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This paper presents an overview of the arts-based methodology used in a research project that aimed to explore the impact of the lived experiences of racism on 10- and 11-year-old children in the United Kingdom. The research responds to the relative lack of literature concerning the racialised experiences of young children. We discuss how we developed the arts-based method of body mapping as an ethical approach to foregrounding the children's voices. We consider that this approach contributes to knowledge and understanding about exploring the nuanced and complex relationship between the children's external worlds and their internal feelings, and supporting them to process and communicate this. We suggest that the method presented is transferable, and present our ethically engaged, arts-based planning framework that can be used if others wish to adopt this way of working.

This paper explores how storying can be used to uncover experiences of student belonging throughout their time in Higher Education. It adopts a framing of belonging that is fluid and which recognises shifting notions of belonging over time. A focus on storying is particularly useful for understanding belonging as it enables university staff to listen carefully and with empathy to what matters to students, what shapes their experiences, and how to communicate these in a way which invites positive action. Through storying with undergraduate student articulations gathered through a survey, interviews and focus groups at a university in the UK, the paper identifies the multifaceted and connected spaces of belonging, temporalities and relationships that come to affect student belonging. Ultimately the paper argues for the collective responsibility of staff and students to create a space of belonging for all, rather than the prevalent discourse which often puts the onus on an individual to "fit in".

This article outlines an exploratory study that investigated students' perceptions of the benefits and disadvantages of lecture recordings delivered as part of an introductory chemistry program in the UK during the COVID-19 lockdown in Spring 2020. Three features of these lecture recordings are considered: 1) the production of a series of mini-lectures rather than 50 minute recordings; 2) the inclusion of quiz questions in the video timeline; and 3) the inclusion of a picture-in-picture talking head showing the instructor alongside a captured screen. Analysis of survey data indicates that a majority of students felt that each of these features had a positive impact on their learning and/or experience, with a significant number expressing a preference for the retention of online lectures after the resumption of on-campus teaching. Qualitative data provides valuable insight regarding the specific aspects of the recorded lectures that were perceived to enhance the student experience, supporting the design of future provision both during and beyond the COVID-19 pandemic. The generalizability of the recommendations is also discussed, along with the limitations of the study.

Many instructors globally reported a lack of engagement in synchronous online sessions during the COVID-19 lockdowns. This article outlines the use of collaborative small group tasks mediated via breakout rooms in Teams during the 2020/21 academic year. The rationale for the activities, which are available for download, is described along with details of the evaluation of their impact. Key findings were that a majority of students reported enjoying the tasks and felt that they improved their learning during online sessions.

This paper explores the roles and relationships of emotions in the promotion of critical development geographies, as engendered through a student field trip from a university in the so-called Global North to a country in the so-called Global South. Through a case-study involving a field trip led by the authors taking Masters students from the UK to Nepal, we find that emotions are integral to the pedagogical process and critical political potential of the trip. We show how emotions are central to the connections students create with people and places during the trip, and to their learning within it, particularly around questions of positionality, privilege and power. We highlight crucial emotions of curiosity and care, demonstrating however that these do not emerge out of nowhere, but rather can be deliberately cultivated by reflective pedagogies and practices. We argue that when conducted sensitively; involving reflective pedagogies and close collaborations, field trips to the so-called Global South can promote critical learning on questions of global justice, that are in line with demands to decolonize academia, geography and development geographies specifically.

The recruitment and retention 'crises' in US and UK teaching have major and negative implications for the future of education. This pilot study uses extended conversations with Asian and African teaching staff to examine the role of values in helping teachers sustain positive contributions to children's lives and world. In five elementary schools, the researcher asked: "What is the role of personal values in recruiting, retaining, sustaining and building the creative capacity of teachers?" The study found that a close alignment of institutional and individual values generated strong positive impacts on teacher fulfillment and resilience. It further suggests that by using their own autobiographical 'values-stories', teachers could advance personal values and build their capacity to contribute. The article proposes implications for all education departments, universities and schools seeking to address declining rates of teacher recruitment and retention. Recommendations include greater attention to the values that bring individuals to education, a steer towards using values-stories across the curriculum and a focus on 'Big Issues' in Initial Teacher Education.

This article considers the proposals of the final report of the Commission on Religious Education (CoRE 2018) and its controversial conclusion that the law should require religious education to include teaching about non-religious worldviews alongside religions, presumably in equal measure. Attention is given both to Trevor Cooling's recent defence of CoRE's proposals against already expressed criticisms and to additional criticisms, that of the abstract nature of a worldview as a highly ramified, philosophical concept, which is educationally ill-suited to the interests and intellectual capabilities of many pupils, and that of the failure of the proposals to indicate in what ways they overcome current systemic weaknesses. It is concluded that religious education should not be reconceptualised as the study of religious and non-religious worldviews nor should it adopt a framework that construes religions primarily as worldviews.

In this paper, we consider educational populism on social media in England and Australia. In both contexts, academics are positioned as a key constituent of an unjust elite with previously voiceless teachers (UK) and students (Australia) framed as the 'just people'. While populism often speaks to nations and nationalism, as 'the people' against an 'unjust elite' or 'other', micropopulism concerns a particular community against an elite. Although educational micropopulism has been catalysed by social media, there is an underlying political project growing from the New Right coalition of economic liberals and social conservatives. New Right 2.0, a contemporary reformulation of New Right, has an agenda that goes beyond promoting free-market hegemony to promoting civic capitalism and exploits a hybridised media environment to set a policy agenda through provoking polarisation. While there are similarities in New Right 2.0 strategies in England and Australia, the key difference is the way in which micropopulism has emerged and how it plays a role in the hybridised media ecology. We develop a theoretical account of the phenomena of educational micropopulism and offer an understanding of contemporary forms of populism that reflect the sub-national as well as international dimensions of micropopulist.

The authors describe their resources for raising awareness and encouraging positive water behaviours among young children. The DRY (Drought Risk and You) project brought together a multidisciplinary team to create a research-informed storybook and teachers' notes for 7- to 11-year-olds. This article takes a brief look at the book and reflects on what teachers, trainee teachers and learners had to say about it.

This paper makes an important and original contribution to the updating of methodological approaches to research syntheses. We analysed all 813 Proceedings of the British Society for Research into Learning Mathematics from 2003 to 2018, first using a quantitative corpus-survey and qualitative thematic coding and, again, independently, using topic modelling. We found strong convergence between findings from the different methods. We compare our findings to those from an earlier Proceedings review (1995-2002) and to a recent review of the corpus of publications in the "Journal for Research in Mathematics Education and Educational Studies in Mathematics," as well as to a review by the European Society for Research into Learning Mathematics and several other reviews. We found considerable similarity between the issues discussed, and similar trends over time. We conclude that the efficiency of topic modelling makes it a powerful option to include among a range of methodological approaches to research review.

