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Preparedness for practice and workplace support of newly qualified allied health professionals: A qualitative study
No full textINTRODUCTION: Allied health professionals (AHPs) constitute a significant part of the global healthcare workforce. It is important that AHPs are well prepared for practice to provide quality care for patients, for their personal wellbeing, and for workforce retention. In comparison to doctors, there has been strikingly limited research on AHPs preparedness for practice. The aim of this study was (1) to understand how well newly qualified AHPs were prepared for practice and (2) to investigate support in the workplace for newly qualified AHPs.
METHODS: We conducted a national qualitative study involving semi-structured interviews with multiple stakeholders across the UK. Sixty interviews were conducted with 61 participants across 15 professions newly qualified registrants (NQRs), practice supervisors/employers, and policymakers. The interviews were recorded, transcribed, coded in NVivo and analysed using a thematic framework approach.
RESULTS: NQRs were perceived to be well-prepared for their clinical practice and communication skills; however, some were not prepared for decision-making, leadership, putting theory into practice and knowledge base. Underpreparedness for management of caseloads due to workforce shortages was a notable concern. Support for NQRs in the workplace varied hugely in its availability and effectiveness, was influenced by team size, how established a team is, resources, and the policies of different employers/trusts. Support that is tailored to the needs of the individual NQR was most valued by participants.
DISCUSSION: There were more similarities than differences between perceptions of preparedness for practice of AHPs and other health professionals (e.g. doctors). If education providers and employers can better prepare and support NQRs in the workplace (proactive support measures) then this may contribute to fewer problems associated with mental health and well-being to resolve later (reactive support measures), e.g. at individual (impaired mental health) or system level (retention). This initial scene-setting research across all AHPs has identified pertinent issues for in-depth exploration
LandWorks Evaluation 1 April 2024 to 31 March 2025: Generating a harm reduction and desistance community
No full textThis year, LandWorks has experienced both highs and profound challenges. In July 2024, LandWorks won the Overall Award for Excellence at the Charity Awards — the most prestigious awards scheme in the charity sector. The judges highlighted LandWorks’ greatest achievement as “the way it built trust with its trainees and helped them rebuild their lives by understanding the experiences that led to their criminal behaviour in the first place.” Staff, trainees, and graduates were deeply proud of this recognition, which serves as a national endorsement of LandWorks’ accomplishments since its establishment in 2013. Alongside this success, the past twelve months have been marked by the deaths of six graduates. Despite these challenges, LandWorks continues to make a meaningful difference. This year’s evaluation report highlights both the obstacles trainees and graduates face as they move away from a criminal lifestyle, and the ways in which LandWorks supports them to build skills, confidence, and a future in the law-abiding community. In celebrating achievements and reflecting on losses, the organisation remains committed to fostering hope, resilience, and lasting positive change
The career choices of final year nursing students in the United Kingdom: a qualitative study.
No full textAim: The aim of this study is to explore the career choices of final year under-graduate nursing students in the United Kingdom. Background: Worldwide there is a decreasing number of nurses and in the United Kingdom there is a decreasing amount of nursing students. There is sparce evidence relating to the career\u27s choices of nursing students and reasons for those choices. Obtaining a deeper comprehension of these choices may aid healthcare employers, in partnership with universities, to design the future nursing workforce. Design: A qualitative design was used. Methods: Twenty-one final year under-graduate nursing students from across a range of universities volunteered to attend online focus groups to share their experiences of career choices. Results: The themes which emerged were: ‘choosing an employer’; ‘job searches and applications’; ‘should I stay or should I go’; ‘choosing a specialty’ and ‘an alternative career.’ Conclusions: The findings from this study provide reasons and rationales for careers choices of nursing which may aid healthcare employers in partnership with universities to plan their nursing recruitment and retention strategies
Recompression Improves Release Success in Pollack (Pollachius pollachius): A Step Towards Assessing Post Release Mortality in a Recreational Fishery
