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Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is a chronic, relapsing-remitting condition associated with increased morbidity. Previous research has shown patients with AAV report high levels of fatigue, pain, depression and anxiety. Over recent years successful work has been carried out to improve clinical outcomes, resulting in reduced mortality and end stage kidney disease (ESKD). Despite this, little work has been done to better understand the role of the patient within this condition. The prevalence of AAV is increasing and to date, there is a shortage of specific tools that assess and measure key features relating to patient reported outcomes (PROs). This protocol details how we can better understand the lived experiences of those with AAV through the development of a disease specific, patient reported outcome measure (PROM), to be used in clinic practice. This will allow us to recognise and validate PROs and the impact the disease and its treatment has on patients' health related quality of life (HRQoL). In addition, we aim to identify potential differences in PRO's between demographics, organ involvement and treatment subgroups in AAV as well as outcomes relating to the patient experience. Patients from a single centre in the UK will be recruited to take part in the exploratory qualitative study which will include focus groups and semi-structured interviews. The inclusion criteria comprise anyone with a diagnosis of AAV and willing to participate, including those who have active or relapsing disease, those are economically active, unemployed, retired and patients receiving renal replacement therapy. The aim of the project is to identify key issues patients experience in relation to their disease and its management and how these can be better assessed in a new PROM developed for use in the clinic setting. This will enable better delivery of individualised care and inform shared decision making, while also serving as a platform for future research looking at PROs in other glomerulonephritides. [ABSTRACT FROM AUTHOR]

Over the last decade, British universities have become increasingly reliant on an instrumentalist rhetoric to defend the ongoing relevance of research and teaching in the Humanities. This has resulted in a new chapter in the long-running saga concerning the crisis (purported or real) of Modern Languages alongside the study of literature. The very flexibility condemning traditional Modern Languages curricula to the past nevertheless offers new opportunities for literary study when used for the development of new skills. In this article, I employ my experience of a research-led undergraduate project on the UK stage legacy of Federico García Lorca as a case study to suggest ways in which the study of literature and theatre might be revamped. [ABSTRACT FROM AUTHOR]

This article considers how undocumented youth in the UK survive and construct their everyday lives in precarious circumstances. Drawing on multiple in-depth narrative interviews with (n = 7) undocumented youth, I illustrate how these young people focus on the future and engage in purposeful activities as a way of enduring the everyday challenges of living with no papers. I reflect on the relationships, which young people draw on to enable them to endure adversity and rebuild their everyday lives. I conclude that the presence of love and community is critical for young people's survival, safety and wellbeing, and I suggest how practitioners and researchers might make use of these findings. [ABSTRACT FROM AUTHOR]

Plain language summary: Over one‐quarter of women in the UK have a caesarean birth (CB). More than one in 20 of these births occurs near the end of labour, when the cervix is fully dilated (second stage). In these circumstances, and when labour has been prolonged, the baby's head can become lodged deep in the maternal pelvis making it challenging to deliver the baby. During the caesarean birth, difficulty in delivery of the baby's head may result – this emergency is known as impacted fetal head (IFH). These are technically challenging births that pose significant risks to both the woman and baby. Complications for the woman include tears in the womb, serious bleeding and longer hospital stay. Babies are at increased risk of injury including damage to the head and face, lack of oxygen to the brain, nerve damage, and in rare cases, the baby may die from these complications. Maternity staff are increasingly encountering IFH at CB, and reports of associated injuries have risen dramatically in recent years. The latest UK studies suggest that IFH may complicate as many as one in 10 unplanned CBs (1.5% of all births) and that two in 100 babies affected by IFH die or are seriously injured. Moreover, there has been a sharp increase in reports of babies having brain injuries when their birth was complicated by IFH. When an IFH occurs, the maternity team can use different approaches to help deliver the baby's head at CB. These include: an assistant (another obstetrician or midwife) pushing the head up from the vagina; delivering the baby feet first; using a specially designed inflatable balloon device to elevate the baby's head and/or giving the mother a medicine to relax the womb. However, there is currently no consensus for how best to manage these births. This has resulted in a lack of confidence among maternity staff, variable practice and potentially avoidable harm in some circumstances. This paper reviews the current evidence regarding the prediction, prevention and management of IFH at CB, integrating findings from a systematic review commissioned from the National Guideline Alliance. [ABSTRACT FROM AUTHOR]

To improve the storage and transport of clinical specimens for the diagnosis of Neisseria meningitidis (Nm) infections in resource-limited settings, we have evaluated the performance of dried blood spot (DBS) and dried cerebrospinal fluid spot (DCS) assays. DBS and DCS were prepared on filter paper from liquid specimens previously tested for Nm in the United Kingdom. Nm was detected and genogrouped by real-time PCR performed on crude genomic DNA extracted from the DBS (n = 226) and DCS (n = 226) specimens. Targeted whole-genome sequencing was performed on a subset of specimens, DBS (n = 4) and DCS (n = 6). The overall agreement between the analysis of liquid and dried specimens was (94.2%; 95% CI 90.8–96.7) for blood and (96.4%; 95% CI 93.5–98.0) for cerebrospinal fluid. Relative to liquid specimens as the reference, the DBS and DCS assays had sensitivities of (89.1%; 95% CI 82.7–93.8) and (94.2%; 95% CI 88.9–97.5), respectively, and both assays had specificities above 98%. A genogroup was identified by dried specimen analysis for 81.9% of the confirmed meningococcal infections. Near full-length Nm genome sequences (>86%) were obtained for all ten specimens tested which allowed determination of the sequence type, clonal complex, presence of antimicrobial resistance and other meningococcal genotyping. Dried blood and CSF filter spot assays offer a practical alternative to liquid specimens for the molecular and genomic characterisation of invasive meningococcal diseases in low-resource settings. [ABSTRACT FROM AUTHOR]

As UK cities and towns become increasingly ethnically and culturally diverse, researchers have tuned into how people inhabit multiculturalism. Ethnographic approaches have focused on the kind of togetherness that people generate as they go about their everyday lives, observing the affective textures of interactions and happenings of the here and now in granular detail. Missing from these accounts is what crowdsourced data might add to understandings of how multicultural places are experienced. What is vital about this kind of data is that it is 'big', involving a diversity of voices similarly intent on messaging their experiences, presenting opportunities to scale up the affect of encounters and to quantify what is difficult to qualify. This paper brings Digital Geographies into conversation with research on everyday multiculturalism to examine qualitatively and quantitatively how social media use folds into and expresses various practices of sociality and connection. Our paper involves Twitter, Nando's and the city of Leicester in the UK to challenge and advance ways of understanding everyday multiculturalism in an era of global migration and ethnically complex populations. [ABSTRACT FROM AUTHOR]

The article presents the discussion on claims about the nutritional and health benefits of foods and drinks Position Paper emphasises the learnings gaining through the implementation of the European Food Safety Authority evidence‐based process for assessment of proposed claims; and main audience for the Academy's work is the nutrition science community/profession and its stakeholders.