The associations of certain factors, such as age and menopausal hormone therapy, with breast cancer risk are known to differ for interval and screen‐detected cancers. However, the extent to which associations of other established breast cancer risk factors differ by mode of detection is unclear. We investigated associations of a wide range of risk factors using data from a large UK cohort with linkage to the National Health Service Breast Screening Programme, cancer registration, and other health records. We used Cox regression to estimate adjusted relative risks (RRs) and 95% confidence intervals (CIs) for associations between risk factors and breast cancer risk. A total of 9421 screen‐detected and 5166 interval cancers were diagnosed in 517,555 women who were followed for an average of 9.72 years. We observed the following differences in risk factor associations by mode of detection: greater body mass index (BMI) was associated with a smaller increased risk of interval (RR per 5 unit increase 1.07, 95% CI 1.03–1.11) than screen‐detected cancer (RR 1.27, 1.23–1.30); having a first‐degree family history was associated with a greater increased risk of interval (RR 1.81, 1.68–1.95) than screen‐detected cancer (RR 1.52, 1.43–1.61); and having had previous breast surgery was associated with a greater increased risk of interval (RR 1.85, 1.72–1.99) than screen‐detected cancer (RR 1.34, 1.26–1.42). As these differences in associations were relatively unchanged after adjustment for tumour grade, and are in line with the effects of these factors on mammographic density, they are likely to reflect the effects of these risk factors on screening sensitivity. [ABSTRACT FROM AUTHOR]

This paper explores how storying can be used to uncover experiences of student belonging throughout their time in Higher Education. It adopts a framing of belonging that is fluid and which recognises shifting notions of belonging over time. A focus on storying is particularly useful for understanding belonging as it enables university staff to listen carefully and with empathy to what matters to students, what shapes their experiences, and how to communicate these in a way which invites positive action. Through storying with undergraduate student articulations gathered through a survey, interviews and focus groups at a university in the UK, the paper identifies the multifaceted and connected spaces of belonging, temporalities and relationships that come to affect student belonging. Ultimately the paper argues for the collective responsibility of staff and students to create a space of belonging for all, rather than the prevalent discourse which often puts the onus on an individual to "fit in". [ABSTRACT FROM AUTHOR]

Background: Stepping Stones Triple P (SSTP) is a complex parent‐mediated intervention aimed to reduce behaviours that challenge in children with moderate to severe intellectual disabilities, aged 30–59 months. Methods: To formulate a comprehensive understanding of SSTP implementation in the UK, we conducted a process evaluation collecting stakeholder views and considering intervention fidelity, dose, reach, delivery adaptations, and acceptability. Results: Fidelity and quality of delivery ratings were high. Parents perceived SSTP as valuable, reporting increased parental confidence and understanding of the child's behaviours. However, only 30% of families received an adequate dose of the intervention. Parents who only received treatment as usual described feeling abandoned by current services. Service managers emphasised the importance of availability of resources and therapist training for successful intervention delivery. Conclusions: SSTP supports effective management of early‐onset behaviours that challenge. Further work is needed to ensure equitable access to the intervention across health and social care services. Trial Registration: NCT03086876 – https://www.clinicaltrials.gov/ct2/show/NCT03086876?term=Hassiotis+Angela&draw=1&rank=1. [ABSTRACT FROM AUTHOR]

The considerable focus on capturing the 'student experience' has not been matched by investigations into the views and experiences of those teaching and managing programmes. This study aims to contribute to redressing the balance. An online survey of staff responsible for Postgraduate Taught (PGT) programmes in the UK elicited 382 responses from staff in 60 different institutions. Findings relating to perceptions of challenges their students face, students' preparedness for Master's level study and the influence of institutional culture are reported. PGT students were seen as dealing with complexity and juggling multiple demands. A gap between PGT students' readiness for study at this level, the QAA's vision of Master's study, and institutional assumptions about student support required was identified. For this gap to be closed, we suggest a review of institutional practices is required.

This article explores the experiences of international students as they engage in independent learning through formulating dissertation proposals. It contributes new insights by focusing on the 'pre-supervision' stage, where students formulate a research project and write a proposal independently. The analysis draws on questionnaire and focus group data from a large cohort of international taught postgraduates in business disciplines at a UK university. Two types of experience become apparent: one in which students work through the challenges presented by more independent learning, and the other where difficulties in 'getting started' present a barrier to progress. The article concludes by proposing a scaffolding approach, through which students can practise and complete key independent learning tasks involved in writing a dissertation proposal.

This paper presents an overview of the arts‐based methodology used in a research project that aimed to explore the impact of the lived experiences of racism on 10‐ and 11‐year‐old children in the United Kingdom. The research responds to the relative lack of literature concerning the racialised experiences of young children. We discuss how we developed the arts‐based method of body mapping as an ethical approach to foregrounding the children's voices. We consider that this approach contributes to knowledge and understanding about exploring the nuanced and complex relationship between the children's external worlds and their internal feelings, and supporting them to process and communicate this. We suggest that the method presented is transferable, and present our ethically engaged, arts‐based planning framework that can be used if others wish to adopt this way of working. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) is a global health concern with increasing prevalence. Comorbid hypothyroidism (HT) exacerbates kidney, cardiac, neurological and other complications of T2D; these risks can be mitigated pharmacologically upon detecting HT. The current HT standard of care (SOC) screening in T2D is infrequent, delaying HT diagnosis and treatment. We present a first-to-date machine learning algorithm (MLA) clinical decision tool to classify patients as low vs. high risk for developing HT comorbid with T2D; the MLA was developed using readily available patient data from harmonized multinational datasets. The MLA was trained on data from NIH All of US (AoU) and UK Biobank (UKBB) (Combined dataset) and achieved a high negative predictive value (NPV) of 0.989 and an AUROC of 0.762 in the Combined dataset, exceeding AUROCs for the models trained on AoU or UKBB alone (0.666 and 0.622, respectively), indicating that increasing dataset diversity for MLA training improves performance. This high-NPV automated tool can supplement SOC screening and rule out T2D patients with low HT risk, allowing for the prioritization of lab-based testing for at-risk patients. Conversely, an MLA output that designates a patient to be at risk of developing HT allows for tailored clinical management and thereby promotes improved patient outcomes. [ABSTRACT FROM AUTHOR]

Globally, foodborne illness is a significant public health challenge. Food safety inspection plays a crucial role in the regulation of food businesses to prevent foodborne illnesses. To be an effective health protection measure, however, food safety inspections must facilitate the thorough evaluation of food safety risks. Our research examined how food safety inspectors from Australia, Ireland, New Zealand, the UK, and the U.S. assessed food contamination control during food premise inspections. Data were collected via an online survey of environmental health practitioners who routinely conduct food safety inspections. The findings indicated that inspectors are generally aware of food safety hazards that can be present at food businesses and have deployed a variety of relevant data-gathering methods to inform their examination of the extent of contamination control. The findings also indicated a prevailing methodological incongruence stemming from the absence of a robust inspection methodology. We propose that these shortcomings be addressed by solutions that are formulated based on established hazard analysis critical control point (HACCP) principles and qualitative field research. The development of a clear and appropriate methodology will support food safety inspections to provide a robust and reliable means for evaluating food safety risk and ultimately reduce the incidence and burden of foodborne illness. [ABSTRACT FROM AUTHOR]

