Purpose in life is consistently associated with better health outcomes, including lower risk of earlier mortality. We report an updated meta-analysis of the published literature, combined with analysis of individual-participant data, to address replicability, generalizability, and potential mechanisms of the association between purpose in life and risk of mortality.

A random-effects meta-analysis of individual-participant data from ongoing longitudinal studies (k = 8) combined with findings from a systematic review of the published literature (k = 17 samples from 14 publications). Across the 25 samples, there were 488,765 participants, 48,928 deaths, and up to 32 years of follow-up.

Purpose in life was associated with a ~ 30% lower risk of earlier mortality (meta-analytic HR = .76 [1/.76 = 1.32], 95% CI = .70, .83). The association was apparent across sociodemographic groups, with some small differences in magnitude by age, race, and education. The association was attenuated but persisted, controlling for behavioral and clinical risk factors for mortality (meta-analytic HR = .85, 95% CI = .82, .89), or depression (meta-analytic HR = .91, 95% CI = .88, .94).

A meta-analysis of 25 samples from the United States, Europe, and Asia indicated that purpose in life has a consistent association with lower risk of mortality. The association is due in part but not completely to behavioral, clinical, and psychological risk factors for earlier mortality.

Improve identification of patients with restricted eating, standardise the assessment and weight monitoring of patients with restricted eating and improve monitoring for at-risk young people.

This project followed a Plan–Do–Study–Act cycle. The Reading West CAMHScommunity patient list was analysed to gain a baseline measurement of:

• The consistency in identification of patients with restricted eating.

• The effectiveness of weight monitoring being undertaken for the patients on the team caseload.

An anonymous survey was sent to the multidisciplinary team to analyse perceived barriers to identifying patients with restricted eating and gather perspectives.

A focus group was organised involving clinical psychology, psychotherapy and medical teams to examine these barriers and to generate potential interventions.

Based on these findings, changes were implemented in the team, with the intention to expand to other localities if shown to be effective.

Interventions:

• Development of a standardised protocol for documenting weight.

• Addition of screening questions for restricted eating to the proforma for initial assessments of young people.

• Education for the MDT on the risks associated with restricted eating and the importance of early identification and consistent monitoring.

These interventions were disseminated across the team using established channels.

Of the 49 patients on the treatment list, 19 (39%) had documented evidence of restricted eating. Of these, 7 (37%) had adequate weight monitoring and documentation.

Reviews of the notes of these patients found that weight was not always documented, and if it was it was not in a standardised format.

Survey responses highlighted recurring themes including a lack of training and confidence in identifying restricted eating, concerns about the impact of monitoring on therapeutic relationships and the absence of a local protocol. Additional concerns were raised regarding escalation pathways and clinical responsibility.

The preliminary findings indicate that patients with restricted eating make a significant proportion of the caseload, however monitoring of these patients and documentation is not standardised. This indicates missed opportunities to identify and monitor these at-risk patients.

Several barriers to the identification and efficient weight monitoring of at-risk patients were found. These included staff training and confidence and poor standardisation of practice.

We anticipate improved consistency in weight monitoring and identification of high-risk patients with the implemented changes. Repeat analysis will be needed to confirm the post-intervention effect.

Further work will include the development of robust monitoring protocols, establishment of clear escalation pathways and implementation of defined clinical responses for young people identified as high risk.

There is clear evidence that Black men are disproportionately detained under the Mental Health Act (MHA). Our aim was to explore and characterise the clinical, social, organisational and structural factors contributing to this phenomenon, by examining the pathways to compulsory admission among Black adult males, and to generate hypotheses to inform future research and service improvement.

We completed a thematic analysis of Structured Judgment Reviews (SJRs) of a consecutive series of Black adult male patients detained under the MHA within a single NHS mental health trust. The MHA team provided ten consecutive cases organised by date of detention; two cases were excluded due to being minors, leaving eight cases. The reviews were completed by trained clinicians using NHS SJR methodology, to apply structured judgment and qualitative narrative across phases of care. We identified themes relating to routes to detention, (dis)engagement with services, quality of care and social context.

Most patients had psychotic diagnoses (schizophrenia or BPAD), with histories of multiple detentions. Patient-related themes included: disengagement from CMHT services, poor medication adherence, and substance misuse. Several patients experienced significant social adversity, including homelessness, socioeconomic deprivation, exploitation and limited support networks. Migration-related stressors, trauma and language barriers were also evident.

