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A model-based cost-effectiveness analysis of prescribing by dietitians and therapeutic radiographers in EnglandNon-medical prescribing (NMP) was introduced into the UK healthcare system and other countries to improve patient care and facilitate better access to medicine. However, very few studies have evaluated the cost-effectiveness of the prescribing authorities granted to certain healthcare professional groups. This study aims to evaluate the cost-effectiveness of prescribing by dietitians and therapeutic radiographers in England. A model-based cost-effectiveness analysis was conducted to evaluate the services provided by dietitian and therapeutic radiographer prescribers compared to services delivered by dietitian and therapeutic radiographer non-prescribers in terms of direct and indirect costs and effectiveness outcomes, e.g. quality-adjusted life year (QALY) and patient satisfaction, from the National Health Service (NHS) perspective. Unit costs were obtained from the NHS National Reference Costs 2021-22. Sensitivity analyses were performed to assess the robustness of the model parameters. The mean costs associated with NMP were higher for prescribers than non-prescribers due to training costs and consultation time to manage prescriptions. However, these costs were compensated by higher referrals by non-prescribers to other specialists for prescribing. NMP in either profession was perceived as positive by patients. Differences in QALY were not statistically significant among patients managed by prescribers and non-prescribers for either profession. Results were sensitive to the model assumptions and parameters. Our estimates suggest NMP might save £64,269 over five years per dietitian prescriber and £16,570 per therapeutic radiographer prescriber. Despite uncertainties around the cost-effectiveness of NMP, it may save money with minimal or no changes in quality-of-life outcomes for patients being managed by either profession.
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Implementing evidence-based practice in critical care nursing: an ethnographic case study of knowledge useTo explore how critical care nurses access, negotiate and apply knowledge in high-pressure clinical environments, focusing on organisational, cultural and leadership factors influencing evidence-based practice implementation in acute hospital settings. A focused ethnographic collective case study was conducted across two contrasting critical care units in England. Methods included non-participant observation (56 sessions), semi-structured interviews (36 participants) and document review. Spradley's Developmental Research Sequence guided data generation and analysis. Data were collected over an eight-month period (February to September 2022). Five major themes were identified: sources of knowledge and acquisition strategies; institutional and hierarchical influences on knowledge use; role of experiential knowledge and clinical intuition; challenges to evidence-based practice implementation; and strategies for integrating knowledge into practice. Organisational structures, leadership engagement, mentorship and access to updated digital resources were key enablers of evidence-based practice. Barriers included workload pressures, inconsistent guideline dissemination and hierarchical cultures. Adaptive blending of formal evidence, clinical experience and intuition characterised effective knowledge negotiation at the bedside. Knowledge use in critical care nursing is a dynamic, relational process shaped by leadership, organisational culture and systemic pressures. The availability of evidence alone is insufficient; visible leadership, peer learning, protected educational time and valuing of experiential knowledge are critical to embedding evidence-based practice into routine practice. Strengthening organisational systems, investing in nurse manager development, expanding simulation-based learning and legitimising experiential knowledge are vital strategies to enhance evidence-based critical care. This study provides actionable insights for healthcare leaders, educators and policymakers seeking to optimise evidence-based practice adoption in high-acuity clinical environments and improve patient outcomes. The Consolidated Criteria for Reporting Qualitative Research checklist guided reporting. Patients and the public were not involved in the design, conduct, reporting or dissemination of this research.
