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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 papers of Francis Walsingham, being the first batch of secretarial documents deposited in the State Paper Office, initiated the whole business of archiving English State Papers and illustrated how the early State Papers were dispersed into private collections. This article aims to present the formation of the Tudor State Papers by explaining Walsingham’s secretarial procedures in registering, deciphering, summarizing, duplicating, categorizing, and depositing documents. More significantly, the dispersing routes of Walsingham’s papers after his death in 1590 will be reconstructed by tracing backwards from their present distribution. This fragmentation arose chiefly from four causes: retention by Walsingham’s servants either for their immediate keeping or for new patronage; the “public-only” selection policy; theft by Jacobean antiquarians; and various transfers via loan, marriage, sale, inheritance, or bestowal. The formation and dispersal of Tudor State Papers reveals the “invasion” of Elizabethan espionage network, state information system, and government administration by ministerial clienteles. [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]

Background: Harmful Alcohol use is frequent among opioid dependents patients undergoing agonist maintenance treatment. The objective assessment of harmful alcohol use can be done using laboratory measures of serum biomarkers. For community-based patients, there is often a requirement of an alternative method due to lack of onsite laboratory services. The aim of the study was to examine filter paper as a matrix to measure serum biomarkers of harmful alcohol use. Methods: The initial phase involved standardization of the filter-paper-based assay. Conditions were optimised for extraction and estimation of alcohol biomarkers (Aspartate Aminotransferase; AST, Alanine Aminotransferase; ALT, Gamma Glutamyl transferase; GGT and Carbohydrate Deficient Transferrin; CDT) from the filter paper. For clinical validation, serum samples were collected from community clinics. Biomarker levels obtained from both the methods were correlated using linear regression analysis. Limits of agreement between the two methods was estimated using the Intraclass Correlation Coefficient (ICC). Results: The extraction of enzymes (AST, ALT and GGT) from filter paper was carried out using the substrate buffer available with the reagent kit (Randox, UK). CDT was readily extracted from filter paper using deionised water. Serum biomarker levels measured from samples collected from community clinics correlated well with filter paper extracted levels (ICC 0.97-0.99). More than 90% of alcohol biomarker levels were recovered from the filter paper matrix using this method. Conclusion: Filter paper has the potential to be used as a matrix to objectively measure alcohol biomarkers among opioid-dependent patients from community settings lacking onsite laboratory facilities. [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]

In December 2020, seeking to start cashing in on its desired 'Brexit dividends', the UK Government published the Green Paper 'Transforming Public Procurement'. The Green Paper sets out a blueprint for the reform of UK public procurement law that aims to depart from the regulatory baseline of EU law and deliver a much-touted 'bonfire of procurement red tape'. The Green Paper seeks 'to speed up and simplify [UK] procurement processes, place value for money at their heart, and unleash opportunities for small businesses, charities and social enterprises to innovate in public service delivery'. The Green Paper aims to do so by creating 'a progressive, modern regime which can adapt to the fastmoving environment in which business operates' underpinned by 'a culture of continuous improvement to support more resilient, diverse and innovative supply chains.' I argue that the Green Paper has very limited transformative potential and that its proposals merely represent an 'EU law +' approach to the regulation of public procurement that would only result in an overcomplicated regulatory infrastructure, additional administrative burdens for both public buyers and economic operators, and tensions and contradictions in the oversight model. I conclude that a substantial rethink is needed if the Green Paper's goals are to be achieved. [ABSTRACT FROM AUTHOR]

The COVID-19 Psychological Wellbeing Study was designed and implemented as a rapid survey of the psychosocial impacts of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known as COVID-19 in residents across the United Kingdom. This study utilised a longitudinal design to collect online survey based data. The aim of this paper was to describe (1) the rationale behind the study and the corresponding selection of constructs to be assessed; (2) the study design and methodology; (3) the resultant sociodemographic characteristics of the full sample; (4) how the baseline survey data compares to the UK adult population (using data from the Census) on a variety of sociodemographic variables; (5) the ongoing efforts for weekly and monthly longitudinal assessments of the baseline cohort; and (6) outline future research directions. We believe the study is in a unique position to make a significant contribution to the growing body of literature to help understand the psychological impact of this pandemic and inform future clinical and research directions that the UK will implement in response to COVID-19. [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]

