Vaping among children and young people (CYP) has increased globally over the past decade, with rates stabilising in the UK in recent years. Factors such as curiosity, social influence, stress management and attractive flavours contribute to its popularity. Although the long-term health impacts are uncertain, vaping poses risks including nicotine dependence, cardiovascular and respiratory issues, and cognitive impairment, though evidence on long-term effects is still emerging. Despite established smoking cessation programmes for adults, tailored resources for vaping cessation among CYP remain scarce, particularly within healthcare settings, which offer unique opportunities for professional intervention and ongoing support. The objective of this review is to assess the extent and nature of available literature on interventions delivered in healthcare settings to support vaping cessation among CYP under the age of 18 years.

This scoping review will include studies targeting CYP under the age of 18 years, specifically focusing on interventions delivered within healthcare settings. Studies outside healthcare contexts or those without healthcare provider involvement will be excluded. Additionally, interventions delivered solely to parents or carers will not be considered.

A comprehensive search will be conducted in MEDLINE, Embase, Web of Science, Cochrane Library and CINAHL from January 2004 to present, with additional grey literature from sources including grey literature repositories and Google Scholar. Results will be imported into Rayyan for screening, with two independent reviewers assessing studies for inclusion. Data extraction will include study design, population characteristics (including explicit age ranges, specifically CYP under 18 years), intervention details and outcomes. A descriptive synthesis will map study characteristics, while thematic analysis will identify intervention themes and healthcare contexts.

Ethics approval is not required for this secondary analysis. Findings will be disseminated through publication, conference presentations and shared with public health stakeholders.

Psychological trauma is a major public health concern, with high rates of exposure among the population. Within paediatric healthcare settings, exposure can be substantial.1 Such experiences are not always ‘one off’ events but are closely related to adverse childhood experiences (ACEs) such as abuse by caregivers, family dysfunction, parental mental health issues, substance abuse or domestic abuse. Such exposure can have a significant impact on child development, resulting in significantly poorer physical and mental...

To estimate the association between weight and cardiometabolic risk factors across subgroups of individuals with normoglycaemia, non-diabetic hyperglycaemia and type 2 diabetes (T2D) and to explore whether the association differs between weight loss and weight gain.

Observational analysis using mixed-effects regression models of pooled trial data.

The Weight loss Referral for Adults in Primary care (n=1267) and Glucose Lowering through Weight management (n=577) trials recruited individuals with overweight or obesity (body mass index, BMI >25 kg/m²) from primary care practices across England.

The primary outcome measures were the relationships between a change in (BMI; kg/m²) and a change in glycated haemoglobin (HbA_1c; mmol/mol), total cholesterol (mmol/L) or systolic blood pressure (SBP; mm Hg) across three subgroups of individuals with: normoglycaemia, non-diabetic hyperglycaemia and T2D. Secondary outcomes included the influence of weight loss versus weight gain on these relationships.

HbA_1c is positively related to a change in BMI, and a 1 kg/m² change was related to a 1.5 mmol/mol (95% CI: 1.1 to 1.9) change in HbA_1c in individuals with T2D, 0.6 mmol/mol (95% CI: 0.4 to 0.8) change in those with non-diabetic hyperglycaemia and 0.3 mmol/mol (95% CI: 0.2 to 0.4) change in those with normoglycaemia. In individuals with normoglycaemia, weight gain has a larger impact on HbA_1c than weight loss, with a 0.5 mmol/mol (95% CI: 0.3 to 0.7) increase per 1 kg/m2 gained, compared with a relationship that is 0.3 mmol/mol smaller (95% CI: –0.6 to –0.1) per 1 kg/m² of weight loss. BMI reduction improved SBP and total cholesterol significantly; however, effects did not differ between the three subgroups.

Cardiometabolic risk factors are associated with changes in weight. The association with HbA_1c varies by diabetes status, with increasing magnitude in those with non-diabetic hyperglycaemia and T2D. Weight gain has a larger impact on HbA_1c than weight loss in individuals with normoglycaemia, implying an asymmetric relationship.

The healthcare workforce is in crisis. Despite a competitive selection process, a substantial number of doctors leave specialty training (ST) programmes prematurely. This attrition causes increased costs for the National Health Service, exacerbates workforce shortages and threatens quality and safety of care. It also increases pressure on trainees who remain, further compounding the risk of attrition. There is an urgent need to understand why doctors leave ST in order to find ways to maintain the training pipeline from ST to consultant.

We aimed to understand what is known about why doctors choose to leave ST programmes in secondary care, to map current knowledge and identify avenues for future research.

All studies which investigated why doctors leave ST programmes in secondary care were included.

Ovid Medline, Web of Science, SCOPUS and EMBASE were searched until January 2024. Descriptive codes were assigned to the findings of each study. These descriptive codes were reviewed and grouped together in broader categories.

Data was extracted and charted, and a qualitative content approach was used to synthesise data.

A total of 6079 potentially relevant abstracts were retrieved, of which 23 were included in the final analysis. This included the experience of 1896 doctors who have left training and 454 programme directors. Doctors chose to leave training programmes because (1) they felt unsupported and underappreciated, (2) training was associated with unacceptable personal costs and (3) career prospects were unattractive.

There is a mismatch between trainees’ expectations of ST and the reality of being a trainee in ST. Understanding the issues which drive attrition and developing evidence-based solutions, has the potential to both reduce attrition, and improve the training experience for doctors in training more widely.