David Sheffield

Background: Men referred to specialist weight management services are less likely to engage with these services. There is currently limited research exploring their experiences and what may affect engagement. Men are both under-represented in weight management services and in weight management research. This study qualitatively explores the perspectives of men who have been through a National Health Service (NHS) Tier 3 Programme to gain a detailed understanding of the barriers and drivers to joining and elicit patient-generated recommendations on how to engage more men. Methods: Semi-structured interviews were conducted with patients ( n = 9) who had or were more than halfway through completing the Programme and buddies ( n = 3), who are previous users of the service, subsequently supporting others going through it. Peer buddies provide lived-experience, encouragement, social connection and practical accountability to help participants on the Programme with making long-term lifestyle changes. They were included as they have been through the Programme as patients themselves and offer additional insight from their work supporting other patients. The interviews were inductively analysed using Reflexive Thematic Analysis to identify patterns in engagement, barriers and drivers. Results: Four themes were identified. The first two indicate psychological barriers to engagement, the second two denote drivers. The themes were: It’s culturally more acceptable for men to be overweight/obese (Theme 1), with larger size associated with strength and male identity. A male identity which encourages self-reliance and guarded vulnerability means Being vulnerable is uncomfortable for men (Theme 2) and discourages them from seeking help. But Men do need help when obesity becomes a health worry (Theme 3) and Being invited for specialist treatment is helpful for men (Theme 4). This last theme offers new insight in this field for healthcare practitioners, based on what men living with obesity who participated reported. Conclusions: Findings indicate a paradigm shift is needed for male obesity to be understood not as an aesthetic and identity issue for men, but as a threat to their health and for men’s healthcare help-seeking behaviour to be normalised. The findings provide learning for healthcare practitioners, including those in primary care, in the way they frame conversations with men about obesity and insight for NHS weight management leads around service promotion.

Endometriosis is a common chronic condition, affecting around 10% of females of reproductive age (Viganò et al., 2004). Although sometimes asymptomatic (Della Corte et al., 2020), endometriosis can...

Polycystic Ovary Syndrome (PCOS) is an endocrine condition associated with physical (e.g., ache, hair loss) and mental (e.g., depression, anxiety, suicidal-ideation) health complications, which, combined with atypical emotional regulation can result in non-suicidal self-injury (NSSI) and suicidal intent. This cross-sectional investigation assessed whether NSSI type, onset age, duration, and severity differed between women who did (n = 113; WPCOS) and did not (n = 305; WoPCOS) self-report PCOS, and whether distinct typologies of NSSI were present. Participants completed demographic questions and a measure of NSSI. Comparative analyses indicated that WPCOS women reported a greater propensity to cut and scratch, but not other NSSIs. In women who engaged in NSSI, self-reported PCOS neither impacted onset age, duration, or severity of NSSI. Cluster analysis indicated three typologies of NSSI engagement: ‘Scar-deriving’, ‘Nil-to-low engagers’, and ‘Intensive engagers’. Implications for healthcare providers working with women with PCOS are discussed; there is a need for the provision of NSSI- and emotion regulation-related education on an international scale.

This study aimed to understand experiences of social prescribers and those whose roles are closely linked to social prescribing in taking part in Equality, Diversity, and Inclusion (EDI), and cultural competency training programmes in the UK. Online survey responses from 40 participants were analysed using qualitative content analysis. Two main themes were identified: 1) Perceptions of EDI and Cultural Competency Training, and 2) EDI and Cultural Competency Beyond the Training. This paper provides recommendations and offers suggestions for professionals who work in social prescribing contexts regarding how to improve EDI and cultural competency training. In particular, co-production approaches with individuals from diverse backgrounds are highlighted to establish acceptable and effective social prescribing interventions.

