Consensus on innovations and future directions of community first responder schemes in United Kingdom: a national nominal group technique study.

AIM: We aimed to achieve consensus among NHS and community stakeholders to identify and prioritise innovations in Community First Responder (CFR) schemes. METHODS: We conducted a mixed-methods study, adopting a modified nominal group technique with participants from ambulance services, CFR schemes and community stakeholders. The 1-day consensus workshop consisted of four sessions: introduction of innovations derived from primary research; round-robin discussions to generate new ideas; discussion and ranking of innovations; feedback of ranking, re-ranking and concluding statements. Innovations were ranked on a 5-point Likert scale and descriptive statistics of median and interquartile range calculated. Discussions were recorded, transcribed, and analysed thematically. RESULTS: The innovations found were classified into two categories: process innovations and technological innovations. The process innovations included six types of innovations: roles, governance, training, policies and protocols, recruitment, and awareness. The technological innovations included three aspects: information and communication; transport; and health technology. The descriptive statistics revealed that innovations such as counselling and support for CFRs (median: 5 IQR 5,5), peer support [5 (4,5)], and enhanced communication with control room [5 (4,5)] were essential priorities. Contrastingly, innovations such as the provision of dual CFR crew [1.5 (1,3)], CFR responsibilities in patient transport to hospital [1 (1,2)], and CFR access to emergency blue light [1 (1,1.5)] were deemed non-priorities. CONCLUSIONS: This article established consensus on innovations in the CFR schemes and their ranking for improving the provision of care delivered by CFRs in communities. The consensus-building process also informed policy- and decision-makers on the potential future change agenda for CFR schemes.

Developing a foundation information and academic skills programme for potential Student Nursing Associates.

This article outlines the development of 'Prepare to Progress', a preapplication programme for potential Student Nursing Associate (SNA) applicants at Gloucestershire Hospitals NHS Foundation Trust. Created collaboratively by the Trust's Library and Knowledge Services and Professional Education teams, the programme aims to provide realistic course expectations, teach study skills and boost confidence in using library services. Evaluation results indicate increased understanding of the SNA course, improved application decision-making, and enhanced academic confidence among participants. The programme demonstrates the valuable role of library services in preparing healthcare support workers for further education and addressing library anxiety. The study suggests benefits for both participants and library services.

A modified Delphi survey to build expert consensus on the structure and content of an enhanced care pathway for cognitive changes after stroke in the UK.

BACKGROUND: Enhancing long-term support for post-stroke cognitive impairment is a top research priority. Addressing current gaps in UK post-stroke cognitive care provision requires a pragmatic and scalable intervention that can be integrated within the existing stroke care pathway. This study aimed to develop consensus on an initial set of core features for a UK-based monitoring and psychoeducational intervention for cognitive changes after stroke. METHODS: An expert panel of UK healthcare professionals and researchers participated in an online modified Delphi survey. Candidate intervention features were identified from clinical guidelines, existing literature, research team/collaborator expertise, and PPI group lived experience. Survey participants indicated whether they agreed/disagreed/had no opinion about including each candidate feature in the intervention and free-text responses were invited. We analysed responses for consensus (≥ 75% agreement) using descriptive statistics, with items not reaching consensus carried into subsequent rounds. Template analysis was used to identify similarities/differences in viewpoints for items that did not reach consensus. RESULTS: Three survey rounds were completed by 36, 29 and 26 participants, respectively. Participants agreed reviews should include a stroke-specific cognitive screen (97% agree) and assessment of other psychological changes (low mood, anxiety, fatigue: 94%, 90%, 89% agree, respectively). They agreed stroke survivors should be offered at least one review, regardless of their cognitive profile in hospital. They agreed on the importance of various cognition-focused psychoeducation topics, and formal (100% agree) and informal (79% agree) training for those conducting reviews. Consensus was not reached on the review mode (in person/remote options: 67% agree), offering reviews one-year post-discharge to patients without acute cognitive impairments (68% disagree), or including a dementia screen (63% disagree) and/or neuropsychological assessment battery (58% disagree). However, there were similarities in participant viewpoints. For example, participants emphasised the importance of onwards referral where clinically indicated.   CONCLUSIONS: The UK-based post-stroke monitoring and psychoeducation intervention was originally conceptualised as a cognitive care pathway, but expert participants agreed on the importance of simultaneously addressing related psychological changes (e.g. low mood, anxiety). There was clear consensus on a minimum set of intervention features. Recommendations outlined here may usefully inform local service improvements.

