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Whilst the widening participation programme aims to increase the accessibility of undergraduate study for students with a lower socio-economic status, much less support is available for students wishing to progress to postgraduate study. Postgraduate study risks becoming a discipline exclusive to those from upper-middle class and upper-class backgrounds, with too few role models from lower socioeconomic backgrounds encouraging uptake. To explore class-related inequalities in academia reported by existing data through the lens of access to postgraduate study, we developed, and piloted, the CLASS (championing lower-class academic and social success) programme within our university. The programme aims to harness the lived experience of workingclass individuals to uncover the barriers to postgraduate study and to develop strategies at an institutional level. An initial understanding of the barriers and challenges current students experience have been captured in our pilot programme. Future CLASS initiatives include assessment of these barriers at a national level to harness findings through the development of strategies with universities.

Adolescent health-related behaviours and outcomes are shaped by their peers through various social processes. Research using network data on friendship ties has uncovered evidence for processes such as peer influence and imitation. Much less is known about how the structure of small groups within a network, network communities that represents its meso level, affect individuals. The structure and composition of peer groups could play an important role in shaping health behaviour but knowledge of the effects of groups is limited. We used data from The Peers and Levels of Stress study, a cross-sectional social network study conducted in 2006 of 22 secondary schools in Glasgow, Scotland. Students from one year group (15–16 yrs., N = 3148; 50.8% women) provided information on socio-demographics, health behaviour and friendships via a questionnaire. Dependent variables were substance use and general mental wellbeing measured via principal components. We used a series of multilevel models with students (level 1), network communities (peer groups) identified by the Walktrap algorithm (level 2), and schools (level 3). We found substantial and moderate clustering at the peer group level for substance use and mental wellbeing, respectively. Larger and more transitive groups were associated with less substance use, but worse mental wellbeing. Addressing the methodological gap regarding the influence of the choice of group detection method on findings, we repeated our analysis using nine additional methods. The choice of the method somewhat influenced peer group variance and greatly influenced association of peer group properties with health. This study makes two key contributions to school-health improvement research. Beyond describing peer group clustering health outcomes, this is the first demonstration that structural and compositional characteristics of peer groups are associated with individual health, while highlighting the sensitivity of findings to group detection method used. • Network meso level - network communities – are underused in social network and health research. • We used series of multi-level models with network communities as random effects. • Characteristics of friendship network communities in schools are associated with individual health. • We check the sensitivity of findings by using 10 different group detection methods. [ABSTRACT FROM AUTHOR]

Growing concern about children and adolescent physical inactivity has made the promotion of physical activity a public health priority. International recommendations suggest children should accumulate at least 30 min of moderate-to-vigorous physical activity (MVPA) during school hours. This study assessed levels of objectively-measured MVPA in a large nationally representative sample of Scottish children aged 10–11. Risk factors for not meeting the school-hours MVPA recommendation were examined. Cross-sectional. Mean time spent in MVPA during school hours across five weekdays was measured using Actigraph accelerometry (May 2015–May 2016). Binary logistic regression, presented as odds ratio (O.R.) and confidence intervals (C.I.), explored associations between meeting/not meeting the recommendation by sex, socioeconomic status (SES), season, and urban/rural residence in 2022. Valid data were obtained from 773 children (53.9% girls, 46.1% boys) from 471 schools. Mean daily school-hours MVPA was 29 (SD 11) minutes; 42.7% of children reached the recommendation. The odds of girls (O.R. 0.43; C.I. 0.32, 0.57) meeting the recommendation was significantly lower (p < 0.001) compared to boys. Children living in rural areas had higher odds (O.R. 1.49; C.I. 1.04, 2.15) of meeting the recommendation compared with those in urban areas (p = 0.032). No significant differences in meeting the recommendation by SES (p = 0.700). The overall trend for season was significant (p < 0.001), with lower odds of meeting the recommendation in winter compared to summer. Most Scottish children aged 10–11 did not meet the 30 minute MVPA recommendation. Interventions to increase MVPA during school hours are essential to promote public health. [ABSTRACT FROM AUTHOR]

