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There is an ever-growing body of research relating to disabled pupils' experiences of physical education (PE). However, our research is novel because it draws on an ableism-critical perspective to amplify the voices and centre the PE experiences of pupils with juvenile idiopathic arthritis (JIA). We used an online survey to gather quantitative and qualitative data from 100 participants with a diagnosis to explore their perceptions of: (a) the influence of JIA on participation in PE; (b) relationships with same-aged peers and their influence on experiences in PE; (c) relationships with teachers and their influence on experiences in PE; and (d) the appropriateness of the PE curriculum. Microsoft Excel was utilised to analyse quantitative data and produce descriptive statistics that were used to map views and experiences of PE, while qualitative data generated from open questions were analysed thematically. We discuss data in relation to the following themes: (a) pain, fatigue, and fear of injury restricted participation in PE; (b) awareness and (mis)understanding of JIA; (c) the negative judgements of others and peer bullying in PE; and (d) the (in)appropriateness of the PE curriculum. We end this article by emphasising the importance of disrupting ableist ideologies, discourses, and knowledge, particularly as these all relate to (mis)understandings of JIA and negative perceptions about the ability of such pupils in PE, because they are contributing to the marginalisation and ostracisation of pupils with JIA.

The BERA initiative on promoting Close-to-Practice (CtP) research raises new challenges for action research, particularly as uncertainties about the standing and rigour of action research were expressed in the report of the education panel for the 2015 Research Excellence Framework (REF) in the United Kingdom. The work of tackling these challenges is essential in advancing CtP research, and it discloses, in turn, new possibilities. In this paper we review some pioneering developments in action research and analyse the difficulties it has experienced in securing parity of standing with other forms of research. We argue that action research is more than, and sometimes other than, a social science. We seek to show that if action research is to be recognised by credentials that are its own, and judged by criteria that are proper to it, not only does it lose any lower standing. Rather, it becomes a major pathway, with deep roots in the critical traditions of Western practical philosophy, through which the defining purposes of education itself, as a distinctive human practice, are ascertained and affirmed, pursued and appraised.

In the UK, one consequence of neoliberalism has been the development of test cultures in schools and standardised assessment strategies used to judge all pupils against within and across curriculum subjects. Few studies to date have explored the influence of this on assessing the learning of pupils with special educational needs and disabilities (SEND), and none have centred physical education (PE). This study used the concept of ableism and semi-structured interviews to explore mainstream secondary school PE teachers' views and experiences of assessing the learning of pupils with SEND. Based on the findings, we discuss the importance of schools disrupting hegemonic, ableist modes of thinking that cast pupils with SEND as being of inferior ability when compared with their peers and thus being disadvantaged by standardised, normative assessment practices. Specifically, we identify a need for senior leaders and teachers in schools to recognise the needs and capabilities of pupils with SEND, through more holistic assessment approaches that focus on social, affective, cognitive and physical learning and development. We end by discussing the significance of initial teacher education and teacher networks to support this endeavour and advocating for the amplification of the voices of pupils with SEND, given that they have expert knowledge about the perceived inclusivity of assessment in PE because they can draw upon their lived and embodied experiences.

The paper focuses on the importance of Internationalisation at Home, access and support mechanisms which are provided and co-created by students and university departments to encourage sanctuary scholarship. The paper gives particular attention to activities that encourage meaningful interaction with local communities and widen international participation of marginalised groups, such as students from the global south and asylum seeker communities. The paper presents two case studies. The first case study focuses on a student-led project developed by the students and staff of Canterbury Christ Church University. The second case study projects students' voices from the global south and refugee communities at The University of Kent and University College London (UCL). The experiences of these students highlight the importance of welcoming and supporting students from marginalised backgrounds. They also demonstrate the need for both curriculum-based and co-curricular activity and student services which provided tailored support and encouragement.

The Research Excellence Framework is a high-stakes exercise used by the UK government to allocate billions of pounds of quality-related research (QR) funding and used by the media to rank universities and their departments in national league tables. The 2008, 2014 and 2021 assessments were zero-sum games in terms of league table position because the outcomes were captured as Grade Point Averages (GPA) on a ratio scale, unlike the 1996 and 2001 iterations when departments were ranked on a simple seven-point ordinal scale. Although league tables were never part of the assessment itself, they were inevitable in 2008, 2014 and 2021 given the nature of the scoring, and subsequent league table position had a significant effect on investment and disinvestment within universities. This paper uses data from the 2008, 2014 and 2021 assessments to look at the changing competitiveness of different subjects, the size of submissions, and how these are related to QR funding. It finds that competition in the UK research sector is exceptionally tough, but that competitiveness and QR funding are so closely related to submission size that it calls into question the benefit of carrying out any more assessment exercises in their current format.

The COVID-19 pandemic disproportionately affected young people in relation to their mental health, educational provision, and social development, impacting their employment prospects and future prosperity. In response, the United Kingdom government implemented a range of formal policy solutions to address issues around youth employability. However, studies are yet to examine how non-formal or alternative educational approaches, such as sport and physical activity interventions, can be used intentionally to enhance employability and tackle the youth employment challenges brought about by the pandemic. This article draws upon interviews with 20 organisations working within the sport and youth employability sector to provide insight into employment issues that have been created or exacerbated by COVID-19 and outlines how sport-based interventions might help to address these challenges. Findings demonstrate that the intentional use of sport and physical activity offers an attractive means to (re-)engage young people with employability programmes and support their preparedness for work, especially those furthest from an employment destination. The article also highlights how sport-based interventions can generate broader social impact, to address young people's social and emotional difficulties, rebuild their confidence, and re-connect them with formal systems of education and training that many had become dislocated from during the pandemic.

Learners with disabilities are often denied field-based learning experiences in naturalistic disciplines. Geology can present substantial barriers due to rugged terrain in difficult-to-reach locations. In 2014, a field trip was executed with the dual purpose of 1) designing inclusion in field learning and 2) demonstrating to college faculty an accessible field experience. Direct observations of participants on the trip, as well as pre- and post-trip focus groups, illuminate the student and faculty field learning experience. Geoscience faculty have little guidance or support in understanding what disability is, how to reconcile accommodation with field-geology learning goals, and they cited instances where disability service providers acted as gatekeepers. The net effect of these ontologies is to reduce faculty empathy with, and thus their ability to be inclusive of, students with disabilities in field settings. Recommendations for instructors include taking campus disability-services administrators on field trips, opening and maintaining communications with disability service providers, and designing pedagogically sound field trips that align as much as possible to principles of universal design. An advocacy approach is described, which focuses on the students and the educational process, instead of on institutional compliance. Finally, geoscience faculty should conceptualize disability service providers as accessibility service providers. Keywords: field trips, Earth science, accessibility, inclusive, disabilities.

