The role of media and information in supporting internally displaced women in Ukraine

Providing accessible and practical advice through digital platforms could support female IDPs dealing with the economic, psychosocial and health impacts of the war

Forced Marriage: Prevalence and Service Response

Aim The study aimed to inform policy for new guidelines to support statutory responsibility for dealing with cases of forced marriage, to improve understanding of its prevalence and examine responses to cases. What is a forced marriage? A forced marriage is one conducted without the consent of both parties, and under duress. Findings How cases are reported Cases were usually reported direct by young people or by friends to schools, colleges, youth agencies and voluntary sector organisations. Direct reporting to the police was much less common. Prevalence of forced marriage There were between 5,000 and 8,000 reported cases of forced marriage in England (not including ‘hidden’ victims who have not come forward). Over one-third (3%) related to marriages that had taken place. Almost two-thirds related to threats of marriage (62%). 97% were identified as Asian. 96% of victims were female, and 4% were male. 41% of victims were under the age of 18. Service provision and response Local authorities had different understandings of forced marriage and differing opinions on appropriate responses. The quality and character of response depended on factors such as the extent of multi-agency data sharing, partner agency levels of awareness and resource capacity, whether the issue was taken seriously and with cultural sensitivity. The black and minority ethnic voluntary sector performed a central role by providing capacity-building and staff training, by undertaking community development and prevention work with young people. This was usually done with limited resources and without local authority funding. The full report looks at policy solutions for detection and prevention, better coordination and resourcing of services, improved case management and response. Methodology We carried out a literature review, a mapping study, a quantitative data sourcing and analysis exercise and qualitative case studies

Glycemic, Gastrointestinal, Hormonal and Appetitive Responses to Pearl Millet or Oats Porridge Breakfasts: a Randomized, Crossover Trial in Healthy Humans

Whole grain cereal breakfast consumption has been associated with beneficial effects on glucose and insulin metabolism as well as satiety. Pearl millet is a popular ancient grain variety that can be grown in hot, dry regions. However, little is known about its health effects. This study investigated the effect of a pearl millet porridge (PMP) compared with a well-known Scottish oats porridge (SOP) on glycaemic, gastrointestinal, hormonal and appetitive responses. In a randomized, two way crossover trial, 26 healthy participants consumed two iso-energetic/volumetric PMP or SOP breakfast meals, served with a drink of water. Blood samples for glucose, insulin, GLP-1, GIP and PYY, gastric volumes and appetite ratings were collected for two hours postprandially, followed by an ad libitum meal and food intake records for the remainder of the day. The incremental area under the curve (iAUC2h) for blood glucose was not significantly different between the porridges (p ˃ 0.05). The iAUC2h gastric volume was larger for PMP compared with SOP (p = 0.045). The iAUC2h GIP concentration was significantly lower for PMP compared with SOP (p = 0.001). Other hormones and appetite responses were similar between meals. In conclusion, this study reports, for the first time, data on glycaemic and physiological responses to a pearl millet breakfast, showing that this ancient grain could represent a sustainable, alternative, with health-promoting characteristics comparable to oats. GIP is an incretin hormone linked to triacylglycerol absorption in adipose tissue, therefore the lower GIP response for PMP may be an added health benefit

Prior consumption of a fat meal in healthy adults modulates the brain’s response to fat

Background: Consumption of fat is regulated by reward and homeostatic pathways, but no studies have examined the role of the intake of a high fat meal (HFM) on subsequent brain activation to oral stimuli. Objective: We evaluated how prior consumption of a HFM or water load (WL) modulates reward, homeostatic and taste brain responses to subsequent delivery of oral fat. Methods: A randomized 2-way crossover design (1-week apart) was used to compare prior consumption of a 250mL HFM (520kcal) (rapeseed oil (440kcal), emulsifier, sucrose, flavor cocktail) or non-caloric WL on brain activation to the delivery of repeated trials of an oral flavored no-fat control stimulus (CS) or flavored fat stimulus (FS) in 17 healthy adults (11 male, age=25±2 years, BMI=22.4±0.8kg/m2). Analyses tested differences in brain activation to the CS and FS, and baseline cerebral blood flow (CBF), following the HFM and WL. Individual’s plasma cholecystokinin (CCK) concentration following the HFM was correlated with their BOLD activation. Results: Prior consumption of the HFM compared to the WL led to decreased anterior insula taste activation in response to both the CS (36.3%,P<0.05) and FS (26.5%,P<0.05). The HFM caused reduced amygdala activation (25.1%,P<0.01) in response to the FS compared to the CS (fat-related satiety). Baseline CBF significantly reduced in taste (insula (5.7%,P<0.01)), homeostatic (hypothalamus (9.2%,P<0.01), thalamus (5.1%,P<0.05))), and reward areas (striatum (9.2%,P<0.01)) following the HFM. Individual’s plasma CCK concentration negatively correlated with brain activation in taste, oral somatosensory and reward areas. Conclusions: To reduce obesity, policy in industry is to lower the fat content of foods. Our results in healthy adults show that a HFM suppresses BOLD activation in taste and reward areas compared to a WL. This understanding will help inform the reformulation of reduced-fat foods that mimic the brain’s response to high fat counterparts, and guide future interventions to reduce obesity

Safety, immunogenicity, and reactogenicity of BNT162b2 and mRNA-1273 COVID-19 vaccines given as fourth-dose boosters following two doses of ChAdOx1 nCoV-19 or BNT162b2 and a third dose of BNT162b2 (COV-BOOST): a multicentre, blinded, phase 2, randomised trial