No previous research has examined both clinical and psychological predictors of quality of life (QoL) in atrial fibrillation (AF) patients over time. Theoretically informed by the common-sense model, this study aimed to examine how beliefs about illness and treatment, cognitive and behavior responses (CBR) to symptoms, and AF-related interventional procedures predicted QoL over 12 months. AF patients (N = 188) recruited from outpatient clinics, and because of undergo catheter ablation or cardioversion, completed questionnaires assessing social and clinical demographics, illness representations, treatment beliefs, CBR to AF, and QoL at baseline, 3, 6, and 12 months. Mixed effects linear regression models examined QoL predictors over 12 months. Restoration of sinus rhythm, greater beliefs about personal control, and lower scores on timeline beliefs (beliefs that AF is an acute condition) were statistically significantly associated with greater QoL over 12 months. Patients with a profile of procedural treatment success and improved positive illness representations (timeline, illness triggers, personal control) had significantly greater QoL compared with those who had only successful treatment, or positive illness representations, alone. Successful procedural treatment and helpful illness representations are both important predictors of QoL in AF. Alongside clinical procedural treatments, future interventions aimed at improving QoL should therefore incorporate techniques to address self-efficacy around AF self-management and reduce beliefs that AF is long-term/incurable and that symptoms can be triggered by wide-ranging sources (particularly relating to health behaviors and comorbidities). (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Polycystic ovary syndrome (PCOS) is an endocrine condition affecting 8–13% of reproductive-aged women globally. Psychological features of PCOS are often overlooked despite their association with mental health complications. This systematic review synthesises existing evidence of psychological interventions for women with PCOS. Database searches returned 4982 articles, of which 20 papers were eligible; 12 studies were meta-analysed. Compared to control, psychological interventions had statistically beneficial effects on change from baseline values for depression, PCOS-specific quality of life, general health, and body image. Significant improvements were found in all PCOS Questionnaire (PCOSQ) domains except acne, yet the importance of these differences in clinical practice was indeterminable. Despite statistical effects, the quality of evidence was judged as low/very-low due to between study heterogeneity, risk of bias, and imprecision in effect estimates. Future studies should focus on rigorously designed, well-reported trials, in order to address the uncertainty around the effectiveness of psychological interventions. The protocol of this systematic review was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023472417).

Zoological establishments have five main roles: education, conservation, recreation, research, and provision of positive welfare to exhibited and housed animals. This review highlights the effect direct human–animal interactions had on the non-human animals’ physical and psychological wellbeing in relation to short- and long-term education and conservation engagement and action. The literature was reviewed from worldwide English sources, which focused on welfare, direct animal interactions, and alternative provisions. With over 700 million visits made to zoological establishments annually, only USD350 million in funds were reported to be reinvested into conservation efforts worldwide, with the true outcome and impact of this effort unknown. Currently, the main focal area is recreation, with 75% of those surveyed (N = 1241) worldwide found to offer direct human–animal interactions. This review takes a holistic approach to human–animal interactions and highlights key opportunities that are missed in the delivery method of these. Worldwide, direct human–animal interactions during the last 30 years have had no to limited regulations. Organisations such as Pan-Africa Association of Zoos and Aquaria and British and Irish Association of Zoos and Aquaria aim to regulate and monitor welfare, breeding, and husbandry within collections; however, joining is entirely voluntary. This has led to only 13 zoological establishments in Africa accredited under PAAZA, compared to over 100 establishments accredited under BIAZA in the United Kingdom. This review highlights that clear training plans need to be implemented before and during human–animal interactions with particular focus on feeding time demonstrations, CGI models, film rooms, and no-contact interactive areas. Further research needs to quantify the significance of the taxonomy used in direct interactions.