Background: Novel survey methods are needed to tackle declining response rates. The 2020 National Maternity Survey included a randomised controlled trial (RCT) and social media survey to compare different combinations of sampling and data collection methods with respect to: response rate, respondent representativeness, prevalence estimates of maternity indicators and cost. Methods: A two-armed parallel RCT and concurrent social media survey were conducted. Women in the RCT were sampled from ONS birth registrations and randomised to either a paper or push-to-web survey. Women in the social media survey self-selected through online adverts. The primary outcome was response rate in the paper and push-to-web surveys. In all surveys, respondent representativeness was assessed by comparing distributions of sociodemographic characteristics in respondents with those of the target population. External validity of prevalence estimates of maternity indicators was assessed by comparing weighted survey estimates with estimates from national routine data. Cost was also compared across surveys. Results: The response rate was higher in the paper survey (n = 2,446) compared to the push-to-web survey (n = 2,165)(30.6% versus 27.1%, difference = 3.5%, 95%CI = 2.1–4.9, p < 0.0001). Compared to the target population, respondents in all surveys were less likely to be aged < 25 years, of Black or Minority ethnicity, born outside the UK, living in disadvantaged areas, living without a partner and primiparous. Women in the social media survey (n = 1,316) were less representative of the target population compared to women in the paper and push-to-web surveys. For some maternity indicators, weighted survey estimates were close to estimates from routine data, for other indicators there were discrepancies; no survey demonstrated consistently higher external validity than the other two surveys. Compared to the paper survey, the cost saving per respondent was £5.45 for the push-to-web survey and £22.42 for the social media survey. Conclusions: Push-to-web surveys may cost less than paper surveys but do not necessarily result in higher response rates. Social media surveys cost significantly less than paper and push-to-web surveys, but sample size may be limited by eligibility criteria and recruitment window and respondents may be less representative of the target population. However, reduced representativeness does not necessarily introduce more bias in weighted survey estimates. [ABSTRACT FROM AUTHOR]

The coronavirus (COVID-19) pandemic disrupted all surgical specialties significantly and exerted additional pressures on the overburdened United Kingdom (UK) National Health Service. Healthcare professionals in the UK have had to adapt their practice. In particular, surgeons have faced organisational and technical challenges treating patients who carried higher risks, were more urgent and could not wait for prehabilitation or optimisation before their intervention. Furthermore, there were implications for blood transfusion with uncertain patterns of demand, reductions in donations and loss of crucial staff because of sickness and public health restrictions. Previous guidelines have attempted to address the control of bleeding and its consequences after cardiothoracic surgery, but there have been no targeted recommendations in light of the recent COVID-19 challenges. In this context, and with a focus on the perioperative period, an expert multidisciplinary Task Force reviewed the impact of bleeding in cardiothoracic surgery, explored different aspects of patient blood management with a focus on the use of haemostats as adjuncts to conventional surgical techniques and proposed best practice recommendations in the UK. [ABSTRACT FROM AUTHOR]

Background The Medical Certificate of Stillbirth (MCS) records data about a baby's death after 24 weeks of gestation but before birth. Major errors that could alter interpretation of the MCS were widespread in two UK-based regional studies. Methods A multicentre evaluation was conducted, examining MCS issued 1 January 2018 to 31 December 2018 in 76 UK obstetric units. A systematic case-note review of stillbirths was conducted by Obstetric and Gynaecology trainees, generating individual 'ideal MCSs' and comparing these to the actual MCS issued. Anonymized central data analysis described rates and types of error, agreement and factors associated with major errors. Results There were 1120 MCSs suitable for assessment, with 126 additional submitted data sets unsuitable for accuracy analysis (total 1246 cases). Gestational age demonstrated 'substantial' agreement [K = 0.73 (95% CI 0.70–0.76)]. Primary cause of death (COD) showed 'fair' agreement [K = 0.26 (95% CI 0.24–0.29)]. Major errors [696/1120; 62.1% (95% CI 59.3–64.9%)] included certificates issued for fetal demise at <24 weeks' gestation [23/696; 3.3% (95% CI 2.2–4.9%)] or neonatal death [2/696; 0.3% (95% CI 0.1–1.1%)] or incorrect primary COD [667/696; 95.8% (95% CI 94.1–97.1%)]. Of 540/1246 [43.3% (95% CI 40.6–46.1%)] 'unexplained' stillbirths, only 119/540 [22.0% (95% CI 18.8–25.7%)] remained unexplained; the majority were redesignated as either fetal growth restriction [FGR: 195/540; 36.1% (95% CI 32.2–40.3%)] or placental insufficiency [184/540; 34.1% (95% CI 30.2–38.2)]. Overall, FGR [306/1246; 24.6% (95% CI 22.3–27.0%)] was the leading primary COD after review, yet only 53/306 [17.3% (95% CI 13.5–22.1%)] FGR cases were originally attributed correctly. Conclusion This study demonstrates widespread major errors in MCS completion across the UK. MCS should only be completed following structured case-note review, with particular attention on the fetal growth trajectory. [ABSTRACT FROM AUTHOR]

The present study is aimed toward examining the attention received by research papers through social and electronic media in business research. In recent years, altmetrics has emerged as a complementary measure of the impact of research works besides citation analysis and bibliometrics. Using the altmetric attention score (AAS) the paper is the first research of its kind to shed light on the characteristics of 100 papers receiving the highest online attention. Various predictors of online engagement with articles in business research journals having an impact factor greater than 6 are discussed. Data was collected from the Dimensions.ai database and analyzed using R statistical software. It is found that the Journal of Business Ethics contributed maximum papers with the highest AAS followed by the Journal of Business Research. Using the Kruskal-Wallis rank-sum test it was determined that AAS in business research is dependent upon article type, topics, and journal of publication. Most of the papers in high impact factor business journals have been contributed by the authors of USA, UK and China. [ABSTRACT FROM AUTHOR]

Plain language summary: Increasingly, births around the world are started artificially using medications or other methods. This process is known as induction of labour. As it becomes more common, methods are needed to meet the different clinical needs and birth preferences of women. Induction of labour typically includes a combination of the medication dinoprostone inserted into the vagina, artificial rupture of membranes ('releasing the waters'), and synthetic oxytocin (hormone given via a drip). This paper reviews some of the methods less commonly used for induction in the UK, namely a drug called misoprostol, which can be given orally or vaginally, and 'mechanical' methods, where labour is started by stretching the cervix (neck of the womb), most commonly with a soft silicone tube with a balloon near the tip, filled with water. Low‐dose oral misoprostol tablets are now commercially available in the UK. Other methods for labour induction are not reviewed in detail in this paper. The evidence suggests mechanical induction of labour (using a balloon catheter) and misoprostol are both at least as safe and effective as using the standard drug, dinoprostone. There is evidence to suggest a balloon catheter may reduce the chance of serious negative outcomes for babies when compared with dinoprostone, and that giving low‐dose oral misoprostol results in fewer caesarean births. Where possible and after informed consent, the method of induction of labour should be personalised to suit the individual woman, her clinical condition, and the setting in which she is giving birth. Local contexts and resources also need to be taken into account. To date, research into women's perspectives and experiences of induction of labour have been significantly lacking. [ABSTRACT FROM AUTHOR]

Mending tears in translucent papers is a challenging task that requires mending materials with specific mechanical and optical properties. Recently, translucent films from microfibrillated cellulose have been suggested as an attractive alternative to traditional repair materials. We prepared custom films from a commercial microfibrillated cellulose suspension and compared their mechanical and optical properties as mending supports with commercially manufactured microfibrillated cellulose films and Japanese tissue. Tear mending of modern and historic translucent paper samples using the custom-made films and Klucel G or isinglass as adhesives showed satisfactory strength and resilience, and accelerated ageing tests yielded acceptable visual results. A case study on a translucent paper document from the collection of The National Archives, UK, is detailed. We conclude that custom-made tear mending materials from commercially available microfibrillated cellulose suspensions present a cost-effective and attractive approach for the mending of translucent papers. [ABSTRACT FROM AUTHOR]

Objective: The Patient Information Leaflet (PIL) is an authoritative document that all people with epilepsy in the EU receive when prescribed antiseizure medication (ASM). We undertook the first independent, comprehensive assessment to determine how understandable they are. Regulators state that when patients are asked comprehension questions about them, ≥80% should answer correctly. Also, recommended is that PILs have a maximum reading requirement of US grade 8. Methods: Study 1: We obtained 140 current ASM PILs written in English. "Readability" was assessed using four tests, with and without adjustment for influence of familiar, polysyllabic words. A total of 179 online materials on epilepsy were also assessed. Study 2: Two PILs from Study 1 were randomly selected (Pregabalin Focus; Inovelon) and shown to 35 people from the UK epilepsy population. Their comprehension was assessed. Study 3: To understand whether the student population provides an accessible alternative population for future examination of ASM PILs, Study 3 was completed, using the same methods as Study 2, except that participants were 262 UK university students. Results: Study 1: No PIL had a reading level of grade 8. Median was grade 11. Adjusting for context, the PILs were still at grade 10.5. PILs for branded ASMs were most readable. PILs were no more readable than (unregulated) online materials. Study 2: Users struggled to comprehend the PILs' key messages. The eight questions asked about pregabalin were typically answered correctly by 54%. For Inovelon, it was 62%. Study 3: Most student participants comprehended the PILs' key messages. The questions about Inovelon were answered correctly by 90%; for pregabalin it was 86%. Significance: This is the first independent and comprehensive examination of ASM PILs. It found that PILs being used fail to meet recommendations and regulatory requirements and risk not being understandable to a substantial proportion of users. In finding that people from the epilepsy population differ markedly in comprehension of PILs compared to students, this study highlights the importance of completing user testing with the target population. [ABSTRACT FROM AUTHOR]