"They're not mentally ill, their lives are just shit": Stakeholders' understanding of deaths of despair in a deindustrialised community in North East England.

The rise in mortality in high-income countries from drug, suicide, and alcohol specific causes, referred to collectively as 'deaths of despair', has received growing interest from researchers. In both the US and UK, mortality rates from deaths of despair are higher in deprived, deindustrialised communities. In this qualitative study, we sought to learn how stakeholders working with vulnerable populations in Middlesbrough, a deindustrialised town in North East England with above average mortality from deaths of despair, understand and explain the prevalence of deaths from these causes in their area. Participants identified a number of structural and socio-cultural determinants that they believe drive deaths of despair in their community, including the effects of austerity, deindustrialisation, communal identity, and collective trauma; we argue that these determinants are themselves a product of structural violence.

iNaturalist community observations provide valuable data on human-mosquito encounters.

Mosquitoes (Diptera: Culicidae) and the pathogens they transmit represent a threat to human and animal health. Low-cost and effective surveillance methods are necessary to enable sustainable monitoring of mosquito distributions, diversity, and human interactions. This study examined the use of iNaturalist, an online, community-populated biodiversity recording database, for passive mosquito surveillance in the United Kingdom (UK) and Ireland, countries under threat from the introduction of invasive mosquitoes and emerging mosquito-borne diseases. The Mozzie Monitors UK & Ireland iNaturalist project was established to collate mosquito observations in these countries. Data were compared with existing long-term mosquito UK datasets to assess representativeness of seasonal and distribution trends in citizen scientist-recorded observations. The project collected 738 observations with the majority recorded 2020-2022. Records were primarily associated with urban areas, with the most common species Culex pipiens and Culiseta annulata significantly more likely to be observed in urban areas than other species. Analysis of images uploaded to the iNaturalist project also provided insights into human-biting behavior. Our analyses indicate that iNaturalist provides species composition, seasonal occurrence, and distribution figures consistent with existing datasets and is therefore a useful surveillance tool for recording information on human interactions with mosquitoes and monitoring species of concern.

Disease Burden Associated with All Infants in Their First RSV Season in the UK: A Static Model of Universal Immunization with Nirsevimab Against RSV-Related Outcomes.

INTRODUCTION: Respiratory syncytial virus (RSV) leads to significant morbidity in newborn infants in the United Kingdom (UK). Nirsevimab, a long-acting monoclonal antibody, received approval from the European Medicines Agency and has been licensed by the Medicines and Healthcare products Regulatory Agency for preventing RSV lower respiratory tract disease (LRTD) in neonates and infants during their first RSV season. The objective of this study was to assess the potential impact of nirsevimab on RSV-associated LRTDs, related costs, and loss of quality-adjusted life years (QALYs) in infants experiencing their first RSV season. METHODS: The impact of administering nirsevimab across all infant populations compared to palivizumab in the high-risk palivizumab-eligible population was assessed via a static decision-analytic model specified for a UK birth cohort experiencing their first RSV season. The RSV-related health events of interest included primary care (PC), accident and emergency (A&E) visits, hospitalizations [including hospitalizations alone and those resulting in intensive care unit (ICU) admissions], recurrent wheezing in infants who were previously hospitalized, and all-cause LRTD hospitalizations. RESULTS: Under the current standard of practice (SoP), RSV was estimated to result in 329,425 RSV LRTDs annually, including 24,381 hospitalizations and ICU admissions, representing £117.8 million (2024 GBP) in costs. Comparatively, universal immunization of all infants with nirsevimab could avoid 198,886 RSV LRTDs, including 16,657 hospitalizations and ICU admissions, resulting in savings of £77.2 million in RSV treatment costs. Considering the impact on all-cause LRTD of a universal immunization strategy, nirsevimab could be valued between £243 and £274, assuming willingness-to-pay (WTP) thresholds of £20,000 and £30,000 per QALY saved, respectively. CONCLUSIONS: This analysis demonstrated that the health and economic burden of RSV would be substantially reduced in all infants experiencing their first RSV season in the UK (including term, preterm, and palivizumab-eligible infants) as a result of a universal immunization strategy with nirsevimab.

Feasibility and Acceptability Study of a Culturally Adapted Web-Based Intervention to Reduce Suicidal Ideation for Syrian Asylum Seekers and Refugees in the United Kingdom: Protocol for a Mixed Methods Study.