• Our study described 'real' use of natural spaces and private gardens within neighbourhoods. • We linked 15 million individual GPS locations to a natural space and private garden spatial dataset. • We found that 15% of children's time outdoors, outside school hours, was within Natural Space. • This rose to 41% when private gardens were included, highlighting the importance of these spaces. • Increased availability of natural spaces and private gardens were associated with increased use. The objectives of this study were to: (i) determine, by distance from home, the proportion of time children spent in natural space (NS), private gardens (PG) and natural space/private garden (NS/PG); (ii) calculate availability of these environments surrounding homes, and (iii) explore variation in availability and use by socio-economic status (SES). Detailed mobility data for 10/11-year-old children (n = 667) were obtained. Children wore GPS devices and locations were spatially joined to UK national mapping data (Ordnance Survey) to identify if each one was within NS, PG or NS/PG. Euclidean distance between GPS points and home was measured and discretised into 100 m bands (100 m to 800 m). Children spent 15% of their total outdoor, non-school wear time in NS, but 41% in NS/PG. Both time spent in NS & NS/PG and its distance from home varied by SES. Children living in the most deprived areas spent 17% of their total wear time in NS/PG within 100 m from home, and 4.4% in NS/PG over 800 m from home. In contrast, children from the least deprived areas spent 19% of wear time in NS/PG less than 100 m from home and 10.7% in NS/PG over 800 m from home. An increase in the availability of NS and NS/PG around the home was weakly associated with increased use. NS and PG provide a key location that children spend their outdoor time, particularly in areas close to home for those from more deprived areas. Children from the least deprived areas have greater exposure to NS, most of which occurs away from home. [ABSTRACT FROM AUTHOR]

The design of biodegradable and thermoresponsive polymeric hydrogels with tuneable properties holds immense promise for localised and sustained drug delivery. In this study, we designed and synthesised a library of novel pentablock copolymers, incorporating poly(D,L-lactide) (PLA) into methoxypoly(ethylene glycol)-poly(ε-caprolactone)-methoxypoly(ethylene glycol) (mPEG-PCL-mPEG, or PECE) hydrogels to enhance the hydrolytic degradation and drug release profiles. A pentablock copolymer, methoxypoly(ethylene glycol)- b -poly(D,L lactide)- b -poly(ε-caprolactone)- b -poly(D,L lactide)- b -methoxypoly(ethylene glycol) (mPEG-PLA-PCL-PLA-mPEG, or PELCLE), was selected based on its thermoresponsive sol-gel transition behaviour at a physiologically relevant temperature (37 °C). Physicochemical characterisation revealed that both PECE and PELCLE hydrogels self-assembled into micellar structures, with PELCLE exhibiting smaller micellar sizes compared to PECE. The incorporation of PLA led to reduced hydrogel stiffness, enhanced degradability, and decreased swelling compared to PECE. In vitro drug release studies demonstrated that both hydrogels exhibited sustained release of various anti-cancer drugs, with PELCLE generally showing slower release kinetics, highlighting its potential for prolonged drug delivery. For potential pancreatic cancer applications, we evaluated the biocompatibility and therapeutic efficacy of PELCLE hydrogels loaded with gemcitabine and oxaliplatin (GEMOX). In vitro and in vivo studies demonstrated safety and some anti-tumour efficacy of GEMOX-loaded PELCLE compared to free drug administration, attributed to enhanced tumour retention and sustained drug release. These findings highlight the potential of the PELCLE hydrogel as a versatile and effective local drug delivery platform for the treatment of pancreatic cancer and other solid tumours, warranting further investigation towards its clinical translation.