No full textThe recreational fishery for pollack (Pollachius pollachius) in the northeast Atlantic is impacted by the species\u27 high sensitivity to barotrauma. When captured at depth and brought to the surface, gas expansion within the peritoneal cavity can cause a variety of injuries and hinder release. Via an experimental weighted cage, this study evaluated the efficacy of releasing Pollack at depth as a barotrauma mitigation strategy. We found that depth-release significantly increased the probability of released Pollack displaying an active escape response to 83%, compared to 56% for surface-released fish; however, increased capture depth and fish size negatively affected success. Camera observations of depth-released Pollack confirmed the recovery of vital reflexes (vestibulo-ocular reflex, equilibrium maintenance) within 1.5–4 min. Further acoustic telemetry demonstrated that individuals subsequently displayed active dispersion from the release site (0.1–23.8 km) and showed active vertical movements for up to 6 months post-release. These findings indicate that depth-release improves survival outcomes, though further research is required to optimise release methods in open-water environments
Sacrifice of Isaac (Long Gallery, Lanhydrock)
No full text3D digital model of the \u27Sacrifice of Isaac\u27 plaster relief in the Long Gallery at Lanhydrock House (c. 1638/39-1643), based on LiDAR surveys in 2025
Explaining transformer-based classification of radiology reports
No full textObjectivesDeep learning models developed for the classification of radiological reports have lacked explainability. We aimed to validate and explain a pretrained classification model by applying it to the removal of confounding data from a radiological dataset.MethodsTwo radiologists categorized 2038 anonymized MRI head free-text radiology reports for abnormality and for small vessel disease presence. Of these reports, 80% (n = 1630) were used to fine-tune pretrained transformer models to classify scans. Five-fold cross-validation was used in model development. The models were tested on the remaining 20% of the reports (n = 408). SHapley Additive exPlanations (SHAP) were used to explain the results.ResultsThe models exhibited excellent classification performance, with a mean receiver operating characteristic (ROC) area under the curve (AUC) of 0.98 for abnormality classification and 0.99 for small vessel disease classification. SHAP highlighted relevant words in both cases.ConclusionsThis application validated the use of a pretrained transformer in detecting confounding data in research cohorts, and exhibited explainable results that allow the models’ decisions to be understood. By highlighting the specific report terms that drive each prediction, the explainable model output can be reviewed and critiqued by subject matter experts, supporting trust, error analysis, and iterative refinement of AI tools within clinical workflows.Advances in knowledgeThis application demonstrates the feasibility of explainable report classification, and the fine-tuned model could be used in future for automatic removal of confounding data from radiology datasets, while providing transparent, case-level justifications that support audit, governance, and clinician acceptance
The development of the daughter-guarding scale: An exploratory and confirmatory factor analytic study
No full textFathers represent one of the earliest opposite-sex relationships for daughters, and it has been suggested that fathers may shape their daughters\u27 developmental trajectory. Fathers are often stricter with their daughters compared to sons in monitoring and correcting behaviors, most notably in the avenue of social and sexual monitoring. Nonetheless, there are no valid measurement tools for capturing the different factors associated with daughter-guarding by fathers. The current study proposed an instrument for addressing daughter-guarding as reported by fathers. In Study 1, an exploratory factor analysis showed that 3-underlying factors were present in daughter-guarding, such as social monitoring of friends, guarding decisions, and opposite-sex monitoring. In Study 2, a confirmatory factor analysis showed that a 3-factor model was a good fit, and each of the 3-subscales were reliable. This work provides a good avenue for future studies seeking to address paternal behaviors and their influence on daughters\u27 development
Training Healthcare Professionals to Deliver a Group-Based Intervention for People Living With Severe Obesity: Lessons From the PROGROUP Feasibility Trial
No full textIntroduction: Group-based programmes are increasingly adopted to support people living with obesity, as they have the potential to reduce staff time and costs and enhance motivation and capability for behaviour change. Group-based programmes could also provide members with opportunities to form meaningful social connections. As such, training should equip healthcare professionals to deliver group interventions successfully and be accessible and feasible for them to complete. This study presents how mixed-methods process evaluation data from the feasibility randomised controlled trial of PROGROUP (a group-based weight management intervention for people living with severe obesity) informed optimisation of the PROGROUP training programme. Methods: Five healthcare professionals (facilitators) from three specialist weight management services across the United Kingdom participated in a 4-day remote training programme in preparation for facilitating PROGROUP. Four patient cohorts were subsequently delivered across these services. Training content was informed by psychological theory and included communication and group facilitation skills, as well as physical activity and dietary education, delivered by an expert research and practitioner team. Following intervention delivery, facilitators were interviewed about their experiences of training and delivery. Additional data collection sources included fidelity (to form and