ChatGPT could allow students to plagiarize the content of their coursework with little risk of detection. Little is known about undergraduate willingness to use AI tools. In this study, psychology undergraduates (N = 160) from the United Kingdom, indicated their willingness to use, and history of using, ChatGPT to write university assignments. Almost a third (32%) indicated that they would use such tools; 15% indicated that they had used them already. Neither personality (conscientiousness, agreeableness, Machiavellianism, narcissism), academic performance, nor study skills self-efficacy could predict future use of AI tools. A novel Degree Apathy Scale was the only significant predictor. Willingness to use AI tools was greater when the risk of getting caught was low, and punishment was light, particularly for those high in degree apathy. Findings suggest that degree apathy is a key risk factor in academic misconduct. Wider research and pedagogical applications of degree apathy are discussed. • Thirty-two percent of students surveyed reported that they would use ChatGPT on future academic assignments. • Future use of AI tools was significantly predicted by a new Degree Apathy Scale. • Big Five and Dark Triad scores were not significant predictors, nor was previous academic performance. • Likelihood of cheating using ChatGPT was reduced with increasing risk of detection or severity of punishment. [ABSTRACT FROM AUTHOR]

In this academic comic (or acadomic) I reflect on impacts to the creative process when reconceptualizing and recontextualizing a comics-based research (CBR) project as an acadomic for an edited book during the Covid-19 pandemic. The lockdowns intensified computer-mediated-communication (CMC) and I am compelled by two years of virtually exclusive engagement with digital technologies to explore the impact unrestrained online activities have on my creative comics practice, on my conceptions of research, and on my experiences as a teacher. Analysis of this process and its impacts is realized through a mixed research methodology that explores the impacts of conceptualizing and making an earlier acadomic, which in turn documents a comics-based research project between university students and a national charity as they successfully collaborate on the creation of a graphic novel. I probe the boundaries of academic writing by visualizing and performing Baudrillard's theoretical violence to critique digital intensification through metaphor, semiotics, and comics. The work for this article was undertaken during the rolling pandemic lockdowns in the UK and around the world from 2020 to 2022. Academic theory and the medium of comics problematize the digital simulacrum as I action a utopian pedagogy that supports balance between traditional and digital techniques. [ABSTRACT FROM AUTHOR]

Plain language summary: This paper deals with the use of hormone replacement therapy (HRT) after the removal of fallopian tubes and ovaries to prevent ovarian cancer in premenopausal high risk women. Some women have an alteration in their genetic code, which makes them more likely to develop ovarian cancer. Two well‐known genes which can carry an alteration are the BRCA1 and BRCA2 genes. Examples of other genes associated with an increased risk of ovarian cancer include RAD51C, RAD51D, BRIP1, PALB2 and Lynch syndrome genes. Women with a strong family history of ovarian cancer and/or breast cancer, may also be at increased risk of developing ovarian cancer. Women at increased risk can choose to have an operation to remove the fallopian tubes and ovaries, which is the most effective way to prevent ovarian cancer. This is done after a woman has completed her family. However, removal of ovaries causes early menopause and leads to hot flushes, sweats, mood changes and bone thinning. It can also cause memory problems and increases the risk of heart disease. It may reduce libido or impair sexual function. Guidance on how to care for women following preventative surgery who are experiencing early menopause is needed. HRT is usually advisable for women up to 51 years of age (average age of menopause for women in the UK) who are undergoing early menopause and have not had breast cancer, to minimise the health risks linked to early menopause. For women with a womb, HRT should include estrogen coupled with progestogen to protect against thickening of the lining of the womb (called endometrial hyperplasia). For women without a womb, only estrogen is given. Research suggests that, unlike in older women, HRT for women in early menopause does not increase breast cancer risk, including in those who are BRCA1 and BRCA2 carriers and have preventative surgery. For women with a history of receptor‐negative breast cancer, the gynaecologist will liaise with an oncology doctor on a case‐by‐case basis to help to decide if HRT is safe to use. Women with a history of estrogen receptor‐positive breast cancer are not normally offered HRT. A range of other therapies can be used if a woman is unable to take HRT. These include behavioural therapy and non‐hormonal medicines. However, these are less effective than HRT. Regular exercise, healthy lifestyle and avoiding symptom triggers are also advised. Whether to undergo surgery to reduce risk or not and its timing can be a complex decision‐making process. Women need to be carefully counselled on the pros and cons of both preventative surgery and HRT use so they can make informed decisions and choices. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various articles on topics including ENT specialist training in the United Kingdom, providing valuable insights for aspiring ENT surgeons regarding portfolio building, competitiveness of the process, and strategies for success.

Harmful Sexual Behaviour (HSB) has been regularly documented as a demanding area of practice within the United Kingdom (UK). The aim of this paper is to share a practice model developed in an under-resourced inner London borough. The HSB forum is formed of a multi-agency group of professionals and runs monthly providing a platform for practitioners to seek consultation for young people they are working with who are displaying HSB's. Initial feedback for the forum from practitioners has been consistently positive and they have valued specifically the opportunity to formulate, have clear directions, and the multi-disciplinary perspective. In addition, most reported feeling empowered to implement the recommendations suggested. Given the shared vulnerability factors between those displaying HSB's and other at-risk young people such as those who are being sexually exploited, this model provides an innovative way that practitioners can be supported by multiple agencies where there is a lack of specialist services. [ABSTRACT FROM AUTHOR]

Background: Patients who are critically ill are at increased risk of hospital acquired pneumonia and ventilator associated pneumonia. Effective evidence based oral care may reduce the incidence of such iatrogenic infection. Aim: To provide an evidence‐based British Association of Critical Care Nurses endorsed consensus paper for best practice relating to implementing oral care, with the intention of promoting patient comfort and reducing hospital acquired pneumonia and ventilator associated pneumonia in critically ill patients. Design: A nominal group technique was adopted. A consensus committee of adult critical care nursing experts from the United Kingdom met in 2018 to evaluate and review the literature relating to oral care, its application in reducing pneumonia in critically ill adults and to make recommendations for practice. An elected national board member for the British Association of Critical Care Nurses chaired the round table discussion. Methods: The committee focused on 5 aspects of oral care practice relating to critically ill adult patients. The evidence was evaluated for each practice within the context of reducing pneumonia in the mechanically ventilated patient or pneumonia in the non‐ventilated patient. The five practices included the frequency for oral care; tools for oral care; oral care technique; solutions used and oral care in the non‐ventilated patient who is critically ill and is at risk of aspiration. The group searched the best available evidence and evaluated this using the Grading of Recommendations Assessment, Development, and Evaluation system to assess the quality of evidence from high to very low, and to formulate recommendations as strong, moderate, weak, or best practice consensus statement when applicable. Results: The consensus group generated recommendations, delineating an approach to best practice for oral care in critically ill adult patients. Recommendations included guidance for frequency and procedure for oral assessment, toothbrushing, and moisturising the mouth. Evidence on the use of chlorhexidine is not consistent and caution is advised with its routine use. Conclusion: Oral care is an important part of the care of critically ill patients, both ventilated and non‐ventilated. An effective oral care programme reduces the incidence of pneumonia and promotes patient comfort. Relevance to Clinical practice: Effective oral care is integral to safe patient care in critical care. [ABSTRACT FROM AUTHOR]

There is some confusion surrounding the management of people with lymphoedema in the presence of deep vein thrombosis (DVT). This may be in relation to the suitability of commencing compression therapy or regarding the continuation of compression therapy in those who develop DVT. The purpose of this British Lymphology Society position paper is to support evidence-based practice and debunk the myths surrounding the management of DVT and lymphoedema. [ABSTRACT FROM AUTHOR]

