysed inductively, iteratively and collaboratively by a team of psychiatrists, surgeons and a lived experience co-researcher.
Results
Three themes were identified: (1) The journey to the SDEC—participants described uncertainty and fear about potential diagnoses and varied thresholds for help-seeking, (2) The consultation—while many appreciated rapid access to care, experiences of communication and explanation were mixed, with some feeling dismissed or confused by the absence of a clear diagnosis, and (3) Post-consultation reflections—some felt reassured by normal test results, while others struggled with persistent symptoms, a lack of follow-up, and ongoing uncertainty. Discussions around psychosocial factors were rare.
Conclusions
Acute non-specific abdominal pain can be distressing for patients, even after attending acute surgical services, particularly when communication is perceived to be unclear and follow-up is inconsistent. A more structured, patient-centred approach, including standardised follow-up, clear explanations and sensitivity to psychosocial factors, could improve experiences and possibly outcomes for this group.
Patient and Public Contribution
A patient and public involvement and engagement (PPIE) group, comprising individuals with lived and living experience of persistent physical symptoms, shaped the scope and design of the research and co-produced the interview topic guide. A lived experience representative was actively involved in data analysis, interpretation and manuscript preparation
Effectiveness and safety of therapies for patients with opioid use disorder: a systematic review and network meta-analysis
Get PDFAim: Opioid use disorder (OUD) leads to significant morbidity and mortality. While opioid agonist therapies like transmucosal buprenorphine and methadone are effective, they face challenges such as poor adherence, diversion risk and suboptimal abstinence rates, prompting the development of long-acting injectable (LAI) buprenorphine. However, comparative evidence among LAIs and versus standard treatments remains limited. The aim of this study is to provide comparative evidence among buprenorphine LAIs and versus oral opioid agonist treatments.
Materials & methods: We conducted a systematic literature review and network meta-analysis (NMA) evaluating the effectiveness and safety of LAI buprenorphine treatments (extended-release buprenorphine [BUP-XR; monthly injection] and other BUP-LAI [weekly and monthly injection]) versus transmucosal buprenorphine, methadone and buprenorphine implants in adults with OUD. The review included randomized controlled trials (RCTs) and non-RCTs for LAIs (January 2012 and March 2025). Primary outcomes were treatment discontinuation and illicit opioid use. Secondary outcomes were safety and health-related quality of life. Data were synthesized using univariate NMAs, bivariate NMA with surrogate end point modelling. Studies with limited data and single-arm designs were incorporated by using study-level matching techniques.
Results: Ninety-eight studies met the inclusion criteria. BUP-XR demonstrated the highest probability of achieving treatment retention and opioid abstinence across analyses. In combined evidence (RCTs and non-RCTs), BUP-XR showed significantly lower risk of illicit opioid use versus transmucosal buprenorphine (rate ratio [RR] 1.99; 95% credible interval [CrI]: 1.29–3.11) and methadone (RR: 2.66; 95% CrI: 1.40–3.56). BUP-XR showed borderline significantly lower risk of illicit opioid use versus other BUP-LAI (RR: 1.81; 95% CrI: 0.97–3.55) and buprenorphine implant (RR: 2.28; 95% CrI: 0.98–5.38). Treatment discontinuation rates were similar between OUD treatments. Safety outcomes were generally comparable across treatments. Health-related quality of life indicated better recovery among patients treated with BUP-XR.
Conclusion: BUP-XR may enhance treatment retention and abstinence over other OUD therapies, supporting its integration into clinical pathways. The results may help guide future updates to OUD treatment guidelines and policies aimed at optimizing the use of long-acting formulations. Additional research is needed to better define the comparative effectiveness of LAIs
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