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Interventions for cognitive frailty: developing a Delphi consensus with multidisciplinary and multisectoral expertsThe conjunction of physical frailty and cognitive impairment without dementia is described as Cognitive Frailty (CF). Indications that CF is potentially reversible have led to proposals that risk factors, symptoms or mechanisms of CF would be appropriate targets for interventions for prevention, delay or reversal. However, no study has brought experts together across sectors to determine targets, content or mode of interventions, and most resources on interventions are from the perspective of academic or clinical researchers only. This international Delphi consensus study brings together experts from academic and clinical research, lay people with lived experience of CF, informal carers, and professional care practitioners/clinicians. Three rounds of Delphi study were held to discern which factors and statements were agreed upon by the whole sample and which generated different views in those with differing expertise. A scoping review and Round 1 (29 participants) were used to gather initial statements. In Round 2, 58 people responded to statements and open text items, comprising 7 lab-based researchers, 27 researchers working with people, 14 people with lived experience or informal family carers, and 10 professional carers/clinicians. Percent agreement and qualitative responses were analyzed to provide a final set of statements which were checked by 38 respondents in Round 3. Analysis of Round 2 quantitative data provided 74 statements on which there was at least 70% agreement and qualitative data produced a further 24 statements. These were combined to provide 90 statements for Round 3. There was Consensus for 89 of the statements. A few differences between the groups were observed at both stages. The consensus for statements associated with CF interventions provides a useful first step in defining health promotion activities and interventions. Given the prevalence and potential disability caused by CF in older populations, the consensus statements represent expert opinion that is inter-sectoral and will inform public health policies to support implementation of evidence-based prevention and intervention plans. This study is an important step toward changing current approaches, by including all stakeholders from the outset. Outcomes can be used to feed into co-creation of interventions for cognitive frailty.
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Experiences of pre-registration mental health nursing students who witness self-injury amongst service users during placement: a cross-sectional studyMental health nursing (MHN) students will witness self-harm and self-injury (SHSI); however, little is known regarding the experience of MHN students who witness SHSI whilst on placement. The study aimed to understand the personal impact of SHSI upon mental health nursing students on placement with four objectives: 1. To identify the types of self-harm and self-injury (SHSI) witnessed by mental health nursing students; To evaluate MHN students’ perceived self-competence in working with service users who have self-harmed and self-injured; 3. To appraise the access to support and types of support required by mental health nursing students; 4. To assess the potential psychological trauma upon mental health nursing students of witnessing self-harm and self-injury. A cross-sectional questionnaire comprising researcher-generated Likert-style items, a validated trauma scale, and open-ended response questions was utilised. Descriptive analysis was completed of 84 responses from MHN students. The types of SHSI witnessed included cutting (65 participants; 77.4%); head-banging / punching (62 participants; 73.8%) and ligation (36 participants; 42.9%). Factors contributing toward SHSI and that helped students learn from and cope with incidents was evident. Three themes emerged from analysis of open-ended responses: Resilience on placement; Sources of stress; Sources of Support. Key findings were: (i) student nurses need to be prepared witnessing of an SHSI incident, including how to respond compassionately, emotionally and professionally pre and post event; (ii) student experience of SHSI; and, (iii) registered nurse response requires further investigation. A joined-up approach from University and practice partners is needed to address these issues.
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A research proposal to conduct a systematic review of smoking cessation measures amenable to Emergency Department Adult patients.Smoking cessation smoking cessation approaches conducted in emergency departments so far Rationale for the review smoking is still a major mortality cause despite approaches already employed outside Emergency Departments (ED). The ED captures an important unserved hard to reach patients who may be missed in these outside the ED smoking cessation initiatives. Lots of interventions have been applied in several EDs in different countries including the UK but no study has compared these interventions in terms of its impact, cost effectiveness, sustainability and ease of application. This systematic review will provide this comparability and generate evidence based amenable to ED smoking cessation approaches. Review objectives What is the best smoking cessation approach amenable to an Emergency Department in terms of ease of application, cost effectiveness, sustainability and impact.