Residential mobility is a normal feature of family life but thought to be a source of disruption to a child's development. Mobility may have its own direct consequences or reflect families' capabilities and vulnerabilities. This article examines the association between changes of residence and verbal and behavioral scores of children aged 5, contributing to the literature in three ways. First, it compares two countries, by drawing on the Fragile Families and Child Wellbeing study in the United States (N = up to 1,820) and an urban subsample of the U.K. Millennium Cohort study (N = up to 7,967). Second, beside taking into account an extensive range of demographic characteristics, it applies inverse probability weights to minimize observable selection bias associated with residential mobility and further controls for a wide range of family changes that often co-occur with moves. Third, the article adds to extant research on residential mobility by incorporating the type of locality from and into which families move. Individual-level longitudinal data are linked to objective measures of neighborhood socioeconomic status to gauge the quality of moves families make. Results show that residential moves are not inevitably deleterious to children. In both countries the poorer outcomes of some moves result not from moving per se but rather from the context in which they occur.

The concept of capital has risen in prominence within educational policy and practice in the UK since Ofsted introduced cultural capital into its inspection processes in 2019. At the same time, fractured discourses exist across different types of capital -- one of which concerns capitals that are negative in constitution and/or impact. This paper addresses both through: (1) A systematic literature review of these negativities (in social, economic, and intellectual capital) and a thematic analysis of these papers, leading to the derivation of a definition of negative capital; (2) An evaluation of the merit of negative capital via its compatibility with Bourdieu's concepts of social field, social field homology, habitus, and hysteresis; and (3) The application of negative capital to a range of examples from educational practice and theory, including a challenge to Ofsted's use of cultural capital.

Academic work environments are becoming progressively more digitalised and focused on performativity and commodification, increasing the potential to force an unwanted merge of the boundary between work and non-work domains. This study aimed to explore academic wellbeing and the role played by factors related to work-life merge. Data were collected from a cross sectional survey of 605 Australian and 313 UK academics, who were found to have a short version Warwick-Edinburgh Mental Wellbeing Score of 21.47 ± 4.11 and 21.35 ± 4 respectively, which is significantly below population norms. Australian men's scores were significantly lower than Australian women (20.7 ± 0.31, p = 0.007). Job strain was evidenced by excessive work hours, high levels of intrusive work-related thoughts, reduced physical activity and a self-perception that work-life merge adversely affected psychological and physical health, and mostly only occurred to meet work demands. Action by government education and university leaders is urgently required to identify policy and management practices that are contributing to this ongoing health concern. The establishment of national and university based advisory groups and consideration of a data warehouse to curate a public dataset on the wellbeing of staff within universities could assist in ensuring the outcomes of any action are continually assessed.

Objective: This study aimed to understand how family caregivers of people with dementia managed changes caused by COVID-19 restrictions and how they adjusted to the lifting of restrictions. A particular focus of the study was on understanding the impact of social isolation, a reduction of social interactions, and reduced access to healthcare services. Methods and measures: Fourteen voluntary caregivers (nine women) were interviewed using a semi-structured interview schedule. Results: Five themes were identified based on reflexive thematic analysis: (i) Outlets to cope with lockdown; (ii) 'Not all doom and gloom': A silver lining amid COVID-19; (iii) Optimism helps provide resilience; (iv) The challenges and joys of reopening; and (v) Caregiving toward a new normality. Conclusion: The research highlighted difficulties reported by family caregivers and people with dementia during COVID-19, while also showing how such carers coped. Interviews also identified ways that family caregivers often used optimism to help navigate through lockdown and to tackle the reopening stage. Family caregivers in this study reported coping well overall, but welcomed the lifting of restrictions. [ABSTRACT FROM AUTHOR]

Background: Access to timely, age-appropriate palliative care services and end-of-life communication are two standards of care for adolescents and young adults (AYAs) living with cancer where cure is uncertain or unlikely. Health professionals' capacity to facilitate these standards is critical. This study aimed to understand AYA oncology health professionals' experienced practices in, and barriers to, delivering these standards of care across palliative care and end-of-life communication in Australia, New Zealand, and the United Kingdom (UK). Procedure: We invited health professionals to complete a survey examining access, barriers to, and practices around these standards of care. Tailored to local settings, our survey assessed current delivery of palliative care and end-of-life communication services (including advance care planning [ACP]) and barriers to implementation of these. Results: In total, 148 interdisciplinary health professionals participated (89% female overall; 83% female in Australia, 88% female in New Zealand, and 98% female in the UK). Across countries, participants reported that most institutions had an AYA cancer program (74% overall). Introduction to palliative care services was most often prognosis dependent or "not at any uniform time." ACP was less frequently introduced than palliative care. The most endorsed barrier to palliative care team introduction, as well as ACP, was "some team members not knowing how to introduce the topic." Conclusions: Our results indicate that there are common barriers to AYAs receiving palliative care, end-of-life communication, and ACP. Given that health professionals' confidence in this area can enable facilitation of early, age-appropriate communication, resources and training are urgently needed to bridge these practice gaps. [ABSTRACT FROM AUTHOR]

Background/aims: Suicidal Ideation (SI) is a risk factor for suicide, a leading cause of death amongst young men globally. In this study we assess whether sustaining a serious physical combat injury is associated with SI and whether leaving service mediates this association. Methods: We analysed data from male UK Armed Forces personnel who sustained a combat injury in Afghanistan and a frequency-matched comparison group who did not sustain such an injury (the ADVANCE cohort). SI was measured from the Patient Health Questionnaire-9 item 'thoughts that you would be better off dead or of hurting yourself in some way'. Results: Approximately, 11.9% (n = 61) of the uninjured group, 15.3% (n = 83) of the overall injured group, 8.5% (n = 13) of an Amputation injury (AI) subgroup and 17.6% (n = 70) of a Non-Amputation Injury (NAI) subgroup reported SI in the past 2 weeks. The NAI subgroup reported greater likelihood of SI (Relative Risk Ratio (RR) = 1.44, 95% confidence interval (CI) [1.04, 2.00]) compared to the comparison group, whereas the overall injured group (RR = 1.23, 95% CI [0.90, 1.68]) and AI subgroup (RR = 0.65, 95% CI [0.36, 1.18]) did not. Leaving service fully mediated the association between sustaining a NAI and SI (natural direct effect RR = 1.08, 95% CI [0.69, 1.69]). Conclusions: UK military personnel with NAI reported significantly higher rates of SI compared to demographically similar uninjured personnel, while those who sustained AIs reported no significant difference. Leaving service was associated with greater rates of SI for both injured and uninjured personnel and fully mediated the association between sustaining a NAI and SI. [ABSTRACT FROM AUTHOR]