Exposure to natural environments may benefit child mental wellbeing whilst offering a lever to reduce health inequalities. However, understanding of these relationships is limited by evidence from indirect measures of exposure. We objectively measured children's direct use of natural environments-and use in low or high physical activity (PA) states-and associated this with their mental wellbeing. We then examined moderation by sex and household income. Using global positioning system and accelerometry data from children (n = 640), we measured mean daily time in natural environments ('total use'), which we stratified by PA level as 'passive use' (sedentary and light PA) and 'active use' (moderate and vigorous PA). Logistic regression associated exposures with dichotomised Strengths and Difficulties Questionnaire outcomes (internalising difficulties; externalising difficulties; prosocial behaviour), with interactions to examine moderation. A 10-minute increase in total use was associated with 10.5 % lower risk of abnormal internalising outcomes (OR: 0.895; 95 % CI 0.809, 0.990), and 13.2 % lower risk of abnormal externalising outcomes (OR: 0.868; 95 % CI 0.776, 0.990). This suggests that ∼ 60 min of daily total use was associated with 50 % lower risk of abnormal internalising and externalising outcomes. The relative effects of passive and active use were equal, but their associations were moderated by income independently for specific outcomes. For externalising outcomes, the risk of abnormal scores in lower-income children reduced as passive use increased (P = 0.027) but remained constant for higher-income children. For prosocial outcomes, the likelihood of normal scores increased with active use in lower-income children, but not higher-income children (P = 0.005). Sex did not moderate these associations. The findings suggest that targeted interventions supporting disadvantaged children to use natural environments could help address inequalities in mental wellbeing. Further, the moderated associations with types of use suggest the equigenic effects of natural environments may operate through multiple pathways., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Curriculum change is relatively frequent in health professional education. Formal, planned curriculum review must be conducted periodically to incorporate new knowledge and skills, changing teaching and learning methods or changing roles and expectations of graduates. Unplanned curriculum evolution arguably happens continually, usually taking the form of "minor" changes that in combination over time may produce a substantially different programme. However, reviewing assessment practices is less likely to be a major consideration during curriculum change, overlooking the potential for unintended consequences for learning. This includes potentially undermining or negating the impact of even well-designed and important curriculum changes. Changes to any component of the curriculum "ecosystem "- graduate outcomes, content, delivery or assessment of learning - should trigger an automatic review of the whole ecosystem to maintain constructive alignment. Consideration of potential impact on assessment is essential to support curriculum change. Powerful contextual drivers of a curriculum include national examinations and programme accreditation, so each assessment programme sits within its own external context. Internal drivers are also important, such as adoption of new learning technologies and learning preferences of students and faculty. Achieving optimal and sustainable outcomes from a curriculum review requires strong governance and support, stakeholder engagement, curriculum and assessment expertise and internal quality assurance processes. This consensus paper provides guidance on managing assessment during curriculum change, building on evidence and the contributions of previous consensus papers.

The objective of the ASPIRE award programme of the International Association for Health Professions Education is to go beyond traditional accreditation processes. Working in partnership with the ASPIRE Academy, the programme aims to encourage and support excellence in health professions education, in part by showcasing and exemplifying best practices. Each year ASPIRE award applications received from institutions across the globe describe their greatest achievements in a variety of areas, one of which is curriculum development, where evaluation of applications is carried out using a framework of six domains. These are described in this paper as key elements of excellence, specifically, Organisational Structure and Curriculum Management; Underlying Educational Strategy; Content Specification and Pedagogy; Teaching and Learning Methods and Environment; Assessment, Monitoring and Evaluation; Scholarship. Using examples from the content of submissions of three medical schools from very different settings that have been successful in the past few years, achievements in education processes and outcomes of institutions around the world are highlighted in ways that are relevant to their local and societal contexts.

There has been a growing interest in policies that encourage local living by promoting accessible and walkable communities, such as the 20-minute neighbourhood concept. Despite the widespread adoption of this policy in cities worldwide, little research has been conducted on the characteristics of children's 20-minute neighbourhoods and their association with time spent locally. This study aimed to explore the features of Scottish children's 20-minute neighbourhoods by analysing an 800-meter road and path network buffer surrounding 687 children's homes. Based on existing literature, the study identified key features associated with children's time spent locally and the 20-minute neighbourhood policy. The study then examined variations in these features by socioeconomic status, urbanicity, and gender. The findings revealed significant inequalities in the presence of health-benefiting (e.g., green spaces, recreational facilities, healthy food outlets) and health-harming (e.g., major roads, unhealthy commodity retailers) environments within children's 20-minute neighbourhoods. Children from more deprived areas had access to more of both types of environments. The study also found that having a school within a 20-minute neighbourhood was associated with an increased amount of time spent locally (IRR 1.62, 95% CI 1.5 to 1.8, p<0.001). The study suggests that the 20-minute neighbourhood policy should extend beyond mere access to local amenities and prioritise creating healthy 20-minute neighbourhoods, particularly in socioeconomically deprived areas. The research highlights the importance of promoting equal access to quality local environments, which can contribute to improved health and well-being outcomes for children.