The research presented in this paper supports claims by feminists and queer theorists that there are numerous and diverse sex/gender/desire categories (Bem, 1995). Taken from a broader digital ethnography of digital sex markets in the United Kingdom, the findings are based on ten in-depth interviews with those who identified as men or 'gender flexible' and who buy and/or sell sex within digital markets. The participants featured in this paper used digital sex markets as a space to explore and express non-normative/subversive sexual and gender identities. Yet for many of them, these subversive acts were bounded by the market, so they were able to uphold masculine heterosexual identities outside of sex markets. The relative privacy of digital sex markets empowered them to maintain heterosexist power, reducing the social risks of stigmatisation and ostracisation associated with subversive sexual and gender identities. The thematic analysis revealed the limitations of heteronormative and homonormative labels and assumptions of sex work relations, thus, prompting the need to write this paper. Framing sex markets in narrow binary terms, as either homosexual or heterosexual markets, or research participants as customers or workers do not reflect the fluidity and diversity evident in this small yet revealing sample. The study shows multiple and fluid expressions of sex/gender/desire; and a duality in market roles as workers and/or customers amongst men engaged in digital sex markets. [ABSTRACT FROM AUTHOR]

This study investigated the seamless mobile learning practices of UK government workers at various life stages, to understand how context impacted decisions about how, when and where learning was undertaken. Following Hedegaard, the context was understood as involving settings embedded within institutions. Drawing on analysis of data from public domain blogs and reports and anonymised trace data showing e‐learning visits via a mobile device, a picture of institutional practice and values was developed. Against this backdrop, a survey of 50 individuals followed by semi‐structured interviews provided information about seamless mobile learning projects. Mobile learning was often fragmented and ad hoc, rather than part of a longer, seamless learning project. A distinction between just‐in‐time learning and just‐in‐case learning was apparent, with the latter often postponed. For mobile workers, mobile learning focused on current work setting, whereas workers who could work in many interchangeable settings might move to somewhere they could concentrate. Mobile learning was sometimes motivated by a sense of a lack of time and a need to stay 'on top of things' as much as by interest in a topic. Sustained seamless mobile learning projects occurred if there was institutional support for learning that was also of individual interest and if learners had the ability to orchestrate their learning. Learners reported these seamless mobile learning projects to be enjoyable and compelling. This paper contributes to the evidence of seamless mobile learning practice over the life course and illustrates the value of considering an individual's relation to various institutions in conceptualisations of seamless mobile learning. It also offers pointers for the future design of seamless mobile learning tools including a need to offer learners the opportunity to sometimes separate ongoing learning which is related to distinct institutions.Practitioner notesWhat is already known about this topicMobile devices accompany their owners across settings that were previously considered separate, such as work, college and households.This has the potential to impact work/home and other boundaries.From a pedagogical perspective, mobile devices may support seamless learning, in which experiences across distinct settings result in a holistic and unified understanding.What this paper addsIt introduces the concept of the institution to conceptions of seamless learning.It illustrates the ways in which different institutions (workplaces or educational institutions) can shape individual experiences and decisions about when and where to learn.It provides evidence that some working adults engage in seamless learning projects and describe this as compelling and enjoyable, but that others prefer to separate distinct life spheres.Implications for practice and/or policyThere may be value in institutions and designers supporting people who want to engage in seamless mobile learning.However, it is important to be aware that not everyone wants to engage in seamless learning.Seamless learning is more likely to occur when individual and institutional priorities are aligned across several institutions, so there will be challenges for a single institution seeking to promote it. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications What this paper adds What is already known on this subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Attainment inequalities exist for ethnic minority students graduating from higher education institutes (HEIs) in the UK. Previous research has investigated the outcomes and experiences of students from ethnic minority backgrounds on health and social care programmes. However, studies exploring ethnic minority speech and language therapy (SLT) students’ experiences have only focused on international students and were conducted in Australia. No known studies exploring the experiences of both home‐domiciled and international SLT students from ethnic minority backgrounds have been conducted in the UK.To explore the experiences of home‐domiciled and international ethnic minority students on a SLT training programme and to identify ways to improve these experiences.All SLT students attending a pre‐registration postgraduate course who identified as being from an ethnic minority background were invited to participate. Two focus groups, one for three international students and one for six home students, were conducted. Data were analysed using reflexive thematic analysis.Three themes were identified that illustrated students’ current experiences and how experiences could be improved: (1) feeling an outsider, explores students’ sense of belonging in SLT education; (2) finding ways to manage, describes the strategies used by students to cope with their experiences of marginalization, and how adopting these strategies impact on their well‐being; and (3) promoting inclusion, explains how the training programme could be modified to improve the experience of ethnic minority students.A better understanding of the experiences of ethnic minority SLT students can help others to support them more effectively. The findings suggest that making changes to SLT training programmes could improve ethnic minority students’ outcomes and experiences. These include: more training for staff and students, support groups for ethnic minority students, sharing lived experiences of students and experienced SLTs from ethnic minority backgrounds, and clearer ways of reporting racist incidents. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. Previous studies have investigated the experiences of ethnic minority students on a range of HEI programmes, including those for students of physiotherapy and occupational therapy. The only studies investigating the experiences of ethnic minority SLT students are those exploring how international SLT students in Australia can be supported on professional placement. This study explores the experiences of home and international SLT students in the UK who identify as being from minority ethnic backgrounds. Findings suggest that these students feel like outsiders, affecting their sense of belonging. The need to find and implement strategies to manage their feelings of marginalization impacts on their well‐being. The findings suggest measures to promote the inclusion of ethnic minority SLT students to improve their experiences and support their well‐being. These include more training for all staff and students and the creation of a ‘lived experiences library’ where students and experienced SLTs from ethnic minority backgrounds could share positive experiences as well as ways of dealing with challenges. Clearer ways of reporting racist incidents would be beneficial for all students. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. It is important that ethnic minority SLT students are involved in developments that aim to improve their experiences. [ABSTRACT FROM AUTHOR]

Background: Universal health visiting has been a cornerstone of preventative healthcare for children in the United Kingdom (UK) for over 100 years. In 2016, Scotland introduced a new Universal Health Visiting Pathway (UHVP), involving a greater number of contacts with a particular emphasis on the first year, visits within the home setting, and rigorous developmental assessment conducted by a qualified Health Visitor. To evaluate the UHVP, an outcome indicator framework was developed using routine administrative data. This paper sets out the development of these indicators. Methods: A logic model was produced with stakeholders to define the group of outcomes, before further refining and aligning of the measures through discussions with stakeholders and inspection of data. Power calculations were carried out and initial data described for the chosen indicators. Results: Eighteen indicators were selected across eight outcome areas: parental smoking, breastfeeding, immunisations, dental health, developmental concerns, obesity, accidents and injuries, and child protection interventions. Data quality was mixed. Coverage of reviews was high; over 90% of children received key reviews. Individual item completion was more variable: 92.2% had breastfeeding data at 6–8 weeks, whilst 63.2% had BMI recorded at 27–30 months. Prevalence also varied greatly, from 1.3% of children's names being on the Child Protection register for over six months by age three, to 93.6% having received all immunisations by age two. Conclusions: Home visiting services play a key role in ensuring children and families have the right support to enable the best start in life. As these programmes evolve, it is crucial to understand whether changes lead to improvements in child outcomes. This paper describes a set of indicators using routinely-collected data, lessening additional burden on participants, and reducing response bias which may be apparent in other forms of evaluation. Further research is needed to explore the transferability of this indicator framework to other settings. [ABSTRACT FROM AUTHOR]