Background: The COVID‐19 pandemic and the UK government's subsequent coronavirus action plan have fundamentally impacted on every aspect of healthcare. One area that is severely affected is ear, nose and throat (ENT)/laryngology where speech and language therapists (SLTs) engage in a diverse range of practice with patients with a range of conditions, including voice disorders, airway problems, and head and neck cancers (HNCs). A large majority of these patients are in high‐risk categories, and many specialized clinical practices are vulnerable. In addition, workforce and research issues are challenged in both the immediate context and the future. Aims: To discuss the threats and opportunities from the COVID‐19 pandemic for SLTs in ENT/laryngology with specific reference to clinical practice, workforce and research leadership. Methods & Procedures: The relevant sections of the World Health Organisation's (WHO) health systems building blocks framework (2007) were used to structure the study. Expert agreement was determined by an iterative process of multiple‐group discussions, the use of all recent relevant policy documentation, and other literature and shared documentation/writing. The final paper was verified and agreed by all authors. Main Contribution: The main threats to ENT/laryngology SLT clinical services include increased patient complexity related to COVID‐19 voice and airway problems, delayed HNC diagnosis, reduced access to instrumental procedures and inequitable care provision. The main clinical opportunities include the potential for new modes of service delivery and collaborations, and harnessing SLT expertise in non‐instrumental assessment. There are several workforce issues, including redeployment (and impact on current services), training implications and psychological impact on staff. Workforce opportunities exist for service innovation and potential extended ENT/SLT practice roles. Research is threatened by a reduction in immediate funding calls and high competition. Current research is affected by very limited access to participants and the ability to conduct face‐to‐face and instrumental assessments. However, research opportunities may result in greater collaboration, and changes in service delivery necessitate robust investigation and evaluation. A new national set of research priorities is likely to emerge. Conclusions & Implications: The immediate impact of the pandemic has resulted in major disruption to all aspects of clinical delivery, workforce and research for ENT/laryngology SLT. It is unclear when any of these areas will resume operations and whether permanent changes to clinical practice, professional remits and research priorities will follow. However, significant opportunity exists in the post‐COVID era to re‐evaluate current practice, embrace opportunities and evaluate new ways of working. What this paper addsWhat is already known on the subjectENT/laryngology SLTs manage patients with a range of conditions, including voice disorders, airway problems and HNCs. The diverse scope of clinical practice involves highly specialized assessment and treatment practices in patients in high‐risk categories. A large majority of active research projects in this field are patient focused and involve instrumental assessment. The COVID‐19 pandemic has created both opportunities and threats for ENT SLT clinical services, workforce and research.What this paper adds to existing knowledgeThis study provides a discussion of the threats and opportunities from the COVID‐19 pandemic for ENT/laryngology SLT with specific reference to clinical practice, workforce and research leadership.What are the potential or actual clinical implications of this work?The COVID‐19 pandemic has resulted in major disruption to all aspects of clinical delivery, workforce and research for ENT/laryngology SLT. Changes to clinical practice, professional remits and research priorities are of indeterminant duration at this time, and some components could be permanent. Significant clinical practice, workforce and research opportunities may exist in the post‐COVID era. [ABSTRACT FROM AUTHOR]

The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of palliative care interventions in LTCFs. The PACE study mapped palliative care in LTCFs in Europe, evaluated quality of end-of-life care and quality of dying in a cross-sectional study of deceased residents of LTCFs in 6 countries, and undertook a cluster-randomized control trial that evaluated the impact of the PACE Steps to Success intervention in 7 countries. Working with the European Association for Palliative Care, a white paper was written that outlined recommendations for the implementation of interventions to improve palliative and end-of-life care for all older adults with serious illness, regardless of diagnosis, living in LTCFs. The goal of the article is to present these key domains and recommendations. Transparent expert consultation. International experts in LTCFs. Eighteen (of 20 invited) international experts from 15 countries participated in a 1-day face-to-face Transparent Expert Consultation (TEC) workshop in Bern, Switzerland, and 21 (of 28 invited) completed a follow-up online survey. The TEC study used (1) a face-to-face workshop to discuss a scoping review and initial recommendations and (2) an online survey. Thirty recommendations about implementing palliative care for older people in LTCFs were refined during the TEC workshop and, of these, 20 were selected following the survey. These 20 recommendations cover domains at micro (within organizations), meso (across organizations), and macro (at national or regional) levels addressed in 3 phases: establishing conditions for action, embedding in everyday practice, and sustaining ongoing change. We developed a framework of 20 recommendations to guide implementation of improvements in palliative care in LTCFs. [ABSTRACT FROM AUTHOR]