Purpose: School recess provides a valuable opportunity for children's daily moderate- to vigorous-intensity physical activity (MVPA). This study aimed to quantify MVPA during school recess in a representative sample of Scottish children and examine whether recess MVPA varied by gender, socioeconomic status, season, urban/rural residency, and recess length., Method: Five-day accelerometry MVPA data were analyzed from 773 children (53.9% girls, 46.1% boys, 10- to 11-y-olds) from 471 schools. Binary logistic regression explored associations between meeting/not meeting the recommendation to spend 40% of recess time in MVPA and the aforementioned risk factors. Descriptive recess data were also analyzed., Results: Participants spent an average of 3.2 minutes (SD 2.1) in MVPA during recess. Girls engaged in 2.5 minutes (SD 1.7) of MVPA compared with 4.0 minutes (SD 2.2) for boys. Only 6% of children met the recess MVPA recommendation. The odds of girls (odds ratio 0.09; 95% confidence interval, 0.04-0.25) meeting the recommendation was lower (P < .001) compared with boys. No statistically significant differences were observed in meeting the recommendation for the other risk factors., Conclusion: Levels of MVPA during school recess are very low in Scottish children, and interventions aimed at increasing MVPA during recess are needed.

Nature-based play benefits children's health and development. However, the delivery of this in early learning and childcare centres (ELC) is extremely diverse, and implementation is not well understood. We applied a systems science perspective to understand the factors crucial to implementing nature-based outdoor play in ELC settings. Through Group Model Building workshops with 20 participants in managerial and practitioner roles, crucial factors were appraised using Causal Loops Diagrams. Twelve thematic causal loops emerged. Network analysis was employed to analyse the diagram. Exponential Random graph models explained the diagram construction process. Centrality measures alongside conditional uniform tests identified six leverage factors: use of outdoor space, culture of being outdoors, ELC culture of outdoor play, perceived child safety and enjoyment, educator confidence and educator agency. This research brings novel and practically relevant evidence about the important factors, and interdependencies, involved in the implementation of outdoor play practice within ELC settings., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Outdoor and nature experiences including play have been shown to be beneficial for children's physical, cognitive, social and emotional development. Parents/carers play an important role in encouraging or impeding their child's access to the outdoor environment and participation in outdoor play. The COVID-19 pandemic and associated restrictions on free movement and social interactions placed an unprecedented pressure on families to manage the drastic change in their daily routines. This paper reports findings from two combined data sets generated in 2020 during the COVID-19 pandemic and provides a deeper understanding of the interconnected nature of how contextual factors influence parenting processes and outcomes relating to young children's outdoor and nature experiences and subsequent child health. Findings have the potential to inform the messaging of existing outdoor play policies and the content of new interventions aiming to promote the exposure of children to the natural outdoor environment., Competing Interests: Declaration of competing interest The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Systemic drug delivery to the central nervous system (CNS) has been historically impeded by the presence of the blood brain barrier rendering many therapies inefficacious to any cancer cells residing within the brain. Therefore, local drug delivery systems are being developed to overcome this shortfall. Here we have manufactured polymeric microneedle (MN) patches, which can be anchored within a resection cavity site following surgical removal of a tumour such as isocitrate dehydrogenase wild type glioblastoma (GBM). These MN patches have been loaded with polymer coated nanoparticles (NPs) containing cannabidiol (CBD) or olaparib (OLA) and applied to an in vitro brain simulant and ex vivo rat brain tissue to assess drug release and distance of penetration. MN patches loaded with methylene blue dye were placed into a cavity of 0.6 % agarose to simulate brain tissue. The results showed that clear channels were generated by the MNs and the dye spread laterally throughout the agarose. When loaded with CBD-NPs, the agarose showed a CBD concentration of 12.5 µg/g at 0.5 cm from the MN insertion site. Furthermore, high performance liquid chromatography of ex vivo brain tissue following CBD-NP/MN patch insertion showed successful delivery of 59.6 µg/g into the brain tissue. Similarly, OLA-NP loaded MN patches showed delivery of 5.2 µg/g OLA into agarose gel at 0.5 cm distance from the insertion site. Orbitrap secondary ion mass spectrometry (OrbiSIMS) analysis confirmed the presence of OLA and the MN patch at up to 6 mm away from the insertion site following its application to a rat brain hemisphere. This data has provided insight into the capabilities and versatility of MN patches for use in local brain drug delivery, giving promise for future research., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