Aim: To understand the effect of intermittently scanned continuous glucose monitoring (isCGM) in people with diabetes with a 'psychosocial' indication for access. Methods: The study utilized baseline and follow‐up data from the Association of British Clinical Diabetologists nationwide audit of people with diabetes in the UK. Diabetes‐related distress (DRD) was assessed using the two‐item diabetes‐related distress scale (DDS). Participants were categorized into two groups: high DRD (DDS score ≥ 3) and lower DRD (DDS score < 3). The t‐test was used to assess the difference in the pre‐ and post‐isCGM continuous variables. Results: The study consisted of 17 036 people with diabetes, with 1314 (7%) using isCGM for 'psychosocial' reasons. Follow‐up data were available for 327 participants, 322 (99%) of whom had type 1 diabetes with a median diabetes duration of 15 years; 75% (n = 241) had high levels of DRD. With the initiation of isCGM, after a mean follow‐up period of 6.9 months, there was a significant reduction in DDS score; 4 at baseline versus 2.5 at follow‐up (P <.001). The prevalence of high DRD reduced from 76% to 38% at follow‐up (50% reduction in DRD, P <.001). There was also a significant reduction in HbA1c (78.5 mmol/mol [9.3%] at baseline vs. 66.5 mmol/mol [8.2%] at follow‐up; P <.001). This group also experienced an 87% reduction in hospital admissions because of hyperglycaemia/diabetic ketoacidosis (P <.001). Conclusion: People with diabetes who had isCGM initiated for a psychosocial indication had high levels of DRD and HbA1c, which improved with the use of isCGM. [ABSTRACT FROM AUTHOR]

In this brief retrospective essay, the value of a particular kind of classroom talk is extolled--not the kind of talk that simply feeds back information, but rather talk that has the power to shape knowledge through participant engagement with a range of processes: hypothesising, exploration, debate and synthesis. This kind of talk is the antithesis to "right answerism" and facilitates learning which is active and which prepares young people for a complex world with many uncertainties and many occasions when rational choice is required.

The COVID-19 pandemic caused significant negative implications for individual wellbeing and many people accessed green spaces to help them cope with the demands of national lockdown restrictions. In response, the current study used Interpretative Phenomenological Analysis (IPA) to investigate the experiences of ten UK based nature volunteers whose activities had been disrupted due to the UK COVID-19 lockdowns throughout 2020. Each nature volunteer participated in a semi-structured interview held on a virtual platform which invited them to explore their experiences in nature during the pandemic. Analysis identified three main themes. 'Sensations of nature' explored the sense of presence and oneness with nature that the volunteers felt when mindfully engaging with the sensations found in nature. 'Stability from nature' investigated the ways in which the volunteers found meaning in nature and the sense of comfort, stability and hope this provided. Finally, 'Changing relationships with nature' examined the greater environmental awareness that the volunteers experienced and the ways in which this led to a desire to give back to nature. It is argued that mindful engagement with nature enhances a sense of personal wellbeing and cultivates a connection to nature which encourages environmental concern. [ABSTRACT FROM AUTHOR]

Background: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist. Aim: To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin treatment across quintiles of socioeconomic deprivation in the UK. Design and setting: A lifetime microsimulation model was developed using 117 896 participants in 16 statin trials, 501 854 UK Biobank (UKB) participants, and quality-of-life data from national health surveys. Method: A CVD microsimulation model was developed using risk equations for myocardial infarction, stroke, coronary revascularisation, cancer, and vascular and non-vascular death, estimated using trial data. The authors calibrated and further developed this model in the UKB cohort, including further characteristics and a diabetes risk equation, and validated the model in UKB and Whitehall II cohorts. The model was used to predict CVD incidence, life expectancy, quality-adjusted life years (QALYs), and the impact of UK guideline-recommended statin treatment across socioeconomic deprivation quintiles. Results: Age, sex, socioeconomic deprivation, smoking, hypertension, diabetes, and cardiovascular events were key CVD risk determinants. Model-predicted event rates corresponded well to observed rates across participant categories. The model projected strong gradients in remaining life expectancy, with 4–5-year (5–8 QALYs) gaps between the least and most socioeconomically deprived quintiles. Guideline-recommended statin treatment was projected to increase QALYs, with larger gains in quintiles of higher deprivation. Conclusion: The study demonstrated the potential of guideline-recommended statin treatment to reduce socioeconomic inequalities. This CVD model is a novel resource for individualised long-term projections of health outcomes of CVD treatments. [ABSTRACT FROM AUTHOR]

This paper presents a methodology that is designed for rapid exploratory analysis of the outputs from ensembles of climate models, especially when these outputs consist of maps. The approach formalizes and extends the technique of "intermodel empirical orthogonal function" analysis, combining multivariate analysis of variance techniques with singular value decompositions (SVDs) of structured components of the ensemble data matrix. The SVDs yield spatial patterns associated with these components, which we call ensemble principal patterns (EPPs). A unique hierarchical partitioning of variation is obtained for balanced ensembles in which all combinations of factors, such as GCM and RCM pairs in a regional ensemble, appear with equal frequency: suggestions are also proposed to handle unbalanced ensembles without imputing missing values or discarding runs. Applications include the selection of ensemble members to propagate uncertainty into subsequent analyses, and the diagnosis of modes of variation associated with specific model variants or parameter perturbations. The approach is illustrated using outputs from the EuroCORDEX regional ensemble over the United Kingdom. [ABSTRACT FROM AUTHOR]