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Social media perceptions and insights during the COVID-19 pandemic in the United Kingdom: analysis from a social listening study from September 2019-2022Background: Social media listening can be leveraged to obtain authentic perceptions about events, their impact, guidelines and policies. There has been to date no research that has examined coronavirus disease 2019 (COVID-19) patients’ experiences from diagnosis to treatment using social media listening in the United Kingdom. Objective: This study aimed to assess public perceptions, insights, and sentiments throughout the patient journey from diagnosis to treatment COVID-19 pandemic. Methods: A comprehensive search query was designed to retrieve social media data that referred to COVID-19 and treatment. The search was conducted using the social media monitoring tool, Synthesio (Ipsos). Data were retrospectively collected for the period covering September 2019 to September 2022 from Twitter/X, Facebook, Instagram, and YouTube as well as 126 public forums (including Health Unlocked, Mums Net, The Student Room and Patient Forums UK). Available data in the UK expressed in the English language were collected and filtered generating a final dataset consisting of 31,319 posts from an overall initial dataset of 706,634 posts. Complimentary Google trend analyses of search terms mentioning COVID-19 treatments were also performed. Results: Social media posts related to COVID-19 symptoms accounted for 6% of overall posts, compared to 35% of posts related to testing, 25% of posts related to diagnosis, and 32% of posts related to treatment. Overall, the trend observed from social media posts relating to COVID-19 treatment extracted in Synthesio was largely congruent with the trend of COVID-19 searches on Google, indicating a potential relationship between public discourse and social media and online search behaviour. Conclusions: Findings from this study have the potential to inform decision-making regarding public health interventions, communication strategies, and healthcare policies in the UK during future public health emergencies.
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Cohort profile: the Children's Health in London and Luton (CHILL) cohortThe Children’s Health in London and Luton (CHILL) cohort was established to investigate the impact of London’s Ultra Low Emission Zone (ULEZ) on children’s health. Key strengths of CHILL include: the parallel prospective cohort, natural experimental design in which children living in London (exposed to the ULEZ) and children living in Luton (not exposed to a ULEZ or other major air-pollution control measure) are followed over time and compared; its large size (compared with similar studies) and ethnic diversity; high-resolution air pollution exposure data; and objective physiological measurements of lung function.
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A systematic review of influences on engagement with remote health interventions targeting weight management for individuals living with excess weightBackground: Obesity rates are continually rising and remote weight management interventions appear to demonstrate feasible prospects. Previous reviews have investigated influential factors to engagement of such interventions in community settings; however, limited research has examined adults' engagement in remote weight management programmes. Aim: To systematically review the influences on the engagement of adults living with excess weight in synchronous (real time), remote health interventions for weight management. Methods: A systematic review of 12 databases was conducted from inception to October 2023. Studies were included if they delivered a synchronous, remote weight management intervention with participants that were >18 years old with a body mass index ≥ 27.5 kg/m2. A narrative synthesis with inductive thematic analysis was conducted to iteratively extrapolate barriers and facilitators to engagement. This set of themed influences were then deductively mapped to the COM-B model of behaviour change and the Theoretical Domains Framework (TDF). Results: From 36,359 studies screened, 39 studies met the inclusion criteria. A total of 61themed influences were iteratively coded and mapped to the COM-B model: physical capability (n = 3); psychological capability (n = 9), reflective motivation (n = 19); automatic motivation (n = 11); physical opportunity (n = 8); and social opportunity (n = 11) with the assistance of the TDF to guide the coding. Barriers to engagement (n = 18) included concerns surrounding privacy, time burden to engage, embarrassment/anxiety surrounding self-disclosure, technical issues, access to technology, and access to the internet. Facilitators to engagement (n = 43) included digital competency, familiarity with technology, self-monitoring, tailored feedback, convenience, accountability, regular check-ins, support from a professional, social support, peer support, ease of use and simplicity. Conclusion: There are a number of things to consider in relation to capability, opportunity and motivation when designing remote weight management interventions. This review provides evidence to specific barriers and facilitators that if addressed could optimise future efforts.