BACKGROUND: The war in Syria has displaced over 6.8 million people, more than any other conflict since the Second World War. As a result, Syrian asylum seekers and refugees have experienced several life-changing events, resulting in high rates of anxiety, depression, posttraumatic stress disorder, and suicidal ideation (SI). To address the treatment gap and reduce the burden of help-seeking, a web-based intervention to reduce SI developed for general populations was culturally adapted for and with Syrian asylum seekers and refugees in the United Kingdom. The study revealed the importance of understanding their lived experience with migration and the acculturative process in providing treatment for SI. This study will now assess the feasibility and acceptability of the culturally adapted intervention for this population. OBJECTIVE: The first phase of the study will include recruiting participants and delivering the web-based intervention (1) to assess the feasibility of meeting recruitment goals and recruitment rates and (2) to assess the feasibility of outcome measures. The second phase of the study will include one-to-one semistructured interviews (1) to assess the suitability of the culturally adapted intervention in terms of recruitment and adherence rates and barriers and facilitators to engagement and (2) to assess the acceptability of the intervention in terms of its cultural relevance and appropriateness. METHODS: This is a protocol for a single-group, noncontrolled, mixed methods feasibility and acceptability study of a culturally adapted web-based intervention to reduce SI for Syrian asylum seekers and refugees in the United Kingdom. The study will assess the feasibility of recruitment goals, recruitment rates, adherence rates, and outcome measures using individual participant tracking forms, which will be analyzed quantitatively. The suitability and acceptability of the intervention will be assessed using one-to-one semistructured interviews with 12 participants who completed the intervention, which will be analyzed qualitatively. RESULTS: Recruitment began in February 2024 and will run until 30 participants are recruited to the study or until the end of July 2024. Thus far, 19 participants have provided informed consent, 16 were eligible and enrolled, and 12 have completed a postintervention interview. No data have been analyzed. The study, including the write-up period, is expected to end in December 2024. CONCLUSIONS: Despite experiencing several stressors related to forced displacement and high rates of mental health issues, access to treatment is still limited for Syrian asylum seekers and refugees in the United Kingdom. To address the treatment gap and reduce the burden of help-seeking, a web-based intervention to reduce SI was culturally adapted in collaboration with Syrian asylum seekers and refugees in the United Kingdom. This study will now assess the feasibility and acceptability of the intervention and culturally appropriate recruitment strategies. TRIAL REGISTRATION: ISRCTN ISRCTN11417025; https://www.isrctn.com/ISRCTN11417025. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/56957.

Impact of COVID-19 pandemic on the elderly in the United Kingdom: A review study.

The coronavirus disease 2019 (COVID-19) pandemic has significantly altered the lives and lifestyles of several older populations in the United Kingdom. It was important to note how it has affected their physical, mental, and social health and well-being during the first wave of the Covid-19 pandemic. To study the impact of the Covid-19 pandemic and the imposed restrictions on the day-to-day lives of the elderly population in the United Kingdom. A review of the published literature on the first wave of the Covid-19 pandemic and its consequences on the older population in the United Kingdom is done. Search engines used for medical databases were Pubmed, Google Scholar, and Internet Explorer. It was found that physical as well as mental well-being was affected in the elderly citizens of the United Kingdom. Mental health studies noted an obvious increase in anxiety and depressive symptoms. Social isolation and reduced access to healthcare services had a deteriorating impact on their social health. Covid-19-related lockdown and pandemic-associated physical, mental, and social well-being effects have been evident in the elderly population in the United Kingdom. The reasons identified for such findings are lack of physical activity, poor social interactions, social isolation, the perceived threat of a pandemic, and poor access to healthcare facilities.

Interactions of depression, anxiety, and sleep quality with menopausal symptoms on job satisfaction among middle-aged health workers in England: a STROBE-based analysis.