Gallantry medals are invested with deep significance not only by the armed forces but also by civilian society. In the last decade, there has been a debate in sociology about whether the medallic regime has become post-heroic or whether it has professionalized. This article contributes to these debates by focusing on the topic of fraudulent medals. Fake medals are very rare; there has been one proven case in the United Kingdom in the last 20 years. However, precisely because fake medals are the exception, their pathologies illustrate the processes by which medals are actually awarded with particular clarity. This analysis of the fake medal shows that gallantry awards have professionalized; in the UK medals have become more meritocratic, recognizing skill not status. The awarding process is also more objective. Yet, its very professionalism is ironically vulnerable to a specific type of fraud by skilful but cynical citation writers. [ABSTRACT FROM AUTHOR]

Objective Upper limb (UL) disability in people with UL loss is well reported in the literature, less so for people with lower limb loss. This study aimed to compare UL disability in injured (major trauma) and uninjured UK military personnel, with particular focus on people with upper and lower limb loss. Methods A volunteer sample of injured (n  = 579) and uninjured (n  = 566) UK military personnel who served in a combat role in the Afghanistan war were frequency matched on age, sex, service, rank, regiment, role, and deployment period and recruited to the Armed Services Trauma Rehabilitation Outcome (ADVANCE) longitudinal cohort study. Participants completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, scored from 0 (no disability) to 100 (maximum disability) 8 years postinjury. Mann–Whitney U and Kruskal–Wallis tests were used to compared DASH scores between groups. An ordinal model was used to assess the effect of injury and amputation on DASH scores. Results DASH scores were higher in the Injured group compared to the Uninjured group (3.33 vs 0.00) and higher in people with lower limb loss compared to the Uninjured group (0.83 vs 0.00), although this was not statistically significant. In the adjusted ordinal model, the odds of having a higher DASH score was 1.70 (95% CI = 1.18–2.47) times higher for people with lower limb loss compared to the Uninjured group. DASH score was not significantly different between people with major and partial UL loss (15.42 vs 12.92). The odds of having a higher DASH score was 8.30 (95% CI = 5.07–13.60) times higher for people with UL loss compared to the Uninjured group. Conclusion People with lower limb loss have increased odds of having more UL disability than the Uninjured population 8 years postinjury. People with major and partial UL loss have similar UL disability. The ADVANCE study will continue to follow this population for the next 20 years. Impact For the first time, potential for greater long-term UL disability has been shown in people with lower limb loss, likely resulting from daily biomechanical compensations such as weight-bearing, balance, and power generation. This population may benefit from prophylactic upper limb rehabilitation, strength, and technique. [ABSTRACT FROM AUTHOR]

Background: Strength and power represent two crucial physical qualities for the attainment of a high level of performance considering the frequency and the importance of explosive actions occurring during elite soccer match-play. Evaluation of strength and power is a multifaceted concept involving a vast array of tests and outcome variables. Nevertheless, a comprehensive and systematic search of strength and power assessment procedures in elite soccer has yet to be undertaken. Objectives: The aims of this systematic review were to: (1) identify the tests and outcome variables used to assess strength and power of elite male soccer players; (2) provide normative values for the most common tests of strength and power across different playing levels; and (3) report the reliability values of these strength and power tests. Methods: A systematic review of the academic databases MEDLINE, CINAHL, SPORTDiscus, Web of Science and OVID for studies published until August 2023 was conducted, following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were eligible for inclusion if they: (1) were original research studies, published in a peer-reviewed journal, and written in English language; (2) had the primary aim to assess strength and/or power; (3) players were male and older than 17 years of age (i.e., mean age of the group); and (4) their playing level was defined as "professional", "international" or "elite". Results: Regarding strength testing, 115 studies and 29 different tests were identified. The three most frequent strength tests were the knee extensor isokinetic strength test (58 studies), the knee flexor isokinetic strength test (55 studies) and the Nordic hamstring strength test (13 studies). In terms of power testing, 127 studies with 31 different tests were included. The three most frequent power tests were the countermovement jump with hands fixed on hips (99 studies), the squat jump (48 studies) and the vertical jump with arm swing (29 studies). Conclusions: The wide range of different tests and outcome variables identified in this systematic review highlights the large diversity in the employed testing procedures. The establishment of a hybrid testing approach, combining standardised and widely accepted tests for establishing normative standards and enabling comparisons across different contexts, with flexible context-specific testing batteries, has the potential to maximise the impact of testing information for practitioners. In addition, the limited reporting of reliability data across studies highlights the need for practitioners to establish their own reliability measure within their specific contexts, informing the selection of certain tests and outcome variables. [ABSTRACT FROM AUTHOR]

Background: UK cancer deaths remain high; primary care is key for earlier cancer diagnosis as half of avoidable delays occur here. Improvement is possible through lower referral thresholds, better guideline adherence, and better safety-netting systems. Few interventions target whole practice teams. We developed a novel whole-practice team intervention to address this. Aim: To test the feasibility and acceptability of a novel, complex behavioural intervention, 'ThinkCancer!', for assessment in a subsequent Phase III trial. Design & setting: Pragmatic, superiority pilot randomised controlled trial (RCT) with an embedded process evaluation and feasibility economic analysis in Welsh general practices. Method: Clinical outcome data were collected from practices (the unit of randomisation). Practice characteristics and cancer safety-netting systems were assessed. Individual practice staff completed evaluation and feedback forms and qualitative interviews. The intervention was adapted and refined. Results: Trial recruitment and workshop deliveries took place between March 2020 and May 2021. Trial progression criteria for recruitment, intervention fidelity, and routine data collection were met. Staff-level fidelity, retention, and individual level data collection processes were reviewed and amended. Interviews highlighted positive participant views on all aspects of the intervention. All practices set out to liberalise referral thresholds appropriately, implement guidelines, and address safety-netting plans in detail. Conclusion: 'ThinkCancer!' appears feasible and acceptable. The new iteration of the workshops was completed and the Phase III trial has been funded to assess the effectiveness and cost-effectiveness of this novel professional behaviour change intervention. Delivery at scale to multiple practices will likely improve fidelity and reach. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most frequent female malignancy in the UK. Around 20% of cases are linked to weight gain, excess weight and health behaviours. We designed a weight gain prevention, health behaviour intervention for young women at increased risk. Methods: The study comprised a single arm observational study over 2 months testing acceptability and usability of the intervention: online group welcome event, app and private Facebook group. Females aged 18–35 years at moderate or high risk of breast cancer (>17% lifetime risk) were recruited via invite letters and social media posts. The app included behaviour change techniques and education content. Online questionnaires were completed at baseline, as well as at 1 and 2 months. We also assessed feasibility of study procedures. Results: Both recruitment methods were successful. Thirty‐five women were recruited, 26% via social media posts. Median age was 33 (interquartile range = 28.2–34.5) years, the majority (94.1%) were of White ethnicity. Thirty‐four participants were included in the analyses, of which 94% downloaded the app. Median self‐monitoring logs per participant during the study period was 10.0 (interquartile range = 4.8–28.8). App quality mean (SD) score was 3.7 (0.6) at 1 and 2 months (scale: 1–5). Eighty‐nine per cent rated the app at average or above at 1 month and 75.0% at 2 months. Nineteen women (55.9%) joined the Facebook group and there were 61 comments and 83 reactions and votes from participants during the study period. Conclusions: This first iteration of the app and intervention was well received and is suitable to progress to the next stage of refining and further testing. Highlights: The newly developed intervention that focused on weight gain prevention and health behaviour change was tested in young women at increased risk of breast cancer and was well‐received by the target population.Both recruitment methods, by mailshot and social media, were successful.The study was unable to recruit and ethnically diverse population.Future research should retest the intervention in a larger population, after making refinements. [ABSTRACT FROM AUTHOR]

