While there is ample evidence for the efficacy of IPT, confirmed through the results of the efficacy review, on the ground implementation factors are less well understood. We compiled a book on the global reach of IPT by requesting contributions from local authors through word-of-mouth methods. This approach resulted in reports from 31 countries across six continents and 15 diverse populations within the US that spanned the age range and types of usage. In this paper, our aim was to collate and summarize book contributors' descriptions of barriers and facilitators as related to their experiences of implementing IPT across the 31 countries. We conducted a conceptual content analysis and then applied the updated Consolidated Framework of Implementation Research (CFIR) to deductively organize the barriers and facilitators into its five domains. Most found IPT to be relevant and acceptable and described minor variations needed for tailoring to context. National level policies and mental health stigma were highlighted in the outer setting. Availability of specialists and general and mental health infrastructure were considerations relevant to the inner setting. Many sites had successfully implemented IPT through delivery by nonspecialized providers, although provider workload and burnout were common. Clients faced numerous practical challenges in accessing weekly care. Primary strategies to mitigate these challenges were use of telehealth delivery and shortening of the intervention duration. Most programs ensured competency through a combination of didactic training and case supervision. The latter was identified as time-intensive and costly.

Diet indices are quantitative assessments of the quality of population intake. Understanding diet quality is crucial to support health and well-being; however, knowledge of diet quality across racial groups is limited. To examine diet quality of acial groups ‘White’, ‘Black’, ‘Asian’, and ‘Other’ in the United Kingdom (U.K.) and United States (U.S.), U.K. and U.S. national survey data were used to calculate Alternative Healthy Eating Index (AHEI-2010), Diet Quality Index-International (DQI-I), and EAT-Lancet scores. ANCOVA tests compared median total quality scores across racial groups adjusting for covariates. Kruskal–Wallis tests examined differences in individual component scores. Spearman correlations identified association of diet quality scores across indices. Highest diet quality scores were reported for U.K. and U.S. Asian groups. Most noticeable differences were apparent between U.S. Asian and White/Black groups (62% Asians within highest tertile of AHEI-2010 score vs. 29% Whites; P < 0.001). All racial groups demonstrated poor diet quality in terms of sustainability; EAT-Lancet scores were <40% of maximum total score for U.S. White, Black, and Other groups. AHEI-2010 diet quality scores were moderately associated with EAT-Lancet scores, evident across all groups (r = 0.53–0.65; P < 0.001). There is a need for all groups to increase intake of wholegrains, especially Black groups (mean Wholegrain score for U.S. Black group within DQI-I was 0.60 (maximum score of 5)) as demonstrated within AHEI-2010, DQI-I, and EAT-Lancet component scores. Additionally, increased intake of vegetables and legumes and decreased intake of processed and red meat would improve the adequacy, healthiness, and sustainability of U.K. and U.S. racial diets.

The aim of this study was to explore and identify why young adults aged between 18 and 30 years in the UK and France do or do not consume dairy products. Several studies have associated dairy products with a healthy diet, and the production of soft dairy, i.e. milk, yoghurt, and soft cheese, as more environmentally friendly than some other animal-based products. Yet recent reports highlight that dairy intake is lower than recommended for health, especially among young adults. Using a qualitative methodology, forty-five participants aged 18–30 years (UK: n = 22; France: n = 23) were asked about their reasons for (non)consumption of a wide range of dairy products. Audio-recorded focus groups and individual interviews were conducted in English in the UK and in French in France, transcribed and coded. A thematic analysis found four themes and sixteen sub-themes (theme product-related: sub-themes sensory, non-sensory, composition; theme individual-related: sub-themes mode of consumption, preferences, personal reasons, knowledge, attitudes and concerns, needs or cravings; theme cultural aspects: sub-themes product categorization, social norms, use; theme market offering: sub-themes alternative, packaging, value for money, availability) to influence participants’ dairy (non)consumption in both countries. A seventeenth sub-theme (theme cultural aspects: sub-theme structure of the meal) was found to influence dairy consumption only in France. Further studies are needed to investigate these themes within larger samples, but these findings contribute to understanding dairy (non)consumption in young adults in the UK and France and may aid the development of strategies to improve young adults’ diets.