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True awareness of mental health remains in the shadow: an exploratory study on implementing mental health support in the workplaceMental health in the workplace is critical for employee engagement, productivity, and profitability. In India, only 0.09% of the 1.1 million registered companies have implemented Employee Assistance Programs (EAPs) for providing mental health support. This study leverages the Socio-Ecological Model (SEM) framework to examine the multi-layered dimensions impacting the implementation of mental health activities in the corporate sector in emerging economies, such as India. For a qualitative study, interviews were conducted with thirty-six industry experts representing diverse sectors to glean insights into the implementation of EAPs. Our analysis indicates that while the advantages of EAPs in early detection, proactive support, and mental well-being are widely recognized in the selected Indian corporate environments, the implementation of EAPs is restricted by the cultural-specific barriers, as well as quantitative measure of ROI, among other factors. Our findings will inform practitioners and policymakers in designing tailored strategies to encourage successful EAP implementation in the Indian corporate sector.
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What makes a good nursing education: meeting the needs of students and society in a free-market education system - cluster analysis of United Kingdom universitiesExamine quality of education through classification of universities providing undergraduate pre-registration nursing courses in the United Kingdom using data from university league tables. Educational quality for nursing courses can be defined in many ways. University league tables are often used, but it can be difficult to interpret these because of the diversity of measures. These include educational input and output measures, but are not patient focussed. Cluster analysis of league table data. Data were from the Complete University and Guardian University League Tables. Cluster analysis was undertaken using euclidean distance and average linkage. Data were scaled by turning each value into a percentage of the maximum possible score. Careers and graduate prospects for nurses are high. Satisfaction with teaching and feedback are closely related and while these broadly cluster with research quality but there was a weak relationship between research quality and overall student satisfaction (correlation -0.008, SE 0.049, p = 0.869, adjusted R2 = -0.014). There was no clear pattern and few universities excelled in all areas. Traditional methods of ranking universities does not fit nursing well, where employment is higher and research quality lower than other subjects. There was no clear pattern in university results. Countries considering a free-market approach to nurse education should consider how they will meet the needs of students and health and social care services, while promoting research. The quality of nursing education should include broader measures of societal value and address the theory-practice gap.
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Theoretical mapping of the barriers and enablers to having blood pressure checked among adults without a hypertension diagnosis: a systematic review and theoretical synthesis using behaviour change frameworksIdentifying influences on engagement with blood pressure (BP) checks can assist with intervention design for hypertension detection. This systematic review searched four databases (Embase, Emcare, MEDLINE and Web of Science) for papers published from 2015 - 2023 (PROSPERO ID: CRD42023398002). Eligible studies reported influences on BP checks in community or primary care settings. Data were coded and mapped using the Action, Actor, Context, Target, Time framework, and Behaviour Change Wheel. Analysis of 18 studies generated eight themes: (1) ‘Difficult-to-use devices with no accessible information on how to use them’ (2) ‘Lack of awareness about hypertension and BP checks’, (3) ‘Stigma and disconnect with identity’ (4) ‘Beliefs about the value of BP checks’, (5) ‘Fear and uncertainty’, (6) ‘Lack of appropriate and comfortable local services’ (7) ‘Financial cost of engaging with BP check services’, and (8) ‘Social contacts or health professional recommended a check’. Knowledge, identity, emotions, social contacts and environmental factors are key behavioural influences on adults’ engagement with BP checks. Potential intervention strategies include education on hypertension, addressing misconceptions about BP checks, increasing access to BP check services, and harnessing the influence of social norms, social connections and trusted sources to improve engagement.
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Exploring socio-ecological factors that influence the use of urban greenspace: a case study of a deprived ethnically diverse community in the UKUrban greenspaces are considered an important health asset associated with improved population health and well-being. However, inequalities in access to and use of the outdoors continue to exist, particularly among low- income and minority ethnic populations. Following a socio-ecological approach, this study aimed to investigate the individual, interpersonal, and environmental factors that influence the use of greenspaces among an ethnically diverse community in the UK and explore strategies to increase use. A mixed-methods cross-sectional community survey was conducted between March and June 2022 with residents of two ethnically diverse towns situated in Southeast England, UK. Data were collected on factors that influence greenspace use alongside demographic information on age, ethnicity, and social deprivation. An open-ended question explored respondents’ views on strategies to increase engagement with greenspaces. The survey was completed by 906 participants aged between 16 and 94 (60.7% female; 94.5% non-white British). The findings revealed that age, gender, perceived importance of using greenspaces, awareness of greenspaces, and the natural environment were all significant predictors of greenspace use. Qualitative evidence supported these findings and provided useful strategies for increasing access. The findings have provided an increased understanding of the factors that influence greenspace use and suggest that to improve access. There is a clear need to improve the quality of the available green spaces, making them safe and visually appealing to the local communities they serve. Increasing awareness and providing more opportunities for social and intergenerational interaction were also considered important strategies for increasing use.