content) checklists, audio and video recordings of intervention delivery, and field note summaries from in-person observations and debrief calls. Interview data was analysed thematically. Results: Fidelity findings showed that intervention content was largely delivered as intended across all cohorts (average across cohorts = 68%), with facilitators showing confidence in delivering the educational components of the intervention. However, variability was observed across cohorts, indicating differences in facilitators\u27 ability to deliver flexibly and in line with intervention delivery principles. Facilitators also reported challenges in attending all training days in full and expressed a preference for more self-directed learning. In response, to improve accessibility and delivery fidelity, training was adapted to include self-directed learning and a greater focus on developing the necessary skills and knowledge to facilitate according to intervention delivery principles. Conclusion: This study outlines a process for optimising training for healthcare professionals, with learnings applicable to other group-based healthcare settings. Findings highlight the need for healthcare professionals to develop skills aligned with delivering such interventions with fidelity, to maximise potential effectiveness. A flexible, self-directed training format can enhance feasibility and acceptability, balancing healthcare professionals\u27 needs with intervention requirements, and offers a valuable and novel training resource for those delivering group-based care
Long-term evaluation of the energy consumption of 100 energy-efficient buildings in Austria
No full textIn 2019, buildings greenhouse gas (GHG) emissions accounted for 21 % of global emissions, therefore regions such as Europe have strong policies to decrease such emissions. The literature shows different examples simulating energy refurbishment of buildings or districts where an important GHG reduction can be achieved, but there is a clear gap on real measurements of exemplary buildings. This paper shows an assessment of more than 100 energy-efficient buildings in Austria, showing that this GHG emissions reduction is really possible. The paper evaluates residential and non-residential buildings, where the energy consumption was 50 % below the consumption of typical multi-apartment buildings. Moreover, the emissions in such buildings were well below the Paris agreement targets
Developing a novel typology of unprofessional behaviours between healthcare staff: a best fit framework synthesis
No full textBackground: Unprofessional behaviours such as bullying, harassment, and microaggressions negatively affect patient safety and staff psychological wellbeing in healthcare systems globally. These behaviours do so by: (i) inhibiting health care professionals’ abilities to speak up to raise safety concerns; (ii) impairing team communication and individuals’ concentration; and (iii) promoting tolerance of bad practice. Unfortunately, there is little consensus in practice or academia about how these behaviours are defined. This can lead to an underestimation of the prevalence of these behaviours, inhibition of speaking up by victims and bystanders, and reduced accountability by those who enact these behaviours. We aimed to map definitions of unprofessional behaviours between staff to understand their similarities and differences and to develop a useful typology for theory-informed interventions. Methods: We used a six-step modified best-fit framework synthesis methodology to formulate our new typology, as a part of a wider realist review project. We employed a systematic approach to develop a framework for understanding UB. First, we identified relevant literature through a systematic search of Embase, CINAHL and MEDLINE databases (and more) (n = 146 sources). An initial framework outlining the dimensions of unprofessional behaviours was then constructed based on extracted definitions. Terms from included studies were then coded against this framework, with new dimensions introduced as needed to accommodate terms that did not align with existing categories. The resulting framework was refined iteratively and validated through stakeholder engagement, enhancing its relevance and validity. Results: We identified 37 behaviours drawing on 146 literature sources and found little consensus in how unprofessional behaviours between staff are defined in the academic literature. By collating definitions, we identified five dimensions inherent to unprofessional behaviours between staff namely: visibility; inherent frequency; whether they are highly targeted; if behaviours target protected characteristics (personal attributes that are legally safeguarded against discrimination in the UK and many other countries, such as race, sex or religion); if behaviours are physical; and if hierarchy is required. These dimensions enabled formulation of the typology with increased understanding of the differences between unprofessional behaviour types. Conclusions: We found that poor and inconsistent understanding of unprofessional behaviour could undermine interventions by inhibiting speaking up, enabling instigators to avoid accountability, and inhibiting ability to measure unprofessional behaviour and address it. Our typology provides a useful resource for academics, healthcare organisations, intervention architects, and individuals who are seeking to understand and clarify the range of unprofessional behaviours that may be encountered in healthcare settings