Background and Objective: Chronic pain lowers health‐related quality of life (HRQoL). This review presents the most complete examination to date of how Interdisciplinary Multimodal Pain Treatment (IMPT) affects domains of HRQoL in adults with chronic pain. We compared IMPT with treatment as usual (TAU) and active control groups (ACGs) at short, intermediate and long‐term follow‐up. Databases and Data Treatment: We searched EBSCO, Embase, Cochrane, Google Scholar, Web of Science, ASSIA, Dimensions and CORE from inception to December 2024. We included RCTs and quasi‐RCTs of IMPTs reporting HRQoL outcomes. Pre‐ and post‐intervention means were extracted; comparable subscales were combined into amalgamated domains. Random‐effects meta‐analyses of standardised mean differences were conducted. Risk of bias was assessed using Cochrane ROB 1, and evidence quality was rated using GRADE. Sensitivity analyses addressed heterogeneity and study quality. Results: Forty‐one articles ( N = 6613) informed 39 meta‐analyses. Sample sizes ranged from n = 10 to n = 703. IMPTs showed small positive effects versus TAU for Physical Functioning at short and long follow‐up, and for Pain, General Health and Emotional Functioning at all follow‐up points. Exploratory analyses found benefits for Pain versus ACG at short and intermediate follow‐up, Vitality versus TAU and Social Functioning versus both comparators. Heterogeneity was high and evidence quality was very low. Conclusion: This study adds support and novel evidence regarding the continued use of IMPTs to improve domains of HRQoL in chronic pain. Findings suggest broader benefits than previously reported. Future research should develop methodological designs to improve evidence quality and support deeper insights going forward. Significance Statement: This is the first review to compare Interprofessional Multimodal Pain Therapy (IMPT) with treatment‐as‐usual (TAU) and active control groups (ACG) across all Health‐Related Quality of Life (HRQoL) domains for chronic pain, with short, intermediate and long‐term follow‐up, adjusting for intervention duration. Findings provide evidence of IMPT's superiority over TAU for physical and emotional functioning, pain and general health. Novel findings show benefits over both TAU and ACG for social functioning, over TAU for vitality and over ACG for pain.

Objectives: To evaluate the effects of singing interventions on well-being, mental health and communication, motor and respiratory functions through meta-analysis and to examine the practices used in the singing interventions. Design: Systematic review and meta-analysis. Inclusion criteria: Both randomised and non-randomised studies, involving participants living with Parkinson’s and receiving singing interventions. Data sources: Four databases (CINAHL, Medline, PsycINFO, Web of Science) and Google Scholar were searched. The last search was conducted on 3 April 2025. Primary and secondary outcome measures: Eligible studies reported on the following outcomes: quality of life, voice-related acoustic measures, respiratory function, mental health and motor function. The risk of bias was assessed using the Downs and Black Quality checklist for controlled studies and national heart, lung, blood institute study quality assessment tool for non-controlled studies. Analysis: Meta-analyses were conducted to pool effect sizes across included studies using random-effects models. All analyses were performed using Meta-Essentials. Additionally, key elements of singing practices were narratively synthesised. Results: 23 studies (3 randomised controlled trials (RCTs), 20 non-RCTs) involving 540 participants were included in the analysis. Common elements of singing intervention practices included breathing exercises, vocal warm-ups and singing participants’ preferred songs, which are largely led by music therapists.Three meta-analyses based on RCTs were conducted on clinical outcome measures; results suggest that singing was favoured in only one outcome measure, vocal loudness during sustained vowel production (standard mean difference (SMD)=0.67, 95% CI 0.29 to 1.05, I ² =0%). However, the certainty of this evidence is very low due to a high risk of bias, imprecision and indirectness. Further, when combining results from RCTs and non-RCTs, positive changes for three further outcome measures were observed: maximum phonation time (k=11, n=157, SMD=0.38, 95% CI 0.18 to 0.59, I ² =23.48%), vocal loudness of sustained vowel (k=8, n=99, SMD=0.50, 95% CI 0.14 to 0.86, I ² =50.96%) and a respiratory function measure of maximal inspiration pressure (k=4, n=65, SMD=0.46, 95% CI 0.07 to 0.85, I ² =0%). However, these findings are largely based on non-controlled studies with very low quality of evidence. Conclusions: Singing interventions may support people living with Parkinson’s, but due to insufficient high-quality evidence, we are unable to determine the effects of singing interventions. We discuss implications for future work and practice, emphasising that more robust RCTs are needed.