Many supplementary and complementary schools operating in the United Kingdom and other countries have connections and relationships with religious organisations. However, there is considerable variety and complexity in these links and connections. Amidst some public concerns about these schools and as so little is known about them compared with other school sectors, a new heuristic device is offered to support leadership practice in supplementary and mainstream schools, and to encourage research particularly in the areas of governance, leadership and management. The need for this heuristic is made all the more urgent because of the disengagement of the state, at various levels, from appreciation of and support for the work of these schools, compounded by the lack of knowledge and understanding of their governance, leadership and management in particular. The exclusion of supplementary schools with religious links from future research and school partnerships needs to be avoided.

This paper presents findings from a recent study on choice-making among teachers, school leaders and parents in a for-profit British international school in Kuwait. Using a Bourdieusian field analysis, the choice-making of the various stakeholders is investigated to reveal their positionality within the school's social space, to examine the resources they hold and the capitals in which they are willing to invest. We find that choices made by, and within, an international school reveal symbolic violence, and a 'taken-for-granted understanding' that this form of schooling (British- rather than American-style international schooling) is superior. Participants in the study included teachers, parents, graduating class students and school leaders. Teachers and parents were a representative mix of local (both Arab and non-Arab) and expatriate. The study makes an important contribution to the body of knowledge relating to international schools, in its theoretical framework and its inclusion of the wider stakeholder population, which together generate a deeper understanding of professional practice in the international school context.

Objectives: To understand the views of qualified medical practitioners regarding "reasonable adjustments" and the quality of the care and treatment provided to adults with intellectual disabilities when admitted to acute hospitals as inpatients. Methods: Semi-structured interviews took place with 14 medical practitioners, seven from each of two acute hospitals, with a thematic analysis of the resulting data. Results: All 14 medical practitioners reported problems in the diagnosis and treatment of patients with intellectual disabilities. Most participants attributed these difficulties to communication problems and/or behaviours that, in the context of a hospital ward, were non-conforming. However, a minority reported that, because they were likely to have multiple comorbid health conditions, patients with intellectual disabilities were more complex. In addition, half of all these respondents reported making little use of "reasonable adjustments" introduced to improve the quality of the care received by this group of patients. Conclusions: Medical practitioners should make better use of the "reasonable adjustments" introduced in the UK to address inequities in care and treatment received by patients with intellectual disabilities. However, training should also focus on the biomedical complexities often presented by these men and women.

In the context of increasing international mobility in higher education, educators experience multiple challenges in the classroom. In the UK, policy discourses often frame international students as desirable resources. However, international students are frequently problematised as in academic deficit. Cultural reasons are posited for different patterns of participation in seminar discussions and critical engagement. This deficit narrative is neo-imperialist. A critical and ethical pedagogy should position international students as equals and as co-contributors. This article suggests that by changing pedagogical structures of traditional higher education classroom in the UK, subverting norms for epistemological interactions, international students can be empowered to engage actively and critically. This approach draws on the principles of Active Blended Learning to develop an ethical pedagogy, with equitable epistemic access for internationally mobile students. This paper explores how a module designed in keeping with ethical pedagogy [Madge, Clare, Parvati Raghuram, and Patricia Noxolo. 2009. "Engaged Pedagogy and Responsibility: A Postcolonial Analysis of International Students." "Geoforum" 40 (1): 34-45] succeeded in critically engaging students.

A global health archive consisting of podoconiosis tissue slides and blocks (which was collected and imported into the UK before the introduction of the Human Tissue Act), was donated to Brighton & Sussex Medical School in 2014. There is little guidance on the socioethical and legal issues surrounding the retrospective use of archived or 'abandoned' tissue samples, which poses a number of questions relating to the ethical standing of the archive. There is a great deal of interpretation in the guidelines that are currently in existence; however, modern ethical principles cannot be applied as it is not feasible to either reconsent or retrospectively seek approval. Our research team believed that it was unethical to leave the archive in storage, as this option favours neither researcher nor subjects. Permission was obtained from the Human Tissue Authority and a local ethics board for the tissues to be utilized in on-going research on podoconiosis aetiology. There is a delicate balance between the benefits gained by society relating to the development and progress of scientific research and the risks to the donor regarding the reuse of their tissues. Clearer guidelines should be made available to ensure that researchers are able to reuse tissue archives in contemporary research.

A considerable amount of research has been conducted into women's experiences of leadership in the education sector with calls to further promote equality, increase diversity and foster inclusion but ways forward seem less easy to implement with the same experiences and frustrations continuing to emerge. This article applies insights from critical realism to educational leadership development to seek a fuller understanding as to why these concerns remain and how they might be addressed. The article begins by considering barriers to women attaining leadership positions and accessing leadership development including those posed by the 'leadership turn' and new managerialism. Some ideas behind critical realism are briefly introduced before exploring the possible implications for educational leadership development. It is argued that a fundamental challenge to, and changing of, the dominant concept of leadership must take place before progress can be made. Directions are proposed for critical realist work in the theory and practice of educational leadership development and the wider field.