To investigate the extent to which differences in regional model projections can be explained by differences in the warming rates of their driving models, we compare projections of temperature and precipitation over the UK from two regional climate ensembles—the EuroCORDEX multi‐model ensemble and UKCP18 perturbed parameter ensemble—along with projections produced by the "parent" GCMs from which boundary conditions were taken. We evaluate the ensembles in terms of their representation of recent climate, then compare the changes simulated between 1981–2010 and 2050–2079. While both ensembles exhibit seasonal biases with similar magnitudes and spatial patterns during the evaluation period, the UKCP18 ensemble exhibits a somewhat stronger change signal in future simulations, due to a combination of higher climate sensitivity of the driving models, variations in the forcings applied, and—in the regional simulations—the inclusion of time‐varying aerosols. In order to reconcile the two sets of projections, we compare two periods corresponding to fixed global warming levels in the driving models, to constrain the variability within and between the ensembles which can be ascribed to differing rates of global warming: the discrepancy between the ensembles is greatly reduced, although some differences in the local response remain, with the UKCP18 runs slightly warmer and drier than the EuroCORDEX runs, particularly in summer. We also highlight potential pitfalls of comparing warming levels with a reference time period, due to uncertainty about the warming that has already occurred in the driving models prior to the reference period. Plain Language Summary: We compare temperature and precipitation over the UK from two different collections (known as "ensembles") of climate model runs: the EuroCORDEX ensemble, consisting of simulations from many combinations of global‐ and regional‐scale models; and the UKCP18 regional ensemble, which uses a single pair of models, but adjusts the model parameters for each run. Both ensembles perform well in the current climate, but future changes in the UKCP18 ensemble are generally larger by 2050–2079 than those in the EuroCORDEX ensemble. This is largely because the UKCP18 global models warm more quickly in response to the greenhouse gases in the atmosphere, and use slightly higher concentrations of greenhouse gases. To understand the differences between the two ensembles that cannot be explained by differences in the rate of global warming, we also look at changes as the models warm from 1 to 2°C globally above levels in the early 20th century. This reduces the discrepancy between the ensembles, although some differences remain: the UKCP18 ensemble remains slightly warmer and drier than EuroCORDEX, particularly in summer. We highlight issues that arise when comparing simulations at a given warming level against simulations in a fixed decade, due to uncertainty about how much warming has already occurred. Key Points: The UKCP and EuroCORDEX regional model ensembles have similar biases, but project very different future climate over the UKThese differences are driven largely by differences in the climate sensitivity of the GCMs used to force the regional modelsComparing projections after a specified degree of warming, rather than in specified decades, reduces but does not resolve these differences [ABSTRACT FROM AUTHOR]

Aim: Frequent hypoglycaemia results in disruption to usual hypoglycaemic autonomic responses leading to impaired awareness of hypoglycaemia, which is associated with an increased risk of severe hypoglycaemia requiring third‐party assistance (SH). The UK Driving and Vehicle Licensing Agency (DVLA) does not permit car driving if they have either a complete loss of hypoglycaemia awareness or more than one SH event a year. Methods: The FreeStyle Libre (FSL) Association of British Clinical Diabetologists (ABCD) Nationwide Audit consists of data collected by clinicians during routine clinical work, submitted into a secure web‐based tool held within the National Health Service (NHS) N3 network. Analysis of paired baseline and follow‐up data for people with type 1 diabetes who also held a driving licence was undertaken. Results: The study consisted of 6304 people who had data recorded about driving status from 102 UK specialist diabetes centres, of which 4218 held a driving licence: 4178 a group 1, standard licence, 33 a group 2, large lorries and buses, seven a taxi licence; 1819 did not drive. Paired baseline and follow‐up data were available for a sub‐cohort of 1606/4218. At a mean follow‐up of 6.9 months [95% CI (6.8, 7.1)], the Gold score had improved (2.3 ± 1.5 vs. 2.0 ± 1.3 p <.001), and the number of people who experienced an SH episode was also significantly lower (12.1% vs. 2.7%, p <.001). Conclusion: This study suggests that intermittently scanned continuous glucose monitoring may improve impaired awareness of hypoglycaemia and reduce the number of people with type 1 diabetes with a driving licence experiencing a severe hypoglycaemic episode. [ABSTRACT FROM AUTHOR]

This study investigated whether the amount and timing of group-based childcare between birth and 51 months were predictive of cognitive development at 51 months, taking into account other non-parental childcare, demographic characteristics, cognitive development at 18 months, sensitive parenting and a stimulating home environment. Children's (N=978) cognitive development was assessed at 51 months with four subscales of the British Ability Scales: two verbal and two non-verbal. Mothers were interviewed and observed at 3, 10, 18, and 36 months and the quality of group care was assessed at 10, 18, and 36 months (N=239) if it was used for =12 hours per week. Age of starting in group care and amount were highly associated (r = -0.75). Multiple regressions indicated that, controlling for other factors, higher cognitive development and particularly non-verbal ability was associated with more hours per week in group care from 0 to 51 months, or an earlier start, or group care before age 2. Nevertheless, the majority of variance was explained by other predictors: sex (girl), higher cognitive development at 18 months, older mother, first language English, mother of white ethnic background, with more qualifications, higher family social class, more maternal responsivity at 10 months and a more stimulating home learning environment (HLE) at 36 months. Hours per week in relative care or home-based care were not significant predictors of cognitive scores. For the smaller relatively advantaged sample who had group care quality information (N=239), quality was a marginal predictor of better cognitive development but age of starting group care was not. Most variance was explained by 18 month cognitive development, maternal education, and family social class.

Technological advancements in computer science have started to bring artificial intelligence (AI) from the bench closer to the bedside. While there is still lots to do and improve, AI models in medical imaging and radiotherapy are rapidly being developed and increasingly deployed in clinical practice. At the same time, AI governance frameworks are still under development. Clinical practitioners involved with procuring, deploying, and adopting AI tools in the UK should be well-informed about these AI governance frameworks. This scoping review aimed to map out available literature on AI governance in the UK, focusing on medical imaging and radiotherapy. Searches were performed on Google Scholar, Pubmed, and the Cochrane Library, between June and July 2022. Of 4225 initially identified sources, 35 were finally included in this review. A comprehensive conceptual AI governance framework was proposed, guided by the need for rigorous AI validation and evaluation procedures, the accreditation rules and standards, and the fundamental ethical principles of AI. Fairness, transparency, trustworthiness, and explainability should be drivers of all AI models deployed in clinical practice. Appropriate staff education is also mandatory to ensure AI’s safe and responsible use. Multidisciplinary teams under robust leadership will facilitate AI adoption, and it is crucial to involve patients, the public, and practitioners in decision-making. Collaborative research should be encouraged to enhance and promote innovation, while caution should be paid to the ongoing auditing of AI tools to ensure safety and clinical effectiveness. [ABSTRACT FROM AUTHOR]

Background: The management of leg ulceration through compression has predominately been considered a community care need. In 2021, Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust, in partnership with the Doncaster Wound Care Alliance, developed and launched a framework of interventions including education, a joint wound care formulary and clinical pathways, all aimed at standardising care. Additionally, they introduced the UrgoKTwo multicomponent compression system to provide seamless care across community, primary and secondary care using the National Wound Care Strategy Programme's (NWCSP) 2020 lower limb recommendations. As a result of changes implemented by the Skin Integrity Team at Doncaster and Bassetlaw Teaching Hospitals, NHS Foundation Trust, within secondary care, the knowledge of hospital staff increased by an average of 34% following attendance at structured education programmes, with 99% of staff being assessed as competent in the practical application of UrgoKTwo multicomponent compression bandage system. These improvements allowed the Skin Integrity Team to perform timely assessments, diagnoses and treatments for venous leg ulcers (VLUs), resulting in 89% of VLUs commencing UrgoKTwo multicomponent compression bandage system while patients were in the hospital and achieved healing within 12 months. [ABSTRACT FROM AUTHOR]