This paper provides empirical evidence that individuals substantially revise their stated wealth redistribution preferences after fiscal scandals. The 2016 Panama Papers scandal revealed top-income tax evasion behaviour simultaneously worldwide. The empirical investigation exploits this event as a quasi-natural experiment. I rely on two original datasets, a UK household longitudinal dataset and a survey conducted in 22 European countries. I use a difference-in-differences strategy and find that pro-redistribution statements increased between 2% and 3.3% after the scandal. Responses are heterogeneous and larger for right-wing individuals and low-income individuals. This change in wealth redistribution preferences is likely to have been translated into a slight change in votes. The results suggest an increase in stated voting intentions for the left and a decrease for the right. Complementary estimations reveal that more media coverage and more individuals involved by country increase the magnitude of the response. [ABSTRACT FROM AUTHOR]

In 2016 the Government invited English local authority employers of social workers and university providers of social work qualifying programmes to apply jointly for funding to become social work teaching partnerships. This was in response to its concerns about the limited engagement of local authorities with qualifying training programmes. It was also part of the Government's strategy to ensure that students qualified as social workers with what it considered to be the right knowledge and skills and to improve their recruitment, retention and development and overall quality of practice. Following an evaluation of one partnership, this discussion paper addresses the evolution of these arrangements as found in consultations with representatives of 10 social work teaching partnerships (held 2017–18), the four original pilots and the six others that were subsequently funded. Drawing on a synthesis of the partnerships' reported experiences, this paper reports the variations in their approaches and sets out the challenges they faced and addressed, contextualising this in the policy landscape in which they were introduced and operated. [ABSTRACT FROM AUTHOR]

Globally there is a shortage of organs available for transplant resulting in thousands of lives lost as a result. Recently in the United Kingdom 457 people died as a result of organ shortage in just 1 year. 1 NHS Blood and Transplant suggest national debates to test public attitudes to radical actions to increase organ donation should be considered in addressing organ shortage. The selling of organs for transplant in the United Kingdom is prohibited under the Human Tissue Act 2004. This discussion paper considers five ethical objections raised in the United Kingdom to paid donation and discusses how these objections are addressed within the only legal and regulated paid living unrelated renal donation programme in the world in Iran, where its kidney transplant list was eliminated within 2 years of its commencement. This article discusses whether paid living unrelated donation in Iran increases riskier donations and reduced altruistic donation as opponents of paid donation claim. The paper debates whether objections to paid donation based upon commodification arguments only oppose enabling financial ends, even if these ends enable beneficent acts. Discussions in relation to whether valid consent can be given by the donor will take place and will also debate the objection that donors will be coerced and exploited by a paid model. This article suggests that exploitation of the paid donor within the Iranian model exists within the legally permitted framework. However, paid living kidney donation should be discussed further and other models of paid donation considered in the United Kingdom as a radical means of increasing donation. [ABSTRACT FROM AUTHOR]