Background: Liver disease is an increasing cause of morbidity and mortality in the United Kingdom and can be challenging to live with in the advanced stages. There has been little research exploring the healthcare experiences of UK individuals with decompensated disease when the liver cannot carry out its functions properly. A PhD research project was developed with people who have liver disease to explore care experiences in decompensated advanced liver disease. Public involvement (PI) is an essential aspect of meaningful health research, and this paper reports on the progression of our PI approach in this ongoing study. Objective: To embed PI throughout the research project to ensure that the study is meaningful to individuals with liver disease and the people who support them. Methods: The research adopts a Constructivist Grounded Theory methodology to develop a theory of care experience. Various PI approaches were considered in developing the PI strategy for this qualitative study. Initially, Embedded consultation was the preferred model, which has evolved to include aspects of collaboration and coproduction. A PI group was set up to oversee the project through the national public engagement website VOICE, and reflections on PI from three members of the group are included in this paper to illuminate the PI process. Results: Six individuals with liver disease and three carers from across the United Kingdom are part of an ongoing PI group. Their role includes commenting on the findings of the systematic literature review for this project and contributing to decisions about recruitment, data collection and data analysis. Additionally, they had a direct impact on changing the focus of the research. The PI group will continue involvement until the completion of the project. Conclusion: Successfully embedding PI into doctoral research, as demonstrated in this project, requires commitment, planning and dedication to reciprocal working for the benefit of PI contributors as well as the research. This approach could be adopted by other postgraduate researchers. Patient or Public Contribution: This project is overseen by the PI group, whose contribution is described throughout, including reflections from three PI group members. [ABSTRACT FROM AUTHOR]

This paper draws on an oral history project which focuses on former coalminers' experiences of education and training. It presents the stories of five participants, all of whom undertook significant programmes of post-compulsory education during or immediately after leaving the coal industry and achieved a degree of social mobility over the course of their working lives. The paper compares and contrasts their experiences with those which now exist in Britain's former coalmining communities which, it is argued, have been substantively attenuated over time, especially for young men. Whilst it is evident that individual choice and motivation can play an important role in helping (or hindering) young people's journeys through education and employment, the central argument of the paper is that individual labour market success lies at the intersection of structure and agency – although the data presented also demonstrate the extent to which opportunities available to young men in the former coalfields have been diminished by de-industrialisation. [ABSTRACT FROM AUTHOR]

Support for school-age children with speech, language and communication needs (SLCN) usually takes place within the school setting. Successful outcomes for children with SLCN rely on effective collaborative working between speech and language therapists (SLTs), school staff and families. We need to understand the current evidence regarding the joint working practices, relationships and collaboration experiences of SLT and teaching staff within mainstream primary schools, in order to identify whether sufficient research exists for a systematic review within this field, and to inform practice. The purpose of this scoping review was to identify what research currently exists regarding collaboration, roles and relationships of SLTs and teaching staff within mainstream UK primary schools, and clarify the nature, participants and concepts described within this literature. A scoping review framework was used, consisting of identification of the review objectives, identification of relevant studies, study selection and iterative searches, data charting and reporting of the results. Information regarding research question, participants, data collection and analysis and terms used for key concepts was extracted. This scoping review identified 14 papers, however, collaboration was the primary focus of only 5 of these. Clarity and perceptions of roles were key themes within six of the papers. Whilst facilitators and barriers to collaboration are discussed in all 14 papers, only 4 studies aimed to investigate barriers and facilitators. Teaching assistant (TA) views are underrepresented within the research. Drawing conclusions from the body of research is challenging due to the varied ways in which the key concept 'collaboration' is used. Currently, there is insufficient literature to carry out a systematic review. This scoping review highlights the need for research that considers collaboration within the complex social network of school staff (including TAs) and SLTs, in order to ensure that future guidance is rooted in research. [ABSTRACT FROM AUTHOR]

This paper reports on the employment migration behavior of non‐White ethnic minority graduates in the United Kingdom for the 2018/2019 graduation cohort, which is the last cohort to enter the labor market before the COVID‐19 pandemic. Using data from the new Graduate Outcomes survey and controlling for a rich set of background characteristics, the findings indicate that ethnic minority graduates are more likely than their White counterparts to find work in ethnically diverse areas of the United Kingdom after leaving higher education. An identity utility framework is then formalized that combines identity economics with traditional approaches of human capital theory and job search theory. A test of an ethnic identity‐based hypothesis reveals that Asian, Black, and Mixed‐background graduates are comparatively more likely to migrate to areas with higher ethnic diversity levels, rather than less diverse areas. In addition to traditional explanations based on human capital theory and job search theory, this paper argues that these patterns are best explained by ethnic identity norms, which introduce a preference for working in ethnically diverse places. However, the results should be interpreted with some caution because of concerns related to heterogeneity within the ethnic group classifications used in the paper and possible omitted and unobserved variables. [ABSTRACT FROM AUTHOR]

In attempting to understand and prevent fare evasion, existing research and policy have often categorised fare evaders based on passenger 'types' or profiles. However, such categorisations of 'malicious' or 'virtuous' behaviours rely on underlying moral claims which often go unexamined. In this paper, we study how different actors construct such moral claims as part of everyday interactions. We demonstrate that the everyday moralities of not or under-paying are diverse, locally occasioned, and emotionally charged. Drawing on social media and video data from Chile and the UK, we examine interactions between passengers, by-standers, transport workers, and transport operators. We highlight the diverse resources that actors draw upon to construct moral claims around fare evasion, including the mobilisation of alternative moral categories; attempts to produce exceptions to formal rules; and the foregrounding of moral emotions. The paper engages with an interdisciplinary body of work which reassesses existing policies and societal responses to fare evasion, while also contributing to a nascent literature on everyday morality and mobilities. [ABSTRACT FROM AUTHOR]

Using one sex worker-led collective as a case example, this paper explores how feminism, precarious work and entrepreneurialism coexist together in contradictory ways. I begin by highlighting how freelance work within UK strip clubs creates precarity and hostile work environments for sex workers when coupled with exploitative managerial practices; however, when similar, equally precarious gig work and promotional activities are combined with sex worker-led collectivist practices, they can instead be used to advance feminist politics. The paper then shifts to a discussion of how the transformative potential of the sex worker collective and their efforts to fight for labour rights and safer working conditions are continually and violently undermined by the feminism of those outside the stripping industry and with access to more privilege, power, and resources. While there are many different feminisms, the article ends by arguing for the ongoing need to seek some reconciliation within the movement to ensure that the voices and concerns of those most marginalised remain at the centre of politics and action. [ABSTRACT FROM AUTHOR]

This paper analyses the working practices of several feminist creative and cultural enterprises in London (which I term 'feminist CCIs'). In particular, it shows how pandemic precarity has driven feminist CCIs towards more entrepreneurial, self-promotional, and self-branding practices in order to sustain their work. Drawing on both digital ethnographic material and interviews with 12 workers in feminist CCIs conducted online between 2020 and 2022, the article provides insights into the landscape and contemporary realities of arts and cultural funding within these fields. It considers how decades of austerity measures and cuts have forced some feminist CCIs to operate independently outside of the UK public sector funding models. Survival tactics include adopting corporate funding models, subscription and membership schemes, platformisation and digitalisation. Focusing on funding, money and subjectivity, it unpacks the contradictions these imperatives bring to feminist politics: tensions about which some feminist CCI workers themselves are aware of and critical of. In the process, this paper considers how activism, feminism, entrepreneurialism, and precarity are fused together and negotiated in this form of 'freelance feminism'. [ABSTRACT FROM AUTHOR]

The 1970sand 19805 marked a significant period of advancement in non-destructivetesting (NDT) techniques, particularly ultrasonic testing (UT) and eddy current testing (ET). Some of the strongest drivers for this were the needs of the civil nuclear power industry. This paper explores the historical developments during this era, highlighting the challenges faced by the nuclear industry and the subsequent innovations that emerged. The paper concentrates on technical achievements of the Central Electricity Generating Board (CEGB) and the UK Atomic Energy Authority (UKAEA) in the UK, but also mentions the significant contributions from the improved regulatory framework, validation and certification, and collaborative efforts between industry and research institutions. This paper was written to mark the 60th Annual Conference of the British Institute of Non-Destructive Testing (BINDT) and mentions the role of the Institute's Past Presidents where appropriate. [ABSTRACT FROM AUTHOR]

Education-UK and British private schools more specifically are often framed as a global brand of 'world-class' quality. However, the increased competition within the international education market has meant British private schools cannot rest on their laurels but instead must continue to project their 'world-classness' in a way that does not diminish their brand image. Drawing on interviews of parents and key gatekeepers, this paper examines how British private schools in Nigeria (BPS-NIG) and British private boarding schools in the UK (BPBS-UK) evoked and projected their supposed world-classness through the strategic use of white symbolism and the expensive admission process. The paper contends that the latter are types of soft-sell marketing techniques utilised by BPS-NIG and BPBS-UK to sell British schools without imperilling their brand image. The paper concludes by drawing attention to the racial implication of framing whiteness and white British specifically as synonymous with high-quality, 'world-class' education. [ABSTRACT FROM AUTHOR]