Introduction: The key to understanding the COVID-19 correlates of protection is assessing vaccine-induced immunity in different demographic groups. Young people are at a lower risk of COVID-19 mortality, females are at a lower risk than males, and females often generate stronger immune responses to vaccination. Methods: We studied immune responses to two doses of BNT162b2 Pfizer COVID-19 vaccine in an adolescent cohort (n = 34, ages 12-16), an age group previously shown to elicit significantly greater immune responses to the same vaccine than young adults. Adolescents were studied with the aim of comparing their response to BNT162b2 to that of adults; and to assess the impacts of other factors such as sex, ongoing SARS-CoV-2 infection in schools, and prior exposure to endemic coronaviruses that circulate at high levels in young people. At the same time, we were able to evaluate immune responses to the co-administered live attenuated influenza vaccine. Blood samples from 34 adolescents taken before and after vaccination with COVID-19 and influenza vaccines were assayed for SARS-CoV-2-specific IgG and neutralising antibodies and cellular immunity specific for SARS-CoV-2 and endemic betacoronaviruses. The IgG targeting influenza lineages contained in the influenza vaccine were also assessed. Results: Robust neutralising responses were identified in previously infected adolescents after one dose, and two doses were required in infection-naïve adolescents. As previously demonstrated, total IgG responses to SARS-CoV-2 Spike were significantly higher among vaccinated adolescents than among adults (aged 32-52) who received the BNT162b2 vaccine (comparing infection-naïve, 49,696 vs. 33,339; p = 0.03; comparing SARS-CoV-2 previously infected, 743,691 vs. 269,985; p <0.0001) by the MSD v-plex assay. There was no evidence of a stronger vaccine-induced immunity in females compared than in males. Discussion: These findings may result from the introduction of novel mRNA vaccination platforms, generating patterns of immunity divergent from established trends and providing new insights into what might be protective following COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Background: The population prevalence of multimorbidity (the existence of at least 2 or more long-term conditions [LTCs] in an individual) is increasing among young adults, particularly in minority ethnic groups and individuals living in socioeconomically deprived areas. In this study, we applied a data-driven approach to identify clusters of individuals who had an early onset multimorbidity in an ethnically and socioeconomically diverse population. We identified associations between clusters and a range of health outcomes. Methods and findings: Using linked primary and secondary care data from the Clinical Practice Research Datalink GOLD (CPRD GOLD), we conducted a cross-sectional study of 837,869 individuals with early onset multimorbidity (aged between 16 and 39 years old when the second LTC was recorded) registered with an English general practice between 2010 and 2020. The study population included 777,906 people of White ethnicity (93%), 33,915 people of South Asian ethnicity (4%), and 26,048 people of Black African/Caribbean ethnicity (3%). A total of 204 LTCs were considered. Latent class analysis stratified by ethnicity identified 4 clusters of multimorbidity in White groups and 3 clusters in South Asian and Black groups. We found that early onset multimorbidity was more common among South Asian (59%, 33,915) and Black (56% 26,048) groups compared to the White population (42%, 777,906). Latent class analysis revealed physical and mental health conditions that were common across all ethnic groups (i.e., hypertension, depression, and painful conditions). However, each ethnic group also presented exclusive LTCs and different sociodemographic profiles: In White groups, the cluster with the highest rates/odds of the outcomes was predominantly male (54%, 44,150) and more socioeconomically deprived than the cluster with the lowest rates/odds of the outcomes. On the other hand, South Asian and Black groups were more socioeconomically deprived than White groups, with a consistent deprivation gradient across all multimorbidity clusters. At the end of the study, 4% (34,922) of the White early onset multimorbidity population had died compared to 2% of the South Asian and Black early onset multimorbidity populations (535 and 570, respectively); however, the latter groups died younger and lost more years of life. The 3 ethnic groups each displayed a cluster of individuals with increased rates of primary care consultations, hospitalisations, long-term prescribing, and odds of mortality. Study limitations include the exclusion of individuals with missing ethnicity information, the age of diagnosis not reflecting the actual age of onset, and the exclusion of people from Mixed, Chinese, and other ethnic groups due to insufficient power to investigate associations between multimorbidity and health-related outcomes in these groups. Conclusions: These findings emphasise the need to identify, prevent, and manage multimorbidity early in the life course. Our work provides additional insights into the excess burden of early onset multimorbidity in those from socioeconomically deprived and diverse groups who are disproportionately and more severely affected by multimorbidity and highlights the need to ensure healthcare improvements are equitable. Fabiola Eto and co-workers study variations in comorbidity, service use and health outcomes by ethnicity and socioeconomic position, among people aged 16-39 years. Author summary: Why was this study done?: Most studies of multimorbidity focus on older adults, and only a few have investigated multimorbidity in younger populations. The prevalence of multimorbidity is increasing among young adults, particularly in minority ethnic groups and individuals living in socioeconomically deprived areas. There is evidence showing that individuals with socioeconomic vulnerability experience poorer health outcomes, such as lower quality healthcare provision, premature death, and higher mortality rates. The association between early onset multimorbidity and poor health outcomes in ethnically and socially diverse populations in England remains underinvestigated. What did the researchers do and find?: We used primary and secondary healthcare electronic health records from 837,869 individuals of White, South Asian, and Black African/Caribbean ethnicity in England with early onset of multimorbidity who were registered with an English general practice between 2010 and 2020. We found that the early onset of multimorbidity was more common among minority ethnic groups (59% and 56%, in the South Asian and Black populations, respectively) than in the White population (42%) living in the UK. South Asians and Black individuals with early onset multimorbidity died earlier than White individuals with early onset multimorbidity (52 and 48 years old in the median, respectively, versus 61 years old). South Asian and Black groups were more socioeconomically deprived than White groups, with a consistent deprivation gradient across all multimorbidity clusters. In White groups, the cluster of individuals with the highest rates/odds of the outcomes was more socioeconomically deprived than the cluster with the lowest rates/odds of the outcomes. What do these findings mean?: Our findings emphasise the need to identify, prevent, and manage multimorbidity early in the life course. Our work highlights the need to ensure that public health policies are equitable and reach those living in socioeconomic deprivation and minority ethnic groups who are disproportionately and more severely affected by early onset multimorbidity. [ABSTRACT FROM AUTHOR]

A substantial body of evidence points to the heritability of dietary preferences. While vegetarianism has been practiced for millennia in various societies, its practitioners remain a small minority of people worldwide, and the role of genetics in choosing a vegetarian diet is not well understood. Dietary choices involve an interplay between the physiologic effects of dietary items, their metabolism, and taste perception, all of which are strongly influenced by genetics. In this study, we used a genome-wide association study (GWAS) to identify loci associated with strict vegetarianism in UK Biobank participants. Comparing 5,324 strict vegetarians to 329,455 controls, we identified one SNP on chromosome 18 that is associated with vegetarianism at the genome-wide significant level (rs72884519, β = -0.11, P = 4.997 x 10−8), and an additional 201 suggestively significant variants. Four genes are associated with rs72884519: TMEM241, RIOK3, NPC1, and RMC1. Using the Functional Mapping and Annotation (FUMA) platform and the Multi-marker Analysis of GenoMic Annotation (MAGMA) tool, we identified 34 genes with a possible role in vegetarianism, 3 of which are GWAS-significant based on gene-level analysis: RIOK3, RMC1, and NPC1. Several of the genes associated with vegetarianism, including TMEM241, NPC1, and RMC1, have important functions in lipid metabolism and brain function, raising the possibility that differences in lipid metabolism and their effects on the brain may underlie the ability to subsist on a vegetarian diet. These results support a role for genetics in choosing a vegetarian diet and open the door to future studies aimed at further elucidating the physiologic pathways involved in vegetarianism. [ABSTRACT FROM AUTHOR]