Previous research indicates an association of body dysmorphic disorder (BDD) with suicidal thoughts and behaviours, but has largely relied on small cohorts drawn from specialist clinics. Anonymised health-records from the South London and Maudsley NHS Foundation Trust between 2007 and 2019 were systematically searched using the Clinical Record Interactive Search data system. 298 patients diagnosed with BDD between age 12 and 65 years were identified. 206 (69 %) had experienced lifetime suicidal ideation. 149 (50 %) had recorded lifetime acts of self-harm or suicide attempts, most commonly involving cutting and self-poisoning. Rates of self-harm/suicide attempts were similar in those diagnosed before or after 18 years. Comorbid depression was associated with suicidal ideation (OR: 4.26 95% CI 2.07–9.72). Additionally, comorbid depression, OCD and anxiety were all associated with self-harm/suicide attempts (OR: 1.94 95% CI 1.15–3.31, OR: 1.99 95% CI 1.09–3.73, and OR: 1.93 95% CI 1.09–3.45, respectively). The presence of two or more psychiatric comorbidities was associated with a significantly elevated likelihood of suicidal ideation (OR: 7.06 95% CI 2.80–21.7) and self-harm/suicide attempts (OR: 4.62 95% CI 2.32–9.62). It is likely that BDD was under-diagnosed in the cohort, and those identified may not be representative. Additionally, the frequency and detail with which suicidal thoughts and behaviours were assessed varied and may also represent underestimates. Suicidal ideation and self-harm/suicide attempts are common among individuals with BDD accessing mental health services. Psychiatric comorbidity and suicidal ideation should be assessed in all BDD patients. • Suicidal thoughts and behaviours are frequently observed in people with Body Dysmorphic Disorder (BDD). • Co-morbidity significantly increases the risk of suicidality in people with BDD. • Multiple co-morbidities are associated with a particularly high risk of suicidality. • Methods of self-harm in BDD are similar to those seen in other psychiatric conditions. [ABSTRACT FROM AUTHOR]

From around the 2008 crisis there has been a marked slowdown in UK productivity. This has been referred to as a productivity puzzle as there is no consensus on the key explanations for this slowdown. Using data for all the 168 International Territorial Level 3 areas in Great Britain (2004–2020), we make two empirical contributions to the literature on this puzzle. First, we are the first to analyze this productivity puzzle using a stochastic frontier model to account for technical inefficiency. Second, to aid policymakers we uncover the areas that represent spatial total factor productivity (TFP) growth hubs, spokes, leaders and followers. Of the components of TFP growth (growth rates of technical change, returns to scale and efficiency), we find that Britain's productivity slowdown can be more specifically described as a rise in inefficiency. [ABSTRACT FROM AUTHOR]

Aim: Black queer men in the UK are increasingly at risk of mental health problems related to anxiety and depression, often triggered by traumatic experiences. This study explored the efficacy of integrative practice with Black queer men who experienced trauma from a decolonised, intersectional and queer‐affirming perspective. Method: One‐to‐one semi‐structured interviews with nine integrative practitioners were completed. Data collected from these interviews were analysed using Braun and Clarke's six stages of reflexive thematic analysis (RTA). Findings: RTA identified four subordinate themes: (1) understanding the experience of Black queer men, (2) developing the working alliance and use of self in practice, (3) effective integrative practice and (4) intersectional differences and considerations. Findings discussed the varying forms of trauma Black queer male clients experienced that impacted their mental health and how developing a strong working alliance with Black queer men was crucial when supporting them to recover from trauma. Additionally, the participants described a breadth of trauma‐informed integrative counselling and coaching practice. A decolonised approach utilising the intersection of race, gender and sexuality of Black queer men was successfully integrated into the approach used by practitioners in this study. Conclusion: Overall, this study evidenced that a decolonised perspective to integrative practice effectively supports Black queer men to recover from trauma. Future research should focus on an integrated approach with Black queer men and other gender and sexual ethnic minority clients who experienced trauma. [ABSTRACT FROM AUTHOR]

Introduction: Posterior native hip dislocations (NHD) are high-energy injuries. Thompson-Epstein Type I dislocations describe those without significant associated femoral or acetabular fracture. The aim of this study was to compare the clinical and radiological outcomes of patients with Type I NHDs. We also evaluate the association between radiological indicators of femoroacetabular impingement (FAI) and NHD. Patients and methods: A retrospective study from January 2012 to May 2021 compared skeletally mature patients (⩾16 years) with Type I posterior NHD to age and gender-matched controls with Type II–V posterior NHD. Patient demographics, mechanism of injury, complications and patient-reported outcome measures (PROMs) are presented. Post reduction radiographs and computed tomography were used to assess for FAI. Univariate analyses were performed to evaluate radiological outcomes. Results: 13 patients (77% male) with Type I posterior NHD were compared to a control group of 40 patients (80% male) with Type II–V posterior NHD. 11 patients in the study group and 14 in the control group experienced isolated injuries (p = 0.01). Post-reduction complications were similar. The study group had significantly lower post-injury osteoarthritis incidence (n = 0) compared to controls (n = 18, p = 0.0083). Patients reported a mean Oxford Hip Score of 43.5 ± 2.2 and EQ-5D-VAS score of 87.1 ± 7.4, with 6 patients indicating minimal symptoms across all EQ-5D-5L domains. Radiological femoroacetabular impingement (FAI) was prevalent in both groups, especially among males. Conclusions: Patients who underwent emergent closed reduction of Type I NHD demonstrated good short to medium term outcomes. Our radiological findings suggest a high prevalence of FAI. Future work should aim to quantify longer term outcomes following this injury. We call for further comparative studies of patients who suffer NHD with and without fractures to aid our understanding of risk factors. Given the rarity of this injury, multicentre efforts will be required to capture large numbers of patients. [ABSTRACT FROM AUTHOR]