Background Some high-income countries have deployed fourth doses of COVID-19 vaccines, but the clinical need, effectiveness, timing, and dose of a fourth dose remain uncertain. We aimed to investigate the safety, reactogenicity, and immunogenicity of fourth-dose boosters against COVID-19.Methods The COV-BOOST trial is a multicentre, blinded, phase 2, randomised controlled trial of seven COVID-19 vaccines given as third-dose boosters at 18 sites in the UK. This sub-study enrolled participants who had received BNT162b2 (Pfizer-BioNTech) as their third dose in COV-BOOST and randomly assigned them (1:1) to receive a fourth dose of either BNT162b2 (30 µg in 0·30 mL; full dose) or mRNA-1273 (Moderna; 50 µg in 0·25 mL; half dose) via intramuscular injection into the upper arm. The computer-generated randomisation list was created by the study statisticians with random block sizes of two or four. Participants and all study staff not delivering the vaccines were masked to treatment allocation. The coprimary outcomes were safety and reactogenicity, and immunogenicity (antispike protein IgG titres by ELISA and cellular immune response by ELISpot). We compared immunogenicity at 28 days after the third dose versus 14 days after the fourth dose and at day 0 versus day 14 relative to the fourth dose. Safety and reactogenicity were assessed in the per-protocol population, which comprised all participants who received a fourth-dose booster regardless of their SARS-CoV-2 serostatus. Immunogenicity was primarily analysed in a modified intention-to-treat population comprising seronegative participants who had received a fourth-dose booster and had available endpoint data. This trial is registered with ISRCTN, 73765130, and is ongoing.Findings Between Jan 11 and Jan 25, 2022, 166 participants were screened, randomly assigned, and received either full-dose BNT162b2 (n=83) or half-dose mRNA-1273 (n=83) as a fourth dose. The median age of these participants was 70·1 years (IQR 51·6–77·5) and 86 (52%) of 166 participants were female and 80 (48%) were male. The median interval between the third and fourth doses was 208·5 days (IQR 203·3–214·8). Pain was the most common local solicited adverse event and fatigue was the most common systemic solicited adverse event after BNT162b2 or mRNA-1273 booster doses. None of three serious adverse events reported after a fourth dose with BNT162b2 were related to the study vaccine. In the BNT162b2 group, geometric mean anti-spike protein IgG concentration at day 28 after the third dose was 23 325 ELISA laboratory units (ELU)/mL (95% CI 20 030–27 162), which increased to 37 460 ELU/mL (31 996–43 857) at day 14 after the fourth dose, representing a significant fold change (geometric mean 1·59, 95% CI 1·41–1·78). There was a significant increase in geometric mean anti-spike protein IgG concentration from 28 days after the third dose (25 317 ELU/mL, 95% CI 20 996–30 528) to 14 days after a fourth dose of mRNA-1273 (54 936 ELU/mL, 46 826–64 452), with a geometric mean fold change of 2·19 (1·90–2·52). The fold changes in anti-spike protein IgG titres from before (day 0) to after (day 14) the fourth dose were 12·19 (95% CI 10·37–14·32) and 15·90 (12·92–19·58) in the BNT162b2 and mRNA-1273 groups, respectively. T-cell responses were also boosted after the fourth dose (eg, the fold changes for the wild-type variant from before to after the fourth dose were 7·32 [95% CI 3·24–16·54] in the BNT162b2 group and 6·22 [3·90–9·92] in the mRNA-1273 group).Interpretation Fourth-dose COVID-19 mRNA booster vaccines are well tolerated and boost cellular and humoral immunity. Peak responses after the fourth dose were similar to, and possibly better than, peak responses after the third dose

Using mobile health to strengthen the communication skills for effective delivery of health information in Nepal: A qualitative study of the perspectives of Female Community Health Volunteers

# Background Female Community Health Volunteers (FCHVs) play an important role in linking community members-particularly marginalised and vulnerable women and health facilities in Nepal. There has been increased use of mobile phones amongst FCHVs and their support to improve the quality of health services FCHVs provide, with positive results. Under the leadership of Ministry of Health and Population (MoHP), Department of Health Services (DoHS), and investment by the UK Department for International Development (DFID) via Nepal Health Sector Support Programme 3 (NHSSP 3), BBC Media Action designed and tested an innovative mobile phone-based solution that can best support FCHVs in their work as health promoters in local communities. This study aimed to examine the changes in the FCHVs-beneficiary interaction and communication since the introduction of a mobile-based intervention (Mobile Chautari). # Methods A qualitative study was conducted in three districts of Nepal: Tehrathum, Darchula and Rautahat using in-depth interviews, focus group discussions with FCHVs, pregnant women and mothers with children less than 5 years old, mothers-in-law, and health facility staff. In addition, observation of Health Mothers Group (HMG) meeting was also conducted. Data analysis was conducted using thematic analysis. # Results The mHealth intervention was acceptable to the FCHVs and the use of Mobile Chautari helped FCHVs recognise the value of communication aids and facilitate effective discussions in HMG meeting. FCHVs felt more confident when talking about health issues and communicated more effectively with diverse beneficiaries. FCHVs felt that Mobile Chautari improved their status in the communities, which also helped enhance trust between FCHVs and communities. # Conclusions Mobile Chautari has the potential to strengthen the communication skills of FCHVs and bridge the gap between the FCHVs and their beneficiaries. Mobile Chautari appears to be a promising way to communicate health related information and communicate with diverse clients. In the short period the study has been able to show the potential of Mobile Chautari and how it could support positive behaviour change

Time to act to solve gaps in practice: The BSACI National Allergy Education Strategy.

RD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.Published version, accepted versio