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Background Well-designed public health interventions ideally aspire to reduce health disparities between racial and ethnic groups. Yet, there remains virtually no research examining racial/ethnic disparities in interventions for marginalized perinatal populations with substance use disorders (SUD). We sought to examine whether there were racial/ethnic differences at intake, in retention, and in program outcomes among pregnant or postpartum women with prenatal substance use enrolled in a three-year intensive case management intervention. We hypothesized that: (1) at baseline, numerous racial/ethnic disparities in well-being, health, and health care would be observed, and (2) after the three-year intervention few racial/ethnic disparities in maternal and child health and welfare would be found. Methods We used self-reported data from 3,165 women aged 18 to 45 years enrolled in the Parent-Child Assistance Program in Washington State between May 10, 2006, and September 21, 2017. We used Fisher-Freeman-Halton Exact Tests and t -tests to compare racial/ethnic groups at program enrollment and exit and logistic regression to examine likelihood of completing the intervention by group, controlling for other factors. Results Despite numerous racial/ethnic differences at enrollment, there were no such differences in outcomes among those who finished the program and completed an exit interview. Different racial/ethnic groups received comparable case manager time. American Indians/Alaska Natives were less likely to finish the program (Adjusted Odds = 0.66). Conclusions Participants who finished the program achieved comparable outcomes regardless of race/ethnicity. More work is needed to understand why American Indian/Alaska Native women were less likely than the others to finish the program and to close this service gap.

Purpose The anti-apoptotic function of the 70 kDa family of heat shock proteins and their role in cancer is well documented. Dual targeting of Hsc70 and Hsp70 with siRNA induces proteasome-dependent degradation of Hsp90 client proteins and extensive tumor specific apoptosis as well as the potentiation of tumor cell apoptosis following pharmacological Hsp90 inhibition. Methods We have previously described the discovery and synthesis of novel adenosine-derived inhibitors of the 70 kDa family of heat shock proteins; the first inhibitors described to target the ATPase binding domain. The in vitro activity of VER-155008 was evaluated in HCT116, HT29, BT474 and MDA-MB-468 carcinoma cell lines. Cell proliferation, cell apoptosis and caspase 3/7 activity was determined for VER-155008 in the absence or presence of small molecule Hsp90 inhibitors. Results VER-155008 inhibited the proliferation of human breast and colon cancer cell lines with GI₅₀s in the range 5.3-14.4 μM, and induced Hsp90 client protein degradation in both HCT116 and BT474 cells. As a single agent, VER-155008 induced caspase-3/7 dependent apoptosis in BT474 cells and non-caspase dependent cell death in HCT116 cells. VER-155008 potentiated the apoptotic potential of a small molecule Hsp90 inhibitor in HCT116 but not HT29 or MDA-MB-468 cells. In vivo, VER-155008 demonstrated rapid metabolism and clearance, along with tumor levels below the predicted pharmacologically active level. Conclusion These data suggest that small molecule inhibitors of Hsc70/Hsp70 phenotypically mimic the cellular mode of action of a small molecule Hsp90 inhibitor and can potentiate the apoptotic potential of a small molecule Hsp90 inhibitor in certain cell lines. The factors determining whether or not cells apoptose in response to Hsp90 inhibition or the combination of Hsp90 plus Hsc70/Hsp70 inhibition remain to be determined.

christopher.graham@postgrad.manchester.ac.uk The reach of alcohol sports marketing is huge.1 The 2018 FIFA World Cup, for example, delivered several billion branded alcohol impressions to UK viewers, including several hundred million to children.2 Worryingly, exposure to alcohol sports sponsorship is associated with alcohol consumption in children.3 Alcohol marketing also poses a risk to recovery from alcohol problems.4 The UK has a self-regulatory (alcohol industry led) approach to alcohol marketing, which undermines public health, as alcohol sponsors seek a return on their investment: increased alcohol sales.1 Self-regulation does not work,5 and countries with statutory controls on alcohol marketing have less alcohol sports sponsorship than those with self-regulation.6 As recommended by the World Health Organization,7 Scotland can support public health by banning alcohol sports marketing and sponsorship. Bans should be comprehensive and robust (including independent monitoring and enforcement) and informed by expert guidance, including Alcohol Focus Scotland’s comprehensive report from an international alcohol marketing expert network.4 SHAAP’s Calling Time campaign to encourage the Scottish government to ban alcohol sports marketing and sponsorship has received cross party political support and backing from health and football organisations, including Scottish Women’s Football.10 Scottish voters can email their member of Scottish parliament via SHAAP’s campaign website to call for their support for this proposed ban.10 Make your voice heard.810 Support public health and give alcohol sports marketing the red card. 35524237 3 Brown K. Association between alcohol sports sponsorship and consumption: a systematic review.

Since its inception, the concept of neurodiversity has been defined in a number of different ways, which can cause confusion among those hoping to educate themselves about the topic. Learning about neurodiversity can also be challenging because there is a lack of well-curated, appropriately contextualized information on the topic. To address such barriers, we present an annotated reading list that was developed collaboratively by a neurodiverse group of researchers. The nine themes covered in the reading list are: the history of neurodiversity; ways of thinking about neurodiversity; the importance of lived experience; a neurodiversity paradigm for autism science; beyond deficit views of ADHD; expanding the scope of neurodiversity; anti-ableism; the need for robust theory and methods; and integration with open and participatory work. We hope this resource can support readers in understanding some of the key ideas and topics within neurodiversity, and that it can further orient researchers towards more rigorous, destigmatizing, accessible, and inclusive scientific practices.