Regarding organisational factors, inpatient care was generally timely and of adequate or good quality, with appropriate multidisciplinary involvement. Transitions from inpatient to community care emerged as a consistent point of vulnerability. Communication difficulties between services, missed opportunities for assertive follow-up, inconsistent provision of interpreters, and delays in initiating substance misuse interventions were recurrent. In several cases, rapid relapse occurred within months of discharge, leading to repeated crisis presentations and subsequent detention.

Our analysis of the themes suggests that compulsory admission under the MHA disproportionately affect Black males due to cumulative interactions of clinical complexity, social deprivation and system-level gaps in care continuity, rather than care quality alone. Although our findings cannot establish generalisability or causation, they are supportive for the hypothesis that earlier, more tailored and integrated community care may reduce detention for Black men. Future work could practice on larger samples and lived-experience perspective to inform culturally responsive service models and ongoing MHA reform. The Trust’s Quality Committee welcomed the report, endorsed further exploration of the key theme, and agreed the recommendations would be progressed through relevant governance committees.

Alcohol harm in the UK imposes a substantial clinical and societal burden, with 339,916 alcohol-specific hospital admissions recorded in 2023/24. Current pathways for identifying and supporting people at risk rely on self-identification of alcohol use.The aim of this work is to examine the extent to which self-identification as a “heavy drinker” aligns with clinically defined alcohol-risk levels and to identify the structural, stigma-related, and systemic barriers that prevent higher-risk drinkers from accessing appropriate support.

This analysis draws on nationally representative polling of 2,037 UK adults (mean age 48.77, SD=17.74, 52.33% female) applying the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) scoring to examine clinical risk, self-perception of drinking identity, barriers to accessing support, and systemic implications for service design.

Among adults meeting AUDIT-C criteria for increasing or higher risk (25.8%), 90% did not self-identify as a heavy drinker, with most describing themselves as “moderate” or “occasional” drinkers. This disconnect challenges the continuing reliance on self-referral and identity-based messaging within NHS and workplace pathways. Help-seeking was shaped primarily by systemic barriers: long NHS wait times (24.5%), stigma (24.1%), and the cost of private care (19.4%), while “not knowing where to go for help” ranked only sixth (16.9%). These findings contradict policy assumptions that awareness deficits are the primary obstacle. Exposure to alcohol harm extended far beyond the drinker: 49.3% of UK adults knew someone they considered a heavy drinker, indicating significant family, peer, and workplace impact and highlighting a missed early-intervention opportunity within social networks.

Self-identification is not a reliable gateway to care; stigma-laden service framing actively excludes the majority at clinical risk; and capacity constraints limit timely support even when motivation exists. These findings highlight the need for a shift toward routine use of the AUDIT-C in primary care, workplace health initiatives, and NHS Health Checks so that alcohol-risk detection no longer depends on individuals self-identifying as “heavy drinkers”. Services should adopt identity-neutral language, such as referring to “supported reduction” or “health optimisation”, to reduce the stigma that prevents many higher-risk drinkers from seeking help. Supporting families, friends, and colleagues to play a constructive role in early recognition and intervention when they observe escalating risk, is critical. Commissioning should prioritise rapid-access and digitally enabled models of support, to reduce long wait times and make care more accessible and discreet for people who face barriers related to work, geography, or stigma.

This audit aims to assess adherence to RCPsych guidance regarding timely admission blood tests (performed within 24 hours of admission), and what blood tests were performed as part of this. In addition, we aimed to evaluate adherence to Trust policy regarding vitamin D and calcium assessment and appropriate management of deficiency.

Retrospective case audit evaluating admissions to an inpatient adult working age psychiatry unit in December 2025 (excluding PICU patients). Records of 19 patients were reviewed (10 female, 9 male). Clinical notes and ICE records were used to obtain data. Information gathered included date of admission, date and results of admission blood tests, documentation of these blood results on the clinical system and medication prescriptions and discharge letter details.

Of 19 patients, 79% had bloods done within 24 hours of admission. For 1 patient, these samples were in adequate and so a repeat sample was treated as their admission set for purposes of this audit. Of those with a delay >24hrs, 75% had a reason documented.

The most common admission bloods performed were full blood count, urea & electrolytes and liver function tests (84%), followed by thyroid function tests and haematinics (79%), lipid and calcium profiles (74%), HbA1c and prolactin (63%), with glucose done least commonly (53%). Vitamin D levels were checked in 68% of patients (including 1 patient who did not initially have vitamin D levels checked, but levels were subsequently done).

Of those with a reported vitamin D level, 23% had sufficient levels, 31% had mild deficiency, and 54% had significant deficiency.