Elite schools in the UK are bound to the history of British colonialism. This paper examines the material ties between these schools and the transatlantic slave trade. We combine multiple sources to examine which schools and their alumni accrued substantial economic capital derived from the enslavement of Black people. We find two principal connections: first, in donations and foundations of schools from those who made their fortune in the slave trade; and second, through income of boys attending these schools. Drawing on the Legacies of British Slavery dataset, we show that schools with alumni benefitting from the slave trade include the most prestigious British private schools. Moreover, this paper traces the histories of several secondary schools founded by, or in receipt of, substantial donations from slave-owning families. We argue that extractive, violent forms of colonial capital accumulation have been central to, the formation and maintenance of these elite educational institutions. [ABSTRACT FROM AUTHOR]

Nation‐wide cuts to bus subsidies have led to reduced service in rural communities in the UK, leaving those who do not have access to a car – most of whom are older, have a disability, or have a low income – with few other options to meet their travel needs. This has resulted in greater demand on community transport, small‐scale, local, and community‐based transport schemes that are run by the not‐for‐profit sector and are primarily volunteer‐run. Drawing on 28 interviews conducted with volunteers and staff from community transport schemes across Oxfordshire, this paper describes the provision of community transport schemes at the intersection of informal transport and an ethics of care. This sector is posited as informal, however; unlike many informal transport schemes, community transport is non‐entrepreneurial. Instead, these schemes emerge from the community and are care‐driven. Volunteers who run these schemes all provide skilled labour that is a practice of caring about, caring for, or care giving. This framing highlights the undervaluing of community transport. Indeed, the labour and schemes are underfunded and lack recognition. This study therefore emphasises the socio‐political nature of community transport and shows the importance of supporting caring transport services. It concludes by discussing how this undervalued sector might be re‐valorised so that it can continue to support those with few other transport options. Community transport refers to small‐scale, local, and community‐based transport schemes that are run by the not‐for‐profit sector and are primarily volunteer‐run. Drawing on 28 interviews conducted with scheme providers, this paper describes the provision of community transport schemes at the intersection of informal transport and an ethics of care. This care‐driven informality framing highlights the undervaluing of community transport, a trend that might be applied to other sectors in need of revalorisation. [ABSTRACT FROM AUTHOR]

This paper focuses on the complex relationship between pace and place, offering a novel lens for understanding mobility within the context of canal boating. Drawing on fieldwork on the canals in north‐west England, the paper focuses on mobile placemaking practices. Canal boats act as physical and material but also ideological pacemakers, guiding the boaters towards subscribing to the idea of slow living, where certain canal‐based pace‐myths play an important role. Pacemaking on the canals is therefore a form of placemaking, realised through the mobility of the vessel, materialities of the infrastructure, tempos and temporalities, representations and stories about canal life as well as the bodies on board and on towpaths as canal boaters modulate and manage their experience and performance of pace. The investigation of the interplay between the slow pace, rhythms, embodied practices, canal infrastructure, and the prevalent pace‐myths offers valuable insights into the ways places are shaped by the pace of mobility, thus expanding the concept of placemaking. By foregrounding pace as a key concept in mobility studies, the paper demonstrates the need for a more nuanced understanding of the temporalities associated with different modes of movement. [ABSTRACT FROM AUTHOR]

Sensed and soil sample data are used in two approaches for mapping soil properties in precision agriculture: management zone (MZs) and contour maps. This is the second paper in a two-part series that focuses on contour maps. Detailed and accurate contour maps of soil properties for precision agriculture are often costly to produce because of the large sampling effort required. Such maps or those of sensed ancillary data are often simplified to represent MZs. This research investigated the accuracy of detailed maps of soil properties produced inexpensively from sensed data by transforming them to z-scores. The z-scores of ancillary values are then transformed to values of soil variables using the mean and standard deviation of a small soil data set. The errors from this mapping approach are examined with historic soil data from three field sites with different scales of spatial variation in the United Kingdom. Errors from the conversion of z-scores of sensed data to soil variable ranges are compared with those from MZ averages (Paper I in this series). For soil properties with a moderate relation to ancillary data, the errors related to the z-score conversion were small irrespective of sample size. The root mean squared errors associated with the MZ mean rather than values from the digital map were generally smaller except when sample size was very small. The results suggest that when the scale of variation is small and more samples are required to define MZs, calibrating z-scores of sensed ancillary data may provide better MZ averages than sampling on a grid; it also provides a detailed map of spatial variation within the field. The z-score conversion approach is less sensitive to sample size and captures small features of the variation compared to the standard 100 m grid sampling to determine MZ averages. [ABSTRACT FROM AUTHOR]

Sensed and soil sample data are used in two main approaches for mapping soil properties in precision agriculture: management zones (MZs) and contour maps. This is the first of two papers that explores maps of MZs. Management zones based on variation in sensed data that are related to the more permanent soil properties assume that the zones are multi-purpose. Soil properties are then often sampled on a grid to provide the average values of each property per zone. This paper examines the plausibility of this approach by examining how the number of samples taken on a grid and the application of kriging affect mean soil property values for MZs. The suitability of MZs based on ancillary data for managing several agronomically important properties simultaneously is also considered. These concepts are examined with historic soil data from four field sites in southern UK with different scales of spatial variation. Results showed that when the grid sampling interval is large, there is less difference in the means of properties between MZs, but kriging the soil data increased the differences between zones when the sampling interval was large and sample small. Sensed data are used increasingly to aid the identification of MZs, but these could not be considered multi-purpose at all sites. The MZs produced were most useful for phosphorus (P), pH and volumetric water content (VWC) at the Wallingford site and useful for most properties at the Clays and Y215 sites. For the latter site this was true only when the most dense data were used to calculate MZ averages. The results show that sampling interval for MZ averages should relate to the scale of variation or the size of the MZs at a site. The sampling density could be based on the variogram range of ancillary data. This research suggests that there should be 6–8 samples per zone to obtain accurate averages of soil properties. Nutrient data for more than one year were examined at two sites and showed that patterns remained consistent in the short term unless variable-rate management was used, but also the range of values changed in the short term. [ABSTRACT FROM AUTHOR]

Mental health services are under unprecedented pressure with overwhelming referrals and a current waiting list of 1.2 million people of all ages. The cross-government White Paper 'No health without mental health' was launched 12 years ago detailing the importance of wellbeing services in the creation of mentally healthy communities through health promotion and illness prevention. While primary care, community services and psychiatry are pivotal in the treatment of mental Illness/disorder, mental health care per se is on a continuum, and a great deal of work can be undertaken in communities by wellbeing services to prevent avoidable referrals. This paper proposes a broad framework of education and training for wellbeing/positive mental health services, primary and community care, and nurses working in Community Mental Health Treatment Teams and Home Treatment Teams to ensure all those working with potentially vulnerable adults and children are regulated and meet national standards for mandatory mental health education and training. [ABSTRACT FROM AUTHOR]

There is a lack of research that focuses on the lived experiences of British Yemeni young people in the UK as they pertain to their learning and development. This paper aims to bridge the gap by exploring the case of Nuha, an 18-year-old British Yemeni young woman, as she navigates the conduct of her everyday life. The paper presents a developed conceptual model and associated methodological approach for exploring Nuha. It does so by first reviewing what might be viewed as dominant approaches to the study of ethnic young people's experiences that advocate a social identity theory. A critique of such thinking is developed that takes issue with much of this writing that has the potential for an essentialised abstracted approach. The paper instead advocates the use of a subjectively focused, practice orientated and yet culturally sensitive approach to exploring human behaviour in the context of the conduct of everyday life. Based on an analytical matrix that is developed from such thinking, I examine Nuha's life experiences using Dreier's theory of a person. In doing so, I recognise the additional importance of personhood in practice that provide a reference point for exploring more deeply the learning and development of Nuha. The research is generated through a case study narrative that is analysed dialectically through theory, recognising how theory is simultaneously driven by the data. The paper concludes with arguments made about the centrality of an extended and developed sense of the conduct of everyday life to get at the nuanced evolving sense of being and doing for British Yemeni young people. [ABSTRACT FROM AUTHOR]

