Background In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov ( NCT04381936 ). Findings Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research.

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Our objective in this qualitative study was to investigate the acceptance and experience of treatment for postnatal depression (PND). Fifteen women who had received treatment and support from the community mental health service for PND were interviewed. Interviews were transcribed verbatim and then analyzed using the modified analytic induction method. The majority of women interviewed had reached "crisis point" before they sought and received treatment. The stigma attached to an inability to cope and being a "bad mother" emerged as the main barrier to seeking help earlier. In addition, women were unable to differentiate between "normal" levels of postpartum distress and depressive symptoms that might require intervention. Talking about their distress and experiences, both with health professionals and other mothers, was regarded as of primary importance in the recovery process.

This paper reports on a prevalence study of sexual abuse of 65 women and 120 men with intellectual disabilities who were referred for sex education. The prevalence rate of abuse was found to be significantly higher for women (61%) than men (25%). Almost all perpetrators were men, with the majority being men with intellectual disabilities or fathers. Women are shown to experience the sexual contact more negatively than the men, although it was usual for both the women and men to feel quite ambivalent about the perpetrator and what he had done to them. Typically the abuse was revealed by the victims themselves, but they were unaware of its social meaning. Generally responses to the abuse were very weak, however there is evidence that the abuse of men is taken more seriously. The poorest service responses were recorded for women who had been abused by men with intellectual disabilities.

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The aim of this research was to investigate whether, and to what extent, women with learning disabilities were enabled to exercise choice and control when it came to their use of contraception. Semi-structured in-depth interviews were conducted with 23 women with learning disabilities in the UK to explore these issues. Findings suggest that most women with learning disabilities did not make their own decisions and some of those who did, found their choices constrained by various factors, such as their young age, fears of losing their service, and previous traumatic experiences. The over-use of Depo-Provera is discussed, as are the common practices of giving contraception to women who are not sexually active and those whose fertility has declined naturally due to their age. The factors which lead to women's relative lack of autonomy are explored.

Background Contraception is widely prescribed to women with intellectual disabilities, yet little is known about what the women think and feel about this. One of the aims of the study was to explore what women understood and to what extent they were able to exercise choice and control. Method Twenty-three women with mild and moderate intellectual disabilities in South East England were interviewed about their current and past use of contraception, their knowledge of contraception more broadly, the process of being prescribed contraception and sources of information and support. Results Knowledge of how contraception works was very limited and approximately half the women also lacked basic knowledge about reproduction. Few women attended medical appointments alone and none had been given any accessible information about contraception. Conclusions There is a role for increased education, support and advocacy for women with intellectual disabilities when they are prescribed contraception. This would help to ensure women are prescribed methods which are best for them as individuals and to help maximize their participation in the process.

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