Purpose: The immediate impact of coronavirus disease 2019 (COVID-19) visiting restrictions for family members has been well-documented. However, the longer-term trajectory, including mechanisms for support, is less well-known. To address this knowledge gap, we aimed to explore the post-hospital recovery trajectory of family members of patients hospitalised with a critical care COVID-19 admission. We also sought to understand any differences across international contexts. Methods: We undertook semi-structured interviews with family members of patients who had survived a COVID-19 critical care admission. Family members were recruited from Spain and the United Kingdom (UK) and telephone interviews were undertaken. Interviews were analysed using a thematic content analysis. Results: Across the international sites, 19 family members were interviewed. Four themes were identified: changing relationships and carer burden; family health and trauma; social support and networks and differences in lived experience. We found differences in the social support and networks theme across international contexts, with Spanish participants more frequently discussing religion as a form of support. Conclusions: This international qualitative investigation has demonstrated the challenges which family members of patients hospitalised with a critical care COVID-19 admission experience following hospital discharge. Specific support mechanisms which could include peer support networks, should be implemented for family members to ensure ongoing needs are met. [ABSTRACT FROM AUTHOR]

This explores the narratives from three individuals in low-skilled employment in the UK. The interviewees reflected upon their experiences of learning from compulsory education and beyond and their pathways through education to employment. The narratives illustrate how with the support of significant others, resilience and proactivity, they can overcome negative influences and subjective barriers to learning. Their barriers to learning will be examined in terms of their impact on future pathways and aspirations. The discussion will conclude by examining the role of significant others, and the potential role of career professionals, in combatting negative experiences of learning in order to raise aspirations and support positive pathways.

In 2007, Qualified Teacher Learning and Skills standards (QTLS) were introduced for all teachers working in UK further education institutions, with the expressed aim of improving professional standards within the sector. British Sign Language (BSL) teaching is largely delivered by deaf native signers through evening classes at local FE colleges, but the majority hold no formal teaching qualifications. Therefore this initiative provided BSL teachers with an opportunity to enhance their skills and practice, but also presented a formidable barrier to achieving Qualified Teacher status. Two research projects undertaken by the University of Central Lancashire in 2009 and 2010 assessed the suitability of training courses designed to help FE teachers achieve these new qualifications, with particular emphasis on whether these courses meet the specific pedagogic needs of deaf learners. The shortcomings in training provision that were found illustrate the invidious position deaf learners find themselves in, on the one hand wanting to enhance their skills and qualifications whilst at the same time being effectively barred from doing so by a lack of adequate and appropriate training opportunities. This article highlights some of the experiences of deaf BSL teachers seeking to gain these awards and illustrates the ways in which the delivery of training courses fails on virtually every level to respond to the different learning requirements of sign language users.

Introduction: Family studies of antiviral immunity provide an opportunity to assess virus-specific immunity in infected and highly exposed individuals, as well as to examine the dynamics of viral infection within families. Transmission of SARS-CoV-2 between family members represented a major route for viral spread during the early stages of the pandemic, due to the nature of SARS-CoV-2 transmission through close contacts. Methods: Here, humoral and cellular immunity is explored in 264 SARS-CoV-2 infected, exposed or unexposed individuals from 81 families in the United Kingdom sampled in the winter of 2020 before widespread vaccination and infection. Results: We describe robust cellular and humoral immunity into COVID-19 convalescence, albeit with marked heterogeneity between families and between individuals. T-cell response magnitude is associated with male sex and older age by multiple linear regression. SARS-CoV-2-specific T-cell responses in seronegative individuals are widespread, particularly in adults and in individuals exposed to SARS-CoV-2 through an infected family member. The magnitude of this response is associated with the number of seropositive family members, with a greater number of seropositive individuals within a family leading to stronger T-cell immunity in seronegative individuals. Discussion: These results support a model whereby exposure to SARS-CoV-2 promotes T-cell immunity in the absence of an antibody response. The source of these seronegative T-cell responses to SARS-CoV-2 has been suggested as cross-reactive immunity to endemic coronaviruses that is expanded upon SARS-CoV-2 exposure. However, in this study, no association between HCoV-specific immunity and seronegative T-cell immunity to SARS-CoV-2 is identified, suggesting that de novo T-cell immunity may be generated in seronegative SARS-CoV-2 exposed individuals. [ABSTRACT FROM AUTHOR]

Shared haemodialysis (HD) care (SHC) is a person-centred approach delivering a flexible choice of options for centre-based HD patients to become more involved in their treatment. To support this, a 4-day course was developed to provide healthcare professionals with the confidence and skills to engage, involve, support and train patients in their care and has been accessed by >700 UK staff over 9 years. The disruption caused by the coronavirus disease 2019 pandemic in 2020 prompted a revision of what was deliverable within the restrictions. In response to this, we designed, developed and tested a virtual training program that was shorter and more accessible while remaining effective in meeting its core objectives. This provides a greater geographical reach and enables a collaborative team approach with patients and staff learning from and with each other, thus supporting a partnership approach advocated in shared decision making. In this review we explore the learning that informed the virtual training program 2022 and provide qualitative evaluation to demonstrate evidence of understanding, behavioural change and organisational benefit. Using a validated evaluation, we present key themes that support the initiation, development and sustainability of SHC in the form of a roadmap to guide strategic planning. [ABSTRACT FROM AUTHOR]

Summary: Background: The digital flexor tendon sheath (DFTS) is a common site of pathology in the UK equine population, often necessitating tenoscopic exploration. Common intrathecal pathologies may lead to fetlock canal constriction. The palmar/plantar annular ligament (PAL) is often surgically transected to relieve constriction or to facilitate surgical access and instrumentation. Objectives: The objectives of this study were (1) to establish whether diagnostic quality needle tenoscopy can be achieved in the proximal DFTS in cadaver limbs; (2) to determine if needle tenoscopy can be used to safely guide PAL transection; and (3) to evaluate iatrogenic damage when undertaking needle tenoscopy and PAL transection. Study design: Ex vivo experimental. Methods: Six cadaveric limbs were used and needle tenoscopy of the DFTS was performed via biaxial approach at the base of the sesamoids. Access to and diagnostic assessment of the proximal DFTS, as well as the completeness of needle tenoscopically guided transection of the PAL was recorded. Limbs were dissected and examined for iatrogenic damage and completion of PAL transection. Results: Positioning of the cannula/obturator unit was achieved on the first attempt 11/12 times. Laterally 16/24 and medially 18/24 proximal DFTS channels were accessed. Images were of diagnostic quality in 12/24 and 11/24 channels following lateral and medial approach, respectively. The PAL was completely transected in 4/6 limbs with partial transection in 1/6 limbs. The superficial digital flexor tendon (SDFT) was longitudinally lacerated instead of the PAL in one limb, with other iatrogenic damage limited to mild fibrillation to the intersesamoidean ligament. Main limitations: Ex vivo and sample size. Conclusions: The findings in this pilot study suggest that needle tenoscopically guided PAL transection in the live horse is not recommended currently. While diagnostic needle tenoscopy offered partial assessment of most of the proximal DFTS, further refinement is necessary before needle tenoscopy could be considered a viable alternative to traditional tenoscopy. [ABSTRACT FROM AUTHOR]