Team members share recent moments of joy (from wherever—home and family life, work, social life, and so on) with their team, helping build stronger connections as people learn more about each other and what they find meaningful. When achievements and best practice are recognised, techniques like appreciative inquiry can focus on and build upon excellence and inspire quality improvement efforts.4 Moments of joy and win of the week both align with recommendations from the Institute for Healthcare Improvement on ensuring a joyful, engaged workforce.5 Implementing and encouraging such initiatives shows compassionate leadership through fostering supportive relationships where team members are listened to, understood, and valued.6 Our suggestions thus promote inclusion and can support wider efforts to foster psychological safety, where everyone feels comfortable asking questions, sharing and learning from mistakes, and challenging problematic behaviours.7 Views expressed are the authors’ own and do not necessarily reflect those of their employers. King’s Fund. 2022. https://www.kingsfund.org.uk/insight-and-analysis/long-reads/what-is-compassionate-leadership 7 NHS Employers.

NHS Health Scotland will undertake an independent multicomponent assessment of the impact of MUP on a range of outcomes, reporting their complete results in 2023.4 Meanwhile in Russia the World Health Organization reports that total per capita alcohol consumption dropped by 43% from 2003 to 2016.56 The report provides a timeline of alcohol policies mapped to changes in mortality rates (table 2, figure 14).6 MUP for vodka was introduced in 2003, followed by MUP for other alcoholic beverages. Mounting evidence shows that MUP is effective1789 and cost effective, particularly when combined with tax increases.8 Although alcohol consumption remains high in Russia—total per capita alcohol consumption was11.7 L of pure ethanol in 2016, compared with the WHO European average of 9.8 L6—we can learn from its success to date.56 For more information on Scotland’s MUP policy, see the 14th research and policy briefing from Scottish Health Action on Alcohol Problems.3 Opinions expressed are the author’s own and do not necessarily reflect the view of the University of Manchester or the Royal College of Physicians of Edinburgh. The effects of alcohol control measures on mortality and life expectancy in the Russian Federation. 2019. http://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/publications/2019/alcohol-policy-impact-case-study-the-effects-of-alcohol-control-measures-on-mortality-and-life-expectancy-in-the-russian-federation-2019 7 Boniface S Scannell JW Marlow S. Evidence for the effectiveness of minimum pricing of alcohol: a systematic review and assessment using the Bradford Hill criteria for causality.

[...]the Healthcare Leadership Academy (HLA)’s scholars programme, founded in 2016, is a year long, funded leadership development programme mapped to the NHS leadership framework that nurtures and empowers tomorrow’s healthcare leaders.3 The programme can be undertaken in parallel to studies or work and explores the leader as communicator, manager, follower, negotiator, philosopher, and entrepreneur or innovator. [...]current and past scholars interact regularly, supporting and learning from each other through a messaging platform, community weekends, and other events. [...]the Faculty of Medical Leadership and Management’s trainee steering group—a diverse committee of resident leaders from across the UK, specialties, and training grades—offers free online resources.

This article highlights current models used in child protection to assess safety and risk, and discusses implications for child maltreatment fatalities. The authors advance that current risk and safety practice approaches were not designed to accurately estimate the likelihood of low base-rate phenomena and have not been empirically tested in their ability to predict or prevent severe or fatal child maltreatment. They advance that, regardless of the ultimate effectiveness of safety and risk tools, competent assessment and decisionmaking in child protection depend on sound professional judgment and a comprehensive systemic approach that transcends the use of specific tools.

c.graham@rcpe.ac.uk Warren describes the use of example imagery to help patients describe their pain experience, which should substantially improve doctor-patient communication.1 Padfield and colleagues explored the same clinical tool in their engaging perspective piece.2 They describe a therapeutic triangle linking the clinician, patient, and image and showcase the revealing patient narratives generated. In one study, eight of 10 women with chronic pelvic pain who experienced pain imagery also experienced coping imagery.5 Pain imagery might provide a novel target for image based psychological therapies, such as cognitive behavioural therapy.589 We recommend Berna and colleagues’ article, which includes the example of a patient who experiences both negative pain imagery and positive coping imagery,8 and Berna’s chapter in Meanings of Pain.10 Opinions expressed are the authors’ own. Presence of mental imagery associated with chronic pelvic pain: a pilot study.

In this study, the authors examined the combined effects of caregiver mental health, alcohol use, and social network support/satisfaction on child mental health needs among African American caregiver-child dyads at risk of maltreatment. The sample included 514 eight-year-old African American children and their caregivers who participated in the Longitudinal Studies of Child Abuse and Neglect. A structural equation model was created with caregiver mental health/alcohol use and caregiver social network support/satisfaction as the exogenous variables and child mental health need as the endogenous variable. Caregivers with less-supportive networks and whose capacity to parent was challenged by alcohol, depression, or other mental health problems had children with elevated mental health needs. These findings confirm the need to examine the effects of caregiver influences (for example, caregiver mental health and social network support/satisfaction) on mental health among African American children at risk of maltreatment and to further explain how the social networks of caregivers are accessed when caregivers and children have mental health problems. Implications for identifying mental health needs among this vulnerable group and improving their connections to formal mental health services through social network-level interventions are discussed.