During the early years, children's outdoor play is dependent on parental supervision. Parents' perceptions are likely to influence what the child is permitted to do. To better understand the involved mechanisms in parents' decision making in such contexts, an online photo-based questionnaire was administered. The tool investigates, in different situations, parents and their children's experience, parents' perceptions, and permission to play. A total of 417 parents of children aged from 1.5 and 6.0 completed the questionnaire. Results showed that parents, overall, have a positive attitude towards outdoor play. Main concerns were about risk of injury but in most cases, perceived benefits outweigh perceived dangers. "Sawing wood" was the only situation with a negative benefits/dangers balance. A linear regression analysis revealed that permission to play outdoors is based on parental assessment of benefits and dangers. Perceived benefits appeared to have more influence on parental decision than perceived dangers, while perceived competence had only a small influence. The results also showed that parents' childhood experience of outdoor play was an important determinant for adults' perceptions, perhaps demonstrating intergenerational concerns, as outdoor play is in decline. To overcome a negative intergenerational effect on children's outdoor play, interventions and communication should focus on associated benefits.

Nature-based play and learning provision is becoming increasingly popular across the early learning and childcare (ELC) sector in Scotland. However, there remains a lack of understanding of how the program is expected to function. This has implications for program learning and may affect wider rollout of the program. Secondary data analysis of parent interviews ( n  = 22) and observations ( n  = 7) in Scottish ELC settings, and review of internationally published studies ( n  = 33) were triangulated to develop a program theory using the Theory of Change approach. This approach makes a program's underlying assumptions explicit by systematically demonstrating the relationship between each component: inputs, activities, outcomes, impact , and the contexts of the program. Findings suggested that location of outdoor nature space, affordances, availability of trained practitioners, and transport to location lead to activities such as free play, educator-led activities, and interactions with nature, resulting in longer durations of physical activity, interactions with peers and educators, and increased engagement with the natural environment. These activities are vital for supporting children's physical, cognitive, social, and emotional development. Our results demonstrate the value of using secondary data analysis to improve our understanding of the underlying theory of nature-based ELC which can support future evaluation designs. These findings will be of interest to program evaluators, researchers, practitioners, and funders, who find themselves with limited resources and want to better understand their program before investing in an evaluation. We encourage researchers and evaluators in the field of early years and outdoor play in other countries to refine this logic model in their own context-specific setting., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Traynor, Martin, Johnstone, Chng, Kenny and McCrorie.)

Systematic reviews have demonstrated the scarcity of well-designed evaluations investigating outdoor nature-based play and learning provision for children in the early learning and childcare (ELC) sector among global Western countries. This study will examine the feasibility and acceptability of the programme and the evaluation design of outdoor nature-based play and learning provision across urban ELC settings in a Scottish metropolitan city. Six ELC settings with different outdoor nature-based play delivery models will be recruited. One trial design will be tested: a quasi-experimental comparison of children attending three different models of outdoor play and learning provision. Measures will be assessed at baseline and five weeks later. Key feasibility questions include: recruitment and retention of ELC settings and children; suitability of statistical matching based on propensity score; completeness of outcome measures. Process evaluation will assess the acceptability of trial design methods and provision of outdoor nature-based play among ELC educators. These questions will be assessed against pre-defined progression criteria. This feasibility study will inform a powered effectiveness evaluation and support policy making and service delivery in the Scottish ELC sector.