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Barriers to conversations about deceased organ donation among adults living in the UK: a systematic review with narrative synthesisObjectives To explore the barriers to conversations about deceased organ donation among adults living in the UK. Design Systematic review with narrative synthesis. Data sources PubMed, MEDline via OVID, APA PsycInfo via EBSCO, Web of Science via Clarivate and Scopus via Elsevier, covering studies that were published between January 2006 and December 2023. Searches were conducted on 1 December 2023 and completed on 2 February 2024. Eligibility criteria Studies published between January 2006 and December 2023, focusing on barriers to organ donation conversations among adults in the UK. Both qualitative and quantitative studies were included, emphasising cultural and generational factors. Non-English studies and those unrelated to the UK were excluded. Data extraction and synthesis Screening and data extraction were conducted by two independent reviewers using a standardised tool. Quality assessment was performed using Joanna Briggs Institute checklists, evaluating study bias. A narrative synthesis approach was used to integrate findings from heterogeneous studies. Results 11 studies (6 qualitative, 5 quantitative) with a total of 4991 participants were included. Four main thematic barriers emerged: (1) jinx factor—cultural beliefs associating discussion of death with bad luck; (2) generational impact—younger people were more open but cautious of upsetting parents; (3) ethnic disparities in conversations—varied challenges across diverse backgrounds and (4) cues to action—media and personal experiences prompted conversations. Facilitators included culturally tailored communication and community engagement. Conclusion Conversations about death and organ donation are often brief and hindered by cultural taboos surrounding death, generational differences in attitudes and the influence of family dynamics. Further research is needed to understand communication patterns better and to tailor interventions that encourage open discussions about organ donation across different ethnic groups.
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Palin stuttering therapy for school aged children and usual treatment: a randomised controlled trial feasibility studyBackground: Despite a clear need for and evidence-based therapy for some children who stutter aged 8–14, there is no high-level evidence of effectiveness, with Speech and Language Therapists rating knowledge and confidence low. One programme which might address these needs, increase availability of services and improve outcomes, is Palin Stammering Therapy for School aged Children (Palin STSC(8 14)). Aim: To investigate the feasibility of conducting a definitive randomised controlled trial comparing Palin STSC(8 14) with usual treatment. Objectives were to establish: recruitment and retention rates; appropriateness of the outcome measures; acceptability of the research and Palin STSC(8 14) therapy; treatment fidelity; and, appropriateness of the cost-effectiveness measures. Method: A two-arm, cluster-randomised trial, with randomisation of therapists, stratified by service. Children aged 8;0–14;11, and their parent(s), were allocated to therapist and completed questionnaires pre-therapy and six months later. Assessments were selected for their potential to measure or predict therapy outcome. Therapists completed measures at the start and end of the trial. A process analysis was conducted, incorporating semi-structured interviews and treatment fidelity examination. Results: Recruitment targets were exceeded (Children n = 67; SLTs n = 37). Research processes were largely acceptable, as was Palin STSC(8 14) therapy. Treatment fidelity was high, with SLT adherence at 85.7 % Mean number of sessions per child for Palin STSC(8 14) was 6.9 compared to 3.5 for usual treatment. Conclusions: The feasibility targets were met. Based on recruitment, retention and adherence rates and our outcome measures, a full-scale randomised controlled trial appears feasible and warranted to assess the effectiveness of Palin STSC(8 14).