Background: CLUSTER is a UK consortium focussed on precision medicine research in JIA/JIA-Uveitis. As part of this programme, a large-scale JIA data resource was created by harmonizing and pooling existing real-world studies. Here we present challenges and progress towards creation of this unique large JIA dataset. Methods: Four real-world studies contributed data; two clinical datasets of JIA patients starting first-line methotrexate (MTX) or tumour necrosis factor inhibitors (TNFi) were created. Variables were selected based on a previously developed core dataset, and encrypted NHS numbers were used to identify children contributing similar data across multiple studies. Results: Of 7013 records (from 5435 individuals), 2882 (1304 individuals) represented the same child across studies. The final datasets contain 2899 (MTX) and 2401 (TNFi) unique patients; 1018 are in both datasets. Missingness ranged from 10 to 60% and was not improved through harmonisation. Conclusions: Combining data across studies has achieved dataset sizes rarely seen in JIA, invaluable to progressing research. Losing variable specificity and missingness, and their impact on future analyses requires further consideration. [ABSTRACT FROM AUTHOR]

Background: Electronic early warning systems have been used in adults for many years to prevent critical deterioration events (CDEs). However, implementation of similar technologies for monitoring children across the entire hospital poses additional challenges. While the concept of such technologies is promising, their cost-effectiveness is not established for use in children. In this study we investigate the potential for direct cost savings arising from the implementation of the DETECT surveillance system. Methods: Data were collected at a tertiary children's hospital in the United Kingdom. We rely on the comparison between patients in the baseline period (March 2018 to February 2019) and patients in the post-intervention period (March 2020 to July 2021). These provided a matched cohort of 19,562 hospital admissions for each group. From these admissions, 324 and 286 CDEs were observed in the baseline and post-intervention period, respectively. Hospital reported costs and Health Related Group (HRG) National Costs were used to estimate overall expenditure associated with CDEs for both groups of patients. Results: Comparing post-intervention with baseline data we found a reduction in the total number of critical care days, driven by an overall reduction in the number of CDEs, however without statistical significance. Using hospital reported costs adjusted for the Covid-19 impact, we estimate a non-significant reduction of total expenditure from £16.0 million to £14.3 million (corresponding to £1.7 million of savings – 11%). Additionally, using HRG average costs, we estimated a non-significant reduction of total expenditure from £8.2 million to £ 7.2 million (corresponding to £1.1 million of savings – 13%). Discussion and conclusion: Unplanned critical care admissions for children not only impose a substantial burden on patients and families but are also costly for hospitals. Interventions aimed at reducing emergency critical care admissions can be crucial to contribute to the reduction of these episodes' costs. Even though cost reductions were identified in our sample, our results do not support the hypothesis that reducing CDEs using technology leads to a significant reduction on hospital costs. Trial registration: Current Controlled Trials ISRCTN61279068, date of registration 07/06/2019, retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Existing research suggests that there is a relationship between greater exposure to center-based child care and child behavioral problems though the mechanism for the impact is unclear. However the measure used to document child care has usually been average hours, which may be particularly unreliable in the early months when fewer children are in center care. In addition individual trajectories for behavior difficulties have not been studied. Objective: The purpose of the current study was to examine whether the extent of exposure to center-based child care before 2 years predicted the trajectory of children's difficult behavior (i.e., tantrums and unmanageable behavior) from 30 to 51 months controlling for child and maternal characteristics. Method: Data were drawn from UK-based families, children and child care study (n = 1201). Individual growth models were fitted to test the relation between early center-based child care experiences and subsequent difficult behavior. Results: Children with more exposure to center-based care before two had less difficult behavior at 30 months, but more increase over time. Initial levels were predicted by higher difficult temperament and lower verbal ability. Higher difficult temperament and lower family socio-economic status predicted its change over time. Conclusion: Findings suggest that early exposure to center-based care before 2 years old is a risk factor for subsequent behavior problems especially when children have a longer period of exposure. A possible explanatory process is that child coping strategies to manage frustration are less well developed in a group context, especially when they lag behind in expressive language.

This empirical study explores the roles that Emotional Intelligence (EI) and Emotional Self-Efficacy (ESE) play in undergraduates' mathematical literacy, and the influence of EI and ESE on students' attitudes towards and beliefs about mathematics. A convenience sample of 93 female and 82 male first-year undergraduates completed a test of mathematical literacy, followed by an online survey designed to measure the students' EI, ESE and factors associated with mathematical literacy. Analysis of the data revealed significant gender differences. Males attained a higher mean test score than females and out-performed the females on most of the individual questions and the associated mathematical tasks. Overall, males expressed greater confidence in their mathematical skills, although both males' and females' confidence outweighed their actual mathematical proficiency. Correlation analyses revealed that males and females attaining higher mathematical literacy test scores were more confident and persistent, exhibited lower levels of mathematics anxiety and possessed higher mathematics qualifications. Correlation analyses also revealed that in male students, aspects of ESE were associated with beliefs concerning the learning of mathematics (i.e. that intelligence is malleable and that persistence can facilitate success), but not with confidence or actual performance. Both EI and ESE play a greater role with regard to test performance and attitudes/beliefs regarding mathematics amongst female undergraduates; higher EI and ESE scores were associated with higher test scores, while females exhibiting higher levels of ESE were also more confident and less anxious about mathematics, believed intelligence to be malleable, were more persistent and were learning goal oriented. Moderated regression analyses confirmed mathematics anxiety as a negative predictor of test performance in males and females, but also revealed that in females EI and ESE moderate the effects of anxiety on test performance, with the relationship between anxiety and test performance linked more to emotional management (EI) than to ESE.