This paper explores the development of a smart Structural Health Monitoring (SHM) platform tailored for long-span bridge monitoring, using the Forth Road Bridge (FRB) as a case study. It discusses the selection of smart sensors available for real-time monitoring, the formulation of an effective data strategy encompassing the collection, processing, management, analysis, and visualization of monitoring data sets to support decision-making, and the establishment of a cost-effective and intelligent sensor network aligned with the objectives set through comprehensive communication with asset owners. Due to the high data rates and dense sensor installations, conventional processing techniques are inadequate for fulfilling monitoring functionalities and ensuring security. Cloud-computing emerges as a widely adopted solution for processing and storing vast monitoring data sets. Drawing from the authors' experience in implementing long-span bridge monitoring systems in the UK and China, this paper compares the advantages and limitations of employing cloud- computing for long-span bridge monitoring. Furthermore, it explores strategies for developing a robust data strategy and leveraging artificial intelligence (AI) and digital twin (DT) technologies to extract relevant information or patterns regarding asset health conditions. This information is then visualized through the interaction between physical and virtual worlds, facilitating timely and informed decision-making in managing critical road transport infrastructure. [ABSTRACT FROM AUTHOR]

This article explores the impact of the 'hostile environment' on racialised migrant women's experiences of pregnancy and childbirth in England, arguing that the 'hostile environment' functions as a technology of 'stratified reproduction.' First coined by Shellee Colen, the concept of stratified reproduction describes the dynamic by which some individuals and groups may be supported in their reproductive activities, while others are disempowered and discouraged. This paper locates the stratified reproduction produced by the 'hostile environment' as intertwined with wider gendered and racialised discourses around British citizenship which have been 'designed to fail' racialised residents of the UK. Drawing on interviews with racialised migrant mothers in the north of England, this paper analyses how the proliferation and intensification of immigration controls interacts with gender, race, class, and other social regimes to differentially allocate the resources necessary for a safe and healthy pregnancy and childbirth, and how this is experienced materially by pregnant migrants. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide a literature review on what is known about unpaid family carers who are at risk of or have experienced abuse from the people they provide care for and relevant policy/legal and practice responses for affected family carers. Design/methodology/approach: A literature search was carried out to locate literature relating to unpaid family carers who are at risk of or have experienced abuse from the people they provide care for. This also incorporated grey literature, including policy guidance and law, to determine the existing knowledge base, gaps in practice and areas that might require further research. Findings: The findings suggest that although carer harm is serious, it is under-researched. In addition, the unique needs of unpaid family carers who are at risk of or have experienced abuse, violence and harm from the people they provide care for are subsumed in safeguarding policy/law processes and practice under the auspices of the protection of "adults at risk" rather than the protection of "carers at risk". Research limitations/implications: It is important that those who support unpaid family carers who are at risk of abuse and harm know about their unique safeguarding needs and concerns to offer appropriate support. It is also apparent that policy and law need to address the gap in provision relating to the unique safeguarding concerns involving the abuse of unpaid family carers by the people they provide care for. This paper is based on this literature review and not on other types of research. Originality/value: The paper provides insights into what is known about the abuse of unpaid family carers by the people they provide care for, and the policy/legal and practice responses to affected unpaid family carers. It contributes to the body of knowledge on carer abuse and safeguarding carers from abuse and harm. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to introduce the concept of using the well-established Shared Lives approach to support survivors of domestic abuse with complex needs including those with learning and physical disabilities, older people and carers. Design/methodology/approach: Survivors with complex needs are often excluded from traditional domestic abuse support services thus increasing their risk and making recovery impossible. Using the Shared Lives approach in suitable cases could address gaps in provision and improve the outcomes for survivors with disabilities, older survivors and carers. Findings: The paper draws on evidence from reports and research about the experiences of these cohorts of survivors to explain how the Shared Lives approach could increase support options for specific categories of survivors. Practical implications: Using the Shared Lives approach to support cohorts of victims/survivors who experience barriers to accessing support could improve outcomes for these people, reduce risk of serious harm and improve quality of life. Originality/value: With the recent recommendation from Association of Directors of Adult Social Services around increasing use of Shared Lives, this paper provides one potential way to meet this recommendation. [ABSTRACT FROM AUTHOR]

Within the UK a polarised and politicised discourse exists that attempts to pitch transgender identities in opposition to discourses on sexual orientations. This suggests that interventions assisting clients in their understanding of one, would be detrimental on exploration of the other i.e., to be affirming of gender identity is to cause conversion of sexuality and vice versa. This paper attempts to address some of the problems with this oppositional critique and solve some of the practical problems that the theorist and/or clinician may encounter while attempting to help their clients within the realm of psychological therapies. It does so through Deleuzian ontologies of difference, coupled with Bhaskarian critical realism. We aim to present a (re)consideration of the biopsychosocial model of Health. The recent publication of the International Classification of Diseases 11th Edition and its reclassification of trans aetiology as a Disorder of Sexual Development has presented a conceptual shift from gender dysphoria towards a gender incongruence model (WHO 2022). The aim of this article therefore is to develop practice by enhancing the conceptual toolbox of the clinician and therapist working with Gender Sex and Relationship Diversities (GSRD). Thereby enabling them to better approach a wider diversity of clients safely. This paper explores current conversations and ideas around the phenomenon of trans gender identities and minority orientations. It aims to present an ethical model which can inform the clinical practice of therapists and is underpinned by a critical realist interpretation of biological, psychological and sociological aspects of the mind and body. Overall, the paper acts as a call to action against conversion practices which aim to position trans experience and sexual attraction in opposition to each other. [ABSTRACT FROM AUTHOR]

Background: Telehealth for paediatric speech and language therapy became one of the most salient modes of service delivery during the COVID‐19 pandemic. Evidence for speech and language therapy services via telehealth in comparison to face‐to‐face delivery demonstrates promising outcomes, and studies have begun to explore practitioner and client experiences. However, across the literature, many critical elements of services are overlooked, and there is a need to frame the evidence base within a theoretical model that can draw out practical implications that consider the range of factors having an impact on clinical implementation in real‐world contexts. The APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria offer such a model. The current study explored practising UK speech and language therapists' (SLTs) clinical experience of telehealth through the lens of the APEASE criteria and aimed to identify recommendations for future service provision from the practitioner perspective. Methods: An online survey structured using the APEASE criteria was developed in collaboration with the UK Royal College of Speech and Language Therapists. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using reflexive thematic analysis. Results: Four hundred and thirty‐eight qualified and practicing UK paediatric SLTs completed the survey. Telehealth was broadly acceptable and practicable to SLTs yet there remains some uncertainty about its efficacy and cost‐effectiveness compared to face‐to‐face interventions and how equitable it is for different population groups. SLTs reported that effective implementation of telehealth services was dependent upon several contextual factors; affordability was a perceived barrier to clients having access to telehealth resources, intervention via telehealth was perceived as more acceptable than assessment, and whilst many SLTs welcomed aspects of telehealth, there were concerns about the physical and mental health consequences for practitioners. Six themes for the future development of telehealth in paediatric speech and language therapy were identified: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. Conclusions: Outcomes highlight promising, concerning and uncertain aspects of telehealth in paediatric speech and language therapy. SLTs value a flexible and tailored approach to service delivery and recommend that effective leadership, clear communication, ongoing policy and guidance development, upskilling of users and careful evaluation of impact are required to ensure optimal implementation. The APEASE criteria offer a valuable opportunity to enhance and streamline practice and research to ensure sustainable implementation of telehealth in the paediatric speech and language therapy services of tomorrow. WHAT THIS PAPER ADDS: What is already known on this subject: The COVID‐19 pandemic led to the increased use of telehealth as a main mode of service delivery in paediatric speech and language therapy. Pre‐COVID‐19, evidence for the use of telehealth in this field included small‐scale experimental studies that reported on children with particular disorders and explored telehealth outcomes in comparison to face‐to‐face delivery. The realities of at‐scale clinical practice were not well‐represented, and critical elements of service such as cost‐effectiveness were often overlooked in the paediatric literature. Furthermore, despite emerging global evidence for temporary telehealth responses to the crisis in speech and language therapy, the long‐term and future use of telehealth remains unclear. What this paper adds to existing knowledge: The current study applied the lens of the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria, which were used in this case to consider socioeconomic, ecological and cultural factors to capture an overarching understanding of the use of telehealth in paediatric speech and language therapy, and to inform the role of telehealth in future, longer‐term and at‐scale service development. Results indicated emerging trends in UK paediatric speech and language therapists' (SLTs') perceptions of telehealth and SLTs perceived a hybrid approach to service delivery, combining mostly face‐to‐face services with some telehealth, was likely to continue in the future. We identified six themes to guide the future development of telehealth in paediatric speech and language therapy services: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. What are the potential or actual clinical implications of this work?: UK SLTs believe that speech and language therapy services using telehealth should be reflective, tailored and flexible to meet the requirements and circumstances of the children, young people and families served, as well as the physical and emotional needs of practitioners. SLTs recommend that this service development is clearly communicated to all stakeholders and suggested that those using telehealth should be supported through appropriate training, and ongoing effectiveness should be monitored. Telehealth is here to stay and the APEASE criteria offer a unique opportunity to ensure sustainable models of service delivery; to support co‐ordinated leadership at the local, national and international levels and the development of policy and clinical guidance. [ABSTRACT FROM AUTHOR]