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Leading evidence-based practice: nurse managers' strategies for knowledge utilisation in acute care settingsThe implementation of evidence-based practice (EBP) in nursing is essential for improving patient care outcomes, yet systemic barriers, leadership challenges, and resource limitations continue to hinder its integration into clinical practice. Nurse managers (NMs) play a crucial role in bridging the gap between policy directives and frontline implementation, yet the dynamic interplay between leadership strategies, knowledge utilisation, and organisational barriers remains underexplored, particularly in resource-constrained settings. This study examines how NMs navigate these challenges to sustain EBP adoption in acute care environments. This collective case study employed a longitudinal qualitative design across two acute care settings in the UK. Data were collected over eight months through semi-structured interviews with NMs, nonparticipant observations, and document analysis of clinical guidelines and internal reports. A thematic analysis approach was used to synthesise findings and provide a nuanced understanding of leadership strategies and systemic factors influencing EBP adoption. Six interconnected themes emerged: (1) Adaptive leadership strategies, where NMs employ a hybrid of directive and collaborative leadership approaches to drive EBP; (2) Overcoming organisational and resource barriers, including staff shortages, financial constraints, and competing priorities; (3) Knowledge utilisation and learning networks, highlighting the role of informal mentorship, structured CPD, and peer learning in sustaining EBP; (4) Digital transformation and EBP, examining the benefits and challenges of integrating digital tools and addressing IT literacy gaps; (5) Patient-centred adaptations, exploring how NMs balance evidence-based interventions with patient preferences and cultural considerations; and (6) Emotional and psychological support, underscoring the importance of managing staff resistance and mitigating change fatigue. Findings of this study emphasise the pivotal role of NMs in driving EBP implementation through adaptive leadership, strategic resource management, and fostering learning networks. Addressing organisational barriers requires multi-level interventions that integrate leadership actions with systemic enablers to promote sustainable, evidence-informed nursing practice. Findings provide critical insights for healthcare policymakers, hospital administrators, and educators in enhancing EBP uptake within resource-limited settings.
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London's Ultra Low Emission Zone and active travel to school: a qualitative study exploring the experiences of children, families and teachersTaking a qualitative approach, we aimed to understand how London's Ultra Low Emission Zone (ULEZ) might work to change behaviour and improve health in the context of the school journey. Primary qualitative study embedded within an existing natural experimental study. A population-level health intervention implemented across London. Purposive sampling was used to recruit children (aged 10-11 years) from ethnically and socioeconomically diverse backgrounds within an existing cohort study, Children's Health in London and Luton. In-person and online interviews were conducted with 21 families and seven teachers from the children's schools between November 2022 and March 2023. Verbatim transcripts were analysed drawing on Braun and Clarke's reflexive thematic analysis and guided by realist evaluation principles to identify contexts, mechanisms and outcomes using NVivo. Common context, mechanism, outcome (CMO) configurations were identified reflecting congruent narratives across children, parents and teachers, for example, current active travellers (context) reported reductions in pollution (mechanism) leading to improvements in health, including alleviated symptoms of asthma (outcome). These CMOs were broadly captured by two themes: (i) how you travelled before the ULEZ matters: the impact of travel mode on experiences of the ULEZ and (ii) your context matters: the role of socioeconomic position in experiences of the ULEZ. Participants highlighted the potential for the ULEZ to positively impact their choice of travel mode to school, experiences of the journey and their health. However, the impact of the ULEZ differed inequitably by journey length, travel mode before implementation and access to reliable and affordable public transport. The capacity for the ULEZ to both narrow and exacerbate inequities across different travel contexts suggests when developing such schemes, more emphasis needs to be placed on providing accessible and affordable alternatives to driving.