There are no high-quality data on dietary behaviour of adolescents in India. This study aimed to assess the intake of energy (E), macronutrients and selected micronutrients in a sample of 11–13-year-old schoolchildren in Delhi, India. Participants from private schools (n=10) recorded dietary intake using a 3-d food diary. Information was entered into the dietary assessment tool, Intake24, to ascertain portion size and convert data into nutrient intake through integrated food tables. Of the 514 consenting participants, 393 (76·4 %) (169 girls, 224 boys) aged 11·4 (±1·8) years completed the study. The median (interquartile range (IQR) daily E intake was 2580 (2139·3–2989·8) kcal (10·8 (9·0 − 12·5) MJ) for girls and 2941·5 (2466·7–3599·3) kcal (12·3 (10·3–15·2) MJ) for boys. The median (IQR) daily nutrient intakes for girls and boys respectively were protein 64·6 (54·8–79·3) g, 74·4 (61·4; 89·4) g; carbohydrate 336·5 (285·3–393·6) g, 379·6 (317·8–461·8) g; and saturated fat 45·6 (34·8–58·3) g, 54·6 (41·9–69·5) g. There were no significant between-gender differences in percentage E from protein (10·2 (9·2–11·4)), or carbohydrate (52·4 (48·7–56·7)). Girls obtained less percentage E from saturated fat (16·1 (11·0–18·2) compared with boys 16·3 (14·2–19·1) (P < 0·05). E from saturated fat was above FAO recommendations in >74 % of participants. The estimated average requirement for iron was achieved by < 40 % of girls. In conclusion, strategies to optimise the dietary intake of adolescents in India should focus on preventing excess intakes of E and saturated fat and improving iron intake in girls.

Development of gastrointestinal illness after animal contact at petting farms is well described, as are factors such as handwashing and facility design that may modify transmission risk. However, further field evidence on other behaviours and interventions in the context of Cryptosporidium outbreaks linked to animal contact events is needed. Here, we describe a large outbreak of Cryptosporidium parvum (C. parvum) associated with a multi-day lamb petting event in the south-west of England in 2023 and present findings from a cohort study undertaken to investigate factors associated with illness. Detailed exposure questionnaires were distributed to email addresses of 647 single or multiple ticket bookings, and 157 complete responses were received. The outbreak investigation identified 23 laboratory-confirmed primary C. parvum cases. Separately, the cohort study identified 83 cases of cryptosporidiosis-like illness. Associations between illness and entering a lamb petting pen (compared to observing from outside the pen; odds ratio (OR) = 2.28, 95 per cent confidence interval (95% CI) 1.17 to 4.53) and self-reported awareness of diarrhoeal and vomiting disease transmission risk on farm sites at the time of visit (OR = 0.40, 95% CI 0.19 to 0.84) were observed. In a multivariable model adjusted for household clustering, awareness of disease transmission risk remained a significant protective factor (adjusted OR (aOR) = 0.07, 95% CI 0.01 to 0.78). The study demonstrates the likely under-ascertainment of cryptosporidiosis through laboratory surveillance and provides evidence of the impact that public health messaging could have.

How governments raise tax revenue is at the core of domestic political conflict. Public opinion towards taxation is measured generally and qualitatively by many surveys, but previous research has not closely linked public preferences to the budget problem faced by governments regarding how best to raise or cut a marginal quantity of revenue. We present results from a novel tax preference experiment in which UK respondents are given choices over different tax ‘levers’ that are expected to raise or cut equal revenue. We find that while different tax levers vary substantially in their popularity, there is a ‘hidden consensus’ regarding different tax levers across income levels and partisanship of the respondents.

Following an outbreak of Salmonella Typhimurium in Wales in July 2021 associated with sheep meat and offal, further genetically related cases were detected across the UK. Cases were UK residents with laboratory-confirmed Salmonella Typhimurium in the same 5-single-nucleotide polymorphism (SNP) single-linkage cluster with specimen date between 01/08/2021–2031/12/2022. We described cases using routine (UK) and enhanced (Wales only) surveillance data. Exposures in cases in Wales were compared with non-Typhimurium Salmonella case–controls. Environmental Health Practitioners and the Food Standards Agency investigated supply chains of food premises reported by ≥2 cases. Animal, carcass, and environmental samples taken for diagnostic or monitoring purposes for gastrointestinal pathogens were included in microbiological investigations. We identified 142 cases: 75% in England, 23% in Wales and 3% in Scotland. Median age was 32 years, and 59% were male. Direct contact with sheep was associated with becoming a case (aOR: 14, 95%CI: 1.4–145) but reported by few (6/32 cases). No single food item, premises, or supplier linked all cases. Multi-agency collaboration enabled the identification of isolates in the same 5-SNP single-linkage cluster from a sheep carcass at an English abattoir and in ruminant, wildlife, poultry, and environmental samples, suggesting multiple vehicles and pathways of infection.