Plain language summary: What is it?: Fetal neonatal alloimmune thrombocytopenia (FNAIT), also known as neonatal alloimmune thrombocytopenia (NAIT) or fetomaternal alloimmune thrombocytopenia (FMAIT), is a rare condition which affects a baby's platelets. This can put them at risk of problems with bleeding, particularly into the brain. One baby per week in the UK may be seriously affected and milder forms can affect one in every 1000 births. How is it caused?: Platelets are blood cells that are very important in helping blood to clot. All platelets have natural proteins on their surface called human platelet antigens (HPAs). In babies, half of these antigens are inherited from the mother and half from the father. During pregnancy, some of the baby's platelets can cross into the mother's bloodstream. In most cases, this does not cause a problem. But in cases of FNAIT, the mother's immune system does not recognise the baby's HPAs that were inherited from the father and develops antibodies, which can cross the placenta and attack the baby's platelets. These antibodies are called anti‐HPAs, and the commonest antibody implicated is anti‐HPA‐1a, but there are other rarer antibody types. If this happens, the baby's platelets may be destroyed causing their platelet count to fall dangerously low. If the platelet count is very low there is a risk to the baby of bleeding into their brain before they are born. This is very rare but if it happens it can have serious effects on the baby's health. How is it inherited?: A baby inherits half of their HPAs from its mother and half from its father. Consequently, a baby may have different HPAs from its mother. As the condition is very rare, and even if the baby is at risk of the condition we have no way of knowing how severely they will be affected, routine screening is not currently recommended. What can be done?: FNAIT is usually diagnosed if a previous baby has had a low platelet count. The parents are offered blood tests and the condition can be confirmed or ruled out. There are many other causes of low platelets in babies, which may also need to be tested for. As the condition is so rare, expertise is limited to specialist centres and normally a haematologist and fetal medicine doctor will perform and interpret the tests together. Fortunately, there is an effective treatment for the vast majority of cases called immunoglobulin, or IVIg. This 'blood product' is given intravenously through a drip every week to women at risk of the condition. It may be started from as early as 16 weeks in the next pregnancy, until birth, which would be offered at around 36–37 weeks. Less common treatments that may be considered depending on individual circumstances include steroid tablets or injections, or giving platelet transfusions to the baby. What does this paper tell you?: This paper considers the latest evidence in relation to treatment options in the management of pregnancies at risk of FNAIT. Specifically, we discuss the role of screening, when IVIg should be started, what dose should be used, and what evidence there is for maternal steroids. We also consider in very rare selected cases, the use of fetal blood sampling and giving platelet transfusions to the baby before birth. Finally, we consider the approaches to blood testing mothers to tell if babies are at risk, which is offered in some countries, and development of new treatments to reduce the risk of FNAIT. [ABSTRACT FROM AUTHOR]

Staphylococcus argenteus and Staphylococcus schweitzeri, previously known as divergent Staphylococcus aureus clonal lineages, have been recently established as novel, difficult-to-delimit, coagulase-positive species within the S. aureus complex. Methicillin-resistant strains of S. argenteus are known from Australia and the UK. Knowledge of their epidemiology, medical significance and transmission risk is limited and partly contradictory, hampering definitive recommendations. There is mounting evidence that the pathogenicity of S. argenteus is similar to that of 'classical' S. aureus , while as yet no S. schweitzeri infections have been reported. To provide decision support on whether and how to distinguish and report both species. PubMed, searched for S. argenteus and S. schweitzeri. This position paper reviews the main characteristics of both species and draws conclusions for microbiological diagnostics and surveillance as well as infection prevention and control measures. We propose not distinguishing within the S. aureus complex for routine reporting purposes until there is evidence that pathogenicity or clinical outcome differ markedly between the different species. Primarily for research purposes, suitably equipped laboratories are encouraged to differentiate between S. argenteus and S. schweitzeri. Caution is urged if these novel species are explicitly reported. In such cases, a specific comment should be added (i.e. 'member of the S.aureus complex') to prevent confusion with less- or non-pathogenic staphylococci. Prioritizing aspects of patient safety, methicillin-resistant isolates should be handled as recommended for methicillin-resistant Staphylococcus aureus (MRSA). In these cases, the clinician responsible should be directly contacted and informed by the diagnosing microbiological laboratory, as they would be for MRSA. Research is warranted to clarify the epidemiology, clinical impact and implications for infection control of such isolates. [ABSTRACT FROM AUTHOR]

