Birmingham City University

The following case study provides an overview of the challenges surrounding the recruitment and retention of Special Constables (SC) for the 43 police forces in England and Wales and proposes a set of recommendations for organisations to follow in order to maximise volunteer numbers and minimise attrition rates. Fundamentally, the challenges surrounding the recruitment and retention of SCs can be seen as early as the application and assessment stages of the joining process, where inconsistencies in the quality and accessibility of information from force to force, acts as a barrier to entry. Furthermore, a number of reported challenges such as significant time delays, poor communication from recruiting forces and limited support mechanisms are impacting applicant experience, potentially causing candidates to reconsider their decision to join. Further still, the early experiences of Special Constables, from recruitment to first operational deployment, plays a significant part in potentially determining the longevity and commitment to the role, with factors such as negative relationships between Specials and regulars often seen as a common demoralising theme. Focusing specifically on the following HMICFRS (2023b) PEEL inspection framework Question 9 - How good is the force at building, developing, and supporting its workforce and encouraging an ethical, lawful, and inclusive workplace? - this case study primarily explores the impact to Special Constable candidates during the recruitment process but also considers how challenging working relationships and personal experiences may also damage volunteer officer retention levels. In particular, the PEEL 2023-25 cycle places a greater onus on inspecting, “…how forces are ensuring those newly recruited into the organisation are retained and how they develop into front-line leaders” (HMICFRS, 2023b: pg1) which can clearly be applied to both Special Constables as well as regular officers. Lastly, a set of simple and achievable recommendations including more support during the recruitment process, more timely updates from recruiting teams, a culture of respect and acceptance, greater use of conversations with potential leavers, plus the recognition of the value that Special Constables bring to the workforce will be detailed. By embracing these recommendations, police forces should help their respective organisations achieve the outstanding classifications they strive to meet as detailed in the HMICFRS judgement criteria.

Over the past 50-60 years, a decline in the density of the thermosphere has been observed of about 2% per decade at 400 km altitude. This is largely attributed to the increase in atmospheric CO2 concentration, causing cooling and contraction across the stratosphere, mesosphere, and thermosphere. The reduction in thermospheric density reduces drag on active satellites and space debris, affecting orbital characteristics and increasing debris lifetimes. To manage the risk of the growing space debris population and ensure the long-term sustainability of the Low Earth Orbit (LEO) environment, we need to understand the impacts of likely future density changes. Here we used a long transient simulation with the Whole Atmosphere Community Climate Model eXtension (WACCM-X) 2.0 to define future density scenarios used as input for simulations with the Realisations of the Engineered and Natural Evolution of the Global Atmosphere and Debris Environment (RENEGADE) model. The WACCM-X simulation followed Shared Socio-economic Pathway 2–4.5 and included realistic assumptions on main magnetic field changes and variations in solar activity, which also affect the climate of the upper atmosphere. RENEGADE simulations under a "best-case" scenario for debris generation showed that the projected long-term density trend would lead to ∼8% more objects in LEO by 2070 and a significantly enhanced average collision rate, from 0.22±0.01 to 0.25±0.01 per year. The largest enhancements in debris spatial density, of around 30-35% by 2070, were found at ∼400 km altitude. The thermospheric density trend will therefore have a disproportionally large impact on infrastructure operating around this altitude.