Of those with significant deficiency, all had vitamin D loading doses prescribed. However, only 50% of those with mild deficiency had vitamin D prescribed. At the point of data collection, 26% of the patients involved in this audit had been discharged; 67% of those discharged had a significant vitamin D deficiency, but only 75% of these patients had ongoing supplementation provided. None of these patients had a plan to re-check serum calcium as per guidelines on their discharge letter.

In conclusion, although the majority of new inpatient admissions had some form of bloods taken within 24hrs of admission, the type of bloods they had done was variable. Vitamin D levels were checked in 74% of patients, with 50% of those having a significant vitamin D deficiency. Initial prescription of loading dose therapy had a high compliance but follow up appeared poor, representing an area of possible improvement.

Alcohol use in the workplace is typically addressed through impairment-focused policies or reactive disciplinary responses. Yet national data suggest a deeper, systemic relationship between work-related stressors and higher-risk alcohol consumption. The aim of this work is to quantify the prevalence of higher-risk alcohol use among full-time workers and investigate the role of work-related stressors and workplace-specific barriers in shaping drinking behaviour and help-seeking patterns.

Data from a population survey of 2,037 UK adults (mean age=48.77 years, standard deviation=17.74; 1,066 female [52.33%], 971 male [47.67%]) were analysed to examine the prevalence of higher-risk drinking among full-time workers, demographic distribution, attribution of drinking to life stressors, and work-specific barriers that inhibit help-seeking.

Higher-risk alcohol use was substantially elevated among full-time workers (30.8%), second only to students, and distributed across all income levels, including 40% earning £50,000+. Only 9.6% of this group self-identified as heavy drinkers. Work-related pressures emerged as a core driver: 25.7% of higher-risk workers cited work stress, nearly double the rate among all drinkers (14.3%), with additional attribution to cost-of-living pressures, loneliness, and remote working (2.4× more common than in the general sample).These findings support a model in which alcohol use reflects a stress-response pattern rather than individual pathology. Workplace structures also shaped barriers to accessing support: concerns about career impact (17.8%) and difficulty taking time off work (17.1%) featured prominently among higher-risk adults, indicating that traditional clinic-based services are poorly aligned with the needs of working populations.

Workforce alcohol harm in the UK is widespread, socially invisible, and tightly linked to occupational and economic stressors. Reliance on self-disclosure, performance deterioration, or manager-led referral will systematically miss the majority of affected workers. These findings emphasise the importance of incorporating AUDIT-C screening into occupational health processes and routine workplace wellbeing assessments, ensuring that alcohol-related risk is identified proactively rather than reactively. Alcohol use should be recognised as a meaningful indicator of occupational mental health, considered alongside other markers such as workplace stress, sleep disruption, and burnout. It is also essential to commission flexible, digital, or remote care pathways that minimise career-related stigma and reduce the need for employees to take time away from work in order to access support. Finally, workplace alcohol interventions should be reframed away from an emphasis on individual responsibility and instead approached as part of a broader organisational mental health strategy, acknowledging the role of workplace conditions in shaping alcohol-related risk.

Little is known about implementation of antimicrobial stewardship (AMS) programs in retirement homes, a setting with an older adult population which is at increased risk of antibiotic-related harm. This study evaluated a pharmacist-led prospective audit and feedback (PAF) pilot program in retirement homes.

This quasi-experimental study evaluated antibiotic use in 9 intervention homes and 396 control homes from June 2022 to May 2023 (baseline period), compared to June 2023 to December 2024 (intervention period). PAF was conducted remotely by long-term care pharmacists; recommendations were provided to the prescriber via fax. The primary outcome was antibiotic days of therapy (DOT) per 1000 resident-days. Determinants to implementation were gathered from participating pharmacists and mapped to the Theoretical Domains Framework.

During the intervention, of 794 antibiotic assessments, 89 recommendations were made and 27 (30%) were accepted. Total antibiotic use measured in DOT per 1,000 resident days in intervention homes was similar before and after PAF (54.0 before vs. 57.9 after). Similarly, usage in the control group was relatively stable (49.0 before vs. 51.6 after) (DiD Analysis: +2.4 DOT/1,000 resident days, 95% CI −7.8, 12.3). Barriers to PAF implementation included communication challenges (communication via fax) and limited clinical information (lack of indication on prescription). Facilitators included organizational support and pharmacist motivation.

While this pilot had limited uptake and was not associated with a change in antibiotic use, it highlighted important barriers and facilitators for AMS in retirement homes. This initiative strengthened local capabilities for antibiotic use surveillance to support future AMS interventions.