Key Points: Question: For people with chronic obstructive pulmonary disease (COPD) at high risk of exacerbations, does bisoprolol reduce the number of exacerbations? Finding: In this randomized double-blind placebo-controlled trial of 515 people with COPD, the number of exacerbations requiring treatment with oral corticosteroids, antibiotics, or both did not differ significantly with use of bisoprolol (mean exacerbations, 2.03/y) vs placebo (mean exacerbations, 2.01/y). Meaning: Treatment with bisoprolol did not reduce COPD exacerbations requiring treatment with oral corticosteroids, antibiotics, or both. This randomized clinical trial examines whether the addition of bisoprolol to treatment of people with chronic obstructive pulmonary disease (COPD) at high risk of exacerbation reduces the rate of moderate to severe exacerbations. Importance: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Observational studies report that β-blocker use may be associated with reduced risk of COPD exacerbations. However, a recent trial reported that metoprolol did not reduce COPD exacerbations and increased COPD exacerbations requiring hospital admission. Objective: To test whether bisoprolol decreased COPD exacerbations in people with COPD at high risk of exacerbations. Design, Setting, and Participants: The Bisoprolol in COPD Study (BICS) was a double-blind placebo-controlled randomized clinical trial conducted in 76 UK sites (45 primary care clinics and 31 secondary clinics). Patients with COPD who had at least moderate airflow obstruction on spirometry (ratio of forced expiratory volume in the first second of expiration [FEV1] to forced vital capacity <0.7; FEV1 <80% predicted) and at least 2 COPD exacerbations treated with oral corticosteroids, antibiotics, or both in the prior 12 months were enrolled from October 17, 2018, to May 31, 2022. Follow-up concluded on April 18, 2023. Interventions: Patients were randomly assigned to bisoprolol (n = 261) or placebo (n = 258). Bisoprolol was started at 1.25 mg orally daily and was titrated as tolerated during 4 sessions to a maximum dose of 5 mg/d, using a standardized protocol. Main Outcomes and Measures: The primary clinical outcome was the number of patient-reported COPD exacerbations treated with oral corticosteroids, antibiotics, or both during the 1-year treatment period. Safety outcomes included serious adverse events and adverse reactions. Results: Although the trial planned to enroll 1574 patients, recruitment was suspended from March 16, 2020, to July 31, 2021, due to the COVID-19 pandemic. Two patients in each group were excluded postrandomization. Among the 515 patients (mean [SD] age, 68 [7.9] years; 274 men [53%]; mean FEV1, 50.1%), primary outcome data were available for 514 patients (99.8%) and 371 (72.0%) continued taking the study drug. The primary outcome of patient-reported COPD exacerbations treated with oral corticosteroids, antibiotics, or both was 526 in the bisoprolol group, with a mean exacerbation rate of 2.03/y, vs 513 exacerbations in the placebo group, with a mean exacerbation rate of 2.01/y. The adjusted incidence rate ratio was 0.97 (95% CI, 0.84-1.13; P =.72). Serious adverse events occurred in 37 of 255 patients in the bisoprolol group (14.5%) vs 36 of 251 in the placebo group (14.3%; relative risk, 1.01; 95% CI, 0.62-1.66; P =.96). Conclusions and Relevance: Among people with COPD at high risk of exacerbation, treatment with bisoprolol did not reduce the number of self-reported COPD exacerbations requiring treatment with oral corticosteroids, antibiotics, or both. Trial Registration: isrctn.org Identifier: ISRCTN10497306 [ABSTRACT FROM AUTHOR]

We studied clinical AI-supported decision-making as an example of a high-stakes setting in which explainable AI (XAI) has been proposed as useful (by theoretically providing physicians with context for the AI suggestion and thereby helping them to reject unsafe AI recommendations). Here, we used objective neurobehavioural measures (eye-tracking) to see how physicians respond to XAI with N = 19 ICU physicians in a hospital's clinical simulation suite. Prescription decisions were made both pre- and post-reveal of either a safe or unsafe AI recommendation and four different types of simultaneously presented XAI. We used overt visual attention as a marker for where physician mental attention was directed during the simulations. Unsafe AI recommendations attracted significantly greater attention than safe AI recommendations. However, there was no appreciably higher level of attention placed onto any of the four types of explanation during unsafe AI scenarios (i.e. XAI did not appear to 'rescue' decision-makers). Furthermore, self-reported usefulness of explanations by physicians did not correlate with the level of attention they devoted to the explanations reinforcing the notion that using self-reports alone to evaluate XAI tools misses key aspects of the interaction behaviour between human and machine. [ABSTRACT FROM AUTHOR]

Background The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective functioning (RF), i.e. the capacity to understand one's own and others' mental states, may relate to CD, psychopathology, and aggression. Here, we characterized the structure of psychopathology in adult male-offenders and its role, along with RF, in mediating the relationship between CD in their adolescence and current aggression. Methods A secondary analysis of pre-treatment data from 313 probation-supervised offenders was conducted, and measures of CD symptoms, general and specific psychopathology factors, RF, and aggression were evaluated through clinical interviews and questionnaires. Results Confirmatory factor analyses indicated that a bifactor model best fitted the sample's psychopathology structure, including a general psychopathology factor (p factor) and five specific factors: internalizing, disinhibition, detachment, antagonism, and psychoticism. The structure of RF was fitted to the data using a one-factor model. According to our mediation model, CD significantly predicted the p factor, which was positively linked to RF impairments, resulting in increased aggression. Conclusions These findings highlight the critical role of a transdiagnostic approach provided by RF and general psychopathology in explaining the link between CD and aggression. Furthermore, they underscore the potential utility of treatments focusing on RF, such as mentalization-based treatment, in mitigating aggression in offenders with diverse psychopathologies. [ABSTRACT FROM AUTHOR]

Widening participation outcomes in admissions to UK medical schools have not changed 2007–2018, partly due to inequity in selection. This study models the effects of changing selection, using a novel method of contextualising applicants, on widening participation. We studied 1084 English school leaver applicants to a single medical school over two years, using data from their public exams taken 2 years pre-application (GCSE) and recent admissions test (UCAT). Widening participation was defined by postcode. We modelled two shortlists for a pre-determined number of 500; one ranked on UCAT total score, and the other on a metric that contextualised applicants' GCSE grades against their schools' average GCSE performance. There was a significant difference in the postcode-defined widening participation characteristics of the two shortlists; 46% by contextualisation and 32.2% by UCAT (Chisquare p < 0.00001). As widening participation covers 42% of postcodes, the "contextualise everyone" method achieves equity. Conventionally, contextual admissions identify individuals belonging to under-represented groups and gives them preferential treatment. Changing the rules for everyone, by using a relative attainment instead of simple absolute attainment metric, benefits from treating applicants equally; and could promote equity through widening participation. [ABSTRACT FROM AUTHOR]