Chronic diseases account for 74% of global deaths. In the UK, multimorbidity prevalence is projected to nearly double by 2035. Addressing this burden requires a holistic, multidisciplinary approach that considers genetic, lifestyle, environmental, and psychosocial factors. The increasing focus on holistic care has revived interest in traditional and complementary healthcare practices, with a 2013 survey indicating that 23.6% of the UK’s ethnic population utilizes these modalities. Among these practices, Ayurveda has gained significant global traction. Despite the growing popularity of Ayurveda, discussions between patients and healthcare professionals (HCPs) remain limited. Consequently, patients often explore Ayurveda centres independently, risking unreliable sources that could have serious consequences on their health. Opening conversations about Ayurveda is crucial to ensure patients are well-informed. These conversations largely depend on the awareness, attitudes, and having the confidence and the ability to signpost patients to reputable Ayurvedic centres. The study utilized a cross-sectional survey to assess UK HCPs’ awareness, attitudes, and training needs on Ayurveda. After a pilot test, an anonymous Google Form was distributed, yielding 147 responses. Cronbach’s alpha for the questionnaire was 0.9261, indicating high internal consistency. Descriptive statistics, Chi-Square Test, and Fisher’s Exact Test were used for data analysis. Of 147 surveyed HCPs, 10.2% were very familiar with Ayurveda, 46.3% somewhat familiar, and 43.5% had little to no familiarity. Herbal medications (59.6%) and dietary interventions (41.1%) were most recognized. Only 10.9% fully understood Ayurveda’s known safety and effectiveness. Most (80.3%) felt unprepared to advise patients on Ayurveda, and majority (83%) had no formal training. Regarding attitudes, 46.2% supported including Ayurveda as a treatment option, and 82.3% thought it should be regulated by the Medicines and Health Products Regulatory Agency (MHRA) or the NHS. The majority (70.7%) favoured collaboration with Ayurvedic practitioners. Attitudes about Ayurveda’s role in chronic disease varied, with 47.7% believing it could help those not benefited by conventional medicine. A strong majority (83.7%) supported patient education on its benefits and risks, and most (86.4%) willing to learn more. In terms of patient engagement, nearly half (47.6%) refrained from offering definitive advice on Ayurveda, and only a few (8.8%) referred patients to Ayurvedic practitioners. However, most (84.4%) supported interprofessional cooperation. Key challenges to integration included lack of scientific evidence (55.1%) and limited understanding (44.2%), with many advocating for research (51.7%) and education (45.6%). Ethnicity significantly influenced responses (p<0.001), with Asians showing familiarity but limited understanding, Black respondents displaying more knowledge and support for integration, and White respondents expressing scepticism and a need for regulation. The survey highlights significant gaps in awareness and understanding of Ayurveda among UK healthcare professionals, alongside varying attitudes toward its integration in chronic disease management. Most HCPs expressed support for collaboration with Ayurvedic practitioners and for educating patients about its benefits and risks. These findings underscore the need for enhanced education and structured training programs for HCPs to enable safe and informed discussions about Ayurveda in clinical practice. In response to the identified gaps, an educational video was subsequently developed by the University of Birmingham for HCPs to address knowledge gaps and support informed patient decisions on Ayurveda.

To explore the associations of sarcopenia and sarcopenic obesity (SO) with memory. Data from the Guangzhou Biobank Cohort Study (GBCS) were used to conduct both cross-sectional (n = 6390) and longitudinal (n = 3979) analyses. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019, while obesity was defined by 20 obesity indicators. Memory was assessed by the Delayed Word Recall Test (DWRT). Linear regression was used to analyze these associations. Two-sample Mendelian randomization (2SMR) was used to investigate potential causal associations of sarcopenia-related traits with memory. Compared to participants without sarcopenia, those with sarcopenia had lower baseline and follow-up DWRT score, and greater decrease in mean annual change (MAC) and MAC rate of DWRT score, with adjusted βs (95% CIs) being -0.24 (-0.33 to -0.14), -0.10 (-0.20 to -0.004), -0.03 (-0.06 to -0.001) and -0.79 (-1.57 to -0.01), respectively. Among all the SO definitions, the associations of SO defined by waist-to-hip-to-height ratio (WHHR) appeared to be the strongest (-0.36 [-0.50 to -0.22], -0.31 [-0.45 to -0.17], -0.09 [-0.14 to -0.05] and -2.70 [-3.81 to -1.59]), and stronger than those with sarcopenia only or obesity only. In 2SMR, walking pace (one of the sarcopenia indicators) was positively associated with working memory (1.61 [0.59, 2.62]). Sarcopenia and SO were associated with faster memory decline. Using the central obesity indicator WHHR to define SO may better predict late-life memory.