BACKGROUND: This study examined the association between menopausal symptoms and job satisfaction, and ascertained whether three psychosomatic factors (e.g., anxiety, depression, and sleep quality) interact with menopausal symptoms on job satisfaction. METHODS: A cross-sectional design with sensitivity analysis was adopted. The participants of the study were clinical health workers in England. Data from 154 health workers were analyzed with the hierarchical linear regression (HLR) analysis. RESULTS: There was a negative association between menopausal symptoms and job satisfaction (ß = -0.38; t = -4.81, p < 0.001), but this relationship became non-significant after adjusting for work stress, self-reported health, job tenure, and resilience at work. An interaction between menopausal symptoms and the psychosomatic factors was found. The strength of the negative association between menopausal symptoms and job satisfaction was weakened by sleep quality (ß = 0.05; t = 0.48; p > 0.05) but was strengthened by anxiety (ß = -0.22; t = -2.28; p < 0.05) and depression (ß = -0.24; t = -2.16; p < 0.05). CONCLUSION: Menopausal symptoms can be directly associated with lower job satisfaction and indirectly associated with lower job satisfaction through its interaction with depression and anxiety. Menopausal symptoms can weaken the positive association between sleep quality and job satisfaction.

Belongingness in medical students: did it change during lockdown?

Belongingness has been proposed as a potential proxy for legitimate peripheral participation in medical education. Previous studies have shown good internal and external validity for tools designed to measure this variable, with potential use measuring the effectiveness of clinical teaching environments and as a marker of student wellbeing. This study examined changes in belongingness in medical students at the University of Exeter measured in spring 2019 and the equivalent period in 2021, during which COVID-19 related restrictions were in place in the United Kingdom. This study used a validated assessment tool that was self-administered via an online survey platform in 2021. Anonymised data was collected from undergraduate medical students from all years of training and results compared with previous data collected in 2019. The belongingness assessment tool described here had validity in undergraduate medical students studying at the University of Exeter and identified statistically significant changes in belongingness (as measured with this tool) between 2019 and the period during which COVID-19 restrictions were in place. These results suggest that belongingness - in undergraduate medical students fluctuates and varies under different conditions and that there was a statistically significant change during the period of lockdown restrictions. The ability to measure this key facet of educational development has the potential to monitor teaching environments to ensure optimal learning conditions for all students. Further work is required to assess whether the impacts of lockdown restrictions are transient or persist beyond the period of teaching restrictions and to determine any association with academic outcomes.

Low Genetic Impact of the Roman Occupation of Britain in Rural Communities.

The Roman period saw the empire expand across Europe and the Mediterranean, including much of what is today Great Britain. While there is written evidence of high mobility into and out of Britain for administrators, traders, and the military, the impact of imperialism on local, rural population structure, kinship, and mobility is invisible in the textual record. The extent of genetic change that occurred in Britain during the Roman military occupation remains underexplored. Here, using genome-wide data from 52 ancient individuals from eight sites in Cambridgeshire covering the period of Roman occupation, we show low levels of genetic ancestry differentiation between Romano-British sites and indications of larger populations than in the Bronze Age and Neolithic. We find no evidence of long-distance migration from elsewhere in the Empire, though we do find one case of possible temporary mobility within a family unit during the Late Romano-British period. We also show that the present-day patterns of genetic ancestry composition in Britain emerged after the Roman period.

Autochthonous Human Babesia divergens Infection, England.

We describe a case of autochthonous human Babesia divergens infection in an immunocompetent woman in England. The patient had fever, hemolysis, multiorgan failure, and 18% parasitemia. We confirmed B. divergens by 18S rDNA PCR and sequencing. Clinicians should consider babesiosis as a differential diagnosis in patients with unexplained hemolysis.

Investigation of a Human Case of Francisella tularensis Infection, United Kingdom, 2023.

Tularemia, caused by Francisella tularensis, is not known to occur in the United Kingdom. We report a case of tularemia diagnosed in July 2023 in a UK patient with no travel in the 6 weeks before symptom onset. We describe the subsequent multiagency investigation into possible routes of acquisition.

Parental migration, socioeconomic deprivation and hospital admissions in preschool children in England: national birth cohort study, 2008 to 2014.