To determine whether primary trabeculectomy or medical treatment produces better outcomes in terms of quality of life (QoL), clinical effectiveness, and safety in patients with advanced glaucoma. Multicenter randomized controlled trial. Between June 3, 2014, and May 31, 2017, 453 adults with newly diagnosed advanced open-angle glaucoma in at least 1 eye (Hodapp classification) were recruited from 27 secondary care glaucoma departments in the United Kingdom. Two hundred twenty-seven were allocated to trabeculectomy, and 226 were allocated medical management. Participants were randomized on a 1:1 basis to have either mitomycin C-augmented trabeculectomy or escalating medical management with intraocular pressure (IOP)-reducing drops as the primary intervention and were followed up for 5 years. The primary outcome was vision-specific QoL measured with the 25-item Visual Function Questionnaire (VFQ-25) at 5 years. Secondary outcomes were general health status, glaucoma-related QoL, clinical effectiveness (IOP, visual field, and visual acuity), and safety. At 5 years, the mean ± standard deviation VFQ-25 scores in the trabeculectomy and medication arms were 83.3 ± 15.5 and 81.3 ± 17.5, respectively, and the mean difference was 1.01 (95% confidence interval [CI], –1.99 to 4.00; P = 0.51). The mean IOPs were 12.07 ± 5.18 mmHg and 14.76 ± 4.14 mmHg, respectively, and the mean difference was –2.56 (95% CI, –3.80 to –1.32; P < 0.001). Glaucoma severity measured with visual field mean deviation were –14.30 ± 7.14 dB and –16.74 ± 6.78 dB, respectively, with a mean difference of 1.87 (95% CI, 0.87–2.87 dB; P < 0.001). Safety events occurred in 115 (52.2%) of patients in the trabeculectomy arm and 124 (57.9%) of patients in the medication arm (relative risk, 0.92; 95% CI, 0.72–1.19; P = 0.54). Serious adverse events were rare. At 5 years, the Treatment of Advanced Glaucoma Study demonstrated that primary trabeculectomy surgery is more effective in lowering IOP and preventing disease progression than primary medical treatment in patients with advanced disease and has a similar safety profile. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. [ABSTRACT FROM AUTHOR]

Background and purpose: The eye is a well‐established model of brain structure and function, yet region‐specific structural correlations between the retina and the brain remain underexplored. Therefore, we aim to explore and describe the relationships between the retinal layer thicknesses and brain magnetic resonance image (MRI)‐derived phenotypes in UK Biobank. Methods: Participants with both quality‐controlled optical coherence tomography (OCT) and brain MRI were included in this study. Retinal sublayer thicknesses and total macular thickness were derived from OCT scans. Brain image‐derived phenotypes (IDPs) of 153 cortical and subcortical regions were processed from MRI scans. We utilized multivariable linear regression models to examine the association between retinal thickness and brain regional volumes. All analyses were corrected for multiple testing and adjusted for confounders. Results: Data from 6446 participants were included in this study. We identified significant associations between volumetric brain MRI measures of subregions in the occipital lobe (intracalcarine cortex), parietal lobe (postcentral gyrus), cerebellum (lobules VI, VIIb, VIIIa, VIIIb, and IX), and deep brain structures (thalamus, hippocampus, caudate, putamen, pallidum, and accumbens) and the thickness of the innermost retinal sublayers and total macular thickness (all p < 3.3 × 10−5). We did not observe statistically significant associations between brain IDPs and the thickness of the outer retinal sublayers. Conclusions: Thinner inner and total retinal thicknesses are associated with smaller volumes of specific brain regions. Notably, these relationships extend beyond anatomically established retina–brain connections. [ABSTRACT FROM AUTHOR]

In the United Kingdom, the COVID-19 pandemic in 2020 and 2021 led to two extended periods of school closures. Research on inequality of learning opportunity as a result of these closures used a single indicator of socio-economic status, neglecting important determinants of remote learning. Using data from the Understanding Society (USoc) COVID-19 surveys we analysed the levels and differentials in the uptake of remote schoolwork using parental social class, information technology (IT) availability in the home and parental working patterns to capture the distinct resources that families needed to complete remote schoolwork. This is also the first study to assess the extent to which the differentials between socio-economic groups changed between the first and second school-closure periods caused by the pandemic. We found that each of the three factors showed an independent association with the volume of remote schoolwork and that their effect was magnified by their combination. Children in families where the main parent was in an upper-class occupation, where both parents worked from home and where the children had their own IT spent more time doing remote schoolwork than other groups, particularly compared to children of single parents who work from home, children in families where the main parent was in a working-class occupation, where the child had to share IT, and where the parents did not work regularly from home. The differentials between socio-economic groups in the uptake of schoolwork were found to be stable between the two school-closure periods. [ABSTRACT FROM AUTHOR]

Many countries use national-level surveys to capture student opinions about their university experiences. It is necessary to interpret survey results in an appropriate context to inform decision-making at many levels. To provide context to national survey outcomes, we describe patterns in the ratings of science and engineering subjects from the UK's National Student Survey (NSS). New, robust statistical models describe relationships between the Overall Satisfaction' rating and the preceding 21 core survey questions. Subjects exhibited consistent differences and ratings of "Teaching", "Organisation" and "Support" were thematic predictors of "Overall Satisfaction" and the best single predictor was "The course was well designed and running smoothly". General levels of satisfaction with feedback were low, but questions about feedback were ultimately the weakest predictors of "Overall Satisfaction". The UK's universities affiliated groupings revealed that more traditional "1994" and "Russell" groups over-performed in a model using the core 21 survey questions to predict "Overall Satisfaction", in contrast to the under-performing newer universities in the Million+ and Alliance groups. Findings contribute to the debate about "level playing fields" for the interpretation of survey outcomes worldwide in terms of differences between subjects, institutional types and the questionnaire items.

The COVID-19 pandemic fundamentally changed the way we live, work, and interact with each other. Nowhere was the pandemic more profoundly experienced than on the frontline of healthcare. From overwhelmed Intensive Care Units to shortages of Personal Protective Equipment (PPE) and clap for carers, the UK's National Health Service (NHS) became the focal point for the pandemic response. Utilising data from online survey responses (N = 16) complemented by four online interviews and one face-to-face interview (N = 5) with NHS workers primarily during the height of the pandemic, this article offers a preliminary analysis on the challenges the UK's healthcare workers faced through working in conditions of crisis management. The article particularly addresses NHS workers' amplification of fear, anxiety, and exhaustion; the absence of widespread solidarity; and implications of the absence of coherent governmental messaging upon the workforce. We situate this discussion within a critical account of neoliberal political economy, the theoretical framework of social harm, and the absence to explicate the harmful conditions of the pandemic's frontline. While the data are confined to the UK's NHS workers, its findings are relevant to other countries across the world that enacted similar responses to deal with COVID-19. [ABSTRACT FROM AUTHOR]

