The profile of public health professionals (PHPs) and COVID-19 preparedness is assessed against the employment outcomes (EO), precarious employment (PE), and job satisfaction (JS) of the European Public Health Master programme alumni. The study is descriptive, crosssectional, conducted from May-October 2020. A survey was developed to assess the EO, PE and JS. Participants were recruited by email. SPSS statistics 26 version was used to perform descriptive analysis. A total of 189 PHPs participated (65% response) with majority women (66%), the mean age was 36 years. Participants were employed (80%), in non-governmental organisations (20%), and academia (19%). Common employment positions were managerial (37%) and consultancy (18%). Majority of PHPs were exposed to PE (81%), the most frequent elements were 'temporary employment' (54%), and 'the lack of labour union' (53%). The JS of PHPs was 'satisfied'. A blend of scientific public health knowledge and interpersonalThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Objective Cancer of unknown primary (CUP) is a metastatic malignancy with an unidentifiable primary tumour origin. Previous studies suggest that type 2 diabetes mellitus (T2DM) and CUP risk are associated. This study examines the association in greater depth by investigating T2DM status, T2DM duration, T2DM age at diagnosis, and medication that was being used in relation to CUP. Methods Data were utilized from the Netherlands Cohort Study, a prospective cohort that includes 120 852 participants aged 55–69 years at baseline in 1986. All participants completed a self-administered questionnaire on cancer risk factors. CUP cases were identified through record linkage with the Netherlands Cancer Registry and Dutch Pathology Registry. After 20.3 years of follow-up, 963 incident CUP cases and 4288 subcohort members were available for case-cohort analyses. Proportional hazards models were employed to estimate multivariable-adjusted hazard ratios (HRs). Results Overall, we observed a nonsignificant positive association between T2DM status and CUP risk [HR, 1.35; 95% confidence interval (CI), 0.92–1.99], which increased in women after stratification for sex (HR, 1.55; 95% CI, 0.90–2.64). For participants who were aged less than 50 years at diagnosis of T2DM, a statistically significant positive association was found in relation to CUP (HR, 2.42; 95% CI, 1.26–4.65), compared with participants without T2DM. Conclusion Our findings indicate that there is a nonsignificant positive association between T2DM and CUP risk and that the association became stronger in women in stratified analyses.

Background The unequal distribution of academic and professional outcomes between different minority groups is a pervasive issue in many fields, including surgery. The implications of differential attainment remain significant, not only for the individuals affected but also for the wider health care system. An inclusive health care system is crucial in meeting the needs of an increasingly diverse patient population, thereby leading to better outcomes. One barrier to diversifying the workforce is the differential attainment in educational outcomes between Black and Minority Ethnic (BME) and White medical students and doctors in the United Kingdom. BME trainees are known to have lower performance rates in medical examinations, including undergraduate and postgraduate exams, Annual Review of Competence Progression, as well as training and consultant job applications. Studies have shown that BME candidates have a higher likelihood of failing both parts of the Membership of the Royal Colleges of Surgeons exams and are 10% less likely to be considered suitable for core surgical training. Several contributing factors have been identified; however, there has been limited evidence investigating surgical training experiences and their relationship to differential attainment. To understand the nature of differential attainment in surgery and to develop effective strategies to address it, it is essential to examine the underlying causes and contributing factors. The Variation in Experiences and Attainment in Surgery Between Ethnicities of UK Medical Students and Doctors (ATTAIN) study aims to describe and compare the factors and outcomes of attainment between different ethnicities of doctors and medical students. Objective The primary aim will be to compare the effect of experiences and perceptions of surgical education of students and doctors of different ethnicities. Methods This protocol describes a nationwide cross-sectional study of medical students and nonconsultant grade doctors in the United Kingdom. Participants will complete a web-based questionnaire collecting data on experiences and perceptions of surgical placements as well as self-reported academic attainment data. A comprehensive data collection strategy will be used to collect a representative sample of the population. A set of surrogate markers relevant to surgical training will be used to establish a primary outcome to determine variations in attainment. Regression analyses will be used to identify potential causes for the variation in attainment. Results Data collected between February 2022 and September 2022 yielded 1603 respondents. Data analysis is yet to be competed. The protocol was approved by the University College London Research Ethics Committee on September 16, 2021 (ethics approval reference 19071/004). The findings will be disseminated through peer-reviewed publications and conference presentations. Conclusions Drawing upon the conclusions of this study, we aim to make recommendations on educational policy reforms. Additionally, the creation of a large, comprehensive data set can be used for further research. International Registered Report Identifier (IRRID) DERR1-10.2196/40545

Aim Which theories, concepts and frameworks have been evidenced for surgical innovation in leadership in the United Kingdom, European Union, and the United States of America? Method Systematic scoping synthesis of literature will be employed where appropriate theories, concepts and frameworks will be identified. Drawing upon broader literature on leadership innovation in surgery further examples will be utilised within surgery. s and full- text articles will be used and reviewed for relevance to the research question against an inclusion and exclusion criteria. Results The theories of innovative leadership in surgery are broad and non-specific. It demands a professionalism, competence, teamwork, and motivation. Upon comparison of the three country/region profiles there are strong similarities but present differences. It is paramount to understand and underpin these theories in order to foster the future of innovation in surgery. Surgery is fast evolving and developments in leadership must evolve with it. Within innovation, leadership skills must be harnessed including experience and observation. It is through an interprofessional team that surgeons must collaborate in order to provide optimum results and to permit the profession to evolve. Conclusions Innovation and surgery are symbiotic, and the next generation of surgical leaders must foster an environment where this is possible to cultivate. Programmes across these country profiles must ensure innovative leadership is present through good mentorship, coaching, team empowerment and feedback. Future directions must be put in place in post -graduate surgical training programmes to ensure that patient care is optimised as the primary objective.

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