Aim: Precarious employment is known to be detrimental to health, and some population subgroups (young individuals, migrant workers, and females) are at higher risk of precarious employment. However, it is not known if the risk to poor health outcomes is consistent across population subgroups. This scoping review explores differential impacts of precarious employment on health. Methods: Relevant studies published between 2009 and February 2019 were identified across PubMed, OVID Medline, PsycINFO, and Scopus. Articles were included if (1) they presented original data, (2) examined precarious employment within one of the subpopulations of interest, and (3) examined health outcomes. Results: Searches yielded 279 unique results, of which 14 met the eligibility criteria. Of the included studies, 12 studies examined differences between gender, 3 examined the health impacts on young individuals, and 3 examined the health of migrant workers. Mental health was explored in nine studies, general health in four studies, and mortality in two studies. Conclusion: Mental health was generally poorer in both male and female employees as a result of precarious employment, and males were also at higher risk of mortality. There was limited evidence that met our inclusion criteria, examining the health impacts on young individuals or migrant workers.

Background This review updates a systematic review published in 2010 (http://www.environmentalevidence.org/completed-reviews/how-effective-is-greening-of-urban-areas-in-reducing-human-exposure-to-ground-level-ozone-concentrations-uv-exposure-and-the-urban-heat-island-effect) which addressed the question: How effective is ‘greening’ of urban areas in reducing human exposure to ground-level ozone concentrations, UV exposure and the ‘urban heat island effect’? Methods Searches of multiple databases and journals for relevant published articles and grey literature were conducted. Organisational websites were searched for unpublished articles. Eligibility criteria were applied at title, abstract and full text and included studies were critically appraised. Consistency checks of these processes were undertaken. Pre-defined data items were extracted from included studies. Quantitative synthesis was performed through meta-analysis and narrative synthesis was undertaken. Review findings 308 studies were included in this review. Studies were spread across all continents and climate zones except polar but were mainly concentrated in Europe and temperate regions. Most studies reported on the impact of urban greening on temperature with fewer studies reporting data on ground-level UV radiation, ozone concentrations (or precursors) or public health indicators. The findings of the original review were confirmed; urban green areas tended to be cooler than urban non-green areas. Air temperature under trees was on average 0.8 °C cooler but treed areas could be warmer at night. Cooling effect showed tree species variation. Tree canopy shading was a significant effect modifier associated with attenuation of solar radiation during the day. Urban forests were on average 1.6 °C cooler than comparator areas. Treed areas and parks and gardens were associated with improved human thermal comfort. Park or garden cooling effect was on average 0.8 °C and trees were a significant influence on this during the day. Park or garden cooling effect extended up to 1.25 kms beyond their boundaries. Grassy areas were cooler than non-green comparators, both during daytime and at night, by on average 0.6 °C. Green roofs and walls showed surface temperature cooling effect (2 and 1.8 °C on average respectively) which was influenced by substrate water content, plant density and cover. Ground-level concentrations of nitrogen oxides were on average lower by 1.0 standard deviation units in green areas, with tree species variation in removal of these pollutants and emission of biogenic volatile organic compounds (precursors of ozone). No clear impact of green areas on ground level ozone concentrations was identified. Conclusions Design of urban green areas may need to strike a balance between maximising tree canopy shading for day-time thermal comfort and enabling night-time cooling from open grassy areas. Choice of tree species needs to be guided by evapotranspiration potential, removal of nitrogen oxides and emission of biogenic volatile organic compounds. Choice of plant species and substrate composition for green roofs and walls needs to be tailored to local thermal comfort needs for optimal effect. Future research should, using robust study design, address identified evidence gaps and evaluate optimal design of urban green areas for specific circumstances, such as mitigating day or night-time urban heat island effect, availability of sustainable irrigation or optimal density and distribution of green areas. Future evidence synthesis should focus on optimal design of urban green areas for public health benefit.

The COVID-19 pandemic has resulted in increased demand and delays to diagnostic services. Community diagnostic centres (which are generally referred to as Regional Diagnostic Hubs in Wales) aim to reduce this backlog and the waiting times for patients by providing a broad range of elective diagnostic services in the community, away from acute hospital facilities. As diagnostic services account for over 85% of clinical pathways and cost the National Health Service (NHS) over six billion pounds a year (NHS 2022), community diagnostic centres across a broader range of diagnostic services may be an effective, efficient, and cost-effective introduction to the UK health sector. This Rapid Evidence Map aimed to identify, describe, and map the available evidence on the effectiveness of diagnostic centres. 50 primary studies were identified. Studies were published between 1995 and 2021: A wide range of study designs were used, and studies were conducted in a range of countries including the UK. 30 studies were specific to cancer diagnosis, whilst the remaining 20 studies focused on diagnosis associated with: anaemia, autism, cerebral palsy, intellectual disability, multiple sclerosis, respiratory conditions, shoulder pain, and unexplained fever Eleven studies reported information on multi-condition diagnostic centres, rather than a specific condition. The majority of studies were conducted within hospital settings. Two studies evaluated diagnostic centres within a community setting. The diagnostic centres offered a wide range of diagnostic tests and incorporated different staff and facilities. Participants were mainly referred by GPs, primary care centres and emergency departments. However, referrals were also made from outpatient clinics located within the same hospital as the diagnostic centre. Over 100 different outcomes were reported covering: patient data and referral outcomes, clinical outcomes, performance outcomes, economic outcomes, and patient and physician-reported outcomes. The findings of this rapid evidence map were used to select a substantive focus for a subsequent rapid review on community diagnostic centres that can be accessed by primary care teams.

Surgical waiting times have reached a record high, in particular with elective and non-emergency treatments being suspended or delayed during the COVID-19 pandemic. Prolonged waits for surgery can impact negatively on patients who may experience worse health outcomes, poor mental health, disease progression, or even death. Time spent waiting for surgery may be better utilised in preparing patients for surgery. This rapid review sought to identify innovations to support patients on surgical waiting lists to inform policy and strategy to address the elective surgical backlog in Wales. The review is based on the findings of existing reviews with priority given to robust evidence synthesis using minimum standards (systematic search, study selection, quality assessment, and appropriate synthesis). The search dates for prioritised reviews ranged from 2014-2021. Forty-eight systematic reviews were included. Most available evidence is derived from orthopaedic surgery reviews which may limit generalisability. The findings show benefits of exercise, education, smoking cessation, and psychological interventions for patients awaiting elective surgery. Policymakers, educators, and clinicians should consider recommending such interventions to be covered in curricula for health professionals. Further research is required to understand how various patient subgroups respond to preoperative interventions, including those from underserved and minority ethnic groups, more deprived groups and those with lower educational attainments. Further research is also needed on social prescribing or other community-centred approaches. It is unclear what impact the pandemic (and any associated restrictions) could have on the conduct or effectiveness of these interventions.