Since the roll-out of antiretroviral therapy (ART), there has been a significant reduction in Human Immunodeficiency Virus 1 (HIV-1) related mortality and morbidity. Nonetheless, drug resistance has emerged significantly, affecting treatment outcomes, but there is limited surveillance of HIV-1 drug resistance and subtype diversity, which is critical for clinical decision-making on therapeutic choices as well as public health control measures. The goal of this systematic review was to analyze data from 2004 to 2024 on subtype diversity and drug resistance mutations (DRMs) among persons living with HIV-1 in Ghana. We searched PubMed, Scopus, Cochrane CENTRAL, CINAHL Complete, Web of Science, and Google Scholar for cross-sectional and longitudinal studies reporting on HIV-1 subtype diversity, drug resistance, or both among individuals in Ghana published from 2004 to 2024 and reviewed according to PRISMA guidelines. The protocol for this review was registered with PROSPERO (CRD42024529606). A total of 2472 studies were screened, 28 were selected for full-text review, and 18 were included. The overall sample size was 2001 individuals. HIV-1 subtypes observed were CRF02_AG (68.9%), A (2.2%), A3 (1.7%), B (2.1%), C (0.6%), G (3.5%), CRF06_cpx (3.3%), CRF09_cpx (0.6%), and other recombinant forms (16.8%). Only one occurrence was observed each for Subtypes D and K. Key DRMs for NRTIs were documented, with M184V/I detected at 41.2%, followed by M41L (15.4%) and T215Y/F (11.8%). For NNRTIs, DRMs were in the set as K103N (28.4%), G190A/S (10.1%), and V106I/AT (10.7%). The DRMs for PI were primarily marked by M46I/L (25.0%), while I54V, L90M, and V82A were each identified in 12.5% of cases. The INSTIs accessory mutations observed were L74I/M (46.7%), E157Q (20.0%), G163R/K and T97A (13.3% each). Only two studies analyzed sequences for DRMs from the integrase gene; however, these were accessory DRMs and are not known to produce resistance to the current INSTI regimen. Also, mutational profiles varied notably by ART history, and key mutations in NRTIs, NNRTIs, and INSTIs were significantly associated with ART experience. The findings reveal CRF02_AG predominance and a considerable increase in NNRTI DRMs, highlighting the need for tailored therapies and continued surveillance to address emerging resistance in Ghana.

High consumption of ultra-processed food (UPF) has been consistently linked to negative health outcomes, but existing tools for assessing UPF consumption are often lengthy, culturally specific, or psychometrically underdeveloped. The present research aimed to develop and validate the Ultra-Processed Food Consumption Scale (UPFCS); that is, a brief, psychometrically sound, and cross-culturally applicable measurement. In Study 1 (n = 325), exploratory factor analysis (EFA) was conducted to examine the factorial structure and internal consistency of the 30-item UPFCS. Study 2 (n = 129) evaluated test-retest reliability across a 2-week interval, and Study 3 (n = 144) assessed convergent validity by examining associations to Mediterranean diet adherence, body mass index (BMI), and food addiction, as well as testing the moderating role of Mediterranean diet adherence. EFA and internal consistency supported a unidimensional structure, while test-retest reliability was moderate to strong. UPFCS scores were positively associated with food addiction symptoms, but not with BMI or Mediterranean diet adherence. Exploratory moderation analysis indicated that adherence to a Mediterranean diet attenuated the relationship between UPF consumption and food addiction symptoms, with the effect strongest among those with low Mediterranean dietary adherence. The UPFCS demonstrates robust psychometric properties and practical utility for assessing ultra-processed food consumption in behavioural and nutritional research.