Background: Metabolite profiling of blood by nuclear magnetic resonance (NMR) is invaluable to clinical biomarker discovery. To ensure robustness, biomarkers require validation in large cohorts and across multiple centres. However, collection procedures are known to impact on the stability of biofluids that may, in turn, degrade biomarker signals. We trialled three blood collection tubes with the aim of solving technical challenges due to preanalytical variation in blood metabolite levels that are common in cohort studies. Methods: We first investigated global NMR-based metabolite variability between biobanks, including the large-scale UK Biobank and TwinsUK biobank of the general UK population, and more targeted biobanks derived from multicentre clinical trials relating to inflammatory bowel disease. We then compared the blood metabolome of 12 healthy adult volunteers when collected into either sodium fluoride/potassium oxalate, lithium heparin, or serum blood tubes using different pre-processing parameters. Results: Preanalytical variation in the method of blood collection strongly influences metabolite composition within and between biobanks. This variability can largely be attributed to glucose and lactate. In the healthy control cohort, the fluoride oxalate collection tube prevented fluctuation in glucose and lactate levels for 24 hours at either 4 °C or room temperature (20 °C). Conclusions: Blood collection into a fluoride oxalate collection tube appears to preserve the blood metabolome with delayed processing up to 24 hours at 4 °C. This method may be considered as an alternative when rapid processing is not feasible. [ABSTRACT FROM AUTHOR]

Although online learning (OL) is becoming widely accessible and is often viewed as cutting-edge, the actual number of regular faculty participating in this form of teaching remains small. Moreover, OL, despite its growing recognition, is often associated with high rates of student dissatisfaction and isolation, withdrawal, and attrition. Furthermore, although administrators typically champion support of OL, they often seem unable or unwilling to marshal the necessary financial, human, and technological resources to produce high-quality course materials and to effect efficient course delivery. In short, online learning seems paradoxically to be both booming and busting simultaneously. It is expanding supply yet hitting similar obstacles that distance education encountered generations earlier. Under these circumstances, OL is unlikely to become mainstream without a major redirection. This article applies economic principles and concepts to OL. The revised conceptualization posits that an understanding of stakeholder priorities is the key to improved online course design and delivery. (Contains 6 figures and 1 footnote.)

This article presents an overview of how the popular "3-Cs" model (creative, critical and cultural) for literacy and media literacy can be applied to the study of computer games in the English and Media classroom. Focusing on the development of an existing computer games course that encompasses many opportunities for critical activity and creativity, it considers how the cultural function of literacy has been neglected for those functions that are easier to measure. It considers how opportunities to explore the cultural functions of texts, especially games, might be developed and how computer games might provide a unique opportunity for students to bring their own "cultural capital" into the classroom. It examines some student work from such "cultural" activities and concludes by recommending how and why we might develop "structured play" when using "living texts" such as computer games in the classroom. (Contains 2 figures.)

In a period of student loan scandals and U.S. financial market instability impacting on the cost and availability of student loans, this paper looks at alternative models of higher education funding. In this context, it also considers the level of financial support that the government should provide to higher education.

Objective: Digital storytelling and other methods of self-expression and autobiography have become an increasingly important tool for those working with young people, including those from migrant, refugee or other 'culturally diverse' backgrounds. A structured scoping review was undertaken to better understand the potential value and challenges of using digital stories to promote the health and well-being of these diverse groups of young people and to identify key knowledge gaps. Design: The review process comprised a systematic search of the literature and strategic consultations with professionals working with young people in the area of sexual and reproductive health promotion and care. A descriptive-analytic method was used to collate and synthesise the literature and apply narrative and thematic analyses. Results: In total, 28 papers were deemed eligible for inclusion. Findings are presented as two analyses: what is known from the literature and key knowledge gaps. Identified themes included the use of digital stories as social activism and as research intervention, recognition of digital stories as complex terrain and recommendations for good practice. Three key gaps of particular relevance to our research aims were identified. These were (1) the lack of digital stories on sexual health and relationships by 'culturally diverse' young people in Australia, (2) the need for discussion of the ethical considerations of using digital storytelling and related methods in sexual health fields and (3) the value of exploring opportunities to employ digital methods as self-representation and autobiography to generate new knowledge and build organisational capacity. Conclusion: As confirmed in discussions with professionals working in the youth, migrant and sexual health sectors, the literature highlighted the many potential applications of digital storytelling to promoting the sexual health and well-being of young people from diverse backgrounds. Additional research is required to understand the particular ethical and contextual issues shaping, and at times constraining, this engagement in specific cultural contexts.

Few data exist on the prevalence of autism in low-income countries. We translated, adapted and tested the acceptability of a Nepali-language version of a screening tool for autism (Autism Quotient-10). Using this tool, we estimated autism prevalence in 4098 rural Nepali children aged 9-13 years. Fourteen children scored > 6 out of 10, indicative of elevated autistic symptomatology, of which 13 also screened positive for disability. If the AQ-10 screening tool is as sensitive and specific in the Nepali population as it is in the UK, this would yield an estimated true prevalence of 3 in 1000 (95% confidence interval 2-5 in 1000). Future research is required to validate this tool through in-depth assessments of high-scoring children.

There is a propensity for academics and policy makers in Britain to use the terms integration and inclusion synonymously, possibly resulting in diverse interpretations of the inclusion principles laid out in the new National Curriculum. Much of the research available relating to conceptualisations of inclusion in physical education (PE) is from the perspective of teachers. Moreover, PE as a relatively unique learning environment is often neglected in much of the research that does analyse educational inclusion. In this paper, the key theoretical tools of cultural studies, in particular the concept of cultural hegemony, are used to analyse how special educational needs coordinators (SENCOs) and learning support assistants (LSAs) conceptualise inclusion in mainstream secondary school PE in Britain. Semi-structured, individual interviews explored SENCO (n = 12) and LSA (n = 12) educational ideologies and experiences of SEN and inclusion in PE. Open, axial and selective coding was undertaken to systematically analyse (textual) data. The research found that most conceptualisations reflected a social ideology because they focused on how educational arrangements can be made to ensure that pupils with SEN have comparable learning experiences to their age peers. Emphasis was placed on the power and influence of PE teachers, and the importance of identifying the specific needs and capabilities of pupils with SEN, as ways of ensuring that an inclusive culture can develop and is maintained in PE. The paper concludes by arguing that PE teachers and LSAs need access to PE-specific and up-to-date guidance and learning targets so that they can use the influence they have over the norms and values of PE to cultivate an inclusive culture in that subject.

Some devalue recess because they assume it to be a waste of time. There is no theory or empirical evidence to support this point of view. There is, however, abundant and clear evidence that recess has beneficial effects on children's social competence and academic performance. The author tells how his interest in standardized tests led him to years of recess study, compares recess survey findings in the United States to those in the United Kingdom, and summarizes the benefits of recess for school performance.