Background: People who have communication difficulties may benefit from using augmentative and alternative communication (AAC). Understanding and measuring outcomes from the use of AAC is an important part of evaluating the impact of devices and services. Outcome measurement needs to reflect the changing nature of the impact of using AAC on an individual's ability to participate in activities of daily life. There is a limited understanding of the concepts that should inform the evaluation of outcomes from AAC device provision, nor how people's expectations from AAC may change over time. Aims: To inform the development of a patient‐reported outcome measure for AAC by understanding more about people's expectations from AAC and how these change over time. Methods & Procedures: A longitudinal qualitative research study was designed and carried out with seven participants over a period of 2 years. Participants were recruited from a regional specialist assessment service for AAC in the south‐west of the UK. Four semi‐structured interviews were carried out: (1) before assessment for AAC, (2) after assessment, (3) directly after provision of an AAC device and (4) between 6 and 12 months after provision. An original analytic method was used in this study that built on the principles of longitudinal interpretative phenomenology analysis, applied with a dialogic theoretical lens. This approach enabled the inclusion of a range of multimodal and embodied data collected to this study and allowed the research team to draw out salient themes across the cohort group while attending to the influence of time and context on experience. Outcomes & Results: The results confirm and extend the three core concepts that were used to guide analysis: changes; contexts; future possibilities. The contextual and temporal influences on outcomes attainable from AAC for this cohort were also identified and illustrated through cross‐case comparison. Deeper, analytic, and conceptual engagement with theory, which was then applied to analysis of the data, provided methodological rigour in the study. The results enhance our understanding of people's hopes and expectations from AAC and how these change over time. Conclusions & Implications: This qualitative longitudinal research study provides new insights into the journeys of people who experience communication disability, and the shifting nature of their sense of identity as they engage with, and learn from using, AAC. The study is significant as it attends to the dynamic nature of experience and how contextual and experiential factors influence people's hopes and expectations from AAC. The paper presents an original application of longitudinal qualitative research methodology with people who use AAC which can be further applied and tested in the field of communication disability research. WHAT THIS PAPER ADDS: What is already known on this subject: We did not know the impact that time has on the concepts that have been identified to represent important outcomes from AAC. The existing concepts used to define outcomes from AAC were not adequately conceptualized to develop a patient‐reported outcome measure. This study sought to extend our knowledge about outcomes from AAC. What this paper adds to the existing knowledge: This study adds to the methodological toolkit available for qualitative inquiry in the field of communication disability research by presenting a longitudinal qualitative research methodology. It adds depth to our understanding of the concepts that underpin outcomes from AAC and highlights the dynamic nature of contexts and how this influences desired outcomes. What are the potential or actual clinical implications of this work?: This longitudinal qualitative research study provides a broader perspective on the experience of getting AAC. It will enable clinicians to better navigate the contextual and transitionary factors that influence people's experience of acquiring AAC devices. The enhanced concepts described will also support clinical conversations that consider the wider facets of communication and what AAC can add to existing communicative tool kits beyond getting a message across. [ABSTRACT FROM AUTHOR]

Background: We explore the theoretical and methodological aspects of decolonising speech and language therapy (SLT) higher education in the United Kingdom. We begin by providing the background of the Rhodes Must Fall decolonisation movement and the engagement of South African SLTs in the decoloniality agenda. We then discuss the evolution of decoloniality in SLT, highlighting its focus on reimagining the relationships between participants, students, patients and the broader world. Objective: The primary objective of this discussion is to fill a gap in professional literature regarding decoloniality in SLT education. While there is limited research in professional journals, social media platforms have witnessed discussions on decolonisation in SLT. This discussion aims to critically examine issues such as institutional racism, lack of belonging, inequitable services and limited diversity that currently affect the SLT profession, not just in the United Kingdom but globally. Methods: The methods employed in this research involve the engagement of SLT academics in Critical conversations on decolonisation. These conversations draw on reflexivity and reflexive interpretation, allowing for a deeper understanding of the relationship between truth, reality, and the participants in SLT practice and education. The nature of these critical conversations is characterised by their chaotic, unscripted and fluid nature, which encourages the open discussion of sensitive topics related to race, gender, class and sexuality. Discussion points: We present our reflections as academics who participated in the critical conversations. We explore the discomfort experienced by an academic when engaging with decolonisation, acknowledging white privilege, and the need to address fear and an imposter syndrome. The second reflection focuses on the experiences of white academics in grappling with their complicity in a system that perpetuates racism and inequality. It highlights the need for self‐reflection, acknowledging white privilege and working collaboratively with colleagues and students toward constructing a decolonised curriculum. Finally, we emphasise that while action is crucial, this should not undermine the potential of dialogue to change attitudes and pave the way for practical implementation. The paper concludes by emphasising the importance of combining dialogue with action and the need for a nuanced understanding of the complexities involved in decolonising SLT education. Conclusion: Overall, this paper provides a comprehensive overview of the background, objectives, methods and key reflections related to the decolonisation of SLT higher education in the United Kingdom. It highlights the challenges, discomfort and responsibilities faced by academics in addressing decoloniality and emphasizes the importance of ongoing critical conversations and collective action in effecting meaningful change. WHAT THIS PAPER ADDS: What is already known on this subject: Prior to this paper, it was known that the decolonial turn in speech and language therapy (SLT) was a recent focus, building on a history of professional transformation in South Africa. However, there was limited literature on decoloniality in professional journals, with most discussions happening on social media platforms. This paper aims to contribute to the literature and provide a critical conversation on decolonising SLT education, via the United Kingdom. What this paper adds to existing knowledge: This paper adds a critical conversation on decolonising SLT higher education. It explores theoretical and methodological aspects of decoloniality in the profession, addressing issues such as institutional racism, lack of sense of belonging, inequitable services and limited diversity. The paper highlights the discomfort experienced by academics in engaging with decolonisation and emphasizes the importance of reflection, collaboration and open dialogue for meaningful change. Notably we foreground deimperialisation (vs. decolonisation) as necessary for academics oriented in/with the Global North so that both processes enable each other. Deimperialisation is work that focuses the undoing of privilege exercised by academics in/with the Global North not only for localising their research and education agenda but checking their rite of passage into the lives of those in the Majority World. What are the potential or actual clinical implications of this work?: The paper highlights the need for SLT practitioners and educators to critically examine their practices and curricula to ensure they are inclusive, decolonised and responsive to the diverse needs of communities. The discussions emphasise the importance of addressing institutional racism and promoting a sense of belonging for research participants, SLT students and patients. This paper offers insights and recommendations that can inform the development of more equitable and culturally responsive SLT services and education programmes. [ABSTRACT FROM AUTHOR]