BACKGROUND: A third of children born in England have at least one parent born outside the United Kingdom (UK), yet family migration history is infrequently studied as a social determinant of child health. We describe rates of hospital admissions in children aged up to 5 years by parental migration and socioeconomic group. METHODS: Birth registrations linked to Hospital Episode Statistics were used to derive a cohort of 4,174,596 children born in state-funded hospitals in England between 2008 and 2014, with follow-up until age 5 years. We looked at eight maternal regions of birth, maternal country of birth for the 6 most populous groups and parental migration status for the mother and second parent (UK-born/non-UK-born). We used Index of Multiple Deprivation (IMD) quintiles to indicate socioeconomic deprivation. We fitted negative binomial/Poisson regression models to model associations between parental migration groups and the risk of hospital admissions, including interactions with IMD group. RESULTS: Overall, children whose parents were both born abroad had lower emergency admission rates than children with parents both born in the UK. Children of UK-born (73.6% of the cohort) mothers had the highest rates of emergency admissions (171.6 per 1000 child-years, 95% confidence interval (CI) 171.4-171.9), followed by South Asia-born mothers (155.9 per 1000, 95% CI 155.1-156.7). The high rates estimated in the South Asia group were driven by children of women born in Pakistan (186.8 per 1000, 95% CI 185.4-188.2). A socioeconomic gradient in emergency admissions was present across all maternal regions of birth groups, but most pronounced among children of UK-born mothers (incidence rate ratio 1.43, 95% CI 1.42-1.44, high vs. low IMD group). Patterns of planned admissions followed a similar socioeconomic gradient and were highest among children with mothers born in Middle East and North Africa, and South Asia. CONCLUSIONS: Overall, we found the highest emergency admission rates among children of UK-born parents from the most deprived backgrounds. However, patterns differed when decomposing maternal place of birth and admission reason, highlighting the importance of a nuanced approach to research on migration and health.

Hip fracture projections up to the year 2060: an analysis based on data from the National Hip Fracture Database (NHFD) for England, Wales, and Northern Ireland.

INTRODUCTION: Hip fractures are common and cause a huge socioeconomic burden to patients, their carers, and healthcare services worldwide. Our aim was to examine how much hip fracture numbers would be expected to rise over coming decades, simply as a consequence of the ageing of the population. METHODS: We used data from the National Hip Fracture Database on the volume of hip fractures occurring in England, Wales and Northern Ireland in the year 2019 (n = 67,210). We projected future numbers of hip fractures by applying this number, assuming stable rates, to population growth forecast data provided by the Office for National Statistics up to the year 2060. RESULTS: By 2060, the number of hip fractures occurring in England, Wales and Northern Ireland are projected to increase by 107 % (n = 139,105). In males, there was an estimated increase of 130 % compared with 97 % in females. There was an estimated increase across all age ranges, however the oldest age groups demonstrated the largest relative increases. The estimated increase for those aged 90 years or over was as high as 348 % and 198 % for males and females, respectively. CONCLUSION: As a consequence of future ageing of the population, the demand on the health service posed by people with hip fracture is projected to more than double by the year 2060. Policymakers should be striving to mitigate against the huge public health impact of these projections by maximising fracture prevention strategies as far as possible and by improving the quality of hip fracture care.

Considering the Role of Behavioural Fatigue in the COVID-19 Lockdown Debates in Great Britain: A Retrospective Analysis of a National Survey Assessing the Relationships between Capability, Opportunity, Motivation, and Behaviour.

During the COVID-19 pandemic, the term "behavioural fatigue" became the centre of policy debates in Great Britain. These debates involved deciding when to go into lockdown and whether behavioural interventions could be effective. Behavioural interventions can only succeed where people's Capabilities, Opportunities, and Motivations to perform target behaviours are supported. Our retrospective data analyses examine the relationships between people's Capabilities, Opportunities, Motivations, and Behaviours, i.e., adherence to lockdown guidelines. Our cross-sectional analyses include 17,962 unique participants in Great Britain who completed a survey over the initial 30 days of the first lockdown (April 2020). We examine trends in responses to each scale and then the relationships between the scales using Granger's causality test with tests for stationarity and cointegration. A mixture of increasing and decreasing trends was identified for Capabilities and Opportunities. Decreasing trends were identified for Motivation and Behaviour. Granger's causality tests found that Capability forecasts Opportunity and Behaviour and that Motivation forecasts Opportunity. The discussion reiterates that to realise and maintain Behaviour changes, policies surrounding people's Capabilities, Opportunities, and Motivations must continue to support target behaviours.

SARS-CoV-2 Dynamics in the Premier League Testing Program, United Kingdom.

During 2020-2022, players and staff in the English Premier League in the United Kingdom were tested regularly for SARS-CoV-2 with the aim of creating a biosecure bubble for each team. We found that prevalence and reinfection estimates were consistent with those from other studies and with community infection trends.

UK paediatricians' attitudes towards the chicken pox vaccine: The SPOTTY study.