The level of similarity of knowledge work across occupations and industries allows for the design of supportive information and communication technology (ICT) that can be widely used. In a previous ethnographically informed study, we identified activities that can be supported to increase knowledge maturing, conceptualized as goal-oriented learning on a collective level. The aim of this paper is to investigate the current state of support and success of these knowledge maturing activities and to contrast them with their perceived importance, to identify those which have the highest potential for being supported by ICT. Quantitative and qualitative data were collected through telephone interviews with representatives from 126 organizations throughout Europe in a sample stratified according to size, sector, and knowledge-intensity. The activities that appear to be most promising are "reflecting on and refining work practices and processes," "finding people with particular knowledge or expertise," as well as "assessing, verifying, and rating information." Rich empirical material about how these activities are performed and also the issues that emerged and need to be managed were collected. Three clusters of organizations were identified: best performing organizations, people- and awareness-oriented organizations, and hesitant formalists. It was found that a balanced knowledge strategy that leaned toward personalization outperformed a codification strategy.

Little research has been undertaken into the profession of British Sign Language (BSL) teaching, despite a huge increase in the number of BSL classes offered over the past twenty years. Following the introduction of Qualified Teacher Learning and Skills standards in 2007, BSL teachers working in "further education" (FE) colleges were required to hold formal teaching qualifications for the first time. Therefore, it is timely to investigate the impact of these changes on the teaching of BSL in the five years since their introduction. This new framework offered the opportunity to greatly enhance BSL teaching through the development of professional skills among BSL teachers but the stark reality is that this has not occurred. This article draws on two research projects that investigated the teaching qualifications held by BSL teachers, their career and professional development aspirations and their views on the training opportunities currently available to deaf sign language users. The research highlighted that there is a need to improve access to relevant information, establish and strengthen peer support networks as well as to establish a designated career path for BSL teachers. Although there are a number of training programmes by which teachers can achieve these new minimum core requirements, very few are specifically tailored to the pedagogic needs of deaf people wishing to gain these qualifications. The potential impact of recent government proposals for teacher qualifications in the FE sector will also be addressed, together with the likely consequences for those wishing to train as BSL teachers.

Aims: To investigate the change in glycated haemoglobin (HbA1c), hypoglycaemia awareness and diabetes‐related distress in people with type 1 diabetes (T1D) using FreeStyle Libre (FSL) over a 2‐year follow‐up period. Methods: FSL user data from U.K wide hospitals collected during routine clinical care were analysed. People living with T1D were categorised into four groups based on the duration of follow‐up. Group I (< 1 year, n = 6940), group II (1 to 1.5 years, n = 662), group III (1.5 to 2 years, n = 385), and group IV (> 2 years, n = 642). The t‐test was used to compare the baseline and follow‐up HbA1c, GOLD score (a measure of hypoglycaemia awareness) and diabetes‐related distress scale (DDS score) (quality of life measure). Results: The study consisted of 16,834 people, with follow‐up data available for 8,629 participants. The change in HbA1c, GOLD and DDS score from baseline within the follow‐up sub‐groups (group I vs group II vs group III vs group IV) was HbA1c (−6 vs −6 vs −4 vs −4 mmol/mol; p < 0.001) (−0.55 vs −0.55 vs −0.37 vs −0.37 %), GOLD score (−0.31 vs −0.45 vs −0.26 vs −0.42; p < 0.0001 group I, II, IV and p 0.07 group III), and DDS score(−0.59 vs −0.58 vs −0.63 vs −0.50; p < 0.001), respectively. Conclusions: In people with T1D, FSL use resulted in a sustained improvement in HbA1c, hypoglycaemia awareness and diabetes‐related distress for over two years. [ABSTRACT FROM AUTHOR]

Large-scale declines in terrestrial insects have been reported over much of Europe and across the world, however, population change assessments of other key invertebrate groups, such as soil invertebrates, have been largely neglected through a lack of available monitoring data. This study collates historic data from previously published studies to assess whether it is possible to infer previously undocumented long-term changes in soil invertebrate abundance. Earthworm and tipulid data were collated from over 100 studies across the UK, spanning almost 100 years. Analyses suggested long-term declines in earthworm abundance of between 1.6 to 2.1% per annum, equivalent to a 33% to 41% decline over 25 years. These appeared greatest in broadleaved woodlands and farmland habitats, and were greater in pasture than arable farmland. Significant differences in earthworm abundance between habitats varied between models but appeared to be highest in urban greenspaces and agricultural pasture. More limited data were available on tipulid abundance, which showed no significant change over time or variation between enclosed farmland and unenclosed habitats. Declines in earthworm populations could be contributing to overall declines in ecosystem function and biodiversity as they are vital for a range of ecosystem services and are keystone prey for many vertebrate species. If robust, our results identify a previously undetected biodiversity decline that would be a significant conservation and economic issue in the UK, and if replicated elsewhere, internationally. We highlight the need for long-term and large-scale soil invertebrate monitoring, which potentially could be carried out by citizen/community scientists. [ABSTRACT FROM AUTHOR]

Background: Previous studies show the uptake of biannual ultrasound (US) surveillance in patients with cirrhosis is suboptimal. Here, our goal was to understand in broader terms how surveillance is being delivered to cirrhosis patients with cured hepatitis C in the UK. Methods: Hepatitis C cirrhosis patients achieving a sustained viral response (SVR) to antiviral therapies were identified from the national Hepatitis‐C‐Research‐UK resource. Data on (i) liver/abdominal US examinations, (ii) HCC diagnoses, and (iii) HCC curative treatment were obtained through record‐linkage to national health registries. The rate of US uptake was calculated by dividing the number of US episodes by follow‐up time. Results: A total of 1908 cirrhosis patients from 31 liver centres were followed for 3.8 (IQR: 3.4–4.9) years. Overall, 10 396 liver/abdominal USs were identified. The proportion with biannual US was 19% in the first 3 years after SVR and 9% for all follow‐up years. Higher uptake of biannual US was associated with attending a liver transplant centre; older age and cirrhosis decompensation. Funnel plot analysis indicated significant inter‐centre variability in biannual US uptake, with 6/29 centres outside control limits. Incident HCC occurred in 133 patients, of which 49/133 (37%) were treated with curative intent. The number of US episodes in the two years prior to HCC diagnosis was significantly associated with higher odds of curative‐intent treatment (aOR: 1.53; 95% CI: 1.12–2,09; p =.007). Conclusions: This study provides novel data on the cascade of care for HCC in the UK. Our findings suggest biannual US is poorly targeted, inefficient and is not being delivered equitably to all patients. [ABSTRACT FROM AUTHOR]

Career adaptability is mediated by personality factors and socio-psychological processes, with learning playing an important role. Using a five-fold career adapt-abilities competency framework (defined here as control, curiosity, commitment, confidence and concern), which was developed from the international quantitative study that is the focus of this special edition, an explicitly qualitative study of the career biographies of mid-career changers from two European countries was undertaken. Data from 64 in-depth interviews with adults in contrasting labor markets from Norway and the UK were analysed deductively, using a career adapt-abilities framework. Results demonstrate the utility of the framework, as well as how adaptive adults used both formal and informal learning to develop career adapt-ability competencies, over time, across occupations and occupational sectors. A key conclusion relates to how this career adapt-abilities competency framework could be used to motivate adults in mid-career to adopt behaviors that help them effect positive career change.