Previous research exploring how working-class women experience UK Higher Education (HE) work has made evident recurring themes around social segregation and corresponding difficulties with feeling they belong. This paper develops this work by exploring the ways in which UK, HE based working-class women lecturers talk about their sense of belonging. It was found that, in contemporary UK HE, lecturing work is located within a marketised space where caring for students is central and the deployment of emotional labour to seen to be a necessary requirement to meet those demands. In addition, this labour is understood to be work that working-class women can readily take up, and as one of the few vehicles to enable feelings of value and belonging. However, this work is also devalued, unaccounted for and potentially harmful to those who do engage in it, therefore shoring up/ reinforcing a class and gender stratified UK academy. [ABSTRACT FROM AUTHOR]

The internet has revolutionised our ability to communicate and connect across historic social, political and geographic divides. Where previously gatekeepers mitigated and negotiated access to mass media platforms, today potentially anyone – and any content – can reach millions of users in an instant. This development bears great opportunities for the democratisation of expression and the diversification of public discourse but has likewise broadened the impact of harm caused online. This raises the question how platforms and services can be regulated effectively to combat online harms without jeopardising free and open discourse. The paper explores the Online Harms White Paper published by the UK Government earlier this year and compares its regulatory approach with the infamous German Network Enforcement Law. [ABSTRACT FROM AUTHOR]

This article examines John Bruce's vision of the bureaucratic archives of the British state and empire at the end of the eighteenth century. As Historiographer to the East India Company and Keeper of State Papers in the 1790s and early 1800s, Bruce used the archives of corporate and state government as sources of bureaucratic knowledge to justify and plan imperial and domestic policy. In this way, Bruce deployed a strategy of governance by the authority of "state papers," rooted in early modern political practice, across imperial and domestic government. The demise of Bruce's influence signaled the waning of this role of the archive as a technology of governance in Britain during the nineteenth century. [ABSTRACT FROM AUTHOR]

Summary: The International Collaboration for Transfusion Medicine Guidelines (ICTMG) has published guidance on transfusion for haemoglobinopathies. To give a UK perspective on this guidance, each of the recommendations in the ICTMG guideline were reviewed and the applicability for transfusion practice in the UK considered with reference to relevant published British Society for Haematology (BSH) guidelines and national standards. There was much consensus; however, there was disparity surrounding the recommendations for routinely extended matching in those with alloimmunisation. [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]

As an increasing number of British universities are now requiring/encouraging mathematics applicants to have taken ‘extension papers’ such as the Mathematics Admissions Test (MAT), Advanced Extension Award (AEA) and Sixth Term Examination Paper (STEP), current students were asked how useful they were in preparation for their degree. The MAT was most commonly described as good preparation for undergraduate mathematics, whilst most participants who had taken the AEA were indifferent regarding its usefulness. Participants were positive about STEP, commending its similarity to undergraduate-style assessment and its challenging questions. The students’ views suggested that those wishing to be well prepared for tertiary mathematics should take one of these papers, preferably STEP. However, whilst universities may not necessarily wish to require applicants to pass extension papers, it may be beneficial for universities to recommend students to take them in order to improve their mathematical thinking and expectations of undergraduate mathematics study. [ABSTRACT FROM AUTHOR]

Medication abortion has been established globally as safe and effective. This modality has increased accessibility and the opportunity to centre individual autonomy at the heart of abortion care, by facilitating self-managed abortion. Previous research has shown how self-managed abortion is beneficial in myriad settings ranging from problematic to (relatively) unproblematic contexts of access. In this paper we explore the relationship between self-management and sources of support (including health professionals, family, and friends); as well as considering issues of reproductive control and autonomy. Drawing on qualitative, experience-centred interviews, we utilise the concept of social connectedness to examine how supported self-managed abortion was experienced in the United Kingdom during the COVID-19 pandemic. Overall, self-management was welcomed, with participants speaking positively about managing their own abortion at home. However, a sense of connectedness was crucial in helping participants deal with difficult experiences; and functioned to support individual autonomy in self-care. This paper is the first to examine factors of connection, support, and isolation, as experienced by those undergoing self-managed abortion in the UK in detail. Our research suggests a continued need to advocate for high quality support for self-managed abortion, as well as for choice of abortion method, to support patient-centered care. [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]