OBJECTIVES: An effective vaccine for chicken pox has been included in immunisation schedules since the 1990s. In the UK the recommendation for routine inclusion came in November 2023; it has not yet been implemented. We explored paediatricians' attitudes towards the vaccine and their personal and professional use; as this has been shown to be an influential factor in parents' vaccine decision making. METHODS: We conducted a cross-sectional online survey using a structured questionnaire exploring attitudes and knowledge towards the chicken pox vaccine of UK based paediatricians between June and September 2023. RESULTS: We received 272 responses, 211 female (78%), 228 based in England (85%) with remainder in Wales (23), Scotland (8) and Northern Ireland (9); 150 (56%) reporting practicing paediatrics <10 years. The majority (n = 207; 78%) agreed that the chicken pox vaccine should be included in the UK routine schedule. Half the cohort, 52% (n = 135), reported having their own children vaccinated against chicken pox, 73% of those with appropriately aged children. Most, 86% (n = 225), recommended the vaccine to family and friends routinely or when asked; however, 42% (n = 108) did not feel able to advise patients' parents due to insufficient information. Of those who do not recommend the vaccine to family and friends, 22 (59%) reported insufficient information to discuss in a professional setting. Of those who did not think it should be included, or were unsure, 38/55 (69%) also felt they had insufficient information to advise parents regarding the vaccine. CONCLUSIONS: Whilst many paediatricians choose to vaccinate their children and agreed the chicken pox vaccine should be added to the routine schedule, the proportion disagreeing is not insignificant. Targeted education to improve paediatricians' knowledge of the chicken pox vaccine and their confidence discussing it should be implemented prior to the national roll out.

Health and social care experience and research perception of different ethnic minority populations in the East Midlands, United Kingdom (REPRESENT study).

INTRODUCTION: Ethnic minority populations experience significant health and social care disparities; despite experiencing a greater burden of diseases, these groups are underrepresented in health and social care research. Consequently, related research can be less applicable to these population groups. The REPRESENT study aims to explore the health and social care experiences of ethnic minorities and other minoritised populations, their research interests and appropriate research practices. METHODS: Focus groups and semistructured interviews were conducted between May and September 2022 with members of a number of ethnic minority communities in England. Data were audio recorded, transcribed and thematically coded using NVivo 12. Rigour was determined through extensive sampling, iterative data collection and analysis. FINDINGS: Fifty-two ethnic minority members were engaged in group interviews and one-to-one interviews. Participants included representatives of the following groups: African Caribbean, Eastern European, Gypsy Travellers, Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual+, Refugee/Asylum Seekers, Somali and South Asian communities. Interviews were also conducted with ethnic minority healthcare providers and researchers. Three overarching categories were identified: health information, medical service experiences, health and social care concerns and health research. Health and social care services challenges were mostly attributed to discrimination, delayed services, poor cultural relevance and language and cultural barriers. The most influential information sources were local community organisations and word-of-mouth. The main health and social care concerns were chronic long-term health conditions, mental health, maternal health and child development. Recommendations for research involved understanding the motivations for participation, improving communication and empowering communities. Top research priorities were long-term health conditions, health promotion and education, early care interventions and understanding community needs. INTERPRETATION: Discrimination and bias in health and social care provision have severe implications for worsening ethnic health inequalities. Healthcare commissioning authorities and policymakers can leverage the preference of ethnic minority groups for pharmacy services and community organisations to improve access to care. Improving research interest and engagement requires understanding individual community needs, community sensitivity, research relevance and cultural appropriateness. PATIENT OR PUBLIC CONTRIBUTION: Members of ethnic minority Patient and Public Involvement and Engagement group and Community Advisory Board supported the REPRESENT study design, conceptualisation and report development.

Marginalised or privileged? Analysing nursing education for male students in the UK and Taiwan with fragmented frameworks of gender.

This comparative analysis explores interactions and relationships influenced by gender in nursing education for male students in the United Kingdom (UK) and Taiwan, using Unterhalter's (2007) fragmented frameworks of gender to understand historical backgrounds, policies, and clinical curricula. While the UK demonstrates a gradual increase in male nurses over time, emphasising specialisation and comprehensive clinical exposure, Taiwan faces challenges influenced by cultural factors, particularly resistance to male nurses in certain fields. Disparities in the percentage of male nurses on registers and challenges during clinical placements are examined, highlighting the multifaceted nature of gender as a noun, adjective, and verb. Both countries grapple with the imperative of gender inclusivity, with recommendations for targeted recruitment campaigns to challenge existing gender norms and eliminate barriers, fostering equitable environments in nursing education.