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Impact of breakfast consumption timing versus breakfast omission on post-lunch glycaemia and insulinaemia in adolescent girls: a randomised crossover trialAdolescent girls often skip breakfast due to time constraints and reduced morning appetite. This study examined the acute impact of breakfast consumption timing versus breakfast omission (BO) on glycaemic and insulinaemic responses to lunch in infrequent breakfast-consuming girls. Fifteen girls (13.1±0.8 years) completed three conditions in a randomised crossover design: early-morning breakfast consumption (EM-BC; 8:30), mid-morning breakfast consumption (MM-BC; 10:30), and BO. A standardised lunch was provided at 12:30, followed by a 2-h post-lunch observation period. Blood and expired gas samples were collected periodically. Linear mixed models with Cohen's d effect sizes compared outcomes between conditions. Pre-lunch glucose and insulin incremental area under the curve (iAUC) were higher in the breakfast conditions versus BO (P≤0.009), with no differences between breakfast conditions. MM-BC reduced post-lunch glucose iAUC by 36% and 25% compared with BO and EM-BC, respectively (P<0.001, d=0.92-1.44). A moderate, non-significant 15% reduction in post-lunch glucose iAUC was seen with EM-BC versus BO (P=0.077, d=0.52). These reductions occurred without changes in post-lunch insulinemia (P≥0.323) and were accompanied by increased post-lunch carbohydrate oxidation compared with BO (P≤0.018, d=0.58-0.75); with no differences between EM-BC and MM-BC. MM-BC lowered glycaemic response over the experimental period compared with BO (P=0.033, d=0.98) and EM-BC (P=0.123, d=0.93), with no difference between EM-BC and BO. Compared with BO, both breakfast conditions lowered post-lunch glycaemic responses with mid-morning breakfast eliciting a greater second-meal effect than early-morning breakfast. These findings indicate the breakfast-to-lunch meal interval may be a crucial factor affecting postprandial glycaemia in infrequent breakfast-consuming girls.
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Health psychology's role within the biopsychosocial sciencesThis chapter focuses on understanding health psychology in the wider system. The main aim is to show the interdisciplinary reach of health psychology and to highlight the importance of interconnectivity and collaborative working. Initially, synergies and differences between health psychology and other practitioner psychology branches will be discussed. The chapter will then focus outwards on the connection of health psychology with the biopsychosocial sciences. A particular focus will be made on behavioural, social, and medical sciences. The chapter will conclude with a discussion on the role health psychology plays and could play in multi-, inter-, and transdisciplinary teams.
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Future directions for the discipline of health psychologyFor the profession of health psychology to continuously evolve, we need to consider our history, roots, and core philosophy. We further need to embrace teachable moments, critically evaluate where we may have missed opportunities to contribute or lead and identify how we can overcome historical challenges for the discipline and profession. In doing so, we can strategically consider where we are heading and how we can work together to achieve great things. This chapter will consider the previous four chapters in this section, and offer a strategic vision of the future direction of health psychology. This will include a global view of the growth of the discipline, linking to research and the paradigms that are drawn upon, education, policy and practice. The relevance of health psychology to achieving national and international goals will be highlighted, and the need for wider funded opportunities, placements, mentoring, career pathways, and connections with stakeholders, employers, and policy will be discussed. The chapter will set the scene for future sections of the book that will discuss these issues in more detail. This chapter will end with a call to action to unite the global ‘divisions’ of health psychology, connecting countries to a central family tree, reducing structural barriers and silos, and optimising opportunities wherever they may lie.
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Health psychology theories and models of behaviourTheories, models, and their application are a crucial part of the development and growth of health psychology. This chapter contextualises health psychology in its foundations of the biopsychosocial model and discusses, non-exhaustively, key theories, models, and concepts used in the field relating to behaviour. The development of theories and models over the decades will be presented, showcasing the movement from cognitive to socio-cognitive, self-regulation to whole systems approaches, and where they are applied, to include individuals, populations, environments, behaviours, and conditions. This chapter will help to situate health psychology in the health and social care system, and critically discuss its contribution to science, education, policy, and practice.