This systematic review synthesised evidence on associations between nature-based early childhood education (ECE) and children's social, emotional, and cognitive development. A search of nine databases was concluded in August 2020. Studies were eligible if: (a) children (2-7 years) attended ECE, (b) ECE integrated nature, and (c) assessed child-level outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis included effect direction, thematic analysis, and results-based convergent synthesis. One thousand three hundred and seventy full-text articles were screened, and 36 (26 quantitative; 9 qualitative; 1 mixed-methods) studies were eligible. Quantitative outcomes were cognitive ( n = 11), social and emotional ( n = 13), nature connectedness ( n = 9), and play ( n = 10). Studies included controlled ( n = 6)/uncontrolled ( n = 6) before-after, and cross-sectional ( n = 15) designs. Based on very low certainty of the evidence, there were positive associations between nature-based ECE and self-regulation, social skills, social and emotional development, nature relatedness, awareness of nature, and play interaction. Inconsistent associations were found for attention, attachment, initiative, environmentally responsible behaviour, and play disruption/disconnection. Qualitative studies ( n = 10) noted that nature-based ECE afforded opportunities for play, socialising, and creativity. Nature-based ECE may improve some childhood development outcomes, however, high-quality experimental designs describing the dose and quality of nature are needed to explore the hypothesised pathways connecting nature-based ECE to childhood development (Systematic Review Registration : CRD42019152582).

Background: The purpose was to synthesize evidence on the association between nature-based Early Childhood Education (ECE) and children's physical activity (PA) and motor competence (MC)., Methods: A literature search of 9 databases was concluded in August 2020. Studies were eligible if (1) children were aged 2-7 years old and attending ECE, (2) ECE settings integrated nature, and (3) assessed physical outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis was conducted using effect direction (quantitative), thematic analysis (qualitative), and combined using a results-based convergent synthesis., Results: 1370 full-text articles were screened and 39 (31 quantitative and 8 qualitative) studies were eligible; 20 quantitative studies assessed PA and 6 assessed MC. Findings indicated inconsistent associations between nature-based ECE and increased moderate to vigorous PA, and improved speed/agility and object control skills. There were positive associations between nature-based ECE and reduced sedentary time and improved balance. From the qualitative analysis, nature-based ECE affords higher intensity PA and risky play, which could improve some MC domains. The quality of 28/31 studies was weak., Conclusions: More controlled experimental designs that describe the dose and quality of nature are needed to better inform the effectiveness of nature-based ECE on PA and MC.

Historically, pre-clinical neuro-oncological drug delivery studies have exhaustively relied upon overall animal survival as an exclusive measure of efficacy. However, with no adopted methodology to both image and quantitate brain parenchyma penetration of label-free drugs, an absence of efficacy typically hampers clinical translational potential, rather than encourage re-formulation of drug compounds using nanocarriers to achieve greater tissue penetration. OrbiSIMS, a next-generation analytical instrument for label-free imaging, combines the high resolving power of an OrbiTrapTM mass spectrometer with the relatively high spatial resolution of secondary ion mass spectrometry. Here, we develop an ex vivo pipeline using OrbiSIMS to accurately detect brain penetration of drug compounds. Secondary ion spectra were acquired for a panel of drugs (etoposide, olaparib, gemcitabine, vorinostat and dasatinib) under preclinical consideration for the treatment of isocitrate dehydrogenase-1 wild-type glioblastoma. Each drug demonstrated diagnostic secondary ions (all present molecular ions [M-H]− which could be discriminated from brain analytes when spiked at >20 µg/mg tissue. Olaparib/dasatinib and olaparib/etoposide dual combinations are shown as exemplars for the capability of OrbiSIMS to discriminate distinct drug ions simultaneously. Furthermore, we demonstrate the imaging capability of OrbiSIMS to simultaneously illustrate label-free drug location and brain chemistry. Our work encourages the neuro-oncology community to consider mass spectrometry imaging modalities to complement in vivo efficacy studies, as an analytical tool to assess brain distribution of systemically administered drugs, or localised brain penetration of drugs released from micro- or nano-scale biomaterials.